Needs of specialists in rural and remote Canada.

INTRODUCTION: Very little literature exists on rural specialists as a unique group and how best to meet their needs. We sought to provide some baseline information on specialists practising in rural and remote Canada to better understand their reasons for working rurally, their workload and how supported they felt, as well as their sources of advice and satisfaction with continuing medical education (CME). METHODS: The Society of Rural Physicians of Canada mailed a survey to specialists working in rural and remote Canada. Specialists were identified based on databases of the Canadian Medical Association (CMA) and the provincial colleges. The survey focused on reason(s) for working in a rural or remote setting, level of support and CME. RESULTS: The survey was sent to 1500 physicians and yielded a 19% response rate. Although 85% of respondents felt supported overall, less than 20% felt supported by the CMA or by the Royal College of Physicians and Surgeons of Canada (RCPSC). Conversely, most felt supported by immediate colleagues (85%) and their community (78%). Most wished they had access to more training, with close to 90% agreeing that additional training should be available if they had worked for several years in a rural or remote area and a need was demonstrated. CONCLUSION: The CMA and the RCPSC may wish to work with rural specialists to foster a more supportive relationship and better meet their needs. Additionally, efforts should be made to provide rural specialists with better access to relevant CME.

Genetic variation in taste and its influence on food selection.

Abstract Taste perception plays a key role in determining individual food preferences and dietary habits. Individual differences in bitter, sweet, umami, sour, or salty taste perception may influence dietary habits, affecting nutritional status and nutrition-related chronic disease risk. In addition to these traditional taste modalities there is growing evidence that "fat taste" may represent a sixth modality. Several taste receptors have been identified within taste cell membranes on the surface of the tongue, and they include the T2R family of bitter taste receptors, the T1R receptors associated with sweet and umami taste perception, the ion channels PKD1L3 and PKD2L1 linked to sour taste, and the integral membrane protein CD36, which is a putative "fat taste" receptor. Additionally, epithelial sodium channels and a vanilloid receptor, TRPV1, may account for salty taste perception. Common polymorphisms in genes involved in taste perception may account for some of the interindividual differences in food preferences and dietary habits within and between populations. This variability could affect food choices and dietary habits, which may influence nutritional and health status and the risk of chronic disease. This review will summarize the present state of knowledge of the genetic variation in taste, and how such variation might influence food intake behaviors.