Student gender was a marker for suboptimal exposure for performing opposite-sex, gender-specific examinations. The only predictor of confidence in performing these examinations was the number of exams performed. Special efforts should be made to eliminate gender disparity in opportunities to perform gender-specific exams.

The US spends more money than any other country in the world on health care but does not have the best health outcomes. Most healthcare dollars are spent on treatment of preventable chronic conditions including heart disease, hypertension, diabetes, hypertension, and obesity. Many recent studies have shown that a poor diet and low cardiorespiratory fitness are associated with significant morbidity and an increased risk of all-cause mortality. There is evidence that those with higher cardiorespiratory fitness have lower annual healthcare costs. Despite continued research on the essential role of diet and exercise in optimal health, these vital health behaviors have been slow to change in the US population and do not receive adequate attention. We propose more objective screening, visible and monitored in the Electronic Health Record, to improve awareness, help educate patients, and monitor their progress over time. It would also help identify those individuals that would benefit from referral to interventional behavioral resources in the clinic and community. With an increased focus on preventive and population health measures, now is an ideal time to include both exercise and diet in health metrics. A few relatively simple changes could prompt providers to assess and educate patients about nutrition and fitness and promote a healthier population.

We found good adherence to the USPSTF 2002 guidelines for osteoporosis screening in women aged ≥65 years by primary care physicians in a large urban academic medical center. The practice site and not gender of the provider resulted in significantly different screening rates.

Nutrient profiles in Southwest Pacific interstitial solutions suggest that in environments of oxic pelagic sedimentation microbially mediated nitrification is recognizable as a two-step process. During the first step partially oxidized nitrogenous intermediaries accumulate in distinctive ammonia and nitrite maxima along with nitrate. During the second step nitrification continues and all intermediate species are fully oxidized to nitrate. Both steps occur within a zone that corresponds in thickness to the biologically active surface layer. Similarly, experimental nitrogen regeneration from decomposition of plankton in seawater RAKESTRAW, 1941: VON BRAND et aL, 1942) suggests that each step corresponds to a distinct reaction in the microbially mediated transformation of N-org NH3-*NOz-+ N03. The resolution of distinct reaction zones in pore water nutrient profiles possibly depends on the nature and mode of supply of the organic matter undergoing nitrification or reflects the spatial succession downcore of microbial populations capable of deamination, ammonium oxidation and nitrite oxidation, respectively. Finally, stoichiometric ratios of nutrients in the free water column here demonstrated on published data from Saanich Inlet reflect the same two steps of nitrification as delineated by the dissolved pore water species. Future pore water studies should include dissolved oxygen measurements as well as accurate ECO2, P04 and nitrogenous species profiles, to verify and better quantify these separate steps in nitrification mechanism of oxic pelagic sediments.