Protein structure topological comparison, discovery and matching service.

UNLABELLED: We describe a fold level fast protein comparison and motif matching facility based on the TOPS representation of structure. This provides an update to a previous service at the EBI, with a better graph matching with faster results and visualization of both the structures being compared against and the common pattern of each with the target domain. AVAILABILITY: Web service at http://balabio.dcs.gla.ac.uk/tops or via the main TOPS site at http://www.tops.leeds.ac.uk. Software is also available for download from these sites.

Trends in overweight and obesity among adults in Canada (1970-1992): evidence from national surveys using measured height and weight.

PURPOSE: To examine secular trends in obesity and overweight among Canadian adults between 1970 and 1992. The impact of education level and smoking on weight trends is explored. DATA: Adults aged 20-69 participating in three national health surveys which obtained measured height and weight: the Nutrition Canada Survey conducted between 1970 and 1972 (analysis sample n=5963); the Canada Health Survey of 1978-1979 (analysis sample n=3622); and the Canadian Heart Health Surveys conducted between 1986 and 1992 (analysis sample n=17 699). METHODS: Comparison of percentage overweight (age-standardized body mass index (BMI) 25.0-29.9) and obese (age-standardized BMI > or = 30.0) by sex, education level and smoking status across the three surveys. RESULTS: Among men, the proportion overweight and obese increased steadily from 1970-1972 to 1986-1992. Among women, there was a substantial increase in the proportion overweight and obese between 1970-1972 and 1978-1979, then an increase in proportion obese, but not overweight, between 1978-1979 and 1986-1992. Although the prevalence of obesity increased in all education levels, the sub-groups with the greatest relative increase are men in the primary education category, and women in the secondary and post-secondary between 1970-1972 and 1986-1992. An increase in the prevalence of obesity was greatest among current smokers and, to a lesser extent, among former smokers. CONCLUSION: While excess weight has become an increasing public health problem among Canadian adults, the rate of increase in prevalence of obesity since 1970 varied with sex, education level and smoking status. There is a need for new data on measured heights and weights of Canadian adults and children and youth to update trends.

A radiological measure of shoulder subluxation in hemiplegia: its reliability and validity.

This study describes the reliability and validity of a new radiological method to measure shoulder subluxation that is based on taking a single x-ray of the affected shoulder in the plane of the scapula. A digitizer and a computer are used to quantify the measurements directly from the x-ray. One single radiological view of the shoulder taken in a standardized position provides four measures of subluxation including a measure of vertical subluxation, horizontal subluxation, a normalized distance sensitive to both vertical and horizontal subluxation, and an angular measure. A total of 72 volunteers with cerebrovascular accidents participated in the study. Thirty-six subjects had a clinical shoulder subluxation and 36 had no clinical subluxation. The construct validity analysis showed significant differences (p < .001) between the mean scores for subluxed and nonsubluxed groups on all four measures of subluxation. The concurrent validity of the x-ray measures in relation to external clinical measures (finger's breadth, measures in centimeters with calipers or a plexiglass jig) was moderate. Three measures were found to be reliable and valid whereas the fourth, a measure of horizontal subluxation has lower reliability. However, it does have clinical significance. The clinical and research implications of this study are presented.

Clinical measures of shoulder subluxation: their reliability.

The purpose of this report is to describe the reliability of three clinical measures used to evaluate changes in shoulder subluxation. The three methods include measuring the subacromial space in fingers breadth, using calipers, or a plexiglass jig. Thirty-six patients with shoulder subluxation who had experienced a cerebrovascular accident were the subjects. Four occupational therapists with experience in stroke rehabilitation were divided into two teams of two therapists and rated the subjects independently. Each rater repeated her assessments on nine subjects to test intrarater agreement. Inter-rater agreement was assessed both between members of the same team (27 subjects per rater pair) and members of different teams (18 subjects per rater pair). The measure of reliability was the intraclass correlation coefficient (ICC2, 1) as derived from two-way analysis of variance. The highest intra-rater reliability was displayed by the finger breadth method, the second highest by the caliper method and the lowest by the plexiglass jig. The coefficients in the former two cases were always above .8. Using the jig only one rater achieved this level. Agreement between the two members of the same team were above .75 for the fingers and caliper methods, but less than this for the jig. Between members of different teams however, only the finger breadth method attained reliabilities above .7, and the plexiglass jig, in particular, showed very low reliability. These results demonstrate the difficulty of achieving consistent clinical measurement for a condition like shoulder subluxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Medical dominance in Canada in historical perspective: the rise and fall of medicine?

Freidson's concept of medical dominance is compared to the alternative conceptions of neo-Marxist writers. Dominance is then examined in historical perspective, using medicine in Canada (mainly Ontario) as a case study. Medicine emerged as the dominant health occupation in Canada in the late 19th and early 20th centuries, consolidating its power between World War I and the Saskatchewan doctors' strike of 1962. The authors argue that medical dominance has declined since that time due to such factors as the involvement of the state in health insurance, the rise of other health occupations, increasing public or at least elite skepticism, and possible internal fragmentation. The underlying social explanation for this historical process is sought in changes in the Canadian class structure, specifically the spread of the capitalist mode of production, the decline of the petite bourgeoisie, and the rise of the state. It is suggested that Freidson's specific accounts of the history of medicine must be incorporated for explanatory purposes within the broader neo-Marxist view of medicine as an intermediary rather than an ultimately determining institution.