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Sample records for bone health designing

  1. A Design Method for FES Bone Health Therapy in SCI

    Directory of Open Access Journals (Sweden)

    Brian Andrews

    2016-11-01

    Full Text Available FES assisted activities such as standing, walking, cycling and rowing induce forces within the leg bones and have been proposed to reduce osteoporosis in spinal cord injury (SCI. However, details of the applied mechanical stimulus for osteogenesis is often not reported. Typically, comparisons of bone density results are made after costly and time consuming clinical trials. These studies have produced inconsistent results and are subject to sample size variations. Here we propose a design process that may be used to predict the clinical outcome based on biomechanical simulation and mechano-biology. This method may allow candidate therapies to be optimized and quantitatively compared. To illustrate the approach we have used data obtained from a rower with complete paraplegia using the RowStim (III system.

  2. A Design Method for FES Bone Health Therapy in SCI

    Science.gov (United States)

    Andrews, Brian; Shippen, James; Armengol, Monica; Gibbons, Robin; Holderbaum, William; Harwin, William

    2016-01-01

    FES assisted activities such as standing, walking, cycling and rowing induce forces within the leg bones and have been proposed to reduce osteoporosis in spinal cord injury (SCI). However, details of the applied mechanical stimulus for osteogenesis is often not reported. Typically, comparisons of bone density results are made after costly and time consuming clinical trials. These studies have produced inconsistent results and are subject to sample size variations. Here we propose a design process that may be used to predict the clinical outcome based on biomechanical simulation and mechano-biology. This method may allow candidate therapies to be optimized and quantitatively compared. To illustrate the approach we have used data obtained from a rower with complete paraplegia using the RowStim (III) system. PMID:28078075

  3. Smoking and Bone Health

    Science.gov (United States)

    ... supported by your browser. Home Bone Basics Lifestyle Smoking and Bone Health Publication available in: PDF (85 ... late to adopt new habits for healthy bones. Smoking and Osteoporosis Cigarette smoking was first identified as ...

  4. Green tea polyphenols and Tai Chi for bone health: Designing a placebo-controlled randomized trial

    Directory of Open Access Journals (Sweden)

    Chyu Ming-Chien

    2009-09-01

    Full Text Available Abstract Background Osteoporosis is a major health problem in postmenopausal women. Evidence suggests the importance of oxidative stress in bone metabolism and bone loss. Tea consumption may be beneficial to osteoporosis due to its antioxidant capability. However, lack of objective data characterizing tea consumption has hindered the precise evaluation of the association between tea ingestion and bone mineral density in previous questionnaire-based epidemiological studies. On the other hand, although published studies suggest that Tai Chi (TC exercise can benefit bone health and may reduce oxidative stress, all studies were conducted using a relatively healthy older population, instead of a high-risk one such as osteopenic postmenopausal women. Therefore, this study was designed to test an intervention including green tea polyphenol (GTP and TC exercise for feasibility, and to quantitatively assess their individual and interactive effects on postmenopausal women with osteopenia. Methods/Design One hundred and forty postmenopausal women with osteopenia (defined as bone mineral density T-score at the spine and/or hip between 1 to 2.5 SD below the reference database were randomly assigned to 4 treatment arms: (1 placebo group receiving 500 mg medicinal starch daily, (2 GTP group receiving 500 mg of GTP per day, (3 placebo+TC group receiving both placebo treatment and TC training (60-minute group exercise, 3 times per week, and (4 GTP+TC group receiving both GTP and TC training for 24 weeks. The outcome measures were bone formation biomarker (serum bone alkaline phosphatase, bone resorption biomarker (serum tartrate resistant acid phosphatase, and oxidative DNA damage biomarker (urinary 8-hydroxy-2'-deoxyguanosine. All outcome measures were determined at baseline, 4, 12, and 24 weeks. Urinary and serum GTP concentrations were also determined at baseline, 4, 12, and 24 weeks for bioavailability. Liver function was monitored monthly for safety. A

  5. Bone Health and Osteoporosis.

    Science.gov (United States)

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  6. Sodium and bone health

    DEFF Research Database (Denmark)

    Teucher, B.; Dainty, J. R.; Spinks, C. A.

    2008-01-01

    High salt intake is a well-recognized risk factor for osteoporosis because it induces calciuria, but the effects of salt on calcium metabolism and the potential impact on bone health in postmenopausal women have not been fully characterized. This study investigated adaptive mechanisms in response...... was negative on both high and low salt diets....

  7. Marijuana May Blunt Bone Health

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161575.html Marijuana May Blunt Bone Health Study finds heavy users ... 19, 2016 WEDNESDAY, Oct. 19, 2016 (HealthDay News) -- Marijuana may be bad to the bone, a new ...

  8. Vitamin D, Calcium, and Bone Health

    Science.gov (United States)

    ... in Balance › Vitamin D, Calcium, and Bone Health Vitamin D, Calcium, and Bone Health March 2012 Download ... also helps keep your bones strong. Why are vitamin D and calcium important to bone health? Vitamin ...

  9. Vitamin A and Bone Health

    Science.gov (United States)

    ... supported by your browser. Home Bone Basics Nutrition Vitamin A and Bone Health Publication available in: PDF ( ... Find More Information? For Your Information What Is Vitamin A? Vitamin A is a family of compounds ...

  10. Bone health in disorders of sex differentiation.

    Science.gov (United States)

    Bertelloni, S; Baroncelli, G I; Mora, S

    2010-09-01

    Sex steroids are main regulators of skeletal growth, maturation and mass in both men and women. People with disorders of sex development (DSD) may experience problems in developing normal bone growth, structure and mass, because abnormal sex steroid secretion or action may be operative. In complete androgen insensitivity syndrome several reports documented reduced bone mineral density (BMD). Reduced BMD is evident in patients with not removed or removed gonads, but it is poorer in the latter, mainly when compliance with estrogen replacement therapy is not guaranteed. Large impairment of BMD does not seem to be present in patients with partial androgen insensitivity syndrome or 5alpha-reductase-2 deficiency, providing that gonads are not removed or that substitutive therapy is optimized. In congenital adrenal hyperplasia, BMD may be impaired as a result of not optimal glucocorticoid administration. In Turner syndrome, impaired BMD may result from the combined actions of estrogen deficiency, low bone dimensions, altered bone geometry, deficient cortical bone, and trabecular bone loss. Optimal estrogen administration seems to be important in preserving bone mass and enhancing trabecular bone volume. On the whole, bone health represents a main clinical issue for the management of persons with disorders of sex differentiation, and well designed longitudinal studies should be developed to improve their bone health and well-being.

  11. Vitamin K and bone health.

    Science.gov (United States)

    Hamidi, Maryam S; Gajic-Veljanoski, Olga; Cheung, Angela M

    2013-01-01

    Vitamin K has been purported to play an important role in bone health. It is required for the gamma-carboxylation of osteocalcin (the most abundant noncollagenous protein in bone), making osteocalcin functional. There are 2 main forms (vitamin K1 and vitamin K2), and they come from different sources and have different biological activities. Epidemiologic studies suggest a diet high in vitamin K is associated with a lower risk of hip fractures in aging men and women. However, randomized controlled trials of vitamin K1 or K2 supplementation in white populations did not increase bone mineral density at major skeletal sites. Supplementation with vitamin K1 and K2 may reduce the risk of fractures, but the trials that examined fractures as an outcome have methodological limitations. Large well-designed trials are needed to compare the efficacies of vitamin K1 and K2 on fractures. We conclude that currently there is not enough evidence to recommend the routine use of vitamin K supplements for the prevention of osteoporosis and fractures in postmenopausal women.

  12. Children's bone health

    NARCIS (Netherlands)

    I.M. van der Sluis (Inge)

    2002-01-01

    textabstractThe thesis can be divided in two main parts. In the first part (Chapter 2 to 5) bone mineral density, bone metabolism and body composition in healthy children and young adults have been evaluated, while in the second part (Chapter 6 to 10) these issues were studied in children with vario

  13. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...

  14. Ethnic Differences in Bone Health

    Directory of Open Access Journals (Sweden)

    Ayse eZengin

    2015-03-01

    Full Text Available There are differences in bone health between ethnic groups in both men and in women. Variations in body size and composition are likely to contribute to reported differences. Most studies report ethnic differences in areal bone mineral density (aBMD which do not consistently parallel ethnic patterns in fracture rates. This suggests that other parameters beside aBMD should be considered when determining fracture risk between and within populations, including other aspects of bone strength: bone structure and microarchitecture as well muscle strength (mass, force generation, anatomy and fat mass. We review what is known about differences in bone-densitometry derived outcomes between ethnic groups and the extent to which they account for the differences in fracture risk. Studies are included that were published primarily between 1994 – 2014. A ‘one size fits all approach’ should not be used to understand better ethnic differences in fracture risk.

  15. Green tea and bone health

    Science.gov (United States)

    Osteoporosis is a major health problem in the elderly, particularly women. Epidemiological evidence has shown an association between tea consumption and the prevention of age-related bone loss in elderly women and men. Ingestion of green tea and green tea bioactive compounds may be beneficial in mit...

  16. Dairy products, yogurts, and bone health.

    Science.gov (United States)

    Rizzoli, René

    2014-05-01

    Fracture risk is determined by bone mass, geometry, and microstructure, which result from peak bone mass (the amount attained at the end of pubertal growth) and from the amount of bone lost subsequently. Nutritional intakes are an important environmental factor that influence both bone mass accumulation during childhood and adolescence and bone loss that occurs in later life. Bone growth is influenced by dietary intake, particularly of calcium and protein. Adequate dietary calcium and protein are essential to achieve optimal peak bone mass during skeletal growth and to prevent bone loss in the elderly. Dairy products are rich in nutrients that are essential for good bone health, including calcium, protein, vitamin D, potassium, phosphorus, and other micronutrients and macronutrients. Studies supporting the beneficial effects of milk or dairy products on bone health show a significant inverse association between dairy food intake and bone turnover markers and a positive association with bone mineral content. Fortified dairy products induce more favorable changes in biochemical indexes of bone metabolism than does calcium supplementation alone. The associations between the consumption of dairy products and the risk of hip fracture are less well established, although yogurt intake shows a weakly positive protective trend for hip fracture. By consuming 3 servings of dairy products per day, the recommended daily intakes of nutrients essential for good bone health may be readily achieved. Dairy products could therefore improve bone health and reduce the risk of fractures in later life.

  17. Phytonutrients for bone health during ageing.

    Science.gov (United States)

    Sacco, Sandra Maria; Horcajada, Marie-Noëlle; Offord, Elizabeth

    2013-03-01

    Osteoporosis is a skeletal disease characterized by a decrease in bone mass and bone quality that predispose an individual to an increased risk of fragility fractures. Evidence demonstrating a positive link between certain dietary patterns (e.g. Mediterranean diet or high consumption of fruits and vegetables) and bone health highlights an opportunity to investigate their potential to protect against the deterioration of bone tissue during ageing. While the list of these phytonutrients is extensive, this review summarizes evidence on some which are commonly consumed and have gained increasing attention over recent years, including lycopene and various polyphenols (e.g. polyphenols from tea, grape seed, citrus fruit, olive and dried plum). Evidence to define a clear link between these phytonutrients and bone health is currently insufficient to generate precise dietary recommendations, owing to mixed findings or a scarcity in clinical data. Moreover, their consumption typically occurs within the context of a diet consisting of a mix of phytonutrients and other nutrients rather than in isolation. Future clinical trials that can apply a robust set of outcome measurements, including the determinants of bone strength, such as bone quantity (i.e. bone mineral density) and bone quality (i.e. bone turnover and bone microarchitecture), will help to provide a more comprehensive outlook on how bone responds to these various phytonutrients. Moreover, future trials that combine these phytonutrients with established bone nutrients (i.e. calcium and vitamin D) are needed to determine whether combined strategies can produce more robust effects on skeletal health.

  18. Pregnancy, Breastfeeding, and Bone Health

    Science.gov (United States)

    ... need for calcium. During pregnancy, women produce more estrogen, a hormone that protects bones. Any bone mass lost during pregnancy is typically ... mass during breastfeeding because they’re producing less estrogen, which is the hormone that protects bones. The good news is that, like bone lost ...

  19. Oral Health and Bone Disease

    Science.gov (United States)

    ... low bone mass. Research suggests a link between osteoporosis and bone loss in the jaw. The bone in the jaw supports and anchors the teeth. When the jawbone becomes less dense, tooth loss can occur, a common occurrence in older adults. Skeletal Bone Density and Dental Concerns Periodontal Disease ...

  20. [Bone health in Geneva retirees].

    Science.gov (United States)

    Biver, E; Durosier, C; Chevalley, T; Rizzoli, R; Ferrari, S

    2015-03-18

    GERICO (Geneva Retirees Cohort) is a cohort of 953 men and women recruited at the age of 65 in Canton of Geneva, Switzerland, providing a picture of bone health at retirement time. Despite few comorbidities and good nutritional intake and vitamin D status, 30% of subjects have a history of vertebral or clinical fracture after the age of 45, 20% of women and 11% of men have osteoporosis assessed by DXA. 22% have a 10-year probability of a major osteoporotic fracture assessed by FRAX greater than 15%, -i.e. the current intervention thresholds recommended in this age-class in Switzerland. Nevertheless, only 1.4% subject benefits of an anti-osteoporotic drug. These data underscore the importance of primary and secondary prevention of osteoporosis and fractures in healthy elderly at time of retirement.

  1. Optimizing Bone Health in Duchenne Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Jason L. Buckner

    2015-01-01

    Full Text Available Duchenne muscular dystrophy (DMD is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA, as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA.

  2. Bone health. New role for vitamin K?

    OpenAIRE

    Ryan-Harshman, Milly; Aldoori, Walid

    2004-01-01

    OBJECTIVE: To assess growing evidence that vitamin K (phylloquinone) plays an important role in bone health and, subsequently, in prevention of osteoporotic fractures. QUALITY OF EVIDENCE: We searched MEDLINE from January 1972 to December 2002 using the key words vitamin K and bone health. We reviewed 30 articles that seemed relevant or had a human focus. All evidence can be categorized as level II. MAIN MESSAGE: Evidence suggests that dietary phylloquinone intake of

  3. Tea and bone health: steps forward in translational nutrition.

    Science.gov (United States)

    Shen, Chwan-Li; Chyu, Ming-Chien; Wang, Jia-Sheng

    2013-12-01

    Osteoporosis is a major health problem in the aging population worldwide. Cross-sectional and retrospective evidence indicates that tea consumption may be a promising approach in mitigating bone loss and in reducing risk of osteoporotic fractures among older adults. Tea polyphenols enhance osteoblastogenesis and suppress osteoclastogenesis in vitro. Animal studies reveal that intake of tea polyphenols have pronounced positive effects on bone as shown by higher bone mass and trabecular bone volume, number, and thickness and lower trabecular separation via increasing bone formation and inhibition of bone resorption, resulting in greater bone strength. These osteoprotective effects appear to be mediated through antioxidant or antiinflammatory pathways along with their downstream signaling mechanisms. A short-term clinical trial of green tea polyphenols has translated the findings from ovariectomized animals to postmenopausal osteopenic women through evaluation of bioavailability, safety, bone turnover markers, muscle strength, and quality of life. For future studies, preclinical animal studies to optimize the dose of tea polyphenols for maximum osteoprotective efficacy and a follow-up short-term dose-response trial in postmenopausal osteopenic women are necessary to inform the design of randomized controlled studies in at-risk populations. Advanced imaging technology should also contribute to determining the effective dose of tea polyphenols in achieving better bone mass, microarchitecture integrity, and bone strength, which are critical steps for translating the putative benefit of tea consumption in osteoporosis management into clinical practice and dietary guidelines.

  4. Impairment of bone health in pediatric patients with hemolytic anemia.

    Directory of Open Access Journals (Sweden)

    Michael M Schündeln

    Full Text Available INTRODUCTION: Sickle cell anemia and thalassemia result in impaired bone health in both adults and youths. Children with other types of chronic hemolytic anemia may also display impaired bone health. STUDY DESIGN: To assess bone health in pediatric patients with chronic hemolytic anemia, a cross-sectional study was conducted involving 45 patients with different forms of hemolytic anemia (i.e., 17 homozygous sickle cell disease and 14 hereditary spherocytosis patients. Biochemical, radiographic and anamnestic parameters of bone health were assessed. RESULTS: Vitamin D deficiency with 25 OH-vitamin D serum levels below 20 ng/ml was a common finding (80.5% in this cohort. Bone pain was present in 31% of patients. Analysis of RANKL, osteoprotegerin (OPG and osteocalcin levels indicated an alteration in bone modeling with significantly elevated RANKL/OPG ratios (control: 0.08+0.07; patients: 0.26+0.2, P = 0.0007. Osteocalcin levels were found to be lower in patients compared with healthy controls (68.5+39.0 ng/ml vs. 118.0+36.6 ng/ml, P = 0.0001. Multiple stepwise regression analysis revealed a significant (P<0.025 influence of LDH (partial r2 = 0.29, diagnosis of hemolytic anemia (partial r2 = 0.05 and age (partial r2 = 0.03 on osteocalcin levels. Patients with homozygous sickle cell anemia were more frequently and more severely affected by impaired bone health than patients with hereditary spherocytosis. CONCLUSION: Bone health is impaired in pediatric patients with hemolytic anemia. In addition to endocrine alterations, an imbalance in the RANKL/OPG system and low levels of osteocalcin may contribute to this impairment.

  5. Divergent effects of obesity on bone health

    Science.gov (United States)

    Gower, Barbara A; Casazza, Krista

    2017-01-01

    Historically, obesity was thought to be advantageous for maintaining healthy bones due to the greater BMD observed in overweight individuals. However, recent observations of increased fracture in some obese individuals has led to concern that common metabolic complications of obesity, such as type 2 diabetes, metabolic syndrome, impaired glucose tolerance, insulin resistance, hyperglycemia, and inflammation may be associated with poor bone health. In support of this hypothesis, greater visceral fat, a hallmark of insulin resistance and metabolic syndrome, is associated with lower BMD. Research is needed to determine if and how visceral fat and/or poor metabolic health are causally associated with bone health. Clinicians should consider adding a marker metabolic health, such as waist circumference or fasting plasma glucose concentration, to other known risk factors for osteoporosis and fracture. PMID:24063845

  6. Adherence to Mediterranean diet and bone health

    Directory of Open Access Journals (Sweden)

    Antonio Romero Pérez

    2014-05-01

    Full Text Available Introduction: Several studies have concluded that incidences of osteoporosis and osteoporosis-related fractures vary across the European Union, the lowest incidence being reported in the Mediterranean area. The beneficial effect is mainly attributed to a specific eating pattern. The Mediterranean diet contain a complex array of naturally occurring bioactive molecules with antioxidant, anti-inflammatory and alkalinising properties that may contribute to the bone-sparing effect of the Mediterranean diet. Objective: The purpose of this review is to examine the evidence to date on the effects of Mediterranean diet on bone health. Methods: The search for articles came from extensive research in the following databases: PubMed, Scopus and Web of Science. We used the search terms "Mediterranean diet", "adherence", "fruit and vegetable", "olive oil", "fish" "legume", "cereal" "alcohol", "bone", "osteoporosis", "fracture", and combinations, such as "Mediterranean diet and bone" or "Mediterranean diet and fracture". Results: A limited number of studies have examined the relationship between Mediterranean Diet and bone health, and they have reported conflicting results. On the one hand, adherence to a traditional MeDi has been associated with higher bone mineral density and lower fracture risk. The results of these studies could be attributed to the combined beneficial effects of individual components of the Mediterranean diet. On the contrary, several studies failed to show any association between adherence to the MeDi and indices of bone mass. Conclusions: Further large-scale studies are required to clarify the effect of Mediterranean diet on bone health, in order to establish the role of this diet in the prevention of osteoporosis.

  7. Vitamin D and Bone Health; Potential Mechanisms

    Directory of Open Access Journals (Sweden)

    J.J. Strain

    2010-07-01

    Full Text Available Osteoporosis is associated with increased morbidity, mortality and significant economic and health costs. Vitamin D is a secosteriod hormone essential for calcium absorption and bone mineralization which is positively associated with bone mineral density [BMD]. It is well-established that prolonged and severe vitamin D deficiency leads to rickets in children and osteomalacia in adults. Sub-optimal vitamin D status has been reported in many populations but it is a particular concern in older people; thus there is clearly a need for effective strategies to optimise bone health. A number of recent studies have suggested that the role of vitamin D in preventing fractures may be via its mediating effects on muscle function (a defect in muscle function is one of the classical signs of rickets and inflammation. Studies have demonstrated that vitamin D supplementation can improve muscle strength which in turn contributes to a decrease in incidence of falls, one of the largest contributors to fracture incidence. Osteoporosis is often considered to be an inflammatory condition and pro-inflammatory cytokines have been associated with increased bone metabolism. The immunoregulatory mechanisms of vitamin D may thus modulate the effect of these cytokines on bone health and subsequent fracture risk. Vitamin D, therefore, may influence fracture risk via a number of different mechanisms.

  8. Bone health and aging: implications for menopause.

    Science.gov (United States)

    Mirza, Faryal S; Prestwood, Karen M

    2004-12-01

    Osteoporosis is one major health condition that contributes to excess morbidity and mortality in women after menopause. In the past, hormone therapy (HT) was prescribed commonly for symptoms of menopause, and there was also evidence that HT protected against osteoporosis. Recently, however, the overall health risks have been reported to exceed benefits, with the beneficial effects seen only in the decreased incidence of hip fractures and colon cancer. The role of HT in menopausal women is unclear at this time, although many women may require it to reduce menopausal symptoms. Osteoporosis may be an area where the benefit of using HT may outweigh the risks in a select group of women. Further, because lower than usual doses of estrogen have been shown to reduce menopausal symptoms and to protect bone, additional research will likely expand physicians' current knowledge of the use of HT in menopausal women. This article reviews the use of low-dose estrogen to promote bone health in postmenopausal women.

  9. Aging, human immunodeficiency virus, and bone health

    Directory of Open Access Journals (Sweden)

    Kim C Mansky

    2010-09-01

    Full Text Available Kim C ManskyDivision of Orthodontics, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USAAbstract: Highly active antiretroviral therapy (HAART has had a profound impact on improving the long-term prognosis for individuals infected with human immunodeficiency virus (HIV. HAART has been available for close to two decades, and now a significant number of patients with access to HAART are over the age of 50 years. Many clinical studies have indicated that HIV infection, as well as components of HAART, can increase the risk in these individuals to a variety of noninfectious complications, including a risk to bone health. There is a significant need for detailed mechanistic analysis of the aging, HIV-infected population regarding the risk of HIV infection and therapy in order to maintain bone health. Insights from basic mechanistic studies will help to shed light on the role of HIV infection and the components of HAART that impact bone health, and will help in identifying preventative countermeasures, particularly for individuals 50 years of age and older.Keywords: osteopenia, osteomalacia, osteoporosis, bisphosphonates, tenofovir, osteoimmunology

  10. NCCN Task Force Report: Bone Health In Cancer Care.

    Science.gov (United States)

    Gralow, Julie R; Biermann, J Sybil; Farooki, Azeez; Fornier, Monica N; Gagel, Robert F; Kumar, Rashmi; Litsas, Georgia; McKay, Rana; Podoloff, Donald A; Srinivas, Sandy; Van Poznak, Catherine H

    2013-08-01

    Bone health and maintenance of bone integrity are important components of comprehensive cancer care. Many patients with cancer are at risk for therapy-induced bone loss, with resultant osteoporotic fractures, or skeletal metastases, which may result in pathologic fractures, hypercalcemia, bone pain, and decline in motility and performance status. Effective screening and timely interventions are essential for reducing bone-related morbidity. Management of long-term bone health requires a broad knowledge base. A multidisciplinary health care team may be needed for optimal assessment and treatment of bone-related issues in patients with cancer. Since publication of the previous NCCN Task Force Report: Bone Health in Cancer Care in 2009, new data have emerged on bone health and treatment, prompting NCCN to convene this multidisciplinary task force to discuss the progress made in optimizing bone health in patients with cancer. In December 2012, the panel members provided didactic presentations on various topics, integrating expert judgment with a review of the key literature. This report summarizes issues surrounding bone health in cancer care presented and discussed during this NCCN Bone Health in Cancer Care Task Force meeting.

  11. Inulin, oligofructose and bone health: experimental approaches and mechanisms.

    Science.gov (United States)

    Weaver, Connie M

    2005-04-01

    Inulin-type fructans have been proposed to benefit mineral retention, thereby enhancing bone health. Many, but not all, experimental animal studies have shown increased mineral absorption by feeding non-digestible oligosaccharides. Possible reasons for inconsistencies are explored. A few studies have reported an enhanced bone mineral density or content. Bone health can be evaluated in chronic feeding studies with bone densitometry, bone breaking strength, bone mineral concentration and bone structure. Isotopic Ca tracers can be used to determine the point of metabolism affected by feeding a functional food ingredient. These methods and the effects of feeding inulin-type fructose are reviewed. Inulin-type fructans enhance Mg retention. Chicory long-chain inulin and oligofructose enhance femoral Ca content, bone mineral density and Ca retention through enhanced Ca absorption and suppressed bone turnover rates, but it is not bone-promoting under all conditions.

  12. Tea and bone health: steps forward in translational nutrition12345

    OpenAIRE

    2013-01-01

    Osteoporosis is a major health problem in the aging population worldwide. Cross-sectional and retrospective evidence indicates that tea consumption may be a promising approach in mitigating bone loss and in reducing risk of osteoporotic fractures among older adults. Tea polyphenols enhance osteoblastogenesis and suppress osteoclastogenesis in vitro. Animal studies reveal that intake of tea polyphenols have pronounced positive effects on bone as shown by higher bone mass and trabecular bone vo...

  13. Progesterone and Bone: Actions Promoting Bone Health in Women

    Directory of Open Access Journals (Sweden)

    Vanadin Seifert-Klauss

    2010-01-01

    Full Text Available Estradiol (E2 and progesterone (P4 collaborate within bone remodelling on resorption (E2 and formation (P4. We integrate evidence that P4 may prevent and, with antiresorptives, treat women's osteoporosis. P4 stimulates osteoblast differentiation in vitro. Menarche (E2 and onset of ovulation (P4 both contribute to peak BMD. Meta-analysis of 5 studies confirms that regularly cycling premenopausal women lose bone mineral density (BMD related to subclinical ovulatory disturbances (SODs. Cyclic progestin prevents bone loss in healthy premenopausal women with amenorrhea or SOD. BMD loss is more rapid in perimenopause than postmenopause—decreased bone formation due to P4 deficiency contributes. In 4 placebo-controlled RCTs, BMD loss is not prevented by P4 in postmenopausal women with increased bone turnover. However, 5 studies of E2-MPA co-therapy show greater BMD increases versus E2 alone. P4 fracture data are lacking. P4 prevents bone loss in pre- and possibly perimenopausal women; progesterone co-therapy with antiresorptives may increase bone formation and BMD.

  14. [Bone and Men's Health. Bone selective androgen receptor modulators].

    Science.gov (United States)

    Furuya, Kazuyuki

    2010-02-01

    Androgen, one of the sex steroid hormones shows various biological activities on the corresponding various tissues. Many efforts to produce novel drug materials maintaining a desired biological activity with an adequate tissue selectivity, which is so-called selective androgen receptor modulators (SARMs) , are being performed. As one of such efforts, studies on SARMs against bone tissues which possess a significant potential to stimulate a bone formation with reducing undesirable androgenic virilizing activities are in progress all over the world. This review focuses on the research and development activities of such SARMs and discuses their usefulness for the treatment of osteoporosis.

  15. Nutrition in bone health revisited: a story beyond calcium.

    Science.gov (United States)

    Ilich, J Z; Kerstetter, J E

    2000-01-01

    Osteoporosis is a complex, multi-factorial condition characterized by reduced bone mass and impaired micro-architectural structure, leading to an increased susceptibility to fractures. Although most of the bone strength (including bone mass and quality) is genetically determined, many other factors (nutritional, environmental and life-style) also influence bone. Nutrition is important modifiable factor in the development and maintenance of bone mass and the prevention and treatment of osteoporosis. Approximately 80-90% of bone mineral content is comprised of calcium and phosphorus. Other dietary components, such as protein, magnesium, zinc, copper, iron, fluoride, vitamins D, A, C, and K are required for normal bone metabolism, while other ingested compounds not usually categorized as nutrients (e.g. caffeine, alcohol, phytoestrogens) may also impact bone health. Unraveling the interaction between different factors; nutritional, environmental, life style, and heredity help us to understand the complexity of the development of osteoporosis and subsequent fractures. This paper reviews the role of dietary components on bone health throughout different stages of life. Each nutrient is discussed separately, however the fact that many nutrients are co-dependent and simultaneously interact with genetic and environmental factors should not be neglected. The complexity of the interactions is probably the reason why there are controversial or inconsistent findings regarding the contribution of a single or a group of nutrients in bone health.

  16. A Review on the Relationship between Aspirin and Bone Health

    Directory of Open Access Journals (Sweden)

    Kok-Yong Chin

    2017-01-01

    Full Text Available Aspirin is a cyclooxygenase inhibitor commonly used in primary prevention of cardiovascular diseases and cancers. Its users are elderly population susceptible to osteoporosis. It also inhibits the synthesis of prostaglandin E2 essential in bone remodeling. This prompts the question whether it can influence bone health among users. This review aimed to summarize the current literature on the use of aspirin on bone health. A literature search on experimental and clinical evidence on the effects of aspirin on bone health was performed using major scientific databases. In vitro studies showed that aspirin could enhance the survival of bone marrow mesenchymal stem cells, the progenitors of osteoblasts, and stimulate the differentiation of preosteoblasts. Aspirin also inhibited the nuclear factor kappa-B (NFκB pathway and decreased the expression of receptor activator of NFκB ligand, thus suppressing the formation of osteoclast. Aspirin could prevent bone loss in animal models of osteoporosis. Despite a positive effect on bone mineral density, the limited human epidemiological studies revealed that aspirin could not reduce fracture risk. A study even suggested that the use of aspirin increased fracture risk. As a conclusion, aspirin may increase bone mineral density but its effect on fracture prevention is inconclusive. More data are needed to determine the effects of aspirin and bone health in human.

  17. Aging and Bone Health in Individuals with Developmental Disabilities

    OpenAIRE

    Joan Jasien; Caitlin M Daimon; Stuart Maudsley; Shapiro, Bruce K.; Bronwen Martin

    2012-01-01

    Low bone mass density (BMD), a classical age-related health issue and a known health concern for fair skinned, thin, postmenopausal Caucasian women, is found to be common among individuals with developmental/intellectual disabilities (D/IDs). It is the consensus that BMD is decreased in both men and women with D/ID. Maintaining good bone health is important for this population as fractures could potentially go undetected in nonverbal individuals, leading to increased morbidity and a further l...

  18. Vitamins and bone health: beyond calcium and vitamin D.

    Science.gov (United States)

    Ahmadieh, Hala; Arabi, Asma

    2011-10-01

    Osteoporosis is a major health disorder associated with an increased risk of fracture. Nutrition is among the modifiable factors that influence the risk of osteoporosis and fracture. Calcium and vitamin D play important roles in improving bone mineral density and reducing the risk of fracture. Other vitamins appear to play a role in bone health as well. In this review, the findings of studies that related the intake and/or the status of vitamins other than vitamin D to bone health in animals and humans are summarized. Studies of vitamin A showed inconsistent results. Excessive, as well as insufficient, levels of retinol intake may be associated with compromised bone health. Deficiencies in vitamin B, along with the consequent elevated homocysteine level, are associated with bone loss, decreased bone strength, and increased risk of fracture. Deficiencies in vitamins C, E, and K are also associated with compromised bone health; this effect may be modified by smoking, estrogen use or hormonal therapy after menopause, calcium intake, and vitamin D. These findings highlight the importance of adequate nutrition in preserving bone mass and reducing the risk of osteoporosis and fractures.

  19. Bone health in endurance athletes: runners, cyclists, and swimmers.

    Science.gov (United States)

    Scofield, Kirk L; Hecht, Suzanne

    2012-01-01

    Weight-bearing exercise has been recognized widely to be beneficial for long-term bone health. However inherent differences in bone-loading characteristics and energy expenditure during participation in endurance sports place many endurance athletes at a relative disadvantage with regard to bone health compared with other athletes. Adolescents and adults who participate in endurance sports, such as running, and non-weight-bearing sports, such as biking and swimming, often have lower bone mineral density (BMD) than athletes participating in ball and power sports, and sometimes their BMD is lower than their inactive peers. Low BMD increases the risk of stress and fragility fractures, both while an athlete is actively competing and later in life. This article reviews the variable effects of distance running, cycling, swimming, and triathlons on bone health; the evaluation of stress and fragility fractures; and the diagnosis, management, and prevention of low BMD in endurance athletes.

  20. EFFECTS OF BODY MASS INDEX (BMI), EATING ATTITUDE AND PHYSICAL ACTIVITY ON BONE HEALTH AMONG UNDERGRADUATE STUDENTS IN MALAYSIA

    OpenAIRE

    Omar Dev, Roxana; Henry, Ewiwe

    2017-01-01

    Healthy and strong bones form the basis for a dynamic and energetic life. However, Malaysian university students still lack of knowledge towards positive bone health status and osteoporosis prevention and show a poor practice of healthy lifestyle. Therefore, this study was done to examine the relationship of eating attitude and physical activity on bone health among undergraduate students from the Faculty of Educational Studies in Universiti Putra Malaysia. A correlational study design was co...

  1. Tea flavonoids for bone health: from animals to humans.

    Science.gov (United States)

    Shen, Chwan-Li; Chyu, Ming-Chien

    2016-10-01

    Osteoporosis is a skeletal disease characterized by a deterioration of bone mass and bone quality that predisposes an individual to a higher risk of fragility fractures. Emerging evidence has shown that the risk for low bone mass and osteoporosis-related fractures can be reduced by nutritional approaches aiming to improve bone microstructure, bone mineral density, and strength. Tea and its flavonoids, especially those of black tea and green tea, have been suggested to protect against bone loss and to reduce risk of fracture, due to tea's antioxidant and anti-inflammatory properties. Based on the results of animal studies, moderate intake of tea has shown to benefit bone health as shown by mitigation of bone loss and microstructural deterioration as well as improvement of bone strength and quality. Epidemiological studies have reported positive, insignificant, and negative impacts on bone mineral density at multiple skeletal sites and risk of fracture in humans with habitual tea consumption. There are limited human clinical trials that objectively and quantitatively assessed tea consumption and bone efficacy using validated outcome measures in a population at high risk for osteoporosis, along with safety monitoring approach. This review summarizes the current state of knowledge of laboratory animal research, epidemiological observational studies, and clinical trials assessing the skeletal effects of tea and its active flavonoids, along with discussion of relevant future directions in translational research.

  2. Sex Steroids and Bone Health Status in Men

    Directory of Open Access Journals (Sweden)

    Kok-Yong Chin

    2012-01-01

    Full Text Available Male osteoporosis is a health problem which deserves more attention as nearly 30% of osteoporotic fractures happen in men aged 50 years and above. Although men do not experience an accelerated bone loss phase and testosterone deficiency is not a universal characteristic for aged men, osteoporosis due to age-related testosterone deficiency does have a negative impact on bone health status of men. Observations from epidemiological studies indicate that elderly men with higher testosterone can preserve their BMD better and thus are less prone to fracture. Observations on men with estrogen resistance or aromatase deficiency indicate that estrogen is equally important in the maintenance of bone health status. This had been validated in several epidemiological studies which found that the relationships between estrogen and bone health indices are significant and sometimes stronger than testosterone. Studies on the relationship between quantitative ultrasound and bone remodeling markers suggest that testosterone and estrogen may have differential effects on bone, but further evidence was needed. In conclusion, both testosterone and estrogen are important in the maintenance of bone health in men.

  3. Bone Health in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Vit Zikan

    2011-01-01

    Full Text Available Multiple sclerosis (MS is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorption with depressed bone formation and a marked disruption of mechanosensory network of tightly connected osteocytes due to increase of osteocyte apoptosis. Patients with higher level of disability have also higher risk of falls that combined with a bone loss increases the frequency of bone fractures. There are currently no recommendations how to best prevent and treat osteoporosis in patients with MS. However, devastating effect of immobilization on the skeleton in patients with MS underscores the importance of adequate mechanical stimuli for maintaining the bone structure and its mechanical competence. The physical as well as pharmacological interventions which can counteract the bone remodeling imbalance, particularly osteocyte apoptosis, will be promising for prevention and treatment of osteoporosis in patients with MS.

  4. Bone health in children and adolescents with perinatal HIV infection

    Directory of Open Access Journals (Sweden)

    George K Siberry

    2013-06-01

    Full Text Available The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.

  5. Green tea and bone health: Evidence from laboratory studies.

    Science.gov (United States)

    Shen, Chwan-Li; Yeh, James K; Cao, Jay J; Chyu, Ming-Chien; Wang, Jia-Sheng

    2011-08-01

    Osteoporosis is a major health problem in the elderly. Epidemiological evidence has shown an association between tea consumption and the prevention of bone loss in the elderly population. Ingestion of green tea and green tea bioactive compounds may be beneficial in mitigating bone loss of this population and decreasing their risk of osteoporotic fractures. This review describes the effect of green tea with its bioactive components on bone health with an emphasis on the following: (i) the etiology of osteoporosis, (ii) evidence of osteo-protective impacts of green tea on bone mass and microarchitecture in various bone loss models in which induced by aging, sex hormone deficiency, and chronic inflammation, (iii) discussion of impacts of green tea on bone mass in two obesity models, (iv) observation of short-term green tea supplementation given to postmenopausal women with low bone mass, (v) possible mechanisms for the osteo-protective effects of green tea bioactive compounds, and (vi) a summary and future research direction of green tea and bone health.

  6. Bone Health for Life: Health Information Basics for You and Your Family

    Science.gov (United States)

    ... and Your Family Publication available in: Español Chinese Korean Vietnamese Related Resources What Is Bone? Bone Density ... Trials and You was designed to help people learn more about clinical trials, why they matter, and ...

  7. Curriculum Design in Health Education

    Science.gov (United States)

    Conceicao, Simone C. O.; Colby, Holly; Juhlmann, Anne; Johaningsmeir, Sarah

    2011-01-01

    While health care providers are knowledgeable of health conditions and of the information patients need to make appropriate health decisions and follow health providers' recommendations, they lack information about adult teaching and learning and appropriate curriculum design. Adult educators can contribute more sophisticated skills in program…

  8. Designated Health Professional Shortage Areas

    Data.gov (United States)

    U.S. Department of Health & Human Services — Health Professional Shortage Areas (HPSAs) Data Download makes data and information concerning Designated HPSAs readily available to our users in a one-stop...

  9. Aging and bone health in individuals with developmental disabilities.

    Science.gov (United States)

    Jasien, Joan; Daimon, Caitlin M; Maudsley, Stuart; Shapiro, Bruce K; Martin, Bronwen

    2012-01-01

    Low bone mass density (BMD), a classical age-related health issue and a known health concern for fair skinned, thin, postmenopausal Caucasian women, is found to be common among individuals with developmental/intellectual disabilities (D/IDs). It is the consensus that BMD is decreased in both men and women with D/ID. Maintaining good bone health is important for this population as fractures could potentially go undetected in nonverbal individuals, leading to increased morbidity and a further loss of independence. This paper provides a comprehensive overview of bone health of adults with D/ID, their risk of fractures, and how this compares to the general aging population. We will specifically focus on the bone health of two common developmental disabilities, Down syndrome (DS) and cerebral palsy (CP), and will discuss BMD and fracture rates in these complex populations. Gaining a greater understanding of how bone health is affected in individuals with D/ID could lead to better customized treatments for these specific populations.

  10. Aging and Bone Health in Individuals with Developmental Disabilities

    Directory of Open Access Journals (Sweden)

    Joan Jasien

    2012-01-01

    Full Text Available Low bone mass density (BMD, a classical age-related health issue and a known health concern for fair skinned, thin, postmenopausal Caucasian women, is found to be common among individuals with developmental/intellectual disabilities (D/IDs. It is the consensus that BMD is decreased in both men and women with D/ID. Maintaining good bone health is important for this population as fractures could potentially go undetected in nonverbal individuals, leading to increased morbidity and a further loss of independence. This paper provides a comprehensive overview of bone health of adults with D/ID, their risk of fractures, and how this compares to the general aging population. We will specifically focus on the bone health of two common developmental disabilities, Down syndrome (DS and cerebral palsy (CP, and will discuss BMD and fracture rates in these complex populations. Gaining a greater understanding of how bone health is affected in individuals with D/ID could lead to better customized treatments for these specific populations.

  11. Wine and bone health: a review.

    Science.gov (United States)

    Kutleša, Zvonimir; Budimir Mršić, Danijela

    2016-01-01

    A light-to-moderate wine consumption has been shown to provide several beneficial effects on the skeletal system, including reduced risk of bone mass loss and fractures. Wine is rich in phenolic compounds, strong phytoestrogens and natural antioxidants, to which bone protection is mainly attributed. The objective of this review was to give an overview of the exact mechanisms by which wine consumption is involved in bone protection. We found a great variety of in vitro research on the beneficial effects of isolated wine phenolics on the skeletal system, with a significant lack of evidence of their in vivo effects. In addition, we found almost no studies investigating how wine, a mixture of these phenolics dissolved in ethanol, affects the skeletal system. Our results warrant further research on this interesting topic.

  12. Role of obesity , alcohol and smoking on bone health.

    Science.gov (United States)

    Fini, Milena; Salamanna, Francesca; Veronesi, Francesca; Torricelli, Paola; Nicolini, Andrea; Benedicenti, Stefano; Carpi, Angelo; Giavaresi, Gianluca

    2012-06-01

    The burden of osteoporosis is increasing in all societies. In comparison with other organs or apparatuses fewer studies have focused on incorrect lifestyles and bone. This article reviews clinical and experimental studies on the effects of obesity, alcohol abuse and smoking on bone. Overweight and obesity protect bone, thus reducing the fracture risk and the development of osteoporosis in older adults. However, extreme obesity (body mass index more than 40 kilogram/meter squared) seems to be a risk factor for osteoporosis. Moderate alcohol consumption may have a protective effect, whereas excessive consumption is an important risk factor. Cytokines are the main mediators of the detrimental effects of obesity and alcohol. Smoking contributes to bone loss and fracture probably by interfering with estrogens, calcium and vitamin D. Health information campaigns against these harmful lifestyles should be strengthened by using available scientific information to increase awareness about their consequences on the bone.

  13. Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

    Science.gov (United States)

    Lovald, Scott T; Khraishi, Tariq; Wagner, Jon; Baack, Bret

    2009-03-01

    Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

  14. Lean mass appears to be more strongly associated with bone health than fat mass in urban black South African women

    NARCIS (Netherlands)

    Sotunde, O.F.; Kruger, H.S.; Wright, H.H.; Havemann-Nel, L.; Kruger, Ina; Wentzel-Viljoen, E.; Kruger, A.; Tieland, M.

    2015-01-01

    Objectives: To examine the association between body composition (fat mass, lean mass and body mass index, BMI) and bone health (bone mineral density, BMD and fracture risk) in urban black South African women. Design: A cross sectional study examining associations between body composition, dietary

  15. [THE IMPORTANCE OF "MILK BONES" TO "WISDOM BONES" - COW MILK AND BONE HEALTH - LESSONS FROM MILK ALLERGY PATIENTS].

    Science.gov (United States)

    Nachshon, Liat; Katz, Yitzhak

    2016-03-01

    The necessity of milk consumption in the western diet is a subject of intense controversy. One of the main benefits of milk is that it is the main source of dietary calcium. Calcium is a major bone mineral, mandatory for bone health. Its supply is derived exclusively from external dietary sources. During the growth period, an increased calcium supply is needed for the process of bone mass accumulation. An optimal bone mass achieved by the end of the growth period may be protective later in life against the bone mass loss that commonly occurs. This in turn, can be preventative against the occurrence of osteoporosis and the development of spontaneous bone fractures. Over the past several decades, an increased incidence of osteoporosis has been documented in western countries, leading to high rates of morbidity and mortality in the middle-aged and geriatric population. Many studies have investigated the dietary calcium requirements for different ages, to achieve and maintain proper bone health. Based on their results, guidelines concerning calcium intake in every stage of life have been published by national and international organizations. In the western diet, it is difficult to achieve the recommended calcium intake without milk consumption. Moreover, calcium bioavailability for intestinal absorption is high. Several studies have recently raised doubts concerning the amounts of calcium intake in the western diet and its effectiveness in preventing osteoporosis. The main disadvantage of these studies is their being based on the patient's past memory recall of milk consumption. Patients with IgE-mediated cow's milk protein allergy are a unique population. Their lifetime negligible milk consumption is undisputed. A recent study investigated for the first time, the bone density of young adults with milk allergy at the end of their growth period. Their severe reduction in bone mineral density and dietary calcium intake defines them as a high risk group for the

  16. [Nutrition and bone health: What ist the evidence?].

    Science.gov (United States)

    Ströhle, Alexander; Hahn, Andreas

    2016-06-01

    Nutrients are of particular importance for bone health: they act as structural elements of bones, modulate the activity of osteoblasts and osteoclasts, and influence bone remodeling through various mediators. A bone protective diet can be characterised as a diet rich in fruits and vegetables, dairy products, seeds and nuts, whole grain and soy products and moderate amounts of fish, eggs and lean meat. This diet provides sufficient amounts of protein, calcium, magnesium and vitamins (e. g. K, C, folic acid, B6 and B12), which are important for bone development. For specific nutrients, the following bone-protective recommendations can be given: 1.0-1.3 g protein/kg body weight and day; 1000-1200 mg/day calcium, preferably as part of the normal diet. In case of insufficient calcium intake or on antiresorptive medication a supplementation of 200-500 mg or 500-1000 mg calcium/day, respectively, should be given. Furthermore, for prevention of bone fractures a cut off level of ≥ 75 nmol calcidiol/l is suggested.

  17. Bone health, vitamin D and lupus.

    Science.gov (United States)

    Sangüesa Gómez, Clara; Flores Robles, Bryan Josué; Andréu, José Luis

    2015-01-01

    The prevalence of vitamin D deficiency and insufficiency among patients with systemic lupus erythematosus is high. This is likely due to photoprotection measures in addition to intrinsic factors of the disease. Low levels of vitamin D increase the risk of low bone mineral density and fracture. Vitamin D deficiency could also have undesirable effects on patients' immune response, enhancing mechanisms of loss of tolerance and autoimmunity. Vitamin D levels should be periodically monitored and patients should be treated with the objective of reaching vitamin D levels higher than 30-40 ng/ml.

  18. Primary Hyperparathyroidism: Effects on Bone Health.

    Science.gov (United States)

    Zanocco, Kyle A; Yeh, Michael W

    2017-03-01

    Primary hyperparathyroidism (PHPT) is the most common cause of chronic hypercalcemia. With the advent of routine calcium screening, the classic presentation of renal and osseous symptoms has been largely replaced with mild, asymptomatic disease. In hypercalcemia caused by PHPT, serum parathyroid hormone levels are either high, or inappropriately normal. A single-gland adenoma is responsible for 80% of PHPT cases. Less frequent causes include 4-gland hyperplasia and parathyroid carcinoma. Diminished bone mineral density and nephrolithiasis are the major current clinical sequelae. Parathyroidectomy is the only definitive treatment for PHPT, and in experienced hands, cure rates approach 98%.

  19. Dietary protein: an essential nutrient for bone health.

    Science.gov (United States)

    Bonjour, Jean-Philippe

    2005-12-01

    Nutrition plays a major role in the development and maintenance of bone structures resistant to usual mechanical loadings. In addition to calcium in the presence of an adequate vitamin D supply, proteins represent a key nutrient for bone health, and thereby in the prevention of osteoporosis. In sharp opposition to experimental and clinical evidence, it has been alleged that proteins, particularly those from animal sources, might be deleterious for bone health by inducing chronic metabolic acidosis which in turn would be responsible for increased calciuria and accelerated mineral dissolution. This claim is based on an hypothesis that artificially assembles various notions, including in vitro observations on the physical-chemical property of apatite crystal, short term human studies on the calciuric response to increased protein intakes, as well as retrospective inter-ethnic comparisons on the prevalence of hip fractures. The main purpose of this review is to analyze the evidence that refutes a relation of causality between the elements of this putative patho-physiological "cascade" that purports that animal proteins are causally associated with an increased incidence of osteoporotic fractures. In contrast, many experimental and clinical published data concur to indicate that low protein intake negatively affects bone health. Thus, selective deficiency in dietary proteins causes marked deterioration in bone mass, micro architecture and strength, the hallmark of osteoporosis. In the elderly, low protein intakes are often observed in patients with hip fracture. In these patients intervention study after orthopedic management demonstrates that protein supplementation as given in the form of casein, attenuates post-fracture bone loss, increases muscles strength, reduces medical complications and hospital stay. In agreement with both experimental and clinical intervention studies, large prospective epidemiologic observations indicate that relatively high protein intakes

  20. Participatory Design & Health Information Technology

    DEFF Research Database (Denmark)

    Health Information Technology (HIT) continues to increase in importance as a component of healthcare provision, but designing HIT is complex. The creation of cooperative learning processes for future HIT users is not a simple task. The importance of engaging end users such as health professionals......, in collaboration with a wide range of people, a broad repertoire of methods and techniques to apply PD within multiple domains has been established. This book, Participatory Design & Health Information Technology, presents the contributions of researchers from 5 countries, who share their experience and insights......, patients and relatives in the design process is widely acknowledged, and Participatory Design (PD) is the primary discipline for directly involving people in the technological design process. Exploring the application of PD in HIT is crucial to all those involved in engaging end users in HIT design and...

  1. Vitamin A and bone health: the balancing act.

    Science.gov (United States)

    Tanumihardjo, Sherry A

    2013-01-01

    The role of vitamin A status as it relates to bone health is historical yet controversial. Population-based studies have linked high dietary intake of preformed vitamin A, which is obtained from animal-source foods, fortified foods, and some supplements, to greater risk of osteoporosis and hip fracture. In contrast, carotenoids, some of which are vitamin A precursors from plants, are associated with improved bone health. Carotenoids may be a biomarker that reflects a generally healthy lifestyle, which includes fruit and vegetable consumption. Current dietary recommendations to increase fruit and vegetable intake in the Dietary Guidelines for Americans will result in greater intakes of provitamin A carotenoids if consumers comply. This could lead to artificially high intakes of vitamin A in dietary analyses. However, multiple factors affect the bioconversion of provitamin A carotenoids to the active form of vitamin A. The human body will strive to maintain vitamin A balance by down-regulating provitamin A carotenoid bioconversion. If high preformed vitamin A intake is associated with poor bone health and provitamin A carotenoids are protective, future studies are needed to clarify the associations between total body stores of vitamin A, dietary intake of the pre- and pro-forms, and bone health throughout the life cycle.

  2. Effects of tai chi exercise on bone health in perimenopausal and postmenopausal women: a systematic review and meta-analysis.

    Science.gov (United States)

    Sun, Z; Chen, H; Berger, M R; Zhang, L; Guo, H; Huang, Y

    2016-10-01

    Tai chi exercise may have positive effects on bone health in perimenopausal and postmenopausal women. This systematic review is the first to summarize evidence to clarify the efficacy of tai chi exercise in bone health. The benefits of tai chi exercise on bone health remain unclear; further studies are needed. Emerging randomized controlled trials (RCTs) exploring the efficacy of tai chi exercise on bone health among older women, but yielded inconclusive results. Our objective is to conduct a systematic review to evaluate evidence from RCTs to clarify the efficacy of tai chi exercise on bone mineral density (BMD), and bone turnover markers (BTM) in perimenopausal and postmenopausal women. Six electronic databases were searched, and reference lists of systematic reviews and identified studies from the search strategy were also screened. We included all RCTs that investigate tai chi exercise for bone health in perimenopausal and postmenopausal women. Data selection, extraction, and evaluation of risk of bias were performed independently by two reviewers. Ten trials detailed in 11 articles were included. Six of the 11 studies reported positive outcomes on bone health. Results of our meta-analysis showed a significant effect of tai chi exercise on BMD change at the spine compared with no treatment in perimenopausal and postmenopausal women. When tai chi exercise combined with a calcium supplement was compared with the calcium supplement alone, the result of BMD change at the spine showed no significant effect. Because the measurable effect observed was minimal, and due to the low quality of methodology of the studies, we conclude that the result is of limited reliability. Tai chi exercise may have benefits on bone health in perimenopausal and postmenopausal women, but the evidence is sometimes weak, poor, and inconsistent. Consequently, only limited conclusions can be drawn regarding the efficacy of tai chi exercise on bone health. Further well designed studies with

  3. Regulation of placental calcium transport and offspring bone health

    Directory of Open Access Journals (Sweden)

    Laura eGoodfellow

    2011-02-01

    Full Text Available Osteoporosis causes considerable morbidity and mortality in later life, and the risk of the disease is strongly determined by peak bone mass, which is achieved in early adulthood. Poor intrauterine and early childhood growth are associated with reduced peak bone mass, and increased risk of osteoporotic fracture in older age. In this review we describe the regulatory aspects of intrauterine bone development, and then summarise the evidence relating early growth to later fracture risk. Physiological systems include vitamin D, PTH; leptin; GH/ IGF-1; finally the potential role of epigenetic processes in the underlying mechanisms will be explored. Thus factors such as maternal lifestyle, diet, body build, physical activity and vitamin D status in pregnancy all appear to influence offspring bone mineral accrual. These data demonstrate a likely interaction between environmental factors and gene expression, a phenomenon ubiquitous in the natural world (developmental plasticity, as the potential key process. Intervention studies are now required to test the hypotheses generated by these epidemiological and physiological findings, to inform potential novel public health interventions aimed at improving childhood bone health and reducing the burden of osteoporotic fracture in future generations.

  4. Food fortification for bone health in adulthood: a scoping review

    Science.gov (United States)

    Whiting, S J; Kohrt, W M; Warren, M P; Kraenzlin, M I; Bonjour, J-P

    2016-01-01

    Food fortification can deliver essential micronutrients to large population segments without modifications in consumption pattern, suggesting that fortified foods may be formulated for populations at risk for fragility fractures. This scoping review determined the extent to which randomized controlled studies have been carried out to test the impact of fortified foods on bone outcomes, searching PubMed for all studies using the terms ‘fortified AND bone', and ‘fortification AND bone'. Studies were restricted to English language, published between 1996 and June 2015. From 360 articles, 24 studies met the following criteria: human study in adults ⩾18 years (excluding pregnancy or lactation); original study of a fortified food over time, with specific bone outcomes measured pre- and post intervention. Six studies involved adults <50 years; 18 involved adults ⩾50 years. Singly or in combination, 17 studies included calcium and 16 included vitamin D. There were 1 or 2 studies involving either vitamin K, magnesium, iron, zinc, B-vitamins, inulin or isoflavones. For adults <50 years, the four studies involving calcium or vitamin D showed a beneficial effect on bone remodeling. For adults ⩾50 years, n=14 provided calcium and/or vitamin D, and there was a significant bone turnover reduction. No consistent effects were reported in studies in which addition of vitamin K, folic acid or isoflavone was assessed. Results from this scoping review indicate that up to now most studies of fortification with bone health have evaluated calcium and/or vitamin D and that these nutrients show beneficial effects on bone remodeling. PMID:27026430

  5. Factors that characterize bone health with aging in healthy postmenopausal women.

    Science.gov (United States)

    Ikegami, Shota; Uchiyama, Shigeharu; Nakamura, Yukio; Mukaiyama, Keijiro; Hirabayashi, Hiroki; Kamimura, Mikio; Nonaka, Kiichi; Kato, Hiroyuki

    2015-07-01

    The exponential increase in the incidence of fragility fractures in older people is attributed to attenuation of both bone strength and neuromuscular function. Decrease in bone mineral density (BMD) does not entirely explain this increase. The objective of this study is to investigate the effect of age on various parameters related to bone health with aging, and to identify combinations of factors that collectively express the bone metabolic state in healthy postmenopausal women. Height, weight, and grip strength were measured in 135 healthy postmenopausal volunteer women. Hip BMD, biomechanical indices derived from quantitative computed tomography (QCT), cross-sectional areas of muscle and fat of the proximal thigh, and various biochemical markers of bone metabolism were measured. A smaller group of factors explanatory for bone health was identified using factor analysis and each was newly named. As a result, the factors bone mass, bone turnover, bone structure, and muscle strength had the greatest explanatory power for assessing the bone health of healthy postmenopausal women. Whereas dual X-ray absorptiometry parameters only loaded on the factor bone mass, QCT parameters loaded on both the factors bone mass and bone structure. Most bone turnover markers loaded on the factor bone turnover, but deoxypyridinoline loaded on both bone turnover and muscle strength. Age was negatively correlated with bone mass (r = -0.49, p aging is associated as much with muscle weakening as with low BMD. More attention should be paid to the effects of muscle weakening during aging in assessments of bone health.

  6. Bike racing, recreational riding, impact sport and bone health

    Directory of Open Access Journals (Sweden)

    Carmont Michael R

    2012-12-01

    Full Text Available Abstract Cycling has been shown to confer considerable benefits in terms of health, leading to reductions in death rates principally due to cardiovascular improvements and adaptation. Given the disparity between the benefits of cycling on cardiovascular fitness and previous research finding that cycling may not be beneficial for bone health, Hugo Olmedillas and colleagues performed a systematic review of the literature. They concluded that road cycling does not appear to confer any significant osteogenic benefit. They postulate that the cause of this is that, particularly at a competitive level, riders spend long periods of time in a weight-supported position on the bike. Training programs may be supplemented with impact loading to preserve bone health; however, the small increased risk of soft tissue injury must also be considered. See related commentary http://www.biomedcentral.com/1741-7015/10/168

  7. Postgraduate Symposium: Positive influence of nutritional alkalinity on bone health.

    Science.gov (United States)

    Wynn, E; Krieg, M A; Lanham-New, S A; Burckhardt, P

    2010-02-01

    There is growing evidence that consumption of a Western diet is a risk factor for osteoporosis through excess acid supply, while fruits and vegetables balance the excess acidity, mostly by providing K-rich bicarbonate-rich foods. Western diets consumed by adults generate approximately 50-100 mEq acid/d; therefore, healthy adults consuming such a diet are at risk of chronic low-grade metabolic acidosis, which worsens with age as a result of declining kidney function. Bone buffers the excess acid by delivering cations and it is considered that with time an overstimulation of this process will lead to the dissolution of the bone mineral content and hence to reduced bone mass. Intakes of K, Mg and fruit and vegetables have been associated with a higher alkaline status and a subsequent beneficial effect on bone health. In healthy male volunteers an acid-forming diet increases urinary Ca excretion by 74% and urinary C-terminal telopeptide of type I collagen (C-telopeptide) excretion by 19% when compared with an alkali (base-forming) diet. Cross-sectional studies have shown that there is a correlation between the nutritional acid load and bone health measured by bone ultrasound or dual-energy X-ray absorptiometry. Few studies have been undertaken in very elderly women (>75 years), whose osteoporosis risk is very pertinent. The EVAluation of Nutrients Intakes and Bone Ultra Sound Study has developed and validated (n 51) an FFQ for use in a very elderly Swiss population (mean age 80.4 (sd 2.99) years), which has shown intakes of key nutrients (energy, fat, carbohydrate, Ca, Mg, vitamin C, D and E) to be low in 401 subjects. A subsequent study to assess net endogenous acid production (NEAP) and bone ultrasound results in 256 women aged > or = 75 years has shown that lower NEAP (P=0.023) and higher K intake (P=0.033) are correlated with higher bone ultrasound results. High acid load may be an important additional risk factor that may be particularly relevant in very elderly

  8. Changes in total body bone mineral density following a common bone health plan with two versions of a unique bone health supplement: a comparative effectiveness research study

    Directory of Open Access Journals (Sweden)

    Dapilmoto Monika

    2011-04-01

    Full Text Available Abstract Background The US Surgeon General's Report on Bone Health suggests America's bone-health is in jeopardy and issued a "call to action" to develop bone-health plans that: (1 improve nutrition, (2 increase health literacy and, (3 increase physical activity. This study is a response to this call to action. Methods After signing an informed consent, 158 adults agreed to follow an open-label bone-health plan for six months after taking a DXA test of bone density, a 43-chemistry blood test panel and a quality of life inventory (AlgaeCal 1. Two weeks after the last subject completed, a second group of 58 was enrolled and followed the identical plan, but with a different bone-health supplement (AlgaeCal 2. Results There were no significant differences between the two groups in baseline bone mineral density (BMD or in variables related to BMD (age, sex, weight, percent body fat, fat mass, or fat-free mass. In both groups, no significant differences in BMD or related variables were found between volunteers and non-volunteers or between those who completed per protocol and those who were lost to attrition. Both groups experienced a significant positive mean annualized percent change (MAPC in BMD compared to expectation [AlgaeCal 1: 1.15%, p = 0.001; AlgaeCal 2: 2.79%, p = 0.001]. Both groups experienced a positive MAPC compared to baseline, but only AlgaeCal 2 experienced a significant change [AlgaeCal 1: 0.48%, p = 0.14; AlgaeCal 2: 2.18%, p p = 0.005. The MAPC contrast between compliant and partially compliant subjects was significant for both plans (p = 0.001 and p = 0.003 respectively. No clinically significant changes in a 43-panel blood chemistry test were found nor were there any changes in self-reported quality of life in either group. Conclusions Following The Plan for six months with either version of the bone health supplement was associated with significant increases in BMD as compared to expected and, in AlgaeCal 2, the increase from

  9. The impact of methods for estimating bone health and the global burden of bone disease.

    Science.gov (United States)

    Cole, Zoë A; Dennison, Elaine M; Cooper, Cyrus

    2009-01-01

    Osteoporosis constitutes a major public health problem through its association with age related fractures. Fracture rates are generally higher in caucasian women than in other populations. Important determinants include estrogen deficiency in women, low body mass index, cigarette smoking, alcohol consumption, poor dietary calcium intake, physical inactivity, certain drugs and illnesses. Thus, modification of physical activity and dietary calcium/vitamin D nutrition should complement high risk approaches. In addition, the recently developed WHO algorithm for evaluation of 10-year absolute risk of fracture provides a means whereby various therapies can be targeted cost-effectively to those at risk. Risk factors, together with bone mineral density (BMD) and biochemical indices of bone turnover, can be utilised to derive absolute risks of fracture and cost-utility thresholds at which treatment is justified. These data will provide the basis for translation into coherent public health strategies aiming to prevent osteoporosis both in individuals and in the general population.

  10. Experimental design of natural and accellerated bone and wood ageing

    DEFF Research Database (Denmark)

    Facorellis, Y.; Pournou, A.; Richter, Jane;

    2015-01-01

    This paper presents the experimental design for natural and accelerated ageing of bone and wood samples found in museum conditions that was conceived as part of the INVENVORG (Thales Research Funding Program – NRSF) investigating the effects of the environmental factors on natural organic materials....

  11. Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study

    Science.gov (United States)

    Reavley, Nicola; Garland, Suzanne M.; Gorelik, Alexandra; Wark, John D.

    2015-01-01

    Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public health Vitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared

  12. Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population.

    Science.gov (United States)

    Calvo, Mona S; Uribarri, Jaime

    2013-07-01

    This review explores the potential adverse impact of the increasing phosphorus content in the American diet on renal, cardiovascular, and bone health of the general population. Increasingly, studies show that phosphorus intakes in excess of the nutrient needs of a healthy population may significantly disrupt the hormonal regulation of phosphate, calcium, and vitamin D, which contributes to disordered mineral metabolism, vascular calcification, impaired kidney function, and bone loss. Moreover, large epidemiologic studies suggest that mild elevations of serum phosphate within the normal range are associated with cardiovascular disease (CVD) risk in healthy populations without evidence of kidney disease. However, few studies linked high dietary phosphorus intake to mild changes in serum phosphate because of the nature of the study design and inaccuracies in the nutrient composition databases. Although phosphorus is an essential nutrient, in excess it could be linked to tissue damage by a variety of mechanisms involved in the endocrine regulation of extracellular phosphate, specifically the secretion and action of fibroblast growth factor 23 and parathyroid hormone. Disordered regulation of these hormones by high dietary phosphorus may be key factors contributing to renal failure, CVD, and osteoporosis. Although systematically underestimated in national surveys, phosphorus intake seemingly continues to increase as a result of the growing consumption of highly processed foods, especially restaurant meals, fast foods, and convenience foods. The increased cumulative use of ingredients containing phosphorus in food processing merits further study given what is now being shown about the potential toxicity of phosphorus intake when it exceeds nutrient needs.

  13. Bone health history in breast cancer patients on aromatase inhibitors.

    Directory of Open Access Journals (Sweden)

    Marilyn L Kwan

    Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

  14. A Mouse Model for Studying Nutritional Programming: Effects of Early Life Exposure to Soy Isoflavones on Bone and Reproductive Health

    Science.gov (United States)

    Ward, Wendy E.; Kaludjerovic, Jovana; Dinsdale, Elsa C.

    2016-01-01

    Over the past decade, our research group has characterized and used a mouse model to demonstrate that “nutritional programming” of bone development occurs when mice receive soy isoflavones (ISO) during the first days of life. Nutritional programming of bone development can be defined as the ability for diet during early life to set a trajectory for better or compromised bone health at adulthood. We have shown that CD-1 mice exposed to soy ISO during early neonatal life have higher bone mineral density (BMD) and greater trabecular inter-connectivity in long bones and lumbar spine at young adulthood. These skeletal sites also withstand greater forces before fracture. Because the chemical structure of ISO resembles that of 17-β-estradiol and can bind to estrogen receptors in reproductive tissues, it was prudent to expand analyses to include measures of reproductive health. This review highlights aspects of our studies in CD-1 mice to understand the early life programming effects of soy ISO on bone and reproductive health. Preclinical mouse models can provide useful data to help develop and guide the design of studies in human cohorts, which may, depending on findings and considerations of safety, lead to dietary interventions that optimize bone health. PMID:27187422

  15. A Mouse Model for Studying Nutritional Programming: Effects of Early Life Exposure to Soy Isoflavones on Bone and Reproductive Health.

    Science.gov (United States)

    Ward, Wendy E; Kaludjerovic, Jovana; Dinsdale, Elsa C

    2016-05-11

    Over the past decade, our research group has characterized and used a mouse model to demonstrate that "nutritional programming" of bone development occurs when mice receive soy isoflavones (ISO) during the first days of life. Nutritional programming of bone development can be defined as the ability for diet during early life to set a trajectory for better or compromised bone health at adulthood. We have shown that CD-1 mice exposed to soy ISO during early neonatal life have higher bone mineral density (BMD) and greater trabecular inter-connectivity in long bones and lumbar spine at young adulthood. These skeletal sites also withstand greater forces before fracture. Because the chemical structure of ISO resembles that of 17-β-estradiol and can bind to estrogen receptors in reproductive tissues, it was prudent to expand analyses to include measures of reproductive health. This review highlights aspects of our studies in CD-1 mice to understand the early life programming effects of soy ISO on bone and reproductive health. Preclinical mouse models can provide useful data to help develop and guide the design of studies in human cohorts, which may, depending on findings and considerations of safety, lead to dietary interventions that optimize bone health.

  16. The Science and Practice of Bone Health in Oncology: Managing Bone Loss and Metastasis in Patients With Solid Tumors

    Science.gov (United States)

    Lipton, Allan; Uzzo, Robert; Amato, Robert J.; Ellis, Georgiana K.; Hakimian, Behrooz; Roodman, G. David; Smith, Matthew R.

    2011-01-01

    Cancer and its treatment can compromise bone health, leading to fracture, pain, loss of mobility, and hypercalcemia of malignancy. Bone metastasis occurs frequently in advanced prostate and breast cancers, and bony manifestations are commonplace in multiple myeloma. Osteoporosis and osteopenia may be consequences of androgen-deprivation therapy for prostate cancer, aromatase inhibition for breast cancer, or chemotherapy-induced ovarian failure. Osteoporotic bone loss and bone metastasis ultimately share a pathophysiologic pathway that stimulates bone resorption by increasing the formation and activity of osteoclasts. Important mediators of pathologic bone metabolism include substances produced by osteoblasts, such as RANKL, the receptor activator of nuclear factor kappa B ligand, which spurs osteoclast differentiation from myeloid cells. Available therapies are targeted to various steps in cascade of bone metastasis. PMID:19878635

  17. Dietary phosphorus in bone health and quality of life.

    Science.gov (United States)

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2012-06-01

    Awareness of phosphorus intake is important because both phosphorus deficiency and overloading impair bone health and quality of life. Phosphorus consumption is increasing in many countries. Most dietary phosphorus is contained in protein-rich foods such as meat, milk, cheese, poultry, fish, and processed foods that contain phosphate-based additives to improve their consistency and appearance. Elevation of extracellular phosphorus levels causes endothelial dysfunction and medial calcification, which are closely associated with the development of cardiovascular disease (CVD). Long-term excessive phosphorus loading, even if it does not cause hyperphosphatemia, can be a risk factor for CVD. In epidemiological studies, higher levels of phosphorus intake have been associated with reduced blood pressure. Interestingly, when examined further, phosphorus from dairy products, but not from other sources, was usually associated with lower blood pressure. A dietary approach to phosphorus reduction is particularly important to prevent bone impairment and CVD in patients with chronic kidney disease. In order to improve bone health and quality of life in the general population, the impact of phosphorous, including in processed foods, should be considered, and measures to indicate the amount of phosphorous in food products should be implemented.

  18. Bone Health and Osteoporosis: A Guide for Asian Women Aged 50 and Older

    Science.gov (United States)

    ... your browser. Home Osteoporosis Women Bone Health and Osteoporosis: A Guide for Asian Women Aged 50 and ... and anticonvulsants history of anorexia nervosa. What Is Osteoporosis? Osteoporosis is a disease that makes bones fragile ...

  19. Closing the gap: bone health education in orthopaedic practice.

    Science.gov (United States)

    Rouhe, Mellissa

    2008-01-01

    Bone health education in an orthopaedic office and hospital setting is uncommon, yet essential. Many benefits are possible for patients by preventing future fractures and improving quality of life in those afflicted with osteoporosis and osteopenia. Ninety percent of hip fractures are due to osteoporosis; only stroke occupies more hospital bed days than hip fracture each year. Clinical time constraints, physician unawareness, cost-effectiveness, and patient noncompliance include some of the obstacles to education. Orthopaedic nurses can be a vital part of the challenging solution to removing barriers and bridging the educational gap for physicians and patients.

  20. Designing digital health information in a health literacy context

    NARCIS (Netherlands)

    Meppelink, C.S.

    2016-01-01

    Digital health information is widely available, but not everyone fully benefits due to limited health literacy. Until now, little was known about how health literacy influences information processing and how design features of digital health information can be used to create optimal health messages

  1. Evolutionary design of bone scaffolds with reference to material selection.

    Science.gov (United States)

    Heljak, M K; Swięszkowski, W; Lam, C X F; Hutmacher, D W; Kurzydłowski, K J

    2012-01-01

    The favourable scaffold for bone tissue engineering should have desired characteristic features, such as adequate mechanical strength and three-dimensional open porosity, which guarantee a suitable environment for tissue regeneration. In fact, the design of such complex structures like bone scaffolds is a challenge for investigators. One of the aims is to achieve the best possible mechanical strength-degradation rate ratio. In this paper we attempt to use numerical modelling to evaluate material properties for designing bone tissue engineering scaffold fabricated via the fused deposition modelling technique. For our studies the standard genetic algorithm was used, which is an efficient method of discrete optimization. For the fused deposition modelling scaffold, each individual strut is scrutinized for its role in the architecture and structural support it provides for the scaffold, and its contribution to the overall scaffold was studied. The goal of the study was to create a numerical tool that could help to acquire the desired behaviour of tissue engineered scaffolds and our results showed that this could be achieved efficiently by using different materials for individual struts. To represent a great number of ways in which scaffold mechanical function loss could proceed, the exemplary set of different desirable scaffold stiffness loss function was chosen.

  2. Bone mineral density and body composition of children and adolescents in health and disease

    NARCIS (Netherlands)

    A.M. Boot (Annemieke)

    1997-01-01

    textabstractOsteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Osteoporosis is a major public health problem involving postmenopausal women and aging individuals. The life

  3. Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study

    Directory of Open Access Journals (Sweden)

    Emma T. Callegari

    2015-11-01

    Full Text Available Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study. Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.

  4. How I do it: managing bone health in patients with prostate cancer.

    Science.gov (United States)

    Barkin, Jack

    2014-08-01

    Urologists have two scenarios where they have to address bone loss or increased risk of fractures in men with prostate cancer. In the first setting, a patient who has been started on androgen deprivation therapy may develop cancer-treatment-induced bone loss. In the second setting, a patient's prostate cancer may have metastasized to the bone. This article describes six steps to manage bone health in patients diagnosed with prostate cancer in a community practice.

  5. Bone health in adults treated with endocrine therapy for early breast or prostate cancer.

    Science.gov (United States)

    Van Poznak, Catherine H

    2015-01-01

    Bone is a hormonally responsive organ. Sex hormones and calcium regulating hormones, including parathyroid hormone, 1-25 dihydroxy vitamin D, and calcitonin, have effects on bone resorption and bone deposition. These hormones affect both bone quality and bone quantity. The sex hormone estrogen inhibits bone resorption, and estrogen therapy has been developed to prevent and treat osteoporosis. Androgens are an important source of estrogen through the action of the enzyme aromatase and may themselves stimulate bone formation. Hence, the sex steroids play a role in bone metabolism. Breast cancer and prostate cancer are frequently hormonally responsive and may be treated with antiestrogens or antiandrogens respectfully. In addition, chemotherapy and supportive medications may alter the patient's endocrine system. In general, the suppression of sex hormones has a predictable affect on bone health, as seen by loss of bone mineral density and increased risk of fragility fractures. The bone toxicity of cancer-directed endocrine therapy can be mitigated through screening, counseling on optimization of calcium and vitamin D intake, exercise, and other lifestyle/behavioral actions, as well as the use of medications when the fracture risk is high. Maintaining bone health in patients who are treated with endocrine therapy for breast and prostate cancer is the focus of this review.

  6. A Comparative Effectiveness Study of Bone Density Changes in Women Over 40 Following Three Bone Health Plans Containing Variations of the Same Novel Plant-sourced Calcium

    Directory of Open Access Journals (Sweden)

    Gilbert R. Kaats, Harry G. Preuss, Harry A. Croft, Samuel C. Keith, Patti L. Keith

    2011-01-01

    Full Text Available Background: The US Surgeon General's Report on Bone Health suggests America's bone-health is in jeopardy and issued a “call to action” to develop bone-health plans incorporating components of (1 improved nutrition, (2 increased health literacy, and (3 increased physical activity.Objective: To conduct a Comparative Effectiveness Research (CER study comparing changes in bone mineral density in healthy women over-40 with above-average compliance when following one of three bone health Plans incorporating the SG's three components.Methods: Using an open-label sequential design, 414 females over 40 years of age were tested, 176 of whom agreed to participate and follow one of three different bone-health programs. One Plan contained a bone-health supplement with 1,000 IUs of vitamin D3 and 750 mg of a plant-sourced form of calcium for one year. The other two Plans contained the same plant form of calcium, but with differing amounts of vitamin D3 and other added bone health ingredients along with components designed to increase physical activity and health literacy. Each group completed the same baseline and ending DXA bone density scans, 43-chemistry blood test panels, and 84-item Quality of Life Inventory (QOL. Changes for all subjects were annualized as percent change in BMD from baseline. Using self-reports of adherence, subjects were rank-ordered and dichotomized as “compliant” or “partially compliant” based on the median rating. Comparisons were also made between the treatment groups and two theoretical age-adjusted expected groups: a non-intervention group and a group derived from a review of previously published studies on non-plant sources of calcium.Results: There were no significant differences in baseline BMD between those who volunteered versus those who did not and between those who completed per protocol (PP and those who were lost to attrition. Among subjects completing per protocol, there were no significant differences

  7. Design and Fabrication of Manual Bone Scaffolds via Rapid Prototyping

    Institute of Scientific and Technical Information of China (English)

    HU Qingxi; HUANG Xianxu; LIN Liulan; FANG Minglun

    2006-01-01

    Biomaterials, β-TCP (β-tricalcium phosphate), and polymeric blends were used on a selective laser sintering (SLS) system, a kind of rapid prototyping machine, to produce some scaffold specimens which were designed with CAD (Computer Aided Design) software according to bone tissue engineering scaffold characteristics and properties. The scaffolds were produced with a pore size 800μm, and regular geometrical cylinder or sphere pores, depending on the processing. Then the specimens were treated by high temperature to assess their suitability on SLS processing. Their microstructures which had been investigated by scanning electron microscopy (SEM) exhibited fully interconnected pore which had a range size 500-800μm. X-ray diffraction analysis performed after high temperature treatment showed that β-TCP did not change. The porosity checked was about 71.29%. And the treated scaffolds could be provided an inter-connective network for the circulation of tissue fluid and hence sped up osteogenesis.

  8. Bioactive ceramic-based materials with designed reactivity for bone tissue regeneration

    OpenAIRE

    Ohtsuki, Chikara; Kamitakahara, Masanobu; Miyazaki, Toshiki

    2009-01-01

    Bioactive ceramics have been used clinically to repair bone defects owing to their biological affinity to living bone; i.e. the capability of direct bonding to living bone, their so-called bioactivity. However, currently available bioactive ceramics do not satisfy every clinical application. Therefore, the development of novel design of bioactive materials is necessary. Bioactive ceramics show osteoconduction by formation of biologically active bone-like apatite through chemical reaction of t...

  9. Evidence for an interaction between exercise and nutrition for improving bone and muscle health.

    Science.gov (United States)

    Daly, Robin M; Duckham, Rachel L; Gianoudis, Jenny

    2014-06-01

    Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, are prescribed as strategies to optimize peak bone mass and maintain bone and muscle health throughout life. Although the mechanism of action of exercise and nutrition on bone and muscle health are different-exercise has a site-specific modifying effect, whereas nutrition has a permissive generalized effect-there is evidence that combining calcium (or calcium rich dairy foods) or dietary protein with exercise can have a synergetic effect on bone mass and muscle health, respectively. However, many questions still remain as to whether there is a threshold level for these nutrients to optimize the exercise-induced gains. Further studies are also needed to investigate whether other dietary factors, such as vitamin D, soy isoflavones or omega-3 fatty acids, or a multinutrient supplement, can enhance the effects of exercise on bone and muscle health.

  10. Infant milk feeding influences adult bone health: a prospective study from birth to 32 years.

    Directory of Open Access Journals (Sweden)

    Satu Pirilä

    Full Text Available BACKGROUND: Peak bone mass, attained by early adulthood, is influenced by genetic and life-style factors. Early infant feeding and duration of breastfeeding in particular, associate with several health-related parameters in childhood. The aim of this study was to examine whether the effects of early infant feeding extend to peak bone mass and other bone health characteristics at adult age. METHODS AND FINDINGS: A cohort of 158 adults (76 males born in Helsinki, Finland, 1975, prospectively followed up from birth, underwent physical examination and bone densitometry to study bone area, bone mineral content (BMC, and bone mineral density (BMD at 32 years of age. Life-style factors relevant for bone health were recorded. For data analysis the cohort was divided into three equal-size groups according to the total duration of breastfeeding (BF: Short (≤3 months, Intermediate and Prolonged (≥7 months BF groups. In males short BF is associated with higher bone area, BMC, and BMD compared to longer BF. Males in the Short BF group had on average 4.7% higher whole body BMD than males in the Prolonged BF group. In multivariate analysis, after controlling for multiple confounding factors, the influence of BF duration on adult bone characteristics persisted in males. Differences between the three feeding groups were observed in lumbar spine bone area and BMC, and whole body BMD (MANCOVA; p = 0.025, p = 0.013, and p = 0.048, respectively, favoring the Short BF group. In women no differences were observed. CONCLUSIONS: In men, early infant milk feeding may have a significant impact on adult bone health. A potential explanation is that the calcium and phosphate contents were strikingly higher in formula milk and commercial cow milk/cow milk dilutions as opposed to human milk. Our novel finding merits further studies to determine means to ensure optimal bone mass development in infants with prolonged breastfeeding.

  11. Minerals and vitamins in bone health: the potential value of dietary enhancement.

    Science.gov (United States)

    Bonjour, Jean-Philippe; Guéguen, Léon; Palacios, Cristina; Shearer, Martin J; Weaver, Connie M

    2009-06-01

    Nutrition is important to bone health, and a number of minerals and vitamins have been identified as playing a potential role in the prevention of bone diseases, particularly osteoporosis. Despite this, there is currently no consensus on maximum levels to allow in food or as dietary supplements. The benefits of supplementation of populations at risk of osteoporosis with Ca and vitamin D are well established. Prolonged supplementation of Ca and vitamin D in elderly has been shown to prevent bone loss, and in some intervention studies to prevent fragility fractures. Although P is essential to bone health, the average intake is considered to be more than sufficient and supplementation could raise intake to adverse levels. The role of vitamin K in bone health is less well defined, though it may enhance the actions of Ca and vitamin D. Sr administered in pharmacological doses as the ranelate salt was shown to prevent fragility fractures in postmenopausal osteoporosis. However, there is no hard evidence that supplementation with Sr salts would be beneficial in the general population. Mg is a nutrient implicated in bone quality, but the benefit of supplementation via foodstuffs remains to be established. A consensus on dietary supplementation for bone health should balance the risks, for example, exposure of vulnerable populations to values close to maximal tolerated doses, against evidence for benefits from randomised clinical trials, such as those for Ca and vitamin D. Feedback from community studies should direct further investigations and help formulate a consensus on dietary supplementation for bone health.

  12. Late health effects of chronic radiation exposure of bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Yarmoshenko, Ilia V.; Malinovsky, Georgy P.; Konshina, Lidia G.; Zhukovsky, Michael V. [Institute of Industrial Ecology UB RAS, 620219, 20, Sophy Kovalevskoy St., Ekaterinburg (Russian Federation); Tuzankina, Irina A. [Institute of Immunology and Physiology UB RAS, 620049, 106, Pervomayskaya St., Ekaterinburg (Russian Federation)

    2014-07-01

    Accidental explosion of waste storage tank at former soviet plutonium production plant 'Mayak' in 1957 resulted in emission of considerable amount of radioactive substances to the atmosphere. Atmospheric transfer and fallout caused contamination of the environment by Sr-90 and short-lived radionuclides (East-Ural Radioactive Trace, EURT). Due to consumption of contaminated food and milk some internal organs were affected to relatively high radiation exposure. Archive data of causes of deaths of rural population of EURT northern part for period 1957-2000 were used to create the Register on causes of deaths. Register records related to the settlements where initial surface contamination by Sr-90 was above and below 3.7 kBq/m2 were included to exposed (4 844 records) and unexposed (6 158 records) group respectively. Basing on the Register the analysis of cancer and non-cancer health effects of radiation exposure was conducted. By estimating proportionate mortality ratios statistically significant excess mortality due to the groups of causes of death as follow was observed in exposed population: stomach, liver and cervix cancers; group consisted only of stomach cancer; non-cancer deceases of infectious etiology. Non-significant but remarkably high risk was observed for the following groups of causes of death: bone cancer; leukemia; liver cancer; cervix cancer. Insignificant, virtually zero risk was found for: non-gastrointestinal solid cancers; colon and lung cancers; non-infectious non-cancer deceases. At the same time, considerable radiation doses were absorbed in bone (mean bone surface dose about 0.1 Gy) and colon (mean dose about 0.07 Gy). Doses absorbed in other organs and tissues were negligible and amounted less than 0.01 Gy for most tissues. It can be seen that some disagreement between observed effects and absorbed doses is revealed. Most remarkable is the high excess risks of stomach, liver and cervix cancers as well as non-cancer deceases of

  13. [Effects of SERMs on bone health. Mechanisms of bone mass control by selective estrogen receptor modulator].

    Science.gov (United States)

    Imai, Yuuki; Kato, Shigeaki

    2010-03-01

    The bone mass, which is controlled by the balances between bone formation and bone resorption can be reduced by estrogen deficiency in post-menopausal osteoporosis. Reduced bone mass can be recovered by hormone replacement therapy (HRT) , however, HRT has various side effects. Although SERMs can rescue the bone mass with less side effect compared to HRT, the precise mechanisms of this effect is still elusive. From the results of the analyses for osteoclast specific estrogen receptor (ER) alphaknockout mice and the genome wide approach of ERalphabinding site, estrogen and SERMs can, at least in part, protect the bone mass by inducing the expression of Fas ligand and controling the life span of osteoclasts. More precise molecular mechanisms of the effect of SERM, especially in tissue/cell type specificity, may help to investigate new SERM, which is more specific and effective to treat post-menopausal osteoporosis.

  14. The Personal Health Technology Design Space

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Frost, Mads

    2016-01-01

    Interest is increasing in personal health technologies that utilize mobile platforms for improved health and well-being. However, although a wide variety of these systems exist, each is designed quite differently and materializes many different and more or less explicit design assumptions...

  15. Designing Mobile Health Technology for Bipolar Disorder

    DEFF Research Database (Denmark)

    Bardram, JE; Frost, Mads; Szántó, Károly

    2013-01-01

    usefulness of the system was high. Based on this study, the paper discusses three HCI questions related to the design of personal health technologies; how to design for disease awareness and self-treatment, how to ensure adherence to personal health technologies, and the roles of different types...... of technology platforms....

  16. Food fortification for bone health in adulthood: a scoping review

    OpenAIRE

    Whiting, S J; Kohrt, W. M.; Warren, M P; Kraenzlin, M I; Bonjour, Jean-Philippe

    2016-01-01

    Food fortification can deliver essential micronutrients to large population segments without modifications in consumption pattern, suggesting that fortified foods may be formulated for populations at risk for fragility fractures. This scoping review determined the extent to which randomized controlled studies have been carried out to test the impact of fortified foods on bone outcomes, searching PubMed for all studies using the terms ‘fortified AND bone', and ‘fortification AND bone'. Studies...

  17. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  18. A Review of Dental Implant Treatment Planning and Implant Design Based on Bone Density

    Directory of Open Access Journals (Sweden)

    Torkzaban

    2013-06-01

    Full Text Available Context A key determinant for clinical success is the diagnosis of the bone density in a potential implant site. The percentage of bone-implant contact is related to bone density, and the axial stress contours around an implant are affected by the density of bone. Evidence Acquisition A number of reports have emphasized the importance of the quality of bone on the survival of dental implants. The volume and density of the recipient bone have also been shown to be determining criteria to establish proper treatment plans with adequate number of implants and sufficient surface area. Previous clinical reports that did not alter the protocol of treatment related to bone density had variable survival rates. To the contrary, altering the treatment plan to compensate for soft bone types has provided similar survival rates in all bone densities. Results When bone density decreases and bone become softer, the implant surface in contact with the bone decreases, therefore treatment plan should be modified by changing the drilling protocol, using gradual loading and reducing the force on the prosthesis or increasing the loading area with increasing implant number, implant position, implant size, implant design (deeper and more threads with more pitch, squared shape and implant body surface condition. Conclusions Once the prosthetic option, key implant position, and patient force factors have been determined, the bone density in the implant sites should be evaluated to modify the treatment plan. Inappropriate implant number or design in poor quality bone results in higher failure rates. Changing the treatment plan and implant design is suggested, based on bone density to achieve higher survival rates.

  19. A Coaching Intervention to Promote Nutrition and Bone Health in Deployed Soldiers

    Science.gov (United States)

    2015-03-13

    body fat, waist circumference , resting energy expenditure), dietary intake, physical activity, and bone health biomarkers to measure the impact of...evident in survey data. Body weight, waist circumference , and BMI were essentially unchanged for the TG, leaving no clear rationale for the...remainder influenced by hormonal status, diet, environmental factors, and exercise. The most important modifiable risk factors associated with bone density

  20. Impact of air pollution on vitamin D deficiency and bone health in adolescents.

    Science.gov (United States)

    Feizabad, Elham; Hossein-Nezhad, Arash; Maghbooli, Zhila; Ramezani, Majid; Hashemian, Roxana; Moattari, Syamak

    2017-12-01

    The association between air pollution and bone health was evaluated in adolescents in the city of Tehran. This study is essentially ecological. Vitamin D deficiency among adolescents has been reported at higher rates in polluted areas than in non-polluted areas. Additionally, residence in polluted areas is associated with lower levels of bone alkaline phosphatase.

  1. Understanding and optimizing bone health in breast cancer.

    Science.gov (United States)

    Guise, Theresa A; Brufsky, Adam; Coleman, Robert E

    2010-12-01

    Bone is the preferred site of metastasis for breast cancer, and presence of skeletal lesions is associated with significant morbidity and poor prognosis. Skeletal-related effects such as pain, pathologic fractures, spinal compression, and hypercalcemia are frequent consequences of skeletal lesions of breast cancer that have debilitating effects on the patients' quality of life. In addition to direct cancer effects on the skeleton, therapies commonly used to treat patients with breast cancer such as chemotherapy and aromatase inhibitors (AI) result in cancer therapy-induced bone loss (CTIBL) which is associated with increased risk of skeletal complications such as fractures. Bisphosphonates are a class of antiresorptive drugs that are now firmly established as the cornerstone of the management of skeletal-related events due to breast cancer. Other novel bone-targeting agents such as the anti-receptor activator of NF-κB ligand (RANKL) monoclonal antibody denosumab are also showing promising activity in the treatment of bone metastasis secondary to breast cancer. Moreover, recent provocative evidence suggests that bisphosphonates might also exhibit antitumor activity via direct and indirect mechanisms. The goal of this review is to summarize the pathophysiology of osteolytic bone lesions secondary to breast cancer, provide clinical evidence of currently available bone-targeted drugs in the treatment of bone metastasis and CTIBL, and explore the antitumor activity of current bone-targeted agents in patients with breast cancer.

  2. School meals for better nutrition and bone health.

    Science.gov (United States)

    O'Brien, Melanie

    2008-01-01

    Mandatory new standards for food served in schools in England are being phased in from September 2008. These comprise three sets of standards: food-based, nutrient-based and standards covering food other than lunch. They reflect the Governments concern about poor nutrition and rising trends of obesity among the school-age population and the effect of these on ong- as well as short-term health, including increased risks of diabetes, coronary heart disease and cancers. The standards set minimum requirements for healthier foods and restrict less healthy items served at lunchtimes and other meals and snacks at school, including from vending machines or tuck shops. The standards set specific requirements for nutrients and the frequency, and in some cases the quantity, on which they should be provided. They cover fruit and vegetables (not less than two portions per pupil per day), drinks, deep-fried foods and micronutrients. There are requirements for calcium, as evidence shows that many school-age children and adolescents do not consume adequate amounts for bone health. The standards recommend that a variety of dairy foods, low-fat where possible, should be provided, including milk, cheese, yoghurt, fromage frais and custard. A minimum of 193 mg of calcium must be provided at lunch for all primary school children from September 2008. The standards apply to all Local Authority maintained primary and secondary schools, sixth forms on the premises of secondary schools, schools for children with special educational needs, and pupil referral units. They are not mandatory for independent schools although these will be expected to comply. The standards are derived from the UK nutrient recommendations (Dietary Reference Values). Responsibility for the provision of school meals and for ensuring the standards are met lies with the Local Authorities, or the schools under delegated powers. Monitoring will be by Ofsted, the body responsible for inspecting schools. Implementing the

  3. Bone health and the female athlete triad in adolescent athletes.

    Science.gov (United States)

    Ackerman, Kathryn E; Misra, Madhusmita

    2011-02-01

    Peak bone mass (PBM) is a negative predictor of osteoporosis and lifelong fracture risk. Because osteoporosis is such a prevalent disease with life-threatening consequences, it is important to try to maximize PBM. Adolescence is a critical period for bone acquisition. This article discusses some of the differences in male and female skeletal development and modifiable factors that enhance bone accrual in this age group, particularly in athletes. Hormonal influences, effects of physical activity, and nutritional contributions are included, with a focus on the adolescent athlete. Emphasis is placed on the importance of appropriate energy availability in this age group. We also review prevention and treatment strategies for the female athlete triad (ie, the inter-relationship of decreased energy availability, menstrual irregularity, and low bone density) in adolescents and athletic women. Recommendations for maximizing bone density in both male and female adolescents are discussed.

  4. Invited review: Dairy intake and bone health: a viewpoint from the state of the art.

    Science.gov (United States)

    Caroli, A; Poli, A; Ricotta, D; Banfi, G; Cocchi, D

    2011-11-01

    The aim of this review was to focus on the complex relationships between milk and dairy products intake and bone health, with particular emphasis on osteoporosis. The literature was extensively examined to provide an objective overview of the most significant achievements on the subject. Osteoporosis can be defined as a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Although the major determinants of peak bone mass and strength are genetic, major factors during childhood and adolescence may affect the ability to achieve peak bone mass. These include nutrition, particularly calcium and protein intake, physical activity, endocrine status, as well as exposure to a wide variety of risk factors. The role of calcium intake in determining bone mineral mass is well recognized to be the most critical nutritional factor to achieve optimal peak bone mass. The greatest amount of dietary calcium is obtained from milk and dairy foods, which also provide the human diet with vitamin D (particularly for products fortified with vitamin D), potassium, and other macro- and micronutrients. Although studies supporting the beneficial effects of milk or calcium on bone health are predominant in the literature, perplexity or discordance on this subject was expressed by some authors. Discordant data, mainly on the risk of fractures, provided limited proof of the unfavorable effect of dairy intake. More often, discordant works indicate no effect of dairy consumption on bone safety. Some considerations can be drawn from this viewpoint. Milk and dairy products are an optimal source of calcium as well as of other limiting nutrients (e.g., potassium and magnesium), with important effects on bone health. Bioactive components occurring in milk and dairy products may play an essential role on bone metabolism, as shown by in vivo and in vitro studies on colostrum acidic

  5. Obstacles in the optimization of bone health outcomes in the female athlete triad.

    Science.gov (United States)

    Ducher, Gaele; Turner, Anne I; Kukuljan, Sonja; Pantano, Kathleen J; Carlson, Jennifer L; Williams, Nancy I; De Souza, Mary Jane

    2011-07-01

    Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the 'female athlete triad'. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture. This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging. Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.

  6. Dietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study.

    Science.gov (United States)

    Sahni, Shivani; Mangano, Kelsey M; McLean, Robert R; Hannan, Marian T; Kiel, Douglas P

    2015-08-01

    Osteoporosis is characterized by systemic impairment of bone mass, strength, and microarchitecture, resulting in increased risk for fragility fracture, disability, loss of independence, and even death. Adequate nutrition is important in achieving and maintaining optimal bone mass, as well as preventing this debilitating disease. It is widely accepted that adequate calcium and vitamin D intake are necessary for good bone health; however, nutritional benefits to bone go beyond these two nutrients. This review article will provide updated information on all nutrients and foods now understood to alter bone health. Specifically, this paper will focus on related research from the Framingham Osteoporosis Study, an ancillary study of the Framingham Heart Study, with data on more than 5000 adult men and women.

  7. Selenium in bone health: roles in antioxidant protection and cell proliferation.

    Science.gov (United States)

    Zeng, Huawei; Cao, Jay J; Combs, Gerald F

    2013-01-10

    Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Such findings may relate to roles of Se in antioxidant protection, enhanced immune surveillance and modulation of cell proliferation. Elucidation of the mechanisms by which Se supports these cellular processes can lead to a better understanding of the role of this nutrient in normal bone metabolism. This article reviews the current knowledge concerning the molecular functions of Se relevant to bone health.

  8. Dietary Habits, Nutrients and Bone Mass in Spanish Premenopausal Women: The Contribution of Fish to Better Bone Health

    Directory of Open Access Journals (Sweden)

    Julian F. Calderon-Garcia

    2012-12-01

    Full Text Available The moderate consumption of fish is recommended for a healthy diet and is also a feature of the Mediterranean diet. Fish is a major food group in diets throughout the world, and studies show that fish consumption is associated with a lower risk of a number of conditions. Spain has one of the highest annual per capita consumptions of fish worldwide. As fish is a source of high quality protein; n-3 polyunsaturated fatty acids; vitamins, such as A and D; and minerals, such as selenium, calcium, iodine, magnesium, copper and zinc, nutrients that have positive effects on bone characteristics, it has been proposed that its consumption could improve bone health. In this cross-sectional study, we have investigated the relationship between dietary habits and nutrient intake of 151 Spanish premenopausal women and analyzed the association of fish consumption on bone mass measured by quantitative ultrasound of the phalanges. A higher (P < 0.05 bone mass and vitamin D intake (P < 0.05 was observed in the group with a fish intake of 5–7 servings/week. We conclude that increased fish consumption is helpful in maintaining an adequate bone mass in Spanish premenopausal women.

  9. Dietary habits, nutrients and bone mass in Spanish premenopausal women: the contribution of fish to better bone health.

    Science.gov (United States)

    Calderon-Garcia, Julian F; Moran, Jose M; Roncero-Martin, Raul; Rey-Sanchez, Purificacion; Rodriguez-Velasco, Francisco J; Pedrera-Zamorano, Juan D

    2012-12-27

    The moderate consumption of fish is recommended for a healthy diet and is also a feature of the Mediterranean diet. Fish is a major food group in diets throughout the world, and studies show that fish consumption is associated with a lower risk of a number of conditions. Spain has one of the highest annual per capita consumptions of fish worldwide. As fish is a source of high quality protein; n-3 polyunsaturated fatty acids; vitamins, such as A and D; and minerals, such as selenium, calcium, iodine, magnesium, copper and zinc, nutrients that have positive effects on bone characteristics, it has been proposed that its consumption could improve bone health. In this cross-sectional study, we have investigated the relationship between dietary habits and nutrient intake of 151 Spanish premenopausal women and analyzed the association of fish consumption on bone mass measured by quantitative ultrasound of the phalanges. A higher (P < 0.05) bone mass and vitamin D intake (P < 0.05) was observed in the group with a fish intake of 5-7 servings/week. We conclude that increased fish consumption is helpful in maintaining an adequate bone mass in Spanish premenopausal women.

  10. Optimization of bone health in children before and after renal transplantation: current perspectives and future directions

    Directory of Open Access Journals (Sweden)

    Kristen eSgambat

    2014-02-01

    Full Text Available The accrual of healthy bone during the critical period of childhood and adolescence sets the stage for lifelong skeletal health. However, in children with chronic kidney disease (CKD, disturbances in mineral metabolism and endocrine homeostasis begin early on, leading to alterations in bone turnover, mineralization, and volume, and impairing growth. Risk factors for CKD-mineral and bone disorder (CKD-MBD include nutritional vitamin D deficiency, secondary hyperparathyroidism, increased fibroblast growth factor 23 (FGF23, altered growth hormone and insulin like growth factor-1 (GH/IGF-1 axis, delayed puberty, malnutrition, and metabolic acidosis. After kidney transplantation, nutritional vitamin D deficiency, persistent hyperparathyroidism, tertiary FGF23 excess, hypophosphatemia, hypomagnesaemia, immunosuppressive therapy, and alteration of sex hormones continue to impair bone health and growth. As function of the renal allograft declines over time, CKD-MBD associated changes are reactivated, further impairing bone health. Strategies to optimize bone health post-transplant include healthy diet, weight-bearing exercise, correction of vitamin D deficiency and acidosis, electrolyte abnormalities, steroid avoidance, and consideration of recombinant human growth hormone therapy. Other drug therapies have been used in adult transplant recipients, but there is insufficient evidence for use in the pediatric population at the present time. Future therapies to be explored include anti-FGF23 antibodies, FGF23 receptor blockers, and treatments targeting the colonic microbiota by reduction of generation of bacterial toxins and adsorption of toxic end products that affect bone mineralization.

  11. Gamified Design for Health Workshop.

    Science.gov (United States)

    Giunti, Guido

    2016-01-01

    Increasing lifespans for chronic disease sufferers means a population of young patients who require lifestyle intervention from an early age. For multiple sclerosis (MS) patients, social problems begin with the decline of cognitive skills and their quality of life is affected. In this workshop, organizers will propose participants to work on different gamification design approachs to solve MS patients' engagement problem. Participants will obtain skills that can be extrapolated to other conditions that require patients change to adopt a different behavior. At the end, participants will present their proposed gamification design and discuss and comment each solution, assessing potential unintended outcomes and advantages.

  12. Design of a multi-axis implantable MEMS sensor for intraosseous bone stress monitoring

    Science.gov (United States)

    Alfaro, Fernando; Weiss, Lee; Campbell, Phil; Miller, Mark; Fedder, Gary K.

    2009-08-01

    The capability to assess the biomechanical properties of living bone is important for basic research as well as the clinical management of skeletal trauma and disease. Even though radiodensitometric imaging is commonly used to infer bone quality, bone strength does not necessarily correlate well with these non-invasive measurements. This paper reports on the design, fabrication and initial testing of an implantable ultra-miniature multi-axis sensor for directly measuring bone stresses at a micro-scale. The device, which is fabricated with CMOS-MEMS processes, is intended to be permanently implanted within open fractures, or embedded in bone grafts, or placed on implants at the interfaces between bone and prosthetics. The stress sensor comprises an array of piezoresistive pixels to detect a stress tensor at the interfacial area between the MEMS chip and bone, with a resolution to 100 Pa, in 1 s averaging. The sensor system design and manufacture is also compatible with the integration of wireless RF telemetry, for power and data retrieval, all within a 3 mm × 3 mm × 0.3 mm footprint. The piezoresistive elements are integrated within a textured surface to enhance sensor integration with bone. Finite element analysis led to a sensor design for normal and shear stress detection. A wired sensor was fabricated in the Jazz 0.35 µm BiCMOS process and then embedded in mock bone material to characterize its response to tensile and bending loads up to 250 kPa.

  13. Roles of Zinc and Iron on Bone Health in a Rat Model of Osteoporosis

    Science.gov (United States)

    Yan, Danhua

    Bone is one of the most vital organs in animals, serving as both structural and protective functions. Remodeling of bone is an important indicator of bone health, and disorders in bone remodeling may lead to bone diseases such as osteoporosis. Osteoporosis increases risk of bone fracture and even death, and much more preferable to be happened in postmenopausal women due to great changes in hormones. Micronutrients, such as Zinc (Zn) and Iron (Fe), would as well influence bone health in different manners. That Zn would promote bone health is widely accepted, for the reasons Zn increases osteoblast cell proliferation and differentiation, inhibits osteoclast cell activities, and forms alkaline phosphatase that does help to maintain bone metabolism. Diseases caused by Fe overload is usually related to osteoporosis. Ferric ion could facilitate osteoclast differentiation, inhibit osteoblast and alkaline phosphatase activities, and interfere with hydroxyapatite crystal growth and depositions. However, changes of concentrations and distributions for Zn and Fe in osteoporotic bones are seldom studied. In this thesis, ovariectomized rat femur bones are used as a model of postmenopausal osteoporosis. Rats from different ages and health conditions are categorized as 6 AM (6-month age matched control), 6 OVX (6-month ovariectomized control), 12 AM (12-month age matched control), 12 OVX (12-month ovariectomized control). The trace elements Zn and Fe is studied through Synchrotron Radiation X-Ray Fluorescence (SRXRF). Elemental maps are used to observe changes in distribution, and further quantitative analysis is used to discover changes in concentration among different animal groups. Both the decrease of Zn and the increase of Fe are significant from healthy to osteoporotic bones (p0.1) is also observed over age in healthy groups. Both elements show changes in distribution, that healthy animals present a more even distribution while in OVX groups the tendency of aggregation is

  14. Greater access to fast food outlets is associated with poorer bone health in young children

    Science.gov (United States)

    Vogel, Christina; Parsons, Camille; Godfrey, Keith; Robinson, Sian; Harvey, Nicholas C; Inskip, Hazel; Cooper, Cyrus; Baird, Janis

    2016-01-01

    Purpose Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. Methods 1107 children participating in the Southampton Women’s Survey, United Kingdom, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and four and/or six years by Dual-energy X-ray Absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant’s neighbourhood were used to derive three measures of the food environment: the counts of fast food outlets, healthy speciality stores and supermarkets. Results Neighbourhood exposure to fast food outlets was associated with lower BMD in infancy (β=−0.23(z-score): 95% CI −0.38, −0.08), and lower BMC after adjustment for bone area and confounding variables (β=−0.17(z-score): 95% CI −0.32, −0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at four and six years (β=0.16(z-score): 95% CI 0.00, 0.32 and β=0.13(z-score): 95% CI −0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at four years but not at six years. Conclusions The neighbourhood food environment pregnant mothers and young children are exposed to may effect bone development during early childhood. If confirmed in future studies, action to reduce access to fast food outlets could have benefits for childhood development and long term bone health. PMID:26458387

  15. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care,...

  16. The intravertebral distribution of bone density: correspondence to intervertebral disc health and implications for vertebral strength

    Science.gov (United States)

    Jackman, T. M.; Morgan, S. R.; Barest, G. D.; Morgan, E. F.

    2015-01-01

    Summary This study's goal was to determine associations among the intravertebral heterogeneity in bone density, bone strength, and intervertebral disc (IVD) health. Results indicated that predictions of vertebral strength can benefit from considering the magnitude of the density heterogeneity and the congruence between the spatial distribution of density and IVD health. Introduction This study aims to determine associations among the intravertebral heterogeneity in bone density, bone strength, and IVD health Methods Regional measurements of bone density were performed throughout 30 L1 vertebral bodies using microcomputed tomography (μCT) and quantitative computed tomography (QCT). The magnitude of the intravertebral heterogeneity in density was defined as the interquartile range and quartile coefficient of variation in regional densities. The spatial distribution of density was quantified using ratios of regional densities representing different anatomical zones (e.g., anterior to posterior regional densities). Cluster analysis was used to identify groups of vertebrae with similar spatial distributions of density. Vertebral strength was measured in compression. IVD health was assessed using two scoring systems. Results QCT- and μCT-based measures of the magnitude of the intravertebral heterogeneity in density were strongly correlated with each other (p<0.005). Accounting for the interquartile range in regional densities improved predictions of vertebral strength as compared to predictions based only on mean density (R2=0.59 vs. 0.43; F-test p-value=0.018). Specifically, after adjustment for mean density, vertebral bodies with greater heterogeneity in density exhibited higher strength. No single spatial distribution of density was associated with high vertebral strength. Analyses of IVD scores suggested that the health of the adjacent IVDs may modulate the effect of a particular spatial distribution of density on vertebral strength. Conclusions Noninvasive

  17. Computational model-informed design and bioprinting of cell-patterned constructs for bone tissue engineering.

    Science.gov (United States)

    Carlier, Aurélie; Skvortsov, Gözde Akdeniz; Hafezi, Forough; Ferraris, Eleonora; Patterson, Jennifer; Koç, Bahattin; Van Oosterwyck, Hans

    2016-05-17

    Three-dimensional (3D) bioprinting is a rapidly advancing tissue engineering technology that holds great promise for the regeneration of several tissues, including bone. However, to generate a successful 3D bone tissue engineering construct, additional complexities should be taken into account such as nutrient and oxygen delivery, which is often insufficient after implantation in large bone defects. We propose that a well-designed tissue engineering construct, that is, an implant with a specific spatial pattern of cells in a matrix, will improve the healing outcome. By using a computational model of bone regeneration we show that particular cell patterns in tissue engineering constructs are able to enhance bone regeneration compared to uniform ones. We successfully bioprinted one of the most promising cell-gradient patterns by using cell-laden hydrogels with varying cell densities and observed a high cell viability for three days following the bioprinting process. In summary, we present a novel strategy for the biofabrication of bone tissue engineering constructs by designing cell-gradient patterns based on a computational model of bone regeneration, and successfully bioprinting the chosen design. This integrated approach may increase the success rate of implanted tissue engineering constructs for critical size bone defects and also can find a wider application in the biofabrication of other types of tissue engineering constructs.

  18. Vitamin D and bone health in postmenopausal women.

    Science.gov (United States)

    Malabanan, Alan O; Holick, Michael F

    2003-03-01

    Osteoporosis, a disease of increased skeletal fragility, is becoming increasingly common as the U.S. population ages. Adequate vitamin D and calcium intake is the cornerstone of osteoporosis prevention and treatment. Age-related changes in vitamin D and calcium metabolism increase the risk of vitamin D insufficiency and secondary hyperparathyroidism. Although longitudinal data have suggested a role of vitamin D intake in modulating bone loss in perimenopausal women, studies of vitamin D and calcium supplementation have failed to support a significant effect of vitamin D and calcium during early menopause. There is a clearer benefit in vitamin D and calcium supplementation in older postmenopausal women. Vitamin D intake between 500 and 800 IU daily, with or without calcium supplementation, has been shown to increase bone mineral density (BMD) in women with a mean age of approximately 63 years. In women older than 65, there is even more benefit with vitamin D intakes of between 800 and 900 IU daily and 1200-1300 mg of calcium daily, with increased bone density, decreased bone turnover, and decreased nonvertebral fractures. The decreases in nonvertebral fractures may also be influenced by vitamin D-mediated decreases in body sway and fall risk. There are insufficient available data supporting a benefit from vitamin D supplementation alone, without calcium, to prevent osteoporotic fracture in postmenopausal women.

  19. A study of the bone healing kinetics of plateau versus screw root design titanium dental implants.

    LENUS (Irish Health Repository)

    Leonard, Gary

    2009-03-01

    This study was designed to compare the bone healing process around plateau root from (PRF) and screw root from (SRF) titanium dental implants over the immediate 12 week healing period post implant placement.

  20. Long-term effect of thin interdental alveolar bone on periodontal health after orthodontic treatment.

    Science.gov (United States)

    Artun, J; Osterberg, S K; Kokich, V G

    1986-06-01

    The present experiment was undertaken to determine if an interproximal area with a thin interdental bone septum following orthodontic treatment provides less resistance against marginal periodontal breakdown than an interproximal area with a normal width of bone between the roots. Only adult patients, at least 16 years after active orthodontic treatment, were studied. The distance between the roots was measured directly on periapical radiographs. Gingival health, level of attachment and bone level in sites with thin interdental bone were compared with neighboring or contralateral sites with a normal width of bone between the roots. No statistically significant differences in inflammation, level of attachment and clinical scores for bone level were observed. When measured radiographically the distance from the cementoenamel junction to the alveolar bone was significantly shorter in neighboring control sites (P less than 0.05). This discrepancy was most likely due to radiographic distortion. The results of this investigation suggest that in anterior areas marginal periodontal breakdown is unrelated to the thickness of bone between the roots. Too few molar sites were included to draw conclusions regarding such areas.

  1. Instructional design strategies for health behavior change.

    Science.gov (United States)

    Kinzie, Mable B

    2005-01-01

    To help health educators build upon the best of different health behavior change theories, this paper offers a unified set of instructional design strategies for health education interventions. This set draws upon the recommendations of Rosenstock (Health Belief Model), Bandura (Social Cognitive Theory), and Dearing (Diffusion Theory), and uses a modified Events of Instruction framework (adapted from Robert Gagne): gain attention (convey health threats and benefits), present stimulus material (tailor message to audience knowledge and values, demonstrate observable effectiveness, make behaviors easy-to-understand and do), provide guidance (use trustworthy models to demonstrate), elicit performance and provide feedback (to enhance trialability, develop proficiency and self-efficacy), enhance retention and transfer (provide social supports and deliver behavioral cues). Sample applications of these strategies are provided. A brief review of research on adolescent smoking prevention enables consideration of the frequency with which these strategies are used, and possible patterns between strategy use and behavioral outcomes.

  2. Comparison in Adherence to Osteoporosis Guidelines according to Bone Health Status in Korean Adult

    OpenAIRE

    Lim, Hee-Sook; Kim, Soon-Kyung; Lee, Hae-Hyeog; Byun, Dong Won; Park, Yoon-Hyung; Kim, Tae-Hee

    2016-01-01

    Background Osteoporosis one of the most serious disease to decrease the quality of life and cause economic loss. Thus, prevention of osteoporosis has become an important health concern. The study examined in adherence to osteoporosis guidelines and compared the levels of adherence to osteoporosis guidelines between bone health status in Korean adult. Methods This study used data from a nationally represented sample of Koreans (n=3,419) from 2008 to 2011 Korea National Health and Nutrition Exa...

  3. Implant design and its effects on osseointegration over time within cortical and trabecular bone.

    Science.gov (United States)

    Beutel, Bryan G; Danna, Natalie R; Granato, Rodrigo; Bonfante, Estevam A; Marin, Charles; Tovar, Nick; Suzuki, Marcelo; Coelho, Paulo G

    2016-08-01

    Healing chambers present at the interface between implant and bone have become a target for improving osseointegration. The objective of the present study was to compare osseointegration of several implant healing chamber configurations at early time points and regions of interest within bone using an in vivo animal femur model. Six implants, each with a different healing chamber configuration, were surgically implanted into each femur of six skeletally mature beagle dogs (n = 12 implants per dog, total n = 72). The implants were harvested at 3 and 5 weeks post-implantation, non-decalcified processed to slides, and underwent histomorphometry with measurement of bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) within healing chambers at both cortical and trabecular bone sites. Microscopy demonstrated predominantly woven bone at 3 weeks and initial replacement of woven bone by lamellar bone by 5 weeks. BIC and BAFO were both significantly increased by 5 weeks (p < 0.001), and significantly higher in cortical than trabecular bone (p < 0.001). The trapezoidal healing chamber design demonstrated a higher BIC than other configurations. Overall, a strong temporal and region-specific dependence of implant osseointegration in femurs was noted. Moreover, the findings suggest that a trapezoidal healing chamber configuration may facilitate the best osseointegration. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1091-1097, 2016.

  4. Revisiting Estrogen: Efficacy and Safety for Postmenopausal Bone Health

    Directory of Open Access Journals (Sweden)

    Sandra M. Sacco

    2010-01-01

    Full Text Available The rapid decline in endogenous estrogen production that occurs during menopause is associated with significant bone loss and increased risk for fragility fracture. While hormone therapy (HT is an effective means to re-establish endogenous estrogen levels and reduce the risk of future fracture, its use can be accompanied by undesirable side effects such as stroke and breast cancer. In this paper, we revisit the issue of whether HT can be both safe and effective for the prevention of postmenopausal bone loss by examining standard and alternative doses and formulations of HT. The aim of this paper is to continue the dialogue regarding the benefits and controversies of HT with the goal of encouraging the dissemination of-up-to date evidence that may influence how HT is viewed and prescribed.

  5. Design of functionally graded dental implant in the presence of cancellous bone.

    Science.gov (United States)

    Hedia, H S

    2005-10-01

    In a previous work by the author [Hedia HS, Mahmoud NA. Biomed Mater Eng 2004;14(2):133--143], a functionally graded material (FGM) dental implant was designed without cancellous bone in the model. In this investigation, the effect of the presence of cancellous bone as a thin layer around the dental implant was investigated. It is well known that the main inorganic component of natural bone is hydroxyapatite (HAP) and that the main organic component is collagen (Col). HAP implants are not bioabsorbable, and because induction of bone into and around the artificially made HAP is not always satisfactory, loosening or breakage of HAP implants might occur after implantation in the clinical application. The development of a new material that is bioabsorbable and that has osteo-conductive activity is needed. Therefore, the aim of the current investigation was to design an implant, in the presence of cancellous bone as a thin layer around it, from FGM. In this study, a novel biomaterial, Col/HAP, as a FGM, was developed using the finite element and optimization techniques that are available in the ANSYS package. These materials have a self-organized character similar to that of natural bone. The investigations have shown that the maximum stress in the cortical bone and cancellous bone for the Col/HAP functionally graded implant has been reduced by about 40% and 19%, respectively, compared with currently used titanium dental implants.

  6. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Versijpt, J.; Dierckx, R.A.; Bondt, P. de [Division of Nuclear Medicine, University Hospital Gent (Belgium); Dierckx, I. [Department of Radiology, St. Elisabeth Hospital Antwerpen (Belgium); Lambrecht, L. [Outpatient Internal Medicine Clinic, Gent (Belgium); Sadeleer, C. de [Division of Nuclear Medicine, University Hospital Gent (Belgium)]|[Department of Nuclear Medicine, O.L.V. Hospital Geraardsbergen (Belgium)

    1999-08-01

    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  7. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review.

    Science.gov (United States)

    Movassagh, Elham Z; Vatanparast, Hassan

    2017-01-01

    Nutrition is an important modifiable factor that affects bone health. Diet is a complex mixture of nutrients and foods that correlate or interact with each other. Dietary pattern approaches take into account contributions from various aspects of diet. Findings from dietary pattern studies could complement those from single-nutrient and food studies on bone health. In this study we aimed to conduct a scoping review of the literature that assessed the impact of dietary patterns (derived with the use of both a priori and data-driven approaches) on bone outcomes, including bone mineral status, bone biomarkers, osteoporosis, and fracture risk. We retrieved 49 human studies up to June 2016 from the PubMed, Embase, and CINAHL databases. Most of these studies used a data-driven method, especially factor analysis, to derive dietary patterns. Several studies examined adherence to a variety of the a priori dietary indexes, including the Mediterranean diet score, the Healthy Eating Index (HEI), and the Alternative Healthy Eating Index (AHEI). The bone mineral density (BMD) diet score was developed to measure adherence to a dietary pattern beneficial to bone mineral density. Findings revealed a beneficial impact of higher adherence to a "healthy" dietary pattern derived using a data-driven method, the Mediterranean diet, HEI, AHEI, Dietary Diversity Score, Diet Quality Index-International, BMD Diet Score, Healthy Diet Indicator, and Korean Diet Score, on bone. In contrast, the "Western" dietary pattern and those featuring some aspects of an unhealthy diet were associated inversely with bone health. In both a priori and data-driven dietary pattern studies, a dietary pattern that emphasized the intake of fruit, vegetables, whole grains, poultry and fish, nuts and legumes, and low-fat dairy products and de-emphasized the intake of soft drinks, fried foods, meat and processed products, sweets and desserts, and refined grains showed a beneficial impact on bone health. Overall

  8. Validation of scaffold design optimization in bone tissue engineering: finite element modeling versus designed experiments.

    Science.gov (United States)

    Uth, Nicholas; Mueller, Jens; Smucker, Byran; Yousefi, Azizeh-Mitra

    2017-02-21

    This study reports the development of biological/synthetic scaffolds for bone tissue engineering (TE) via 3D bioplotting. These scaffolds were composed of poly(L-lactic-co-glycolic acid) (PLGA), type I collagen, and nano-hydroxyapatite (nHA) in an attempt to mimic the extracellular matrix of bone. The solvent used for processing the scaffolds was 1,1,1,3,3,3-hexafluoro-2-propanol. The produced scaffolds were characterized by scanning electron microscopy, microcomputed tomography, thermogravimetric analysis, and unconfined compression test. This study also sought to validate the use of finite-element optimization in COMSOL Multiphysics for scaffold design. Scaffold topology was simplified to three factors: nHA content, strand diameter, and strand spacing. These factors affect the ability of the scaffold to bear mechanical loads and how porous the structure can be. Twenty four scaffolds were constructed according to an I-optimal, split-plot designed experiment (DE) in order to generate experimental models of the factor-response relationships. Within the design region, the DE and COMSOL models agreed in their recommended optimal nHA (30%) and strand diameter (460 μm). However, the two methods disagreed by more than 30% in strand spacing (908 μm for DE; 601 μm for COMSOL). Seven scaffolds were 3D-bioplotted to validate the predictions of DE and COMSOL models (4.5-9.9 MPa measured moduli). The predictions for these scaffolds showed relative agreement for scaffold porosity (mean absolute percentage error of 4% for DE and 13% for COMSOL), but were substantially poorer for scaffold modulus (51% for DE; 21% for COMSOL), partly due to some simplifying assumptions made by the models. Expanding the design region in future experiments (e.g., higher nHA content and strand diameter), developing an efficient solvent evaporation method, and exerting a greater control over layer overlap could allow developing PLGA-nHA-collagen scaffolds to meet the mechanical requirements for

  9. Health and Welfare IT Product Design

    DEFF Research Database (Denmark)

    Merritt, Timothy; Grønbæk, Kaj

    2012-01-01

    finding a suitable problem to solve, iterating and refining their designs, evaluating prototypes with users, and finally presenting their work as a potential product with a detailed plan for how the product would be sold in the market. The primary contribution of this paper is to share innovative design......In this paper we describe the outcomes from a university design class focused on the design of systems intended to solve problems faced by health care professionals, patients and systems that support welfare or extended independence for older people. The students worked in groups for 10 weeks...... ideas with the design community and to reflect on lessons learned by the students who, for the first time, were designing robust prototypes that solve real world problems....

  10. Bone Health in a Nonjaundiced Population of Children with Biliary Atresia

    Directory of Open Access Journals (Sweden)

    Rachel A. Kramer

    2009-01-01

    Full Text Available Objectives. To assess bone health in a cohort of nonjaundiced children with biliary atresia (BA and the effect of growth and development on bone outcomes. Methods. Children ages one to eighteen years receiving care from Children's Hospital of Philadelphia were recruited. Each child was seen once and assessed for growth, pubertal development, concurrent medications, bilirubin, ALT, albumin, vitamin D status, bone mineral density (BMD, and bone mineral content (BMC of the lumbar spine and whole body. Results. BMD declined significantly with age, and upon further analysis with a well-phenotyped control cohort, it was found that BMC was significantly decreased for both lumbar spine and whole body, even after adjustment for confounding variables. An age interaction was identified, with older subjects having a significantly greater impairment in BMC. Conclusions. These preliminary results demonstrate that children with BA, including those without jaundice, are likely to have compromised bone health even when accounting for height and puberty, which are common confounding factors in chronic disease. Further investigation is needed to identify the determinants of poor bone mineral status and to develop strategies to prevent osteoporosis later in life.

  11. Natural Products from Chinese Medicines with Potential Benefits to Bone Health

    Directory of Open Access Journals (Sweden)

    Chun-Tao Che

    2016-02-01

    Full Text Available Osteoporosis is a progressive, systemic bone disorder characterized by loss of bone mass and microstructure, leading to reduced bone strength and increased risk of fracture. It is often associated with reduced quality of life and other medical complications. The disease is common in the aging population, particularly among postmenopausal women and patients who receive long-term steroidal therapy. Given the rapid growth of the aging population, increasing life expectancy, the prevalence of bone loss, and financial burden to the healthcare system and individuals, demand for new therapeutic agents and nutritional supplements for the management and promotion of bone health is pressing. With the advent of global interest in complementary and alternative medicine and natural products, Chinese medicine serves as a viable source to offer benefits for the improvement and maintenance of bone health. This review summarizes the scientific information obtained from recent literatures on the chemical ingredients of Chinese medicinal plants that have been reported to possess osteoprotective and related properties in cell-based and/or animal models. Some of these natural products (or their derivatives may become promising leads for development into dietary supplements or therapeutic drugs.

  12. Smart Sensing System for the Prognostic Monitoring of Bone Health

    KAUST Repository

    Afsarimanesh, Nasrin

    2016-06-24

    The objective of this paper is to report a novel non-invasive, real-time, and label-free smart assay technique for the prognostic detection of bone loss by electrochemical impedance spectroscopy (EIS). The proposed system incorporated an antibody-antigen-based sensor functionalization to induce selectivity for the C-terminal telopeptide type one collagen (CTx-I) molecules—a bone loss biomarker. Streptavidin agarose was immobilized on the sensing area of a silicon substrate-based planar sensor, patterned with gold interdigital electrodes, to capture the antibody-antigen complex. Calibration experiments were conducted with various known CTx-I concentrations in a buffer solution to obtain a reference curve that was used to quantify the concentration of an analyte in the unknown serum samples. Multivariate chemometric analyses were done to determine the performance viability of the developed system. The analyses suggested that a frequency of 710 Hz is the most discriminating regarding the system sensitivity. A detection limit of 0.147 ng/mL was achieved for the proposed sensor and the corresponding reference curve was linear in the range of 0.147 ng/mL to 2.669 ng/mL. Two sheep blood samples were tested by the developed technique and the results were validated using enzyme-linked immunosorbent assay (ELISA). The results from the proposed technique match those from the ELISA.

  13. Effects of early vitamin D deficiency rickets on bone and dental health, growth and immunity.

    Science.gov (United States)

    Zerofsky, Melissa; Ryder, Mark; Bhatia, Suruchi; Stephensen, Charles B; King, Janet; Fung, Ellen B

    2016-10-01

    Vitamin D deficiency is associated with adverse health outcomes, including impaired bone growth, gingival inflammation and increased risk for autoimmune disease, but the relationship between vitamin D deficiency rickets in childhood and long-term health has not been studied. In this study, we assessed the effect of early vitamin D deficiency on growth, bone density, dental health and immune function in later childhood to determine if children previously diagnosed with rickets were at greater risk of adverse health outcomes compared with healthy children. We measured serum 25-hydroxyvitamin D, calcium, parathyroid hormone, bone mineral density, anthropometric measures, dietary habits, dental health, general health history, and markers of inflammation in 14 previously diagnosed rickets case children at Children's Hospital Oakland Research Center. We compared the findings in the rickets cases with 11 healthy children selected from the population of CHO staff families. Fourteen mothers of the rickets cases, five siblings of the rickets cases, and seven mothers of healthy children also participated. Children diagnosed with vitamin D deficiency rickets had a greater risk of fracture, greater prevalence of asthma, and more dental enamel defects compared with healthy children. Given the widespread actions of vitamin D, it is likely that early-life vitamin D deficiency may increase the risk of disease later in childhood. Further assessment of the long-term health effects of early deficiency is necessary to make appropriate dietary recommendations for infants at risk of deficiency.

  14. Association between bipolar spectrum disorder and bone health: a meta-analysis and systematic review protocol

    Science.gov (United States)

    Brennan-Olsen, Sharon L; Stuart, Amanda L; Pasco, Julie A; Berk, Michael; Hodge, Jason M; Williams, Lana J

    2017-01-01

    Introduction Bipolar spectrum disorder is a chronic, episodic illness, associated with significant personal, social and economic burden. It is estimated to affect ∼2.4% of the population worldwide and is commonly associated with psychological and/or physiological comorbidities. Osteoporosis is one such comorbidity, a disease of bone that is asymptomatic until a fracture occurs. This systematic review attempts to capture, collate, assess and discuss the literature investigating the association between bipolar spectrum disorder and bone health. Methods and analysis We aim to identify articles that investigate the association between bipolar spectrum disorder and bone health in adults by systematically searching the MEDLINE, PubMed, OVID and CINAHL databases. Two independent reviewers will determine eligibility of studies according to predetermined criteria, and methodological quality will be assessed using a previously published scoring system. A meta-analysis will be conducted, and statistical methods will be used to identify and control for heterogeneity, if possible. If numerical syntheses are prevented due to statistical heterogeneity, a best evidence synthesis will be conducted to assess the level of evidence for associations between bipolar spectrum disorder and bone health. Ethics and dissemination Ethical permission will not be required for this systematic review since only published data will be used. This protocol will be registered with PROSPERO. Findings of the review will be published in a peer-reviewed scientific journal, and will be presented to clinical and population health audiences at national and international conferences. PMID:28246138

  15. Evidence for designing health promoting pocket parks

    DEFF Research Database (Denmark)

    Peschardt, Karin Kragsig; Stigsdotter, Ulrika K.

    2014-01-01

    The use of urban green environments has repeatedly been associated with improved health and well-being for people living in cities. This study focuses on the health promoting potential of pocket parks in the dense city area of Copenhagen. A natural experiment was conducted, which evaluated one...... pocket park, Dantes Plads, before and after a redesign. Six people were interviewed about their perception of the change. First of all, the results show that Dantes Plads is primarily used for ‘rest and restitution’. Furthermore, the interviewees prefer to have the presence of sun, shade and planting....... The findings add to existing knowledge on the design of health promoting pocket parks for ‘rest and restitution’ in dense city areas....

  16. Interactions between inorganic and organic phases in bone tissue as a source of inspiration for design of novel nanocomposites

    NARCIS (Netherlands)

    Farbod, K.; Nejadnik, M.R.; Jansen, J.A.; Leeuwenburgh, S.C.G.

    2014-01-01

    Mimicking the nanostructure of bone and understanding the interactions between the nanoscale inorganic and organic components of the extracellular bone matrix are crucial for the design of biomaterials with structural properties and a functionality similar to the natural bone tissue. Generally, thes

  17. Effects of lifestyle exercise on premenopausal bone health: a randomised controlled trial.

    Science.gov (United States)

    Babatunde, Opeyemi; Forsyth, Jacky

    2014-09-01

    Osteoporosis, a slowly evolving public health epidemic, often with an insidious presentation is largely preventable but the optimal dimensions of exercise that may be prescribed for enhancing bone-health among premenopausal adults are yet to be elucidated. Hence, the escalating incidence and burden of prevalence of osteoporosis is yet unabated. Considering that exogenous hormones in the form of hormonal contraception are known to modulate bone mass, investigations of their possible influence on the translation of exercise-induced osteogenic stimuli on the mature bone is pertinent. The aim of this study was to examine the effect of specified lifestyle exercise on bone-health of premenopausal women. Premenopausal women (n = 96, mean age: 22.25 ± 3.5 years; mean BMI: 23.43 ± 3.5 kg/m(2)) participated in a 6-month randomised controlled trial involving home-based rest-interspersed bouts of high-impact exercise for the intervention group and sham exercise for the control group. Approximately half (47) of the participants (24-exercise, 23-control) were on hormonal-based contraception while the other half (49: 24-exercise, 25-control) were not on hormonal contraception. The regime led to a significant 3.7 % increase in broadband ultrasound attenuation of exercisers compared to controls; hormonal contraceptive use did not appear to potentiate the osteogenic effects of the lifestyle exercise regime. The research highlights that short, discrete bouts of high-impact exercise may be a potential public health prescription for enhancing premenopausal bone-health regardless of hormonal contraceptive use.

  18. The Influence of Partial Knee Replacement Designs on Tensile Strain at Implant-Bone Interface

    Directory of Open Access Journals (Sweden)

    He Wang

    2012-01-01

    Full Text Available Partial knee replacement (PKR results in fast recovery and good knee mechanics and is ideal to treat medial knee osteoarthritis. Cementless PKR depends on bone growing into the implant surface for long-term fixation. Implant loosening may occur due to high tensile strain resulted from large mechanical loads during rehab exercises. The purpose of this study is to investigate whether external fixations such as superior screw and frontal flange could reduce the tensile strain at the implant-bone interface. Three medial PKRs were designed. The first PKR had no external fixations. A superior screw and a frontal flange were then added to the first PKR to form the second and third PKR designs, respectively. Finite element analysis was performed to examine the tensile strain at the implant-bone interface during weight-bearing exercises. The PKR with no external fixations exhibited high tensile strain at the anterior implant-bone interface. Both the screwed and flanged PKRs effectively reduced the tensile strain at the anterior implant-bone interface. Furthermore, the flanged PKR resulted in a more uniform reduction of the tensile strain than the screwed PKR. In conclusion, external fixations are necessary to alleviate tensile strain at the implant-bone interface during knee rehab exercises.

  19. Skeletal Health Part 1: Overview Of Bone Health and Management In the Cancer Setting.

    Science.gov (United States)

    Turner, Bruce; Ali, Sacha; Drudge-Coates, Lawrence; Pati, Jhumur; Nargund, Vinod; Wells, Paula

    2016-01-01

    Cancer-induced bone disease and cancer therapy-induced bone loss are significant skeletal problems related to the treatment for urological and other cancers. Our team of specialists and nurse practitioners developed a nurse practitioner-led Bone Support Clinic for urologic cancer patients at a university hospital in London, England, United Kingdom, to address this issue. The clinic has been well-accepted, has made a positive impact on the patient journey, helps to ensure continuity of care, and highlights patients who require assessment or treatment for impending skeletal-related events in a timely fashion. This article has been divided into two parts for improved readability.

  20. Designing Work, Family & Health Organizational Change Initiatives.

    Science.gov (United States)

    Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

    2014-01-01

    For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

  1. Analysis and design of rolling-contact joints for evaluating bone plate performance.

    Science.gov (United States)

    Slocum, Alexander H; Cervantes, Thomas M; Seldin, Edward B; Varanasi, Kripa K

    2012-09-01

    An apparatus for testing maxillofacial bone plates has been designed using a rolling contact joint. First, a free-body representation of the fracture fixation techniques utilizing bone plates is used to illustrate how rolling contact joints accurately simulate in vivo biomechanics. Next, a deterministic description of machine functional requirements is given, and is then used to drive the subsequent selection and design of machine elements. Hertz contact stress and fatigue analysis for two elements are used to ensure that the machine will both withstand loads required to deform different plates, and maintain a high cycle lifetime for testing large numbers of plates. Additionally, clinically relevant deformations are presented to illustrate how stiffness is affected after a deformation is applied, and to highlight improvements made by the machine over current testing standards, which do not adequately re-create in vivo loading conditions. The machine performed as expected and allowed for analysis of bone plates in both deformed and un-deformed configurations to be conducted. Data for deformation experiments is presented to show that the rolling-contact testing machine leads to improved loading configurations, and thus a more accurate description of plate performance. A machine for evaluation of maxillofacial bone plates has been designed, manufactured, and used to accurately simulate in vivo loading conditions to more effectively evaluate the performance of both new and existing bone plates.

  2. Investigating the role of natural phyto-oestrogens on bone health in postmenopausal women

    NARCIS (Netherlands)

    Valtueña, S.; Cashman, K.; Robins, S.P.; Cassidy, A.; Kardinaal, A.; Branca, F.

    2003-01-01

    Research on the bone effects of natural phyto-oestrogens after menopause is at a relatively early stage. Published studies are few, difficult to compare and often inconclusive, due in part to design weaknesses. Currently, many questions remain to be answered including to what extent a safe daily int

  3. Effects of diet containing flaxseed flour (Linum usitatissimum) on body adiposity and bone health in young male rats.

    Science.gov (United States)

    da Costa, Carlos Alberto Soares; da Silva, Paula Cristina Alves; Ribeiro, Danielle Cavalcante; Pereira, Aline D'Avila; dos Santos, Aline de Sousa; de Abreu, Maíra Duque Coutinho; Pessoa, Letícia Rozeno; Boueri, Bianca Ferolla da Camara; Pessanha, Carolina Ribeiro; do Nascimento-Saba, Celly Cristina Alves; da Silva, Eduardo Moreira; Boaventura, Gilson Teles

    2016-02-01

    Flaxseed flour has been described as an excellent alpha-linolenic acid source. This study was designed to evaluate the effects of flaxseed flour on body adiposity and bone health in rats fed a flaxseed flour diet during lactation until 90 days. At birth, male Wistar rats were randomly assigned to control (C) and experimental (FF) groups, whose dams were treated with a control or flaxseed flour diet, respectively, during lactation. At 21 days, pups were weaned and fed a control and experimental diet until 90 days. Food intake, body mass and length were evaluated during a 21-90 day period. At 90 days, composition by dual-energy X-ray absorptiometry, serum hormonal profile, intra-abdominal fat mass, and lumbar vertebra and femur analyses was determined. Differences were deemed significant at p < 0.05. The FF group displayed the following (P < 0.05): a higher total lean mass (+7%), a lower total (-16%) and intra-abdominal (-24%) fat mass, a smaller adipocyte area (-30%), a higher femoral mass (+5%), bone mineral density (+5%) and radiodensity (+20%), and a higher maximum force (+10%) and breaking strength (+11%). The flaxseed flour diet displayed functional properties related to body growth maintenance associated with a lower risk of developing metabolic alterations, obesity and bone fragility.

  4. Beneficial effects of phytoestrogens and their metabolites produced by intestinal microflora on bone health.

    Science.gov (United States)

    Chiang, Shen-Shih; Pan, Tzu-Ming

    2013-02-01

    Phytoestrogens are a class of bioactive compounds derived from plants and exert various estrogenic and antiestrogenic effects. Estrogen deficiency osteoporosis has become a serious problem in elderly women. The use of ovariectomized (OVX) rat or mice models to simulate the postmenopausal condition is well established. This review aimed to clarify the sources, biochemistry, absorption, metabolism, and mode of action of phytoestrogens on bone health in intervention studies. In vitro, phytoestrogens promote protein synthesis, osteoprotegerin/receptor activation of nuclear factor-kappa B ligand ratio, and mineralization by osteoblast-like cells (MC3T3-E1). In the OVX murine model, administration of phytoestrogens can inhibit differentiation and activation of osteoclasts, expression of tartrate-resistant acid phosphatase, and secretion of pyridinoline compound. Phytoestrogens also enhance bone formation and increase bone mineral density and levels of alkaline phosphatase, osteocalcin, osteopontin, and α1(I) collagen. Results of mechanistic studies have indicated that phytoestrogens suppress the rate of bone resorption and enhance the rate of bone formation.

  5. Evaluation of impact of steroid replacement treatment on bone health in children with 21-hydroxylase deficiency.

    Science.gov (United States)

    Delvecchio, M; Soldano, L; Lonero, A; Ventura, A; Giordano, P; Cavallo, L; Grano, M; Brunetti, G; Faienza, M F

    2015-04-01

    There are conflicting data regarding the potential impact of chronic glucocorticoid (GC) therapy on the bone mineral density of patients with congenital adrenal hyperplasia (CAH). Previous studies performed by dual-energy X-ray absorptiometry reported conflicting results. The purpose of this study was to assess the impact of chronic GC replacement treatment in children with classical and non classical CAH due to 21-hydroxylase deficiency (21-OHD) by quantitative ultrasonometry (QUS), an easy, cheap, and radiation-free technique. The study population consisted of nineteen 21-OHD patients (nine males) on lifelong GC treatment. Anthropometric, hormonal, and treatment data were recorded for each patient, and bone quality was assessed by QUS measurements. QUS findings (amplitude-dependent speed of sound and bone transmission time) were normal in 21-OHD patients and did not correlate with duration of treatment, daily, total, and yearly hydrocortisone dose. Furthermore, no significant correlation was found between QUS findings and 17α-hydroxy progesterone, Δ4-androstenedione, and testosterone levels. In conclusion, our results provide reassurance that currently used replacement doses of GC do not have a major impact on bone in patients with CAH. QUS seems to be a reliable tool for screening of bone health in children with 21-OHD.

  6. Designing for health in school buildings

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette; Jensen, Bjarne Bruun; Larsen, Kristian;

    2015-01-01

    Aim: To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Methods: Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings.......-dependent. It makes the knowledge vulnerable. Conclusions: Special attention has to be paid by research to concepts and principles to guide the decision-making in practice. Further is recommended to consider new kinds of collaboration between researchers and practitioners....

  7. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

    Science.gov (United States)

    Wang, Xiaojian; Xu, Shanqing; Zhou, Shiwei; Xu, Wei; Leary, Martin; Choong, Peter; Qian, M; Brandt, Milan; Xie, Yi Min

    2016-03-01

    One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations.

  8. Bone health in children with long–term idiopathic subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Di Mase Raffaella

    2012-10-01

    Full Text Available Abstract Background Subclinical hypothyroidism (SH is a relatively common condition characterized by a mild persistent thyroid failure. The management of children with SH is still a controversial issue and the decision to treat with L-thyroxine represents a clinical dilemma. Thyroid hormone and TSH play an important role in skeletal growth and bone mineral homeostasis. Aim To evaluate whether untreated idiopathic SH may affect bone health in childhood and to compare two different diagnostic tools such as dual-energy X-ray densitometry (DXA and quantitative ultrasound (QUS. Patients and Methods Twenty-five children and adolescents (11 males aged 9.8 ± 3.5 years (range 4.2-18.7 with untreated idiopathic SH were enrolled in the study. SH was diagnosed on the basis of normal FT4 levels with TSH concentrations between 4.2 and 10 mU/l. Children have been followed for 3.3 ± 0.3 years from the time of SH diagnosis. Twenty-five healthy children, age- and sex-matched, were enrolled as controls. Patients and controls underwent DXA to evaluate lumbar spine bone mineral density (BMD and QUS at proximal phalanges of the non-dominant hand to assess bone quality, measured as amplitude-dependent speed of sound (Ad-SoS and bone transmission time (BTT. Results Mean BMD Z-score was −0.4 ± 1.36 in patients and −0.2 ± 1.2 in controls. Mean Ad-SoS Z-score was 0.01 ± 1.0 in patients and 0.1 ± 1.2 in controls and mean BTT Z-score was −0.03 ± 0.8 and 0.04 ± 1.1 respectively. All values were within the normal range, both in patients and in controls. There were no statistically significant differences between the two groups. Conclusion Bone health, evaluated by lumbar spine DXA and phalangeal QUS, is not impaired in our children, despite long-term duration of idiopathic SH. Data about bone status provided by QUS are comparable to those provided by DXA. Therefore, QUS may represent a good, cheaper and safe screening test for bone evaluation in children with SH.

  9. Energy availability, menstrual dysfunction and bone health in sports: an overwiew of the female athlete triad

    OpenAIRE

    Sara Márquez; Olga Molinero

    2013-01-01

    Introduction: The female athlete triad (FAT) is a serious health-related problem that threatens women who exercise. This condition is an interrelated multifactorial syndrome which includes low energy availability, menstrual cycle disturbances and decreased bone mineral density. Objective: To review the major components of the FAT and their relationships, as well as strategies for diagnosis and treatment. Methods: Articles related to the topic were reviewed through PubMed and SportDiscus datab...

  10. The Tarsal Bone Test: A Basic Test of Health Sciences Students' Knowledge of Lower Limb Anatomy

    Directory of Open Access Journals (Sweden)

    José Manuel Castillo-López

    2014-01-01

    Full Text Available Objectives. The aim of the present study was to design an easy-to-use tool, the tarsal bone test (TBT, to provide a snapshot of podiatry students’ basic anatomical knowledge of the bones of the lower limb. Methods. The study included 254 podiatry students from three different universities, 145 of them were first-year students and 109 were in their fourth and final years. The TBT was administered without prior notice to the participants and was to be completed in 5 minutes. Results. The results show that 97.2% of the subjects (n=247 correctly labelled all tarsal bones, while the other 2.8% (n=7 incorrectly labelled at least one bone, that was either the cuboid (7 times or the navicular (6 times. Although only one fourth-year student inaccurately identified one bone, no significant differences in the distribution of the correct and incorrect responses were found between first and fourth-year students. Conclusions. The TBT seems to be a straightforward and easy-to-apply instrument, and provides an objective view of the level of knowledge acquired at different stages of podiatry studies.

  11. TU-AB-204-03: Advances in CBCT for Orhtopaedics and Bone Health Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zbijewski, W. [Johns Hopkins University (United States)

    2015-06-15

    , significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and

  12. A Mouse Model for Studying Nutritional Programming: Effects of Early Life Exposure to Soy Isoflavones on Bone and Reproductive Health

    OpenAIRE

    2016-01-01

    Over the past decade, our research group has characterized and used a mouse model to demonstrate that “nutritional programming” of bone development occurs when mice receive soy isoflavones (ISO) during the first days of life. Nutritional programming of bone development can be defined as the ability for diet during early life to set a trajectory for better or compromised bone health at adulthood. We have shown that CD-1 mice exposed to soy ISO during early neonatal life have higher bone minera...

  13. Facts about Broken Bones

    Science.gov (United States)

    ... Room? What Happens in the Operating Room? Broken Bones KidsHealth > For Kids > Broken Bones Print A A ... sticking through the skin . What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  14. Broken Bones (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Broken Bones KidsHealth > For Parents > Broken Bones Print A A ... bone fragments in place. When Will a Broken Bone Heal? Fractures heal at different rates, depending upon ...

  15. Physical Activity and Bone Health%体力活动与骨健康

    Institute of Scientific and Technical Information of China (English)

    李红娟; 王正珍; 严翊

    2012-01-01

    The present study aims to review the progress and trend of the research concerning physical activity and bone health with Dr.Wolffe memorial lecture in the 59th ACSM annual meeting as the breakthrough point.Evidence-based research provides moderate evidence for the positive role of physical activity in improving bone health and preventing osteoporosis fracture.The Wolff Law and the Mechanostat lay the theory foundation for the positive effect of physical activity in improving bone health.But there is lack of strong evidence in the clinical guidance of the physical activity in preventing osteoporosis.It′s necessary to expand Mechanostat theory and explore it′s mechanism through multi-discipline research.Multi-disciplinary and multi-type research was conducted to discuss mechanical load mechanism of the function of physical activity on bones and its metabolizing effect.It also conducted the research on the effect of different types of exercises on bone metabolize and effective exercise load of different groups of people.Multi-center randomized controlled trial for years would be the best way to get strong evidence for the role of physical activity in health promotion.%以2012年ACSM第59届年会Dr.Wolffe纪念讲座为切入点,对体力活动与骨骼健康的研究进展及未来发展趋势进行综述。循证研究表明:体力活动有益骨健康和预防骨质疏松性骨折,证据等级为中等,Wolff定律、机械负荷理论等为体力活动促进骨健康奠定了理论基础。但现有预防骨质疏松的体力活动临床指南还缺乏强有力的证据支持,必须进一步拓展和深入研究机械负荷理论,从多学科、多层次探讨体力活动作用于骨骼的机械负荷机制和代谢影响;开展不同运动方式对骨代谢的影响及不同人群有效运动负荷的研究;通过多中心的随机对照试验,可为体力活动促进骨健康提供更多更有力的证据支持。

  16. Increasing dietary phosphorus intake from food additives: potential for negative impact on bone health.

    Science.gov (United States)

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2014-01-01

    It is important to consider whether habitual high phosphorus intake adversely affects bone health, because phosphorus intake has been increasing, whereas calcium intake has been decreasing in dietary patterns. A higher total habitual dietary phosphorus intake has been associated with higher serum parathyroid hormone (PTH) and lower serum calcium concentrations in healthy individuals. Higher serum PTH concentrations have been shown in those who consume foods with phosphorus additives. These findings suggest that long-term dietary phosphorus loads and long-term hyperphosphatemia may have important negative effects on bone health. In contrast, PTH concentrations did not increase as a result of high dietary phosphorus intake when phosphorus was provided with adequate amounts of calcium. Intake of foods with a ratio of calcium to phosphorus close to that found in dairy products led to positive effects on bone health. Several randomized controlled trials have shown positive relations between dairy intake and bone mineral density. In our loading test with a low-calcium, high-phosphorus lunch provided to healthy young men, serum PTH concentrations showed peaks at 1 and 6 h, and serum fibroblast growth factor 23 (FGF23) concentrations increased significantly at 8 h after the meal. In contrast, the high-calcium, high-phosphorus meal suppressed the second PTH and FGF23 elevations until 8 h after the meal. This implies that adequate dietary calcium intake is needed to overcome the interfering effects of high phosphorus intake on PTH and FGF23 secretion. FGF23 acts on the parathyroid gland to decrease PTH mRNA and PTH secretion in rats with normal kidney function. However, increased serum FGF23 is an early alteration of mineral metabolism in chronic kidney disease, causing secondary hyperthyroidism, and implying resistance of the parathyroid gland to the action of FGF23 in chronic kidney disease. These findings suggest that long-term high-phosphorus diets may impair bone health

  17. Monitoring Bone Health after Spaceflight: Data Mining to Support an Epidemiological Analysis of Age-related Bone Loss in Astronauts

    Science.gov (United States)

    Baker, K. S,; Amin, S.; Sibonga, Jean D.

    2009-01-01

    Through the epidemiological analysis of bone data, HRP is seeking evidence as to whether the prolonged exposure to microgravity of low earth orbit predisposes crewmembers to an earlier onset of osteoporosis. While this collaborative Epidemiological Project may be currently limited by the number of ISS persons providing relevant spaceflight medical data, a positive note is that it compares medical data of astronauts to data of an age-matched (not elderly) population that is followed longitudinally with similar technologies. The inclusion of data from non-ISS and non-NASA crewmembers is also being pursued. The ultimate goal of this study is to provide critical information for NASA to understand the impact of low physical or minimal weight-bearing activity on the aging process as well as to direct its development of countermeasures and rehabilitation programs to influence skeletal recovery. However, in order to optimize these results NASA needs to better define the requirements for long term monitoring and encourage both active and retired astronauts to contribute to a legacy of data that will define human health risks in space.

  18. Fat mass is positively associated with bone mass in relatively thin adolescents: data from the Kitakata Kids Health Study.

    Science.gov (United States)

    Kouda, Katsuyasu; Fujita, Yuki; Sato, Yuho; Ohara, Kumiko; Nakamura, Harunobu; Uenishi, Kazuhiro; Iki, Masayuki

    2014-07-01

    Epidemiologic studies have found that higher body weight is associated with better bone health. Body weight consists of both fat mass (FM) and lean soft tissue mass (LSTM). Previous studies have examined the effects of FM levels during childhood on bone health, with conflicting results. In the present study, we investigated the independent contributions of FM to bone mass in Japanese adolescents. Subjects were 235 adolescents aged 15-18 years old in August 2010 and in August 2013 from the Kitakata Kids Health Study in Japan. We obtained cross-sectional data on body composition as well as bone mineral density (BMD). Body composition and BMD were measured using a dual-energy X-ray absorptiometry scanner. We found moderate and positive relationships between FM index and LSTM index (males, r=0.69; females, r=0.44). To verify a potentially additive effect of FM on the variance of bone variables beyond LSTM, we assessed the association between FM index and bone variables after stratification by tertiles of the LSTM index. In the lowest tertile of the LSTM index, FM index was significantly (PLSTM index. These findings indicate that FM can influence how high bone mass is obtained among relatively thin adolescents, but not among those who are of normal weight or overweight.

  19. The influence of anthropometry and body composition on children's bone health: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark.

    Science.gov (United States)

    Heidemann, Malene; Holst, René; Schou, Anders J; Klakk, Heidi; Husby, Steffen; Wedderkopp, Niels; Mølgaard, Christian

    2015-02-01

    Overweight, physical inactivity and sedentary behaviour have become increasing problems during the past decade. Increased sedentary behaviour may change the body composition (BC) by increasing the fat mass relative to the lean mass (LM). These changes may influence bone health to describe how anthropometry and BC predict the development of the bone accruement. The longitudinal study is a part of The CHAMPS study-DK. Children were DXA scanned at baseline and at 2-year follow-up. BC (LM, BF %) and BMC, BMD and BA were measured. The relationship between bone traits, anthropometry and BC was analysed by multilevel regression analyses. Of the invited children, 742/800 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow-up. Mean (range) of age at baseline was 9.5 years (7.7-12.1). Height, BMI, LM and BF % predicted bone mineral accrual and bone size positively and independently. Height and BMI are both positive predictors of bone accruement. LM is a more precise predictor of bone traits than BF % in both genders. The effects of height and BMI and LM on bone accruement are nearly identical in the two genders, while changes in BF % have different but positive effects on bone accretion in both boys and girls.

  20. Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence.

    Directory of Open Access Journals (Sweden)

    Amanda Jefferson

    Full Text Available We developed clinical guidelines for the management of bone health in Rett syndrome through evidence review and the consensus of an expert panel of clinicians.An initial guidelines draft was created which included statements based upon literature review and 11 open-ended questions where literature was lacking. The international expert panel reviewed the draft online using a 2-stage Delphi process to reach consensus agreement. Items describe the clinical assessment of bone health, bone mineral density assessment and technique, and pharmacological and non-pharmacological interventions.Agreement was reached on 39 statements which were formulated from 41 statements and 11 questions. When assessing bone health in Rett syndrome a comprehensive assessment of fracture history, mutation type, prescribed medication, pubertal development, mobility level, dietary intake and biochemical bone markers is recommended. A baseline densitometry assessment should be performed with accommodations made for size, with the frequency of surveillance determined according to individual risk. Lateral spine x-rays are also suggested. Increasing physical activity and initiating calcium and vitamin D supplementation when low are the first approaches to optimizing bone health in Rett syndrome. If individuals with Rett syndrome meet the ISCD criterion for osteoporosis in children, the use of bisphosphonates is recommended.A clinically significant history of fracture in combination with low bone densitometry findings is necessary for a diagnosis of osteoporosis. These evidence and consensus-based guidelines have the potential to improve bone health in those with Rett syndrome, reduce the frequency of fractures, and stimulate further research that aims to ameliorate the impacts of this serious comorbidity.

  1. Reliability analysis of instrument design of noninvasive bone marrow disease detector

    Science.gov (United States)

    Su, Yu; Li, Ting; Sun, Yunlong

    2016-02-01

    Bone marrow is an important hematopoietic organ, and bone marrow lesions (BMLs) may cause a variety of complications with high death rate and short survival time. Early detection and follow up care are particularly important. But the current diagnosis methods rely on bone marrow biopsy/puncture, with significant limitations such as invasion, complex operation, high risk, and discontinuous. It is highly in need of a non-invasive, safe, easily operated, and continuous monitoring technology. So we proposed to design a device aimed for detecting bone marrow lesions, which was based on near infrared spectrum technology. Then we fully tested its reliabilities, including the sensitivity, specificity, signal-to-noise ratio (SNR), stability, and etc. Here, we reported this sequence of reliability test experiments, the experimental results, and the following data analysis. This instrument was shown to be very sensitive, with distinguishable concentration less than 0.002 and with good linearity, stability and high SNR. Finally, these reliability-test data supported the promising clinical diagnosis and surgery guidance of our novel instrument in detection of BMLs.

  2. Bone Health Monitoring in Astronauts: Recommended Use of Quantitative Computed Tomography [QCT] for Clinical and Operational Decisions

    Science.gov (United States)

    Sibonga, J. D.; Truskowski, P.

    2010-01-01

    This slide presentation reviews the concerns that astronauts in long duration flights might have a greater risk of bone fracture as they age than the general population. A panel of experts was convened to review the information and recommend mechanisms to monitor the health of bones in astronauts. The use of Quantitative Computed Tomography (QCT) scans for risk surveillance to detect the clinical trigger and to inform countermeasure evaluation is reviewed. An added benefit of QCT is that it facilitates an individualized estimation of bone strength by Finite Element Modeling (FEM), that can inform approaches for bone rehabilitation. The use of FEM is reviewed as a process that arrives at a composite number to estimate bone strength, because it integrates multiple factors.

  3. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health.

    Science.gov (United States)

    Maresz, Katarzyna

    2015-02-01

    Inadequate calcium intake can lead to decreased bone mineral density, which can increase the risk of bone fractures. Supplemental calcium promotes bone mineral density and strength and can prevent osteoporosis. Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening. An adequate intake of vitamin K2 has been shown to lower the risk of vascular damage because it activates matrix GLA protein (MGP), which inhibits the deposits of calcium on the walls. Vitamin K, particularly as vitamin K2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. Vitamin K deficiency results in inadequate activation of MGP, which greatly impairs the process of calcium removal and increases the risk of calcification of the blood vessels. An increased intake of vitamin K2 could be a means of lowering calcium-associated health risks.

  4. Physical activity and bone health in schoolchildren: the mediating role of fitness and body fat.

    Directory of Open Access Journals (Sweden)

    Ana Torres-Costoso

    Full Text Available The relationship between physical activity (PA and bone health is well known, although the role of percent body fat (%BF and fitness as confounders or mediators in this relationship remains uncertain.To examine whether the association between PA and bone mineral content (BMC is mediated by %BF and cardiorespiratory fitness (CRF.In this cross sectional study, BMC, total %BF (by DXA, vigorous PA (VPA, CRF, age and height were measured in 132 schoolchildren (62 boys, aged 8-11 years. ANCOVA was used to test differences in BMC by %BF, CRF and VPA, controlling for different sets of confounders. Simple mediation analyses and serial multiple mediation analyses were fitted to examine whether the relationship between PA and BMC is mediated by %BF and fitness.Children with high %BF had higher total body BMC than their peers after controlling for all sets of confounders. Children with good CRF or VPA had significantly less total body BMC after controlling for age and sex but in children with good CRF this inverse relation disappeared after adjusting by %BF. %BF and CRF both act as a full mediator in the association between VPA and BMC, after inclusion of the potential confounders in the models.Fitness and %BF seem to have a mediator role on the relationship between physical activity and bone mass.

  5. Leveraging design thinking to build sustainable mobile health systems.

    Science.gov (United States)

    Eckman, Molly; Gorski, Irena; Mehta, Khanjan

    Mobile health, or mHealth, technology has the potential to improve health care access in the developing world. However, the majority of mHealth projects do not expand beyond the pilot stage. A core reason why is because they do not account for the individual needs and wants of those involved. A collaborative approach is needed to integrate the perspectives of all stakeholders into the design and operation of mHealth endeavours. Design thinking is a methodology used to develop and evaluate novel concepts for systems. With roots in participatory processes and self-determined pathways, design thinking provides a compelling framework to understand and apply the needs of diverse stakeholders to mHealth project development through a highly iterative process. The methodology presented in this article provides a structured approach to apply design thinking principles to assess the feasibility of novel mHealth endeavours during early conceptualisation.

  6. Rationale and Design for the Intramyocardial Injection of Autologous Bone Marrow Mononuclear Cells for Patients with Chronic Ischemic Heart Disease and Left Ventricular Dysfunction Trial (FOCUS)

    Science.gov (United States)

    Willerson, James T.; Perin, Emerson C.; Ellis, Stephen G.; Pepine, Carl J.; Henry, Timothy D.; Zhao, David X.M.; Lai, Dejian; Penn, Marc S.; Byrne, Barry J.; Silva, G; Gee, Adrian; Traverse, Jay H.; Hatzopoulos, Antonis K.; Forder, John R.; Martin, Daniel; Kronenberg, Marvin; Taylor, Doris A.; Cogle, Christopher R.; Baraniuk, Sarah; Westbrook, Lynette; Sayre, Shelly L.; Vojvodic, Rachel W.; Gordon, David J.; Skarlatos, Sonia I.; Moyé, Lemuel A.; Simari, Robert D.

    2010-01-01

    Background The increasing worldwide prevalence of coronary artery disease (CAD) continues to challenge the medical community. Management options include medical and revascularization therapy. Despite advances in these methods, CAD is a leading cause of recurrent ischemia and heart failure, posing significant morbidity and mortality risks along with increasing health costs in a large patient population worldwide. Trial Design The Cardiovascular Cell Therapy Research Network (CCTRN) was established by the National Institutes of Health to investigate the role of cell therapy in the treatment of chronic cardiovascular disease. FOCUS is a CCTRN-designed randomized Phase II, placebo-controlled clinical trial that will assess the effect of autologous bone marrow mononuclear cells delivered transendocardially to patients with left ventricular (LV) dysfunction and symptomatic heart failure or angina. All patients need to have limiting ischemia by reversible ischemia on SPECT assessment. Results After thoughtful consideration of both statistical and clinical principles, we will recruit 87 patients (58 cell treated and 29 placebo) to receive either bone marrow–derived stem cells or placebo. Myocardial perfusion, LV contractile performance, and maximal oxygen consumption are the primary outcome measures. Conclusions The designed clinical trial will provide a sound assessment of the effect of autologous bone marrow mononuclear cells in improving blood flow and contractile function of the heart. The target population is patients with CAD and LV dysfunction with limiting angina or symptomatic heat failure. Patient safety is a central concern of the CCTRN, and patients will be followed for at least 5 years. PMID:20691824

  7. Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence

    DEFF Research Database (Denmark)

    Jefferson, Amanda; Leonard, Helen; Siafarikas, Aris

    2016-01-01

    and biochemical bone markers is recommended. A baseline densitometry assessment should be performed with accommodations made for size, with the frequency of surveillance determined according to individual risk. Lateral spine x-rays are also suggested. Increasing physical activity and initiating calcium...... and vitamin D supplementation when low are the first approaches to optimizing bone health in Rett syndrome. If individuals with Rett syndrome meet the ISCD criterion for osteoporosis in children, the use of bisphosphonates is recommended. CONCLUSION: A clinically significant history of fracture in combination...... with low bone densitometry findings is necessary for a diagnosis of osteoporosis. These evidence and consensus-based guidelines have the potential to improve bone health in those with Rett syndrome, reduce the frequency of fractures, and stimulate further research that aims to ameliorate the impacts...

  8. Design and Fabrication of 3D printed Scaffolds with a Mechanical Strength Comparable to Cortical Bone to Repair Large Bone Defects.

    Science.gov (United States)

    Roohani-Esfahani, Seyed-Iman; Newman, Peter; Zreiqat, Hala

    2016-01-19

    A challenge in regenerating large bone defects under load is to create scaffolds with large and interconnected pores while providing a compressive strength comparable to cortical bone (100-150 MPa). Here we design a novel hexagonal architecture for a glass-ceramic scaffold to fabricate an anisotropic, highly porous three dimensional scaffolds with a compressive strength of 110 MPa. Scaffolds with hexagonal design demonstrated a high fatigue resistance (1,000,000 cycles at 1-10 MPa compressive cyclic load), failure reliability and flexural strength (30 MPa) compared with those for conventional architecture. The obtained strength is 150 times greater than values reported for polymeric and composite scaffolds and 5 times greater than reported values for ceramic and glass scaffolds at similar porosity. These scaffolds open avenues for treatment of load bearing bone defects in orthopaedic, dental and maxillofacial applications.

  9. Design and Fabrication of 3D printed Scaffolds with a Mechanical Strength Comparable to Cortical Bone to Repair Large Bone Defects

    Science.gov (United States)

    Roohani-Esfahani, Seyed-Iman; Newman, Peter; Zreiqat, Hala

    2016-01-01

    A challenge in regenerating large bone defects under load is to create scaffolds with large and interconnected pores while providing a compressive strength comparable to cortical bone (100–150 MPa). Here we design a novel hexagonal architecture for a glass-ceramic scaffold to fabricate an anisotropic, highly porous three dimensional scaffolds with a compressive strength of 110 MPa. Scaffolds with hexagonal design demonstrated a high fatigue resistance (1,000,000 cycles at 1–10 MPa compressive cyclic load), failure reliability and flexural strength (30 MPa) compared with those for conventional architecture. The obtained strength is 150 times greater than values reported for polymeric and composite scaffolds and 5 times greater than reported values for ceramic and glass scaffolds at similar porosity. These scaffolds open avenues for treatment of load bearing bone defects in orthopaedic, dental and maxillofacial applications.

  10. The association of dietary quality and food group intake patterns with bone health status among Korean postmenopausal women: a study using the 2010 Korean National Health and Nutrition Examination Survey Data

    OpenAIRE

    Go, Gyeongah; Tserendejid, Zuunnast; Lim, Youngsook; Jung, Soyeon; Min, Younghee; Park, Haeryun

    2014-01-01

    BACKGROUND/OBJECTIVES Osteoporosis and osteoporosis-related disease are drawing a lot of attention in Korea as one of the serious health problems. Bone health status may be influenced by the general dietary quality and dietary pattern. SUBJECTS/METHODS To determine the relationship between dietary quality and intake patterns and bone health status, the %RNI, NAR, DDS, and food group intake patterns were assessed according to their bone health status for 847 postmenopausal women using the 2010...

  11. A Prospective Cluster-Randomized Trial of Telehealth Coaching to Promote Bone Health and Nutrition in Deployed Soldiers

    Directory of Open Access Journals (Sweden)

    Mary S. McCarthy

    2014-12-01

    Full Text Available Findings from previous studies suggest that inadequate consumption of calcium and vitamin D and a decrease in exercise while deployed can be detrimental to bone health. This study enrolled 234 soldiers randomized to receive one-time nutrition and exercise education pre-deployment (n = 149, or telehealth coaching (n = 85, throughout the deployment cycle. Results suggest that online educational efforts may enhance sports activity, bone turnover, and vitamin D status. Improving vitamin D status and remaining active while deployed appears to sustain healthy bone density in young soldiers. Early and aggressive educational outreach to young adults may prevent chronic musculoskeletal conditions and disabling osteoporosis later in life.

  12. Design and optimization of a tissue-engineered bone graft substitute

    Science.gov (United States)

    Shimko, Daniel Andrew

    2004-12-01

    formulation, and scaffold material from all preceding studies were combined and a tissue-engineered bone graft was fabricated. The graft was exposed to long-term in vitro culture, and then mechanically evaluated to determine its clinical potential. The studies contained herein constitute the first steps in the conception and development of a viable tissue-engineered bone graft substitute and establish a solid scientific foundation for future in vivo experimentation utilizing this design.

  13. Rodent bone densitometer on the International Space Station: Instrument design and performance

    Science.gov (United States)

    Vellinger, John C.; Barton, Kenneth; Faget, Paul; Todd, Paul; Boland, Eugene

    2016-07-01

    The study of bone loss dynamics, mechanisms and countermeasures has been a publicly stated purpose of biomedical research aboard the International Space Station. Rodent research has always played a major role in terrestrial laboratories studying bone loss. The "gold standard" for assessing bone loss in human patients has been dual-energy x-ray absorptiometry (DEXA). DEXA is also widely applied to the study of bone loss in laboratory animals, so this technology has been added to the ISS inventory of analytical tools in the form of the ISS Bone Densitometer (BD) designed, constructed, tested and integrated by Techshot, Inc. (Greenville, Indiana, USA). The BD is a re-packaged COTS device known as PIXImus (GE-Lunar, USA), which was installed on ISS in November 2014 after launching on SpaceX-4. To facilitate operations in microgravity and to meet spaceflight facility and safety requirements the commercial x-ray source, control electronics and imaging system were modified and packaged by Techshot into a drawer that fits into a single EXPRESS Locker replacement. A space-rated "Exam Box" is also supplied for containment of the anesthetized subject during transfer into the BD and during exposure. The commercial software package controls four paired-energy exposures, 80 and 35 kV, and applies DEXA algorithms to the fluorescence images and displays bone mineral density (BMD), bone mineral content, lean mass, fat mass, total mass and per cent fat. The BD is therefore also a means for measuring mass and body composition making it a versatile tool for many types of rodent studies on orbit. The BD has been operated multiple times on orbit, and its performance has not differed significantly from its performance on the ground. It has been shown to measure body mass with a precision of +/- 0.1 g and on-orbit accuracy of -0.3 g. It is expected to detect BMD losses of approximately 2%. The image data are stored in a manner that allows post-test data analysis especially including the

  14. Why Health Care Needs Design Research

    DEFF Research Database (Denmark)

    Knutz, Eva; Ammentorp, Jette; Kofoed, Poul-Erik

    2015-01-01

    . Furthermore, the data reveal that pediatric patients display a radically different play pattern than children who are not in hospital. The inquiry takes an interdisciplinary approach; it has obvious health care-related objectives and seeks to meet the urgent need for new methods within health care to optimize...

  15. How many patients are needed? Variation and design considerations in bone histomorphometry.

    Science.gov (United States)

    Hauge, E M; Mosekilde, L; Melsen, F; Frydenberg, M

    2001-05-01

    In osteoporosis research, bone histomorphometry plays an important role in documenting the biological effects and possible side-effects of new drug treatments. To ensure that the study is properly scaled, it is important to be concerned with the risk of type II error; that is, the risk of failing to detect a real difference. We therefore calculated the necessary sample size in bone histomorphometric studies according to a specified difference of 15% between two groups. The calculations were based on variance components estimated from three different studies: women with a distal fracture of the forearm (n = 22); patients with pituitary insufficiency (n = 21); and patients with primary hyperparathyroidism (n = 21). Using a significance level of 0.05 and a risk of type II error of 0.20, the statistical power of two different designs was compared: a single biopsy design comparing the responses in two groups after the treatment; and a paired biopsy design in which individual differences (posttreatment minus baseline) were calculated before the comparison of the two groups. We found that the mineral apposition rate, wall thickness, and erosion depth are statistically powerful indices that, in the single biopsy design, require no more than n = 25 in each group to detect differences of 15% between the groups. Bone volume, erosion surface, osteoid surface, mineralizing surface, and activation frequency need group sizes of 100-600 individuals to find a 15% difference to be statistically significant. However, the effect of bisphosphonate treatment, for instance, is large enough to reduce the group size to 20 individuals concerning activation frequency. The remodeling balance reaches extreme group sizes of several thousand for a 15% difference to be statistically significant, but for a 5 microm (approximately 150%) improvement, about 100 individuals are required in the single biopsy design. An analysis of the components of variance showed that the variation between individuals

  16. Including customers in health service design.

    Science.gov (United States)

    Perrott, Bruce E

    2013-01-01

    This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

  17. Impact of orange juice consumption on bone health of the U.S. population in the national health and nutrition examination survey 2003-2006.

    Science.gov (United States)

    Lee, Sang Gil; Yang, Meng; Wang, Ying; Vance, Terrence; Lloyd, Beate; Chung, Sang-Jin; Koo, Sung I; Chun, Ock K

    2014-10-01

    Orange juice (OJ) fortified with calcium (Ca) and vitamin D has turned OJ into a readily available source of these nutrients for children and adults. However, the impact of OJ consumption on Ca and vitamin D adequacy and bone health has not been documented. The aim of this study was the evaluation of the contribution of 100% OJ consumption to dietary and serum Ca and vitamin D status, and bone health parameters in the U.S. population aged 4 years and older (n=13,971) using the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and 2005-2006. Food consumption data were coded to produce micronutrient intake values using the USDA Food and Nutrient Database for Dietary Studies 3.0. Serum concentrations of bone-related micronutrients and biomarkers, bone mineral density (BMD), and bone mineral content (BMC) were measured. Analysis of data was conducted using SAS software 9.2 and SUDAAN. OJ consumers showed higher intakes of bone-related micronutrients, compared with nonconsumers (P<.05). In addition, OJ consumers had higher serum Ca levels in adults (P<.01) and had a lower odds ratio for serum 25-hydroxyvitamin D3 <20 ng/mL in children (P<.05). OJ consumption was positively associated with femur BMD in children (P<.05) and with femur BMC in both children and adults (P<.05). In conclusion, OJ may be recommended as an effective dietary means of improving the status of Ca and vitamin D, acid-base balance, and of promoting bone health in children and adults.

  18. New miniplate for osteosynthesis of mandibular angle fractures designed to improve formation of new bone.

    Science.gov (United States)

    Pituru, Teodora Silagieva; Bucur, Alexandru; Gudas, Claudiu; Pituru, Silviu-Mirel; Marius Dinca, Octavian

    2016-04-01

    The purpose of this article is to present the study of a new miniplate designed to keep the maximum strains developed in the cortical bone near the fracture line during accidental biting to values below the threshold causing bone resorption. Designed to offer maximum fracture stability with minimal implanted volume and patient intrusion, the design uses a novel approach to account for the effects of the distance from the fracture line to the nearest screws. Its geometry minimizes the peak forces that can develop during most cases of mandible biomechanical loadings. A three-dimensional (3D) osteosynthesis finite element model for a human mandible confirmed the operational effectiveness of the miniplate. It also provided numerical estimates for the strains and screw forces in the cortical surface during incisor bites with clinically relevant forces of 200 N. Two prototypes, 0.6 mm and 0.8 mm in thickness, were repeatedly tested on fractured sheep mandibles, fixed in a purpose-built jig, to loads up to 150% of the maximum forces developed by human patients. The tests indicated good fracture stability, and the proof tests carried for each of the two prototypes terminated at more than 350 N due to failure of the loading cable and respectively, secondary mandible fractures occurring away from the miniplate.

  19. Maternal Dietary Vitamin D Does Not Program Systemic Inflammation and Bone Health in Adult Female Mice Fed an Obesogenic Diet

    Directory of Open Access Journals (Sweden)

    Christopher R. Villa

    2016-10-01

    Full Text Available Obesity is associated with systemic inflammation and impaired bone health. Vitamin D regulates bone metabolism, and has anti-inflammatory properties and epigenetic effects. We showed that exposure to high dietary vitamin D during pregnancy and lactation beneficially programs serum concentration of lipopolysaccharide (LPS and bone structure in male offspring fed an obesogenic diet. Here we assessed if this effect is also apparent in females. C57BL/6J dams were fed AIN93G diet with high (5000 IU/kg diet or low (25 IU/kg diet vitamin D during pregnancy and lactation. Post-weaning, female offspring remained on their respective vitamin D level or were switched and fed a high fat and sucrose diet (44.2% fat, 19.8% sucrose until age seven months when glucose response, adiposity, serum LPS, and bone mineral, trabecular and cortical structure, and biomechanical strength properties of femur and vertebra were assessed. There was no evidence for a programming effect of vitamin D for any outcomes. However, females exposed to a high vitamin D diet post-weaning had higher bone mineral content (p = 0.037 and density (p = 0.015 of lumbar vertebra. This post-weaning benefit suggests that in females, bone mineral accrual but not bone structure is compromised with low vitamin D status in utero until weaning in an obesogenic context.

  20. Investigating the impact of socioeconomic status on the effectiveness of a pamphlet on achieving and maintaining bone health in breast cancer survivors: a patient education resource development primer.

    Science.gov (United States)

    Adirim, Tara; Chafranskaia, Aleksandra; Nyhof-Young, Joyce

    2012-03-01

    Considerable need exists to raise awareness of breast cancer (BC) treatment-induced bone loss and provide management and preventative strategies. We describe the development and evaluation process of an educational pamphlet for BC survivors on achieving and maintaining bone health. A Participatory Design approach was used. The pamphlet was first critically evaluated by interdisciplinary healthcare professionals and less vulnerable members of the target audience prior to evaluation by 45 BC survivors, who completed two questionnaires inquiring about demographics and pamphlet evaluation and satisfaction. Pamphlet effectiveness was correlated with income and education to determine differences between socioeconomic groups. Perceived knowledge increased significantly after reading the brochure for all groups. Socioeconomic status had no impact on pamphlet effectiveness. This methodological approach is presented as a blueprint to promote knowledge translation in cancer patient education contexts aiming to provide cancer patients with the best possible resources for effective self-management of their conditions.

  1. Development of a novel method for surgical implant design optimization through noninvasive assessment of local bone properties.

    Science.gov (United States)

    Schiuma, D; Brianza, S; Tami, A E

    2011-03-01

    A method was developed to improve the design of locking implants by finding the optimal paths for the anchoring elements, based on a high resolution pQCT assessment of local bone mineral density (BMD) distribution and bone micro-architecture (BMA). The method consists of three steps: (1) partial fixation of the implant to the bone and creation of a reference system, (2) implant removal and pQCT scan of the bone, and (3) determination of BMD and BMA of all implant-anchoring locations along the actual and alternative directions. Using a PHILOS plate, the method uncertainty was tested on an artificial humerus bone model. A cadaveric humerus was used to quantify how the uncertainty of the method affects the assessment of bone parameters. BMD and BMA were determined along four possible alternative screw paths as possible criteria for implant optimization. The method is biased by a 0.87 ± 0.12 mm systematic uncertainty and by a 0.44 ± 0.09 mm random uncertainty in locating the virtual screw position. This study shows that this method can be used to find alternative directions for the anchoring elements, which may possess better bone properties. This modification will thus produce an optimized implant design.

  2. Interoperability design of personal health information import service.

    Science.gov (United States)

    Tuomainen, Mika; Mykkänen, Juha

    2012-01-01

    Availability of personal health information for individual use from professional patient records is an important success factor for personal health information management (PHIM) solutions such as personal health records. In this paper we focus on this crucial part of personal wellbeing information management splutions and report the interoperability design of personal information import service. Key requirements as well as design factors for interfaces between PHRs and EPRs are discussed. Open standards, low implementation threshold and the acknowledgement of local market and conventions are emphasized in the design.

  3. Low to moderate alcohol consumption on serum vitamin D and other indicators of bone health in postmenopausal women in a controlled feeding study

    Science.gov (United States)

    Heavy alcohol drinking adversely affects vitamin D status and bone health. However, data from randomized, placebo-controlled trials (RCTs) on the effects of low to moderate alcohol consumption on vitamin D status and bone health in humans is unavailable. The objective of this cross-over RCT was to e...

  4. Design and testing of small scale fish meat bone separator useful for fish processing.

    Science.gov (United States)

    Ali Muhammed, M; Manjunatha, N; Murthy, K Venkatesh; Bhaskar, N

    2015-06-01

    The present study relates to the food processing machinery and, more specifically machine for producing boneless comminuted meat from raw fish fillet. This machine is of belt and drum type meat bone separator designed for small scale fish processing in a continuous mode. The basic principal involved in this machine is compression force. The electric geared motor consists of 1HP and the conveyor belt has a linear velocity of 19 to 22 m min(-1), which was sufficient to debone the fish effectively. During the meat bone separation trials an efficiency up to 75 % on dressed fish weight basis was observed and with a capacity to separate 70 kg h(-1) of meat from fish at the machine speed of 25 rpm. During the trials, it was demonstrated that there was no significant change in the proximate composition of comminuted fish meat when compared to unprocessed fish meat. This design has a greater emphasis on hygiene, provision for cleaning-in-place (CIP) and gives cost effective need and reliability for small scale industries to produce fish meat in turn used for their value added products.

  5. Evidence for designing health promoting pocket parks

    DEFF Research Database (Denmark)

    Peschardt, Karin Kragsig; Stigsdotter, Ulrika K.

    2014-01-01

    pocket park, Dantes Plads, before and after a redesign. Six people were interviewed about their perception of the change. First of all, the results show that Dantes Plads is primarily used for ‘rest and restitution’. Furthermore, the interviewees prefer to have the presence of sun, shade and planting......The use of urban green environments has repeatedly been associated with improved health and well-being for people living in cities. This study focuses on the health promoting potential of pocket parks in the dense city area of Copenhagen. A natural experiment was conducted, which evaluated one...... in relation to rest and restitution, while varied ‘terrain’ may create fascination thereby providing the opportunity for restoration. ‘Noise level’ is perceived differently from subject to subject, while ‘benches’ as well as ‘visual angels’ should not be oriented directly towards disturbing surroundings...

  6. A Review of Dental Implant Treatment Planning and Implant Design Based on Bone Density

    OpenAIRE

    Torkzaban; Moradi Haghgoo; khoshhal; Arabi; Razaghi

    2013-01-01

    Context A key determinant for clinical success is the diagnosis of the bone density in a potential implant site. The percentage of bone-implant contact is related to bone density, and the axial stress contours around an implant are affected by the density of bone. Evidence Acquisition A number of reports have emphasized the importance of the quality of bone on the survival of dental implants. The volume and density of the recipien...

  7. Novel biocompatible polymeric blends for bone regeneration: Material and matrix design and development

    Science.gov (United States)

    Deng, Meng

    The first part of the work presented in this dissertation is focused on the design and development of novel miscible and biocompatible polyphosphazene-polyester blends as candidate materials for scaffold-based bone tissue engineering applications. Biodegradable polyesters such as poly(lactide-co-glycolide) (PLAGA) are among the most widely used polymeric materials for bone tissue engineering. However, acidic degradation products resulting from the bulk degradation mechanism often lead to catastrophic failure of the structure integrity, and adversely affect biocompatibility both in vitro and in vivo. One promising approach to circumvent these limitations is to blend PLAGA with other macromolecules that can buffer the acidic degradation products with a controlled degradation rate. Biodegradable polyphosphazenes (PPHOS), a new class of biomedical materials, have proved to be superior candidate materials to achieve this objective due to their unique buffering degradation products. A highly practical blending approach was adopted to develop novel biocompatible, miscible blends of these two polymers. In order to achieve this miscibility, a series of amino acid ester, alkoxy, aryloxy, and dipeptide substituted PPHOS were synthesized to promote hydrogen bonding interactions with PLAGA. Five mixed-substituent PPHOS compositions were designed and blended with PLAGA at different weight ratios producing candidate blends via a mutual solvent method. Preliminary characterization identified two specific side groups namely glycylglycine dipeptide and phenylphenoxy that resulted in improved blend miscibility and enhanced in vitro osteocompatibility. These findings led to the synthesis of a mixed-substituent polyphosphazene poly[(glycine ethyl glycinato)1(phenylphenoxy)1phosphazene] (PNGEGPhPh) for blending with PLAGA. Two dipeptide-based blends having weight ratios of PNGEGPhPh to PLAGA namely 25:75 (Matrix1) and 50:50 (Matrix2) were fabricated. Both of the blends were

  8. Design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite as a potential bone graft substitute material

    Science.gov (United States)

    Florschutz, Anthony Vatroslav

    Utilization of bone grafts for the treatment of skeletal pathology is a common practice in orthopaedic, craniomaxillofacial, dental, and plastic surgery. Autogenous bone graft is the established archetype but has disadvantages including donor site morbidity, limited supply, and prolonging operative time. In order to avoid these and other issues, bone graft substitute materials are becoming increasingly prevalent among surgeons for reconstructing skeletal defects and arthrodesis applications. Bone graft substitutes are biomaterials, biologics, and guided tissue/bone regenerative devices that can be used alone or in combinations as supplements or alternatives to autogenous bone graft. There is a growing interest and trend to specialize graft substitutes for specific indications and although there is good rationale for this indication-specific approach, the development and utility of a more universal bone graft substitute may provide a better answer for patients and surgeons. The aim of the present research focuses on the design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite composites for potential use as a bone graft substitutes. After initial establishment of rational material design, gelatinhydroxyapatite scaffolds were fabricated with different gelatin:hydroxyapatite ratios and crosslinking concentrations. The synthesized scaffolds were subsequently evaluated on the basis of their swelling behavior, porosity, density, percent composition, mechanical properties, and morphology and further assessed with respect to cell-biomaterial interaction and biomineralization in vitro. Although none of the materials achieved mechanical properties suitable for structural graft applications, a reproducible material design and synthesis was achieved with properties recognized to facilitate bone formation. Select scaffold formulations as well as a subset of scaffolds loaded with recombinant human bone morphogenetic protein-2 were

  9. User-centered design and interactive health technologies for patients.

    Science.gov (United States)

    De Vito Dabbs, Annette; Myers, Brad A; Mc Curry, Kenneth R; Dunbar-Jacob, Jacqueline; Hawkins, Robert P; Begey, Alex; Dew, Mary Amanda

    2009-01-01

    Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design is an approach that involves end users throughout the development process so that technologies support tasks, are easy to operate, and are of value to users. In this article, we provide an overview of user-centered design and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH) to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes.

  10. CMOS IC design for wireless medical and health care

    CERN Document Server

    Wang, Zhihua; Chen, Hong

    2014-01-01

    This book provides readers with detailed explanation of the design principles of CMOS integrated circuits for wireless medical and health care, from the perspective of two successfully-commercialized applications. Design techniques for both the circuit block level and the system level are discussed, based on real design examples. CMOS IC design techniques for the entire signal chain of wireless medical and health care systems are covered, including biomedical signal acquisition, wireless transceivers, power management and SoC integration, with emphasis on ultra-low-power IC design techniques. • Discusses CMOS integrated circuit design for wireless medical and health care, based on two successfully-commercialized medical and health care applications; • Describes design techniques for the entire signal chain of wireless medical and health care systems; • Focuses on techniques for short-range wireless communication systems; • Emphasizes ultra-low-power IC design techniques; • Enables readers to tu...

  11. 42 CFR 5.3 - Procedures for designation of health professional(s) shortage areas.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for designation of health professional(s) shortage areas. 5.3 Section 5.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS § 5.3 Procedures for designation of health professional(s)...

  12. Body Composition, Nutritional Profile and Muscular Fitness Affect Bone Health in a Sample of Schoolchildren from Colombia: The Fuprecol Study

    Directory of Open Access Journals (Sweden)

    Mónica Adriana Forero-Bogotá

    2017-02-01

    Full Text Available The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls. Calcaneal broadband ultrasound attenuation (c-BUA was obtained as a marker of bone health. Body composition (fat mass and lean mass was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI was calculated. Standing long-jump (SLJ and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤−1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤−1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life.

  13. Body Composition, Nutritional Profile and Muscular Fitness Affect Bone Health in a Sample of Schoolchildren from Colombia: The Fuprecol Study

    Science.gov (United States)

    Forero-Bogotá, Mónica Adriana; Ojeda-Pardo, Mónica Liliana; García-Hermoso, Antonio; Correa-Bautista, Jorge Enrique; González-Jiménez, Emilio; Schmidt-RíoValle, Jacqueline; Navarro-Pérez, Carmen Flores; Gracia-Marco, Luis; Vlachopoulos, Dimitris; Martínez-Torres, Javier; Ramírez-Vélez, Robinson

    2017-01-01

    The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤−1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤−1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life. PMID:28165360

  14. Biosecurity through Public Health System Design.

    Energy Technology Data Exchange (ETDEWEB)

    Beyeler, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arndt, William [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walser, Alex Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-11-01

    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulates key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.

  15. Top 10 Research Questions Related to Physical Activity and Bone Health in Children and Adolescents

    Science.gov (United States)

    Janz, Kathleen F.; Thomas, David Q.; Ford, M. Allison; Williams, Skip M.

    2015-01-01

    Evidence strongly supports a positive, causal effect of physical activity on bone strength and suggests long-term benefits of childhood physical activity to the prevention of osteoporosis. The contribution of healthy bone development in youth is likely to be as important to fracture prevention as the amount of late adulthood bone loss. Families,…

  16. Effectiveness of community intervention in improving bone health behaviors in older adults.

    Science.gov (United States)

    Plawecki, Karen; Chapman-Novakofski, Karen

    2013-01-01

    An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control, 963 mg; treatment, 1023 mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1023 mg calcium, 128 IU vitamin D) and treatment (1005 mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.

  17. Participatory Design in Health Care – Participation, power and knowledge

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Danbjørg, Dorthe Boe; Myhre Jensen, Charlotte;

    2016-01-01

    -established science tradition, language, culture and biomedical approach in health science. This workshop will be an opportunity to share our experiences in using participatory design in healthcare and research, or experiences in applying participatory design activities across different healthcare systems......, particularly addressing dilemmas on knowledge, power and participation....

  18. Reusable design: A proposed approach to Public Health Informatics system design

    Directory of Open Access Journals (Sweden)

    Revere Debra

    2011-02-01

    Full Text Available Abstract Background Since it was first defined in 1995, Public Health Informatics (PHI has become a recognized discipline, with a research agenda, defined domain-specific competencies and a specialized corpus of technical knowledge. Information systems form a cornerstone of PHI research and implementation, representing significant progress for the nascent field. However, PHI does not advocate or incorporate standard, domain-appropriate design methods for implementing public health information systems. Reusable design is generalized design advice that can be reused in a range of similar contexts. We propose that PHI create and reuse information design knowledge by taking a systems approach that incorporates design methods from the disciplines of Human-Computer Interaction, Interaction Design and other related disciplines. Discussion Although PHI operates in a domain with unique characteristics, many design problems in public health correspond to classic design problems, suggesting that existing design methods and solution approaches are applicable to the design of public health information systems. Among the numerous methodological frameworks used in other disciplines, we identify scenario-based design and participatory design as two widely-employed methodologies that are appropriate for adoption as PHI standards. We make the case that these methods show promise to create reusable design knowledge in PHI. Summary We propose the formalization of a set of standard design methods within PHI that can be used to pursue a strategy of design knowledge creation and reuse for cost-effective, interoperable public health information systems. We suggest that all public health informaticians should be able to use these design methods and the methods should be incorporated into PHI training.

  19. A Design of Mobile Health for Android Applications

    Directory of Open Access Journals (Sweden)

    Dr. Vuda Sreenivasa Rao

    2015-06-01

    Full Text Available For healthiness and wellness, exercising is one of the key factors. In this paper, a mobile health application is developed to recommend healthcare support referring to exercises on the Android Smart Phone. This application has been designed to provide exercise advice depending on Body Mass Index (BMI, Basal Metabolic Rate (BMR and the energy used in each activity or sport (e.g. aerobic dancing, cycling, jogging working and swimming. Also, this application has been designed to present special exercise advice for patients with health issues. Moreover, it has been designed to store information in a database and to have the ability to produce reports to users.

  20. Outpatient health care statistics data warehouse--logical design.

    Science.gov (United States)

    Natek, S

    1999-01-01

    Outpatient Health Care Statistics on a state level is a central point where all relevant statistic data are collected from various sources from all over the country. Various and complex requirements for processing and reporting data makes Outpatient Health Care Statistics on a state level a perfect example for efficient implementing of Data warehouse technology. The research investigates logical design of data warehouse with a special attention on a different data modeling technique in various phases of a logical data warehouse design. The research shows that a requirement for processing statistical data determines the design decision and thus the scope and semantic value of final data warehouse.

  1. Evaluation of Strain Distribution in Bone around Implant in Treatment Design of Overdentures Using Computer and Modeling of Finite Elements

    Directory of Open Access Journals (Sweden)

    Masoumeh Khoshhal

    2015-12-01

    Full Text Available Introduction: Introduction: Few studies have investigated the distribution of stress around implants. In this study the distribution of stress in bones around implants was investigated in five overdenture (OD treatment designs including OD-1, OD-2, OD-3, OD-4 and OD-5. Materials and methods: The Catia modeling software was used in order to simulate the tooth/implant model and bone. First, the borders of cancellous and cortical bone in each section of the CT images were attained by Photoshop software. Then, modeling softwares SolidWorks and NUMBER were applied to make the final three-dimensional model of jaw. Finally, the amount of stress on the surface of bone/implant was studied by means of stress analysis software (Ansys v11.0. Results: Protrusive movements of implants B and D in OD-1 showed the highest amount of strain, 2435 εµ. Also, high amounts of strain, 1668 and 1557 εµwere observed in OD-1 and OD-2 designs in lateral movements respectively. Conclusion: The bottom line is that no forces to the extent of destruction based on the Ferost model were found for these designs. The highest amount of strain occurred in OD-1 design, which is held in mild overload window. Moreover, the amounts of strain in the rest of designs investigated were in adaptive window.

  2. Design and Implementation of a Controller for a BeagleBone Quadcopter

    Science.gov (United States)

    Olejnik, Peter

    Unmanned aerial vehicles are quickly becoming a significant and permanent feature in today's world of aviation. Amongst the various types of UAVs, a popular type is the quadcopter. Also referred to as a quadrotor, this rotor craft's defining feature is that it has four propellers. While its use is common in the hobbyist community, this aircraft's use within industry is blooming. Presented are the efforts to design and implement a controller for a BeagleBone based quadcopter. As part of this effort, characteristics of the quadcopter were experimentally determined. These characteristics consist of physical properties of the quadcopter, such as the moments of inertia, the motor performance characteristics, and variance within its sensors. A model was then created and implemented within a MATLAB environment to simulate the flight of the quadcopter. With a simulated environment created, a controller was designed to control the flight of the quadcopter and a Kalman Filter was implemented to filter a sensor input. These designs were then verified in the simulated environment.

  3. Smart health monitoring systems: an overview of design and modeling.

    Science.gov (United States)

    Baig, Mirza Mansoor; Gholamhosseini, Hamid

    2013-04-01

    Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

  4. Home health monitoring – EyKos HealthHub (product design concept)

    OpenAIRE

    Phillips, Mark; Dulake, Nick; Willox, Matt; Gwilt, Ian; Craig, Claire; Auton, Kevin

    2015-01-01

    This work focused on creating a product design concept for a home health monitoring system, known as EyKos HealthHub, which is intended to be a ‘crossover product’ in the emerging medical/consumer product space. Working collaboratively with Aseptika Ltd, the team carried out product concept design and interaction design for the EyKos system, and undertook further design and prototyping work to create an object for use in research. Aseptika is carrying out technical development of this project...

  5. Rethinking behavioral health processes by using design for six sigma.

    Science.gov (United States)

    Lucas, Anthony G; Primus, Kelly; Kovach, Jamison V; Fredendall, Lawrence D

    2015-02-01

    Clinical evidence-based practices are strongly encouraged and commonly utilized in the behavioral health community. However, evidence-based practices that are related to quality improvement processes, such as Design for Six Sigma, are often not used in behavioral health care. This column describes the unique partnership formed between a behavioral health care provider in the greater Pittsburgh area, a nonprofit oversight and monitoring agency for behavioral health services, and academic researchers. The authors detail how the partnership used the multistep process outlined in Design for Six Sigma to completely redesign the provider's intake process. Implementation of the redesigned process increased access to care, decreased bad debt and uncollected funds, and improved cash flow--while consumer satisfaction remained high.

  6. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health

    OpenAIRE

    Maresz, Katarzyna

    2015-01-01

    Inadequate calcium intake can lead to decreased bone mineral density, which can increase the risk of bone fractures. Supplemental calcium promotes bone mineral density and strength and can prevent osteoporosis. Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition...

  7. Effect of soy isolate protein and resistance exercises on muscle performance and bone health of osteopenic/osteoporotic post-menopausal women.

    Science.gov (United States)

    Shenoy, Shweta; Bedi, Reecha; Sandhu, Jaspal S

    2013-01-01

    There are contradictory reports regarding the effect of soy protein isolate on bone health in menopause. The main objective of this study was to assess the influence of soy isolate protein intake and resistance exercises on isokinetic muscle strength, endurance, power, and bone health parameters in osteopenic/osteoporotic postmenopausal women. Sixty osteoporotic sedentary women (mean age 54.55 years) were randomly assigned to three groups: soy isolate protein (Group A), soy + exercise group (Group B), and control group (Group C). Group B performed supervised progressive resistance exercises 4 times/week for 12 weeks. Muscle performance was measured by isokinetic dynamometry, and bone health was measured by ultrasound densitometry. Analysis of variance showed significant bone and muscle strength gains (p < .05) both in Group A and B, with the improvements more pronounced in Group B. Significant muscle performance changes, after intervention, were evident and bone strength increases may parallel changes in muscle strength.

  8. Energy availability, menstrual dysfunction and bone health in sports: an overwiew of the female athlete triad

    Directory of Open Access Journals (Sweden)

    Sara Márquez

    2013-08-01

    Full Text Available Introduction: The female athlete triad (FAT is a serious health-related problem that threatens women who exercise. This condition is an interrelated multifactorial syndrome which includes low energy availability, menstrual cycle disturbances and decreased bone mineral density. Objective: To review the major components of the FAT and their relationships, as well as strategies for diagnosis and treatment. Methods: Articles related to the topic were reviewed through PubMed and SportDiscus databases. Results: Interrelationship between components of the FAT may result in clinical manifestations, including eating disorders, amenorrhea and osteoporosis. Clinical conditions are not always exhibited simultaneously. Prevention is important to minimize complications. Diagnosis and treatment is complicated and often must involve an interdisciplinary therapeutic approach. Conclusions: Understanding of the disease may be facilitated by a unified framework focusing on energy deficiency. Preventive or early interventions require to increase energy availability through a higher total energy intake or a decrease in energy expenditure trough excessive physical exercise. A healthy lifestyle, and support by parents and coaches should be included. Psychotherapy may be necessary when eating disorders are present.

  9. Nutrition and lifestyle in relation to bone health and body weight in Croatian postmenopausal women.

    Science.gov (United States)

    Ilich, Jasminka Z; Cvijetic, Selma; Baric, Irena Colic; Cecic, Ivana; Saric, Marija; Crncevic-Orlic, Zeljka; Blanusa, Maja; Korsic, Mirko

    2009-06-01

    The objective was to investigate the association of nutrients and lifestyle modifiers with bone mineral density (BMD) and weight and/or body mass index (BMI) in 120 healthy Croatian postmenopausal women. The hip and spine BMD was assessed by Lunar Prodigy (GE Medical Systems). Nutrient assessment from 3-day records was analyzed using the US Department of Agriculture Food Composition Tables and the Croatian National Institute of Public Health database. Subjects were asked to record the consumption of alcohol, coffee, tea and mineral waters, the amount of salt added to foods and smoking habits, as well as involvement in recreational activities, walking and heavy housework. Spot urine samples were analyzed for calcium, magnesium, sodium, potassium and zinc and were normalized by creatinine. Alcohol showed statistically significant positive association with femur and spine BMD and its consumption was higher in subjects without osteoporosis. Urinary sodium/creatinine was significantly positively associated with femoral neck and trochanter BMD, while urinary calcium/creatinine was significantly negatively associated with trochanter, total femur and spine BMD. Consumption of mineral waters was inversely associated with weight/BMI and so were dietary fiber and magnesium. In conclusion, moderate alcohol consumption and urinary sodium were positively associated while urinary calcium was negatively associated with either hip and/or spine BMD. Mineral waters, higher fiber and magnesium intake were beneficial for weight/BMI in this population of apparently healthy Croatian women.

  10. Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health.

    Science.gov (United States)

    Cuenca-Sánchez, Marta; Navas-Carrillo, Diana; Orenes-Piñero, Esteban

    2015-05-01

    Long-term consumption of a high-protein diet could be linked with metabolic and clinical problems, such as loss of bone mass and renal dysfunction. However, although it is well accepted that a high-protein diet may be detrimental to individuals with existing kidney dysfunction, there is little evidence that high protein intake is dangerous for healthy individuals. High-protein meals and foods are thought to have a greater satiating effect than high-carbohydrate or high-fat meals. The effect of high-protein diets on the modulation of satiety involves multiple metabolic pathways. Protein intake induces complex signals, with peptide hormones being released from the gastrointestinal tract and blood amino acids and derived metabolites being released in the blood. Protein intake also stimulates metabolic hormones that communicate information about energy status to the brain. Long-term ingestion of high amounts of protein seems to decrease food intake, body weight, and body adiposity in many well-documented studies. The aim of this article is to provide an extensive overview of the efficacy of high protein consumption in weight loss and maintenance, as well as the potential consequences in human health of long-term intake.

  11. Integrating health behavior theory and design elements in serious games.

    OpenAIRE

    Cheek, Colleen; Fleming, Theresa; Lucassen, Mathijs F. G.; Bridgman,Heather; Stasiak, Karolina; Shepherd, Matthew; Orpin, Peter

    2015-01-01

    Background: Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better ...

  12. Osteoporosis: Modern Paradigms for Last Century's Bones.

    Science.gov (United States)

    Kruger, Marlena C; Wolber, Frances M

    2016-06-17

    The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

  13. Using Participatory Design to design and develop mHealth for women with osteoporosis

    DEFF Research Database (Denmark)

    Jakobsen, Pernille Ravn; Wiil, Uffe Kock; Søndergaard, Jens

    2016-01-01

    and sick, and the women should be aided in learning to live with osteoporosis and how to prevent fractures (2). The effects of mHealth on self-care and self-management appear to be promising (3). Involvement of users in health care research is important, especially when developing new technologies......, to ensure that these technologies meet the needs of the users (4). PURPOSE Design and development of mHealth to increase self-care and self-management among postmenopausal women newly diagnosed with osteoporosis. We combine user driven innovation and research in a participatory design process. METHODS...... The design and development of mHealth is based on a participatory design process. In the first phase, needs among the users are identified using qualitative methods as participant observations (10 hours), semi structured interviews (n=17) and focus groups (n=3). In the second phase, ideas and concepts...

  14. Serum percentage undercarboxylated osteocalcin, a sensitive measure of vitamin K status, and its relationship to bone health indices in Danish girls

    DEFF Research Database (Denmark)

    O'Connor, Eibhlis; Mølgaard, Christian; Michaelsen, Kim F.

    2007-01-01

    status to modulate childhood bone health. Serum %ucOC and serum 25-hydroxyvitamin D (25 (OH) D) were measured at baseline in a study of 223 healthy girls aged 11-12 years. Urinary pyridinium crosslinks of collagen and serum total osteocalcin as markers of bone resorption and formation, respectively...

  15. Designing minimum data sets of health smart card system

    Directory of Open Access Journals (Sweden)

    Mohtaram Nematollahi

    2014-10-01

    Full Text Available Introduction: Nowadays different countries benefit from health system based on health cards and projects related to smart cards. Lack of facilities which cover this technology is obvious in our society. This paper aims to design Minimum Data Sets of Health Smart Card System for Iran. Method: This research was an applied descriptive study. At first, we reviewed the same projects and guidelines of selected countries and the proposed model was designed in accordance to the country’s needs, taking people’s attitude about it by Delphi technique. A data analysis in study stage of MDS(Minimum Data Sets of Health Smart Card in the selective countries was done by comparative tables and determination of similarities and differences of the MDS. In the stage of gaining credit for model, it was accomplished with descriptive statistics to the extent of absolute and relative frequency through SPSS (version 16. Results: MDS of Health Smart Card for Iran is presented in the patient’s card and health provider’s card on basisof studiesin America, Australia, Turkey and Belgium and needs of our country and after doing Delphi technique with 94 percent agreement confirmed. Conclusion: Minimum Data Sets of Health Smart Card provides continuous care for patients and communication among providers. So, it causes a decrease in the complications of threatening diseases. Collection of MDS of diseases increases the quality of care assessment

  16. Sound & Vibration 20 Design Guidelines for Health Care Facilities

    CERN Document Server

    Tocci, Gregory; Cavanaugh, William

    2013-01-01

    Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...

  17. Design and Preparation of Bone Tissue Engineering Scaffolds with Porous Controllable Structure

    Institute of Scientific and Technical Information of China (English)

    LIN Liulan; ZHANG Huicun; ZHAO Li; HU Qingxi; FANG Minglun

    2009-01-01

    A novel method of designing and preparing bone tissue engineering scaffolds with controllable porous structure of both macro channels and micro pores was proposed. The CAD soft-ware UG NX3.0 was used to design the macro channels' shape, size and distribution. By integrating rapid prototyping and traditional porogen technique, the macro channels and micro pores were formed respectively. The size, shape and quantity of micro pores were controlled by porogen particulates. The sintered β-TCP porous scaffolds possessed connective macro channels of approximately 500 μm and micro pores of 200-400 μm. The porosity and connectivity of micro pores became higher with the in-crease of porogen ratio, while the mechanical properties weakened. The average porosity and com-pressive strength of β-TCP scaffolds prepared with porogen ratio of 60wt% were 78.12% and 0.2983 Mpa,respectively. The cells' adhesion ratio of scaffolds was 67.43%. The ALP activity, OCN content and cells micro morphology indicated that cells grew and proliferated well on the scaffolds.

  18. The Influence of Anthropometry and Body Composition on Children’s Bone Health

    DEFF Research Database (Denmark)

    Heidemann, M.; Holst, R.; Schou, A. J.;

    2015-01-01

    anthropometry and BC predict the development of the bone accruement. The longitudinal study is a part of The CHAMPS study-DK. Children were DXA scanned at baseline and at 2-year follow-up. BC (LM, BF %) and BMC, BMD and BA were measured. The relationship between bone traits, anthropometry and BC was analysed...... by multilevel regression analyses. Of the invited children, 742/800 (93 %) accepted to participate. Of these, 682/742 (92 %) participated at follow-up. Mean (range) of age at baseline was 9.5 years (7.7-12.1). Height, BMI, LM and BF % predicted bone mineral accrual and bone size positively and independently....... Height and BMI are both positive predictors of bone accruement. LM is a more precise predictor of bone traits than BF % in both genders. The effects of height and BMI and LM on bone accruement are nearly identical in the two genders, while changes in BF % have different but positive effects on bone...

  19. A Patient Specific Biomechanical Analysis of Custom Root Analogue Implant Designs on Alveolar Bone Stress: A Finite Element Study

    Directory of Open Access Journals (Sweden)

    David Anssari Moin

    2016-01-01

    Full Text Available Objectives. The aim of this study was to analyse by means of FEA the influence of 5 custom RAI designs on stress distribution of peri-implant bone and to evaluate the impact on microdisplacement for a specific patient case. Materials and Methods. A 3D surface model of a RAI for the upper right canine was constructed from the cone beam computed tomography data of one patient. Subsequently, five (targeted press-fit design modification FE models with five congruent bone models were designed: “Standard,” “Prism,” “Fins,” “Plug,” and “Bulbs,” respectively. Preprocessor software was applied to mesh the models. Two loads were applied: an oblique force (300 N and a vertical force (150 N. Analysis was performed to evaluate stress distributions and deformed contact separation at the peri-implant region. Results. The lowest von Mises stress levels were numerically observed for the Plug design. The lowest levels of contact separation were measured in the Fins model followed by the Bulbs design. Conclusions. Within the limitations of the applied methodology, adding targeted press-fit geometry to the RAI standard design will have a positive effect on stress distribution, lower concentration of bone stress, and will provide a better primary stability for this patient specific case.

  20. The Copenhagen Oral Health Senior Cohort: design, population and dental health

    DEFF Research Database (Denmark)

    Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow;

    2011-01-01

    the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non-participation. Materials and methods: Seven hundred and eighty-three individuals aged 65 years or older, from a total of 1918 invited elderly people......Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe......, underwent an interview regarding oral health-related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. Results: Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more...

  1. Design, synthesis, and biological evaluation of novel estradiol-bisphosphonate conjugates as bone-specific estrogens.

    Science.gov (United States)

    Morioka, Masahiko; Kamizono, Akihito; Takikawa, Hirosato; Mori, Akihisa; Ueno, Hiroaki; Kadowaki, Shu-ichiro; Nakao, Yoshihide; Kato, Kuniki; Umezawa, Kazuo

    2010-02-01

    Bone deficiency causes osteoporosis and often decreases quality of life in patients with rheumatoid arthritis. Estrogens are known to protect elderly women from bone loss. Synthesis of new estradiol-bisphosphonate conjugates (E(2)-BPs) was accomplished and their in vivo activity as bone-specific estrogens were examined. Among them, MCC-565 showed selective estrogenic activity in bones; but it showed little estrogenic activity in the uterus. We also found that the linker moiety in E(2)-BPs was essential for the absorption and specificity of the conjugates.

  2. System perspectives for mobile platform design in m-Health

    Science.gov (United States)

    Roveda, Janet M.; Fink, Wolfgang

    2016-05-01

    Advances in integrated circuit technologies have led to the integration of medical sensor front ends with data processing circuits, i.e., mobile platform design for wearable sensors. We discuss design methodologies for wearable sensor nodes and their applications in m-Health. From the user perspective, flexibility, comfort, appearance, fashion, ease-of-use, and visibility are key form factors. From the technology development point of view, high accuracy, low power consumption, and high signal to noise ratio are desirable features. From the embedded software design standpoint, real time data analysis algorithms, application and database interfaces are the critical components to create successful wearable sensor-based products.

  3. The role of vitamin D in maintaining bone health in older people.

    Science.gov (United States)

    Hill, Thomas R; Aspray, Terry J

    2017-04-01

    This review summarises aspects of vitamin D metabolism, the consequences of vitamin D deficiency, and the impact of vitamin D supplementation on musculoskeletal health in older age. With age, changes in vitamin D exposure, cutaneous vitamin D synthesis and behavioural factors (including physical activity, diet and sun exposure) are compounded by changes in calcium and vitamin D pathophysiology with altered calcium absorption, decreased 25-OH vitamin D [25(OH)D] hydroxylation, lower renal fractional calcium reabsorption and a rise in parathyroid hormone. Hypovitaminosis D is common and associated with a risk of osteomalacia, particularly in older adults, where rates of vitamin D deficiency range from 10-66%, depending on the threshold of circulating 25(OH)D used, population studied and season. The relationship between vitamin D status and osteoporosis is less clear. While circulating 25(OH)D has a linear relationship with bone mineral density (BMD) in some epidemiological studies, this is not consistent across all racial groups. The results of randomized controlled trials of vitamin D supplementation on BMD are also inconsistent, and some studies may be less relevant to the older population, as, for example, half of participants in the most robust meta-analysis were aged under 60 years. The impact on BMD of treating vitamin D deficiency (and osteomalacia) is also rarely considered in such intervention studies. When considering osteoporosis, fracture risk is our main concern, but vitamin D therapy has no consistent fracture-prevention effect, except in studies where calcium is coprescribed (particularly in frail populations living in care homes). As a J-shaped effect on falls and fracture risk is becoming evident with vitamin D interventions, we should target those at greatest risk who may benefit from vitamin D supplementation to decrease falls and fractures, although the optimum dose is still unclear.

  4. 76 FR 12307 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-03-07

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  5. 75 FR 79329 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  6. 75 FR 67303 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-11-02

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Designation of Medically Underserved Populations and Health Professional Shortage Areas is to establish...

  7. 75 FR 79330 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  8. 76 FR 50442 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-08-15

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  9. 76 FR 10825 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-02-28

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  10. 76 FR 20867 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-04-14

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  11. Design of a health-promoting neighborhood intervention.

    Science.gov (United States)

    Semenza, Jan C; Krishnasamy, Prasanna V

    2007-07-01

    Design and implementation of health-promoting community interventions can advance public health and community well-being; however, realization of such programs is often challenging. Even more challenging is the implementation of ecologic interventions to revitalize built urban environments. A structured intervention entitled ;Intersection Repair; was devised in Portland, Oregon, by a non-profit organization, to implement urban gathering places in the public right of way; specific steps included situation analysis, community outreach, asset mapping, design workshops, construction permitting, building workshops, and process evaluation. The community created human-scale urban landscapes with interactive art installations to encourage social interactions. Such aesthetic improvements, which included painted street murals, information kiosks, hanging gardens, water fountains, benches, and so on, were intended to strengthen social networks and social capital by providing places for residents to engage in conversation. Community engagement in neighborhood design benefits the public at multiple levels, by promoting a healthier lifestyle, over and above urban landscape improvements.

  12. Design and validation of bending test method for characterization of miniature pediatric cortical bone specimens.

    Science.gov (United States)

    Albert, Carolyne I; Jameson, John; Harris, Gerald

    2013-02-01

    Osteogenesis imperfecta is a genetic disorder of bone fragility; however, the effects of this disorder on bone material properties are not well understood. No study has yet measured bone material strength in humans with osteogenesis imperfecta. Small bone specimens are often extracted during routine fracture surgeries in children with osteogenesis imperfecta. These specimens could provide valuable insight into the effects of osteogenesis imperfecta on bone material strength; however, their small size poses a challenge to their mechanical characterization. In this study, a validated miniature three-point bending test is described that enables measurement of the flexural material properties of pediatric cortical osteotomy specimens as small as 5 mm in length. This method was validated extensively using bovine bone, and the effect of span/depth aspect ratio (5 vs 6) on the measured flexural properties was examined. The method provided reasonable results for both Young's modulus and flexural strength in bovine bone. With a span/depth ratio of 6, the median longitudinal modulus and flexural strength results were 16.1 (range: 14.4-19.3)GPa and 251 (range: 219-293)MPa, respectively. Finally, the pilot results from two osteotomy specimens from children with osteogenesis imperfecta are presented. These results provide the first measures of bone material strength in this patient population.

  13. The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys.

    Directory of Open Access Journals (Sweden)

    Eunjoo Choi

    Full Text Available Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women.A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011, who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA examination. Bone mineral density (BMD was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use.After adjusting for various demographic and lifestyle confounders (including hormonal factors, subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015. This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively. In addition, age- and body mass index (BMI-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively.Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.

  14. Biomimetic design of a bacterial cellulose/hydroxyapatite nanocomposite for bone healing applications

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, Kristen A., E-mail: kazimmer@vt.edu [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); School of Biomedical Engineering Sciences, Virginia Tech, Blacksburg, VA 24060 (United States); LeBlanc, Jill M.; Sheets, Kevin T.; Fox, Robert W. [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); Gatenholm, Paul [Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA 24060 (United States); School of Biomedical Engineering Sciences, Virginia Tech, Blacksburg, VA 24060 (United States)

    2011-01-01

    This study describes the design and synthesis of bacterial cellulose/hydroxyapatite nanocomposites for bone healing applications using a biomimetic approach. Bacterial cellulose (BC) with various surface morphologies (pellicles and tubes) was negatively charged by the adsorption of carboxymethyl cellulose (CMC) to initiate nucleation of calcium-deficient hydroxyapatite (cdHAp). The cdHAp was grown in vitro via dynamic simulated body fluid (SBF) treatments over a one week period. Characterization of the mineralized samples was done with X-ray Photoelectron Spectroscopy (XPS) and Field Emission Scanning Electron Microscopy (FESEM) with Energy Dispersive Spectroscopy (EDS). The amount of cdHAp observed varied among different samples. XPS demonstrated that the atomic presence of calcium and phosphorus ranged from 0.44 at.% to 7.71 at.% Ca and 0.27 at.% to 11.18 at.% P. The Ca/P overall ratio ranged from 1.22 to 1.92. FESEM images showed that the cdHAp crystal size increased with increasing nanocellulose fibril density. To determine the viability of the scaffolds in vitro, the morphology and differentiation of osteoprogenitor cells was analyzed using fluorescence microscopy and alkaline phosphatase gene expression. The presence of cdHAp crystals on BC surfaces resulted in increased cell attachment.

  15. [Vitamin D, determinant of bone and extrabone health. Importance of vitamin D supplementation in milk and dairy products].

    Science.gov (United States)

    Navarro Valverde, Cristina; Quesada Gómez, José Manuel

    2015-04-07

    Vitamin D is obtained mainly from ultraviolet irradiation of 7-dehydrocholesterol in the skin to form cholecalciferol (vitamin D3), and minimally from diet, unless vitamin D fortified food is taken, mainly enriched milk. In some countries, vitamin D is added to diet as ergocalciferol (vitamin D2). In the liver, vitamin D3 is hydroxylated to form 25-hydroxyvitamin D3 (marker of body nutritional status of vitamin D). Subsequently, in the kidney, 25OHD3 is hydroxylated to form 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). By VDR stimulation, (1,25)OH)2D3 controls calcium homeostasis and bone health and, what is more, many other cells and tissues including skin, muscle, cardiovascular and immune systems as well as glucose homeostasis. Thus, about 3% of the human genome is regulated by this hormone. Association and recent intervention studies describe beneficial effects on bone, cardiovascular disease, hypertension, diabetes mellitus type 2,colorectal cancer, breast cancer, multiple sclerosis, immune function inflammation etc. A minimum target for public health should be to achieve serum 25OHD levels above 20 ng/ml to ensure optimum status for bone health. However, levels above 30 ng/ml should be reached to achieve other health goals. Paradoxically, inadequacy (or even deficiency) in vitamin D levels is highly prevalent in children and youth in Spain. This deficit persists in adults, as well as in postmenopausal women (osteoporotic or not) and the elderly (especially amongst those institutionalized). Seasonal variation barely normalizes serum 25OHD levels after summer-autumn. Treated postmenopausal osteoporotic women also show high prevalence of inadequate levels of vitamin D, a major contributor to antiresortive treatments failure. A normalization of serum vitamin D enables diet to provide the calcium necessary to achieve a good bone health and an adequate response to antiresortive drugs. Given the difficulty to get adequate levels of vitamin D by UV irradiation and diet, a

  16. Effects of Soy Phytoestrogens and New Zealand Functional Foods on Bone Health.

    Science.gov (United States)

    Kruger, M C; Tousen, Y; Katsumata, S; Tadaishi, M; Kasonga, A E; Deepak, V; Coetzee, M; Ishimi, Y

    2015-01-01

    New Zealand is a rich source of food components that may have bioactivity on bone. Docosahexaenoic acid (DHA) from fish oil has been shown to maintain bone in ovariectomised (OVX) rats. Kiwifruit, a source of fibre and carotenoids, may also affect bone via a prebiotic as well as direct cell-based mechanisms. We aimed to 1) ascertain the effects of DHA on two cell models, including interactions with soy isoflavones; 2) and investigate the specific effects of carotenoids from kiwifruit as well as whole kiwifruit in cell-based and rodent models as well as in a human study. RAW 264.7 mouse monocytes or mouse bone marrow was used to generate osteoclasts (OC). Cells were exposed to the agents between 5 and 21 d and formation and activity of OC measured, including molecular markers. DHA inhibited OC formation in both cell models, including expression of cathepsin K, NFATc1 as well as actin ring formation. Combination with isoflavones enhanced these effects. In OVX rats and mice fed with kiwifruit for 8 wk, green kiwifruit reduced the rate of bone loss after OVX, and in mice it reduced C-telopeptide of Type 1 collagen (CTX) levels and RANKL expression while in menopausal women, green kiwifruit affected blood lipids and bone markers positively.

  17. Prevalence of low bone health using quantitative ultrasound in Indian women aged 41-60 years: Its association with nutrition and other related risk factors.

    Science.gov (United States)

    Shenoy, Shweta; Chawla, Jasmine Kaur; Gupta, Swati; Sandhu, Jaspal Singh

    2017-02-02

    The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41-60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.

  18. Quantitative ultrasound and bone health Ultrasonido cuantitativo y salud ósea

    Directory of Open Access Journals (Sweden)

    Karen M Knapp

    2009-01-01

    Full Text Available This review of quantiative ultrasound (QUS and bone health uses the current literature to summarise the clinical and research effectiveness of QUS. QUS has been demonstrated to have the ability to predict fracture, particularly at the hip. However, the magnitude of prediction is fracture-site, measurement-site and device dependent. The correlations between dual X-ray absorptiometry (DXA and bone mineral density (BMD are weak to moderate, resulting in different subjects being identified as being at risk of fracture by the two different methods. QUS is sensitive to age and menopause-related changes and to clinical risk factors and lifestyle factors associated with osteoporosis. Whilst a limited ability of QUS to monitor therapeutic intervention has been demonstrated, this is still an area where it's poorer precision, in comparison to DXA, results in limited applicability. Whilst DXA remains the gold standard for the diagnosis of osteoporosis, QUS may be of use for the prediction of those at risk of future fracture in areas where there is limited availability of DXA.En esta revisión sobre el Ultrasonido Cuantitativo (QUS y su aplicación en la evaluación de la salud de los huesos, se analiza detalladamente la literatura disponible para conocer su papel y efectividad en la clínica cotidiana y en los programas de investigación. El QUS ha probado ser útil para predecir fracturas, especialmente de la cadera. Sin embargo, la exactitud de la predicción depende del sitio de fractura que se desea evaluar, del sitio anatómico donde se realiza la medición y de los diferentes instrumentos. La correlación que existe entre densitometría de rayos X (DXA y QUS puede ser débil a moderada, porque ambos métodos determinan diferentes componentes de la masa ósea relacionados con la presentación de las fracturas. El resultado del QUS como el del DXA también es sensible a la edad, cambios relacionados con la menopausia, a factores de riesgo clínicos y de

  19. Designing Systems for Health Promotion and Autonomy in Older Adults

    Science.gov (United States)

    Lindgren, Helena; Nilsson, Ingeborg

    The inclusion and autonomy of older people in the society where large parts of the life is organized with computer and Internet use as means is addressed in an ongoing project in the rehabilitation and health domains. Part from investigating the potentials of using ICT for rehabilitation of older people with limited or no computer skills, the aim for the project is to develop methods and tools for the purpose, and also for the interaction design domain where systems are developed for older people. The resulting methods are used for informing the design of the system in an iterative process.

  20. Vulnerability analysis for design of bridge health monitoring system

    Science.gov (United States)

    Sun, L. M.; Yu, G.

    2010-03-01

    The recent engineering implementation of health monitoring system for long span bridges show difficulties for precisely assessing structural physical condition as well as for accurately alarming on structural damages, although hundreds of sensors were installed on a structure and a great amount of data were collected from the monitoring system. The allocation of sensors and the alarming algorithm are still two of the most important tasks to be considered when designing the structural health monitoring system. Vulnerability, in its original meaning, is the system susceptibility to local damage. For a structural system, the vulnerability can thus be regarded as structural performance susceptibility to local damage of structure. The purpose of this study is to propose concepts and methods of structural vulnerability for determining monitoring components which are more vulnerable than others and the corresponding warning threshold once the damages occur. The structural vulnerability performances to various damage scenarios depend upon structural geometrical topology, loading pattern on the structure and the degradation of component performance. A two-parameters structural vulnerability evaluation method is proposed in this paper. The parameters are the damage consequence and the relative magnitude of the damage scenarios to the structural system, respectively. Structural vulnerability to various damage scenarios can be regarded as the tradeoff between the two parameters. Based on the results of structural vulnerability analysis, the limited structural information from health monitoring can be utilized efficiently. The approach of the design of bridge health monitoring system is illustrated for a cable-stayed bridge.

  1. Exercise therapy for bone and muscle health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Hagen Kåre

    2012-12-01

    Full Text Available Abstract Background Musculoskeletal conditions (MSCs are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored. Methods We included four common conditions: fibromyalgia (FM, low back pain (LBP, neck pain (NP, and shoulder pain (SP, and four specific musculoskeletal diseases: osteoarthritis (OA, rheumatoid arthritis (RA, ankylosing spondylitis (AS, and osteoporosis (OP. We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes. Results We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes

  2. Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

    Directory of Open Access Journals (Sweden)

    Alexander H. G. Paterson

    2013-12-01

    Full Text Available Bone loss is common in patients with breast cancer. Bone modifying agents (BMAs, such as bisphosphonates and denosumab, have been shown to reverse or stabilize bone loss and may be useful in the primary and metastatic settings. The purpose of this review is to provide clear evidence-based strategies for the management of bone loss and its symptoms in breast cancer. A systematic review of clinical trials and meta-analyses published between 1996 and 2012 was conducted of MEDLINE and EMBASE. Reference lists were hand-searched for additional publications. Recommendations were developed based on the best available evidence. Zoledronate, pamidronate, clodronate, and denosumab are recommended for metastatic breast cancer patients; however, no one agent can be recommended over another. Zoledronate or any oral bisphosphonate and denosumab should be considered in primary breast cancer patients who are postmenopausal on aromatase inhibitor therapy and have a high risk of fracture and/or a low bone mineral density and in premenopausal primary breast cancer patients who become amenorrheic after therapy. No one agent can be recommended over another. BMAs are not currently recommended as adjuvant therapy in primary breast cancer for the purpose of improving survival, although a major Early Breast Cancer Cooperative Trialists’ Group meta-analysis is underway which may impact future practice. Adverse events can be managed with appropriate supportive care.

  3. Inulin-type fructans and bone health: state of the art and perspectives in the management of osteoporosis.

    Science.gov (United States)

    Coxam, Véronique

    2005-04-01

    If the primary role of diet is to provide sufficient nutrients to meet the metabolic requirements of an individual, there is an emerging rationale to support the hypothesis that, by modulating specific target functions in the body, it can help achieve optimal health. Regarding osteoporosis prevention, since Ca is most likely to be inadequate in terms of dietary intake, every strategy targeting an improvement in Ca absorption is very interesting. Actually, this process may be susceptible to manipulation by fermentable substrates. In this light, inulin-type fructans are very interesting, even if we need to gather more data targeting bone metabolism before health professionals can actively advocate their consumption to prevent senile osteoporosis. Besides targeting the prevention of postmenopausal osteoporosis, inulin-type fructans still remain a source for putative innovative dietary health intervention. Indeed, given in combination with isoflavones, they may have a potential for maintaining or improving the bone mass of human subjects, by modulating the bioavailability of phyto-oestrogens.

  4. Torsional resistance as a principal component of the structural design of long bones: comparative multivariate evidence in birds.

    Science.gov (United States)

    de Margerie, Emmanuel; Sanchez, Sophie; Cubo, Jorge; Castanet, Jacques

    2005-01-01

    Here we study the occurrence of torsion-resisting morphological and histological features (thin bone walls, circular shaft cross-section, oblique collagen fibers, and laminar tissue arrangement) in a sample of 168 long bones from wings and legs of 22 bird species. These structural parameters were measured in mid diaphyseal undemineralized cross-sections and analyzed using uni-, bi-, and multivariate (principal components analysis) data analysis techniques. We found that the four variables are significantly and positively correlated, and that covariation between variables accounts for as much as 58% of the total variation. These results suggest that torsion is a main determinant of the macro- and microstructural design of long bones in birds. Humerus, ulna, and femur generally possess torsion-resisting features, while other bones (radius, carpometacarpus, tibiotarsus, tarsometatarsus, and foot phalanx) rather show bending/axial load-resisting structural properties. These results are congruent with in vivo strain data from the literature, which reported high torsional loading in humerus and ulna during flapping flight, but also in the subhorizontal avian femur during terrestrial locomotion. The precise function of the laminar tissue spatial arrangement, the role of pneumatization, and the influence of flight mode are discussed.

  5. Design of smart neonatal health monitoring system using SMCC.

    Science.gov (United States)

    De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

    2017-02-01

    Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

  6. Factors related to variation in premenopausal bone mineral status: a health promotion approach.

    Science.gov (United States)

    Tudor-Locke, C; McColl, R S

    2000-01-01

    Bone loss prior to menopause may contribute to later risk of fracture due to osteoporosis. Women may be able to optimize premenopausal bone mass and/or prevent losses. Heredity, and possibly age at menarche (retrospectively determined), are unmodifiable risk factors and attention should therefore be directed to more amenable factors. Amenorrhea, low body weight, disordered eating, and smoking are modifiable risk factors. Vitamin D is not a factor for premenopausal women who receive incidental sun exposure and consume fortified foods, but supplementation should be considered for others, especially during the winter months. Protective factors include a higher body weight (especially due to increased muscularity), calcium supplementation, and purposeful load-bearing exercise. Positive effects of oral contraceptives are most apparent in women with menstrual irregularities. Reproductive history (parity), lactation, moderate intakes of alcohol and caffeine, and the appropriate treatment of endometriosis have no apparent effect on premenopausal bone.

  7. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  8. Physical education in West Virginia schools: are we doing enough to generate peak bone mass and promote skeletal health?

    Science.gov (United States)

    Shuler, Franklin D; Lycans, Dana; Gill, Thomas; Oliashirazi, Ali

    2013-01-01

    Peak bone mass (PBM) is attained at 25-35 years of age, followed by a lifelong decline in bone strength. The most rapid increase in bone mass occurs between the ages of 12-17. Daily school physical education (PE) programs have been shown to produce measurable increases in PBM, but are not federally mandated. Increases in PBM can decrease the lifelong risk of osteoporosis and fractures; critical for West Virginia prevention programs. Nationally only 1 in 6 schools require PE three days per week, with 4% of elementary schools, 8% of middle schools and 2% of high schools providing daily PE. In 2005, West Virginia passed the Healthy Lifestyles Act that returned physical education to the K-12 curriculum. This law requires only one credit of PE from grades 9-12 and provides only 35% of the recommended PE for grades K-12. This article highlights the relationship of PE to PBM and discusses the potential impact on West Virginia skeletal health.

  9. Vitamin B12: a novel indicator of bone health in vulnerable groups

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.

    2004-01-01

    Background: A number of modifiable predictors for osteoporosis and fractures have been identified, including nutritional factors, such as vitamin D deficiency and low calcium intake. Cobalamin deficiency has been suggested to affect bone metabolism. Pernicious anaemia, which can result in cobalamin

  10. The clinical diagnosis of Osteoporosis: A position statement from the National Bone Health Alliance working group

    Science.gov (United States)

    Osteoporosis is a common disorder of reduced bone strength that predisposes to an increased risk for fractures in older individuals. In the United States, the standard criterion for the diagnosis of osteoporosis in postmenopausal women and older men is a T-score less than or equal to-2.5 at the lum...

  11. FES-Rowing versus Zoledronic Acid to Improve Bone Health in SCI

    Science.gov (United States)

    2015-10-01

    Leslie R. Morse, DO Betty Diamond 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: lmorse4@partners.org 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION...bone strength of the lower extremity in a dose dependent fashion. Reportable Outcomes Publications Taylor JA, Picard G, Porter A, Morse LR

  12. Designing food structures for nutrition and health benefits.

    Science.gov (United States)

    Norton, Jennifer E; Wallis, Gareth A; Spyropoulos, Fotis; Lillford, Peter J; Norton, Ian T

    2014-01-01

    In addition to providing specific sensory properties (e.g., flavor or textures), there is a need to produce foods that also provide functionality within the gastrointestinal (GI) tract, over and above simple nutrition. As such, there is a need to understand the physical and chemical processes occurring in the mouth, stomach, small intestine, and large intestine, in addition to the food structure-physiology interactions. In vivo techniques and in vitro models have allowed us to study and simulate these processes, which aids us in the design of food microstructures that can provide functionality within the human body. Furthermore, it is important to be aware of the health or nutritional needs of different groups of consumers when designing food structures, to provide targeted functionality. Examples of three groups of consumers (elderly, obese, and athletes) are given to demonstrate their differing nutritional requirements and the formulation engineering approaches that can be utilized to improve the health of these individuals. Eating is a pleasurable process, but foods of the future will be required to provide much more in terms of functionality for health and nutrition.

  13. Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: a cross-sectional investigation.

    Science.gov (United States)

    Zopf, E M; Newton, R U; Taaffe, D R; Spry, N; Cormie, P; Joseph, D; Chambers, S K; Baumann, F T; Bloch, W; Galvão, D A

    2016-09-20

    Cancer patients with bone metastases have previously been excluded from participation in physical activity programmes due to concerns of skeletal fractures. Our aim was to provide initial information on the association between physical activity levels and physical and mental health outcomes in prostate cancer patients with bone metastases. Between 2012 and 2015, 55 prostate cancer patients (mean age 69.7 ± 8.3; BMI 28.6 ± 4.0) with bone metastases (58.2% >2 regions affected) undertook assessments for self-reported physical activity, physical and mental health outcomes (SF-36), objective physical performance measures and body composition by DXA. Sixteen men (29%) met the current aerobic exercise guidelines for cancer survivors, while 39 (71%) reported lower aerobic exercise levels. Men not meeting aerobic exercise guidelines had lower physical functioning (p = .004), role functioning (physical and emotional) (p health scores (p = .014) as well all lower measures of physical performance (p exercise are associated with reduced physical and mental health outcomes in prostate cancer patients with bone metastases. While previous research has focused primarily in those with non-metastatic disease, our initial results suggest that higher levels of aerobic exercise may preserve physical and mental health outcomes in prostate cancer patients with bone metastases.

  14. Design principles in the development of (public) health information infrastructures.

    Science.gov (United States)

    Neame, Roderick

    2012-01-01

    In this article the author outlines the key issues in the development of a regional health information infrastructure suitable for public health data collections. A set of 10 basic design and development principles as used and validated in the development of the successful New Zealand National Health Information Infrastructure in 1993 are put forward as a basis for future developments. The article emphasises the importance of securing clinical input into any health data that is collected, and suggests strategies whereby this may be achieved, including creating an information economy alongside the care economy. It is suggested that the role of government in such developments is to demonstrate leadership, to work with the sector to develop data, messaging and security standards, to establish key online indexes, to develop data warehouses and to create financial incentives for adoption of the infrastructure and the services it delivers to users. However experience suggests that government should refrain from getting involved in local care services data infrastructure, technology and management issues.

  15. Designing smart analytical data services for a personal health framework.

    Science.gov (United States)

    Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas

    2016-01-01

    Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.

  16. Structural health monitoring feature design by genetic programming

    Science.gov (United States)

    Harvey, Dustin Y.; Todd, Michael D.

    2014-09-01

    Structural health monitoring (SHM) systems provide real-time damage and performance information for civil, aerospace, and other high-capital or life-safety critical structures. Conventional data processing involves pre-processing and extraction of low-dimensional features from in situ time series measurements. The features are then input to a statistical pattern recognition algorithm to perform the relevant classification or regression task necessary to facilitate decisions by the SHM system. Traditional design of signal processing and feature extraction algorithms can be an expensive and time-consuming process requiring extensive system knowledge and domain expertise. Genetic programming, a heuristic program search method from evolutionary computation, was recently adapted by the authors to perform automated, data-driven design of signal processing and feature extraction algorithms for statistical pattern recognition applications. The proposed method, called Autofead, is particularly suitable to handle the challenges inherent in algorithm design for SHM problems where the manifestation of damage in structural response measurements is often unclear or unknown. Autofead mines a training database of response measurements to discover information-rich features specific to the problem at hand. This study provides experimental validation on three SHM applications including ultrasonic damage detection, bearing damage classification for rotating machinery, and vibration-based structural health monitoring. Performance comparisons with common feature choices for each problem area are provided demonstrating the versatility of Autofead to produce significant algorithm improvements on a wide range of problems.

  17. Design for Health and Well Being: Knitted Products for Diabetics

    Science.gov (United States)

    Gault, A.

    2016-07-01

    This paper will discuss the design development, manufacturing and testing of knitted products maximizing the use of new innovations in Nano- technology and the integration of Phase Changing Materials specifically for diabetics. The project identified key aspects requiring design solutions to bring improvement to the circulatory problems with specific reference to the diabetic condition. Diabetics have particular difficulty in regulating their body temperature and this can result in the condition worsening, and resulting in loss of digits or limbs. The design of products to prevent the deterioration of the diabetic condition and to help those with limb loss was developed in collaboration with a Northern Ireland diabetic consultant, a product engineer and a knitwear designer. The fusion of ideas between the stakeholders resulted in the development and manufacture of a range of products that have been successfully tested at the yarn and fabric development stage and have been proven to maintain body temperature by either cooling or warming and therefore bring improvement to health and well-being. Whilst the product has a performance element the design ideas created desirable products that not only provided solutions to the brief but also resulted in products that had further market applications.

  18. Therapeutic-designed electrospun bone scaffolds: mesoporous bioactive nanocarriers in hollow fiber composites to sequentially deliver dual growth factors.

    Science.gov (United States)

    Kang, Min Sil; Kim, Joong-Hyun; Singh, Rajendra K; Jang, Jun-Hyeog; Kim, Hae-Won

    2015-04-01

    A novel therapeutic design of nanofibrous scaffolds, holding a capacity to load and deliver dual growth factors, that targets bone regeneration is proposed. Mesoporous bioactive glass nanospheres (MBNs) were used as bioactive nanocarriers for long-term delivery of the osteogenic enhancer fibroblast growth factor 18 (FGF18). Furthermore, a core-shell structure of a biopolymer fiber made of polyethylene oxide/polycaprolactone was introduced to load FGF2, another type of cell proliferative and angiogenic growth factor, safely within the core while releasing it more rapidly than FGF18. The prepared MBNs showed enlarged mesopores of about 7 nm, with a large surface area and pore volume. The protein-loading capacity of MBNs was as high as 13% when tested using cytochrome C, a model protein. The protein-loaded MBNs were smoothly incorporated within the core of the fiber by electrospinning, while preserving a fibrous morphology. The incorporation of MBNs significantly increased the apatite-forming ability and mechanical properties of the core-shell fibers. The possibility of sequential delivery of two experimental growth factors, FGF2 and FGF18, incorporated either within the core-shell fiber (FGF2) or within MBNs (FGF18), was demonstrated by the use of cytochrome C. In vitro studies using rat mesenchymal stem cells demonstrated the effects of the FGF2-FGF18 loadings: significant stimulation of cell proliferation as well as the induction of alkaline phosphate activity and cellular mineralization. An in vivo study performed on rat calvarium defects for 6 weeks demonstrated that FGF2-FGF18-loaded fiber scaffolds had significantly higher bone-forming ability, in terms of bone volume and density. The current design utilizing novel MBN nanocarriers with a core-shell structure aims to release two types of growth factors, FGF2 and FGF18, in a sequential manner, and is considered to provide a promising therapeutic scaffold platform that is effective for bone regeneration.

  19. Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial.

    Science.gov (United States)

    Oh, Eui Geum; Yoo, Jae Yong; Lee, Jung Eun; Hyun, Sa Saeng; Ko, Il Sun; Chu, Sang Hui

    2014-08-01

    In this randomized controlled trial, we examined the effects of a 3-month therapeutic lifestyle modification (TLM) intervention on knowledge, self-efficacy, and health behaviors related to bone health in postmenopausal women in rural Korea. Forty-one women ages 45 or older were randomly assigned to either the intervention (n = 21) or control (n = 20) group. The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium-vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis.

  20. 76 FR 61294 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-10-04

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and...: The purpose of the Negotiated Rulemaking Committee on Designation of Medically Underserved...

  1. Designing and developing management systems for environmental, health and safety

    Energy Technology Data Exchange (ETDEWEB)

    Holdsworth, Rodger D.; Franklyn-Alderman, Christy [Risk, Reliability and Safety Engineering, Houston, TX (United States)

    2000-07-01

    The introduction of Quality, Risk, Safety and Environmental management philosophies has significantly changed industry view of company organization and controlling processes entering the new millennium. Quality, Risk, Health and Environmental programs and systems, such as ISO/Q S 9000, ISO 14000, Process Safety, risk management are impacting the way industry meet the challenges of safety and environmental risks and the needs of the customer. A wealth of knowledge can be extracted from practical application, which might otherwise be unobtainable without years of management systems experience related to management systems design, development, implementation and control. (author)

  2. 76 FR 39062 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-07-05

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  3. 76 FR 53377 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-08-26

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  4. Visual design: a step towards multicultural health care.

    Science.gov (United States)

    Alvarez, Juliana

    2014-02-01

    Standing at the crossroads of anthropology, communication, industrial design and new technology theories, this article describes the communication challenges posed during hospital emergencies resulting from linguistic and cultural differences between health care professionals and patients. In order to overcome communication barriers, the proposal of a visual solution was analyzed. Likewise, the problem was studied based on the concepts of perception, comprehension, interpretation and graphic representation according to visual culture and semiotics theories. One hundred and ffty images showing symptoms were analyzed in order to identify a pluricultural iconographic code. Results enabled to develop a list of design criteria and create the application: "My Symptoms Translator" as an option to overcome verbal language barriers and cultural differences.

  5. The Consequences of Modern Military Deployment on Calcium Status and Bone Health

    Science.gov (United States)

    2010-01-01

    tobacco use, high bone turnover rates, and family history of osteoporosis all contribute to a higher risk of osteoporosis .23 During the physical...soldiers who returned for follow-up reported taking oral contraceptives or other estrogen treatment for birth control. Weight and BMI The mean BMI (25.9 kg...risk of osteoporosis .29 The department’s research efforts have been primarily directed at ways to prevent stress fractures in new military recruits

  6. Exposure to urban air pollution and bone health in clinically healthy six-year-old children.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Mora-Tiscareño, Antonieta; Francolira, Maricela; Torres-Jardón, Ricardo; Peña-Cruz, Bernardo; Palacios-López, Carolina; Zhu, Hongtu; Kong, Linglong; Mendoza-Mendoza, Nicolás; Montesinoscorrea, Hortencia; Romero, Lina; Valencia-Salazar, Gildardo; Kavanaugh, Michael; Frenk, Silvestre

    2013-01-01

    Air pollution induces systemic inflammation, as well as respiratory, myocardial and brain inflammation in children. Peak bone mass is influenced by environmental factors. We tested the hypothesis that six-year-olds with lifetime exposures to urban air pollution will have alterations in inflammatory markers and bone mineral density (BMD) as opposed to low-polluted city residents when matched for BMI, breast feeding history, skin phototype, age, sex and socioeconomic status. This pilot study included 20 children from Mexico City (MC) (6.17 years ± 0.63 years) and 15 controls (6.27 years ± 0.76 years). We performed full paediatric examinations, a history of outdoor exposures, seven-day dietary recalls, serum inflammatory markers and dual-energy X-ray absorptiometry (DXA). Children in MC had significantly higher concentrations of IL-6 (p=0.001), marked reductions in total blood neutrophils (p= 0.0002) and an increase in monocytes (p=0.005). MC children also had an insufficient Vitamin D intake and spent less time outdoors than controls (p<0.001) in an environment characterized by decreased UV light, with ozone and fine particulates concentrations above standard values. There were no significant differences between the cohorts in DXA Z scores. The impact of systemic inflammation, vitamin D insufficiency, air pollution, urban violence and poverty may have long-term bone detrimental outcomes in exposed paediatric populations as they grow older, increasing the risk of low bone mass and osteoporosis. The selection of reference populations for DXA must take into account air pollution exposures.

  7. Assessment of growth, nutritional status, and bone health in children with cerebral palsy

    OpenAIRE

    Finbråten, Ane-Kristine

    2015-01-01

    Cerebral palsy (CP) is the most common cause of chronic motor disability in childhood. Children with CP experience motor difficulties as well as a number of associated impairments, such as feeding problems, malnutrition, and poor growth. Children with physical disabilities that limit ambulation usually have low bone mineral density (BMD), and many will sustain fractures. Impaired growth and feeding problems are common among children with CP. It is important to monitor nutrition...

  8. Adaptive bone-remodeling theory applied to prosthetic-design analysis

    NARCIS (Netherlands)

    R. Huiskes (Rik); H.H. Weinans (Harrie); H.J. Grootenboer; M. Dalstra; B. Fudala; T.J. Slooff

    1987-01-01

    textabstractThe subject of this article is the development and application of computer-simulation methods to predict stress-related adaptive bone remodeling, in accordance with 'Wolff's Law'. These models are based on the Finite Element Method (FEM) in combination with numerical formulations of adap

  9. The role of low acid load in vegetarian diet on bone health: a narrative review.

    Science.gov (United States)

    Burckhardt, Peter

    2016-01-01

    Vegetarian and vegan diets contain low amounts of protein and calcium. For this reason they are supposed to cause low bone mineral density (BMD) and osteoporosis. But this is not the case, except for vegans with a particularly low calcium intake. The absence of osteoporosis or low BMD can be explained by the low acid load of these diets. Nutritional acid load is negatively correlated with bone mineral density (BMD) and positively with fracture risk. Low acid load is correlated with lower bone resorption and higher BMD. It is linked to high intake of potassium-rich nutrients, such as fruits and vegetables, as found in vegetarian diets. The total nutritional acid load, which not only depends on the potassium content of the nutrition, was recently assessed in several studies on vegetarian and vegan diets and was found to be very low or absent, while the diet of Western-style omnivores produces daily 50 to 70 mEq of acid. This might be an important factor for the protection of vegetarians from osteoporosis.

  10. Analysis of the relationships between edentulism, periodontal health, body composition, and bone mineral density in elderly women

    Directory of Open Access Journals (Sweden)

    Ignasiak Z

    2016-03-01

    Full Text Available Zofia Ignasiak,1 Malgorzata Radwan-Oczko,2 Krystyna Rozek-Piechura,3 Marta Cholewa,4 Anna Skrzek,5 Tomasz Ignasiak,6 Teresa Slawinska1 1Department of Biostructure, University School of Physical Education, Wroclaw, Poland; 2Department of Periodontology, Wroclaw Medical University, Wroclaw, Poland; 3Department of Physiotherapy and Occupation Therapy in Internal Diseases, University School of Physical Education, Wroclaw, Poland; 4DENTARAMA Dentistry Center, Walbrzych, Poland; 5Department of Physiotherapy and Ocupation Therapy in Motor-System Dysfunction, University School of Physical Education, Wroclaw, Poland; 6Karkonosze State Higher School in Jelenia Gora, Jelenia Gora, Poland Objective: The relationship between bone mineral density (BMD and tooth loss in conjunction with periodontal disease is not clear. The suggested effects include alteration in bone remodeling rates as well as the multifaceted etiology of edentulism. There is also a question if other body-related variables besides BMD, such as body composition, may be associated with tooth number and general periodontal health. The aim of this study was to evaluate if tooth number and marginal periodontal status are associated with body composition and BMD in a sample of elderly women. Materials and methods: The study involved 91 postmenopausal women. Data included basic anthropometric characteristics, body composition via bioelectrical impedance analysis, and BMD analysis at the distal end of the radial bone of the nondominant arm via peripheral dual-energy X-ray absorptiometry. A dental examination was performed to assess tooth number, periodontal pocket depth (PD, and gingival bleeding. Results: In nonosteoporotic women, a significant positive correlation was found between BMD and lean body mass, total body water, and muscle mass. The indicators of bone metabolism correlated negatively with PD. Such relationships did not appear in osteoporotic women. In both groups, basic anthropometric

  11. Geometry Design Optimization of Functionally Graded Scaffolds for Bone Tissue Engineering: A Mechanobiological Approach.

    Directory of Open Access Journals (Sweden)

    Antonio Boccaccio

    Full Text Available Functionally Graded Scaffolds (FGSs are porous biomaterials where porosity changes in space with a specific gradient. In spite of their wide use in bone tissue engineering, possible models that relate the scaffold gradient to the mechanical and biological requirements for the regeneration of the bony tissue are currently missing. In this study we attempt to bridge the gap by developing a mechanobiology-based optimization algorithm aimed to determine the optimal graded porosity distribution in FGSs. The algorithm combines the parametric finite element model of a FGS, a computational mechano-regulation model and a numerical optimization routine. For assigned boundary and loading conditions, the algorithm builds iteratively different scaffold geometry configurations with different porosity distributions until the best microstructure geometry is reached, i.e. the geometry that allows the amount of bone formation to be maximized. We tested different porosity distribution laws, loading conditions and scaffold Young's modulus values. For each combination of these variables, the explicit equation of the porosity distribution law-i.e the law that describes the pore dimensions in function of the spatial coordinates-was determined that allows the highest amounts of bone to be generated. The results show that the loading conditions affect significantly the optimal porosity distribution. For a pure compression loading, it was found that the pore dimensions are almost constant throughout the entire scaffold and using a FGS allows the formation of amounts of bone slightly larger than those obtainable with a homogeneous porosity scaffold. For a pure shear loading, instead, FGSs allow to significantly increase the bone formation compared to a homogeneous porosity scaffolds. Although experimental data is still necessary to properly relate the mechanical/biological environment to the scaffold microstructure, this model represents an important step towards

  12. Design and Analysis of Architectures for Structural Health Monitoring Systems

    Science.gov (United States)

    Mukkamala, Ravi; Sixto, S. L. (Technical Monitor)

    2002-01-01

    During the two-year project period, we have worked on several aspects of Health Usage and Monitoring Systems for structural health monitoring. In particular, we have made contributions in the following areas. 1. Reference HUMS architecture: We developed a high-level architecture for health monitoring and usage systems (HUMS). The proposed reference architecture is shown. It is compatible with the Generic Open Architecture (GOA) proposed as a standard for avionics systems. 2. HUMS kernel: One of the critical layers of HUMS reference architecture is the HUMS kernel. We developed a detailed design of a kernel to implement the high level architecture.3. Prototype implementation of HUMS kernel: We have implemented a preliminary version of the HUMS kernel on a Unix platform.We have implemented both a centralized system version and a distributed version. 4. SCRAMNet and HUMS: SCRAMNet (Shared Common Random Access Memory Network) is a system that is found to be suitable to implement HUMS. For this reason, we have conducted a simulation study to determine its stability in handling the input data rates in HUMS. 5. Architectural specification.

  13. The effects of strength training and raloxifene on bone health in aging ovariectomized rats.

    Science.gov (United States)

    Stringhetta-Garcia, Camila Tami; Singulani, Monique Patrício; Santos, Leandro Figueiredo; Louzada, Mário Jefferson Quirino; Nakamune, Ana Cláudia Stevanato; Chaves-Neto, Antonio Hernandes; Rossi, Ana Cláudia; Ervolino, Edilson; Dornelles, Rita Cássia Menegati

    2016-04-01

    The aim of this study was to investigate the effects of strength training (ST) and raloxifene (Ral), alone or in combination, on the prevention of bone loss in an aging estrogen-deficient rat model. Aging Wistar female rats were ovariectomized at 14months and allocated to four groups: (1) non-trained and treated with vehicle, NT-Veh; (2) strength training and treated with vehicle, ST-Veh; (3) non-trained and treated with raloxifene, NT-Ral; and (4) strength training and treated with raloxifene, ST-Ral. ST was performed on a ladder three times per week and Ral was administered daily by gavage (1mg/kg/day), both for 120days. Areal bone mineral density (aBMD), strength, microarchitecture, and biomarkers (osteocalcin, OCN; osteoprotegerin, OPG; and tartrate-resistant acid phosphatase, TRAP) were assessed. Immunohistochemistry was performed for runt-related transcription factor 2 (RUNX2), osterix (OSX), OCN, OPG, TRAP, and receptor activator of nuclear factor kappa-B ligand (RANKL). The rats that performed ST (ST-Veh) or were treated with Ral (NT-Ral) showed significant improvements in aBMD (p=0.001 and 0.004), bone strength (p=0.001), and bone microarchitecture, such as BV/TV (%) (p=0.001), BS/TV (mm(2)/mm(3)) (p=0.023 and 0.002), Conn.Dn (1/mm(3)) (p=0.001), Tb.N (1/mm) (p=0.012 and 0.011), Tb.Th (1/mm) (p=0.001), SMI (p=0.001 and 0.002), Tb.Sp (p=0.001), and DA (p=0.002 and 0.007); there was also a significant decrease in plasma levels of OCN (p=0.001 and 0.002) and OPG (p=0.003 and 0.014), compared with animals in the NT-Veh group. Ral, with or without ST, promoted an increased immunolabeling pattern for RUNX2 (p=0.0105 and p=0.0006) and OSX (p=0.0105), but a reduced immunolabeling pattern for TRAP (p=0.0056) and RANKL (p=0.033 and 0.004). ST increased the immunolabeling pattern for RUNX2 (p=0.0105), and association with Ral resulted in an increased immunolabeling pattern for OPG (p=0.0034) and OCN (p=0.0024). In summary, ST and Ral administration in aged, estrogen

  14. Three-dimensional design optimisation of patient-specific femoral plates as a means of bone remodelling reduction.

    Science.gov (United States)

    Nobari, S; Katoozian, H R; Zomorodimoghadam, S

    2010-12-01

    Previous investigations into the optimisation of internal plates have mostly focused on the material properties of the implant. In this work, we optimise the shape, size and placement of the plate for successfully minimising bone remodelling around the implant. A design optimisation algorithm based on strain energy density criterion, combined with the finite element analysis, has been used in this study. The main optimisation goal was to reduce this change and keep it close to the conditions of an intact femur. The results suggest that the anterolateral side of the bone would be the optimum location for the plate, as for the geometry, the optimum moves towards having a thick, wide and short plate. These important results could be directly applicable to orthopaedic surgeons treating a femur fracture with internal plates. Since the optimisation algorithm remains the same for any patient, this advancement provides the surgeon with a tool to minimise the post surgery remodelling by trying to maintain the natural structure of the bone.

  15. Smoking and body fat mass in relation to bone mineral density and hip fracture: the Hordaland Health Study.

    Directory of Open Access Journals (Sweden)

    Jannike Øyen

    Full Text Available Lower bone mineral density (BMD in smokers may be attributable to lower body weight or fat mass, rather than to a direct effect of smoking. We analyzed the effects of smoking exposure, assessed by plasma cotinine, and body fat on BMD and the risk of subsequent hip fracture. In the community-based Hordaland Health Study (HUSK, 3003 participants 46-49 years and 2091 subjects 71-74 years were included. Cotinine was measured in plasma and information on health behaviors was obtained from self-administered questionnaires. BMD and total body soft tissue composition were measured by dual X-ray absorptiometry. Information on hip fracture was obtained from computerized records containing discharge diagnoses for hospitalizations between baseline examinations 1997-2000 through December 31st, 2009. In the whole cohort, moderate and heavy smokers had stronger positive associations between fat mass and BMD compared to never smokers (differences in regression coefficient (95% CI per % change in fat mass = 1.38 (0.24, 2.52 and 1.29 (0.17, 2.4, respectively. In moderate and heavy smokers there was a nonlinear association between BMD and fat mass with a stronger positive association at low compared to high levels of fat mass (Davies segmented test, p<0.001. In elderly women and men, heavy smokers had an increased risk of hip fracture compared to never smokers (hazard ratio = 3.31, 95% CI: 2.05, 5.35; p<0.001. In heavy smokers there was a tendency of a lower risk of hip fracture with higher percentage of fat mass. The deleterious effect of smoking on bone health is stronger in lean smokers than in smokers with high fat mass.

  16. Bioresorbable scaffolds for bone tissue engineering: optimal design, fabrication, mechanical testing and scale-size effects analysis.

    Science.gov (United States)

    Coelho, Pedro G; Hollister, Scott J; Flanagan, Colleen L; Fernandes, Paulo R

    2015-03-01

    Bone scaffolds for tissue regeneration require an optimal trade-off between biological and mechanical criteria. Optimal designs may be obtained using topology optimization (homogenization approach) and prototypes produced using additive manufacturing techniques. However, the process from design to manufacture remains a research challenge and will be a requirement of FDA design controls to engineering scaffolds. This work investigates how the design to manufacture chain affects the reproducibility of complex optimized design characteristics in the manufactured product. The design and prototypes are analyzed taking into account the computational assumptions and the final mechanical properties determined through mechanical tests. The scaffold is an assembly of unit-cells, and thus scale size effects on the mechanical response considering finite periodicity are investigated and compared with the predictions from the homogenization method which assumes in the limit infinitely repeated unit cells. Results show that a limited number of unit-cells (3-5 repeated on a side) introduce some scale-effects but the discrepancies are below 10%. Higher discrepancies are found when comparing the experimental data to numerical simulations due to differences between the manufactured and designed scaffold feature shapes and sizes as well as micro-porosities introduced by the manufacturing process. However good regression correlations (R(2) > 0.85) were found between numerical and experimental values, with slopes close to 1 for 2 out of 3 designs.

  17. Maternal high fat feeding does not have long-lasting effects on body composition and bone health in female and male Wistar rat offspring at young adulthood.

    Science.gov (United States)

    Miotto, Paula M; Castelli, Laura M; Amoye, Foyinsola; LeBlanc, Paul J; Peters, Sandra J; Roy, Brian D; Ward, Wendy E

    2013-12-06

    High fat diets adversely affect body composition, bone mineral and strength, and alter bone fatty acid composition. It is unclear if maternal high fat (HF) feeding permanently alters offspring body composition and bone health. Female rats were fed control (CON) or HF diet for 10 weeks, bred, and continued their diets throughout pregnancy and lactation. Male and female offspring were studied at weaning and 3 months, following consumption of CON diet. At weaning, but not 3 months of age, male and female offspring from dams fed HF diet had lower lean mass and higher fat and bone mass, and higher femur bone mineral density (females only) than offspring of dams fed CON diet. Male and female offspring femurs from dams fed HF diet had higher monounsaturates and lower n6 polyunsaturates at weaning than offspring from dams fed CON diet, where females from dams fed HF diet had higher saturates and lower n6 polyunsaturates at 3 months of age. There were no differences in strength of femurs or lumbar vertebrae at 3 months of age in either male or female offspring. In conclusion, maternal HF feeding did not permanently affect body composition and bone health at young adulthood in offspring.

  18. European Bone Marrow Working Group trial on reproducibility of World Health Organization criteria to discriminate essential thrombocythemia from prefibrotic primary myelofibrosis

    Science.gov (United States)

    Buhr, Thomas; Hebeda, Konnie; Kaloutsi, Vassiliki; Porwit, Anna; Van der Walt, Jon; Kreipe, Hans

    2012-01-01

    Background The World Health Organization classification of myeloproliferative neoplasms discriminates between essential thrombocythemia and the prefibrotic phase of primary myelofibrosis. This discrimination is clinically relevant because essential thrombocythemia is associated with a favorable prognosis whereas patients with primary myelofibrosis have a higher risk of progression to myelofibrosis or blast crisis. Design and Methods To assess the reproducibility of the classification, six hematopathologists from five European countries re-classified 102 non-fibrotic bone marrow trephines, obtained because of sustained thrombocytosis. Results Consensus on histological classification defined as at least four identical diagnoses occurred for 63% of the samples. Inter-observer agreement showed low to moderate kappa values (0.28 to 0.57, average 0.41). The percentage of unclassifiable myeloproliferative neoplasms rose from 2% to 23% when minor criteria for primary myelofibrosis were taken into account. In contrast, the frequency of primary myelofibrosis dropped from 23% to 7%, indicating that the majority of patients with a histological diagnosis of primary myelofibrosis did not fulfill the complete criteria for this disease. Thus, over 50% of cases in this series either could not be reproducibly classified or fell into the category of unclassifiable myeloproliferative neoplasms. Conclusions World Health Organization criteria for discrimination of essential thrombocythemia from prefibrotic primary myelofibrosis are poorly to only moderately reproducible and lead to a higher proportion of non-classifiable myeloproliferative neoplasms than histology alone. PMID:22058215

  19. Dietary intake of vitamin K in relation to bone mineral density in Korea adults: The Korea National Health and Nutrition Examination Survey (2010-2011).

    Science.gov (United States)

    Kim, Mi-Sung; Kim, Eun-Soo; Sohn, Cheong-Min

    2015-11-01

    Low vitamin K nutritional status has been associated with increased risk of fracture, however inconsistent results exist to support the role of vitamin K on bone mineral density depending on ethnic difference and gender. Our objective was to determine vitamin K intake in Korean adults, examine correlation between vitamin K intake and bone mineral density. This study analyzed raw data from the fifth Korea National Health and Nutrition Examination Survey for adults (2,785 men, 4,307 women) aged over 19 years. Cross-sectional analyses showed only positive association between vitamin K intake and femur bone mineral density in men after adjusting bone-related factors. However, women in high tertiles of vitamin K intake had a significantly higher bone mineral density both in femur and lumber as compared to women in lowest tertiles (pvitamin K intake increased in women, but this effect was not persisted after adjusting factors. The findings of this study indicate that low dietary vitamin K intake was associated with low bone mineral density in subjects. From these results we may suggest an increase in dietary vitamin K intakes for maintaining bone mineral density. (2010-02CON-21-C, 2011-02CON-06-C).

  20. Scenario-based design: A method for connecting information system design with public health operations and emergency management

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne M

    2011-01-01

    Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Methods: Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Results: Interview analysis identified twenty-five information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create twenty-five scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. Conclusion: The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. PMID:21807120

  1. A summary of the influence of exogenous estrogen administration across the lifespan on the GH/IGF-1 axis and implications for bone health.

    Science.gov (United States)

    Southmayd, Emily A; De Souza, Mary Jane

    2017-02-01

    Bone growth, development, and remodeling are modulated by numerous circulating hormones. Throughout the lifespan, the extent to which each of the hormones impacts bone differs. Understanding the independent and combined impact of these hormones on controlling bone remodeling allows for the development of more informed decision making regarding pharmacology, specifically the use of hormonal medication, at all ages. Endocrine control of bone health in women is largely dictated by the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and the hypothalamic-pituitary-ovarian (HPO) axis. Growth hormone, secreted from the pituitary gland, stimulates cells in almost every tissue to secrete IGF-1, although the majority of circulating IGF-1 is produced hepatically. Indeed, systemic IGF-1 concentrations have been found to be correlated with bone mineral density (BMD) in both pre- and post-menopausal women and is often used as a marker of bone formation. Sex steroids produced by the ovaries, namely estradiol, mediate bone resorption through binding to estrogen receptors on osteoclasts and osteoblasts. Specifically, by increasing osteoclast apoptosis and decreasing osteoblast apoptosis, adequate estrogen levels prevent excessive bone resorption, which helps to explain the rapid decline in bone mass that occurs with the menopausal decrease in estrogen production. Though there are documented correlations between endogenous estrogen concentrations and GH/IGF-1 dynamics, this relationship changes across the lifespan as sex-steroid dynamics fluctuate and, possibly, as tissue responsiveness to GH stimulation decreases. Aside from the known role of endogenous sex steroids on bone health, the impact of exogenous estrogen administration is of interest, as exogenous formulations further modulate GH and IGF-1 production. However, the effect and extent of GH and IGF-1 modulation seems to be largely dependent on age at administration and route of administration. Specifically

  2. Geometric and mechanical properties evaluation of scaffolds for bone tissue applications designing by a reaction-diffusion models and manufactured with a material jetting system

    Directory of Open Access Journals (Sweden)

    Marco A. Velasco

    2016-10-01

    Full Text Available Scaffolds are essential in bone tissue engineering, as they provide support to cells and growth factors necessary to regenerate tissue. In addition, they meet the mechanical function of the bone while it regenerates. Currently, the multiple methods for designing and manufacturing scaffolds are based on regular structures from a unit cell that repeats in a given domain. However, these methods do not resemble the actual structure of the trabecular bone which may work against osseous tissue regeneration. To explore the design of porous structures with similar mechanical properties to native bone, a geometric generation scheme from a reaction-diffusion model and its manufacturing via a material jetting system is proposed. This article presents the methodology used, the geometric characteristics and the modulus of elasticity of the scaffolds designed and manufactured. The method proposed shows its potential to generate structures that allow to control the basic scaffold properties for bone tissue engineering such as the width of the channels and porosity. The mechanical properties of our scaffolds are similar to trabecular tissue present in vertebrae and tibia bones. Tests on the manufactured scaffolds show that it is necessary to consider the orientation of the object relative to the printing system because the channel geometry, mechanical properties and roughness are heavily influenced by the position of the surface analyzed with respect to the printing axis. A possible line for future work may be the establishment of a set of guidelines to consider the effects of manufacturing processes in designing stages.

  3. Design and production of sintered {beta}-tricalcium phosphate 3D scaffolds for bone tissue regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Carlos F.L. [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal); Silva, Abilio P. [Centro de Ciencia e Tecnologia Aeroespaciais, Universidade da Beira Interior, Covilha (Portugal); Lopes, Luis [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal); Pires, Ines [Instituto de Engenharia Mecanica - Lisboa (IDMEC Lisboa/IST/UTL), Avenida Rovisco Pais, 1049-001 Lisboa (Portugal); Correia, Ilidio J., E-mail: icorreia@ubi.pt [CICS-UBI - Centro de Investigacao em Ciencias da Saude, Universidade da Beira Interior, Covilha (Portugal)

    2012-07-01

    The characteristics of sintered {beta}-tricalcium phosphate ({beta}-TCP) scaffolds produced by 3D printing were studied by means of X-ray diffraction, Scanning Electron Microscopy, Fourier transform infrared spectroscopy, uniaxial compression tests and cytotoxicity tests, using human osteoblast cells. The results reported include details of the {beta}-TCP scaffolds' porosity, density, phase stability, mechanical behavior and cytotoxic profile. Collectively, these properties are fundamental for the future application of these scaffolds as bone substitutes for individualized therapy. Highlights: Black-Right-Pointing-Pointer {beta}-Tricalcium phosphate ({beta}-TCP) 3D scaffolds were produced by rapid prototyping. Black-Right-Pointing-Pointer Scaffold properties were assessed by SEM, FTIR, XRD and by mechanical tests. Black-Right-Pointing-Pointer The cytotoxic profile of the scaffolds was characterized by in vitro assays. Black-Right-Pointing-Pointer Scaffolds have good properties for its application as bone substitutes for individualized therapy.

  4. Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects

    Science.gov (United States)

    2015-10-01

    mechanically robust, and less vascular. Samples for cell and CTP analysis are minced and digested in collagenase I and dispase. A standard assay for CTP-Os...Comments” section of the grading table. 2) Sternum autograft cancellous bone graft (ACBG) histology A scoring system for ACBG histology has...D’Alleyrand had continued his interaction with Drs. Pluhar and Muschler and the veterinary staff at Cleveland Clinic during the animal surgeries in Aim 2

  5. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study.

    NARCIS (Netherlands)

    Gerritsen, A.A.M.; Bramsen, I.; Devillé, W.; Willigen, L.H.M. van; Hovens, J.E.; Ploeg, H.M. van der

    2004-01-01

    BACKGROUND: This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of th

  6. Current trends in health facility planning, design, and construction.

    Science.gov (United States)

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  7. Dairy products, dietary calcium and bone health: possibility of prevention of osteoporosis in women: the Polish experience.

    Science.gov (United States)

    Wadolowska, Lidia; Sobas, Kamila; Szczepanska, Justyna W; Slowinska, Malgorzata A; Czlapka-Matyasik, Magdalena; Niedzwiedzka, Ewa

    2013-07-16

    The objective of the study was to analyze the consumption of dairy products and dietary calcium by women in the context of bone mineral density and to assess opportunities to prevent osteoporosis in a dietary manner. The study was carried out with 712 Polish women. In 170 women aged 32 to 59 bone mineral density (BMD) was measured. The data on the consumption of dairy products and dietary calcium and some other osteoporosis risk factors was collected from 712 women. The average calcium intake from a diet was 507 mg/day. Only 2% of the women met Polish calcium intake recommendations. During adulthood, dairy product consumption or dietary calcium intake did not differ significantly between women with low BMD (below -1 SD) and women with regular BMD (≥-1 SD) (47.4 vs. 44.3 servings/week and 459 vs. 510 mg/day, respectively, p > 0.05). The odds ratios adjusted for age, menstruation and BMI in women with upper BMD tercile in comparison to the reference group (bottom tercile) was 2.73 (95% CI: 1.14, 6.55; p dairy products during the pre-school period and 2.40 (95% CI: 1.01, 5.70; p dairy products during the school period. Two clusters of women were established. In the S1 cluster, low BMD (below -1 SD) was associated with older age (≥ 50 years), lack of menstrual cycle. In the S2 cluster, regular BMD (≥-1 SD) was related to younger aged women (dairy products (≥28 servings/week) during adulthood and daily intake of dairy products during childhood and adolescence. The results indicate that good bone health to the larg e extent depended upon the combined impact of dietary factors and some non-modifiable risk factors of osteoporosis such as age and the presence of menstruation. Consumption of dairy products in childhood and adolescence may improve bone mineral density and reduce the risk of osteoporosis in adult women.

  8. Design and Implementation of Ubiquitous Health System U-Health Using Smart-Watches Sensors

    Science.gov (United States)

    Razavi Termeh, V.; Sadeghi Niaraki, A.

    2015-12-01

    Today as diseases grow rapidly, the responsibilities of the health clinics in giving services to patients increase and patients have to be more monitored and controlled. Remote systems of monitoring patients result in reducing cost, ease of movement, and also persistent control of patients by their doctors, so that patient can be monitored without need to go to the clinic. Recent advances in the field of ubiquitous sciences as well as using smartphones have resulted in increasingly use of this devices in remote monitoring of patients. The aim of this paper is to design and implement a ubiquitous health system using smartphones and sensors of smart-watches. This is accomplished through the information sent to the smartphone from the sensors of the watch, e.g. heart beat measurement sensor and ultraviolet ray. Then, this information is analyzed in the smartphone and some information based on the position of the patient and the path of him/her using GIS analyses as well as the information about the health level of the patient is sent to the doctor via SMS or phone call. Unnatural heart beats can be resulted in diseases such as Heart Failure and Arterial Fibrillation. With the approach adopted in this study, the patient or the doctor could be aware of these diseases at any time. The proposed approach is a low cost, without need to complex and resilient equipment, system in ubiquitous health that does not limit the movement of the patient.

  9. Iranian mental health survey: design and field proced.

    Directory of Open Access Journals (Sweden)

    Afarin Rahimi-Movaghar

    2014-06-01

    Full Text Available Iranian Mental Health Survey (IranMHS was conducted to assess the twelve-month prevalence and severity of psychiatric disorders in the Iranian adult population and to determine the pattern of health care utilization and cost of services. IranMHS is a cross-sectional national household survey with face-to-face interviews as the main data collection method. The study was carried out between January and June 2011. A three-stage probability sampling was applied for the selection of a representative sample from the non-institutionalized population aged 15 to 64. The primary instrument utilized for assessing the prevalence of mental disorders was the Persian version of Composite International Diagnosis Interview, version 2.1. The instruments for assessing the service and cost of mental illness were developed by the research team. The response rate was 86.2%, and a total of 7886 individuals participated in the study. Sampling weights were the joint product of inverse probability of unit selection, non-response weights and post-stratification weights. This paper presents an overview of the study design, fieldwork organization and procedures, weightings and analysis. The strengths and limitations of the study are also discussed.

  10. VKORC1 common variation and bone mineral density in the Third National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Dana C Crawford

    Full Text Available Osteoporosis, defined by low bone mineral density (BMD, is common among postmenopausal women. The distribution of BMD varies across populations and is shaped by both environmental and genetic factors. Because the candidate gene vitamin K epoxide reductase complex subunit 1 (VKORC1 generates vitamin K quinone, a cofactor for the gamma-carboxylation of bone-related proteins such as osteocalcin, we hypothesized that VKORC1 genetic variants may be associated with BMD and osteoporosis in the general population. To test this hypothesis, we genotyped six VKORC1 SNPs in 7,159 individuals from the Third National Health and Nutrition Examination Survey (NHANES III. NHANES III is a nationally representative sample linked to health and lifestyle variables including BMD, which was measured using dual energy x-ray absorptiometry (DEXA on four regions of the proximal femur. In adjusted models stratified by race/ethnicity and sex, SNPs rs9923231 and rs9934438 were associated with increased BMD (p=0.039 and 0.024, respectively while rs8050894 was associated with decreased BMD (p=0.016 among non-Hispanic black males (n=619. VKORC1 rs2884737 was associated with decreased BMD among Mexican-American males (n=795; p=0.004. We then tested for associations between VKORC1 SNPs and osteoporosis, but the results did not mirror the associations observed between VKORC1 and BMD, possibly due to small numbers of cases. This is the first report of VKORC1 common genetic variation associated with BMD, and one of the few reports available that investigate the genetics of BMD and osteoporosis in diverse populations.

  11. Using Super-Imposition by Translation And Rotation (SITAR) to relate pubertal growth to bone health in later life:the Medical Research Council (MRC) National Survey of Health and Development

    OpenAIRE

    Cole, T J; Kuh, Diana J L; Johnson, W.; Ward, K A; Howe, L.D.; Adams, J E; Hardy, R; Ong, K. K.

    2016-01-01

    BACKGROUND: To explore associations between pubertal growth and later bone health in a cohort with infrequent measurements, using another cohort with more frequent measurements to support the modelling, data from the Medical Research Council (MRC) National Survey of Health and Development (2-26 years, 4901/30 004 subjects/measurements) and the Avon Longitudinal Study of Parents And Children (ALSPAC) (5-20 years) (10 896/74 120) were related to National Survey of Health and Development (NSHD) ...

  12. Designing health care environments: Part I. Basic concepts, principles, and issues related to evidence-based design.

    Science.gov (United States)

    Cesario, Sandra K

    2009-06-01

    A 2001 Institute of Medicine report captured the nation's attention regarding the dangers that can result from the health care environment. This report, fueled by the need for new facilities to be constructed, led to an explosion of research that now links the physical structure and design of health care facilities to the health and well-being of patients, nurses, other health care workers, and visitors. Continuing nursing education that highlights the importance of evidence-based design has been associated with measurable improvement in health care facilities' clinical outcomes, economic performance, employee productivity, customer satisfaction, and cultural congruency. Three major categories of outcomes can be impacted by evidence-based design: stress reduction, safety, and overall health care quality and ecology. In this article, Part I of a two-part series, the basic concepts, principles, and issues related to evidence-based design are introduced. Part II will describe continuing education programs available for nurses.

  13. Effect of human bone morphogenetic protein 2 implant on tooth eruption in an experimental design.

    Science.gov (United States)

    Steinberg, B; Chiego, D J; Huizinga, P J; Wozney, J M; Wikesjö, U M

    1999-07-01

    This study evaluated the influence of recombinant human bone morphogenetic protein 2 (rhBMP-2) on the development and eruption of the secondary dentition. Primary premolar tooth extraction sockets in 12 16-week-old felines were implanted with either rhBMP-2, in collagen sponge or with buffer/absorbable collagen sponge (ACS). Unoperated jaw quadrants served as controls. Experimental conditions were randomized between jaw quadrants in all animals. Two animals receiving rhBMP-2/ACS and buffer/ACS in two quadrants per implant were sacrificed at 4 weeks postsurgery. Ten animals receiving rhBMP-2/ACS (two quadrants), buffer/ACS implants (one quadrant), and one quadrant serving as an unoperated control were evaluated at 12 weeks postsurgery. Clinical assessments included healing, eruption patterns, and crown development. Radiographic assessments included tooth development, eruption patterns, and bone formation. Histological observations were also made from the 4-week animals. The secondary dentition remained unerupted at 4 weeks postsurgery. Histological analysis showed normal alveolar bone coronal to the erupting teeth in rhBMP-2/ACS-implanted quadrants. At 12 weeks postsurgery, all teeth were erupted without differences between quadrants. Clinically, the crowns of all teeth were normal. Radiographs suggested that teeth in rhBMP-2/ACS- and buffer/ACS-implanted jaw quadrants exhibited similar tooth development and eruption patterns as the normal control. The evidence from this study suggests that surgical implantation of rh-BMP-2/ACS in the pathway of the developing and erupting secondary dentition does not interfere with the normal development and eruption patterns of the teeth.

  14. High dietary sodium intake is associated with low bone mass in postmenopausal women: Korea National Health and Nutrition Examination Survey, 2008-2011.

    Science.gov (United States)

    Kwon, S-J; Ha, Y-C; Park, Y

    2017-01-10

    The present cross-sectional study performed using data from the Korea National Health and Nutrition Examination Survey in 9526 women older than 18 years of age demonstrates that high sodium intake is associated with lower bone mineral density and sodium intake ≥2000 mg/day is a risk factor for osteoporosis in postmenopausal women.

  15. Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

    Science.gov (United States)

    Gonzalez, Stefanie M.

    2010-01-01

    The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

  16. Bridges analysis, design, structural health monitoring, and rehabilitation

    CERN Document Server

    Bakht, Baidar

    2015-01-01

    This book offers a valuable guide for practicing bridge engineers and graduate students in structural engineering; its main purpose is to present the latest concepts in bridge engineering in fairly easy-to-follow terms. The book provides details of easy-to-use computer programs for: ·      Analysing slab-on-girder bridges for live load distribution. ·      Analysing slab and other solid bridge components for live load distribution. ·      Analysing and designing concrete deck slab overhangs of girder bridges under vehicular loads. ·      Determining the failure loads of concrete deck slabs of girder bridges under concentrated wheel loads. In addition, the book includes extensive chapters dealing with the design of wood bridges and soil-steel bridges. Further, a unique chapter on structural health monitoring (SHM) will help bridge engineers determine the actual load carrying capacities of bridges, as opposed to their perceived analytical capacities. The chapter addressing structures...

  17. [Vitamin K2 as a protector of bone health and beyond].

    Science.gov (United States)

    Kaneki, Masao

    2005-04-01

    Several lives of evidence indicate a protective effect of vitamin K against osteoporosis. Epidemiological studies showed that low vitamin K intake is associated with the increased risk of osteoporosis. Vitamin K2 (menatetrenone, MK-4) has been clinically used in the treatment of patients with osteoporosis in Japan, Korea and Thailand. Previous studies demonstrated the efficacy of vitamin K2 (45 mg/day) to prevent bone loss and reduce the rate of vertebral fractures, although a large, randomized intervention study is anticipated to provide more detailed evidence. Recently, vitamin K2 has been shown to reduce the progression of hepatocarcinoma. Moreover, it has been proposed that vitamin K may also have beneficial effects to prevent atherogenesis. The clarification of molecular mechanisms by which vitamin K2 exerts these salutary effects deserve further investigations.

  18. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1... National Health Service Corps (NHSC) personnel to provide primary care, dental, or mental health...

  19. Aragon workers’ health study – design and cohort description

    Directory of Open Access Journals (Sweden)

    Casasnovas José A

    2012-06-01

    Full Text Available Abstract Background Spain, a Mediterranean country with relatively low rates of coronary heart disease, has a high prevalence of traditional cardiovascular risk factors and is experiencing a severe epidemic of overweight/obesity. We designed the Aragon Workers’ Health Study (AWHS to characterize the factors associated with metabolic abnormalities and subclinical atherosclerosis in a middle aged population in Spain free of clinical cardiovascular disease. The objective of this paper is to describe the study design, aims and baseline characteristics of participants in the AWHS. Methods/Design Longitudinal cohort study based on the annual health exams of 5,400 workers of a car assembly plant in Figueruelas (Zaragoza, Spain. Study participants were recruited during a standardized clinical exam in 2009–2010 (participation rate 95.6%. Study participants will undergo annual clinical exams and laboratory assays, and baseline and triennial collection of biological materials for biobanking and cardiovascular imaging exams (carotid, femoral and abdominal ultrasonography, coronary calcium score, and ankle-arm blood pressure index. Participants will be followed-up for 10 years. Results The average (SD age, body mass index, and waist circumference were 49.3 (8.7 years, 27.7 (3.6 kg/m2 and 97.2 (9.9 cm, respectively, among males (N = 5,048, and 40.8 (11.6 years, 24.4 (3.8 kg/m2, and 81.9 (9.9 cm, among females (N = 351. The prevalence of overweight, obesity, current smoking, hypertension, hypercholesterolemia, and diabetes were 55.0, 23.1, 37.1, 40.3, 75.0, and 7.4%, respectively, among males, and 23.7, 8.3, 45.0, 12.1, 59.5, and 0.6%, respectively, among females. In the initial 587 study participants who completed all imaging exams (94.5% male, the prevalence of carotid plaque, femoral plaque, coronary calcium score >1 to 100, and coronary calcium score >100 was 30.3, 56.9, 27.0, and 8.8%, respectively. 67.7% of study participants had at least

  20. Effects of water-based exercise on bone health of middle-aged and older adults: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Simas V

    2017-03-01

    Full Text Available Vini Simas,1 Wayne Hing,1 Rodney Pope,1 Mike Climstein1,2 1Water-Based Research Unit, Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, 2Exercise, Health and Performance Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia Background: Age-related bone loss is a major health concern. Only exercises associated with high-impact and mechanical loading have been linked to a positive effect on bone turnover; however, these types of exercises may not always be appropriate for middle-aged and older adults due to physical decline or chronic disorders such as osteoarthritis. Water-based exercise (WBE has been shown to affect different components of physical fitness, has lower risks of traumatic fracture, and applies less stress to joints. However, the effects of WBE on bone health are unclear.Objective: This study aimed to explore whether WBE is effective in preventing age-related bone deterioration in middle-aged and older adults.Methods: A search of relevant databases and the references of identified studies was performed. Critical narrative synthesis and meta-analyses were conducted.Results: Eleven studies, involving 629 participants, met all inclusion criteria. All participants were postmenopausal women. Eight studies compared WBE to a sedentary control group, and four studies had land-based exercise (LBE participants as a comparison group. Meta-analyses revealed significant differences between WBE and control group in favor of WBE for changes in bone mineral density (BMD at the lumbar spine (mean difference [MD] 0.03 g/cm2; 95% confidence interval [CI]: 0.01 to 0.05 and femoral neck (MD 0.04 g/cm2; 95% CI: 0.02 to 0.07. Significant differences were also revealed between WBE and LBE in favor of LBE for changes in lumbar spine BMD (MD −0.04 g/cm2; 95% CI: −0.06 to −0.02. However, there was no significant difference between WBE and LBE for

  1. Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

    Science.gov (United States)

    Velez, Olivia

    2011-01-01

    Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce…

  2. Designing calcium phosphate-based bifunctional nanocapsules with bone-targeting properties

    Energy Technology Data Exchange (ETDEWEB)

    Khung, Yit-Lung; Bastari, Kelsen; Cho, Xing Ling; Yee, Wu Aik; Loo, Say Chye Joachim, E-mail: joachimloo@ntu.edu.sg [Nanyang Technological University, School of Materials Science and Engineering (Singapore)

    2012-06-15

    Using sodium dodecyl sulphate micelles as template, hollow-cored calcium phosphate nanocapsules were produced. The surfaces of the nanocapsule were subsequently silanised by a polyethylene glycol (PEG)-based silane with an N-hydroxysuccinimide ester end groups which permits for further attachment with bisphosphonates (BP). Characterisations of these nanocapsules were investigated using Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy, Fourier Transform Infra-Red Spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Dynamic Light Scattering. To further validate the bone-targeting potential, dentine discs were incubated with these functionalised nanocapsules. FESEM analysis showed that these surface-modified nanocapsules would bind strongly to dentine surfaces compared to non-functionalised nanocapsules. We envisage that respective components would give this construct a bifunctional attribute, whereby (1) the shell of the calcium phosphate nanocapsule would serve as biocompatible coating aiding in gradual osteoconduction, while (2) surface BP moieties, acting as targeting ligands, would provide the bone-targeting potential of these calcium phosphate nanocapsules.

  3. Designing a framework for the concept of health.

    Science.gov (United States)

    Frenk, Julio; Gómez-Dantés, Octavio

    2014-08-01

    We discuss a set of ideas related to defining health--using the World Health Organization definition, several debates in the academic literature, and the Meikirch Model of Health. Given the complex and dynamic nature of health, we cannot aim to generate a once-and-for-all agreement on its precise meaning. Instead, let us work to develop a general framework to guide further explorations to identify and measure the complex components and determinants of that elusive aspiration we call health.

  4. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  5. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

    Science.gov (United States)

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

    2012-01-01

    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  6. The impact on children's bone health of a school-based physical education program and participation in leisure time sports

    DEFF Research Database (Denmark)

    Heidemann, Malene Søborg; Jespersen, Eva; Holst, René

    2013-01-01

    lessons per week) were compared to children at "traditional" schools (2×45min of PE lessons per week) in Svendborg, Denmark. Whole-body DXA scans were performed at baseline (2008) and at a two-year follow-up (2010). Bone mineral content (BMC), bone mineral density (BMD), and bone area (BA) were measured...

  7. Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease.

    Science.gov (United States)

    O'Connor, Eibhlís M; Grealy, Geraldine; McCarthy, Jane; Desmond, Alan; Craig, Orla; Shanahan, Fergus; Cashman, Kevin D

    2014-10-14

    Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (vitamin K1). By conducting two RCT, the present study aimed to first establish whether supplementation with 1000 μg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum (%ucOC; marker of vitamin K status) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass. The initial dose-ranging RCT was conducted in adult patients with CD (n 10 per group) using 0 (placebo), 1000 or 2000 μg of phylloquinone daily for 2 weeks. In the main RCT, the effect of placebo v. 1000 μg vitamin K/d (both co-administered with Ca (500 mg/d) and vitamin D3 (10 μg/d)) for 12 months (n 43 per group) on the biochemical indices of bone turnover (determined by enzyme immunoassay) and bone mass (determined by dual-energy X-ray absorptiometry) were investigated. At baseline, the mean %ucOC was 47 %, and this was suppressed upon supplementation with 1000 μg of phylloquinone daily ( - 81 %; P0·1) on bone turnover markers or on the bone mass of the lumbar spine or femur, but modestly increased (Pvitamin D3) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency.

  8. Effects of rhBMP-2 on Sandblasted and Acid Etched Titanium Implant Surfaces on Bone Regeneration and Osseointegration: Spilt-Mouth Designed Pilot Study

    Directory of Open Access Journals (Sweden)

    Nam-Ho Kim

    2015-01-01

    Full Text Available This study was conducted to evaluate effects of rhBMP-2 applied at different concentrations to sandblasted and acid etched (SLA implants on osseointegration and bone regeneration in a bone defect of beagle dogs as pilot study using split-mouth design. Methods. For experimental groups, SLA implants were coated with different concentrations of rhBMP-2 (0.1, 0.5, and 1 mg/mL. After assessment of surface characteristics and rhBMP-2 releasing profile, the experimental groups and untreated control groups (n = 6 in each group, two animals in each group were placed in split-mouth designed animal models with buccal open defect. At 8 weeks after implant placement, implant stability quotients (ISQ values were recorded and vertical bone height (VBH, mm, bone-to-implant contact ratio (BIC, %, and bone volume (BV, % in the upper 3 mm defect areas were measured. Results. The ISQ values were highest in the 1.0 group. Mean values of VBH (mm, BIC (%, and BV (% were greater in the 0.5 mg/mL and 1.0 mg/mL groups than those in 0.1 and control groups in buccal defect areas. Conclusion. In the open defect area surrounding the SLA implant, coating with 0.5 and 1.0 mg/mL concentrations of rhBMP-2 was more effective, compared with untreated group, in promoting bone regeneration and osseointegration.

  9. Disparities in bone density measurement history and osteoporosis medication utilisation in Swiss women: results from the Swiss Health Survey 2007

    Directory of Open Access Journals (Sweden)

    Born Rita

    2013-01-01

    Full Text Available Abstract Background Although factors associated with the utilisation of bone density measurement (BDM and osteoporosis treatment have been regularly assessed in the US and Canada, they have not been effectively analysed in European countries. This study assessed factors associated with the utilisation of BDM and osteoporosis medication (OM in Switzerland. Methods The Swiss Health Survey 2007 data included self-reported information on BDM and OM for women aged 40 years and older who were living in private households. Multivariable logistic regression analysis was used to identify sociodemographic, socioeconomic, healthcare-related and osteoporosis risk factors associated with BDM and OM utilisation. Results The lifetime prevalence of BDM was 25.6% (95% CI: 24.3-26.9% for women aged 40 years and older. BDM utilisation was associated with most sociodemographic factors, all the socioeconomic and healthcare-related factors, and with major osteoporosis risk factors analysed. The prevalence of current OM was 7.8% (95% CI: 7.0-8.6% and it was associated with some sociodemographic and most healthcare-related factors but only with one socioeconomic factor. Conclusions In Swiss women, ever having had a BDM and current OM were low and utilisation disparities exist according to sociodemographic, socioeconomic and healthcare-related factors. This might foster further health inequalities. The reasons for these findings should be addressed in further studies of the elderly women, including those living in institutions.

  10. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... dental health professional shortage areas (HPSAs) as of May 11, 2013, available on the Health Resources... assignment of National Health Service Corps (NHSC) personnel to provide primary care, ] dental, or...

  11. Spiral and vestibular ganglion estimates in archival temporal bones obtained by design based stereology and Abercrombie methods.

    Science.gov (United States)

    Ishiyama, Gail; Geiger, Christopher; Lopez, Ivan A; Ishiyama, Akira

    2011-03-15

    The objective of this study was to make direct comparisons of the estimates of spiral and vestibular neuronal number in human archival temporal bone specimens using design-based stereology with those using the assumption-based Abercrombie method. Archival human temporal bone specimens from subjects ranging in age from 16 to 80 years old were used. The number of spiral and vestibular ganglia neurons within the counting areas was estimated using the stereology-optical disector technique and compared with estimates obtained using the assumption-based Abercrombie method on the same specimens. Using the optical disector method, there was an average of 41,480 (coefficient of variation=0.12) spiral ganglia neurons and 28,930 (coefficient of variation=0.15) vestibular ganglia neurons. The mean coefficient of error was 0.076 for the spiral ganglion estimates, and 0.091 for the vestibular ganglion estimates. Using the Abercrombie correction method of two-dimensional analysis, an average of 23,110 (coefficient of variation of 0.08) spiral ganglia neurons, and 16,225 vestibular ganglia neurons (coefficient of variation of 0.15) was obtained. We found that there was a large disparity between the estimates with a significant 44% underestimation of the spiral and vestibular ganglion counts obtained using the Abercrombie method when compared with estimates using the optical disector method.

  12. Osteoporosis: Modern Paradigms for Last Century’s Bones

    Directory of Open Access Journals (Sweden)

    Marlena C. Kruger

    2016-06-01

    Full Text Available The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a “brittle bone” disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

  13. Influence of cassette design on three-dimensional perfusion culture of artificial bone.

    Science.gov (United States)

    Du, Dajiang; Ushida, Takashi; Furukawa, Katsuko S

    2015-01-01

    Media perfusion is often required to maintain cell viability within topographically complex 3-dimensional scaffold cultures. Osteoblast-seeded scaffolds for bone regeneration require robust cell proliferation and survival both within the scaffold and over the exterior for optimal osteogenic capacity. Conventional press-fitting cassettes ensure internal fluid flow through the scaffold but may restrict external flow around the scaffold, resulting in a barren (cell-free) external scaffold surface. In this study, we aimed to solve this problem by modifying the cassette structure to enhance external flow in an oscillatory perfusion culture system. Mouse osteoblast-like MC 3T3-E1 cells were seeded in porous ceramic scaffolds and incubated for 3 days either under static culture conditions or in an oscillatory perfusion bioreactor. Scaffolds were held in the bioreactor with either conventional press-fitting cassettes or cassettes with rings to separate the scaffold exterior from the internal cassette wall. The external surfaces of scaffolds maintained under static conditions were well seeded, but cells failed to grow deeply into the core, reflecting poor internal chemotransport. Alternatively, scaffolds cultured by perfusion with press-fitting cassettes had poor cell viability at the cassette-external scaffold surface interface, but cells were widely distributed within the scaffold core. Scaffolds cultured using the modified cassettes with 1 or 2 rings exhibited uniformly distributed living cells throughout the internal pores and over the entire external surface, possibly because of the improved medium flow over the scaffold surface. This modified oscillatory perfusion culture system may facilitate the production of engineered bone with superior osteogenic capacity for grafting.

  14. Design and validation of automated femoral bone morphology measurements in cerebral palsy.

    Science.gov (United States)

    Park, Noyeol; Lee, Jehee; Sung, Ki Hyuk; Park, Moon Seok; Koo, Seungbum

    2014-04-01

    Accurate quantification of bone morphology is important for monitoring the progress of bony deformation in patients with cerebral palsy. The purpose of the study was to develop an automatic bone morphology measurement method using one or two radiographs. The study focused on four morphologic measurements-neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length. Fifty-four three-dimensional (3D) geometrical femur models were generated from the computed tomography (CT) of cerebral palsy patients. Principal component analysis was performed on the combined data of geometrical femur models and manual measurements of the four morphologic measurements to generate a statistical femur model. The 3D-2D registration of the statistical femur model for radiography computes four morphological measurements of the femur in the radiographs automatically. The prediction performance was tested here by means of leave-one-out cross-validation and was quantified by the intraclass correlation coefficient (ICC) and by measuring the absolute differences between automatic prediction from two radiographs and manual measurements using original CT images. For the neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length, the ICCs were 0.812, 0.960, 0.834, and 0.750, respectively, and the mean absolute differences were 2.52°, 2.85°, 0.92°, and 1.88 mm, respectively. Four important dimensions of the femur could be predicted from two views with very good agreement with manual measurements from CT and hip radiographs. The proposed method can help young patients avoid instances of large radiation exposure from CT, and their femoral deformities can be quantified robustly and effectively from one or two radiograph(s).

  15. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  16. Maintained hand function and forearm bone health 14 months after an in-home virtual-reality videogame hand telerehabilitation intervention in an adolescent with hemiplegic cerebral palsy.

    Science.gov (United States)

    Golomb, Meredith R; Warden, Stuart J; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C

    2011-03-01

    Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.

  17. Aphasia friendly written health information: content and design characteristics.

    Science.gov (United States)

    Rose, Tanya A; Worrall, Linda E; Hickson, Louise M; Hoffmann, Tammy C

    2011-08-01

    People with aphasia need communicatively accessible written health information. Healthcare providers require knowledge of how to develop printed education materials (PEMs) in formats that people with aphasia prefer and can read. This study aimed to explore formatting characteristics considered to be barriers and facilitators to reading PEMs. Semi-structured in-depth interviews were conducted with 40 adults with aphasia who were selected using maximum variation sampling across aphasia severity, reading ability, and time post-stroke. Participants were shown stroke and aphasia PEMs obtained from the recruiting stroke services, asked to rank them from most liked to least liked, and comment on factors that made the PEMs easier and harder to read. The majority of participants ranked the aphasia friendly stroke (56.4%, n = 22) and aphasia (87.2%, n = 34) PEMs as most liked. Forty-five facilitator and 46 barrier codes were identified using qualitative content analysis and grouped into two categories; (1) content characteristics and (2) design characteristics. Findings support many of the recommendations found within the literature for developing best practice PEMs and accessible information for other patient groups. Routine consideration of the facilitators and barriers identified will contribute to making written information more accessible to people with aphasia.

  18. A Smart Green Building: An Environmental Health Control Design

    Directory of Open Access Journals (Sweden)

    Jui-Ting Huang

    2012-05-01

    Full Text Available This study proposes the establishment of an environmental health information management platform providing residential users with a comfortable, healthy indoor environment. Taking the S House as an example, the study: (1 assigned environmental health performance indicators, (2 established constraints to maintain environmental conditions, and (3 provided optimized management control mechanisms and methods. The environmental health information management platform provides an optimized control and solution pathway ensuring the quality of the indoor health environment and equipment energy conservation.

  19. Microlearning mApp raises health competence: hybrid service design

    NARCIS (Netherlands)

    Simons, L.P.A.; Foerster, F.; Bruck, P.A.; Motiwalla, L.; Jonker, C.M.

    2015-01-01

    Work place health support interventions can help support our aging work force, with mApps offering cost-effectiveness opportunities. Previous research shows that health support apps should offer users enough newness and relevance each time they are used. Otherwise the ‘eHealth law of attrition’ appl

  20. Design and Use of Chimeric Proteins Containing a Collagen-Binding Domain for Wound Healing and Bone Regeneration.

    Science.gov (United States)

    Addi, Cyril; Murschel, Frederic; De Crescenzo, Gregory

    2016-12-12

    Collagen-based biomaterials are widely used in the field of tissue engineering; they can be loaded with biomolecules such as growth factors (GFs) to modulate the biological response of the host and thus improve its potential for regeneration. Recombinant chimeric GFs fused to a collagen-binding domain (CBD) have been reported to improve their bioavailability and the host response, especially when combined with an appropriate collagen-based biomaterial. This review first provides an extensive description of the various CBDs that have been fused to proteins, with a focus on the need for accurate characterization of their interaction with collagen. The second part of the review highlights the benefits of various CBD/GF fusion proteins that have been designed for wound healing and bone regeneration.

  1. Broken Bones, Sprains, and Strains (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Broken Bones, Sprains, and Strains KidsHealth > For Parents > Broken Bones, ... home. What to Do: For a Suspected Broken Bone: Do not move a child whose injury involves ...

  2. Chemistry, nutritional sources, tissue distribution and metabolism of vitamin K with special reference to bone health.

    Science.gov (United States)

    Shearer, M J; Bach, A; Kohlmeier, M

    1996-04-01

    Vitamin K occurs in nature as a series of compounds with a common 2-methyl- 1,4 naphthoquinone nucleus and differing isoprenoid side chains at the 3 position. They comprise a single major plant form, phylloquinone with a phytyl side chain and a family of bacterially synthesized menaquinones (MKs) with multiprenyl side chains. The major dietary source to humans is phylloquinone for which the chief food contributors are green, leafy vegetables followed by certain vegetable oils (soybean, rapeseed and olive oils). Recent analyses by high pressure liquid chromatography are now providing a wide-ranging database of phylloquinone in foods. Menaquinones are found in moderate concentrations in only a few foods such as cheeses (MK-8 and MK-9). A wider spectrum of MKs is synthesized by the gut microflora, and their intestinal absorption probably accounts for most of the hepatic stores, particularly those with very long side chains (MKs-10--13) synthesized by members of the genus Bacteroides. The site of absorption of floral MKs is not known, but reasonable concentrations are found in the terminal ileum where bile salt-mediated absorption is possible. Both phylloquinone and menaquinones are bioactive in hepatic gamma-carboxylation but long-chain MKs are less well absorbed. Liver stores of vitamin K are relatively small and predominantly MKs-7--13. The hepatic reserves of phylloquinone (approximately 10% of the total) are labile and turn over at a faster rate than menaquinones. Trabecular and cortical bone appear to contain substantial concentrations of both phylloquinone and menaquinones. A majority (approximately 60-70%) of the daily dietary intake of phylloquinone is lost to the body by excretion, which emphasizes the need for a continuous dietary supply to maintain tissue reserves.

  3. Computer-Aided Design and Computer-Aided Manufacturing Hydroxyapatite/Epoxide Acrylate Maleic Compound Construction for Craniomaxillofacial Bone Defects.

    Science.gov (United States)

    Zhang, Lei; Shen, Shunyao; Yu, Hongbo; Shen, Steve Guofang; Wang, Xudong

    2015-07-01

    The aim of this study was to investigate the use of computer-aided design and computer-aided manufacturing hydroxyapatite (HA)/epoxide acrylate maleic (EAM) compound construction artificial implants for craniomaxillofacial bone defects. Computed tomography, computer-aided design/computer-aided manufacturing and three-dimensional reconstruction, as well as rapid prototyping were performed in 12 patients between 2008 and 2013. The customized HA/EAM compound artificial implants were manufactured through selective laser sintering using a rapid prototyping machine into the exact geometric shapes of the defect. The HA/EAM compound artificial implants were then implanted during surgical reconstruction. Color-coded superimpositions demonstrated the discrepancy between the virtual plan and achieved results using Geomagic Studio. As a result, the HA/EAM compound artificial bone implants were perfectly matched with the facial areas that needed reconstruction. The postoperative aesthetic and functional results were satisfactory. The color-coded superimpositions demonstrated good consistency between the virtual plan and achieved results. The three-dimensional maximum deviation is 2.12 ± 0.65  mm and the three-dimensional mean deviation is 0.27 ± 0.07  mm. No facial nerve weakness or pain was observed at the follow-up examinations. Only 1 implant had to be removed 2 months after the surgery owing to severe local infection. No other complication was noted during the follow-up period. In conclusion, computer-aided, individually fabricated HA/EAM compound construction artificial implant was a good craniomaxillofacial surgical technique that yielded improved aesthetic results and functional recovery after reconstruction.

  4. Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, J.; Hornstrup, T.; Christensen, J. F.

    2016-01-01

    Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD...... and physical functioning parameters compared to control. INTRODUCTION: ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone turnover...... markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT. METHODS: Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28) for 32...

  5. Bone health and risk factors of cardiovascular disease--a cross-sectional study in healthy young adults.

    Directory of Open Access Journals (Sweden)

    Satu Pirilä

    Full Text Available OBJECTIVE: Both osteoporosis and cardiovascular disease (CVD are diseases that comprise a growing medical and economic burden in ageing populations. They share many risk factors, including ageing, low physical activity, and possibly overweight. We aimed to study associations between individual risk factors for CVD and bone mineral density (BMD and turnover markers (BTMs in apparently healthy cohort. DESIGN: A cross-sectional assessment of 155 healthy 32-year-old adults (74 males was performed for skeletal status, CVD risk factors and lifestyle factors. METHODS: We analysed serum osteocalcin, procollagen I aminoterminal propeptide (P1NP, collagen I carboxy-terminal telopeptide (ICTP and urine collagen I aminoterminal telopeptide (U-NTX, as well as serum insulin, plasma glucose, triglyceride and HDL-cholesterol levels. BMD, fat and lean mass were assessed using DXA scanning. Associations were tested with partial correlations in crude and adjusted models. Bone status was compared between men with or without metabolic syndrome (defined according to the NCEP-ATPIII criteria with multivariate analysis. RESULTS: Osteocalcin and P1NP correlated inversely with insulin (R = -0.243, P = 0.003 and R = -0.187, P = 0.021 and glucose (R = -0.213, P = 0.009 and R = -0.190, P = 0.019, but after controlling for fat mass and lifestyle factors, the associations attenuated with insulin (R = -0.162, P = 0.053 and R = -0.093, P = 0.266 and with glucose (R = -0.099, P = 0.240 and R = -0.133, P = 0.110, respectively. Whole body BMD associated inversely only with triglycerides in fully adjusted model. In men with metabolic syndrome, whole body BMD, osteocalcin and P1NP were lower compared to healthy men, but these findings disappeared in fully adjusted model. CONCLUSIONS: In young adults, inverse associations between BTM/BMD and risk factors of CVD appeared in crude models, but after adjusting for fat mass

  6. Network design for telemedicine--e-health using satellite technology.

    Science.gov (United States)

    Graschew, Georgi; Roelofs, Theo A; Rakowsky, Stefan; Schlag, Peter M

    2008-01-01

    Over the last decade various international Information and Communications Technology networks have been created for a global access to high-level medical care. OP 2000 has designed and validated the high-end interactive video communication system WinVicos especially for telemedical applications, training of the physician in a distributed environment, teleconsultation and second opinion. WinVicos is operated on a workstation (WoTeSa) using standard hardware components and offers a superior image quality at a moderate transmission bandwidth of up to 2 Mbps. WoTeSa / WinVicos have been applied for IP-based communication in different satellite-based telemedical networks. In the DELTASS-project a disaster scenario was analysed and an appropriate telecommunication system for effective rescue measures for the victims was set up and evaluated. In the MEDASHIP project an integrated system for telemedical services (teleconsultation, teleelectro-cardiography, telesonography) on board of cruise ships and ferries has been set up. EMISPHER offers an equal access for most of the countries of the Euro-Mediterranean area to on-line services for health care in the required quality of service. E-learning applications, real-time telemedicine and shared management of medical assistance have been realized. The innovative developments in ICT with the aim of realizing a ubiquitous access to medical resources for everyone at any time and anywhere (u-Health) bear the risk of creating and amplifying a digital divide in the world. Therefore we have analyzed how the objective needs of the heterogeneous partners can be joined with the result that there is a need for real integration of the various platforms and services. A virtual combination of applications serves as the basic idea for the Virtual Hospital. The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre

  7. Effect of vitamin K on bone health in humans%维生素K在人类骨健康中的作用

    Institute of Scientific and Technical Information of China (English)

    龙燕; 张昌华

    2013-01-01

    骨质疏松及其引发的骨折高发病率已成为世界公共健康问题,探索营养物质对骨健康的有效性具有重要意义。本文综述的目的是对维生素K在人类骨健康中的防治作用进行评价分析。虽然大量观察性研究显示膳食叶绿醌(维生素K1)或MK-7与人体骨密度的提高或骨折发生率的下降有着密切关系,但干预性研究尚不能明确维生素K1或MK-4补剂对骨骼的保护作用。此外,研究资料也未证实维生素K营养状况与骨健康之间的关联性。目前相关研究资料不充分,研究方案及研究结论不一致,维生素K在人类骨健康中的有效防治作用仍存在争议。%The high prevalence of osteoporosis and the consequential fractures has become a public health problem all around the world.Therefore, it is important to explore the effectiveness of nutrients on bone health .The objective of this review is to evaluate the effect of the prevention and treatment effect of vitamin K on bone health in humans .Though several observational studies have reported an association of dietary phylloquinone or MK-7 with high bone mineral density or low risk of fractures , the intervention studies have not yet determined the protective effect of intake daily phylloquinone (vitamin K1) or MK-4 supplementation on bone health.In addition, the data of randomized studies have not shown the correlation between the vitamin K status and bone health .Actually, the effect of vitamin K on bone health in humans remains controversial due to the difference regarding results and /or methodologies of studies , and the insufficiency of available data .

  8. Improving Bone-Health Monitoring in Astronauts: Recommended Use of Quantitative Computed Tomography [QCT] for Clinical and Operational Decisions by NASA

    Science.gov (United States)

    Sibonga, J. D.; Truszkowski, P.

    2010-01-01

    DXA measurement of areal bone mineral density [aBMD,g/cm2] is required by NASA for assessing skeletal integrity in astronauts. Due to the abundance of population-based data that correlate hip and spine BMDs to fragility fractures, BMD is widely applied as a predictor of fractures in the general aging population. In contrast, QCT is primarily a research technology that measures three-dimensional , volumetric BMD (vBMD,mg/cm3) of bone and is therefore capable of differentiating between cortical and trabecular components. Additionally, when combined with Finite Element Modeling [FEM], a computational tool, QCT data can be used to estimate the whole bone strength of the hip [FE strength] for a specific load vector. A recent report demonstrated that aBMD failed to correlate with incurred changes in FE strength (for fall and stance loading) by astronauts over typical 180-day ISS (International Space Station) missions. While there are no current guidelines for using QCT data in clinical practice, QCT increases the understanding of how bone structure and mineral content are affected by spaceflight and recovery on Earth. In order to understand/promote/consider the use of QCT, NASA convened a panel of clinicians specializing in osteoporosis. After reviewing the available, albeit limited, medical and research information from long-duration astronauts (e.g., data from DXA, QCT, FEM, biochemistry analyses, medical records and in-flight exercise performance) the panelists were charged with recommending how current and future research data and analyses could inform clinical and operational decisions. The Panel recommended that clinical bone tests on astronauts should include QCT (hip and lumbar spine) for occupational risk surveillance and for the estimation of whole hip bone strength as derived by FEM. FE strength will provide an improved index that NASA could use to select astronauts of optimal bone health for extended duration missions, for repeat missions or for specific

  9. Design, construction and mechanical testing of digital 3D anatomical data-based PCL-HA bone tissue engineering scaffold.

    Science.gov (United States)

    Yao, Qingqiang; Wei, Bo; Guo, Yang; Jin, Chengzhe; Du, Xiaotao; Yan, Chao; Yan, Junwei; Hu, Wenhao; Xu, Yan; Zhou, Zhi; Wang, Yijin; Wang, Liming

    2015-01-01

    The study aims to investigate the techniques of design and construction of CT 3D reconstructional data-based polycaprolactone (PCL)-hydroxyapatite (HA) scaffold. Femoral and lumbar spinal specimens of eight male New Zealand white rabbits were performed CT and laser scanning data-based 3D printing scaffold processing using PCL-HA powder. Each group was performed eight scaffolds. The CAD-based 3D printed porous cylindrical stents were 16 piece × 3 groups, including the orthogonal scaffold, the Pozi-hole scaffold and the triangular hole scaffold. The gross forms, fiber scaffold diameters and porosities of the scaffolds were measured, and the mechanical testing was performed towards eight pieces of the three kinds of cylindrical scaffolds, respectively. The loading force, deformation, maximum-affordable pressure and deformation value were recorded. The pore-connection rate of each scaffold was 100 % within each group, there was no significant difference in the gross parameters and micro-structural parameters of each scaffold when compared with the design values (P > 0.05). There was no significant difference in the loading force, deformation and deformation value under the maximum-affordable pressure of the three different cylinder scaffolds when the load was above 320 N. The combination of CT and CAD reverse technology could accomplish the design and manufacturing of complex bone tissue engineering scaffolds, with no significant difference in the impacts of the microstructures towards the physical properties of different porous scaffolds under large load.

  10. The relationship between bone health and plasma zinc, copper lead and cadmium concentration in osteoporotic women.

    Science.gov (United States)

    Sadeghi, Naficeh; Oveisi, Mohammad Reza; Jannat, Behrooz; Hajimahmoodi, Mannan; Behzad, Masoomeh; Behfar, Abdolazim; Sadeghi, Fatemeh; Saadatmand, Sahereh

    2014-01-01

    Osteoporosis is a multi factorial disease with dimension of genetic and nutritional considerations. The aim of this study was to present data from the association of plasma zinc, copper and toxic elements of lead and cadmium levels with bone mineral density in Iranian women. 135 women gave their information and enrolled. Fasting plasma was used for measurement of trace elements and heavy metals by Differential Pulse Anodic Stripping Voltammetry. Control group (n = 51) were normal in both lumbar spine (L1-L4) and femoral neck density (T-score ≥ -1), but just femoral neck T-score was considered as criterion in selection of patient group (n = 49, Tscore T-score > -1.7), 1.463 ± 0.174, 1.327 ± 0.147 μg/ml in Severe patient group (T-score < -1.7); respectively. Mean ± SD plasma level of lead and cadmium was 168.42 ± 9.61 ng/l, 2.91 ± 0.18 ng/ml in control group, 176.13 ± 8.64 ng/l, 2.97 ± 0.21 ng/ml in TP, 176.43 ± 13.2 ng/l, 2.99 ± 0.1 ng/ml in mild patients, 221.44 ± 20 ng/l and 3.80 ± 0.70 ng/ml in severe patient group, respectively. In this study plasma zinc, copper, lead & cadmium concentrations were higher in the patients than in the control, though differences were not significant. However, differences were higher between the controls and patients with severe disease (T-score < -1.7). In addition adjusted T-score of femur with age and BMI showed negative significant correlation with plasma levels of zinc and lead in total participants (p < 0.05, r = -0.201, p = 0.044, r = -0.201). It seems that more extensive study with larger ample size might supply definite results about this association for copper and cadmium.

  11. Exercise, lifestyle, and your bones

    Science.gov (United States)

    Osteoporosis - exercise; Low bone density - exercise; Osteopenia - exercise ... your bones strong and lower your risk of osteoporosis and fractures as you get older. Before you begin an exercise program, talk with your health care provider if: ...

  12. Designing a health equity audit model for Iran in 2010

    Directory of Open Access Journals (Sweden)

    Saeed Karimi

    2011-01-01

    Full Text Available Background: Health equity audit, as an alternative solution, is a process by which local partners systematically review inequalities in the patients` health, their access to appropriate services and health system outputs. Then, necessary activities needed in order to have more equitable services are agreed on and these concurrences become the executive scheme and action initiates. Therefore, it is pivotal for health care organizations to pay special attention to this important topic. The objective of the current study was to review the health equity audit model in different countries to gather viewpoints of various involved groups in health sector, particularly health experts, and to offer a practical and appropriate model for health equity audit in Iran. Methods: This study adopted applied research approach in two phases. In the first step, this study conducted theoretical health equity audit models in the texts; the experiences of other countries were studied and the most appropriate model for Iranian health system was selected. In the second step, this study employed the Delphi technique. According to the Delphi technique the questionnaire applied in order to gather data and then, the final model was extracted. Results: Agreeable topics, performing agencies, 6 equity audit stages, and equity indicators under 3 main parts with 16 sub-sections were elaborated and viewpoints of Iranian experts in the above fields were gathered and presented as the proposed health equity audit model for Iran. Conclusions: This study reviewed the model of health equity audit for UK and provided a comparative model for health system of Iran with respect to the opinions of academic experts.

  13. Adequate but not supplemental folic acid combined with soy isoflavones during early life improves bone health at adulthood in male mice.

    Science.gov (United States)

    Kaludjerovic, Jovana; Ward, Wendy E

    2013-10-01

    Previous investigations from our laboratory have demonstrated that neonatal exposure to soy isoflavones (ISO) improves bone outcomes in CD-1 mice at adulthood with greater benefits in females than males. This study determined whether early-life exposure to supplemental folic acid (FA) - that may enhance DNA methylation of target genes - in combination with ISO provides greater benefits to male bone development than ISO alone. CD-1 dams were randomized to a low (0 mg/kg diet), adequate (2 mg/kg diet) or supplemental (8 mg/kg diet) level of FA during pregnancy and lactation. Offspring received corn oil or ISO (7 mg/kg of body weight per day) from postnatal day 1-10. From weaning, males were fed adequate FA and studied to age 4 months. Offspring exposed to adequate FA+ISO had multiple benefits to bone health: higher (Pbenefits to male bone development, while improvements induced by supplemental FA+ISO were limited to a higher level of serum OPG. Mechanistic studies are needed to better understand how FA and ISO improve bone development in male offspring.

  14. Implementation and Integration of a Finite Element Model into the Bone Remodeling Model to Characterize Skeletal Loading

    Science.gov (United States)

    Werner, C. R.; Lewandowski, B.; Boppana, A.; Pennline, J. A.

    2017-01-01

    NASA's Digital Astronaut Project is developing a bone physiology model to predict changes in bone mineral density over the course of a space mission. The model intends to predict bone loss due to exposure in microgravity as well as predicting bone maintenance due to mechanical stimulus generated by exercise countermeasures. These predictions will be used to inform exercise device efficacy and to help design exercise protocols that will maintain bone mineral density during long exposures to microgravity during spaceflight. The mechanical stimulus and the stresses that are exhibited on the bone are important factors for bone remodeling. These stresses are dependent on the types of exercise that are performed and vary throughout the bone due to the geometry. A primary area of focus for bone health is the proximal femur. This location is critical in transmitting loads between the upper and lower body and have been known to be a critical failure point in older individuals with conditions like osteoporosis.

  15. Maternal first-trimester diet and childhood bone mass: The Generation R Study

    NARCIS (Netherlands)

    D.H.M. Heppe (Denise); C. Medina-Gomez (Carolina); A. Hofman (Albert); O.H. Franco (Oscar); F. Rivadeneira Ramirez (Fernando); V.W.V. Jaddoe (Vincent)

    2013-01-01

    textabstractBackground: Maternal diet during pregnancy has been suggested to influence bone health in later life. Objective: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. Design: In a prospective cohort study in 2819 mothers and the

  16. Simulation of mechanical behavior and optimization of simulated injection molding process for PLA based antibacterial composite and nanocomposite bone screws using central composite design.

    Science.gov (United States)

    Heidari, Behzad Shiroud; Oliaei, Erfan; Shayesteh, Hadi; Davachi, Seyed Mohammad; Hejazi, Iman; Seyfi, Javad; Bahrami, Mozhgan; Rashedi, Hamid

    2017-01-01

    In this study, injection molding of three poly lactic acid (PLA) based bone screws was simulated and optimized through minimizing the shrinkage and warpage of the bone screws. The optimization was carried out by investigating the process factors such as coolant temperature, mold temperature, melt temperature, packing time, injection time, and packing pressure. A response surface methodology (RSM), based on the central composite design (CCD), was used to determine the effects of the process factors on the PLA based bone screws. Upon applying the method of maximizing the desirability function, optimization of the factors gave the lowest warpage and shrinkage for nanocomposite PLA bone screw (PLA9). Moreover, PLA9 has the greatest desirability among the selected materials for bone screw injection molding. Meanwhile, a finite element analysis (FE analysis) was also performed to determine the force values and concentration points which cause yielding of the screws under certain conditions. The Von-Mises stress distribution showed that PLA9 screw is more resistant against the highest loads as compared to the other ones. Finally, according to the results of injection molding simulations, the design of experiments (DOE) and structural analysis, PLA9 screw is recommended as the best candidate for the production of biomedical materials among all the three types of screws.

  17. A Bayesian experimental design approach to structural health monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Farrar, Charles [Los Alamos National Laboratory; Flynn, Eric [UCSD; Todd, Michael [UCSD

    2010-01-01

    Optimal system design for SHM involves two primarily challenges. The first is the derivation of a proper performance function for a given system design. The second is the development of an efficient optimization algorithm for choosing a design that maximizes, or nearly maximizes the performance function. In this paper we will outline how an SHM practitioner can construct the proper performance function by casting the entire design problem into a framework of Bayesian experimental design. The approach demonstrates how the design problem necessarily ties together all steps of the SHM process.

  18. A Synthetic Health Curriculum Design in Ecologic Perspective

    Science.gov (United States)

    Hoyman, Howard S.

    1977-01-01

    The newly emerging ecologic approach to health education is focused on the man-environment complex, in terms of not only personal health but of awareness of man's position in the scheme of evolution and his responsibility for the environment of the world. (JD)

  19. Personas: The Linking Pin in Holistic Design for eHealth

    NARCIS (Netherlands)

    Velsen, van L.S.; Gemert-Pijnen, van Lisette; Nijland, Nicol; Beaujean, Desirée; Steenbergen, van Jim

    2012-01-01

    Personas, lively descriptions of distinctive user groups for a technology, have the potential to be a useful tool for designing useful and usable eHealth services. In this paper we discuss the role of personas in a holistic design approach for eHealth: the CeHRes roadmap. We show, using the case of

  20. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    Science.gov (United States)

    Lee, Eunji

    2016-01-01

    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  1. 78 FR 44459 - Designation of Health Professional(s) Shortage Areas

    Science.gov (United States)

    2013-07-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 42 CFR Part 5 Designation of Health Professional(s) Shortage Areas CFR Correction 0 In Title 42 of the Code of Federal Regulations, Parts 1 to 399, revised as of October 1, 2012, on page 80, in Appendix C to Part...

  2. Designing serious video games for health behavior change: Current status and future directions

    Science.gov (United States)

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of o...

  3. Evidence-based benefit design: toward a sustainable health care future for employers.

    Science.gov (United States)

    Bunn, William B; Stave, Gregg M; Allen, Harris; Naim, Ahmad B

    2010-10-01

    Health care costs for employers are rising much faster than inflation. The common approach to health benefit design of increasing cost sharing has failed to contain costs. Some employers, however, have been successful at mitigating the cost trend or actually reducing health care costs. These employers have in common a dedication to data analysis, a search for cost drivers, and a willingness to adjust their approach to health benefit design to address these cost drivers. This approach has much in common with the movement in clinical practice toward evidence-based medicine. We propose that employers adopt a similar approach toward health benefits termed evidence-based benefit design, which is based on a health and productivity framework focused on direct and indirect costs. Evidence-based benefit design incorporates the relevant literature and employer-specific data that are integrated and regularly analyzed.

  4. A framework design for the mHealth system for self-management promotion.

    Science.gov (United States)

    Jia, Guifeng; Yang, Pan; Zhou, Jie; Zhang, Hengyi; Lin, Chengyu; Chen, Jin; Cai, Guolong; Yan, Jing; Ning, Gangmin

    2015-01-01

    Mobile health (mHealth) technology has been proposed to alleviate the lack of sufficient medical resources for personal healthcare. However, usage difficulties and compliance issues relating to this technology restrict the effect of mHealth system-supported self-management. In this study, an mHealth framework is introduced to overcome these drawbacks and improve the outcome of self-management. We implemented a set of ease of use principles in the mHealth design and employed the quantitative Fogg Behavior Model to enhance users' execution ability. The framework was realized in a prototype design for the mHealth system, which consists of medical apparatuses, mobile applications and a health management server. The system is able to monitor the physiological status in an unconstrained manner with simplified operations, while supervising the healthcare plan. The results suggest that the present framework design is accessible for ordinary users and effective in improving users' execution ability in self-management.

  5. Safety and efficacy of tocotrienol supplementation for bone health in postmenopausal women: protocol for a dose–response double-blinded placebo-controlled randomised trial

    Science.gov (United States)

    Shen, Chwan-Li; Mo, Huanbiao; Yang, Shengping; Wang, Shu; Felton, Carol K; Tomison, Michael D; Soelaiman, Ima Nirwana

    2016-01-01

    Introduction Osteoporosis is a major health concern in postmenopausal women, and oxidative stress contributes to the development of bone loss. Cellular studies and ovariectomised rat model mimicking bone loss in postmenopausal women show the bone-protective effect of tocotrienols (TTs) with antioxidant capability. We aim to access the safety and efficacy of TT consumption for bone health in postmenopausal women. Methods and analysis In this 12-week randomised double-blinded placebo-controlled trial for the effects of dietary TT supplementation in postmenopausal women, postmenopausal women aged 45 years and older with at least 1 year after menopause and bone mineral density T-score at the spine and/or hip 2.5 or more below the reference values will be randomly assigned to 3 daily supplements: (1) placebo group receiving 860 mg olive oil, (2) low TT group receiving 430 mg of 70% pure TTs (containing 300 mg TT) and (3) high TT group receiving 860 mg of 70% pure TTs (600 mg TT). The primary outcome measure will be urinary N-terminal telopeptide. The secondary outcome measures will be serum bone-specific alkaline phosphatase, receptor activator of nuclear factor-κB ligand, osteoprotegerin, urinary 8-hydroxy-2’-deoxyguanosine and quality of life. At 0, 6 and 12 weeks, the following will be assessed: (1) primary and secondary outcome measures; (2) serum TT and tocopherol concentrations; (3) physical activity and food frequency questionnaires. Liver function will be monitored every 6 weeks for safety. ‘Intent-to-treat’ principle will be employed for data analysis. A model of repeated measurements with random effect error terms will be applied. Analysis of covariance, χ2 analysis and regression will be used for comparisons. Ethics and dissemination This study was approved by the Bioethics Committee of the Texas Tech University Health Sciences Center. The findings of this trial will be submitted to a peer-reviewed journal in the areas of bone or

  6. Optimum design of multi-layer K-edge filter and multi-stage detectors for triple energy bone densitometer

    Science.gov (United States)

    Mazoochi, Alireza; Rahmani, Faezeh; Abbasi Davani, Fereydoun; Ghaderi, Ruhollah

    2014-03-01

    Dual X-ray bone densitometry may cause some errors in diagnosis due to heterogeneous distribution of adipose tissue. It is necessary to develop a more accurate technique to consider the effects of fat. In this research, a triple energy X-ray method has been introduced and conceptual design of a system consisting of 160 kV X-ray tube, multi-layer K-edge filter and multi-stage detector has been presented. Design calculations have been performed using MCNP4C Monte Carlo code to select the type of filters and detectors with the best thicknesses for better distinguishing materials. The energy peaks (37 keV, 50 keV and 105 keV) can be separated optimally with a multi-layer filter composed of barium (170 μm) and gadolinium (100 μm) as the first and second layers, respectively which are coated on a 1 mm aluminum plate placed between the source and tissue. The transmitted photons have been counted by a multi-stage linear array of detectors consisting of ZnSe(Te) and CsI(Tl) with 400 μm and 5 mm thicknesses, respectively. Monte Carlo simulations show that the triple energy X-ray technique has better accuracy than that of the standard dual energy X-ray technique.

  7. Discovery of Novel Drugs to Improve Bone Health in Neurofibromatosis Type 1: The Wnt/Beta-Catenin Pathway in Fracture Repair and Pseudarthrosis

    Science.gov (United States)

    2015-08-01

    neurofibromatosis. 4 To identify agents that inhibit beta-catenin signaling, we undertook a high throughput screen using mesenchymal cells exhibiting...Med 2007, 4:e249. [3] Poon R HH, Wei X, Pan J, and Alman BA: A high throughput screen identifies Nefopam as targeting cell proliferation in β...AWARD NUMBER: W81XWH-13-1-0113 TITLE: Discovery of Novel Drugs To Improve Bone Health in Neurofibromatosis Type 1: The Wnt/Beta-Catenin

  8. Advancing Treatment for Metastatic Bone Cancer: Consensus Recommendations from the Second Cambridge Conference

    Science.gov (United States)

    Coleman, Robert E.; Guise, Theresa A.; Lipton, Allan; Roodman, G. David; Berenson, James R.; Body, Jean-Jacques; Boyce, Brendan F.; Calvi, Laura M.; Hadji, Peyman; McCloskey, Eugene V.; Saad, Fred; Smith, Matthew R.; Suva, Larry J.; Taichman, Russell S.; Vessella, Robert L.; Weilbaecher, Katherine N.

    2009-01-01

    Purpose Summarize current knowledge, critical gaps in knowledge, and recommendations to advance the field of metastatic bone cancer. Experimental Design A multidisciplinary consensus conference was convened to review recent progress in basic and clinical research, assess critical gaps in current knowledge, and prioritize recommendations to advance research in the next 5 years. The program addressed three principal topics: biology of metastasis, preserving normal bone health, and optimizing bone-targeted therapies. Results A variety of specific recommendations were identified as important to advance research and clinical care over the next 5 years. Conclusions Priorities for research in bone biology include characterizing components of the stem cell niche in bone, developing oncogenic immunocompetent animal models of bone metastasis, and investigating the unique contribution of the bone microenvironment to tumor growth and dormancy. Priorities for research in preserving normal bone health include developing methods to measure and characterize disseminating tumor cells, assessing outcomes from the major prevention trials currently in progress, and improving methodologies to assess risks and benefits of treatment. Priorities for optimizing bone-targeted therapies include advancing studies of serum proteomics and genomics to reliably identify patients who will develop bone metastases, enhancing imaging for early detection of bone metastases and early response evaluation, and developing new tests to evaluate response to bone-directed treatments. PMID:18927277

  9. Designing an Health Insurance Scheme for Government Employees in Bangladesh: A Concept Paper

    OpenAIRE

    Hamid, Syed Abdul

    2014-01-01

    Introducing compulsory health insurance for government employees bears immense importance for stepping towards universal healthcare coverage in Bangladesh. Lack of scientific study on designing such scheme, in the Bangladesh context, motivates this paper. The study aims at designing a comprehensive insurance package simultaneously covering health, life and accident related disability risks of the public employees, where the health component would extend to all dependent family members. ...

  10. [Structural and functional characteristics of bone tissue and blood cytokines in health and disease of the joints].

    Science.gov (United States)

    Kariakina, E V; Norkin, I A; Gladkova, E V; Persova, E A; Matveeva, O V; Puchin'ian, D M

    2014-02-01

    Change of structural and functional state of bone in patients with primary osteoarthrosis of the hip joint compared to healthy individuals is characterized by decreased bone formation with a relative predominance of resorption. Osteopenic syndrome develops in the background of evident imbalance of a blood cytokine profile with increasing the level of proinflammatory and the variability of the level of anti-inflammatory cytokines.

  11. Changes in Crestal Bone Around Endosseous Implants During Functional Loading: A Radiographic Evaluation in Edentulous Patients Comparing Different Implant Designs

    OpenAIRE

    Tymstra, N.; Meijer, H.J.A.; Raghoebar, G.M.; Vissink, A

    2012-01-01

    Marginal bone changes around titanium plasma-sprayed implants (n = 240) placed in the mandibular interforaminal regions of 120 edentulous patients were assessed over 5 years of follow-up, with emphasis on the influence of the locations of the microgap and rough/smooth border. Marginal bone changes were measured on standardized radiographs. Locations of the microgap and the rough/smooth border were both shown not to be major contributing factors in determining the marginal bone level around im...

  12. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  13. Towards responsible system development in health services: a discourse analysis study of design conflict resolution tactics.

    Science.gov (United States)

    Irestig, Magnus; Timpka, Toomas

    2010-02-01

    We set out to examine design conflict resolution tactics used in development of large information systems for health services and to outline the design consequences for these tactics. Discourse analysis methods were applied to data collected from meetings conducted during the development of a web-based system in a public health context. We found that low risk tactics were characterized by design issues being managed within the formal mandate and competences of the design group. In comparison, high risk tactics were associated with irresponsible compromises, i.e. decisions being passed on to others or to later phases of the design process. The consequence of this collective disregard of issues such as responsibility and legitimacy is that the system design will be impossible to implement in factual health service contexts. The results imply that downstream responsibility issues have to be continuously dealt with in system development in health services.

  14. Exploring the Model Design Space for Battery Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Battery Health Management (BHM) is a core enabling technology for the success and widespread adoption of the emerging electric vehicles of today. Although battery...

  15. Prognostics Design Solutions in Structural Health Monitoring Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — The chapter describes the application of prognostic techniques to the domain of structural health and demonstrates the efficacy of the methods using fatigue data...

  16. Impact of Emerging Health Insurance Arrangements on Diabetes Outcomes and Disparities: Rationale and Study Design

    OpenAIRE

    Wharam, James Franklin; Soumerai, Steve; Trinacty, Connie; Eggleston, Emma; Zhang, Fang; LeCates, Robert F; Canning, Claire; Ross-Degnan, Dennis

    2013-01-01

    Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre–post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes q...

  17. Designing role of online health educators in healthcare services.

    Science.gov (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2015-01-01

    Web technology provides healthcare organizations the ability to broaden services beyond usual practices, and thus provides a particularly advantageous environment to achieve complex e-health goals. Furthermore, introducing web technology in healthcare services may add value to the overall healthcare process. Web technology helps healthcare organizations to extend the online health services (e-health) beyond their traditional mechanism. The changes enable customers (patients) to participate more in the process of healthcare, such as through their ability to generate personal health data to their personalized web-based interface. It allows patients to have greater control of information flow between healthcare organizations and customers, and among customers themselves. In this study the authors investigate the extended role of healthcare staff that provide e-health services. The authors have developed e-health models that accommodate customers' participation to engage more actively in the healthcare system. Through the model the authors developed a prototype--namely Clinic 2.0. Clinic 2.0 is set up to facilitate interactions between healthcare providers and customers. In the proposed systems, the authors introduced Online Health Educator (OHE)--a healthcare staff that is specifically responsible for administering Clinic 2.0. The authors have conducted a survey in Indonesia to draw the expectation of participants regarding the important role of OHE in Clinic 2.0 through a semi-structured interview conducted with participants to further investigate the pivotal roles of OHE. The authors found that e-health services need OHE to achieve customers' satisfaction.

  18. EFFECTS OF FOOD ASSISTANCE AND NUTRITION PROGRAMS ON NUTRITION AND HEALTH, VOLUME 1, RESEARCH DESIGN

    OpenAIRE

    Hamilton, William L.; Rossi, Peter H.

    2002-01-01

    This is the first of four reports in the "Nutrition and Health Outcome Study," which assesses the effects of USDA's food assistance and nutrition programs on nutrition and health outcomes. This report reviews the research designs available to evaluators for assessing the effect of USDA's food assistance and nutrition programs. The random assignment experiment is the "gold standard" design for such an evaluation. Where random assignment is impossible, quasi-experimental designs are used to inf...

  19. Design of biomimetic and bioactive cold plasma-modified nanostructured scaffolds for enhanced osteogenic differentiation of bone marrow-derived mesenchymal stem cells.

    Science.gov (United States)

    Wang, Mian; Cheng, Xiaoqian; Zhu, Wei; Holmes, Benjamin; Keidar, Michael; Zhang, Lijie Grace

    2014-03-01

    The objective of this study was to design a biomimetic and bioactive tissue-engineered bone construct via a cold atmospheric plasma (CAP) treatment for directed osteogenic differentiation of human bone morrow mesenchymal stem cells (MSCs). Porous nanocrystalline hydroxyapatite/chitosan scaffolds were fabricated via a lyophilization procedure. The nanostructured bone scaffolds were then treated with CAP to create a more favorable surface for cell attachment, proliferation, and differentiation. The CAP-modified scaffolds were characterized via scanning electron microscope, Raman spectrometer, contact angle analyzer, and white light interferometer. In addition, optimal CAP treatment conditions were determined. Our in vitro study shows that MSC adhesion and infiltration were significantly enhanced on CAP modified scaffolds. More importantly, it was demonstrated that CAP-modified nanostructured bone constructs can greatly promote total protein, collagen synthesis, and calcium deposition after 3 weeks of culture, thus making them a promising implantable scaffold for bone regeneration. Moreover, the fibronectin and vitronection adsorption experiments by enzyme-linked immunosorbent assay demonstrated that more adhesion-mediated protein adsorption on the CAP-treated scaffolds. Since the initial specific protein absorption on scaffold surfaces can lead to further recruitment as well as activation of favorable cell functions, it is suggested that our enhanced stem cell growth and osteogenic function may be related to more protein adsorption resulting from surface roughness and wettability modification. The CAP modification method used in this study provides a quick one-step process for cell-favorable tissue-engineered scaffold architecture remodeling and surface property alteration.

  20. A synergistic approach to the design, fabrication and evaluation of 3D printed micro and nano featured scaffolds for vascularized bone tissue repair

    Science.gov (United States)

    Holmes, Benjamin; Bulusu, Kartik; Plesniak, Michael; Zhang, Lijie Grace

    2016-02-01

    3D bioprinting has begun to show great promise in advancing the development of functional tissue/organ replacements. However, to realize the true potential of 3D bioprinted tissues for clinical use requires the fabrication of an interconnected and effective vascular network. Solving this challenge is critical, as human tissue relies on an adequate network of blood vessels to transport oxygen, nutrients, other chemicals, biological factors and waste, in and out of the tissue. Here, we have successfully designed and printed a series of novel 3D bone scaffolds with both bone formation supporting structures and highly interconnected 3D microvascular mimicking channels, for efficient and enhanced osteogenic bone regeneration as well as vascular cell growth. Using a chemical functionalization process, we have conjugated our samples with nano hydroxyapatite (nHA), for the creation of novel micro and nano featured devices for vascularized bone growth. We evaluated our scaffolds with mechanical testing, hydrodynamic measurements and in vitro human mesenchymal stem cell (hMSC) adhesion (4 h), proliferation (1, 3 and 5 d) and osteogenic differentiation (1, 2 and 3 weeks). These tests confirmed bone-like physical properties and vascular-like flow profiles, as well as demonstrated enhanced hMSC adhesion, proliferation and osteogenic differentiation. Additional in vitro experiments with human umbilical vein endothelial cells also demonstrated improved vascular cell growth, migration and organization on micro-nano featured scaffolds.

  1. New depowdering-friendly designs for three-dimensional printing of calcium phosphate bone substitutes.

    Science.gov (United States)

    Butscher, A; Bohner, M; Doebelin, N; Hofmann, S; Müller, R

    2013-11-01

    Powder-based three-dimensional printing (3DP) is a versatile method that allows creating synthetic calcium phosphate (CaP) scaffolds of complex shapes and structures. However, one major drawback is the difficulty of removing all remnants of loose powder from the printed scaffolds, the so-called depowdering step. In this study, a new design approach was proposed to solve this problem. Specifically, the design of the printed scaffolds consisted of a cage with windows large enough to enable depowdering while still trapping loose fillers placed inside the cage. To demonstrate the potential of this new approach, two filler geometries were used: sandglass and cheese segment. The distance between the fillers was varied and they were either glued to the cage or free to move after successful depowdering. Depowdering efficiency was quantified by microstructural morphometry. The results showed that the use of mobile fillers significantly improved depowdering. Based on this study, large 3DP scaffolds can be realized, which might be a step towards a broader clinical use of 3D printed CaP scaffolds.

  2. The pQCT 'Bone Strength Indices' (BSIs, SSI). Relative mechanical impact and diagnostic value of the indicators of bone tissue and design quality employed in their calculation in healthy men and pre- and post-menopausal women.

    Science.gov (United States)

    Cointry, G R; Ferretti, J L; Reina, P S; Nocciolino, L M; Rittweger, J; Capozza, R F

    2014-03-01

    The pQCT-assessed Bone Strength Indices (BSI's, SSI) depend on the product of a 'quality' indicator, the cortical vBMD (vCtD), and a 'design' indicator, one of the cross-sectional moments of inertia or related variables (MIs) in long bones. As the MIs vary naturally much more than the vCtD and represent different properties, it could be that the variation of the indices might not reflect the relative mechanical impact of the variation of their determinant factors in different individuals or circumstances. To understand this problem, we determined the vCtD and MI's in tibia scans of 232 healthy men and pre- and post-MP women, expressed in SD of the means calculated for each group, and analyzed the independent influence of 1 SD unit of variation of each factor on that of the indices by multiple correlations. Results showed: 1. that the independent influence of the MIs on the indices was generally larger than that of the vCtD, and 2. that in post-MP women the influence of the vCtD was larger than it was in the other groups. This confirms the view that inter-individual variation of vCtD is comparatively small, and that mechanical competence of human bone is mostly determined by 'design' factors.

  3. The role of institutional design and organizational practice for health financing performance and universal coverage.

    Science.gov (United States)

    Mathauer, Inke; Carrin, Guy

    2011-03-01

    Many low- and middle income countries heavily rely on out-of-pocket health care expenditure. The challenge for these countries is how to modify their health financing system in order to achieve universal coverage. This paper proposes an analytical framework for undertaking a systematic review of a health financing system and its performance on the basis of which to identify adequate changes to enhance the move towards universal coverage. The distinctive characteristic of this framework is the focus on institutional design and organizational practice of health financing, on which health financing performance is contingent. Institutional design is understood as formal rules, namely legal and regulatory provisions relating to health financing; organizational practice refers to the way organizational actors implement and comply with these rules. Health financing performance is operationalized into nine generic health financing performance indicators. Inadequate performance can be caused by six types of bottlenecks in institutional design and organizational practice. Accordingly, six types of improvement measures are proposed to address these bottlenecks. The institutional design and organizational practice of a health financing system can be actively developed, modified or strengthened. By understanding the incentive environment within a health financing system, the potential impacts of the proposed changes can be anticipated.

  4. Association of Plasma SDF-1 with Bone Mineral Density, Body Composition, and Hip Fractures in Older Adults: The Cardiovascular Health Study.

    Science.gov (United States)

    Carbone, Laura D; Bůžková, Petra; Fink, Howard A; Robbins, John A; Bethel, Monique; Hamrick, Mark W; Hill, William D

    2017-02-28

    Aging is associated with an increase in circulating inflammatory factors. One, the cytokine stromal cell-derived factor 1 (SDF-1 or CXCL12), is critical to stem cell mobilization, migration, and homing as well as to bone marrow stem cell (BMSC), osteoblast, and osteoclast function. SDF-1 has pleiotropic roles in bone formation and BMSC differentiation into osteoblasts/osteocytes, and in osteoprogenitor cell survival. The objective of this study was to examine the association of plasma SDF-1 in participants in the cardiovascular health study (CHS) with bone mineral density (BMD), body composition, and incident hip fractures. In 1536 CHS participants, SDF-1 plasma levels were significantly associated with increasing age (p SDF-1 levels were associated with lower total hip BMD (p = 0.02). However, there was no significant association of SDF-1 with hip fractures (p = 0.53). In summary, circulating plasma levels of SDF-1 are associated with increasing age and independently associated with lower total hip BMD in both men and women. These findings suggest that SDF-1 levels are linked to bone homeostasis.

  5. Public Participation in Design of Health Empowering Information Systems

    DEFF Research Database (Denmark)

    Barlach, Anders

    2009-01-01

    Policy makers recognise that effective communication and collaboration between healthcare professionals and patients must be the cornerstone of healthcare, and aims to transform this relationship (Johannsen and Kensing 2005). There is an assumption that empowerment can be organised and is present...... as a result of information being accessible. The British Choose and Book portal (www.healthspace.nhs.uk) and Danish e-health portal (www.sundhed.dk) are examples of making knowledge and services available to the individual citizens: Sundhed.dk is the official Danish eHealth Portal for the public Danish...... Healthcare Services (‘sundhed’ means health in Danish). For the first time, the public Danish Healthcare Services have been brought together on the Internet by Sundhed.dk. This makes it possible for patients, their families and healthcare professionals alike to access information and to communicate with each...

  6. Hierarchical Fabrication of Engineered Vascularized Bone Biphasic Constructs via Dual 3D Bioprinting: Integrating Regional Bioactive Factors into Architectural Design.

    Science.gov (United States)

    Cui, Haitao; Zhu, Wei; Nowicki, Margaret; Zhou, Xuan; Khademhosseini, Ali; Zhang, Lijie Grace

    2016-09-01

    A biphasic artificial vascularized bone construct with regional bioactive factors is presented using dual 3D bioprinting platform technique, thereby forming a large functional bone grafts with organized vascular networks. Biocompatible mussel-inspired chemistry and "thiol-ene" click reaction are used to regionally immobilize bioactive factors during construct fabrication for modulating or improving cellular events.

  7. Changes in Crestal Bone Around Endosseous Implants During Functional Loading : A Radiographic Evaluation in Edentulous Patients Comparing Different Implant Designs

    NARCIS (Netherlands)

    Tymstra, N.; Meijer, H.J.A.; Raghoebar, G.M.; Vissink, A.

    2012-01-01

    Marginal bone changes around titanium plasma-sprayed implants (n = 240) placed in the mandibular interforaminal regions of 120 edentulous patients were assessed over 5 years of follow-up, with emphasis on the influence of the locations of the microgap and rough/smooth border. Marginal bone changes w

  8. Molecular interactions in biomineralized hydroxyapatite amino acid modified nanoclay: In silico design of bone biomaterials

    Energy Technology Data Exchange (ETDEWEB)

    Katti, Dinesh R., E-mail: Dinesh.Katti@ndsu.edu; Sharma, Anurag; Ambre, Avinash H.; Katti, Kalpana S.

    2015-01-01

    A simulations driven approach to design of a novel biomaterial nanocomposite system is described in this study. Nanoclays modified with amino acids (OMMT) were used to mineralize hydroxyapatite (HAP), mimicking biomineralization. Representative models of organically modified montmorillonite clay (OMMT) and OMMT-hydroxyapatite (OMMT-HAP) were constructed using molecular dynamics and validated using X-ray Diffraction (XRD), Fourier Transforms Infrared (FTIR) spectroscopy and Transmission Electron Microscopy (TEM). Attractive interactions exist between Ca atoms of HAP and C=O group of aminovaleric acid, indicating chelate formation in OMMT-HAP. Interaction energy maps describe molecular interactions among different constituents and their quantitative contributions in the OMMT and OMMT-HAP systems at both parallel and perpendicular orientations. High attractive and high repulsive interactions were found between PO{sub 4}{sup 3−} and MMT clay as well as aminovaleric molecules in OMMT-HAP perpendicular and parallel models. Large non-bonded interactions in OMMT-HAP indicate influence of neighboring environment on PO{sub 4}{sup 3−} in in situ HAPclay. Extensive hydrogen bonds were observed between functional hydrogen atoms of modifier and MMT clay in OMMT-HAP as compared to OMMT. Thus, HAP interacts with clay through the aminovaleric acid. This computational study provides a framework for materials design and selection for biomaterials used in tissue engineering and other areas of regenerative medicine. - Highlights: • Representative models of a hybrid nanoclay-hydroxyapatite biomaterial are built. • Interaction energy maps are constructed using a molecular dynamics. • Quantitative interactions between the three components of the biomaterial are found. • The modeling and experimental approach provides insight into the complex nanomaterial.

  9. Effects of water-based exercise on bone health of middle-aged and older adults: a systematic review and meta-analysis

    Science.gov (United States)

    Simas, Vini; Hing, Wayne; Pope, Rodney; Climstein, Mike

    2017-01-01

    Background Age-related bone loss is a major health concern. Only exercises associated with high-impact and mechanical loading have been linked to a positive effect on bone turnover; however, these types of exercises may not always be appropriate for middle-aged and older adults due to physical decline or chronic disorders such as osteoarthritis. Water-based exercise (WBE) has been shown to affect different components of physical fitness, has lower risks of traumatic fracture, and applies less stress to joints. However, the effects of WBE on bone health are unclear. Objective This study aimed to explore whether WBE is effective in preventing age-related bone deterioration in middle-aged and older adults. Methods A search of relevant databases and the references of identified studies was performed. Critical narrative synthesis and meta-analyses were conducted. Results Eleven studies, involving 629 participants, met all inclusion criteria. All participants were postmenopausal women. Eight studies compared WBE to a sedentary control group, and four studies had land-based exercise (LBE) participants as a comparison group. Meta-analyses revealed significant differences between WBE and control group in favor of WBE for changes in bone mineral density (BMD) at the lumbar spine (mean difference [MD] 0.03 g/cm2; 95% confidence interval [CI]: 0.01 to 0.05) and femoral neck (MD 0.04 g/cm2; 95% CI: 0.02 to 0.07). Significant differences were also revealed between WBE and LBE in favor of LBE for changes in lumbar spine BMD (MD −0.04 g/cm2; 95% CI: −0.06 to −0.02). However, there was no significant difference between WBE and LBE for changes in femoral neck BMD (MD −0.03 g/cm2; 95% CI: −0.08 to 0.01). Conclusion WBE may have benefits with respect to maintaining or improving bone health in postmenopausal women but less benefit when compared to LBE. Further research is required on this topic.

  10. Are Sexual and Reproductive Health Policies Designed for All?

    DEFF Research Database (Denmark)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-01-01

    for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries...... in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. RESULTS: The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance...

  11. MPH education for the 21st century: design of Columbia University's new public health curriculum.

    Science.gov (United States)

    Begg, Melissa D; Galea, Sandro; Bayer, Ronald; Walker, Julia R; Fried, Linda P

    2014-01-01

    Because public health challenges are changing rapidly, over the past 3 years, we have turned a critical eye to the master of public health program at the Columbia University Mailman School of Public Health. Under a process dubbed "curriculum renewal," we engaged more than 170 faculty, staff, and students (and hundreds of alumni and employers of our graduates) in an initiative to develop a completely new design for master of public health education that launched in fall 2012. We have described its design and structure and presented some preliminary evaluation data.

  12. Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app.

    Science.gov (United States)

    White, Becky K; Burns, Sharyn K; Giglia, Roslyn C; Scott, Jane A

    2016-10-26

    Evaluating complex health promotion interventions that use mobile apps requires comprehensive and adaptive evaluation plans. As mobile usage becomes increasingly sophisticated and personalised, broad evaluation plans are important in determining the impact and efficacy of a mobile health (mHealth) app. Evaluation should consider user feedback and outcome measures, as well as examine elements such as the robustness of the technology, the intervention principles and engagement strategies, and the interaction of the user with the technology. This paper introduces four mHealth evaluation models and tools and describes the evaluation plan that has been developed for Milk Man, a breastfeeding app targeting new and expectant fathers. Milk Man is a socially connected, gamified app that is being tested in a large Randomised Control Trial (RCT). While there is a need for mobile apps to be evaluated in adequately powered RCTs, trialling mobile apps over a long period of time presents challenges. Incorporating robust evaluation design will help ensure that technological performance, app intervention principles, as well as health and behavioural outcomes are measured. The detail and scope of the Milk Man app evaluation plan will ensure the findings add to the evidence base and have broad relevance to health promotion practitioners.So what? Evidence about the efficacy of mHealth interventions is an emerging area and appropriate evaluation skills are needed. This paper illustrates an evaluation planning approach for mHealth interventions that could be adapted for use by health promotion practitioners and researchers.

  13. Health behaviour surveillance of Health Sciences students in Northern Germany: Design and first results

    Directory of Open Access Journals (Sweden)

    Sandra Tobisch

    2015-09-01

    Full Text Available BackgroundHealth of students have most often been neglected in recent studies, although students face a transition of life during their studies which has strong implications on health.  During that time, universities play a key role as a setting where future professionals develop independence and learn skills possibly affecting their development and health. Nevertheless, less in known about this group in society and consequently, the aim of this research project was to monitor health of Health Sciences students through a long-term health surveillance system.MethodsSince 2014, an almost complete convenience sample of Health Sciences students is surveyed twice a year at Hamburg University of Applied Sciences. A paper-pencil questionnaire, which includes questions about socio-demographics, well-being, health-promoting and health-risk behaviours, is administered during courses.ResultsOur first surveys achieved response rates of more than 97%. Up to 83% of enrolled students were reached. Undergraduate Health Sciences students reported health-risk behaviours, e.g. binge-drinking on 1 to 2 days (33.9%, regular cannabis use (4.2%, regular cognitive-enhancement (4.0%. Moreover, unhealthy diet was prevalent but almost all students were physically active.ConclusionsA short paper-pencil questionnaire administered during courses and conducted according to standardized processes provides complete data on students’ health with little effort. Trends can be determined, which assist in making decision whether to take action in prevention and/or to evaluate campaigns. These first results show the need for a more targeted health promotion action for students.

  14. Counter design influences the privacy of patients in health care

    NARCIS (Netherlands)

    Mobach, Mark P.

    2009-01-01

    A re-furnishing of counter areas in primary health care was used to assess patient privacy and its influences on the nature of conversations in a controlled experiment. Patients in two community-based pharmacies in the Netherlands were assigned to enclosed counters and a queue at distance, or to cou

  15. The Peripheral Blood Mononuclear Cell Count Is Associated With Bone Health in Elderly Men: A Cross-Sectional Population-Based Study.

    Science.gov (United States)

    Lin, Xianfeng; Yu, Hejun; Zhao, Chenchen; Qian, Yu; Hong, Dun; Huang, Kangmao; Mo, Jian; Qin, An; Fang, Xiangqian; Fan, Shunwu

    2016-04-01

    The peripheral blood mononuclear cell (PBMC) count is a routinely used and meaningful index for infection and blood diseases. PBMCs may be closely related to osteoclasts and include osteoclast precursors; we examined the association between the PBMC count and bone health. This research included 2806 community men aged ≥50 years who underwent full health examinations from October 2007 through December 2011 in four medical centers. The PBMC count was significantly high among subjects with "at least osteopenia" compared with controls. In analysis of covariance adjusted for potential confounders, the bone mineral density (BMD) value and T-score had a significant decreasing trend across the quartiles of PBMC count. In univariate analysis, the PBMC count had a strong association with "at least osteopenia" (odds ratio [OR] = 2.520, 95% confidence interval [CI]: 1.397-4.547). After adjustment for confounding factors (multivariate analysis) from Model 1 to 4, PBMC count remained as an independent risk factor for "at least osteopenia" (OR = 2.481, 95% CI: 1.176-5.236). Moreover, after adjusting for all confounding variables, participants had a significantly high OR in the body mass index (BMI) blood pressure (SBP) count is significantly associated with bone loss in elderly men and the exact mechanism requires further clarification.

  16. Research designs and making causal inferences from health care studies.

    Science.gov (United States)

    Flannelly, Kevin J; Jankowski, Katherine R B

    2014-01-01

    This article summarizes the major types of research designs used in healthcare research, including experimental, quasi-experimental, and observational studies. Observational studies are divided into survey studies (descriptive and correlational studies), case-studies and analytic studies, the last of which are commonly used in epidemiology: case-control, retrospective cohort, and prospective cohort studies. Similarities and differences among the research designs are described and the relative strength of evidence they provide is discussed. Emphasis is placed on five criteria for drawing causal inferences that are derived from the writings of the philosopher John Stuart Mill, especially his methods or canons. The application of the criteria to experimentation is explained. Particular attention is given to the degree to which different designs meet the five criteria for making causal inferences. Examples of specific studies that have used various designs in chaplaincy research are provided.

  17. Integrating design science theory and methods to improve the development and evaluation of health communication programs.

    Science.gov (United States)

    Neuhauser, Linda; Kreps, Gary L

    2014-12-01

    Traditional communication theory and research methods provide valuable guidance about designing and evaluating health communication programs. However, efforts to use health communication programs to educate, motivate, and support people to adopt healthy behaviors often fail to meet the desired goals. One reason for this failure is that health promotion issues are complex, changeable, and highly related to the specific needs and contexts of the intended audiences. It is a daunting challenge to effectively influence health behaviors, particularly culturally learned and reinforced behaviors concerning lifestyle factors related to diet, exercise, and substance (such as alcohol and tobacco) use. Too often, program development and evaluation are not adequately linked to provide rapid feedback to health communication program developers so that important revisions can be made to design the most relevant and personally motivating health communication programs for specific audiences. Design science theory and methods commonly used in engineering, computer science, and other fields can address such program and evaluation weaknesses. Design science researchers study human-created programs using tightly connected build-and-evaluate loops in which they use intensive participatory methods to understand problems and develop solutions concurrently and throughout the duration of the program. Such thinking and strategies are especially relevant to address complex health communication issues. In this article, the authors explore the history, scientific foundation, methods, and applications of design science and its potential to enhance health communication programs and their evaluation.

  18. Health Reform: A Community Experience Using Design Research as a Guide

    Science.gov (United States)

    Severson, Mary A.; Wood, Douglas L.; Chastain, Christine N.; Lee, Laura G.; Rees, Adam C.; Agerter, David C.; Holtz, Carol P.; Broers, Joan K.; Savoleinen, Kimberly H.; Spurrier, Barbara R.; LaRusso, Nicholas F.

    2011-01-01

    Meaningful health reform in the United States must improve the health of the population while lowering costs. In an effort to provide a framework for doing so, the Institute of Health Care Improvement created the triple aim, which encompasses the goals of (1) improving individual health and experience with the health care system, (2) improving population health, and (3) decreasing the rate of per capita health care costs. Current reform efforts have focused on the development of Patient-Centered Medical Homes (an innovative team-based model of care that facilitates a partnership between the patient’s personal physician coordinating care throughout a patient’s lifetime to maximize health outcomes), but these relatively narrow efforts are focused on office practice and payment methods and are not generally oriented toward community needs. We sought to apply design research in assessing a community opportunity to apply the triple aim as a strategy to transform health care delivery. Mixed methodology provides greater insight into the unexpressed health needs of individuals and into the creation of delivery systems more likely to achieve the triple aim. In a small, midwestern town, a mixed methods approach was used to assess community health needs to facilitate design and implementation of care delivery systems. The research findings suggest that health system design concepts should focus on the creation of health, not health care; foster simplicity; create nurturing relationships; eliminate user fear; and contain costs. These observations can be helpful to health care professionals who are developing new methods of care delivery and policymakers and payers contemplating new payment systems to achieve the goals of the triple aim. PMID:21964174

  19. Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study.

    Science.gov (United States)

    Niu, Kaijun; Ahola, Riikka; Guo, Hui; Korpelainen, Raija; Uchimaru, Jin; Vainionpää, Aki; Sato, Kyoko; Sakai, Aiko; Salo, Sinikka; Kishimoto, Koshi; Itoi, Eiji; Komatsu, Shoko; Jämsä, Timo; Nagatomi, Ryoichi

    2010-09-01

    Although there is ample evidence supporting the effectiveness of physical activity in the prevention and treatment of osteoporosis, there are no previous studies to examine the effect of office-based brief high-impact exercise (HIE) on bone mineral density (BMD) in healthy premenopausal women. This study evaluated the effects of office-based HIE on BMD in healthy premenopausal Japanese women. Ninety-one healthy premenopausal women were randomized to receive stretching exercise (SE) or HIE (stretching, along with up to 5 × 10 vertical and versatile jumps) for 12 months. The BMD of the lumbar spine and proximal femur was measured using dual-energy X-ray absorptiometry. Several cardiovascular risk factors and leg strength also were assessed. An accelerometer-based recorder was used to measure daily impact loading in four 1-week samples. The progression of the HIE program was ensured by the accelerometer. Thirty-three women (71.7%) in the SE group and 34 (75.6%) in the HIE group completed the study. There was a significant difference in the change in the femoral neck BMD between the groups in favor of the HIE group [0.6% (95% CI: -0.4, 1.7) vs. -1.0% (95% CI: -2.2, 0.2)]. Adiponectin, LDL, HDL, and the leg strength of participants in both the groups improved during the intervention. These finding suggested that office-based brief HIE can be recommended for premenopausal women for preventing bone mineral loss.

  20. Healthy Bones at Every Age

    Science.gov (United States)

    .org Healthy Bones at Every Age Page ( 1 ) Bone health is important at every age and stage of life. The skeleton is our body’s storage bank for ... are many things we can do at every age to keep our bones strong and healthy. Peak ...

  1. Design of foods with bioactive lipids for improved health.

    Science.gov (United States)

    Chen, Bingcan; McClements, David Julian; Decker, Eric Andrew

    2013-01-01

    Numerous studies have found an association between the consumption of certain bioactive lipids and improved human health, e.g., the prevention, delay, or treatment of chronic and acute diseases, such as cancer, cardiovascular disease (CVD), osteoporosis, and immune disorders. In this review, we discuss food-based sources and potential beneficial attributes of major dietary bioactive lipids: polyunsaturated fatty acids; carotenoids; phytosterols and phytostanols; and fat-soluble vitamins. We summarize the various challenges associated with incorporating these bioactive lipids into foods and beverages, such as poor water solubility, high melting point, and low chemical stability. Finally, we propose several techniques that have been used to solve the challenges and integrate dietary bioactive lipids into foods for improved health.

  2. Accreditation and Participatory Design in the Health-Care Sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes...... specifying, realizing, and measuring effects from using an information technology. This approach aligns with much of the logic inherent in accreditation and it supports challenging parts of the accreditation process. Effects-driven IT development furthermore might support effects related to clinical evidence......-based thinking. We describe and compare effects- driven IT development with accreditation and discuss the prospects and challenges for this approach to participatory design within the healthcare domain....

  3. Relationship between breast-feeding and bone mineral density among Korean women in the 2010 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yeo, Ui Hyang; Choi, Chang Jin; Choi, Whan Seok; Kim, Kyung Soo

    2016-01-01

    Breast-feeding has the deleterious effect of hypoestrogenemia coupled with loss of calcium in the maternal bone mass. It is not clear whether changes in bone metabolism in lactating women lead to changes in maternal bone mineral density (BMD) over a longer period. The aim of the present study was to investigate the relationship between the duration of breast-feeding and BMD in healthy South Korean women. We analyzed data from the 2010 Korea National Health and Nutrition Examination Survey, a cross-sectional survey of Korean citizens. A total of 1342 women older than 19 years were selected for analysis. In postmenopausal women, the duration of breast-feeding per child was associated with low lumbar spine BMD after adjustment for age, body mass index, smoking, alcohol intake, physical activity, serum 25-hydroxyvitamin D level, and daily intake of calcium and calories (P < 0.05, P trend < 0.005). Prolonged breast-feeding for more than 1 year per child was associated with a deleterious effect on lumbar spine BMD compared with never breast-feeding or a shorter duration of breast-feeding (P < 0.05). These effects were not shown in premenopausal women or in femur BMD. In conclusion, the duration of breast-feeding per child is negatively correlated with lumbar spine BMD in postmenopausal women, but not in premenopausal women. Although the cause of the different results between postmenopausal and premenopausal women is not clear, our findings suggest that proper protective strategies should be recommended during prolonged breast-feeding to maintain bone health later in life.

  4. Dietary intervention restored menses in female athletes with exercise-associated menstrual dysfunction with limited impact on bone and muscle health.

    Science.gov (United States)

    Cialdella-Kam, Lynn; Guebels, Charlotte P; Maddalozzo, Gianni F; Manore, Melinda M

    2014-07-31

    Exercise-related menstrual dysfunction (ExMD) is associated with low energy availability (EA), decreased bone mineral density (BMD), and increased risk of musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein (CHO-PRO) supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day) intervention would improve energy status and musculoskeletal health and restore menses in female athletes (n = 8) with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone health (BMD, bone mineral content, bone markers), muscle strength/power and protein metabolism markers, profile of mood state (POMS), and energy intake (EI)/energy expenditure (7 day food/activity records) were measured. Eumenorrheic athlete controls with normal menses (Eumen); n = 10) were measured at baseline. Multiple linear regressions were used to evaluate differences between groups and pre/post-intervention blocking on participants. Improvements in EI (+382 kcal/day; p = 0.12), EA (+417 kcal/day; p = 0.17) and energy balance (EB; +466 kcal/day; p = 0.14) were observed with the intervention but were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses; 3.5 ± 1.9 cycles); one remaining anovulatory with menses. Female athletes with ExMD for >8 months took longer to resume menses/ovulation and had lower BMD (low spine (ExMD = 3; Eumen = 1); low hip (ExMD = 2)) than those with ExMD for athletes are more sensitive to EA and EB fluctuations.

  5. Human Centred Design Considerations for Connected Health Devices for the Older Adult

    Directory of Open Access Journals (Sweden)

    Richard P. Harte

    2014-06-01

    Full Text Available Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications.

  6. Adaptation to study design challenges in rural health disparities community research

    Science.gov (United States)

    Intervention research in rural health disparities communities presents challenges for study design, implementation, and evaluation, thus threatening scientific rigor, reducing response rates, and confounding study results. A multisite nutrition intervention was conducted in the rural Lower Mississip...

  7. Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs

    NARCIS (Netherlands)

    Schelvis, R.M; Oude Hengel, K.M.; Burdorf, A.; Blatter, B.M.; Strijk, J.E.; Beek, A.J. van

    2015-01-01

    Occupational health researchers regularly conduct evaluative intervention research for which a randomized controlled trial (RCT) may not be the most appropriate design (eg, effects of policy measures, organizational interventions on work schedules). This article demonstrates the appropriateness of a

  8. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

    Directory of Open Access Journals (Sweden)

    Devillé Walter

    2004-03-01

    Full Text Available Abstract Background This article discusses the design of a study on the prevalence of health problems (both physical and mental and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600, as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization, mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire, utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.

  9. Three-dimensional micro-level computational study of Wolff's law via trabecular bone remodeling in the human proximal femur using design space topology optimization.

    Science.gov (United States)

    Boyle, Christopher; Kim, Il Yong

    2011-03-15

    The law of bone remodeling, commonly referred to as Wolff's Law, asserts that the internal trabecular bone adapts to external loadings, reorienting with the principal stress trajectories to maximize mechanical efficiency creating a naturally optimum structure. The goal of the current study was to utilize an advanced structural optimization algorithm, called design space optimization (DSO), to perform a micro-level three-dimensional finite element bone remodeling simulation on the human proximal femur and analyse the results to determine the validity of Wolff's hypothesis. DSO optimizes the layout of material by iteratively distributing it into the areas of highest loading, while simultaneously changing the design domain to increase computational efficiency. The result is a "fully stressed" structure with minimized compliance and increased stiffness. The large-scale computational simulation utilized a 175 μm mesh resolution and the routine daily loading activities of walking and stair climbing. The resulting anisotropic trabecular architecture was compared to both Wolff's trajectory hypothesis and natural femur samples from literature using a variety of visualization techniques, including radiography and computed tomography (CT). The results qualitatively revealed several anisotropic trabecular regions, that were comparable to the natural human femurs. Quantitatively, the various regional bone volume fractions from the computational results were consistent with quantitative CT analyses. The global strain energy proceeded to become more uniform during optimization; implying increased mechanical efficiency was achieved. The realistic simulated trabecular geometry suggests that the DSO method can accurately predict bone adaptation due to mechanical loading and that the proximal femur is an optimum structure as the Wolff hypothesized.

  10. Prioritizing the mHealth Design Space: A Mixed-Methods Analysis of Smokers’ Perspectives

    OpenAIRE

    Hartzler, Andrea L.; BlueSpruce, June; Catz, Sheryl L.; McClure, Jennifer B

    2016-01-01

    Background Smoking remains the leading cause of preventable disease and death in the United States. Therefore, researchers are constantly exploring new ways to promote smoking cessation. Mobile health (mHealth) technologies could be effective cessation tools. Despite the availability of commercial quit-smoking apps, little research to date has examined smokers’ preferred treatment intervention components (ie, design features). Honoring these preferences is important for designing programs tha...

  11. Designing Serious Video Games for Health Behavior Change: Current Status and Future Directions

    OpenAIRE

    Thompson, Debbe

    2012-01-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player’s knowledge and skill, ways in which per...

  12. Reporting an Experience on Design and Implementation of e-Health Systems on Azure Cloud

    OpenAIRE

    Lu, Shilin; Ranjan, Rajiv; Strazdins, Peter

    2013-01-01

    Electronic Health (e-Health) technology has brought the world with significant transformation from traditional paper-based medical practice to Information and Communication Technologies (ICT)-based systems for automatic management (storage, processing, and archiving) of information. Traditionally e-Health systems have been designed to operate within stovepipes on dedicated networks, physical computers, and locally managed software platforms that make it susceptible to many serious limitations...

  13. The Danish National Health Survey 2010. Study design and respondent characteristics

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte;

    2012-01-01

    In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content...... of the questionnaire....

  14. Design and Formative Evaluation of an Information Kiosk on Cattle Health for Landless Cattle Owners

    Science.gov (United States)

    Ramkumar, S.; Garforth, C.; Rao, S. V. N.; Heffernan, C.

    2007-01-01

    This paper describes and analyses the experience of designing, installing and evaluating a farmer-usable touch screen information kiosk on cattle health in a veterinary institution in Pondicherry. The contents of the kiosk were prepared based on identified demands for information on cattle health, arrived at through various stakeholders meetings.…

  15. 76 FR 22070 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Science.gov (United States)

    2011-04-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 5 Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas; Notice of Meeting Correction Proposed Rule document...

  16. Biomimetic fiber mesh scaffolds based on gelatin and hydroxyapatite nano-rods: Designing intrinsic skills to attain bone reparation abilities.

    Science.gov (United States)

    Sartuqui, Javier; Gravina, A Noel; Rial, Ramón; Benedini, Luciano A; Yahia, L'Hocine; Ruso, Juan M; Messina, Paula V

    2016-09-01

    Intrinsic material skills have a deep effect on the mechanical and biological performance of bone substitutes, as well as on its associated biodegradation properties. In this work we have manipulated the preparation of collagenous derived fiber mesh frameworks to display a specific composition, morphology, open macroporosity, surface roughness and permeability characteristics. Next, the effect of the induced physicochemical attributes on the scaffold's mechanical behavior, bone bonding potential and biodegradability were evaluated. It was found that the scaffold microstructure, their inherent surface roughness, and the compression strength of the gelatin scaffolds can be modulated by the effect of the cross-linking agent and, essentially, by mimicking the nano-scale size of hydroxyapatite in natural bone. A clear effect of bioactive hydroxyapatite nano-rods on the scaffolds skills can be appreciated and it is greater than the effect of the cross-linking agent, offering a huge perspective for the upcoming progress of bone implant technology.

  17. Improving Urban Watershed Health Through Suburban Infill Design and Development

    OpenAIRE

    2011-01-01

    Up to 75 percent of new construction between 2000 and 2030 may â be redirected inward or into more compact, mixed-use suburban developments (Nelson, 2004). If this assertion is even nearly true, and if the goals of the Clean Water Act are to be met in the next generation of American cities, then we must find feasible and effective ways of improving urban watershed health using retrofit and infill development as a primary means. The aim of this study is to evaluate the patterns and approache...

  18. Current views of health care design and construction: practical implications for safer, cleaner environments.

    Science.gov (United States)

    Bartley, Judene M; Olmsted, Russell N; Haas, Janet

    2010-06-01

    Infection preventionists (IP) play an increasingly important role in preventing health care-associated infection in the physical environment associated with new construction or renovation of health care facilities. The Guidelines for Design and Construction of Hospital and Healthcare Facilities, 2010, formerly known as "AIA Guidelines" was the origin of the "infection control risk assessment" now required by multiple agencies. These Guidelines represent minimum US health care standards and provide guidance on best practices. They recognize that the built environment has a profound affect on health and the natural environment and require that health care facilities be designed to "first, do no harm." This review uses the Guidelines as a blueprint for IPs' role in design and construction, updating familiar concepts to the 2010 edition with special emphasis on IP input into design given its longer range impact on health care-associated infection prevention while linking to safety and sustainability. Section I provides an overview of disease transmission risks from the built environment and related costs, section II presents a broad view of design and master planning, and section III addresses the detailed design strategies for infection prevention specifically addressed in the 2010 Facility Guidelines Institute edition.

  19. Design and development of mesoporous glass-based biomaterials for bone tissue engineering and drug release systems

    OpenAIRE

    Philippart, Anahí

    2016-01-01

    In order to overcome clinical challenges for bone tissue regeneration, current tissue engineering research focuses on developing highly performant biomaterials in terms of multifunctionality, i.e. materials that are capable of stimulating bone regeneration and exhibit drug delivery capabilities as well as sufficient mechanical stability. In the framework of this research topic, the work here presented focuses on the development of multifunctional mesoporous bioactive glasses (mBGs) and on the...

  20. Bones, brains and B-vitamins : the impact of vitamin B12, folate and homocysteine on bone health and cognitive function in elderly

    NARCIS (Netherlands)

    Wijngaarden, van J.P.

    2013-01-01

    ABackground An elevated homocysteine level has been indicated as a risk factor for cardiovascular disease, cognitive decline, and fractures. Supplementation of vitamin B12 and folic acid in order to normalize homocysteine levels might be of substantial public health importance as

  1. In vivo strains in the femur of the Virginia opossum (Didelphis virginiana) during terrestrial locomotion: testing hypotheses of evolutionary shifts in mammalian bone loading and design.

    Science.gov (United States)

    Butcher, Michael T; White, Bartholomew J; Hudzik, Nathan B; Gosnell, W Casey; Parrish, John H A; Blob, Richard W

    2011-08-01

    Terrestrial locomotion can impose substantial loads on vertebrate limbs. Previous studies have shown that limb bones from cursorial species of eutherian mammals experience high bending loads with minimal torsion, whereas the limb bones of non-avian reptiles (and amphibians) exhibit considerable torsion in addition to bending. It has been hypothesized that these differences in loading regime are related to the difference in limb posture between upright mammals and sprawling reptiles, and that the loading patterns observed in non-avian reptiles may be ancestral for tetrapod vertebrates. To evaluate whether non-cursorial mammals show loading patterns more similar to those of sprawling lineages, we measured in vivo strains in the femur during terrestrial locomotion of the Virginia opossum (Didelphis virginiana), a marsupial that uses more crouched limb posture than most mammals from which bone strains have been recorded, and which belongs to a clade phylogenetically between reptiles and the eutherian mammals studied previously. The presence of substantial torsion in the femur of opossums, similar to non-avian reptiles, would suggest that this loading regime likely reflects an ancestral condition for tetrapod limb bone design. Strain recordings indicate the presence of both bending and appreciable torsion (shear strain: 419.1 ± 212.8 με) in the opossum femur, with planar strain analyses showing neutral axis orientations that placed the lateral aspect of the femur in tension at the time of peak strains. Such mediolateral bending was unexpected for a mammal running with near-parasagittal limb kinematics. Shear strains were similar in magnitude to peak compressive axial strains, with opossum femora experiencing similar bending loads but higher levels of torsion compared with most previously studied mammals. Analyses of peak femoral strains led to estimated safety factor ranges of 5.1-7.2 in bending and 5.5-7.3 in torsion, somewhat higher than typical mammalian values

  2. Bone Markers

    Science.gov (United States)

    ... markers may be seen in conditions such as: Osteoporosis Paget disease Cancer that has spread to the bone (metastatic bone disease) Hyperparathyroidism Hyperthyroidism Osteomalacia in adults and rickets in children—lack of bone mineralization, ...

  3. Bone scan

    Science.gov (United States)

    ... legs, or spine fractures) Diagnose a bone infection (osteomyelitis) Diagnose or determine the cause of bone pain, ... 2015:chap 43. Read More Broken bone Metabolism Osteomyelitis Review Date 12/10/2015 Updated by: Jatin ...

  4. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  5. Bone Diseases

    Science.gov (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  6. Design and validation of a novel bioreactor principle to combine online micro-computed tomography monitoring and mechanical loading in bone tissue engineering.

    Science.gov (United States)

    Hagenmüller, Henri; Hitz, Marco; Merkle, Hans P; Meinel, Lorenz; Müller, Ralph

    2010-01-01

    Mechanical loading plays an important role in bone remodeling in vivo and, therefore, has been suggested as a key parameter in stem cell-based engineering of bone-like tissue in vitro. However, the optimization of loading protocols during stem cell differentiation and subsequent bone-like tissue formation is challenged by multiple input factors, which are difficult to control and validate. These include the variable cellular performance of cells harvested from different patients, nonstandardized culture media components, the choice of the biomaterial forming the scaffold, and its morphology, impacting a broader validity of mechanical stimulation regimens. To standardize the cell culture of bone-like tissue constructs, we suggest the involvement of time-lapsed feedback loops. For this purpose we present a prototype bioreactor that combines online, nondestructive monitoring using micro-computed tomography and direct mechanical loading of three-dimensional tissue engineering constructs. Validation of this system showed displacement steps down to 1 microm and cyclic sinusoidal loadings of up to 10 Hz. Load detection resolution was 0.01 N, and micro-computed tomography data were of high quality. For the first time, the developed bioreactor links time-lapsed, nondestructive, and dynamic imaging with mechanical stimulation, designed for cell culture under sterile conditions. This system is believed to substantially improve today's experimental options to study and optimize osteogenic stem cell culture and differentiation at the interface with mechanical stimulation.

  7. Design and validation of a novel bioreactor principle to combine online micro-computed tomography monitoring and mechanical loading in bone tissue engineering

    Science.gov (United States)

    Hagenmüller, Henri; Hitz, Marco; Merkle, Hans P.; Meinel, Lorenz; Müller, Ralph

    2010-01-01

    Mechanical loading plays an important role in bone remodeling in vivo and, therefore, has been suggested as a key parameter in stem cell-based engineering of bone-like tissue in vitro. However, the optimization of loading protocols during stem cell differentiation and subsequent bone-like tissue formation is challenged by multiple input factors, which are difficult to control and validate. These include the variable cellular performance of cells harvested from different patients, nonstandardized culture media components, the choice of the biomaterial forming the scaffold, and its morphology, impacting a broader validity of mechanical stimulation regimens. To standardize the cell culture of bone-like tissue constructs, we suggest the involvement of time-lapsed feedback loops. For this purpose we present a prototype bioreactor that combines online, nondestructive monitoring using micro-computed tomography and direct mechanical loading of three-dimensional tissue engineering constructs. Validation of this system showed displacement steps down to 1 μm and cyclic sinusoidal loadings of up to 10 Hz. Load detection resolution was 0.01 N, and micro-computed tomography data were of high quality. For the first time, the developed bioreactor links time-lapsed, nondestructive, and dynamic imaging with mechanical stimulation, designed for cell culture under sterile conditions. This system is believed to substantially improve today's experimental options to study and optimize osteogenic stem cell culture and differentiation at the interface with mechanical stimulation.

  8. Design and performance of wireless sensors for structural health monitoring

    Science.gov (United States)

    Watters, D. G.; Jayaweera, P.; Bahr, A. J.; Huestis, D. L.

    2002-05-01

    Wireless sensors can be realized by integrating a sensor with a passive commercial radio-frequency identification (RFID) chip. When activated, the chip responds with a digitally encoded signal that not only identifies the sensor but also contains information about the sensor state. Two devices have been developed to date: a temperature-threshold indicator and a chloride-threshold indicator. This paper discusses basic concepts, design issues, and preliminary performance.

  9. Designer probiotics: Development and applications in gastrointestinal health

    Institute of Scientific and Technical Information of China (English)

    Roy; D; Sleator

    2015-01-01

    Given the increasing commercial and clinical relevance of probiotics, improving their stress tolerance profile and ability to overcome the physiochemical defences of the host is an important biological goal. Herein, I review the current state of the art in the design of engineered probiotic cultures, with a specific focus on their utility as therapeutics for the developing world; from the treatment of chronic and acute enteric infections, andtheir associated diarrhoeal complexes, to targeting HIV and application as novel mucosal vaccine delivery vehicles.

  10. Mimicking the nanostructure of bone matrix to regenerate bone

    Directory of Open Access Journals (Sweden)

    Robert Kane

    2013-11-01

    Full Text Available Key features of bone tissue structure and composition are capable of directing cellular behavior toward the generation of new bone tissue. Bone tissue, as well as materials derived from bone, have a long and successful history of use as bone grafting materials. Recent developments in design and processing of synthetic scaffolding systems has allowed the replication of the bone's desirable biological activity in easy to fabricate polymeric materials with nano-scale features exposed on the surface. The biological response to these new tissue-engineering scaffold materials oftentimes exceeds that seen on scaffolds produced using biological materials.

  11. Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.

    Science.gov (United States)

    Olmsted, Russell N

    2016-09-01

    The built environment supports the safe care of patients in health care facilities. Infection preventionists and health care epidemiologists have expertise in prevention and control of health care-associated infections (HAIs) and assist with designing and constructing facilities to prevent HAIs. However, design elements are often missing from initial concepts. In addition, there is a large body of evidence that implicates construction and renovation as being associated with clusters of HAIs, many of which are life threatening for select patient populations. This article summarizes known risks and prevention strategies within a framework for patient safety.

  12. Designing with daylight; the relationship between daylight and health

    DEFF Research Database (Denmark)

    Hauge, Bettina

    2015-01-01

    . With the concept of ‘dwelling’ (Ingold 2000), which implies that people engage in their environment and create possibilities for dwelling at home to feel comfortable and at home in the world, I illustrate people’s day-to-day entanglements with daylight and highlight the social qualities of daylight. The paper...... concludes that access to daylight is vital for existential reasons (health, social reasons and to feel connected to one’s natural environment), showing the window as much more than a technical artefact. Based on this I argue for the window to be acknowledged as vital for creating dwelling and for its...... and postcards for storytelling, I will show how daylight is perceived, used, coped with, and negotiated by these people in their homes, thus exploring the social character of a natural phenomenon. A metaphor will be used from biomimetics (Benyus 1997), claiming that the Danish people, like plants, need daylight...

  13. Lessons of Researcher-Teacher Co-Design of an Environmental Health Afterschool Club Curriculum

    Science.gov (United States)

    Hundal, Savreen; Levin, Daniel M.; Keselman, Alla

    2014-01-01

    This paper addresses the impact of teachers' beliefs about argumentation and their community of practice framed views of teaching on co-designing an environmental health afterschool club curriculum with researchers. Our team collaborated with a group of four middle school teachers, asking them to co-design a club that would facilitate (1)…

  14. Clinical simulation as a boundary object in design of health IT-systems

    DEFF Research Database (Denmark)

    Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

    2013-01-01

    Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical ...

  15. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    Science.gov (United States)

    Behbehani, J M

    2014-01-01

    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

  16. A game plan: Gamification design principles in mHealth applications for chronic disease management.

    Science.gov (United States)

    Miller, Aaron S; Cafazzo, Joseph A; Seto, Emily

    2016-06-01

    Effective chronic disease management is essential to improve positive health outcomes, and incentive strategies are useful in promoting self-care with longevity. Gamification, applied with mHealth (mobile health) applications, has the potential to better facilitate patient self-management. This review article addresses a knowledge gap around the effective use of gamification design principles, or mechanics, in developing mHealth applications. Badges, leaderboards, points and levels, challenges and quests, social engagement loops, and onboarding are mechanics that comprise gamification. These mechanics are defined and explained from a design and development perspective. Health and fitness applications with gamification mechanics include: bant which uses points, levels, and social engagement, mySugr which uses challenges and quests, RunKeeper which uses leaderboards as well as social engagement loops and onboarding, Fitocracy which uses badges, and Mango Health, which uses points and levels. Specific design considerations are explored, an example of the efficacy of a gamified mHealth implementation in facilitating improved self-management is provided, limitations to this work are discussed, a link between the principles of gaming and gamification in health and wellness technologies is provided, and suggestions for future work are made. We conclude that gamification could be leveraged in developing applications with the potential to better facilitate self-management in persons with chronic conditions.

  17. Designing and Undertaking a Health Economics Study of Digital Health Interventions.

    Science.gov (United States)

    McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

    2016-11-01

    This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences.

  18. Absorption of silicon from artesian aquifer water and its impact on bone health in postmenopausal women: a 12 week pilot study

    Directory of Open Access Journals (Sweden)

    Lee Tsz

    2010-10-01

    Full Text Available Abstract Background Decreased bone mineral density and osteoporosis in postmenopausal women represents a growing source of physical limitations and financial concerns in our aging population. While appropriate medical treatments such as bisphosphonate drugs and hormone replacement therapy exist, they are associated with serious side effects such as osteonecrosis of the jaw or increased cardiovascular risk. In addition to calcium and vitamin D supplementation, previous studies have demonstrated a beneficial effect of dietary silicon on bone health. This study evaluated the absorption of silicon from bottled artesian aquifer water and its effect on markers of bone metabolism. Methods Seventeen postmenopausal women with low bone mass, but without osteopenia or osteoporosis as determined by dual x-ray absorptiometry (DEXA were randomized to drink one liter daily of either purified water of low-silicon content (PW or silicon-rich artesian aquifer water (SW (86 mg/L silica for 12 weeks. Urinary silicon and serum markers of bone metabolism were measured at baseline and after 12 weeks and analyzed with two-sided t-tests with p Results The urinary silicon level increased significantly from 0.016 ± 0.010 mg/mg creatinine at baseline to 0.037 ± 0.014 mg/mg creatinine at week 12 in the SW group (p = 0.003, but there was no change for the PW group (0.010 ± 0.004 mg/mg creatinine at baseline vs. 0.009 ± 0.006 mg/mg creatinine at week 12, p = 0.679. The urinary silicon for the SW group was significantly higher in the silicon-rich water group compared to the purified water group (p Conclusions These findings indicate that bottled water from artesian aquifers is a safe and effective way of providing easily absorbed dietary silicon to the body. Although the silicon did not affect bone turnover markers in the short-term, the mineral's potential as an alternative prevention or treatment to drug therapy for osteoporosis warrants further longer-term investigation

  19. Usefulness of calcaneal quantitative ultrasound stiffness for the evaluation of bone health in HIV-1-infected subjects: comparison with dual X-ray absorptiometry

    Directory of Open Access Journals (Sweden)

    Fantauzzi A

    2016-05-01

    Full Text Available Alessandra Fantauzzi,1 Marco Floridia,2 Fabrizio Ceci,3 Francesco Cacciatore,4 Vincenzo Vullo,5 Ivano Mezzaroma1 1Department of Clinical Medicine, Sapienza – University of Rome, 2Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità (ISS, 3Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, 4U.O. of Cardiac Rehabilitation, Fondazione Salvatore Maugeri, IRCCS, Istituto di Telese Terme, Benevento, 5Department of Public Health and Infectious Diseases, Sapienza – University of Rome, Rome, Italy Objectives: With the development of effective treatments and the resulting increase in life expectancy, bone mineral density (BMD alteration has emerged as an important comorbidity in human immunodeficiency virus type-1 (HIV-1-infected individuals. The potential contributors to the pathogenesis of osteopenia/osteoporosis include a higher prevalence of risk factors, combined antiretroviral therapy (cART-exposure, HIV-1 itself and chronic immune activation/inflammation. Dual-energy X-ray absorptiometry (DXA is the “gold standard” technique for assessing bone status in HIV-1 population. Methods: We conducted a cross-sectional study to investigate bone mineral status in a group of 158 HIV-1-infected subjects. The primary endpoint was the feasibility of calcaneal quantitative ultrasound (QUS as a screening tool for BMD. All subjects were receiving stable cART and were virologically suppressed (HIV-RNA <37 copies/mL from at least 12 months. Calcaneal QUS parameters were analyzed to obtain information on bone mass and microarchitecture. The results were compared with those obtained by DXA. Results: No correlations were found between DXA/QUS parameters and demographic or HIV-1-specific characteristics, also including cART strategies. In the univariate analyses BMD, QUS indexes, and Fracture Risk Assessment Tool scores conversely showed significant associations with one or more

  20. Green Tea and Bone Metabolism

    Science.gov (United States)

    Osteoporosis is a major health problem in elderly men and women. Epidemiological evidence has shown association between tea consumption and age-related bone loss in elderly men and women. The aim of this review is to provide a systemic review of green tea and bone health to cover the following topi...

  1. Towards health care process description framework: an XML DTD design.

    Science.gov (United States)

    Staccini, P; Joubert, M; Quaranta, J F; Aymard, S; Fieschi, D; Fieschi, M

    2001-01-01

    The development of health care and hospital information systems has to meet users needs as well as requirements such as the tracking of all care activities and the support of quality improvement. The use of process-oriented analysis is of-value to provide analysts with: (i) a systematic description of activities; (ii) the elicitation of the useful data to perform and record care tasks; (iii) the selection of relevant decision-making support. But paper-based tools are not a very suitable way to manage and share the documentation produced during this step. The purpose of this work is to propose a method to implement the results of process analysis according to XML techniques (eXtensible Markup Language). It is based on the IDEF0 activity modeling language (Integration DEfinition for Function modeling). A hierarchical description of a process and its components has been defined through a flat XML file with a grammar of proper metadata tags. Perspectives of this method are discussed.

  2. Designing a 100-unit Residential Complex with Public and Mental Health Approach

    Directory of Open Access Journals (Sweden)

    Mohsen Gholizadeh Maktoo

    2014-01-01

    Full Text Available The present study first discuses different climate conditions in Iran and traditional methods of architecture in these places as well as importance of identification and evaluation of these methods. Then, designing methods of residential complexes on the basis of components and conditions of the favorite climate will be closely taken into consideration. Finally, the impact of different methods and techniques of designing on society’s mental and public health will be examined. Accordingly, designing a 100-unit residential complex with open and local green spaces, dense neighborhoods with mixed land uses, physical and visual access to the nature, creation of cultural-social-business and entertainment opportunities adjacent to the residential complex, reducing car dependency in combination with walking, strategies of improving public health in designing residential complexes and architecture in Yazd city are used. Consequently, a few strategies are provided for enhancement of citizens’ health and development of this type of architecture.

  3. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    Science.gov (United States)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  4. Your health!? Transforming health perception into food product characteristics in consumer-oriented product design

    NARCIS (Netherlands)

    Sijtsema, S.J.

    2003-01-01

    Keywords: food perception, health, consumer orientation, product developmentFood is part of everyday life and few things have changed more drastically in the last century than the way food is produced, processed, distributed, marketed and consumed. Food companies want to be more successful in

  5. Design and implementation of a national public health surveillance system in Jordan.

    Science.gov (United States)

    Sheikhali, Sami Adel; Abdallat, Mohammed; Mabdalla, Sultan; Al Qaseer, Bashir; Khorma, Rania; Malik, Mamunur; Profili, Maria Cristina; Rø, Gunnar; Haskew, John

    2016-04-01

    Understanding and improving the health status of communities depend on effective public health surveillance. Adoption of new technologies, standardised case definitions and clinical guidelines for accurate diagnosis, and access to timely and reliable data, remains a challenge for public health surveillance systems however and existing public health surveillance systems are often fragmented, disease specific, inconsistent and of poor quality. We describe the application of an enterprise architecture approach to the design, planning and implementation of a national public health surveillance system in Jordan. This enabled a well planned and collaboratively supported system to be built and implemented using consistent standards for data collection, management, reporting and use. The system is case-based and integrated and employs mobile information technology to aid collection of real-time, standardised data to inform and improve decision-making at different levels of the health system.

  6. Adrenal gland and bone.

    Science.gov (United States)

    Hardy, Rowan; Cooper, Mark S

    2010-11-01

    The adrenal gland synthesizes steroid hormones from the adrenal cortex and catecholamines from the adrenal medulla. Both cortisol and adrenal androgens can have powerful effects on bone. The overproduction of cortisol in Cushing's disease leads to a dramatic reduction in bone density and an increase risk of fracture. Overproduction of adrenal androgens in congenital adrenal hyperplasia (CAH) leads to marked changes in bone growth and development with early growth acceleration but ultimately a significant reduction in final adult height. The role of more physiological levels of glucocorticoids and androgens on bone metabolism is less clear. Cortisol levels measured in elderly individuals show a weak correlation with measures of bone density and change in bone density over time with a high cortisol level associated with lower bone density and more rapid bone loss. Cortisol levels and the dynamics of cortisol secretion change with age which could also explain some age related changes in bone physiology. It is also now clear that adrenal steroids can be metabolized within bone tissue itself. Local synthesis of cortisol within bone from its inactive precursor cortisone has been demonstrated and the amount of cortisol produced within osteoblasts appears to increase with age. With regard to adrenal androgens there is a dramatic reduction in levels with aging and several studies have examined the impact that restoration of these levels back to those seen in younger individuals has on bone health. Most of these studies show small positive effects in women, not men, but the skeletal sites where benefits are seen varies from study to study.

  7. Design and Analysis of Health Products and Services: An Example at a Specialized COPD Unit

    Science.gov (United States)

    Domingo, Christian; Rubio, Vicente Ortún

    2008-01-01

    Health care demands have increased dramatically in recent decades. With the introduction of major changes in the management of health problems, health care costs have spiralled. Today, in the interests of cost control, medicine is geared towards outpatient care whenever possible. In this process, the medical community has been obliged to adapt its traditional criteria to the dictates of national economies. Today the criteria for the organization and evaluation of the health services are based on the concepts of efficacy, effectiveness and efficiency. This has led to the emergence of a new discipline for the design and evaluation of medical service production, known as servuction, an amalgam of “service” and “production”. The organigram of a new health product should include the problems the program faces and the steps proposed to overcome these problems. The concept of evaluation can be divided into two categories: administrative evaluation, and evaluative research. Avedis Donabedian was one of the founders of evaluative research, based on an easy-to-remember triad: structure-process-results. In the final evaluation of a new health care model, the innovations it provides must be considered. In this article we describe the stages involved in the design of a new health product and correlate them with the types of evaluation that should be applied at each point in the process. Our discussion addresses general aspects of servuction, but also focuses on the design of a particular service, created to care for patients with severe COPD. PMID:19340319

  8. Designing an oral health module for the Bachelor of Midwifery program at an Australian University.

    Science.gov (United States)

    Duff, Margaret; Dahlen, Hannah G; Burns, Elaine; Priddis, Holly; Schmied, Virginia; George, Ajesh

    2017-03-01

    Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.

  9. Designing New Financial Management System in Health Sector of Islamic Republic of Iran

    Directory of Open Access Journals (Sweden)

    R Hafezi

    2009-03-01

    Full Text Available "nBackground: In health system of any country, securing financial resources and management of the same is one of the most vital apprehensions in regards policy makers. This article expresses a part of the obstacles and threats present in the man­agement of the government financial resources of health sector and in assimilating this, the requirement for amendments in the financial system and designing new financial management system of health sector in Iran."nMethods: The authors conducted a case study based on interviews with government, and academic participants. Two meth­ods of data collection were used: retrospective analysis of official documents and in-depth interview."nResults: The root of the obstacles relevant to the management of financial resources in health sector in four intricate and fundamental modes of executing cash accounts in contrary to accrual accounts, where there is an intense weakness in the internal controls due to the lack of periodic reports, so as to define the source of deviations, the lack of a mechanized system and ultimately, the absence of a comprehensive monetary plan in the Country. Based on these obstacles, the new financial management system of health sector in Iran was designed including mission, objectives, structure, human resources and duties, processes and procedures, external environment."nConclusion: Designing new financial system in health sector of country is a way to effective and efficient management of financial resources and aid health system to achieve ultimate goals.

  10. Bone mass status of school-aged children in Taiwan assessed by quantitative ultrasound: the Nutrition and Health Survey in Taiwan Elementary School Children (NAHSIT Children 2001-2002).

    Science.gov (United States)

    Lin, Yi-Chin; Tu, Su-Hao; Pan, Wen-Harn L

    2007-01-01

    Bone health status in childhood and adolescence may be important factors influencing the attainment of peak bone mass. The Nutrition and Health Survey in Taiwan Elementary School Children 2000-2001 was carried out to evaluate the overall nutrition and health status of school children aged between 6 and 13 years. The survey was conducted using a multi-stage complex sampling scheme. Townships and city districts in Taiwan were classified into 13 strata. Bone mass measured as broadband ultrasound attenuation was taken at heel by quantitative ultrasound bone densitometry. A total of 1164 boys and 1016 girls who had complete physical examination data with ultrasound bone scan were included in the current analysis. There were no apparent differences in BUA across all strata for both genders. In both boys and girls, age, height, body weight, BMI, and intake frequencies of vegetables and fruits/juices were significantly related to BUA. Results of multivariate regression showed that age (beta=1.36, p=0.0002) and body weight (beta=0.40, pvariables on BUA in boys and girls may be in part due to the development of puberty. It would be necessary to include levels of physical activity in future analyses for better understanding factors influencing the development of peak bone mass in Taiwanese children.

  11. Bone vascularization: a way to study bone microarchitecture?

    Science.gov (United States)

    Blery, P.; Autrusseau, F.; Crauste, E.; Freuchet, Erwan; Weiss, Pierre; Guédon, J.-P.; Amouriq, Y.

    2014-03-01

    Trabecular bone and its microarchitecture are of prime importance for health. Studying vascularization helps to better know the relationship between bone and vascular microarchitecture. This research is an animal study (nine Lewis rats), based on the perfusion of vascularization by a contrast agent (a mixture of 50% barium sulfate with 1.5% of gelatin) before euthanasia. The samples were studied by micro CT at a resolution of 9μm. Softwares were used to show 3D volumes of bone and vessels, to calculate bone and vessels microarchitecture parameters. This study aims to understand simultaneously the bone microarchitecture and its vascular microarchitecture.

  12. Design, implementation and validation of a novel open framework for agile development of mobile health applications.

    Science.gov (United States)

    Banos, Oresti; Villalonga, Claudia; Garcia, Rafael; Saez, Alejandro; Damas, Miguel; Holgado-Terriza, Juan A; Lee, Sungyong; Pomares, Hector; Rojas, Ignacio

    2015-01-01

    The delivery of healthcare services has experienced tremendous changes during the last years. Mobile health or mHealth is a key engine of advance in the forefront of this revolution. Although there exists a growing development of mobile health applications, there is a lack of tools specifically devised for their implementation. This work presents mHealthDroid, an open source Android implementation of a mHealth Framework designed to facilitate the rapid and easy development of mHealth and biomedical apps. The framework is particularly planned to leverage the potential of mobile devices such as smartphones or tablets, wearable sensors and portable biomedical systems. These devices are increasingly used for the monitoring and delivery of personal health care and wellbeing. The framework implements several functionalities to support resource and communication abstraction, biomedical data acquisition, health knowledge extraction, persistent data storage, adaptive visualization, system management and value-added services such as intelligent alerts, recommendations and guidelines. An exemplary application is also presented along this work to demonstrate the potential of mHealthDroid. This app is used to investigate on the analysis of human behavior, which is considered to be one of the most prominent areas in mHealth. An accurate activity recognition model is developed and successfully validated in both offline and online conditions.

  13. Early Bone Formation around Immediately Loaded Transitional Implants Inserted in the Human Posterior Maxilla: The Effects of Fixture Design and Surface

    Science.gov (United States)

    Pires, Jefferson Trabach; Luongo, Giuseppe; Piattelli, Adriano

    2017-01-01

    Aim. To evaluate the effects of fixture design and surface on the early bone formation around immediately loaded implants inserted in the human posterior maxilla. Materials and Methods. Ten totally edentulous subjects received two transitional implants: one tapered implant with knife-edge threads/nanostructured calcium-incorporated surface (test: Anyridge®, Megagen, Gyeongbuk, South Korea) and one cylindrical implant with self-tapping threads/sandblasted surface (control: EZPlus®, Megagen). The implants were placed according to a split-mouth design and immediately loaded to support an interim complete denture; after 8 weeks, they were removed for histologic/histomorphometric analysis. The bone-to-implant contact (BIC%) and the bone density (BD%) were calculated. The Wilcoxon test was used to evaluate the differences. Results. With test implants, a mean BIC% and BD% of 35.9 (±9.1) and 31.8 (±7.5) were found. With control implants, a mean BIC% and BD% of 29.9 (±7.6) and 32.5 (±3.9) were found. The mean BIC% was higher with test implants, but this difference was not significant (p = 0.16). Similar BD% were found in the two groups (p = 0.9). Conclusions. In the posterior maxilla, under immediate loading conditions, implants with a knife-edge thread design/nanostructured calcium-incorporated surface seem to increase the peri-implant endosseous healing properties, when compared to implants with self-tapping thread design/sandblasted surface.

  14. Smokers With Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group

    Science.gov (United States)

    Steinberg, Marc L.; Griffiths, Kim Gesell; Cooperman, Nina

    2013-01-01

    Smokers with co-occurring mental illness or substance use disorders are not designated a disparity group or priority population by most national public health and tobacco control groups. These smokers fulfill the criteria commonly used to identify groups that merit special attention: targeted marketing by the tobacco industry, high smoking prevalence rates, heavy economic and health burdens from tobacco, limited access to treatment, and longer durations of smoking with less cessation. A national effort to increase surveillance, research, and treatment is needed. Designating smokers with behavioral health comorbidity a priority group will bring much-needed attention and resources. The disparity in smoking rates among persons with behavioral health issues relative to the general population will worsen over time if their needs remain unaddressed. PMID:23865661

  15. Personal and political histories in the designing of health reform policy in Bolivia.

    Science.gov (United States)

    Bernstein, Alissa

    2017-03-01

    While health policies are a major focus in disciplines such as public health and public policy, there is a dearth of work on the histories, social contexts, and personalities behind the development of these policies. This article takes an anthropological approach to the study of a health policy's origins, based on ethnographic research conducted in Bolivia between 2010 and 2012. Bolivia began a process of health care reform in 2006, following the election of Evo Morales Ayma, the country's first indigenous president, and leader of the Movement Toward Socialism (Movimiento al Socialism). Brought into power through the momentum of indigenous social movements, the MAS government platform addressed racism, colonialism, and human rights in a number of major reforms, with a focus on cultural identity and indigeneity. One of the MAS's projects was the design of a new national health policy in 2008 called The Family Community Intercultural Health Policy (Salud Familiar Comunitaria Intercultural). This policy aimed to address major health inequities through primary care in a country that is over 60% indigenous. Methods used were interviews with Bolivian policymakers and other stakeholders, participant observation at health policy conferences and in rural community health programs that served as models for aspects of the policy, and document analysis to identify core premises and ideological areas. I argue that health policies are historical both in their relationship to national contexts and events on a timeline, but also because of the ways they intertwine with participants' personal histories, theoretical frameworks, and reflections on national historical events. By studying the Bolivian policymaking process, and particularly those who helped design the policy, it is possible to understand how and why particular progressive ideas were able to translate into policy. More broadly, this work also suggests how a uniquely anthropological approach to the study of health policy

  16. Relationship Between Aldosterone and Parathyroid Hormone, and the Effect of Angiotensin and Aldosterone Inhibition on Bone Health

    DEFF Research Database (Denmark)

    L.S., Bislev; T., Sikjaer; L., Rolighed

    2015-01-01

    Emerging evidence suggests a stimulating effect of parathyroid hormone (PTH) on the reninnullangiotensinnullaldosterone system (RAAS). In primary hyperparathyroidism, chronic-elevated PTH levels seem to stimulate the RAAS which may explain the increased risk of cardiovascular disease (CVD...... hyperparathyroidism due to increased renal calcium excretion. Moreover, the angiotensin II receptor is expressed by human parathyroid tissue, and angiotensin may therefore directly stimulates PTH secretion. An increased bone loss is found in patients with hyperaldosteronism. The angiotensin II receptor seems main...

  17. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  18. Health insurance benefit design and healthcare utilization in northern rural China.

    Directory of Open Access Journals (Sweden)

    Hong Wang

    Full Text Available BACKGROUND: Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. METHODS AND FINDINGS: We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. CONCLUSION: The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful

  19. Study Designs and Evaluation Models for Emergency Department Public Health Research

    OpenAIRE

    Broderick, Kerry B.; Ranney, Megan L.; Vaca, Federico E.; D’Onofrio, Gail; Rothman, Richard E.; Rhodes, Karin V; Becker, Bruce; Haukoos, Jason S.

    2009-01-01

    Public health research requires sound design and thoughtful consideration of potential biases that may influence the validity of results. It also requires careful implementation of protocols and procedures that are likely to translate from the research environment to actual clinical practice. This article is the product of a breakout session from the 2009 Academic Emergency Medicine consensus conference entitled “Public Health in the ED: Screening, Surveillance, and Intervention” and serves t...

  20. Prioritizing the mHealth Design Space: A Mixed-Methods Analysis of Smokers’ Perspectives

    Science.gov (United States)

    BlueSpruce, June; Catz, Sheryl L; McClure, Jennifer B

    2016-01-01

    Background Smoking remains the leading cause of preventable disease and death in the United States. Therefore, researchers are constantly exploring new ways to promote smoking cessation. Mobile health (mHealth) technologies could be effective cessation tools. Despite the availability of commercial quit-smoking apps, little research to date has examined smokers’ preferred treatment intervention components (ie, design features). Honoring these preferences is important for designing programs that are appealing to smokers and may be more likely to be adopted and used. Objective The aim of this study was to understand smokers’ preferred design features of mHealth quit-smoking tools. Methods We used a mixed-methods approach consisting of focus groups and written surveys to understand the design preferences of adult smokers who were interested in quitting smoking (N=40). Focus groups were stratified by age to allow differing perspectives to emerge between older (>40 years) and younger (social support, and incentivizing program use. Participants rated the importance of preselected design features on an exit survey. Qualitative analyses examined emergent discussion themes and quantitative analyses compared feature ratings to determine which were perceived as most important. Results Participants preferred a highly personalized and adaptive mHealth experience. Their ideal mHealth quit-smoking tool would allow personalized tracking of their progress, adaptively tailored feedback, and real-time peer support to help manage smoking cravings. Based on qualitative analysis of focus group discussion, participants preferred pull messages (ie, delivered upon request) over push messages (ie, sent automatically) and preferred interaction with other smokers through closed social networks. Preferences for entertaining games or other rewarding incentives to encourage program use differed by age group. Based on quantitative analysis of surveys, participants rated the importance of

  1. Bone Health Should Be an Important Concern in the Care of Patients Affected by 21 Hydroxylase Deficiency

    Directory of Open Access Journals (Sweden)

    Dulon Jérome

    2010-09-01

    Full Text Available Osteoporosis has been an understandable concern for children and adult patients with congenital adrenal hyperplasia (CAH who may receive or have received supraphysiological doses of glucocorticoids. Some previous reports on bone mineral density (BMD in adult CAH patients showed no significant differences in BMD between patients with CAH and controls, but others have found lower BMD in CAH patients. In reports documenting the BMD reduction, this outcome has been attributed to an accumulated effect of prolonged exposure to excess glucocorticoids during infancy and childhood. We recently conducted a trial to establish the role of the total cumulative glucocorticoid dose on BMD. We established for the first time that there was a negative relationship between total cumulative glucocorticoid dose and lumbar and femoral BMD. Women might benefit from the preserving effect of estrogens compared to men. BMI (Body Mass Index also appeared to protect patients from bone loss. In light of this, physicians should bear in mind the potential consequences of glucocorticoids on bone and therefore adjust the treatment and improve clinical and biological surveillance from infancy. Furthermore, preventive measures against corticosteroid-induced osteoporosis should be discussed right from the beginning of glucocorticoid therapy.

  2. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  3. A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures.

    Science.gov (United States)

    Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan

    2011-01-01

    Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

  4. Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health

    Directory of Open Access Journals (Sweden)

    Lynn Cialdella-Kam

    2014-07-01

    Full Text Available Exercise-related menstrual dysfunction (ExMD is associated with low energy availability (EA, decreased bone mineral density (BMD, and increased risk of musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein (CHO-PRO supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day intervention would improve energy status and musculoskeletal health and restore menses in female athletes (n = 8 with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone health (BMD, bone mineral content, bone markers, muscle strength/power and protein metabolism markers, profile of mood state (POMS, and energy intake (EI/energy expenditure (7 day food/activity records were measured. Eumenorrheic athlete controls with normal menses (Eumen; n = 10 were measured at baseline. Multiple linear regressions were used to evaluate differences between groups and pre/post-intervention blocking on participants. Improvements in EI (+382 kcal/day; p = 0.12, EA (+417 kcal/day; p = 0.17 and energy balance (EB; +466 kcal/day; p = 0.14 were observed with the intervention but were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses; 3.5 ± 1.9 cycles; one remaining anovulatory with menses. Female athletes with ExMD for >8 months took longer to resume menses/ovulation and had lower BMD (low spine (ExMD = 3; Eumen = 1; low hip (ExMD = 2 than those with ExMD for <8 months; for 2 ExMD the intervention improved spinal BMD. POMS fatigue scores were 15% lower in ExMD vs. Eumen (p = 0.17; POMS depression scores improved by 8% in ExMD (p = 0.12. EI, EA, and EB were similar between groups, but the intervention (+360 kcal/day improved energy status enough to reverse ExMD despite no statistically significant changes in EI. Similar baseline EA and EB between groups suggests that some ExMD athletes are more sensitive to EA and EB fluctuations.

  5. Experience based co-design reduces formal complaints on an acute mental health ward.

    Science.gov (United States)

    Springham, Neil; Robert, Glenn

    2015-01-01

    An acute mental health triage ward at Oxleas NHS Foundation Trust was attracting high levels of formal service user and family complaints. The Trust used experience based co-design to examine the issues and redesign procedures. This resulted in an immediate eradication of formal complaints for a period of 23 months. This paper describes two outcomes: firstly, the successful adaptations made to the experience based co-design methodology from its origins in physical care, in order to ensure it was safe and effective in an acute mental health setting; and, secondly, the changes made to the ward as a result of this quality improvement intervention.

  6. User-Centered Design of Health Care Software Development: Towards a Cultural Change.

    Science.gov (United States)

    Stanziola, Enrique; Uznayo, María Quispe; Ortiz, Juan Marcos; Simón, Mariana; Otero, Carlos; Campos, Fernando; Luna, Daniel

    2015-01-01

    Health care software gets better user efficiency, efficacy and satisfaction when the software is designed with their users' needs taken into account. However, it is not trivial to change the practice of software development to adopt user-centered design. In order to produce this change in the Health Informatics Department of the Hospital Italiano de Buenos Aires, a plan was devised and implemented. The article presents the steps of the plan, shows how the steps were carried on, and reflects on the lessons learned through the process.

  7. Alginate/nanohydroxyapatite scaffolds with designed core/shell structures fabricated by 3D plotting and in situ mineralization for bone tissue engineering.

    Science.gov (United States)

    Luo, Yongxiang; Lode, Anja; Wu, Chengtie; Chang, Jiang; Gelinsky, Michael

    2015-04-01

    Composite scaffolds, especially polymer/hydroxyapatite (HAP) composite scaffolds with predesigned structures, are promising materials for bone tissue engineering. Various methods including direct mixing of HAP powder with polymers or incubating polymer scaffolds in simulated body fluid for preparing polymer/HAP composite scaffolds are either uncontrolled or require long times of incubation. In this work, alginate/nano-HAP composite scaffolds with designed pore parameters and core/shell structures were fabricated using 3D plotting technique and in situ mineralization under mild conditions (at room temperature and without the use of any organic solvents). Light microscopy, scanning electron microscopy, microcomputer tomography, X-ray diffraction, and Fourier transform infrared spectroscopy were applied to characterize the fabricated scaffolds. Mechanical properties and protein delivery of the scaffolds were evaluated, as well as the cell response to the scaffolds by culturing human bone-marrow-derived mesenchymal stem cells (hBMSC). The obtained data indicate that this method is suitable to fabricate alginate/nano-HAP composite scaffolds with a layer of nano-HAP, coating the surface of the alginate strands homogeneously and completely. The surface mineralization enhanced the mechanical properties and improved the cell attachment and spreading, as well as supported sustaining protein release, compared to pure alginate scaffolds without nano-HAP shell layer. The results demonstrated that the method provides an interesting option for bone tissue engineering application.

  8. Integrative health care model for climacteric stage women: design of the intervention

    Directory of Open Access Journals (Sweden)

    Pérez-Cuevas Ricardo

    2011-02-01

    Full Text Available Abstract Background Climacteric stage women experience significant biological, psychological and social changes. With demographic changes being observed in the growing number of climacteric stage women in Mexico, it is important to improve their knowledge about the climacteric stage and its potential associated problems, encourage their participation in screening programs, and promote the acquisition of healthy lifestyles. At Mexican health care institutions the predominant health care model for climacteric stage women has a biomedical perspective. Medical doctors provide mostly curative services and have limited support from other health professionals. This study aims to design an integrative health care model (IHCM: bio-psycho-social, multidisciplinary and women-centered applicable in primary care services aimed at climacteric stage women. Methods/Design We present the design, inclusion criteria and detailed description of an IHCM. The IHCM consists of collaborative and coordinated provision of services by a health team, which is involves a family doctor, nurse, psychologist, and the woman herself. The health team promotes the empowerment of women through individual and group counseling on the climacteric stage and health related self-care. The intervention lasts three months followed by a three-month follow-up period to evaluate the effectiveness of the model. The effectiveness of the model will be evaluated through the following aspects: health-related quality of life (HR-QoL, empowerment, self-efficacy and knowledge regarding the climacteric stage and health-related self-care activities, use of screening services, and improvement in lifestyles (regular leisure time physical activity and healthy diet. Discussion Participation in preventive activities should be encouraged among women in Mexico. Designing and evaluating the effectiveness of an integrative health care model for women at the climacteric stage, based on the empowerment approach

  9. DESIGNING E-EDUCATION SUPPORTS IN E-HEALTH BASED SYSTEMS

    Directory of Open Access Journals (Sweden)

    Ikhu-Omoregbe, NICHOLAS

    2008-07-01

    Full Text Available ABSTRACT The inadequate availability of medical information has often made health care services in many developing countries cumbersome with enormous paper work, waste of life, time and resources, long queues, and ineffective treatment procedures. The use of mobile technology devices such as Personal Digital Assistants, Cell phone, Tablet PCs etc for health care delivery promises a revolution in modern health care. However, applications that provide access to real-time patients and research information at the point-of-care via mobile devices are at best in their low stage of adoption across the health sector. In this paper, the experience gained in designing mobile health care applications is used to proffer e-Education functionalities in the design of healthcare systems to enhance their acceptance in the medical domain. The application discussed uses, the Unified Modelling Language, mobile, and Java-based technologies for its development. The application provides a real-time access to medical information at the points of health-care delivery within health care centres.

  10. Beyond tokenistic participation: using representational artefacts to enable meaningful public participation in health service design.

    Science.gov (United States)

    Morrison, Cecily; Dearden, Andy

    2013-10-01

    A number of recent policies promote public participation in health service design. Yet, a growing literature has articulated a gap between policy aims and actual practice resulting in public participation becoming tokenistic. Drawing on theory from participatory design, we argue that choosing appropriate artefacts to act as representations can structure discussions between public participants and health professionals in ways that both groups find meaningful and valid. Through a case study of a service improvement project in outpatient services for older people, we describe three representational artefacts: emotion maps, stories, and tracing paper, and explain how they helped to mediate interactions between public participants and health professionals. We suggest that using such representational artefacts can provide an alternative approach to participation that stands in contrast to the current focus on the professionalisation of public participants. We conclude that including participatory designers in projects, to chose or design appropriate representational artefacts, can help to address the policy-practice gap of including public participants in health service design.

  11. CT assisted biomimetic artificial bone des

    Institute of Scientific and Technical Information of China (English)

    WANG Xian-gang; ZHANG Chao-zong; GUO Zhi-ping; TIAN Jie-mo

    2001-01-01

    @@ In the recent years, bioceramic materials have been widely used in the clinics. They are mainly fabricated as the substitution of human hard tissue, such as artificial bone and false tooth. As a medical implant, those that have similar structure to human bone have better biocompatibility and osteoinductional property. So it is necessary to design bone model close to human bone.

  12. The emotional experience of patient care: a case for innovation in health care design.

    Science.gov (United States)

    Altringer, Beth

    2010-07-01

    This paper considers recent developments in health care facility design and in the psychology literature that support a case for increased design sensitivity to the emotional experience of patient care. The author discusses several examples of innovative patient-centred health care design interventions. These generally resulted in improvements in the patient and staff experience of care, at less cost than major infrastructural interventions. The paper relates these developments in practice with recent neuroscience research, illustrating that the design of the built environment influences patient emotional stress. In turn, patient emotional stress appears to influence patient satisfaction, and in some instances, patient outcomes. This paper highlights the need for further research in this area.

  13. Teachers' perception of oral health status. Design and validation of an evaluation instrument.

    Science.gov (United States)

    Bordoni, Noemi; Cadile, María del Carmen; Sotelo, Romelia; Squassi, Aldo

    2006-01-01

    The evaluation of health status is a complex process that requires the use of indicators that assess health both in terms of disease and of the impact the health-disease-care process has on the quality of life. The aim of the present study was to design and validate an instrument to evaluate teachers 'perceptions of oral health status. The sample comprised 78 teachers of 4 schools (province of Buenos Aires). DESIGN OF THE INSTRUMENT: (a) identification of the 5 categories that compose the instrument and can measure the object of study based on evidence; (b) creation of a questionnaire that contains 32 items by two researchers; (c) evaluation of the questionnaire by 5 professionals of 4 different professions to standardize criteria (Ventegodt et al, 2003) applying an ordinal scale. Items were reduced to 25 (Index of perception of oral health: IPOH). VALIDATION OF THE INSTRUMENT: the following parameters were evaluated: reliability employing the test-retest method at 30 days; internal consistency employing Cronbach's a coefficient (1951); content validity determined by two experts; construct validity employing the method of extreme groups (Student's t test). The established categories were knowledge on oral health, personal experience with oral health care, expectations regarding their students 'families, expectations regarding dentistry, satisfaction with his/her role as a teacher The instrument proved to be reliable as evidenced by a value of r = 0.80 in the test-retest method; a satisfactory intra-items consistency was evidenced by Cronbach's alpha coefficient value of 0.82. The differences between the results of the groups of teachers in the extreme groups were statistically significant (p = 2.2). The instrument designed to measure the teachers' perception of oral health status would be valid. It would be desirable to enlarge the sample and determine criterion validity by comparison with other instruments.

  14. The Design and Use of Animal Models for Translational Research in Bone Tissue Engineering and Regenerative Medicine

    Science.gov (United States)

    2010-01-07

    repair,40,41 evaluation of the differential effects of marrow-derived and periosteal - derived cell populations,42 and in screening for the effects of cell...defect or gap in bone (caused by either tissue loss or distraction maintained by internal or external fixation), local tissue loss (particularly periosteal ...as an excel- lent resource. Critical defects are defined as ‘‘a defect that will not heal without intervention.’’ The femur and tibial diaphysis tend

  15. The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

    Science.gov (United States)

    Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

    2017-03-02

    The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

  16. The impact of information technology on organizational design: Example in health organization

    Directory of Open Access Journals (Sweden)

    Petković Mirjana

    2013-01-01

    Full Text Available The aim of this paper is to explore the impact of information technology (IT on organization including all elements that are integral part of organizational design through Star Model (Kates and Galbraith, 2007, and to show that IT has become an important strategic resource that provides a concentration of all relevant information for quality decision-making and integration of complex organization with the concept of “Big Data” (Manyika et al, 2011. In order to achieve the aim, research was performed in organization in the health sector which affects the quality of life and standard of living. TheIT impact on organizational design and through him on organizational effectiveness in the health care is visible and provide insight into the implications of information technology and opportunities for reasoning about matters that are the subject of research: whether and how information technology causes changes in the design of the organization; whether it affects all elements of design equally; on which elements has the most intense impact and why; whether and why employees and users of health services exhibit resistance to information technology; under what conditions can be reduced or completely eliminated the resistance of employees and users of health services?

  17. A designated centre for people with disabilities operated by Health Service Executive, Tipperary

    LENUS (Irish Health Repository)

    Xiao, Liang

    2011-02-01

    In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR.

  18. The Oslo Health Study: A Dietary Index Estimating Frequent Intake of Soft Drinks and Rare Intake of Fruit and Vegetables Is Negatively Associated with Bone Mineral Density

    Directory of Open Access Journals (Sweden)

    Arne Torbjørn Høstmark

    2011-01-01

    Full Text Available Background. Since nutritional factors may affect bone mineral density (BMD, we have investigated whether BMD is associated with an index estimating the intake of soft drinks, fruits, and vegetables. Methods. BMD was measured in distal forearm in a subsample of the population-based Oslo Health Study. 2126 subjects had both valid BMD measurements and answered all the questions required for calculating a Dietary Index = the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. We did linear regression analyses to study whether the Dietary Index and the single food items included in the index were associated with BMD. Results. There was a consistent negative association between the Dietary Index and forearm BMD. Among the single index components, colas and non-cola soft drinks were negatively associated with BMD. The negative association between the Dietary Index and BMD prevailed after adjusting for gender, age, and body mass index, length of education, smoking, alcohol intake, and physical activity. Conclusion. An index reflecting frequent intake of soft drinks and rare intake of fruit and vegetables was inversely related to distal forearm bone mineral density.

  19. Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs

    Directory of Open Access Journals (Sweden)

    Vicente Vera

    2015-12-01

    Full Text Available We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001. After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001. After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217. We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.

  20. The oslo health study: a dietary index estimating frequent intake of soft drinks and rare intake of fruit and vegetables is negatively associated with bone mineral density.

    Science.gov (United States)

    Høstmark, Arne Torbjørn; Søgaard, Anne Johanne; Alvær, Kari; Meyer, Haakon E

    2011-01-01

    Background. Since nutritional factors may affect bone mineral density (BMD), we have investigated whether BMD is associated with an index estimating the intake of soft drinks, fruits, and vegetables. Methods. BMD was measured in distal forearm in a subsample of the population-based Oslo Health Study. 2126 subjects had both valid BMD measurements and answered all the questions required for calculating a Dietary Index = the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. We did linear regression analyses to study whether the Dietary Index and the single food items included in the index were associated with BMD. Results. There was a consistent negative association between the Dietary Index and forearm BMD. Among the single index components, colas and non-cola soft drinks were negatively associated with BMD. The negative association between the Dietary Index and BMD prevailed after adjusting for gender, age, and body mass index, length of education, smoking, alcohol intake, and physical activity. Conclusion. An index reflecting frequent intake of soft drinks and rare intake of fruit and vegetables was inversely related to distal forearm bone mineral density.

  1. The Oslo Health Study: A Dietary Index Estimating Frequent Intake of Soft Drinks and Rare Intake of Fruit and Vegetables Is Negatively Associated with Bone Mineral Density

    Science.gov (United States)

    Høstmark, Arne Torbjørn; Søgaard, Anne Johanne; Alvær, Kari; Meyer, Haakon E.

    2011-01-01

    Background. Since nutritional factors may affect bone mineral density (BMD), we have investigated whether BMD is associated with an index estimating the intake of soft drinks, fruits, and vegetables. Methods. BMD was measured in distal forearm in a subsample of the population-based Oslo Health Study. 2126 subjects had both valid BMD measurements and answered all the questions required for calculating a Dietary Index = the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. We did linear regression analyses to study whether the Dietary Index and the single food items included in the index were associated with BMD. Results. There was a consistent negative association between the Dietary Index and forearm BMD. Among the single index components, colas and non-cola soft drinks were negatively associated with BMD. The negative association between the Dietary Index and BMD prevailed after adjusting for gender, age, and body mass index, length of education, smoking, alcohol intake, and physical activity. Conclusion. An index reflecting frequent intake of soft drinks and rare intake of fruit and vegetables was inversely related to distal forearm bone mineral density. PMID:21772969

  2. Impact of emerging health insurance arrangements on diabetes outcomes and disparities: rationale and study design.

    Science.gov (United States)

    Wharam, J Frank; Soumerai, Steve; Trinacty, Connie; Eggleston, Emma; Zhang, Fang; LeCates, Robert; Canning, Claire; Ross-Degnan, Dennis

    2013-01-01

    Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre-post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes quality of care, outcomes, and disparities. We will use a 13-year rolling sample (2001-2013) of members of an HDHP and members of a control group. To reduce selection bias, we will limit participants to those whose employers mandate a single health insurance type. The study will measure rates of monthly hemoglobin A1c, lipid, and albuminuria testing; availability of blood glucose test strips; and rates of retinal examinations, high-severity emergency department visits, and preventable hospitalizations. Results could be used to design health plan features that promote high-quality care and better outcomes among people who have diabetes.

  3. The impact of methods for estimating bone health and the global burden of bone disease Impacto de los métodos para medir la salud ósea y la carga global de enfermedades óseas

    Directory of Open Access Journals (Sweden)

    Zoë A Cole

    2009-01-01

    Full Text Available Osteoporosis constitutes a major public health problem through its association with age related fractures. Fracture rates are generally higher in caucasian women than in other populations. Important determinants include estrogen deficiency in women, low body mass index, cigarette smoking, alcohol consumption, poor dietary calcium intake, physical inactivity, certain drugs and illnesses. Thus, modification of physical activity and dietary calcium/vitamin D nutrition should complement high risk approaches. In addition, the recently developed WHO algorithm for evaluation of 10-year absolute risk of fracture provides a means whereby various therapies can be targeted cost-effectively to those at risk. Risk factors, together with bone mineral density (BMD and biochemical indices of bone turnover, can be utilised to derive absolute risks of fracture and cost-utility thresholds at which treatment is justified. These data will provide the basis for translation into coherent public health strategies aiming to prevent osteoporosis both in individuals and in the general population.La osteoporosis constituye un importante problema de salud pública debido a su asociación con fracturas relacionadas con la edad. Las tasas de fractura generalmente son más altas en mujeres caucásicas que en otros grupos poblacionales. Los principales determinantes incluyen deficiencia de estrógeno en mujeres, bajo índice de masa corporal, consumo de tabaco y alcohol, escaso consumo de calcio, inactividad física y algunas drogas y enfermedades. De este modo, la modificación de la actividad física y el consumo de nutrimentos con calcio y vitamina D deben complementar los tratamientos en alto riesgo. Además, el recientemente desarrollado algoritmo de la OMS para la evaluación de riesgo de fractura absoluto a 10 años constituye una herramienta que permite plantear eficientemente diversas terapias a aquellos que están en riesgo. Los factores de riesgo, junto con la

  4. 绝经后激素治疗与骨健康%Postmenopausal hormone therapy and bone health

    Institute of Scientific and Technical Information of China (English)

    徐苓

    2011-01-01

    Estrogen is a promoter for the resorption of calcium in intestine, and a inhibitor for the activity of osteoclasts. Menopause women are at high risk of osteoporosis due to estrogen deficiency that cause the accelerated bone turnover and increased bone loss.Therefore, HT is an appropriate first-line therapy in postmenopausal women presenting with an increased risk for fracture, particularly under the age of 60 years.%雌激素有促进肠钙吸收,抑制破骨细胞活性的功能.绝经后由于雌激素骤然缺乏使破骨细胞活跃,骨吸收增加,骨转换加快,导致骨量迅速丢失.因此,绝经后妇女是骨质疏松的高危人群.激素治疗是60岁以下绝经妇女防治骨质疏松的一线选择.

  5. Transcutaneous Raman Spectroscopy of Bone

    Science.gov (United States)

    Maher, Jason R.

    Clinical diagnoses of bone health and fracture risk typically rely upon measurements of bone density or structure, but the strength of a bone is also dependent upon its chemical composition. One technology that has been used extensively in ex vivo, exposed-bone studies to measure the chemical composition of bone is Raman spectroscopy. This spectroscopic technique provides chemical information about a sample by probing its molecular vibrations. In the case of bone tissue, Raman spectra provide chemical information about both the inorganic mineral and organic matrix components, which each contribute to bone strength. To explore the relationship between bone strength and chemical composition, our laboratory has contributed to ex vivo, exposed-bone animal studies of rheumatoid arthritis, glucocorticoid-induced osteoporosis, and prolonged lead exposure. All of these studies suggest that Raman-based predictions of biomechanical strength may be more accurate than those produced by the clinically-used parameter of bone mineral density. The utility of Raman spectroscopy in ex vivo, exposed-bone studies has inspired attempts to perform bone spectroscopy transcutaneously. Although the results are promising, further advancements are necessary to make non-invasive, in vivo measurements of bone that are of sufficient quality to generate accurate predictions of fracture risk. In order to separate the signals from bone and soft tissue that contribute to a transcutaneous measurement, we developed an overconstrained extraction algorithm that is based upon fitting with spectral libraries derived from separately-acquired measurements of the underlying tissue components. This approach allows for accurate spectral unmixing despite the fact that similar chemical components (e.g., type I collagen) are present in both soft tissue and bone and was applied to experimental data in order to transcutaneously detect, to our knowledge for the first time, age- and disease-related spectral

  6. Rationale, design and methods for a randomised and controlled trial to evaluate "Animal Fun" - a program designed to enhance physical and mental health in young children

    Directory of Open Access Journals (Sweden)

    McLaren Sue

    2010-11-01

    Full Text Available Abstract Background Children with poor motor ability have been found to engage less in physical activities than other children, and a lack of physical activity has been linked to problems such as obesity, lowered bone mineral density and cardiovascular risk factors. Furthermore, if children are confident with their fine and gross motor skills, they are more likely to engage in physical activities such as sports, crafts, dancing and other physical activity programs outside of the school curriculum which are important activities for psychosocial development. The primary objective of this project is to comprehensively evaluate a whole of class physical activity program called Animal Fun designed for Pre-Primary children. This program was designed to improve the child's movement skills, both fine and gross, and their perceptions of their movement ability, promote appropriate social skills and improve social-emotional development. Methods The proposed randomized and controlled trial uses a multivariate nested cohort design to examine the physical (motor coordination and psychosocial (self perceptions, anxiety, social competence outcomes of the program. The Animal Fun program is a teacher delivered universal program incorporating animal actions to facilitate motor skill and social skill acquisition and practice. Pre-intervention scores on motor and psychosocial variables for six control schools and six intervention schools will be compared with post-intervention scores (end of Pre-Primary year and scores taken 12 months later after the children's transition to primary school Year 1. 520 children aged 4.5 to 6 years will be recruited and it is anticipated that 360 children will be retained to the 1 year follow-up. There will be equal numbers of boys and girls. Discussion If this program is found to improve the child's motor and psychosocial skills, this will assist in the child's transition into the first year of school. As a result of these changes

  7. Design principles for data- and change-oriented organisational analysis in workplace health promotion.

    Science.gov (United States)

    Inauen, A; Jenny, G J; Bauer, G F

    2012-06-01

    This article focuses on organizational analysis in workplace health promotion (WHP) projects. It shows how this analysis can be designed such that it provides rational data relevant to the further context-specific and goal-oriented planning of WHP and equally supports individual and organizational change processes implied by WHP. Design principles for organizational analysis were developed on the basis of a narrative review of the guiding principles of WHP interventions and organizational change as well as the scientific principles of data collection. Further, the practical experience of WHP consultants who routinely conduct organizational analysis was considered. This resulted in a framework with data-oriented and change-oriented design principles, addressing the following elements of organizational analysis in WHP: planning the overall procedure, data content, data-collection methods and information processing. Overall, the data-oriented design principles aim to produce valid, reliable and representative data, whereas the change-oriented design principles aim to promote motivation, coherence and a capacity for self-analysis. We expect that the simultaneous consideration of data- and change-oriented design principles for organizational analysis will strongly support the WHP process. We finally illustrate the applicability of the design principles to health promotion within a WHP case study.

  8. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    Science.gov (United States)

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  9. Designing the Optimal Health Assessment System: the Cleveland Quality Choice (CHQC) example.

    Science.gov (United States)

    Sirio, C A; Harper, D

    1996-01-01

    Cleveland Health Quality Choice (CHQC) is an ongoing collaborative partnership between business, hospitals, and physicians designed to assess the performance of health care institutions in the greater Cleveland metropolitan area. CHQC coordinates the collection of data for analysis of intensive care unit outcomes; general medical, surgical and obstetric outcomes; and patient satisfaction. CHQC has documented improved outcomes in all measured spheres over a 4-year period. Its success can be attributed to a leadership strategy focused on providing rigorously tested analytic tools and a shared vision regarding the value of outcome information in assessing institutional performance. CHQC can serve as a model for communities interested in creating joint programs between purchasers and providers of health care to measure health outcomes.

  10. Systems modelling and simulation in health service design, delivery and decision making.

    Science.gov (United States)

    Pitt, Martin; Monks, Thomas; Crowe, Sonya; Vasilakis, Christos

    2016-01-01

    The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future.

  11. mHealth: A Design of an Exercise Recommendation System for the Android Operating System

    Directory of Open Access Journals (Sweden)

    Pongpisit WUTTIDITTACHOTTI

    2014-05-01

    Full Text Available For healthiness and wellness, exercising is one of the key factors. Therefore, this paper aims to present the first phase of a mobile health application developed to recommend healthcare support referring to exercises on an Android smartphone. This application has been designed to provide exercise advice depending on Body Mass Index (BMI, Basal Metabolic Rate (BMR and the energy used in each activity or sport (e.g. aerobic dancing, cycling, jogging working and swimming. Also, this application has been designed to present special exercise advice for patients with health issues. Moreover, it has been designed to store information in a database and to have the ability to produce reports to users. After designing, this proposed mHealth application has been evaluated by 30 subjects who have computer programming skills. It has been found that all diagrams, including use the case diagram, sequence diagrams and overall were assessed as ‘good’, except the part of user interfaces that was assessed as ‘fair’. Therefore, this design can be used to implement in the next phase of this application development with minor revision concerning the user interfaces.

  12. Are Biophilic-Designed Site Office Buildings Linked to Health Benefits and High Performing Occupants?

    Directory of Open Access Journals (Sweden)

    Tonia Gray

    2014-11-01

    Full Text Available This paper discusses the first phase of a longitudinal study underway in Australia to ascertain the broad health benefits of specific types of biophilic design for workers in a building site office. A bespoke site design was formulated to include open plan workspace, natural lighting, ventilation, significant plants, prospect and views, recycled materials and use of non-synthetic materials. Initial data in the first three months was gathered from a series of demographic questions and from interviews and observations of site workers. Preliminary data indicates a strong positive effect from incorporating aspects of biophilic design to boost productivity, ameliorate stress, enhance well-being, foster a collaborative work environment and promote workplace satisfaction, thus contributing towards a high performance workspace. The longitudinal study spanning over two years will track human-plant interactions in a biophilic influenced space, whilst also assessing the concomitant cognitive, social, psychological and physical health benefits for workers.

  13. Are biophilic-designed site office buildings linked to health benefits and high performing occupants?

    Science.gov (United States)

    Gray, Tonia; Birrell, Carol

    2014-11-26

    This paper discusses the first phase of a longitudinal study underway in Australia to ascertain the broad health benefits of specific types of biophilic design for workers in a building site office. A bespoke site design was formulated to include open plan workspace, natural lighting, ventilation, significant plants, prospect and views, recycled materials and use of non-synthetic materials. Initial data in the first three months was gathered from a series of demographic questions and from interviews and observations of site workers. Preliminary data indicates a strong positive effect from incorporating aspects of biophilic design to boost productivity, ameliorate stress, enhance well-being, foster a collaborative work environment and promote workplace satisfaction, thus contributing towards a high performance workspace. The longitudinal study spanning over two years will track human-plant interactions in a biophilic influenced space, whilst also assessing the concomitant cognitive, social, psychological and physical health benefits for workers.

  14. Beyond motivation: job and work design for development, health, ambidexterity, and more.

    Science.gov (United States)

    Parker, Sharon K

    2014-01-01

    Much research shows it is possible to design motivating work, which has positive consequences for individuals and their organizations. This article reviews research that adopts this motivational perspective on work design, and it emphasizes that it is important to continue to refine motivational theories. In light of continued large numbers of poor-quality jobs, attention must also be given to influencing practice and policy to promote the effective implementation of enriched work designs. Nevertheless, current and future work-based challenges mean that designing work for motivation is necessary but insufficient. This review argues that work design can be a powerful vehicle for learning and development, for maintaining and enhancing employees' physical and mental health, and for achieving control and flexibility simultaneously (for example, in the form of ambidexterity); all these outcomes are important given the challenges in today's workplaces. The review concludes by suggesting methodological directions.

  15. Intake of Novel Red Clover Supplementation for 12 Weeks Improves Bone Status in Healthy Menopausal Women

    Directory of Open Access Journals (Sweden)

    Anne Cathrine Thorup

    2015-01-01

    Full Text Available Objective. To investigate the effect by which daily consumption of a novel red clover (RC extract influences bone health, inflammatory status, and cardiovascular health in healthy menopausal women. Design. A 12-week randomized, double-blinded, placebo-controlled trial involving 60 menopausal women receiving a daily dose of 150 mL RC extract containing 37.1 mg isoflavones (33.8 mg as aglycones or placebo. Methods. Bone parameters were changes in bone mineral density (BMD, bone mineral content (BMC, and T-score at the lumbar spine and femoral neck. Bone turnover (CTx and inflammatory markers were measured in plasma and finally blood pressure (BP was evaluated. Results. RC extract had positive effect on bone health, and only the women receiving the placebo experienced a decline in BMD (p<0.01 at the lumbar spine. T-score at the lumbar spine only decreased in the placebo group (p<0.01. CTx decreased in the RC group with −9.94 (±4.93%, although not significant. Conclusion. Daily consumption of RC extract over a 12-week period was found to have a beneficial effect on bone health in menopausal women based on BMD and T-score at the lumbar spine and plasma CTx levels. No changes in BP or inflammation markers were found and no side effects were observed.

  16. The problems of design and construction of health facilities in Angola

    Directory of Open Access Journals (Sweden)

    Bindanda Antonio Afonso

    2014-03-01

    Full Text Available Angola is a country with great economic potential, which can contribute to the solution of construction, architecture and social problems of the country in case of rational use of financial resources. The author focuses on the negative factors that prevent the health authorities from the efficient construction of large hospitals and clinical facilities in Angola. Brief description of the Angolan population is given. The article provides a brief overview of the climate and overall social health problems. Basing on the stated goals, the following problems are considered: Features of architectural and planning decisions of clinical facilities and a brief description of the existing hospitals. The article deals with those minor progressive changes in planning decisions and in the siting of health facilities. Space-planning decisions, the most rational options and requirements for building new hospitals in Angola. The author indentified the main factors that influence architectural solutions for the design and construction of medical facilities. The most rational design options for clinic hospitals were determined. The objectives of the study were formulated with a view to identifying architectural solutions in the construction of new clinical hospitals. The main objective of the study is to improve health care in Angola. The problems are considered in order to identify rational architectural design of new clinical hospitals.

  17. Quality of life measurement in bone metastases: A literature review

    Directory of Open Access Journals (Sweden)

    Sukirtha Tharmalingam

    2008-12-01

    Full Text Available Sukirtha Tharmalingam, Edward Chow, Kristin Harris, Amanda Hird, Emily SinclairRapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, CanadaAbstract: Quality of life (QOL has become an important consideration in the care of patients with bone metastases as prevalence, incidence and patient survival are on the rise. As a result, more interventional studies now measure patient’s QOL as a meaningful endpoint. However, well-developed bone metastases specific quality of life instruments are lacking. A literature review was conducted to better understand the nature of QOL instruments used in bone metastases trials. A total of 47 articles evaluating QOL in patients with bone metastases were identified. Twenty-five different instruments were used to evaluate QOL with study-designed questionnaires and the EORTC QLQ-C30 being most commonly employed. Many studies used more than one scale or instrument to measure QOL. This makes it difficult to compare QOL in bone metastases patients across studies and come to any formal conclusions. Therefore, this review demonstrates the need to develop a bone module that can be used across countries in future clinical trials.Keywords: bone metastases, quality of life, QOL instrument, review

  18. Design and Psychometric Properties of Male Adolescent Health Needs-Assessment Scale

    Science.gov (United States)

    Zare, Elham; Simbar, Masoumeh; Shahhosseini, Zohreh; Alavi Majd, Hamid

    2016-01-01

    ABSTRACT Background: Given the importance of adolescents’ health in establishing health in the newly thriving generation of every society, the first step for adolescents’ health promotion is health needs assessment. The present study was, therefore, conducted to design a valid and reliable scale for health needs assessment of male adolescents. Methods: This is an exploratory sequential mixed method study (2014-2015). The qualitative part was performed using content analysis approach and aimed to generate items pool. Data collection was performed by 7 focus group discussions with 51 male adolescents, and 10 semi-structured in-depth interviews with 10 other adolescents. Nine further in-depth interviews were also performed with 9 key informants. Purposive sampling was used and continued until data saturation. In the quantitative part, the designed scale was psychometrically assessed through the examination of the face and content validities using qualitative and quantitative methods and also the construct validity using the exploratory factor analysis along with the tool’s internal consistency and stability. Results: The content analysis of the data from the qualitative part led to the extraction of 4 main themes and 103 items, which moved to the quantitative stage. The mean content validity index of the scale was estimated 0.91 and content validity ratio was 0.89. The exploratory factor analysis showed 4 factors for the designed scale (49 items), including physical, psychological, social and sexual health needs. The internal consistency and the stability assessment of the scale showed 0.79 and 0.89, respectively. (Phealth needs assessment of male adolescents. PMID:27713893

  19. Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

    OpenAIRE

    2003-01-01

    We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) we...

  20. Exploring qualitative research synthesis: the role of patients' perspectives in health policy design and decision making.

    Science.gov (United States)

    Hansen, Helle Ploug; Draborg, Eva; Kristensen, Finn Børlum

    2011-01-01

    Health systems are placing more and more emphasis on the design and delivery of services that are focused on the patient, and there is a growing interest in patient involvement in health policy research and health technology assessment (HTA). Furthermore, there is a growing research interest in eliciting patients' views, not only on 'what works' for patients but also on the need for intervention and on factors influencing the implementation of particular health technologies, their appropriateness and acceptability. This article focuses on qualitative research synthesis in eliciting patients' perspectives. Its aim is to bring research closer to policy development and decision making, to facilitate better use of research findings for health and welfare, to generate a body of evidence, and to ensure that effective and appropriate information is used in health policy decision design. A variety of synthesizing approaches in qualitative research are explored, such as meta-synthesis, meta-summary, meta-ethnography, and meta-study, focusing especially on methodology. Meta-synthesis and meta-ethnography are probably the most frequently cited approaches in qualitative research synthesis and have perhaps the most developed methodology. The implications of these various synthesizing approaches in relation to health policy and HTA are discussed, and we suggest that meta-synthesis and meta-summary are particularly useful approaches. They have an explicit focus on 'evidence synthesis', fairly clear methodologies, and they are designed to not only present interpretations of the findings but also integrate research findings. Qualitative research synthesis enables researchers to synthesize findings from multiple qualitative studies on patients' perspectives instead of establishing new, expensive, and perhaps redundant studies that might intrude on the lives of patients. Qualitative research synthesis is highly recommended by decision makers and in health policy research and HTA. In

  1. Low-dose hydrocortisone (HC) replacement therapy is associated with improved bone remodeling balance in hypopituitary subjects

    LENUS (Irish Health Repository)

    Behan, L A

    2011-06-01

    The effect of commonly used glucocorticoid replacement regimens on bone health in hypopituitary subjects is not well known. We aimed to assess the effect of 3 hydrocortisone (HC) replacement dose regimens on bone turnover in this group.10 hypopituitary men with severe ACTH deficiency were randomised in a crossover design to 3 HC dose regimens, Dose A (20mg mane, 10mg tarde), Dose B (10mg twice daily) and Dose C (10mg mane, 5mg tarde). Following 6 weeks of each regimen participants underwent fasting sampling of bone turnover markers.Data from matched controls were used to produce a Z score for subject bone formation and resorption markers and to calculate the bone remodeling balance (formation Z score-resorption Z score) and turnover index ((formation Z + resorption Z)\\/2). A positive bone remodeling balance with increased turnover is consistent with a favourable bone cycle. Data are expressed as median (range).The Pro Collagen Type 1 Peptide (PINP) bone formation Z-score was significantly increased in Dose C, (1.805 (-0.6-10.24)) compared to Dose A (0.035 (-1.0-8.1)) p<0.05 while there was no difference in the C-terminal crosslinking telopeptide (CTx) resorption Z score. The bone remodeling balance was significantly lower for dose A -0.02 (-1.05-4.12) compared to dose C 1.13 (0.13-6.4) (p<0.05). Although there was a trend to an increased bone turnover index with the lower dose regimen, this was not statistically significant.Low dose HC replacement (10mg mane\\/5 mg tarde) was associated with increased bone formation and improved bone remodeling balance which is associated with a more favourable bone cycle. This may have a long term beneficial effect on bone health.

  2. A framework for contexual design and evaluation of health information technology.

    Science.gov (United States)

    Kuziemsky, Craig; Kushniruk, Andre

    2015-01-01

    Poor contextual fit is a significant cause of health information technology (HIT) implementation issues. While the need for better fit of HIT and context has been well described there is a shortcoming of approaches for how to do it. While the diversity of the contexts where HIT is used prevents us from designing HIT to fit all contexts, if we had better ways of understanding and modelling contexts we could design and evaluate HIT to better fit contexts of use. This paper addresses the above need by developing a framework consisting of a set of terminology and concepts for modelling contextual structures and behaviours to support HIT design. The framework provides a way of binding contextual considerations to allow us to better model contexts as part of HIT design and evaluation.

  3. Brainstorming Design for Health: Helping Patients Utilize Patient-Generated Information on the Web.

    Science.gov (United States)

    Huh, Jina; Hartzler, Andrea; Munson, Sean; Anderson, Nick; Edwards, Kelly; Gore, John L; McDonald, David; O'Leary, Jim; Parker, Andrea; Streat, Derek; Yetisgen-Yildiz, Meliha; Pratt, Wanda; Ackerman, Mark S

    2012-01-01

    Researchers and practitioners show increasing sinterest in utilizing patient-generated information on the Web. Although the HCI and CSCW communities have provided many exciting opportunities for exploring new ideas and building broad agenda in health, few venues offer a platform for interdisciplinary and collaborative brainstorming about design challenges and opportunities in this space. The goal of this workshop is to provide participants with opportunities to interact with stakeholders from diverse backgrounds and practices-researchers, practitioners, designers, programmers, and ethnographers-and together generate tangible design outcomes that utilize patient-generated information on the Web. Through small multidisciplinary group work, we will provide participants with new collaboration opportunities, understanding of the state of the art, inspiration for future work, and ideally avenues for continuing to develop research and design ideas generated at the workshop.

  4. The relationships among bone health, insulin-like growth factor-1 and sex hormones in adolescent female athletes.

    Science.gov (United States)

    Gruodyte, Rita; Jürimäe, Jaak; Saar, Meeli; Jürimäe, Toivo

    2010-05-01

    The aim of this study was to determine the relationships of bone mineral density (BMD) and content (BMC) with insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3) and estradiol in pubertal female athletes. The participants were 170 healthy adolescent girls (13-15 years) who participated in competitive extramural athletic programs, i.e., sports games (n = 49), track sprinting (n = 24), rhythmic gymnastics (n = 23), swimming (n = 24) and cross-country skiing (n = 17). The control group (n = 33) consisted of girls who took part only in compulsory physical education classes at school. The whole-body BMD and femoral neck and lumbar spine BMD and BMC were measured using DXA, and the volumetric BMD was calculated. Venous blood samples to determine the concentration of IGF-1, IGFBP-3 and estradiol were drawn after an overnight fasting. After adjusting for age, body height and body mass, the relationships among BMD variables, IGF-1 and the IGF-1/IGFBP-3 molar ratio remained significant only in the rhythmic gymnast group. BMDs at the femoral neck and lumbar spine were also related to estradiol levels (r = 0.45-0.60; p < 0.05) only in the rhythmic gymnast group. No relationships were found among the measured BMD, IGF axis and estradiol in other athletic groups. Only BMC at the femoral neck remained associated with the IGF-1/IGFBP-3 molar ratio in the rhythmic gymnast group after adjusting for age, body height and body mass. Stepwise multiple regression analysis indicated that IGF-1 and estradiol together explained 42.6% (R(2) x 100) of total variance in the femoral neck BMD and IGF-1 alone 35.4% (R(2) x 100) of the total variance in the femoral neck BMC only in the rhythmic gymnast group. We conclude that femoral neck and lumbar spine BMD correlated with IGF-1, IGF-1/IGFBP-3 molar ratio and estradiol in rhythmic gymnasts. No relationships were found between bone parameters and the hormones used in other athletic groups.

  5. Design of a Prognostics and Health Management System for Electromechanical Equipment Through Time Stress Analysis

    Institute of Scientific and Technical Information of China (English)

    L(U) Ke-hong; QIU Jing; LIU Guan-jun

    2008-01-01

    Time stress includes all kinds of environment and operating stress such as shock, vibration, temperature and electric current that the electromechanical system suffers in the manufacture, transport and operating process. In this paper, the conception of time stress and prognostics and health management (PHM) system are introduced. Then, in order to improve the false alarm recognition and fault prediction capabilities of the electromechanical equipment, a novel PHM architecture for electromechanical equipment is put forward based on a built-in test (BIT) system design technology and time stress analysis method. Finally, the structure, the design and implementing method and the functions of each module of this PHM system are described in detail.

  6. Design and validation of wireless acceleration sensor network for structural health monitoring

    Institute of Scientific and Technical Information of China (English)

    Yu Yan; Ou Jinping

    2006-01-01

    A wireless sensor network is proposed to monitor the acceleration of structures for the purpose of structural health monitoring of civil engineering structures. Using commercially available parts, several modules are constructed and integrated into complete wireless sensors and base stations. The communication protocol is designed and the fusion arithmetic of the temperature and acceleration is embedded in the wireless sensor node so that the measured acceleration values are more accurate. Measures are adopted to finish energy optimization, which is an important issue for a wireless sensor network. The test is performed on an offshore platform model, and the experimental results are given to show the feasibility of the designed wireless sensor network.

  7. The role of change management in the District Health Authority Consolidation (Transition and Design) project in Nova Scotia.

    Science.gov (United States)

    Stevenson, Colin; Burstall, Dawn

    2016-03-01

    The District Health Authority Consolidation (Transition and Design) project in Nova Scotia was initiated to consolidate the existing nine district health authorities into one provincial health authority. This article provides an overview of the internal change management approach and activities that were developed to support the various phases of the design and transition process. Three phases of work are outlined, and specific change management activities are described as are lessons learned from the overall approach.

  8. Developing the DESCARTE Model: The Design of Case Study Research in Health Care.

    Science.gov (United States)

    Carolan, Clare M; Forbat, Liz; Smith, Annetta

    2016-04-01

    Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered.

  9. Investigating the health implications of social policy initiatives at the local level: study design and methods

    Directory of Open Access Journals (Sweden)

    Carey Gemma E

    2010-12-01

    Full Text Available Abstract Background In this paper we present the research design and methods of a study that seeks to capture local level responses to an Australian national social policy initiative, aimed at reducing inequalities in the social determinants of health. Methods/Design The study takes a policy-to-practice approach and combines policy and stakeholder interviewing with a comparative case study analysis of two not-for-profit organisations involved in the delivery of federal government policy. Discussion Before the health impacts of broad-scale policies, such as the one described in this study, can be assessed at the population level, we need to understand the implementation process. This is consistent with current thinking in political science and social policy, which has emphasised the importance of investigating how, and if, policies are translated into operational realities.

  10. A review of user-centered design for diabetes-related consumer health informatics technologies.

    Science.gov (United States)

    LeRouge, Cynthia; Wickramasinghe, Nilmini

    2013-07-01

    User-centered design (UCD) is well recognized as an effective human factor engineering strategy for designing ease of use in the total customer experience with products and information technology that has been applied specifically to health care information technology systems. We conducted a literature review to analyze the current research regarding the use of UCD methods and principles to support the development or evaluation of diabetes-related consumer health informatics technology (CHIT) initiatives. Findings indicate that (1) UCD activities have been applied across the technology development life cycle stages, (2) there are benefits to incorporating UCD to better inform CHIT development in this area, and (3) the degree of adoption of the UCD process is quite uneven across diabetes CHIT studies. In addition, few to no studies report on methods used across all phases of the life cycle with process detail. To address that void, the Appendix provides an illustrative case study example of UCD techniques across development stages.

  11. Calcium, vitamin D and bone

    OpenAIRE

    Borg, Andrew A.

    2012-01-01

    Calcium, protein and vitamin D are the main nutrients relevant to bone health. This short article discusses the importance of vitamin D and its relation to calcium homeostasis. The various causes, clinical manifestations and treatment are outlined.

  12. Designing serious video games for health behavior change: current status and future directions.

    Science.gov (United States)

    Thompson, Debbe

    2012-07-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player's knowledge and skill, ways in which personal mastery experiences can be incorporated into a video game environment, using game characters and avatars to promote observational learning, creating personalized experiences through tailoring, and the importance of achieving a balance between "fun-ness" and "seriousness." The article concludes with suggestions for future research needed to inform this rapidly growing field.

  13. Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors.

    Science.gov (United States)

    Ratwani, Raj M; Fairbanks, Rollin J; Hettinger, A Zachary; Benda, Natalie C

    2015-11-01

    The usability of electronic health records (EHRs) continues to be a point of dissatisfaction for providers, despite certification requirements from the Office of the National Coordinator that require EHR vendors to employ a user-centered design (UCD) process. To better understand factors that contribute to poor usability, a research team visited 11 different EHR vendors in order to analyze their UCD processes and discover the specific challenges that vendors faced as they sought to integrate UCD with their EHR development. Our analysis demonstrates a diverse range of vendors' UCD practices that fall into 3 categories: well-developed UCD, basic UCD, and misconceptions of UCD. Specific challenges to practicing UCD include conducting contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization. The results of the study provide novel insights for how to improve usability practices of EHR vendors.

  14. Materiomics for Oral Disease Diagnostics and Personal Health Monitoring: Designer Biomaterials for the Next Generation Biomarkers.

    Science.gov (United States)

    Zhang, Wenjun; Wang, Ming L; Khalili, Sammy; Cranford, Steven W

    2016-01-01

    We live in exciting times for a new generation of biomarkers being enabled by advances in the design and use of biomaterials for medical and clinical applications, from nano- to macro-materials, and protein to tissue. Key challenges arise, however, due to both scientific complexity and compatibility of the interface of biology and engineered materials. The linking of mechanisms across scales by using a materials science approach to provide structure-process-property relations characterizes the emerging field of 'materiomics,' which offers enormous promise to provide the hitherto missing tools for biomaterial development for clinical diagnostics and the next generation biomarker applications towards personal health monitoring. Put in other words, the emerging field of materiomics represents an essentially systematic approach to the investigation of biological material systems, integrating natural functions and processes with traditional materials science perspectives. Here we outline how materiomics provides a game-changing technology platform for disruptive innovation in biomaterial science to enable the design of tailored and functional biomaterials--particularly, the design and screening of DNA aptamers for targeting biomarkers related to oral diseases and oral health monitoring. Rigorous and complementary computational modeling and experimental techniques will provide an efficient means to develop new clinical technologies in silico, greatly accelerating the translation of materiomics-driven oral health diagnostics from concept to practice in the clinic.

  15. Why Health Care Needs Design Research: Broadening the Perspective on Communication in Pediatric Care Through Play.

    Science.gov (United States)

    Knutz, Eva; Ammentorp, Jette; Kofoed, Poul-Erik

    2015-01-01

    Today's pediatric health care lacks methods to tap into the emotional state of hospitalized pediatric patients (age 4-6 years). The most frequently used approaches were developed for adults and fail to acknowledge the importance of imaginary experiences and the notion of play that may appeal to children. The scope of this article is to introduce a new design-oriented method of gathering information about the emotional state of pediatric patients using an experimental computer game called the Child Patient game (CPgame). The CPgame was developed at a Danish hospital, and the results of the preliminary tests show that games could serve as a system in which children are willing to express their emotions through play. The results are based on two comparative analyses of the CPgame through which it is possible to identify three different types of players among the patients playing the game. Furthermore, the data reveal that pediatric patients display a radically different play pattern than children who are not in hospital. The inquiry takes an interdisciplinary approach; it has obvious health care-related objectives and seeks to meet the urgent need for new methods within health care to optimize communication with young children. At the same time, design research (i.e., the development of new knowledge through the development of a new design) heavily impacts the method.

  16. Politics and technology in health information systems development: a discourse analysis of conflicts addressed in a systems design group.

    Science.gov (United States)

    Irestig, Magnus; Timpka, Toomas

    2008-02-01

    Different types of disagreements must be managed during the development of health information systems. This study examines the antagonisms discussed during the design of an information system for 175,000 users in a public health context. Discourse analysis methods were used for data collection and analysis. Three hundred and twenty-six conflict events were identified from four design meetings and divided into 16 categories. There were no differences regarding the types of conflicts that the different participants brought into the design discussions. Instead, conflict occurrence was primarily affected by the agendas that set the stage for examinations and debates. The results indicate that the selection of design method and the structure used for the meetings are important factors for the manner in which conflicts are brought into consideration during health information system design. Further studies comparing participatory and non-participatory information system design practices in health service settings are warranted.

  17. Acumulación de plomo en hueso y sus efectos en la salud Lead storage in bone and its effects on health

    Directory of Open Access Journals (Sweden)

    Luz Helena Sanín

    1998-07-01

    Full Text Available Los efectos nocivos del plomo han sido conocidos desde tiempos antiguos por su amplia gama; este metal afecta prácticamente todos los órganos y sistemas del cuerpo humano. Recientemente se han documentado efectos tóxicos crónicos en los sistemas cardiovascular y nervioso, con niveles que antes se consideraban seguros. El sitio primario de almacenamiento de plomo en el organismo es el hueso, pero sólo hasta fechas recientes se ha clarificado la significancia toxicológica de este hecho. En este artículo se analiza el papel del plomo en hueso como fuente de exposición endógena, como biomarcador de exposición crónica y como tejido blanco. Se presentan además los avances recientes para la medición de plomo en hueso mediante los rayos X-fluorescentes (XRF. Finalmente se revisa la importancia, para la salud pública, de estudiar y medir el plomo en hueso en lugares con una historia de exposición crónica como la Ciudad de México y en los ambientes ocupacionales, especialmente como fuente remanente de exposición. Se analiza especialmente el caso de mujeres en edad reproductiva, quienes pueden convertirse en fuentes de exposición para el feto y para el niño amamantado.The adverse effects of lead have been known for long since the metal affects practically all organs and systems of the human body. Recently, toxic effects have been reported in the cardiovascular and nervous systems at lead levels previously considered to be secure. The main lead storage site in the body is bone. The toxicologic significance of this fact has been clarified only recently. The present study analyzes the role of lead as an endogenous source of exposure, as a chronic exposure biomarker and as a target organ. Recent advances to measure bone lead through fluorescent X-Rays are discussed. Additionally, the importance of bone lead from a public health perspective in places with a chronic history of exposure such as Mexico City, and in some occupational

  18. Function of osteocytes in bone.

    Science.gov (United States)

    Aarden, E M; Burger, E H; Nijweide, P J

    1994-07-01

    Although the structural design of cellular bone (i.e., bone containing osteocytes that are regularly spaced throughout the bone matrix) dates back to the first occurrence of bone as a tissue in evolution, and although osteocytes represent the most abundant cell type of bone, we know as yet little about the role of the osteocyte in bone metabolism. Osteocytes descend from osteoblasts. They are formed by the incorporation of osteoblasts into the bone matrix. Osteocytes remain in contact with each other and with cells on the bone surface via gap junction-coupled cell processes passing through the matrix via small channels, the canaliculi, that connect the cell body-containing lacunae with each other and with the outside world. During differentiation from osteoblasts to mature osteocyte the cells lose a large part of their cell organelles. Their cell processes are packed with microfilaments. In this review we discuss the various theories on osteocyte function that have taken in consideration these special features of osteocytes. These are 1) osteocytes are actively involved in bone turnover; 2) the osteocyte network is through its large cell-matrix contact surface involved in ion exchange; and 3) osteocytes are the mechanosensory cells of bone and play a pivotal role in functional adaptation of bone. In our opinion, especially the last theory offers an exciting concept for which some biomechanical, biochemical, and cell biological evidence is already available and which fully warrants further investigations.

  19. Designing a web-based learning portal for geographic visualization and analysis in public health.

    Science.gov (United States)

    Robinson, Anthony C; MacEachren, Alan M; Roth, Robert E

    2011-09-01

    Interactive mapping and spatial analysis tools are under-utilized by health researchers and decision-makers as a result of scarce training materials, few examples demonstrating the successful use of geographic visualization, and poor mechanisms for sharing results generated by geovisualization. Here, we report on the development of the Geovisual EXplication(G-EX) Portal, a web-based application designed to connect researchers in geovisualization and related mapping sciences, to users who are working in public health and epidemiology. This paper focuses on the design and development of the G-EX Portal Learn module, a set of tools intended to disseminate learning artifacts. Initial design and development of the G-EX Portal has been guided by our past research on the use and usability of geovisualization in public health. As part of the iterative design and development process, we conducted a needs assessment survey with targeted end-users, which we report on here. The survey focused on users' current learning habits, their preferred kind of learning artifacts and issues they may have with contributing learning artifacts to web portals. Survey results showed that users desire a diverse set of learning artifacts in terms of both formats and topics covered. Results also revealed a willingness of users to contribute both learning artifacts and personal information that would help other users to evaluate the credibility of the learning artifact source. We include a detailed description of the G-EX Portal Learn module and focus on modifications to the design of the Learn module as a result from feedback we received from our survey.

  20. Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

    Science.gov (United States)

    Wartha, Olivia; Dreyhaupt, Jens; Lämmle, Christine; Friedemann, Eva-Maria; Kelso, Anne; Kutzner, Claire; Hermeling, Lina

    2017-01-01

    Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. PMID:28303253