No abstract

Objectives: To explore the perspectives of older adults on the acceptability of reminder letters for influenza vaccinations. Methods: We randomly selected 23 family physicians from each Family Health and Primary Care network participating in a demonstration project designed to increase the delivery of preventive services in Ontario. From the roster of each physician, we surveyed 35 randomly selected patients over 65 years of age who recently received a reminder letter regarding influenza vaccinations from their physician. The questionnaires sought patient perspectives on the acceptability and usefulness of the letter. We also conducted followup telephone interviews with a subgroup of respondents to explore some of the survey findings in greater depth. Results: 85.3% (663/767) of patients completed the questionnaire. Sixty-five percent of respondents recalled receiving the reminder (n=431), and of those, 77.3% found it helpful. Of the respondents who recalled the letter and received a flu shot (n=348), 11.2% indicated they might not have done so without the letter. The majority of respondents reported that they would like to continue receiving reminder letters for influenza vaccinations (63.0%) and other preventive services (77.1%) from their family physician. The interview participants endorsed the use of reminder letters for improving vaccination coverage in older adults, but did not feel that the strategy was required for them personally. Conclusions: The general attitude of older adults towards reminder letters was favourable, and the reminders appear to have contributed to a modest increase in influenza vaccination rates.

Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives oncervical and breast cancer screening rates

As part of the "Provider and Patient Reminders in Ontario: Multi-strategy Prevention Tools" demonstration project, the purpose of this study was to explore the practice and physician characteristics associated with influenza vaccination rates following a reminder letter intervention for patients 65 years of age and older. Using a sample of 179 physicians, we estimated a multiple linear regression model to examine variables predictive of vaccination delivery rates. Several provider characteristics, including certification with the College of Family Physicians of Canada and practicing in an urban area, were predictive of the success of the reminder letter campaign. Examining other physician and practice factors associated with vaccination delivery following a reminder letter campaign may help improve such prevention efforts.

SUMMARYIon exchange is a unit operation which has several applications in the processing of skim-milk and whey. For example, in the field of whey processing, ion exchange is used in demineralization, lactose hydrolysis and in the pre-treatment of whey prior to protein recovery. In the case of skim-milk, applications include the manufacture of low Na milk and pre-acidification of skim-milk in casein manufacture. However, the ion exchange treatment of skim-milk to replace Ca ions with Na ions leads to far more fundamental changes with regard to the native protein conformation.The effect of Ca removal from skim-milk is essentially to disrupt the native casein micelle structure into unassociated molecules of Na caseinate. Skim-milk modified in this way shows increased stability to alcohol and heat and increased functionality of the skim-milk protein in terms of water binding, emulsification and foaming capacity. The viscosity of Ca-reduced skim-milk is also substantially increased.The improved functionality of Ca-reduced skim-milk makes the latter a potentially useful food ingredient in products where the above mentioned properties are important.