Cancer costing European Union countries 'billions'

Posted by Neill Abayon

Cancer costs countries in the European Union 126bn euro (£107bn) a year, according to the first EU-wide analysis of the economic impact of the disease.

The charity Cancer Research UK said it was a "huge burden".

The figures, published in the Lancet Oncology, included the cost of drugs and health care as well as earnings lost through sickness or families providing care.

Lung cancer was the most costly form of the disease.

The team from the University of Oxford and King's College London analysed data from each of the 27 nations in the EU in 2009.

The showed the total cost was 126bn euro and of that 51bn (£43bn) euro was down to healthcare costs including doctors' time and drug costs.

Lost productivity, because of work missed through sickness or dying young, cost 52bn (£44bn) euro while the cost to families of providing care was put at 23bn (£19.5bn) euro.

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Active brain 'keeps dementia at bay'

By Helen Briggs

Keeping mentally active by reading books or writing letters helps protect the brain in old age, a study suggests.


A lifetime of mental challenges leads to slower cognitive decline after factoring out dementia's impact on the brain, US researchers say.

The study, published in Neurology, adds weight to the idea that dementia onset can be delayed by lifestyle factors.

An Alzheimer's charity said the best way to lower dementia risk was to eat a balanced diet, exercise and stay slim.

In a US study, 294 people over the age of 55 were given tests that measured memory and thinking, every year for about six years until their deaths.

They also answered a questionnaire about whether they read books, wrote letters and took part in other activities linked to mental stimulation during childhood, adolescence, middle age, and in later life.

After death, their brains were examined for evidence of the physical signs of dementia, such as brain lesions and plaques.

The study found that after factoring out the impact of those signs, those who had a record of keeping the brain busy had a rate of cognitive decline estimated at 15% slower than those who did not.


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Lack of sleep 'hits women harder'

Posted by Neill Abayon

Lack of sleep raises a woman's risk of heart disease more than it does for a man, research suggests.

Sleeping less than the recommended eight hours a night has been linked to a raised risk of heart problems.

Researchers found levels of inflammatory markers - indicators of heart disease - vary significantly with sleep duration in women, but not men.

The study, by University College London and the University of Warwick, appears in the journal Sleep.

Previous research has suggested people who sleep less than five hours a night have an increased risk of dying from cardiovascular disease, compared to those who get the full eight hours.

The latest study found levels of a molecule called interleukin-6 (IL-6), which is known to trigger inflammation, were much lower in women who reported sleeping eight hours, compared to those who slept for seven hours.

Levels of another molecule, high-sensitivity C-reactive protein (hs-CRP) - which is linked to heart problems - were significantly higher in women who reported sleeping for five hours or less.

Read the full article here.

Green tea 'slows prostate cancer'

Posted by Neill Abayon

A chemical found in green tea appears to slow the progression of prostate cancer, a study has suggested.

Green tea has been linked to a positive effect on a wide range of conditions, including heart disease, cancer and Alzheimer's disease.

The research, in the US journal Cancer Prevention Research, found a significant fall in certain markers which indicate cancer development.

A UK charity said the tea might help men manage low-risk tumours.

Although previous studies have shown benefits from drinking green tea - including some positive findings in relation to prostate cancer, there have been mixed results.

In this study, Philadelphia-based researchers tested a compound called Polyphenon E.

They were looking for a number of biomarkers - molecules - including vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) which are indicators of developing cancer.

Read the full article here.

Exercise improves functional and reduces rheumatoid arthritis

Posted by Neill Abayon

Copenhagen, Denmark, Thursday 11 June 2009: Undertaking a supervised exercise programme can have beneficial effects on functional status and physical function, reduce the need for daily corticosteroid and anti-inflammatory intake and improve levels of depression and anxiety in people with rheumatoid arthritis (RA), according to a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark.

A three-month programme, comprising moderate aerobic and strengthening exercises, conducted for 50-60 minutes three times per week, proved not only to be safe and beneficial both physically and in terms of quality of life for patients, but was also associated with a stabilising effect in disease activity measured by DAS28*. During the Portuguese study's three month period, researchers observed the following:

• A 33% improvement in the HAQ (Health Assessment Questionnaire) disability index measurement of physical functioning (assessing ability to undertake everyday activities such as dressing, eating and walking, and whether assistance from another person or disability aids is required) (p <>
• An improvement in physical function, as outlined below:
  • 55% improvement in the 'sit and stand' test (p=0.018)
  • 10% improvement in the right-hand grip test (p=0.025) and 15% in the left-hand grip test (p=0.035)
  • 19% improvement in the walk time test (p=0.063)

Read the full article here.

Children Who Take Vitamins Often Don’t Need Them

Posted by Neill Abayon

Most children who take vitamins don’t really need them, and kids who eat poorly and are most likely to benefit from nutritional supplements rarely get them, a new study reports.The results surprised researchers, said lead author Dr. Ulfat Shaikh, a pediatrician at the University of California, Davis School of Medicine who treats children with nutritional problems.

“We hypothesized that people who use minerals and vitamin supplements might be using them to cushion the effects of poor nutrition,” she said. “We actually found the opposite.”

The children who used supplements the most were those who already drank a lot of milk, ate a lot of fiber and didn’t consume much fat or cholesterol, Dr. Shaikh said. They were healthier overall and tended to be white, have health insurance and come from upper-income families. They also tended to get a lot of exercise, weren’t overweight, considered themselves in good health and didn’t watch too much television or spend a lot of time playing video games.

The study was published in today’s issue of the Archives of Pediatrics and Adolescent Medicine.

Read the full article here.

Women Warned: Eat Less or Weigh More

Posted by Neill Abayon

Women who don't try to eat less more than double their risk of substantial weight gain in middle age, a three-year study shows.

If you're a 40-something woman, it doesn't matter whether you're thin or overweight -- odds are, you'll gain weight over time if you don't make an effort to cut back on what you eat.

The finding comes from a study of 192 women with an average age of 40 by Brigham Young University researchers Larry A. Tucker, PhD, and Laura Bates. The women were not obese, had not yet reached menopause, and did not smoke.

At the start of the study the women underwent detailed physical exams, including measures of weight and body fat. They also underwent a seven-day analysis of the food they ate, in which they weighed and recorded every bit of food they put into their mouths.

Three years later, the women underwent another round of physical exams and food-intake analysis. The bottom line was no surprise: Women tend to gain weight and body fat as they age and become less physically active.

Read the full article here.

Chamomile Tea Fights the Effects of Diabetes

Posted y Neill Abayon

Drinking chamomile tea daily with meals may help prevent the complications of diabetes. These complications can include loss of vision, nerve damage, and kidney damage.

Chamomile, also known as manzanilla, has been used for years as a medicinal cure-all to treat a variety of medical problems including stress, colds, and menstrual cramps. Scientists recently proposed that the herbal tea might also be beneficial for fighting diabetes.

Researchers fed chamomile extract to a group of diabetic rats for 21 days and compared the results to a group of animals on a normal diet. The chamomile-supplemented animals showed a significant decrease in blood glucose levels compared with the controls. Chamomile extract was also found to inhibit ALR2 enzymes and sorbitol, which are associated with increased diabetic complications.

Causes of Low Sperm Count

Posted by Neill Abayon

The leading cause of male infertility is low sperm count. Others may be low sperm motility, bad quality sperms, lack of semen. In general, most cases of male infertility are due to low sperm count. There are many biologic and environmental factors that can lead to low sperm count. Here is a list if conditions that may cause low sperm count in men.

Age

The effect of aging on male fertility is not clear, however, evidence is growing that it may be a factor. Fertilization rates are usually over 60% for men under 39 but for those over that age, the rates fell to slightly over half.

Temporary and Lifestyle Causes of Low Sperm Count

Nearly any major physical or mental stress can temporarily reduce sperm count. Some common conditions that lower sperm count, temporarily in nearly all cases, include the following:

1. Emotional Stress. Stress may interfere with the hormone GnRH and reduce sperm counts.

2. Sexual Issues. In less than 1% of males with infertility problems, a problem with sexual intercourse or technique will affect fertility.

3. Impotence, premature ejaculation, or psychologic or relationship problems can contribute to infertility, although these conditions are usually very treatable.

4. Lubricants used with condoms, including spermicides, oils, and Vaseline, can affect fertility. If you need a sperm friendly lubricant, the choice of many couples trying to get pregnant is Pre-Seed.

Testicular Exposure to Overheating.

Overheating (such as from high fever, saunas, and hot tubs) may temporarily lower sperm count. Work exposure to overheating may even impair fertility.

Substance Abuse

Cocaine or heavy marijuana use appears to temporarily reduce the number and quality of sperm by as much as 50%. Sperm actually have receptors for certain compounds in marijuana that resemble natural substances and which may impair the sperm's ability to swim and may also inhibit their ability to penetrate the egg.

Smoking.

Smoking impairs sperm count, sperm motility, reduces sperm lifespan, and may cause genetic changes that affect the offspring. Additionally, a 1999 study found that men who smoke have lower sex drives and less frequent sex.

Malnutrition and Nutrient Deficiencies.

Deficiencies in certain nutrients, such as vitamin C, selenium, zinc, and folate, may be particular risk factors for low sperm count in such cases.

Obesity.

Some studies, but not all, have found an association between obesity in men and low sperm count.

Bicycling.

Bicycling has been linked to impotence in men and also may affect the sperm count. Pressure from the bike seat may damage blood vessels and nerves that are responsible for erections. Mountain biking, which involves riding on off-road terrain, exposes the perineum (the region between the scrotum and the anus) to more extreme shocks and vibrations and increases the risk for injuries to the scrotum.

Genetic Factors

Genetic factors are proving to be important contributors to male infertility. Such genetic conditions may be inherited or caused by environmental assaults. Inherited disorders can genetically impair fertility.

Examples include the following:

Cystic fibrosis patients often have missing or obstructed vas deferens (the tubes that carry sperm) and hence a low sperm count.

Klinefelter syndrome patients carry two X and one Y chromosomes (the norm is one X and one Y), which leads to the destruction of the lining of the seminiferous tubules in the testicles during puberty, although most other male physical attributes are unimpaired.

Kartagener syndrome, a rare disorder that is associated with a reversed position of the major organs, also includes immotile cilia (hair-like cells in lungs and sinuses that have a structure similar to the tails of sperm). Germ cells may also be affected by this condition.

Environmental Assaults

Over exposure to environmental assaults (toxins, chemicals, infections) can reduce sperm count either by direct effects on testicular function or on the hormone systems, although the extent of the effect and specific environmental assaults involved are often controversial. Some chemicals that affect sperm production men are : Oxygen-Free Radicals, Estrogen emulation pesticidal chemicals (DDT, aldrin, dieldrin, PCPs, dioxins, and furans ), plastic softening chemicals like Phthalates, hydrocarbons (ethylbenzene, benzene, toluene, and xylene)

Exposure to Heavy Metals.

Chronic exposure to heavy metals such as lead, cadmium, or arsenic may affect sperm production and most often cause a reduced production in otherwise healthy males. Trace amounts of these metals in semen seem to inhibit the function of enzymes contained in the acrosome, the membrane that covers the head of the sperm.

Radiation Treatment.

Radiation treatments and x-rays affect any rapidly dividing cell, so cells that produce sperm are quite sensitive to radiation damage. Cells exposed to significant levels of radiation may take up to two years to resume normal sperm production, and, in severe circumstances, may never recover.

Low Semen Levels

A reduced amount of ejaculated semen (less than 0.5 milliliters per sample) may be caused by a structural abnormality in the tubes transporting the sperm.
Varicocele

A varicocele is a varicose vein in the cord that connects to the testicle. (A varicose vein is one that is abnormally enlarged and twisted.) Varicoceles are found in 15% to 20% of all men and in 25% to 40% of infertile men. It is not clear how they affect fertility, or even if they do at all.

Does Your Skin Sag?

Posted by Neill Abayon

What really is 'anti -aging' all about ?

Most magazines would have you believe that all you have to do to keep "Father Time" from your door, is to cover yourself with cream. I don't know how many women find that this is the answer, but putting cream on your face certainly cannot do any harm.

I do believe that you are a product of your gene pool, if your mother and grandmother had good skin,then it is likely that this asset gets passed down the generations.

As an "older woman" myself I often wish that I had taken better care of my skin when I was younger.As a teenager of course, I never thought that I would change,skin was just something you had to wash or you got in trouble.

I have tried many different products in many different price ranges,creams to lotions etc and I must say I have not noticed a lot of benefits. I do think however, that mentally I feel better thinking that these treatments are working and therefore making me more confident in my appearance.

My mother always told me to rinse my face after cleansing, with hot water and then to splash it with cold water.She had beautiful skin even when she was in her eighties,so I really think ( now too late)that I should have followed her advice!

I would still recommend this as a nightly beauty routine,as the hot water opens the pores to let any dirt out and then the cold water closes them. It is also a very invigorating feeling.

I have at least one pet peeve when it comes to advertisers of anti- aging products. The women in the ads are nearly always very young, so I would like to see older women using these products, this would relate better to the subject of the advert. Maybe this is just jealousy on my part!!!

Feeling young is as good a tonic as anything out there,we can't change our image , unless we artificially do so,so we should be happy to have our health and to be able to enjoy life.

Eating right and drinking lots of water goes a long way towards the inner"anti-aging" which in turn reflects itself in our outer image.

It is too bad that in our society we are judged on our appearance and not on our experience.So many older people have so much to give to this world, but unless one is young and attractive, does anybody listen ?

"Beauty Foods" Can Help Slow Down the Aging Process

Posted by Neill Abayon

Anti-aging has been a very hot topic over the last 15 years, and we’ve made great discoveries about how to turn back the clock with natural hormones and cosmetic procedures. But who would have guessed that the most powerful way of prolonging your youth and enhancing your health was with “Beauty Cuisine”?

Beauty Cuisine is food which not only nourishes but strengthens the body, slows and reverses the aging process (entropy), and rejuvenates our cells allowing for a beautiful body inside and out. Beauty food was a natural part of our evolutionary diet as Paleolithic humans, but has become rare with our quest for fast foods with a long shelf life. The foundation of true youth, health, and beauty lies within consuming the right foods daily. Ideally, we need to pick foods which are fresh, unrefined, nutrient dense, organic, pH balanced, as well as high in enzymatic value, antioxidants, and phytochemicals.

Here are seven important qualities found in “beauty foods”:
1) A low glycemic index rating. Those with high ratings promote insulin secretion, a hormone which when in excess is known to age and destroy the body. For example, high fiber and low sugar foods are lower on the glycemic index and are more desirable.

2) Anti-inflammatory properties. Our most common ailments such as diabetes, rheumatoid arthritis, heart disease, and bowel disease are caused by inflammation. Consuming spices such as ginger, tumeric, cayenne, and oregano, as well as foods including salmon, garlic, and blueberries, have powerful anti-inflammatory properties.

3) An alkaline or neutral pH. Fast foods and processed, refined foods are acidic and promote deterioration and aging. Yet, foods such as green vegetables, salads, sprouts, watercress, mustard greens, seaweed, sesame seeds, and berries are alkaline and rejuvenating.

4) High enzymatic content. Many illnesses occur as a result of lacking enzymes. They are critical in our food for digestion and assimilation of nutrients, yet they are sorely lacking in our packaged and microwave prepared foods. High enzyme foods are energizing and invigorating, allowing the body to heal and recover significantly faster from injury or aging skin cells and organs. Foods high in enzymes include fresh raw vegetables and berries, as well as raw cheeses, yogurt, and wild game.

5) High mineral content. Foods such as arugula, hemp seeds, walnuts, pumpkin seeds, broccoli sprouts, raw honey, aloe vera, papaya, berries, and burdock root are rich in minerals including silicon, biotin, magnesium, sulfur, zinc, and manganese, all known for their importance for strong hair, skin, and nails.

6) High Syntropy value. Stress, toxins, unhealthy food, and lack of fresh air and sun increase the aging process. They create destruction and disorder or entropy in our bodies, and few things actually work in direct opposition. Syntropy is an order-enhancing energy force stored in food which actually neutralizes entropy and releases the beautifying power in food from the sun. Thus, eating “beauty” foods results in a more youthful energy, body, and mind.

7) Naturally colorful. The vibrant colors of natural foods indicate their wide spectrum of antioxidants, phytochemicals, and nutrients which protect, nourish, and heal the body from disease and aging. From the deep blue blueberries, to the red sockeye salmon, choose a variety of colors each day to optimize your intake of beautifying foods.

“Beauty Cuisine” similar to Paleolithic nutrition, is undeniably the most important new trend for healthy living. It will first stimulate your taste buds and then support your body to eliminate toxins, rejuvenate skin cells, strengthen organs, and increase overall vitality, health, and appearance. Humans evolved on these highly energetic restorative foods for the last two million years, and in order to continue thriving, we must make it a priority to keep consuming the right foods.

Spinning Exercise

Posted by Neill Abayon

Spinning exercise or studio cycling is not only popular these days it's an excellent form of fitness. It helps strengthen your heart, tone your glutes, calves, thighs in addition to being a great exercise to slim legs.

Spinning exercise classes usually consist of about 12 to 20 people. Classes range from 50 to 60 minutes and are set to music. The instructor takes the class on a ride that includes all types of terrain that produces a great spinning workout.

If you are the type of person who doesn't care for traditional exercise classes, this form of exercise is perfect for you. One of the many benefits of spinning is you will always feel like you're keeping up with the class because everyone finishes at the same time.

The special spinning bicycle that you pedal has a weighted flywheel in the front and makes you feel more like you're riding on a real bicycle. The spinning bike allows you to adjust the tension to keep pedaling within a comfortable range for your fitness level.

Adjustments can also be made to the handlebars and seat to make you more comfortable. Here are a few stationary exercise bike tips before you start.

Always bring a bottle of water to class and take frequent drinks while you ride. Spinning works up a sweat and it's important that you keep hydrated. Also bring a small towel to wipe away the sweat to keep more comfortable.

Learn to pace yourself because spinning exercise classes can be very high energy. Don't get caught up in the enthusiasm so much that you ride beyond your fitness level.

Wear padded bike shorts or consider bringing a seat cushion until you get use to the bike seat. They tend to be a little hard on your rear end until you get use to them.

The first step is to sign up for a class so you can start enjoying the benefits of spinning. Remember like any class, the instructors will vary on their focus. Some take you on an imaginary ride while other concentrate on a more rigorous variety of drills.

If you find you don't like the style of one instructor, try another class. It could be a completely different experience with an instructor you like better.

Using a spinning cycle will give you the aerobic burst you need to get your heart racing and boost your endurance. Just climb on and start pedaling to your limit for a spinning exercise workout you'll enjoy.

10 Essential Health Tips

Written by Neill Abayon

1. Move More
Make it a daily challenge to find ways to move your body. Climb stairs if given a choice between that and escalators or elevators. Walk your dog; chase your kids; toss balls with friends, mow the lawn. Anything that moves your limbs is not only a fitness tool, it's a stress buster. Think 'move' in small increments of time. It doesn't have to be an hour in the gym or a 45-minute aerobic dance class or tai chi or kickboxing. But that's great when you're up to it. Meanwhile, move more. Thought for the day: Cha, Cha, Cha…. Then do it!

2. Cut Fat
Avoid the obvious such as fried foods, burgers and other fatty meats (i.e. pork, bacon, ham, salami, ribs and sausage). Dairy products such as cheese, cottage cheese, milk and cream should be eaten in low fat versions. Nuts and sandwich meats, mayonnaise, margarine, butter and sauces should be eaten in limited amounts. Most are available in lower fat versions such as substitute butter, fat free cheeses and mayonnaise. Thought for the day: Lean, mean, fat-burning machine…. Then be one!

3. Quit Smoking
The jury is definitely in on this verdict. Ever since 1960 when the Surgeon General announced that smoking was harmful to your health, Americans have been reducing their use of tobacco products that kill. Just recently, we've seen a surge in smoking in adolescents and teens. Could it be the Hollywood influence? It seems the stars in every movie of late smoke cigarettes. Beware. Warn your children of the false romance or 'tough guy' stance of Hollywood smokers. Thought for the day: Give up just one cigarette…. the next one.

4. Reduce Stress
Easier said than done, stress busters come in many forms. Some techniques recommended by experts are to think positive thoughts. Spend 30 minutes a day doing something you like. (i.e.,Soak in a hot tub; walk on the beach or in a park; read a good book; visit a friend; play with your dog; listen to soothing music; watch a funny movie. Get a massage, a facial or a haircut. Meditate. Count to ten before losing your temper or getting aggravated. Avoid difficult people when possible. Thought for the day: When seeing red, think pink clouds….then float on them.

5. Protect Yourself from Pollution
If you can't live in a smog-free environment, at least avoid smoke-filled rooms, high traffic areas, breathing in highway fumes and exercising near busy thoroughfares. Exercise outside when the smog rating is low. Exercise indoors in air conditioning when air quality is good. Plant lots of shrubbery in your yard. It's a good pollution and dirt from the street deterrent. Thought for the day: 'Smoke gets in your eyes'…and your mouth, and your nose and your lungs as do pollutants….hum the tune daily.

6. Wear Your Seat Belt
Statistics show that seat belts add to longevity and help alleviate potential injuries in car crashes. Thought for the day: Buckle down and buckle up.

7. Floss Your Teeth
Recent studies make a direct connection between longevity and teeth flossing. Nobody knows exactly why. Perhaps it's because people who floss tend to be more health conscious than people who don't? Thought for the day: Floss and be your body's boss.

8. Avoid Excessive Drinking
While recent studies show a glass of wine or one drink a day (two for men) can help protect against heart disease, more than that can cause other health problems such as liver and kidney disease and cancer. Thought for the day: A jug of wine should last a long time.

9. Keep a Positive Mental Outlook
There's a definitive connection between living well and healthfully and having a cheerful outlook on life. Thought for the day: You can't be unhappy when you're smiling or singing.

10. Choose Your Parents Well
The link between genetics and health is a powerful one. But just because one or both of your parents died young in ill health doesn't mean you cannot counteract the genetic pool handed you. Thought for the day: Follow these basic tips for healthy living and you can better control your own destiny.

Is vitamins for All?

Written by Neill Abayon

Increasingly, experts are recommending that all adults take a multivitamin each day as "insurance" against vitamin deficiency. Even without significant deficiency, extra folic acid, B6 and B12 may lower homocysteine and reduce the risk of cardiovascular disease. Folate also may lower risk of breast and colon cancer and birth defects. Vitamin D may lessen the risk of osteoporosis and osteomalacia.

For women who might become pregnant, experts recommend 400 micrograms per day of folic acid. Some recommend 800 micrograms a day for women who are specifically trying to become pregnant.

It's likely that ongoing research will spell out which vitamin supplements are most important and who should take them. Until then, things are likely to remain pretty confusing.

Consumers are deluged with recommendations to take lots of vitamins. Much of this promotion comes from people or companies trying to sell their products, or from studies that may be preliminary or even contradict other research.

It's enough to make your head spin — and there's no good vitamin you can take for that!

Do you really need to take your vitamins? Probably not, especially if you are healthy and already get at least five servings of fruits and vegetables each day.

But if you are concerned that your diet might not meet your vitamin needs, change your diet and take a single daily multivitamin. It should be inexpensive and contain 100% of the recommended daily allowance of the 13 major vitamins. While this might not be absolutely necessary, the minimal cost and risk might just be worth the peace of mind.

Choosing the right Pediatrician

Written by Neill Abayon

Ideally, the best time to choose a doctor for your baby is before the baby is born. In making your selection, you'll need to consider a combination of factors.

One of the first considerations is whether your baby will see a pediatrician or a family practice physician. Both pediatricians and family physicians go through four years of medical school. Pediatricians go through an additional three years of training in the treatment of people from birth to age 21. There is no right or wrong choice. Family doctors have the advantage of being able to treat the whole family. Pediatricians may have greater expertise in treating children.

Once you've decided which type of doctor you prefer, you will want to look at individual doctors' methods and manners. Start by knowing what you're looking for in your baby's doctor. Do you want someone with a more familiar, casual manner or a very professional and more formal manner? Seek referrals from friends and relatives in your area. Ask your obstetrical care provider to recommend a pediatrician or family physician.

Look at practical considerations. Is the doctor affiliated with your health plan and the hospital you plan to use? Is the doctor's office located close to your home? Consider the doctor's office hours and how they fit or conflict with your work or household schedule. Most importantly, meet and talk with the doctor to see whether you feel comfortable with him or her.

During your meeting, you should ask lots of questions, such as:

* What are the doctor's regular office hours? How are calls and emergencies handled after regular office hours?
* Who covers for the doctor when he/she is sick or on vacation?
* Who will respond to questions over the phone during regular office hours?
* Is the office neat and clean? Will your child perceive it to be a warm, friendly place?
* Is the office staff friendly and courteous?
* How long do patients usually have to wait to see the doctor?