Effects of the time of day of walking on dietary behaviour, body composition and aerobic fitness in post-menopausal women.

AIM: Post-menopause is linked to an increased risk of death from cardiovascular disease. Physical exercise and healthy dietary habits are normally suggested to enhance health. The aim of this study was to verify whether the time of day of walking had different effects on both spontaneous dietary intake and body composition modification in overweight and sedentary post-menopausal women. METHODS: Forty-two sedentary post-menopausal women (53.46+/-3.32 yrs) were recruited. Thirty-three completed the study: 29 were suitable for statistical analysis. Of those, 14 walked in the morning (MG) and 15 in the early evening (EG). Body composition, dietary habits and predicted VO2max were investigated. Food intake was analysed for energy, macronutrients and daily distribution. RESULTS: The Mann-Whitney test showed that according to the time of day of walking there were different fat mass (FM) reductions and dietary behaviour responses. EG reduced FM greater than MG and showed a major increase in morning energy intake (EI). Sub-samples did not differ in total EI, daily macronutrient portioning and daily meals variations. The variation of FM was correlated with that of proteins (r=-0.352), morning EI (r=-0.367) and aerobic performance (r=0.369). Both MG and EG improved their aerobic performance. CONCLUSION: The positive effects of walking on health could be optimised by its evening execution because it could also be linked to spontaneous dietary habit modification.

Why employees resist change in medical group practice acquisitions.

Understanding employees' values and considerations is important in undergoing major organizational change. This research provides an insight of the business and financial aspects vs. the human relations aspects of acquiring a medical group practice. The five employees interviewed in this analysis provide insight as to the factors that employees consider in resisting change. Considering how employees feel through communicating will have a significant impact on efficiency, effectiveness and turnover.

Human immunodeficiency virus seroprevalence and condom use among female sex workers in Italy.

BACKGROUND AND OBJECTIVES: In two different studies, we evaluated the human immunodeficiency virus (HIV) seroprevalence rate and the condom use in a group of female sex workers working in Italy. STUDY DESIGN: In the first study we collected data on HIV serologic testing of female sex workers; in the second study, we evaluated the use of condoms and high-risk sexual practices by sex workers with their clients and nonpaying partners. RESULTS: Overall, 131 of 802 (16%) were HIV positive: 36 of 558 (6%) professional sex workers and 95 of 244 (39%) sex workers who used intravenous drugs. There was a significant increase of seroprevalence among professional sex workers between 1988 to 1990 and 1991 to 1995 (2% versus 11%, P < or = 0.001), whereas among the sex workers who used intravenous drugs, the increase was not significant (37% versus 40%, P = 0.70). Similarly, the HIV seroprevalence in the Italian professional sex workers is constant in the two periods of time (2% versus 1%). In the second study, 97 of 102 (95%) sex workers reported regular condom use with clients, whereas 63% of sex workers reported they never used them with nonpaying partners. Fourteen sex workers reported having nonpaying partners who used intravenous drugs and 6 reported having nonpaying bisexual partners; 8 of these 20 partners were HIV positive. CONCLUSION: The results of the first study showed a significant increase of seroprevalence among professional sex workers, whereas the high seroprevalence among sex workers who used intravenous drugs was constant. The results of the second study showed that sex workers may be at higher risk for HIV infection through noncommercial sexual intercourses.

PIP: HIV seroprevalence and condom use among female sex workers (FSWs) in Italy were investigated in two studies, with particular emphasis on trends before and after 1990--the year of arrival for most immigrant FSWs. The first study enrolled 802 FSWs (176 foreigners) presenting to sexually transmitted disease and HIV clinics in 14 cities in northern Italy in 1988-95. Overall, 131 women (16%) tested HIV-positive; 36 of these women were professional FSWs (6% of 558) and 95 were from the subgroup of FSWs who used intravenous (IV) drugs (39% of 244). HIV seroprevalence among professional FSWs increased significantly between 1988-90 (2%) and 1991-95 (11%); the corresponding increase among drug-injecting FSWs (37% to 40%) was not significant. The increase in HIV in the professional subgroup was caused by the influence of immigrant FSWs; seroprevalence in Italian-born FSWs remained constant in both time periods (2% and 1%, respectively). The second study investigated the condom use patterns of 102 FSWs from 9 Italian cities. 97 FSWs (96%) reported always using a condom with clients, but only 6 (5%) used condoms consistently with nonpaying partners. 14 FSWs had nonpaying partners who used IV drugs and 6 reported nonpaying bisexual partners; 8 of these 20 men were reportedly HIV-infected. Of the 75 sex workers who reported being tested for HIV, 4 (5%)--all of whom were IV drug users--were HIV-positive. These findings indicate that FSWs who use IV drugs or are from foreign countries represent high-risk subgroups. They further suggest that professional FSWs may be at higher risk for HIV infection through noncommercial than commercial sexual encounters.

Prevalence of anti-HCV and risk factors for hepatitis C virus infection in healthy pregnant women.

The prevalence of anti-HCV antibodies and the risk factors for HCV infection were assessed in 5,672 pregnant women living in North Italy. All reactive sera were confirmed by RIBA-2 test. Anti-HCV positive pregnant women together with an anti-HCV negative control group, were interviewed by standardised questionnaire to identify "known" or "potential" risk factors for HCV infection. The anti-HCV prevalence was 0.7% (40/5,672), higher than that observed among blood donors in the same geographical area (0.2%). The RIBA-2 assay was positive in 60% (24/40) of cases, indeterminate in 10% (4/40) and negative in 30% (12/40). As for "known" risk factors, considering RIBA-2 positivity, intravenous drug use was by far the main risk factor for HCV infection, resulting in a significantly higher risk than in the control group (50% versus 5.9% [O. R. 15.8, CI 5.4-45.5]). The ten RIBA-2 positive women without histories of transfusion or IV drug use had a significantly higher frequency of "sexual contacts with IV drug users" compared to controls (50% vs 4.9% [O. R. 19.0, CI 3.6-94.0]). In conclusion, our study provides evidence that in our geographical area the anti-HCV antibody prevalence is higher in pregnant women than in blood donors and that IV drug use and sexual contacts with IV drug users represent the most important risk factors for HCV infection among young women in North Italy.

The new Health Sciences Library at the State University of New York at Buffalo.

The new Health Sciences Library at the State University of New York at Buffalo is a harmonious and functional blend of the old and the new. The old is a renovated Georgian style building with formal rooms containing fireplaces, carved woodwork and English oak paneling. The new is a contemporary four-story addition. Through the arrangement of space and the interior design, the new library offers users easy access to services and resources; accommodates the heavy daily flow of users and library materials; provides an environment of comfort, quiet, and safety; and promotes efficient communication among all segments of the library staff. This was accomplished through sound architectural design which included close consultation with the library director and staff during the planning process. The new library is equipped to face the challenge of meeting the needs of biomedical education, research, and clinical programs of the institution and its constituents in the years to come.