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An issue that arises when selecting therapy is whether patient or clinician preferences for treatment moderate the effect of treatment. To evaluate this question we conducted a secondary analysis of the results of a randomized controlled trial of exercise treatment of chronic whiplash. Immediately prior to randomization, treatment preference ratings were collected from each patient and from the physiotherapist who assessed each patient. Patients were then randomized to receive advice alone or exercise and advice with the primary treatment outcomes of pain and function measured immediately after conclusion of treatment. Treatment effect modification was evaluated with a treatment group by preference interaction term in the regression analyses. The analysis revealed that neither patient nor therapist treatment preferences moderated the effect of exercise treatment for chronic whiplash. The interaction effect of treatment group by patient preference was 0.1 (-0.3 to 0.5, p=0.68) on the 0-10 pain intensity scale and -0.1 (-0.5 to 0.3, p=0.64) on the 0-10 function scale. The interaction effect of treatment group by therapist preference was 0.0 (-0.3 to 0.4, p=0.786) on the 0-10 pain intensity scale and -0.2 (-0.4 to 0.1, p=0.296) on the 0-10 function scale. Our findings do not provide evidence that patient or therapist treatment preferences moderate the effect of exercise treatment for chronic whiplash.

In 2001, a national research institute devoted to the study of inter-relationships among sex, gender, and health was created by the Canadian Institutes of Health Research (CIHR) as the first of its kind in the world. Established with a vision "to transform understanding of the impact of gender and sex on health across the lifespan and ensure its application in health research in Canada," the Institute of Gender and Health (IGH) supports research to address how sex (biological factors) and gender (sociocultural experiences) interact with other factors that influence health to create conditions and problems that are unique, more prevalent, more serious, or different with respect to risk factors or effective interventions for women, men, girls, and boys.

Isolated mucosal mast cells (MMC) were used to examine the ability of four neuropeptides, substance P, vasoactive intestinal peptide, beta-endorphin and somatostatin, to release mediators in the presence or absence of parasite antigen. None of the neuropeptides induced the release of sheep mast cell protease (SMCP) or histamine from MMC of helminth-immune sheep in the absence of parasite antigen. Incubation of immune MMC with 100 and 1.0 microgram/mL parasite antigen induced 32.1 and 15.5% specific SMCP release, respectively. While the neuropeptides did not augment SMCP release at 100 micrograms/mL parasite antigen, significant enhancement (40-98%) of SMCP release at 1 microgram/mL antigen was obtained by each neuropeptide at concentrations from 10(-8) to 10(-12) mol/L. The results provide additional support for modulation of MMC degranulation by neural activity in sheep and, to our knowledge, this is the first demonstration that the threshold antigen concentration for allergic responses may also be lowered by neuropeptides to render the reaction more sensitive to antigen.

It has been known for 20 years that the ribosomal protein S6 is rapidly phosphorylated when cells are stimulated to grow or divide. Furthermore, numerous studies have documented that there is a strong correlation between increases in S6 phosphorylation and protein synthesis, leading to the idea that S6 phosphorylation is involved in up-regulating translation. In an attempt to define a mechanism by which S6 phosphorylation exerts translational control, other studies have focused on characterizing the sites of phosphorylation of this protein and its location within the ribosome. Recent data show that S6 is a protein which may have diverse cellular functions and is essential for normal development, and that it may be involved in the translational regulation of a specific class of messages.

A selected literature review has revealed some of the ways in which the audit can be adapted to effectively evaluate the quality of care provided by community health professionals. Although a complex issue, the strengths of the audit can outweigh its limitations when a shared philosophy is adhered to and a review of the quality monitoring process occurs on a regular basis. But its success depends both on the approach and on the action taken. One requirement for an effective audit is a strong commitment of staff to reflect accurately nursing practice in nursing documentation. As the audit is neither inclusive nor exclusive, it should be used in conjunction with other quality assurance mechanisms, and in collaboration with other disciplines. Commitment at all levels--consumer, provider, administrator--is essential for success. There is no doubt that the variety of nursing audit instruments and techniques in existence have served to enhance the effectiveness and efficiency of community health nursing audit programs as well as contributing to community health nursing quality assurance. However, the audit clearly remains a challenging issue, requiring further research to establish the reliability and validity of current audit measures and to develop innovative approaches to future community-based audits.