Background: Despite the fact that peripheral arterial disease (PAD) significantly increases the risk of cardiovascular mortality, it is significantly underdiagnosed and underrated. The purpose of this study was to evaluate the practice at a northeast Tennessee university primary care clinic regarding the diagnosis and treatment of PAD. Methods: A retrospective medical record survey was conducted to evaluate practice patterns in diagnosing and treating PAD in a university primary care clinic. A clinic population of 711 patients was selected using International Classification of Diseases-9 codes for coronary artery disease (CAD), cerebovascular disease (CVD), and/ or PAD. A sample of 180 patients (25.3%) was randomly selected using a systematic statistical method. Of these, 125 patients met the diagnostic criteria for CAD, CVD, and/or PAD. The study covered a 3-year period, from July 2001 until June 2004. Demographic and other data, including the use of antiplatelet therapy, were collected. Results: One hundred ten patients met all of the inclusion and exclusion criteria. Thirty-nine percent were males, and 61% were females. Overall, 79% had CAD, 53% had CVD, and 25% had PAD. Almost half of the patients had some combination of these. Only about 2% had PAD only compared with 36% with CAD only and 17% with CVD only. Although the prevalence of CAD and CVD (among other atherosclerotic vascular diseases) in our clinic was comparable to national figures, the prevalence of PAD was significantly lower (p = .004). The overall use of any antiplatelet agent was 84.2% for patients with only CAD and 80% for only CVD. There was not an adequate number of patients with only PAD to evaluate the use of antiplatelet therapy in this group. Conclusion: The low prevalence of PAD only (most PAD patients had coexisting CAD and CVD) indicates that PAD is underdiagnosed at our clinic. There was suboptimal use of aspirin and other antiplatelet drugs among patients with atherosclerotic vascular disease.

Les théories contemporaines en conservation, en urbanisme, en architecture se rallient toutes pour intégrer la participation citoyenne dans leurs processus, dans la perspective d‘un développement durable. Plusieurs enjeux entrent en ligne de compte et influencent les décisions prises en ce qui concerne le destin de gares de train abandonnées. Cette etude tente d‘éclairer l‘impact de certains de ces enjeux dont : le ou les nouveaux usages qui seront octroyés à la gare dans sa nouvelle «vie », l‘architecture de la gare elle-même et la façon dont elle sera traitée ou modifiée, l‘espace de la gare ainsi que sa transformation et finalement l‘appropriation de cet espace par le citoyen. L‘approche qualitative est l‘approche méthodologique choisie. La recherche combine la méthodologie d‘analyse de contenu et l‘étude de cas. Le cas de la gare de Westmount est examiné en comparaison avec le cas de la gare d‘Orsay transformée en Musée d‘Orsay. Le point de vue de l‘usager est exploré afin de comprendre comment il vit l‘espace de la gare dans le cas où l‘architecture de la gare resterait intacte et un nouvel usage lui est octroyé, et dans le cas où l‘architecture intérieure ou extérieure serait modifiée en y ajoutant des structures contemporaines pour accommoder un ou plusieurs nouveaux usages. La comparaison entre les résultats obtenus pour le Musée d‘Orsay et pour la gare de Westmount a permis de mieux comprendre le contexte et ses variables politiques / économiques, patrimoniales / de développement durable et sociales /spatiales. Un mélange entre architecture historique et architecture contemporaine favoriserait la préservation des parties historiques en remettant le bâtiment ainsi que ses installations à niveau et en prolongeant leur utilisation, cependant, tout cela ne se concrétisera pas sans la réalisation de certaines conditions, notamment l‘appui politico-économique de la part de la ville, une architecture contemporaine qui soit épurée et simple ou une architecture qui imite l‘architecture existante, les opinions sont partagées, et finalement l‘appropriation de l‘espace par les usagers, chose qui semble dépendre de l‘architecture finale et de son harmonisation avec l‘architecture existante; les usagers semblent s‘approprier davantage l‘espace de la gare avec ou sans nouvelle structure surtout s‘il y a participation de leur part au processus de sa réhabilitation. Donner une voix aux usagers et à leurs suggestions est chose importante : ils «habiteraient» mieux l‘espace s‘ils participaient au projet. Également, prendre en considération les recommandations en matière de conservation, puisqu‘un vent de changement pourrait s‘y opérer, plus précisément en matière de mélange entre architecture historique et architecture contemporaine. / Contemporary theories of conservation, urban planning and architecture all work together to integrate citizen participation into their processes, with a view to sustainable development. Several issues influence decisions regarding the fate of abandoned train stations. This study attempts to clarify the impact of some of these issues such as what are the new uses that give the station its new "life", what is the architecture of the station itself and how it will be treated or modified, the space of the station and its transformation and ultimately the appropriation of this space by the citizens. The methodological approach that is chosen is qualitative and combines content analysis and case study methodologies. The case study chosen is of Westmount station in Westmount, Quebec, Canada, it is examined in comparison with the case of Orsay station transformed into the Musée d'Orsay in Paris, France. The views of users are explored to comprehend how they understand the space of the station, how they might react in case its architecture remains intact and a new use is granted to it, and in case the interior and/or exterior architecture is modified by adding contemporary structures to accommodate one or more new uses. Comparing the results of the Musée d'Orsay and Westmount station helped to better understand the context and its political/economic, heritage/sustainability and social/spatial variables. While divided, many participants expressed various and rich opinions. These included having a mix of historic architecture and contemporary architecture to favour the preservation of the historic sections by updating the building and its facilities and extending their use. However, this could not materialize without the fulfillment of certain conditions, including political/economic support from the city, a contemporary architecture that is uncluttered, simple or an architecture that mimics existing architecture, and finally the appropriation of space by users. This appropriation seems to depend on the final architecture and its harmonization with the existing architecture. Users seem to appropriate more the space of the station, with or without a new structure, especially if there is participation on their part in the process of rehabilitation. Giving a voice to users and their suggestions is important as they would "inhabit" better the space if they participate in the project. In addition, recommendations on conservation, especially that some changes could occur, more specifically in terms of the mix of historic architecture and contemporary architecture, are to be considered.