A double-blind, randomized, parallel, comparative study was designed to evaluate the long-term safety and efficacy of subgingivally administered minocycline ointment versus a vehicle control.
One hundred four patients (104) with moderate to severe adult periodontitis (34 to 64 years of age; mean 46 years) were enrolled in the study. Following scaling and root planing, patients were randomized to receive either 2% minocycline ointment or a matched vehicle control. Study medication was administered directly into the periodontal pocket with a specially designed, graduated, disposable applicator at baseline; week 2; and at months 1, 3, 6, 9, and 12. Scaling and root planing was repeated at months 6 and 12. Standard clinical variables (including probing depth and attachment level) were evaluated at baseline and at months 1, 3, 6, 9, 12, and 15. Microbiological sampling using DNA probes was done at baseline; at week 2; and at months 1, 3, 6, 9, 12, and 15.
Both treatment groups showed significant and clinically relevant reductions in the numbers of each of the 7 microorganisms measured during the entire 15-month study period. When differences were detected, sites treated with minocycline ointment always produced statistically significantly greater reductions than sites which received the vehicle control. For initial pockets > or =5 mm, a mean reduction in probing depth of 1.9 mm was seen in the test sites, versus 1.2 mm in the control sites. Sites with a baseline probing depth > or =7 mm and bleeding index >2 showed an average of 2.5 mm reduction with minocycline versus 1.5 mm with the vehicle. Gains in attachment (0.9 mm and 1.1 mm) were observed in minocycline-treated sites, with baseline probing depth > or =5 mm and > or =7 mm, respectively, compared with 0.5 mm and 0.7 mm gain at control sites. Subgingival administration of minocycline ointment was well tolerated.
Overall, the results demonstrate that repeated subgingival administration of minocycline ointment in the treatment of adult periodontitis is safe and leads to significant adjunctive improvement after subgingival instrumentation in both clinical and microbiologic variables over a 15-month period.
To collect national baseline information on asthma management practices by physicians, and to compare these practices with the recommendations of the Canadian Asthma Consensus Conference ('the guidelines').
Cross-sectional survey of representative samples of physicians in Canada in late 1996 and early 1997.
Five specialty types of physicians who manage asthma patients: respirology, pediatrics, internal medicine, allergy and clinical immunology, and general practice and family medicine. Stratified sampling by province and specialty was used to select physicians for the study. Weighting was used in the analysis to generalize the results to the national level for the five specialty groups of physicians.
Mailed questionnaire, self-administered by the respondent; three mailings of the questionnaires were used to increase the response rate.
The frequency with which each of the five specialty types chose specific asthma management choices was determined, using weighted percentages representative of the specialty groups on a national basis. ANOVA determined the statistically significant differences among the five specialties in choosing particular asthma management actions. Then, logistic regression was used to calculate the odds ratios showing an association between the characteristics of the physician respondents and specific asthma management choices that they made in the survey.
The data analysis demonstrated significant variations among physicians in asthma management practices, according to specialty type and other characteristics. The initial report was released in April 1998, and manuscripts for journal submissions are being prepared.
The promoter sequence variant -480T in the hepatic lipase gene (LIPC) has been shown to be significantly associated with low post-heparin hepatic lipase activity. Some studies have also found that the -480T variant is associated with elevation in plasma HDL cholesterol. We tested for associations of LIPC -480T with plasma lipoprotein traits in samples taken from three distinct Canadian populations: 657 Alberta Hutterites, 328 Ontario Oji-Cree and 210 Keewatin Inuit. Plasma HL activity was not available for analyses. The LIPC -480T allele frequencies in these three groups, respectively, were 0.219, 0.527 and 0.383, and the prevalence of LIPC -480T/T homozygotes was, respectively, 0.042, 0.274 and 0.167. No significant association was found between LIPC -480T and plasma HDL cholesterol or apolipoprotein AI concentration, after adjusting for covariates including gender and body mass index. There was no consistent relationship between the population mean plasma HDL cholesterol concentration and the population LIPC -480T frequency. Our findings are consistent with the idea that the common promoter variation in LIPC, which has been reported to be associated with variation in post heparin HL activity and HDL triglyceride concentration, is not always associated with variation in plasma HDL cholesterol concentration, possibly due to yet unspecified environmental or genetic factors.
Despite overall decreasing mortality from cervical cancer, selected groups of Canadian women continue to have suboptimal access to diagnostic and treatment interventions for cervical cancer. In this paper, we present an evaluation of a colposcopy program developed to improve attendance for colposcopy in a lower socio-economic and immigrant population.
All women attending the North Hamilton Community Health Centre (CHC) who required colposcopic assessment and were referred to a newly developed colposcopy program based at the CHC were evaluated. Attendance rates for consultation, follow up and treatment in women referred for colposcopy were compared retrospectively for the CHC-based colposcopy program and concurrently with the regional colposcopy clinic (RCC).
Women referred to the CHC colposcopy program had a significant reduction in their no-show rate after the introduction of the locally based colposcopy program (17.2% vs. 1.3%, p
Comment In: Can J Public Health. 2004 Sep-Oct;95(5):325-815490919
The hypothesis that it is the variability of a person's identity--as opposed to the particular combinations of identities--that produces stress during the acculturation process was examined. Two hundred ninety-five native Anglophone students at the University of Ottawa, Ontario, Canada, provided demographic data and completed the following measures: the Beck Depression Inventory (Beck & Beck, 1972), Rosenberg's Self-Esteem Scale (1965), the Situated Identity Measure (Clément & Noels, 1992), and the Psychological Stress Measure (Lemyre, Tessier, & Fillion, 1990). Results of ANOVAs contrasting level of identification and variability of identification indicated that an exclusively Anglophone identity was related to a higher level of depression, lower self-esteem, and a higher level of stress than the other modes of acculturation, but only when the variability in identity with the English group was high. Thus, the participants who identified strongly with the English group but were not committed to this identity experienced more psychological adjustment problems.
This paper presents a longitudinal study on the acquisition of first, second, and third person pronouns in twelve French-speaking and twelve English-speaking children. Comprehension and production data were collected every two months, beginning when the subjects were aged 1;6 and ending once pronouns were fully acquired. Three hypotheses concerning the rules children develop in learning pronouns were tested: (1) the person-role hypothesis (Charney, 1980), (2) the speech-role hypothesis (Clark, 1978), and (3) the name hypothesis (Clark, 1978). An analysis of children's pronominal confusion when they were addressed listeners as well as when they were non-addressed listeners was performed. The results indicated that the mastery of pronouns did not follow the developmental sequence predicted by the speech-role hypothesis; they provided evidence for the person-role hypothesis only when children were speakers, and partially supported the name hypothesis. The data also suggested that pronominal confusion is not a rare phenomenon among children tested in a non-addressee context. Finally, effects of child gender and native language were observed. Possible interpretations of the data discussed.
Since adducin modulates cellular sodium retention, its follows that ADD1, which encodes the alpha-subunit of adducin, is an attractive candidate gene for blood pressure variation. Association studies examining the relationship between polymorphism at ADD1 codon 460 (G460W) and both hypertension and blood pressure, which were performed in a variety of human population samples derived from different genetic backgrounds, have given inconsistent results. We examined the association between the ADD1 G460W polymorphism and variation in blood pressure in a sample of non-diabetic, largely normotensive Canadian Oji-Cree from an isolated community in Northern Ontario. Among 481 Oji-Cree subjects, we measured blood pressure and related clinical phenotypes and determined genotypes of ADD1 G460W. We observed an allele frequency of 0.08 for the ADD1 W460 variant, which is among the lowest so far observed in human populations. We found significant associations between variation in both systolic and diastolic blood pressure and gender, age, body mass index (BMI), and treatment for hypertension. However, we found no association between the ADD1 W460 allele and increased blood pressure, nor did we observe a higher frequency of the W460 allele in a hypertensive subgroup compared with normotensive subjects. While the low sample frequency of ADD1 W460 is consistent with the low sample prevalence of hypertension, the absence of a specific association with both blood pressure and hypertension suggests that the ADD1 W460 variant is not an important determinant of blood pressure among individuals of this genetic background.
Although making explicit links between procedures and concepts during instruction in mathematics is important, it is still unclear the precise moments during instruction when such links are best made.
The objective was to test the effectiveness of a 3-week classroom intervention on the fractions knowledge of grade 5/6 students. The instruction was based on a theory that specifies three sites during the learning process where concepts and symbols can be connected (Hiebert, 1984): symbol interpretation, procedural execution, and solution evaluation. Sample. Seventy students from one grade 5/6 split and two grade 6 classrooms in two public elementary schools participated.
The students were randomly assigned to treatment and control. The treatment (Sites group) received instruction that incorporated specific connections between fractions concepts and procedures at each of the three sites specified by the Sites theory. Before and after the intervention, the students' knowledge of concepts and procedures was assessed, and a random subsample of 30 students from both conditions were individually interviewed to measure their ability to make specific connections between concepts and symbols at each of the three sites.
Therapies for osteoporosis must be taken for at least 1 year to be effective. The purpose of this study was to determine the difference in adherence to etidronate, alendronate and hormone replacement therapy in a group of patients seen at our tertiary care centres. The Canadian Database of Osteoporosis and Osteopenia (CANDOO), a prospective observational database designed to capture clinical data, was searched for patients who started therapy following entry into CANDOO. There were 1196 initiating etidronate, 477 alendronate and 294 hormone replacement therapy women and men aged (mean, SD) 65.8 (8.7) years in the study. A Cox proportional hazards regression model was used to assess differences between treatment groups in the time to discontinuation of therapy. Several potential covariates such as anthropometry, medications, illnesses, fractures and lifestyle factors were entered into the model. A forward selection technique was used to generate the final model. Hazard ratios and 95% confidence intervals (CI) were calculated. Adjusted results indicated that alendronate-treated patients were more likely to discontinue therapy as compared with etidronate-treated patients (1.404; 95% CI: 1.150, 1.714). After 1 year, 90.3% of patients were still taking etidronate compared with 77.6% for alendronate. No statistically significant differences were found between hormone replacement therapy and etidronate users (0.971; 95% CI: 0.862, 1.093) and hormone replacement therapy and alendronate users (0.824; 95% CI: 0.624, 1.088) after controlling for potential covariates. After 1 year, 80.1% of patients were still taking hormone replacement therapy, which decreased to 44.5% after 6 years. Increasing age and presence of incident non-vertebral fractures were found to be independent predictors of adherence. In conclusion, alendronate users were more likely to discontinue therapy than etidronate users over the follow-up period. Potential barriers to long-term patient adherence to osteoporosis therapies need to be evaluated.
This study examined whether adolescents who were at various stages of the help-seeking process differed on demographic characteristics, use of informal helpers, and markers of emotional and behavioral adjustment.
Youths (N = 644; Grades 7-12) living in three rural communities completed a survey at school. Three comparisons were made: teenagers who reported having serious problems versus few or no problems in the past year; teenagers who felt that they did or did not need professional help with these problems; and teenagers who had or had not sought professional help.
Rural youths with serious problems were more likely to be girls and to be living with someone other than a parent, were less likely to talk to family members about problems, and reported more negative emotional and behavioral adjustment. Teenagers who perceived a need for professional help also reported poorer emotional and behavioral adjustment. Adolescents who sought professional help were more likely to be in senior high, were less likely to talk to others about problems, and were lower on anxiety.
Rural adolescents' demographic characteristics, use of informal helpers, and markers of emotional and behavioral adjustment each contribute to our understanding of their help-seeking behavior. Future studies must examine how these and other variables combine to discern who reports problems, who perceives a need for help, and who sees professionals.