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Sample records for bone health designing

  1. 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

  2. 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.

  3. Exercise for Your Bone Health

    Science.gov (United States)

    ... supported by your browser. Home Bone Basics Lifestyle Exercise for Your Bone Health Publication available in: PDF ( ... A Complete Osteoporosis Program For Your Information Why Exercise? Like muscle, bone is living tissue that responds ...

  4. 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...

  5. 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 ...

  6. Vitamin D, Calcium, and Bone Health

    Science.gov (United States)

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

  7. 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 ...

  8. Smoking and Bone Health

    Science.gov (United States)

    ... It has been called a childhood disease with old age consequences because building healthy bones in youth helps ... stronger. Weight-bearing exercise that forces you to work against gravity is the best exercise for bone. ...

  9. 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.

  10. Children's Bone Health and Calcium

    Science.gov (United States)

    ... Trials Resources and Publications Children's Bone Health and Calcium: Condition Information Skip sharing on social media links ... straight, walk, run, and lead an active life. Calcium is one of the key dietary building blocks ...

  11. Bone health in cancer patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... in the metastatic processes required for cancer dissemination, and there are emerging data showing that, at least in some clinical situations, the use of bone-targeted treatments can reduce metastasis to bone and has potential impact on patient survival.......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...

  12. 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.

  13. 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.

  14. Vitamin D and bone health

    International Nuclear Information System (INIS)

    Vitamin D plays an essential role in maintaining a healthy mineralized skeleton for most land vertebrates including humans. Sunlight causes the photoproduction of vitamin D3 in the skin. Once formed, vitamin D3 is metabolized sequentially in the liver and kidney to 1,25-dihydroxyvitamin D. The major biological function of 1,25-dihydroxyvitamin D is to keep the serum calcium and phosphorus concentrations within the normal range to maintain essential cellular functions and to promote mineralization of the skeleton. Most foods do not contain any vitamin D. Foods fortified with vitamin D have a variable amount present and cannot be depended on as a sole source of vitamin D nutrition. Exposure to sunlight provides most humans with their vitamin D requirement. Aging, sunscreen use and the change in the zenith angle of the sun can dramatically affect the cutaneous production of vitamin D3. Vitamin D insufficiency and vitamin D deficiency is now being recognized as a major cause of metabolic bone disease in the elderly. Vitamin D deficiency not only causes osteomalacia but can exacerbate osteoporosis. It is generally accepted that an increase in calcium intake to 1000-1500 mg/d along with an adequate source of vitamin D of at least 400 IU/d is important for maintaining good bone health

  15. 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.

  16. Bone Quest - A Space-Based Science and Health Education Unit

    Science.gov (United States)

    Smith, Scott M.; David-Street, Janis E.; Abrams, Steve A.

    2000-01-01

    This proposal addresses the need for effective and innovative science and health education materials that focus on space bone biology and its implications for bone health on Earth. The focus of these materials, bone biology and health, will increase science knowledge as well as health awareness. Current investigations of the bone loss observed after long-duration space missions provide a link between studies of bone health in space, and studies of osteoporosis, a disease characterized by bone loss and progressive skeletal weakness. The overall goal of this project is to design and develop web-based and print-based materials for high school science students, that will address the following: a) knowledge of normal bone biology and bone biology in a microgravity environment; b) knowledge of osteoporosis; c) knowledge of treatment modalities for space- and Earth-based bone loss; and d} bone-related nutrition knowledge and behavior. To this end, we propose to design and develop a Bone Biology Tutorial which will instruct students about normal bone biology, bone biology in a microgravity environment, osteoporosis - its definition, detection, risk factors, and prevention, treatment modalities for space- and Earth-based bone loss, and the importance of nutrition in bone health. Particular emphasis will be placed on current trends in . adolescent nutrition, and their relationships to bone health. Additionally, we propose to design and develop two interactive nutrition/health ' education activities that will allow students to apply the information provided in the Bone Biology Tutorial. In the first, students will apply constructs provided in the Bone Biology Tutorial to design "Bone Health Plans" for space travelers.

  17. 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.

  18. Oral Health and Bone Disease

    Science.gov (United States)

    ... for periodontitis and tooth loss. Role of the Dentist and Dental X Rays Research supported by the ... normal bone density. Because many people see their dentist more regularly than their doctor, dentists are in ...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Green Tea and Bone Health: Evidence from Laboratory Studies

    OpenAIRE

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

    2011-01-01

    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 etio...

  4. [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.

  5. 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.

  6. 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.

  7. Cycling and bone health: a systematic review

    OpenAIRE

    Olmedillas Hugo; González-Agüero Alejandro; Moreno Luis A; Casajus José A; Vicente-Rodríguez Germán

    2012-01-01

    Abstract Background Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass. Methods A scientific literature search on studies discussing bone mass and bone metabolism in cyclists was performed to collect all relevant published material up to April 2012. Descriptive, cross-sectional, longitudinal and interventional studies were all reviewed. Inclusion criteria...

  8. 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.

  9. Calcium Fructoborate for Bone and Cardiovascular Health.

    Science.gov (United States)

    Mogoşanu, George Dan; Biţă, Andrei; Bejenaru, Ludovic Everard; Bejenaru, Cornelia; Croitoru, Octavian; Rău, Gabriela; Rogoveanu, Otilia-Constantina; Florescu, Dan Nicolae; Neamţu, Johny; Scorei, Iulia Daria; Scorei, Romulus Ion

    2016-08-01

    Calcium fructoborate (CF), a natural sugar-borate ester found in fresh fruits and vegetables, is a source of soluble boron. CF contains three forms of borate (diester, monoester, and boric acid) and all are biologically active, both at the intracellular (as free boric acid) and extracellular level (as fructose-borate diester and monoester). At the cellular and molecular level, CF is superior to the boric acid/borate, exhibiting a complex "protective" effect against inflammatory response. CF is commercially available in the USA as a "nature-identical" complex, an active compound for dietary supplements. It provides effective and safe support against the discomfort and lack of flexibility associated with osteoarticular conditions (arthritis and joint degeneration), and improves Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and McGill indexes. In addition, orally administered CF is effective in ameliorating symptoms of physiological response to stress, including inflammation of the mucous membranes, discomfort associated with osteoarthritis disorders, and bone loss, and also for supporting cardiovascular health. Clinical studies have exhibited the ability of CF to significantly modulate molecular markers associated with inflammatory mechanisms, mainly on the elevated serum levels of C-reactive protein (CRP). PMID:26686846

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Optimizing Bone Health in Duchenne Muscular Dystrophy

    OpenAIRE

    Buckner, Jason L.; Bowden, Sasigarn A.; Mahan, John D

    2015-01-01

    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 serio...

  15. Bone Health in Patients with Multiple Sclerosis

    OpenAIRE

    Vit Zikan

    2011-01-01

    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 reso...

  16. 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…

  17. 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.

  18. 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...

  19. [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. PMID:27439256

  20. [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.

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

    OpenAIRE

    Emma T. Callegari; Nicola Reavley; Suzanne M Garland; Alexandra Gorelik; Wark, John D.; on behalf of the Safe-D study team

    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 i...

  2. 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.

  3. 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.

  4. Personality Traits, Motivation and Bone Health in Vegetarians

    OpenAIRE

    Bobić, Jasminka; Cvijetić, Selma; Colić Barić, Irena; Šatalić, Zvonimir

    2012-01-01

    Vegetarian diets attract more and more attention due to growing concerns about health, ecology and/or animal welfare in general population. The main purpose of this paper was to examine whether vegetarianism could be associated with some specific personality characteristics, with the emphasis on the main motivational factors which determined acquiring the diet. Since the nutrition is also an important determinant of bone health we additionally analyzed the association between personal charact...

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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....

  12. 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.

  13. 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

  14. 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. PMID:23719553

  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.

    2016-01-01

    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

  16. 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.

  17. Bone health in immigrant Hispanic women living in Texas.

    Science.gov (United States)

    Ballard, Joyce E; Cooper, Cheryl M; Bone, Mary A; Saade, Guillermo; Holiday, David B

    2010-10-01

    Osteoporosis is a serious national public health problem, and is expected to increase significantly over the next few decades, especially in women. A limitation of bone health research exists since few studies have involved Hispanic women, and even fewer, Hispanic immigrant women. For this study we examined the effects of anthropometric, behavioral, and health history variables on bone mineral density (BMD) in 84 immigrant Hispanic women, age 40 and above. BMD was assessed at the spine, femur, and forearm using dual energy x-ray absorptiometry (DXA). Demographic information, health histories, and behavioral risk factors were obtained from a questionnaire. In the younger group (mean age = 44.1 years) 61% had spinal osteopenia, and in the postmenopausal group (mean age = 53.0 years) 59% had osteopenia and 13% had osteoporosis. Femur sites were free of osteoporosis. Mean body mass index (BMI) was 31.8 ± 6.1 and mean waist girth was 95.6 ± 12.5 cm, indicating overall and abdominal obesity. Partial correlations indicated a significant positive relationship between body fat variables and total femur BMD values. ANOVAs revealed no differences in BMD values at any bone site across tertile levels for calcium intake or for physical activity. However, supplemental and dietary calcium intakes were very low and few participants engaged in regular physical activity outside of work and activities of daily living (ADL). In light of the expected increase in osteoporosis in this population and the prevalence of spinal osteopenia in the younger participants, education about the health risks of osteoporosis should be made available to this group. PMID:20012477

  18. A comprehensive bone-health management approach for men with prostate cancer receiving androgen deprivation therapy

    OpenAIRE

    Lee, C. E.; Leslie, W.D.; Czaykowski, P.; Gingerich, J.; Geirnaert, M.; Lau, Y.K.J.

    2011-01-01

    For advanced and metastatic prostate cancer, androgen deprivation therapy (adt) is the mainstay of treatment. Awareness of the potential bone-health complications consequent to adt use is increasing. Many studies have shown that prolonged adt leads to significant bone loss and increased fracture risk that negatively affect quality of life. Clinical practice guidelines for preserving bone health in men with prostate cancer on adt vary across Canada. This paper reviews recent studies on bone he...

  19. Optimizing bone health in older adults: the importance of dietary protein

    OpenAIRE

    Surdykowski, Anna K; Kenny, Anne M.; Insogna, Karl L.; Kerstetter, Jane E

    2010-01-01

    Age-related bone loss is progressive and can lead to osteoporosis. While it is accepted that both dietary calcium and vitamin D are important and beneficial for skeletal health, the impact of dietary protein on calcium metabolism and bone balance remains controversial. Contrary to the hypothesis that increasing dietary protein contributes to bone loss, research supports the notion that protein may play a pivotal role in maintenance of bone health by several mechanisms; for example, increasing...

  20. Yacon flour and Bifidobacterium longum modulate bone health in rats.

    Science.gov (United States)

    Rodrigues, Fabiana Carvalho; Castro, Adriano Simões Barbosa; Rodrigues, Vívian Carolina; Fernandes, Sérgio Antônio; Fontes, Edimar Aparecida Filomeno; de Oliveira, Tânia Toledo; Martino, Hércia Stampini Duarte; de Luces Fortes Ferreira, Célia Lúcia

    2012-07-01

    Yacon flour has been considered a food with prebiotic potential because of the high levels of fructooligosaccharides, which allows for its use in formulating synbiotic foods. The purpose of this study was to evaluate the effect of yacon flour and probiotic (Bifidobacterium longum) on the modulation of variables related to bone health. Thirty-two Wistar rats were divided into 4 groups: control, yacon flour, diet+B. longum, and yacon flour+B. longum. After euthanasia, the bones were removed for analysis of biomechanical properties (thickness, length, and strength of fracture) and mineral content (Ca, Mg, and P); the cecum was removed for analysis of the microbiota and short-chain fatty acids. Tibia Ca, P, and Mg content was significantly (Pyacon flour+B. longum than in the control group. An increase in fracture strength was observed in the yacon flour (8.1%), diet+B. longum (8.6%), and yacon flour+B. longum (14.6%) in comparison to the control group. Total anaerobe and weight of the cecum were higher (Pyacon flour diet compared with the other groups. Cecal concentration of propionate was higher in all experimental groups compared with the control (PYacon flour in combination with B. longum helped increase the concentration of minerals in bones, an important factor in the prevention of diseases such as osteoporosis. PMID:22510044

  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. 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.

  3. Conjugated linoleic acid and calcium co-supplementation improves bone health in ovariectomised mice

    OpenAIRE

    Park, Yooheon; Kim, Jonggun; Scrimgeour, Angus G.; Condlin, Michelle L.; Kim, Daeyoung; Park, Yeonhwa

    2013-01-01

    Osteoporosis is a significant health concern for the elderly; conjugated linoleic acid (CLA) has been shown to improve overall bone mass when calcium is included as a co-supplement. However, potential effects of CLA and calcium on bone mass during a period of bone loss have not been reported. The purpose of this study was to determine how dietary calcium modulates the effects of conjugated linoleic acid (CLA) in preventing bone loss, using an ovariectomised mouse model. CLA supplementation si...

  4. 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.

  5. Designing digital health information in a health literacy context

    NARCIS (Netherlands)

    C.S. Meppelink

    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

  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. 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.

  8. 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.

  9. The Personal Health Technology Design Space

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Frost, Mads

    2016-01-01

    . To enable designers to make informed and well-articulated design decision, the authors propose a design space for personal health technologies. This space consists of 10 dimensions related to the design of data sampling strategies, visualization and feedback approaches, treatment models, and regulatory......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...

  10. 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.

  11. 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

  12. 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.

  13. For Strong Bones...For Lifelong Health...Milk Matters!

    Science.gov (United States)

    ... carry your body weight. Activities such as walking, running, dancing, climbing stairs, and playing team sports like basketball, soccer, and volleyball help make bones stronger. Older teenagers ...

  14. 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.

  15. 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

  16. 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.

  17. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  18. 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.

  19. Multiscale Homogenization Theory: An Analysis Tool for Revealing Mechanical Design Principles in Bone and Bone Replacement Materials

    Science.gov (United States)

    Hellmich, Christian; Fritsch, Andreas; Dormieux, Luc

    Biomimetics deals with the application of nature-made "design solutions" to the realm of engineering. In the quest to understand mechanical implications of structural hierarchies found in biological materials, multiscale mechanics may hold the key to understand "building plans" inherent to entire material classes, here bone and bone replacement materials. Analyzing a multitude of biophysical hierarchical and biomechanical experiments through homogenization theories for upscaling stiffness and strength properties reveals the following design principles: The elementary component "collagen" induces, right at the nanolevel, the mechanical anisotropy of bone materials, which is amplified by fibrillar collagen-based structures at the 100-nm scale, and by pores in the micrometer-to-millimeter regime. Hydroxyapatite minerals are poorly organized, and provide stiffness and strength in a quasi-brittle manner. Water layers between hydroxyapatite crystals govern the inelastic behavior of the nanocomposite, unless the "collagen reinforcement" breaks. Bone replacement materials should mimic these "microstructural mechanics" features as closely as possible if an imitation of the natural form of bone is desired (Gebeshuber et al., Adv Mater Res 74:265-268, 2009).

  20. 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.

  1. 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.

  2. 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.

  3. Severe osteopenia in adolescence: poor bone health for life

    OpenAIRE

    Baldan, Alessandro; et al.

    2014-01-01

    Osteoporosis is a systemic skeletal disorder characterized by low bone mass that leads to increased bone fragility and susceptibility to fracture. Lactose intolerance is characterized by abdominal pain and/or diarrhea following the ingestion of lactose in people with lactase deficiency. The most common therapeutic approach to lactose intolerance is to exclude dairy products from the diet, which are the main source of calcium. We studied a group of patients with symptoms attributab...

  4. 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

  5. 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. PMID:27332273

  6. The influence of anthropometry and body composition on children's bone health

    DEFF Research Database (Denmark)

    Heidemann, Malene; Holst, René; Schou, Anders J;

    2015-01-01

    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...

  7. 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.

  8. 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

  9. Selenium in Bone Health: Roles in Antioxidant Protection and Cell Proliferation

    OpenAIRE

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

    2013-01-01

    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...

  10. Design and fabrication of biomimetic multiphased scaffolds for ligament-to-bone fixation.

    Science.gov (United States)

    He, Jiankang; Zhang, Wenyou; Liu, Yaxiong; Li, Xiang; Li, Dichen; Jin, Zhongmin

    2015-05-01

    Conventional ligament grafts with single material composition cannot effectively integrate with the host bones due to mismatched properties and eventually affect their long-term function in vivo. Here we presented a multi-material strategy to design and fabricate composite scaffolds including ligament, interface and bone multiphased regions. The interface region consists of triphasic layers with varying material composition and porous structure to mimic native ligament-to-bone interface while the bone region contains polycaprolactone (PCL) anchor and microchanneled ceramic scaffolds to potentially provide combined mechanical and biological implant-bone fixation. Finite element analysis (FEA) demonstrated that the multiphased scaffolds with interference value smaller than 0.5 mm could avoid the fracture of ceramic scaffold during the implantation process, which was validated by in-vitro implanting the multiphased scaffolds into porcine joint bones. Pull-out experiment showed that the initial fixation between the multiphased scaffolds with 0.47 mm interference and the host bones could withstand the maximum force of 360.31±97.51 N, which can be improved by reinforcing the ceramic scaffolds with biopolymers. It is envisioned that the multiphased scaffold could potentially induce the regeneration of a new bone as well as interfacial tissue with the gradual degradation of the scaffold and subsequently realize long-term biological fixation of the implant with the host bone. PMID:25746239

  11. Designing online health services for patients

    OpenAIRE

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly ac...

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

    Science.gov (United States)

    Che, Chun-Tao; Wong, Man Sau; Lam, Christopher Wai Kei

    2016-01-01

    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. PMID:26927052

  13. 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.

  14. 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.

  15. Designing online health services for patients.

    Science.gov (United States)

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds. PMID:27307985

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

    Science.gov (United States)

    Afsarimanesh, Nasrin; Zia, Asif I.; Mukhopadhyay, Subhas Chandra; Kruger, Marlena; Yu, Pak-Lam; Kosel, Jurgen; Kovacs, Zoltan

    2016-01-01

    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. PMID:27347968

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Nasrin Afsarimanesh

    2016-06-01

    Full Text Available 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.

  19. Designing Mobile Health Technology for Bipolar Disorder

    DEFF Research Database (Denmark)

    Bardram, JE; Frost, Mads; Szántó, Károly;

    2013-01-01

    An increasing number of pervasive healthcare systems are being designed, that allow people to monitor and get feedback on their health and wellness. To address the challenges of self-management of mental illnesses, we have developed the MONARCA system - a personal monitoring system for bipolar...

  20. 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...

  1. 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.

  2. Psychosocial, Environmental and Behavioral Factors Associated with Bone Health in Middle-School Girls

    Science.gov (United States)

    Sharma, Shreela V.; Hoelscher, Deanna M.; Kelder, Steven H.; Day, R. Sue; Hergenroeder, Albert

    2009-01-01

    The purpose of this study was to identify the psychosocial, environmental and behavioral factors associated with calcium intake, physical activity and bone health in a cohort of adolescent girls. Baseline data (N = 718 girls, mean age: 11.6 plus or minus 0.4 years) from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study…

  3. Mental Health Technologies: Designing With Consumers.

    Science.gov (United States)

    Orlowski, Simone; Matthews, Ben; Bidargaddi, Niranjan; Jones, Gabrielle; Lawn, Sharon; Venning, Anthony; Collin, Philippa

    2016-01-01

    Despite growing interest in the promise of e-mental and well-being interventions, little supporting literature exists to guide their design and the evaluation of their effectiveness. Both participatory design (PD) and design thinking (DT) have emerged as approaches that hold significant potential for supporting design in this space. Each approach is difficult to definitively circumscribe, and as such has been enacted as a process, a mind-set, specific practices/techniques, or a combination thereof. At its core, however, PD is a design research tradition that emphasizes egalitarian partnerships with end users. In contrast, DT is in the process of becoming a management concept tied to innovation with strong roots in business and education. From a health researcher viewpoint, while PD can be reduced to a number of replicable stages that involve particular methods, techniques, and outputs, projects often take vastly different forms and effective PD projects and practice have traditionally required technology-specific (eg, computer science) and domain-specific (eg, an application domain, such as patient support services) knowledge. In contrast, DT offers a practical off-the-shelf toolkit of approaches that at face value have more potential to have a quick impact and be successfully applied by novice practitioners (and those looking to include a more human-centered focus in their work). Via 2 case studies we explore the continuum of similarities and differences between PD and DT in order to provide an initial recommendation for what health researchers might reasonably expect from each in terms of process and outcome in the design of e-mental health interventions. We suggest that the sensibilities that DT shares with PD (ie, deep engagement and collaboration with end users and an inclusive and multidisciplinary practice) are precisely the aspects of DT that must be emphasized in any application to mental health provision and that any technology development process must

  4. 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.

  5. 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.

  6. Dietary intakes of expeditioners during prolonged sunlight deprivation in polar enviroments do not support bone health

    Directory of Open Access Journals (Sweden)

    Sandra Iuliano

    2015-08-01

    Full Text Available Background: Early Antarctic expeditions were plagued by nutrient deficiencies, due to lack of fresh food and reliance on preserved foods. Modern Antarctic expeditioners also require provisions to be shipped in, but improved knowledge and storage options ensure foods are nutritionally sound. Despite this, nutritional imbalances are observed. Objectives: To determine the adequacy of dietary intake of Antarctic expeditioners, with reference to bone health. Design: Dietary intake was determined on 225 adults (mean age 42±11 years, 16% female during 12-month deployments at Australian Antarctic stations from 2004 to 2010, using weighed 3-day food records. Nutrient intake was analysed using FoodWorks. Foods were divided into the 5 food groups according to the Australian Guide to Healthy Eating. Results: Men consumed below the recommended levels [recommended daily intake (RDI/adequate intakes (AI] of calcium (79±42% of RDI, p<0.001, magnesium (83±34% of RDI, p<0.001, potassium (86±29% of AI, p<0.001 and fibre (75±30% of AI, p<0.001, and above the upper limit (UL for sodium (125±48% of UL p<0.001, whereas women consumed below the recommended levels of calcium (68±21% of RDI, p<0.001 and iron (73±37% of RDI, p<0.001. Vitamin D intake is not substantial (<150 IU/d. Men consumed more alcohol than women (18±24 g/d vs. 10±13 g/d, p<0.05, nearer the guideline of ≤20 g/d. Men and women consumed approximately 1 serving of dairy food per day, and 3 of 5 recommended vegetable servings. Discretionary foods were consumed in excess of recommended. Conclusions: Improving consumption of calcium-rich (dairy foods better supports bone health during sunlight deprivation. Increasing vegetable intake to recommended levels will increase fibre, potassium and magnesium intakes. The challenge is the logistics of providing these foods throughout the year.

  7. 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.

  8. In Vitro Assessment of Primary Stability of BoneTrust Sinus Implant Design.

    Science.gov (United States)

    Gülses, Aydin; Ayna, Mustafa; Güçlü, Hakan; Sencimen, Metin; Basiry, M Nabi; Gierloff, Matthias; Açil, Yahya

    2016-01-01

    The aim of this study was to analyze the primary stability of BoneTrust Sinus implants (BTSIs), which are intended to enable higher primary stability by their special design with reduced thread section in cases of reduced vertical bone availability, in comparison with standard BoneTrust implants (SBTIs) in vitro. A bone window 3 cm in length, 4 cm in width, and 3 cm in depth, resembling the maxillary bone window of the lateral sinus wall with 4 mm of residual bone height, was prepared at the dorsal side of freshly slaughtered bovine ribs. One single BTSI and a single SBTI with the same diameter (4 or 5 mm) were placed in each window. After implant placement, the implant stability quotient (ISQ) was measured by using resonance frequency analysis with an Osstell device. A total of 88 implants were placed. ISQ values varied between 63 and 84. Among the implants with 4-mm diameter, all BTSIs showed higher ISQ values compared with SBTIs. One-way analysis of variance showed a significant difference between BTSIs/SBTIs (P < .05). BTSIs with 4-mm diameter showed statistically higher values compared to BTSIs with 5-mm diameter (P < .05). Among the implants with 5-mm diameter, all SBTIs showed higher ISQ values compared to BTSIs but there was no significant difference. The use of 4-mm-diameter BTSIs could present higher ISQ values during simultaneous implant placement in conjunction with lateral sinus floor augmentation. PMID:27560678

  9. 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

  10. Lifecourse study of bone health at age 49–51 years: the Newcastle thousand families cohort study

    OpenAIRE

    Pearce, M; Birrell, F.; Francis, R; Rawlings, D; Tuck, S; Parker, L.

    2005-01-01

    Objective: To quantify the direct and indirect effects of fetal (position in family, weight, and social class at birth), childhood (breast feeding, growth, infections, and social class in childhood, age at menarche), and adult life (social class, alcohol consumption, smoking, diet, reproductive history, exercise, hormone replacement therapy use), and adult size (height, weight) on bone health at age 49–51 years, as measured by bone mineral density, total scanned bone area of the hip and lumba...

  11. Dissemination of a theory-based online bone health program: Two intervention approaches.

    Science.gov (United States)

    Nahm, Eun-Shim; Resnick, Barbara; Bellantoni, Michele; Zhu, Shijun; Brown, Clayton; Brennan, Patricia F; Charters, Kathleen; Brown, Jeanine; Rietschel, Matthew; Pinna, Joanne; An, Minjeong; Park, Bu Kyung; Plummer, Lisa

    2015-06-01

    With the increasing nationwide emphasis on eHealth, there has been a rapid growth in the use of the Internet to deliver health promotion interventions. Although there has been a great deal of research in this field, little information is available regarding the methodologies to develop and implement effective online interventions. This article describes two social cognitive theory-based online health behavior interventions used in a large-scale dissemination study (N = 866), their implementation processes, and the lessons learned during the implementation processes. The two interventions were a short-term (8-week) intensive online Bone Power program and a longer term (12-month) Bone Power Plus program, including the Bone Power program followed by a 10-month online booster intervention (biweekly eHealth newsletters). This study used a small-group approach (32 intervention groups), and to effectively manage those groups, an eLearning management program was used as an upper layer of the Web intervention. Both interventions were implemented successfully with high retention rates (80.7% at 18 months). The theory-based approaches and the online infrastructure used in this study showed a promising potential as an effective platform for online behavior studies. Further replication studies with different samples and settings are needed to validate the utility of this intervention structure. PMID:26021668

  12. 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. PMID:26773669

  13. 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.

  14. Environmental, health, and safety by design

    International Nuclear Information System (INIS)

    Solar Turbines Incorporated created a self-directed work team, the Safety and Environmental Awareness (SEA) Team that initiated a company wide effort to raise employee awareness to promote integrating responsible environmental, health, and safety practices into product design, manufacturing, and services. Environmental, health, and safety issues influence how all businesses operate around the world. Companies choose to operate in an environmentally responsible manner because it not only benefits employees and the communities where they live, it also benefits the business when superior performance results in a competitive advantage. Solar surveyed gas turbines users to identify their top environmental and safety concerns and issues. The authors asked about various environmental and safety aspects of their equipment. Results from the survey has helped engineering and design focus efforts so that future products and product improvements assist customers in meeting their regulatory obligations and social responsibilities. Air pollution has historically been one of the most important environmental issues facing customers, because pollutant emissions greatly influence equipment choices and operation flexibility. There are other environmental, health and safety issues: sustainable fire suppression choices, start systems, hazardous materials use and ability to recycle materials, package accessibility, noise and product take back issues

  15. Facts about Broken Bones

    Science.gov (United States)

    ... White House Lunch Recipes The Facts About Broken Bones KidsHealth > For Kids > The Facts About Broken Bones ... through the skin . continue What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  16. 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...

  17. “Vitamin D supplementation and bone health in adults with diabetic nephropathy: the protocol for a randomized controlled trial”

    OpenAIRE

    Mager, Diana R; Jackson, Stephanie T; Hoffmann, Michelle R; Jindal, Kailash; Senior, Peter A.

    2014-01-01

    Background Suboptimal vitamin D status is highly prevalent in Northern communities, particularly in those patients with chronic diseases such as diabetes and chronic renal disease. Emerging literature suggests that adherence to daily vitamin D supplementation may be an important factor influencing vitamin D status and overall bone health, but compliance with therapies for bone health is a major challenge. It is unknown what level of vitamin D supplementation will ameliorate or improve subopti...

  18. Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study.

    Science.gov (United States)

    Ward, Kate A; Prentice, Ann; Kuh, Diana L; Adams, Judith E; Ambrosini, Gina L

    2016-06-01

    Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis-based dietary patterns and bone health. We investigated whether a protein-calcium-potassium-rich (PrCaK-rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size-adjusted bone mineral content (SA-BMC) and volumetric bone mineral density (vBMD). A food-based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z-scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z-scores were modeled to summarize changes in Z-scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z-score and other confounders. A consistent PrCaK-rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z-scores at age 36 years and age 60 to 64 years were -0.32 ± 0.97 and 2.2 ± 1.5 (women) and -0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z-scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02-SD unit/year higher trajectory in dietary pattern Z-score over time was associated with higher SA-BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary pattern rich in protein, calcium, and potassium

  19. 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

    OBJECTIVE: To evaluate the effect of a school based physical education (PE) program and the amount of leisure time sport (LTS) on children's bone health and to examine if LTS influences the impact of school type on children's bone health. METHODS: Children attending "sports" schools (6×45min PE....... Multilevel regression analyses examined the impact of school type and LTS participation on bone. RESULTS: 742/800 (93%) invited children accepted to participate. 682/742 (92%) participated at two-year follow-up. Mean (SD) age was 9.5years (0.9) at baseline. A positive association between LTS and BMC, BMD (p...

  20. Postmenopausal Breast Cancer, Aromatase Inhibitors, and Bone Health: What the Surgeon Should Know.

    Science.gov (United States)

    Baatjes, K J; Apffelstaedt, J P; Kotze, M J; Conradie, M

    2016-09-01

    Breast cancer, as the most common malignancy in women, remains a major public health issue despite countless advances across decades. Endocrine therapy is the cornerstone of treatment of the hormone-sensitive subtype of breast cancer. The use of aromatase inhibitors (AIs) in the postmenopausal women has extended the survival beyond that of Tamoxifen, but harbors a subset of side effects, most notably accelerated bone loss. This, however, does not occur in all women undergoing treatment. It is vital to identify susceptible patients early, to limit such events, employ early treatment thereof, or alter drug therapy. International trials on AIs, predominantly performed in North American and European females, provide little information on what to expect in women in developing countries. Here, surgeons often prescribe and manage endocrine therapy. The prescribing surgeon should be aware of the adverse effect of the endocrine therapy and be able to attend to side effects. This review highlights clinical and biochemical factors associated with decrease in bone mineral density in an, as yet, unidentified subgroup of postmenopausal women. In the era of personalized medical care, appropriate management of bone health by surgeons based on these factors becomes increasingly important. PMID:27189076

  1. 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.

  2. 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。

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

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

    OpenAIRE

    McCarthy, Mary S.

    2014-01-01

    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 statu...

  11. Walking sticks for muscle, bone and joint health in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Salsbury, Stacie A; Nissen, Nina;

    or household objects. From a therapeutic perspective, homemade and commercial aids were improperly fitted and poorly maintained. Villagers reported walking stick use to: uphold posture and balance; relieve MuBoJo pain; honour fashionable tradition; and assist visually impaired persons to negotiate rough...... providers, villagers claimed little or no instruction for use; no educational notes were identified in villager health cards. Conclusions: Many walking sticks are homemade and most are used without professional instruction. To promote MuBoJo health amongst villagers in Botswana, it is essential...... that healthcare providers are educated to assess and train villagers for mobility aid fit, use, and maintenance. Frequent follow-up observations also are important. Engaging trusted opinion leaders might be valuable to initiate and sustain community-based interventions for walking sticks to support muscle, bone...

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

    Science.gov (United States)

    Lim, Hee-Sook; Kim, Soon-Kyung; Lee, Hae-Hyeog; Byun, Dong Won; 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 Examination Survey. We were divided into three groups by T-score: normal, osteopenia and osteoporosis. Assessment of adherence level was based on 5 components of osteoporosis guidelines, considering intake of sodium, calcium and protein, smoking and regular exercise. Results The sex, body mass index, income and educational level did not significantly differ between three groups. Deficient intake of calcium was significantly associated with a threefold greater odds in osteoporosis group (OR 3.6; 95% confidence interval [CI] 2.52-5.22). Excessive protein intake was significantly increased the risk only in osteoporosis group compared to the normal group (OR 1.71; 95% CI 1.15-2.62). Smoking increased the risk in osteoporosis group compared to the normal group (OR 2.88; 95% CI 1.75-4.76), osteoporosis group compared to the osteopenia group (OR 2.69; 95% CI 1.61-4.55). Conclusions Nutritional factor (intake of calcium and protein) and lifestyle-related factor (smoking and exercise) must be accompanied the management for bone health. An adherence of guidelines is considered very important for the prevention of osteoporosis. PMID:27622178

  13. Project HealthDesign: Stimulating the Next Generation of Personal Health Records

    OpenAIRE

    Brennan, Patricia Flatley; Downs, Stephen; Casper, Gail; Kenron, Daniel

    2007-01-01

    Project HealthDesign is a national program designed to rethink the power and potential of personal health records. It intends to stimulate development of new personal health management tools by harnessing the content of the personal health record and making advice, recommendations, and data-tracking tools available to lay people. The program goals include creating a set of prototype personal health records applications, deriving the core functions needed to support interoperable ‘plug-and-pla...

  14. A health information system in radiotherapy to support health personnel in evaluation of standard pain in patients with bone metastases

    International Nuclear Information System (INIS)

    Radiation therapy is a medical specialty that uses ionizing radiation sources, and can be applied to relieve the pain. The Numerical Dosimetry Group (GDN) of Recife-PE, Brazil presented in June 2012 the SISRAD (Health information system in radiotherapy), developed to organize information about data of patients with bone metastasis, aiming to evaluate patterns of pain after radiation treatment. They have since been carried out interviews with this type of patient and the answers have been added to a data file of the software. Were developed some graphical visualization tools as well as data sheets. The current version of SISRAD reads the data file and displays graphics and numerical results, with options to save them or print them. In this paper is presented a roadmap for the health care professional use with efficiency the SISRAD to form quantitative profiles of intensity of pain that their patients, on their responsibility, feel after the radiation treatment. A hypothesis used in SISRAD consists of organizing the responses of the patients supposing them free from other effects other than those arising from the permanence of the pain he felt before treatment or modification by the treatment. So the way the information is handled in the SISRAD enable the trader can discern patterns of pain and, consequently, improve the quality of treatment. In this sense the computational tool here presented can be classified as educational software for health professionals

  15. 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...... 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....

  16. 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.

  17. Bone marrow biopsy

    Science.gov (United States)

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used. Marrow is removed ...

  18. 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.

  19. 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.

  20. Why Health Care Needs Design Research

    DEFF Research Database (Denmark)

    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....... 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...

  1. 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.

  2. 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. PMID:21748475

  3. Healthy Gaming – Video Game Design to promote Health

    Science.gov (United States)

    Brox, E.; Fernandez-Luque, L.; Tøllefsen, T.

    2011-01-01

    Background There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game. Objective The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects. Methods Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles. Results The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasive games seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose. Conclusion There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health care games it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion. PMID:23616865

  4. Endocrinopathies, Bone Health, and Insulin Resistance in Patients with Fanconi Anemia after Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Barnum, Jessie L; Petryk, Anna; Zhang, Lei; DeFor, Todd E; Baker, K Scott; Steinberger, Julia; Nathan, Brandon; Wagner, John E; MacMillan, Margaret L

    2016-08-01

    A number of endocrinopathies have been described after hematopoietic cell transplantation (HCT), but data are limited in patients with Fanconi anemia (FA). We report several endocrine-based disorders in a cohort of 44 patients with FA after HCT compared with both 74 patients who received HCT for hematologic malignancies and with 275 healthy controls. Endocrinopathies assessed included hypothyroidism, hypogonadism, short stature, dyslipidemia, insulin resistance, abnormalities in body composition, and bone health. Most (86%) patients with FA had at least 1 endocrinopathy, with 11% having 3 or more. Hypothyroidism was seen in 57%, hypogonadism in 27%, short stature in 50%, and reduced total body and lumbar spine bone mineral density (BMD) (height adjusted Z-score android/gynoid ratio by dual energy X-ray absorptiometry. Hypothyroidism, short stature, and reduced total body BMD were more prevalent in patients with FA compared with patients with hematologic malignancies. We recommend an assessment before transplantation and close follow-up afterwards to ensure proper clinical management. Future studies should continue to explore the impact of HCT on endocrinopathies in FA patients.

  5. 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.

  6. 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

  7. 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

    ). In addition to increased PTH levels, low vitamin D levels may also directly increase risk of CVD, as vitamin D, itself, has been shown to inhibit the RAAS. Angiotensin II, aldosterone and cortisol all negatively impact bone health. Hyperaldosteronism is associated with a reversible secondary...

  8. 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.

  9. 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...

  10. 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,…

  11. The optimal design of an implant to improve bone quality of implant surroundings based on stress analysis

    Energy Technology Data Exchange (ETDEWEB)

    Noyama, Yoshihiro; Kuramoto, Koichi [Nakashima Medical Division, Nakashima Propeller Co., Ltd., 688-1 Joto-Kitakata, Okayama-shi, Okayama 700-8691 (Japan); Nagayama, Noriyuki [Department of Mechanical Engineering, Applied Electronics Group Industrial Technology Centre of Okayama Prefecture, 5301 Haga, Okayama 701-1296 (Japan); Nakano, Takayoshi [Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: nakano@mat.eng.osaka-u.ac.jp

    2009-05-01

    Research on how implant surface shape contributes to long-term stability after implantation is important in the field of orthopaedics. In particular, technology that controls various bone quality parameters and voluntary bone inducement in implant surroundings should be developed for the next generation of implants and this will improve the patient's quality of life (QOL). For this research, we focused on the inducement of the appropriate alignment for biological apatite (BAp) crystallites and related collagen (Col.) fibres as a bone quality parameter. In this study, we predicted that when stress is applied to bone, the BAp/Col. preferential alignment can be formed if osteocytes are in an environment that is aligned with the principle stress vector. We tested this idea by introducing grooves in the principal stress direction on the surface of an implant. This work thus analyzes the effect of stress transmission by a load at the proximal femur on the bone inside and near the grooves by using mechanical simulation in which groove angles can be changed on the implant surface. Coordinate data from the mechanical simulation of the combined bone/implant environment was verified against the coordinate data obtained by CT scans of actual canine bone. Results suggest that the tendency of stress transmission differs depending on the position and angle of the grooves and based on a vector diagram of the maximum and minimum principal stresses. The simulation was able to predict bone dynamics in vivo and enabled a best design of an implant to control the BAp/Col. alignment as an index of bone quality.

  12. The optimal design of an implant to improve bone quality of implant surroundings based on stress analysis

    Science.gov (United States)

    Noyama, Yoshihiro; Nagayama, Noriyuki; Kuramoto, Koichi; Nakano, Takayoshi

    2009-05-01

    Research on how implant surface shape contributes to long-term stability after implantation is important in the field of orthopaedics. In particular, technology that controls various bone quality parameters and voluntary bone inducement in implant surroundings should be developed for the next generation of implants and this will improve the patient's quality of life (QOL). For this research, we focused on the inducement of the appropriate alignment for biological apatite (BAp) crystallites and related collagen (Col.) fibres as a bone quality parameter. In this study, we predicted that when stress is applied to bone, the BAp/Col. preferential alignment can be formed if osteocytes are in an environment that is aligned with the principle stress vector. We tested this idea by introducing grooves in the principal stress direction on the surface of an implant. This work thus analyzes the effect of stress transmission by a load at the proximal femur on the bone inside and near the grooves by using mechanical simulation in which groove angles can be changed on the implant surface. Coordinate data from the mechanical simulation of the combined bone/implant environment was verified against the coordinate data obtained by CT scans of actual canine bone. Results suggest that the tendency of stress transmission differs depending on the position and angle of the grooves and based on a vector diagram of the maximum and minimum principal stresses. The simulation was able to predict bone dynamics in vivo and enabled a best design of an implant to control the BAp/Col. alignment as an index of bone quality.

  13. The optimal design of an implant to improve bone quality of implant surroundings based on stress analysis

    International Nuclear Information System (INIS)

    Research on how implant surface shape contributes to long-term stability after implantation is important in the field of orthopaedics. In particular, technology that controls various bone quality parameters and voluntary bone inducement in implant surroundings should be developed for the next generation of implants and this will improve the patient's quality of life (QOL). For this research, we focused on the inducement of the appropriate alignment for biological apatite (BAp) crystallites and related collagen (Col.) fibres as a bone quality parameter. In this study, we predicted that when stress is applied to bone, the BAp/Col. preferential alignment can be formed if osteocytes are in an environment that is aligned with the principle stress vector. We tested this idea by introducing grooves in the principal stress direction on the surface of an implant. This work thus analyzes the effect of stress transmission by a load at the proximal femur on the bone inside and near the grooves by using mechanical simulation in which groove angles can be changed on the implant surface. Coordinate data from the mechanical simulation of the combined bone/implant environment was verified against the coordinate data obtained by CT scans of actual canine bone. Results suggest that the tendency of stress transmission differs depending on the position and angle of the grooves and based on a vector diagram of the maximum and minimum principal stresses. The simulation was able to predict bone dynamics in vivo and enabled a best design of an implant to control the BAp/Col. alignment as an index of bone quality.

  14. Huge "wellness incentives" are more about health plan benefit design than health promotion.

    Science.gov (United States)

    O'Donnell, Michael P

    2014-01-01

    Regulations governing employers' use of financial incentives for employees who participate in health promotion programs or are successful in achieving health goals go into effect today (January 1, 2014). It is important to recognize that huge incentives have more to do with health plan design and less to do with effective strategies to improve health. Comprehensive health promotion programs need to increase awareness of the link between lifestyle and health, enhance motivation to improve health, build the skills important for a healthy lifestyle, and provide an abundance of opportunities to practice a healthy lifestyle. PMID:24380428

  15. 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.

  16. 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...

  17. Refinements in Sarcoma Classification in the Current 2013 World Health Organization Classification of Tumours of Soft Tissue and Bone.

    Science.gov (United States)

    Jo, Vickie Y; Doyle, Leona A

    2016-10-01

    The fourth edition of the World Health Organization (WHO) Classification of Tumours of Soft Tissue and Bone was published in February 2013. The 2013 WHO volume provides an updated classification scheme and reproducible diagnostic criteria, which are based on recent clinicopathologic studies and genetic and molecular data that facilitated refined definition of established tumor types, recognition of novel entities, and the development of novel diagnostic markers. This article reviews updates and changes in the classification of bone and soft tissue tumors from the 2002 volume. PMID:27591490

  18. Peaks Over Threshold Method for Structural Health Monitoring Detector Design

    OpenAIRE

    HMAD, Ouadie; MECHBAL, Nazih; REBILLAT, Marc

    2015-01-01

    Structural Health Monitoring (SHM) system offers new approaches to interrogate the integrity of structures. The most critical step of such systems is the damage detection step since it is the first and because performances of the following steps (damage localization, severity estimation…) depend on it. Care has thus to be taken when designing the detector. The objective of this communication is to discuss issues related to the design of a detector for the structural health monitoring of compo...

  19. 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)...

  20. 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.

  1. eHealth literacy issues, constructs, models, and methods for health information technology design and evaluation

    Directory of Open Access Journals (Sweden)

    Helen Monkman

    2015-12-01

    Full Text Available The concept of eHealth literacy is beginning to be recognized as a being of key importance in the design and adoption of effective and efficient health information systems and applications targeted to lay people and patients. Indeed, many systems such as patient portals and personal health records have not been adopted due to a mismatch between the level of eHealth literacy demanded by a system and the level of eHealth literacy possessed by end users. The purpose of this paper is to present an overview of important concepts related to eHealth literacy, as well as how the notion of eHealth literacy can be applied to improve the design and adoption of consumer health information systems. This paper begins with describing the importance of eHealth literacy with respect to design of health applications for the general public paired with examples of consumer health information systems whose limited success and adoption has been attributed to the lack of consideration for eHealth literacy. This is followed by definitions of what eHealth literacy is and how it emerged from the related concept of health literacy. A model for conceptualizing the importance of aligning consumers’ eHealth literacy skills and the demands systems place on their skills is then described. Next, current tools for assessing consumers’ eHealth literacy levels are outlined, followed by an approach to systematically incorporating eHealth literacy in the deriving requirements for new systems is presented. Finally, a discussion of evolving approaches for incorporating eHealth literacy into usability engineering methods is presented.

  2. 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.

  3. 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....

  4. Anorexia Nervosa and Bone

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors...

  5. 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.

  6. 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.

  7. Project HealthDesign: stimulating the next generation of personal health records.

    Science.gov (United States)

    Brennan, Patricia Flatley; Downs, Stephen; Casper, Gail; Kenron, Daniel

    2007-01-01

    Project HealthDesign is a national program designed to rethink the power and potential of personal health to rethink the power and potential of personal health records. It intends to stimulate development of new personal health management tools by harnessing the content of the personal health record and making advice, recommendations, and data-tracking tools available to lay people. The program goals include creating a set of prototype personal health records applications, deriving the core functions needed to support interoperable 'plug-and-play' resources for managing health challenges, and addressing the ethical, legal, and social issues that confront the development of computer tools to promote health actions. Response to the call for proposals was tremendous; from the over 160 groups who submitted proposals, 9 teams were selected to design and create prototypes of innovative personal health management tools. This paper summarizes the full set of proposals, their populations of interest, and the technical challenges that await full implementation of the PHR-based applications designed to promote health. PMID:18693800

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

    Science.gov (United States)

    Kruger, Marlena C; Wolber, Frances M

    2016-01-01

    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. PMID:27322315

  9. 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.

  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. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

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

    OpenAIRE

    Born Rita; Zwahlen Marcel

    2013-01-01

    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 liv...

  17. 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. PMID:25642607

  18. 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

    Recent cross-sectional data suggest that better vitamin K status in young girls (aged 3-16 years) is associated with decreased bone turnover, even though it is not associated with bone mineral content (BMC). The objective of the present study was to investigate the relationship between serum...... 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...

  19. Front end design of smartphone-based mobile health

    Science.gov (United States)

    Zhang, Changfan; He, Lingsong; Gao, Zhiqiang; Ling, Cong; Du, Jianhao

    2015-02-01

    Mobile health has been a new trend all over the world with the rapid development of intelligent terminals and mobile internet. It can help patients monitor health in-house and is convenient for doctors to diagnose remotely. Smart-phone-based mobile health has big advantages in cost and data sharing. Front end design of it mainly focuses on two points: one is implementation of medical sensors aimed at measuring kinds of medical signal; another is acquisition of medical signal from sensors to smart phone. In this paper, the above two aspects were both discussed. First, medical sensor implementation was proposed to refer to mature measurement solutions with ECG (electrocardiograph) sensor design taken for example. And integrated chip using can simplify design. Then second, typical data acquisition architecture of smart phones, namely Bluetooth and MIC (microphone)-based architecture, were compared. Bluetooth architecture should be equipped with an acquisition card; MIC design uses sound card of smart phone instead. Smartphone-based virtual instrument app design corresponding to above acquisition architecture was discussed. In experiments, Bluetooth and MIC architecture were used to acquire blood pressure and ECG data respectively. The results showed that Bluetooth design can guarantee high accuracy during the acquisition and transmission process, and MIC design is competitive because of low cost and convenience.

  20. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... (54 FR 8735). The criteria for psychiatric HPSAs were expanded to mental health HPSAs on January 22, 1992 (57 FR 2473). Currently funded PHS Act programs use only the primary medical care, mental health... designated HPSAs and supersedes the HPSA lists published in the Federal Register on February 20, 2002 (67...

  1. 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.

  2. 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...

  3. 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

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

    International Nuclear Information System (INIS)

    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.

  5. 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.

  6. The Oslo Health Study: Is bone mineral density higher in affluent areas?

    Directory of Open Access Journals (Sweden)

    Søgaard Anne J

    2007-11-01

    Full Text Available Abstract Background Based on previously reported differences in fracture incidence in the socioeconomic less affluent Oslo East compared to the more privileged West, our aim was to study bone mineral density (BMD in the same socioeconomic areas in Oslo. We also wanted to study whether possible associations were explained by socio-demographic factors, level of education or lifestyle factors. Methods Distal forearm BMD was measured in random samples of the participants in The Oslo Health Study by single energy x-ray absorptiometry (SXA. 578 men and 702 women born in Norway in the age-groups 40/45, 60 and 75 years were included in the analyses. Socioeconomic regions, based on a social index dividing Oslo in two regions – East and West, were used. Results Age-adjusted mean BMD in women living in the less affluent Eastern region was 0.405 g/cm2 and significantly lower than in West where BMD was 0.419 g/cm2. Similarly, the odds ratio of low BMD (Z-score ≤ -1 was 1.87 (95% CI: 1.22–2.87 in women in Oslo East compared to West. The same tendency, although not statistically significant, was also present in men. Multivariate analysis adjusted for education, marital status, body mass index, physical inactivity, use of alcohol and smoking, and in women also use of post-menopausal hormone therapy and early onset of menopause, did hardly change the association. Additional adjustments for employment status, disability pension and physical activity at work for those below the age of retirement, gave similar results. Conclusion We found differences in BMD in women between different socioeconomic regions in Oslo that correspond to previously found differences in fracture rates. The association in men was not statistically significant. The differences were not explained by socio-demographic factors, level of education or lifestyle factors.

  7. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) ; Guidance on the scientific requirements for health claims related to bone, joints, skin and oral health

    DEFF Research Database (Denmark)

    Tetens, Inge

    The Panel on Dietetic Products, Nutrition and Allergies (NDA) has been asked by the European Food Safety Authority (EFSA) to draft guidance on the scientific requirements for health claims related to bone, joints, skin, and oral health. This guidance has been drawn from scientific opinions of the....../outcome measures which are acceptable. Rather, it presents examples drawn from evaluations already carried out to illustrate the approach of the Panel, as well as some examples which are currently under consideration within ongoing evaluations. A draft of this guidance document, endorsed by the NDA Panel on 25...

  8. Comparison of Marginal Bone Changes with Internal Conus and External Hexagon Design Implant Systems: A Prospective, Randomized Study.

    Science.gov (United States)

    Cooper, Lyndon F; Tarnow, Dennis; Froum, Stuart; Moriarty, John; De Kok, Ingeborg J

    2016-01-01

    A central dental implant success criterion is the marginal bone response as measured longitudinally. Factors that influence marginal bone changes include osseous and soft tissue architecture, occlusal loading factors, implant position, implant design, and inflammatory processes. The evolution of implant design is multifactorial and includes the implant-abutment interface geometries. The primary objective of this study was to compare the proximal marginal bone changes following placement and loading of internal conus design implants (ICI) and external hex design implants (EXI) used in the treatment of posterior partial edentulism. Among 45 enrolled participants, 39 were treated with 47 ICI or 46 EXI implants using a one-stage implant protocol. Prosthetic restoration was completed after 12 weeks using stock titanium abutments and all-ceramic crowns. Follow-up visits including clinical and radiographic examinations were performed 6 months after permanent restoration and then annually for 3 years. Marginal bone level changes, papilla index scores, condition of the peri-implant mucosa, presence of complications, and participant satisfaction were evaluated. The mean marginal bone level change from implant placement to 3 years was -0.25 ± 0.60 mm and -0.5 ± 0.93 mm for ICI and EXI implants, respectively. The change recorded from permanent restoration to 3 years was a gain of 0.31 ± 0.41 mm versus 0.04 ± 0.51 mm for ICI and EXI implants, respectively (P 90%) of participants stated they were satisfied or very satisfied with their implant prosthesis and rated function and esthetics highly for both implant types after 3 years in function. Modestly greater marginal bone loss occurred at EXI implants. Further, more positive papilla scores were found between adjacent ICI implants than between adjacent EXI implants. EXI implants displayed more abutment complications than the ICI implants. The implant-abutment interface design may contribute to therapeutic outcome differences

  9. 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.

  10. 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.

  11. 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. PMID:26598831

  12. [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

    2015-01-01

    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

  13. 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

  14. Design and Validation of Automated Femoral Bone Morphology Measurements in Cerebral Palsy

    OpenAIRE

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

    2013-01-01

    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 cere...

  15. Artificial Gravity: Will it Preserve Bone Health on Long-Duration Missions?

    Science.gov (United States)

    Davis-Street, Janis; Paloski, William H.

    2005-01-01

    Prolonged microgravity exposure disrupts bone, muscle, and cardiovascular homeostasis, sensory-motor coordination, immune function, and behavioral performance. Bone loss, in particular, remains a serious impediment to the success of exploration-class missions by increasing the risks of bone fracture and renal stone formation for crew members. Current countermeasures, consisting primarily of resistive and aerobic exercise, have not yet proven fully successful for preventing bone loss during long-duration spaceflight. While other bone-specific countermeasures, such as pharmacological therapy and dietary modifications, are under consideration, countermeasure approaches that simultaneously address multiple physiologic systems may be more desirable for exploration-class missions, particularly if they can provide effective protection at reduced mission resource requirements (up-mass, power, crew time, etc). The most robust of the multi-system approaches under consideration, artificial gravity (AG), could prevent all of the microgravity-related physiological changes from occurring. The potential methods for realizing an artificial gravity countermeasure are reviewed, as well as selected animal and human studies evaluating the effects of artificial gravity on bone function. Future plans for the study of the multi-system effects of artificial gravity include a joint, cooperative international effort that will systematically seek an optimal prescription for intermittent AG to preserve bone, muscle, and cardiovascular function in human subjects deconditioned by 6 degree head-down-tilt-bed rest. It is concluded that AG has great promise as a multi-system countermeasure, but that further research is required to determine the appropriate parameters for implementation of such a countermeasure for exploration-class missions.

  16. 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.

  17. 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

  18. 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.

  19. Effects of Aerobic Step Combined with Resistance Training on Biochemical Bone Markers, Health-Related Physical Fitness and Balance in Working Women.

    Science.gov (United States)

    Anek, Achariya; Kanungsukasem, Vijit; Bunyaratavej, Narong

    2015-09-01

    The objectives of this research were to develop an aerobic step combined with resistance training exercise program, and to compare the effects of A) aerobic step exercise training (STE), B) resistance aerobic exercise training (RES), C) a combined aerobic step with resistance exercise training (COM) on the health-related fitness, balance, and biochemical bone markers. Sixty participants were working female volunteers at the age of 35-45. They were divided into 4 groups by simple random sampling method. Fifteen of the participants were in the STE group, 14 in the RES group, 15 in the COM group, and 16 in the control group (CON). The STE, RES and COM exercise training programs were designed to yield the same intensity and achieve the same range of heart rate during each stage of the program. During the training, music was used to set the tempo of the workouts. At the 8th week, it was found that resting heart rate and systolic blood pressure significantly-increased only in the STE and COM groups. After 16 weeks, the experiment results showed the significant improvement in the COM and STE groups of exercise training for β-CrossLaps, P1NP NMID Osteocalcin and bone formation (PINP/β-CrossLaps x0.31) but not in the RES group. For balance ability, the COM group showed significantly greater change than the RES group after the training intervention (p < 0.05). It can thus be concluded that the STE and COM training were effective in improving bone formation (PINP/β-CrossLaps x 0.31) but not in the RES group. For balance ability, the COM group showed more significant change than the RES group. Therefore, this is not only a good exercise choice for the working-age people but also it can help reduce the risks of osteoporosis and falling in women in particular. PMID:26529814

  20. Module for applications of bone scan in cancer patients

    International Nuclear Information System (INIS)

    This paper reports the application of a software which enables the complete register of patient data, for delivering appropriate information in bone scan reports. Bone scan is a frequent study in Nuclear Medicine, which enables physicians to diagnose a primary bone cancer or metastases. The software was designed in order to complete data given by oncologists and constitutes an aid for the health team attending patients. (authors).

  1. Osteoporosis: Peak Bone Mass in Women

    Science.gov (United States)

    ... Bone Health for Lupus Patients Bone Health and Anorexia Nervosa Partner Resources Screening Tests and Immunizations Guidelines for ... calcium. Physical Activity. Girls and boys and young adults who exercise regularly generally achieve greater peak bone ...

  2. Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design

    Science.gov (United States)

    Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C

    2016-01-01

    Background Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients’ health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients’ health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients’ needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Objective Our aim was to characterize patients’ use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients’ communication needs and preferences. Methods This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study’s first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Results Participants’ rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6

  3. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ... criteria for correctional facility HPSAs were revised and published on March 2, 1989 (54 FR 8735). The criteria for psychiatric HPSAs were expanded to mental health HPSAs on January 22, 1992 (57 FR 2473... on June 29, 2012 (77 FR 38838). The lists also include automatic facility HPSAs, designated as...

  4. 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

  5. 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

  6. Bone tumor

    Science.gov (United States)

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

  7. 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.

  8. Health maintenance organizations: structure, performance, and current issues for employee health benefits design.

    Science.gov (United States)

    Gold, M

    1991-03-01

    After summarizing the origins and key principles of HMOs, including the current characteristics of the HMO industry, this article reviews the evidence of HMO performance in the areas of benefits design, utilization and cost effectiveness, quality of care and consumer satisfaction, and selection and overall employer satisfaction. Outstanding issues and concerns, from the perspective of employee health benefits design, include issues such as assuring a fair price for HMO benefits, employer contribution methods, HMO diversification, and cost escalation and the search for value. Results of research studies have been generally positive about HMO performance on benefits, cost effectiveness, quality, and consumer satisfaction, and more mixed on employer satisfaction. As employers address concerns, some changes are likely in the methods used to integrate HMOs into a health benefits strategy. Because the issues involved in these changes are numerous and complex, careful consideration and design are desirable to assure that the net impact of any change is positive and consistent with overall goals. PMID:1903152

  9. 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.

  10. 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.

  11. Osteosarcopenic obesity: the role of bone, muscle, and fat on health

    OpenAIRE

    Ormsbee, Michael J; Prado, Carla M; Ilich, Jasminka Z.; Purcell, Sarah; Siervo, Mario; Folsom, Abbey; Panton, Lynn

    2014-01-01

    Osteopenia/osteoporosis, sarcopenia, and obesity are commonly observed in the process of aging, and recent evidence suggests a potential interconnection of these syndromes with common pathophysiology. The term osteosarcopenic obesity has been coined to describe the concurrent appearance of obesity in individuals with low bone and muscle mass. Although our understanding of osteosarcopenic obesity’s etiology, prevalence, and consequences is extremely limited, it is reasonable to infer its negat...

  12. 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.

  13. 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.

  14. 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. PMID:27225566

  15. 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

  16. 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.

  17. 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. PMID:26900949

  18. Structural health monitoring feature design by genetic programming

    International Nuclear Information System (INIS)

    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. (paper)

  19. Using conceptual work products of health care to design health IT.

    Science.gov (United States)

    Berry, Andrew B L; Butler, Keith A; Harrington, Craig; Braxton, Melissa O; Walker, Amy J; Pete, Nikki; Johnson, Trevor; Oberle, Mark W; Haselkorn, Jodie; Paul Nichol, W; Haselkorn, Mark

    2016-02-01

    This paper introduces a new, model-based design method for interactive health information technology (IT) systems. This method extends workflow models with models of conceptual work products. When the health care work being modeled is substantially cognitive, tacit, and complex in nature, graphical workflow models can become too complex to be useful to designers. Conceptual models complement and simplify workflows by providing an explicit specification for the information product they must produce. We illustrate how conceptual work products can be modeled using standard software modeling language, which allows them to provide fundamental requirements for what the workflow must accomplish and the information that a new system should provide. Developers can use these specifications to envision how health IT could enable an effective cognitive strategy as a workflow with precise information requirements. We illustrate the new method with a study conducted in an outpatient multiple sclerosis (MS) clinic. This study shows specifically how the different phases of the method can be carried out, how the method allows for iteration across phases, and how the method generated a health IT design for case management of MS that is efficient and easy to use. PMID:26528606

  20. 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.

  1. Designing and regulating health insurance exchanges: lessons from Massachusetts.

    Science.gov (United States)

    Ericson, Keith M Marzilli; Starc, Amanda

    The Massachusetts health care reform provides preliminary evidence on the function of health insurance exchanges and individual insurance markets. This paper describes the type of products consumers choose and the dynamics of consumer choice. Evidence shows that choice architecture, including product standardization and the use of heuristics (rules of thumb), affects choice. In addition, while consumers often choose less generous plans in the exchange than in traditional employer-sponsored insurance, there is considerable heterogeneity in consumer demand, as well as some evidence of adverse selection. We examine the role of imperfect competition between insurers, and document the impact of pricing and product regulation on the level and distribution of premiums. Given our extensive choice data, we synthesize the evidence of the Massachusetts exchange to inform the design and regulation on other exchanges. PMID:23469676

  2. 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.

  3. What's a Funny Bone?

    Science.gov (United States)

    ... Help White House Lunch Recipes What's a Funny Bone? KidsHealth > For Kids > What's a Funny Bone? Print A A A Text Size Have you ... prickly kind of dull pain? That's your funny bone! It doesn't really hurt as much as ...

  4. 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

  5. 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.

  6. Design and production of sintered β-tricalcium phosphate 3D scaffolds for bone tissue regeneration

    International Nuclear Information System (INIS)

    The characteristics of sintered β-tricalcium phosphate (β-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 β-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: ► β-Tricalcium phosphate (β-TCP) 3D scaffolds were produced by rapid prototyping. ► Scaffold properties were assessed by SEM, FTIR, XRD and by mechanical tests. ► The cytotoxic profile of the scaffolds was characterized by in vitro assays. ► Scaffolds have good properties for its application as bone substitutes for individualized therapy.

  7. 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. PMID:24566780

  8. 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.

  9. 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).

  10. 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

  11. 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.

  12. Reproductive health in adolescent girls with special emphasis on menstrual disorders, bone health, sexuality and social factors

    OpenAIRE

    Wiksten-Almströmer, Marianne

    2009-01-01

    Menstrual disturbances are common during adolescence, especially within the first 1-3 years after menarche, and are often explained by immaturity of the hypothalamic-pituitary-gonadal axis. However, little is known about the underlying mechanisms, long-term medical consequences and other reproductive health issues in teenagers. The general aim of this thesis was to investigate aspects of reproductive health in adolescent girls and boys visiting a youth clinic. Endocrine ...

  13. Design of ceramic-based cements and putties for bone graft substitution

    OpenAIRE

    M Bohner

    2010-01-01

    In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considere...

  14. Design of ceramic-based cements and putties for bone graft substitution

    Directory of Open Access Journals (Sweden)

    M Bohner

    2010-07-01

    Full Text Available In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements, and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.

  15. Design of ceramic-based cements and putties for bone graft substitution.

    Science.gov (United States)

    Bohner, M

    2010-01-01

    In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life. PMID:20574942

  16. Finite element modelling of non-bonded piezo sensors for biomedical health monitoring of bones based on EMI technique

    Science.gov (United States)

    Srivastava, Shashank; Bhalla, Suresh; Madan, Alok; Gupta, Ashok

    2016-04-01

    Extensive research is currently underway across the world for employing piezo sensors for biomedical health monitoring in view of their obvious advantages such as low cost,fast dynamics response and bio-compatibility.However,one of the limitations of the piezo sensor in bonded mode based on the electro-mechanical impedance (EMI) technique is that it can cause harmful effects to the humans in terms of irritation ,bone and skin disease. This paper which is in continuation of the recent demonstration of non-bonded configuration is a step towards simulating and analyzing the non-bonded configuration of the piezo sensor for gauging its effectiveness using FEA software. It has been noted that the conductance signatures obtained in non-bonded mode are significantly close to the conventional bonded configuration, thus giving a positive indication of its field use.

  17. Communication of fracture risk and treatment benefit in terms of ‘bone health age’ using FRAX or Qfracture

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Rubin, Katrine Hass; Hansen, Carrinna;

    2013-01-01

    the same time increase agreement between risk algorithms. Results: The algorithms differed less in estimated bone health age than in percent risk. A 60 years old woman with a maternal history of hip fracture has a predicted major osteoporotic fracture risk equivalent to that of a 71 years (FRAX) or 68......Introduction: Communication of absolute and relative risks is challenging despite the development of tools to quickly derive absolute fracture risk estimates from risk factors with or without BMD. We speculated that back-transformation of risks to a risk age could make for a clearer message and at...... years-old woman (Qfracture). Treatment with 40% risk reduction is equivalent to a reduction in risk age by 10 years in both algorithms, reducing risk age to 62 (FRAX) or 60 years (Qfracture). Table 1 Assuming no treatment Assuming treatment with 40% risk reduction FRAX ‘Age’/ 10 years risk Qfracture...

  18. 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

  19. 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.

  20. Bone Biopsy

    Science.gov (United States)

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

  1. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  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. Bone's responses to different designs of implant-supported fixed partial dentures.

    Science.gov (United States)

    Rungsiyakull, Chaiy; Chen, Junning; Rungsiyakull, Pimduen; Li, Wei; Swain, Michael; Li, Qing

    2015-04-01

    This paper explores the biomechanics and associated bone remodeling responses of two different abutment configurations, namely implant-implant-supported versus tooth-implant-supported fixed partial dentures. Two 3D finite element analysis models are created based upon computerized tomography data. The strain energy density induced by occlusal loading is used as a mechanical stimulus for driving the bone remodeling. To measure osseointegration and stability during healing, a resonance frequency analysis is conducted. At the second premolar peri-implant region, overloading resorption around the neck of implant is identified in both the models over the first 12 months. Stress-shielding around the edentulous region is also observed in both the models with a greater resorption rate found in the implant-implant case. The remodeling and resonance frequency analyses reveal that the tooth-implant scheme offers a higher degree of osseointegration. The remodeling procedure is expected to provide prosthodontists with a modeling tool to assess possible long-term clinical outcomes. PMID:25209424

  4. Broken English, broken bones? Mechanisms linking language proficiency and occupational health in a Montreal garment factory.

    Science.gov (United States)

    Premji, Stéphanie; Messing, Karen; Lippel, Katherine

    2008-01-01

    Language barriers are often cited as a factor contributing to ethnic inequalities in occupational health; however, little information is available about the mechanisms at play. The authors describe the multiple ways in which language influences occupational health in a large garment factory employing many immigrants in Montreal. Between 2004 and 2006, individual, semi-structured interviews were conducted with 15 women and 10 men from 14 countries of birth. Interviews were conducted in French and English, Canada's official languages, as well as in non-official languages with the help of colleague-interpreters. Observation within the workplace was also carried out at various times during the project. The authors describe how proficiency in the official languages influences occupational health by affecting workers' ability to understand and communicate information, and supporting relationships that can affect work-related health. They also describe workers' strategies to address communication barriers and discuss the implications of these strategies from an occupational health standpoint. Along with the longer-term objectives of integrating immigrants into the linguistic majority and addressing structural conditions that can affect health, policies and practices need to be put in place to protect the health and well-being of those who face language barriers in the short term. PMID:18341120

  5. Novel Osteogenic Ti-6Al-4V Device For Restoration Of Dental Function In Patients With Large Bone Deficiencies: Design, Development And Implementation

    Science.gov (United States)

    Cohen, D. J.; Cheng, A.; Kahn, A.; Aviram, M.; Whitehead, A. J.; Hyzy, S. L.; Clohessy, R. M.; Boyan, B. D.; Schwartz, Z.

    2016-01-01

    Custom devices supporting bone regeneration and implant placement are needed for edentulous patients with large mandibular deficiencies where endosteal implantation is not possible. We developed a novel subperiosteal titanium-aluminum-vanadium bone onlay device produced by additive manufacturing (AM) and post-fabrication osteogenic micro-/nano-scale surface texture modification. Human osteoblasts produced osteogenic and angiogenic factors when grown on laser-sintered nano-/micro-textured surfaces compared to smooth surfaces. Surface-processed constructs caused higher bone-to-implant contact, vertical bone growth into disk pores (microCT and histomorphometry), and mechanical pull-out force at 5 and 10 w on rat calvaria compared to non surface-modified constructs, even when pre-treating the bone to stimulate osteogenesis. Surface-modified wrap-implants placed around rabbit tibias osseointegrated by 6 w. Finally, patient-specific constructs designed to support dental implants produced via AM and surface-processing were implanted on edentulous mandibular bone. 3 and 8 month post-operative images showed new bone formation and osseointegration of the device and indicated stability of the dental implants. PMID:26854193

  6. Biochemical Assessment of Bone Health in Working Obese Egyptian Females with Metabolic Syndrome; the Effect of Weight Loss by Natural Dietary Therapies

    Directory of Open Access Journals (Sweden)

    Maha I.A. Moaty

    2015-12-01

    CONCLUSION: These results confirm the benefit of doum in improving bone health parameter [25 (OH D/PTH axis] in the MetS patients, beside the MetS criteria. So, we can conclude that natural effective supplements lead towards the optimization of biochemical parameters in favor of a healthy outcome.

  7. 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.

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

    Science.gov (United States)

    Kim, Nam-Ho; Lee, So-Hyoun; Ryu, Jae-Jun; Choi, Kyung-Hee; Huh, Jung-Bo

    2015-01-01

    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. PMID:26504807

  9. Usefulness of calcaneal quantitative ultrasound stiffness for the evaluation of bone health in HIV-1-infected subjects: comparison with dual X-ray absorptiometry

    Science.gov (United States)

    Fantauzzi, Alessandra; Floridia, Marco; Ceci, Fabrizio; Cacciatore, Francesco; Vullo, Vincenzo; Mezzaroma, Ivano

    2016-01-01

    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 vitamin D levels ng/mL (P-values: 0.004, 0.016, and 0.015, respectively). Conclusion As an alternative and/or integrative examination to DXA, calcaneal QUS could be proposed as a useful screening in HIV-1-infected patients for assessing bone health impairment. In fact, the results obtained confirm that calcaneal QUS may be useful for monitoring bone status, being a noninvasive and inexpensive technique, especially in those subjects with the classical traditional risk factors for bone damage that were observed earlier in HIV-1 population. PMID:27330330

  10. 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.

  11. Exploring the Model Design Space for Battery Health Management

    Science.gov (United States)

    Saha, Bhaskar; Quach, Cuong Chi; Goebel, Kai Frank

    2011-01-01

    Battery Health Management (BHM) is a core enabling technology for the success and widespread adoption of the emerging electric vehicles of today. Although battery chemistries have been studied in detail in literature, an accurate run-time battery life prediction algorithm has eluded us. Current reliability-based techniques are insufficient to manage the use of such batteries when they are an active power source with frequently varying loads in uncertain environments. The amount of usable charge of a battery for a given discharge profile is not only dependent on the starting state-of-charge (SOC), but also other factors like battery health and the discharge or load profile imposed. This paper presents a Particle Filter (PF) based BHM framework with plug-and-play modules for battery models and uncertainty management. The batteries are modeled at three different levels of granularity with associated uncertainty distributions, encoding the basic electrochemical processes of a Lithium-polymer battery. The effects of different choices in the model design space are explored in the context of prediction performance in an electric unmanned aerial vehicle (UAV) application with emulated flight profiles.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  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. 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.

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

    Science.gov (United States)

    Kruger, Marlena C.; Wolber, Frances M.

    2016-01-01

    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. PMID:27322315

  19. 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.

  20. 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.

  1. Health technology assessment of magnetic resonance imaging of the spine and bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Verstraete, K.L. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Koenraad.verstraete@ugent.be; Huysse, W.C.J. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Wouter.huysse@ugent.be

    2008-02-15

    The high spatial resolution and the lack of ionizing radiation, makes magnetic resonance imaging the method of choice for imaging most spinal pathology, especially if associated with neurological symptoms. However, due to the high sensitivity of MR imaging, careful correlation between imaging findings and clinical findings is important to ensure appropriate treatment. Substituting radiographic evaluations for rapid MRI in the primary care setting may offer little additional benefit to patients. It may even increase the costs of care but the decisions about the use of imaging depend on judgments concerning whether the small observed improvement in outcome justifies additional cost. Because the presence of an abscess is a major factor in deciding between conservative and surgical treatment, MRI plays an essential role in the decision-making process concerning the treatment of spondylodiscitis. MR is also the method of choice for quantitative evaluation of bone marrow in lymphoma patients when a crucial therapeutic decision has to be made or for the qualitative evaluation of the spinal cord if compression is suspected in primary spinal malignancy or metastatic disease.

  2. Peak Vertical Jump Power as a Marker of Bone Health in Children.

    Science.gov (United States)

    Baptista, F; Mil-Homens, P; Carita, A I; Janz, K; Sardinha, L B

    2016-07-01

    The objective of this investigation was to evaluate the accuracy of peak vertical jump power (VJP) to identify children with bone mineral density (BMD) below average, defined as BMD measured by DXA and adjusted for body height at the whole body less head≤- 1.0 standard deviation (SD). The sample included 114 boys and girls aged 8.5±0.4 years old. VJP was estimated from a countermovement jump performed on a contact mat using the measured flight time to calculate the height of rise of the center of gravity. Logistic regression analysis revealed that the odds ratio of having BMD≤1.0 SD decreased 1.2% per watt of power and the probability of BMD below average was 75.6% higher in boys than in girls with the same peak power jump. Receiver operating characteristic analysis showed that the best trade-off between sensitivity and specificity to identify children with BMDjump of 19.9 cm and 20.5 cm in 8-year-old boys and girls, respectively. The VJP showed a reasonable sensitivity and specificity as well good discriminant ability to identify children with BMD below average.

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

    Science.gov (United States)

    ... 5 Things to Know About Zika & Pregnancy 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 ...

  4. Bones, Muscles, and Joints: The Musculoskeletal System

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Bones, Muscles, and Joints KidsHealth > For Parents > Bones, Muscles, ... able to stand, walk, run, or even sit. Bones and What They Do From our head to ...

  5. 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…

  6. 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

  7. 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.

  8. Bone Metabolism in Adolescents with Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2011-01-01

    Adolescents with anorexia nervosa (AN) are at risk for low bone mass at multiple sites, associated with decreased bone turnover. Bone microarchitecture is also affected, with a decrease in bone trabecular volume and trabecular thickness, and an increase in trabecular separation. The adolescent years are typically the time when marked increases occur in bone mass accrual towards the attainment of peak bone mass, an important determinant of bone health and fracture risk in later life. AN often ...

  9. 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: ...

  10. 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.

  11. 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...... 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...... 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...

  12. 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

  13. 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.

  14. 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 .

  15. 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

  16. Workable competition in health care: Prospects for the Dutch design

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1992-01-01

    markdownabstract__Abstract__ Since 1989 a gradual restructing of the Dutch health care system is taking place to realize a multiple choice social health insurance system with workable competition among health care providers. This paper investigates whether the structural change will induce the inte

  17. Bone Grafts

    Science.gov (United States)

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  18. 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

  19. Understanding the links among neuromedin U Gene, beta2-adrenoceptor gene and bone health: an observational study in European children

    OpenAIRE

    Francesco Gianfagna; Daniela Cugino; Wolfgang Ahrens; Bailey, Mark E.S.; Karin Bammann; Diana Herrmann; Anna C Koni; Yiannis Kourides; Staffan Marild; Dénes Molnár; Moreno, Luis A; Pitsiladis, Yannis P.; Paola Russo; Alfonso Siani; Sabina Sieri

    2013-01-01

    Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 intera...

  20. Aren't technological choices central to designing health systems?

    Science.gov (United States)

    Priya, Ritu

    2013-01-01

    This paper argues that delivery of technology-based preventive, promotive and curative care is one of the central tasks of any health-care system and therefore it forms one of the central pivots for rational structuring/re-structuring of a health-care system. The development of our public health system has, historically, adopted health technologies (HT) uncritically and thereby not explicitly developed institutional mechanisms to assess them for rational choice. Determinants of HT policy choices and structuring of a service delivery system based on that are discussed with examples of modern low cost HT, technologies of codified health knowledge systems other than the modern and local health traditions. Various forms of institutional structures for HT assessment and R and D using a comprehensive primary health-care approach are suggested. PMID:24351381

  1. Aren′t technological choices central to designing health systems?

    Directory of Open Access Journals (Sweden)

    Ritu Priya

    2013-01-01

    Full Text Available This paper argues that delivery of technology-based preventive, promotive and curative care is one of the central tasks of any health-care system and therefore it forms one of the central pivots for rational structuring/re-structuring of a health-care system. The development of our public health system has, historically, adopted health technologies (HT uncritically and thereby not explicitly developed institutional mechanisms to assess them for rational choice. Determinants of HT policy choices and structuring of a service delivery system based on that are discussed with examples of modern low cost HT, technologies of codified health knowledge systems other than the modern and local health traditions. Various forms of institutional structures for HT assessment and R and D using a comprehensive primary health-care approach are suggested.

  2. 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.

  3. 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.

  4. Sprinklr: Designing a ‘cool’ health-oriented social networking site with and for teenagers

    OpenAIRE

    2013-01-01

    Background: Teenagers with chronic health challenges are not disclosing their health on social media. Yet, social and emotional support has an impact on health. Currently there is no online health community in Norway targeting teenage patients. Initiatives such as Upopolis have failed to generate critical user mass because they were not age-appropriate. Objective: This study examines how a ‘cool’ online health community looks like when designing it with teenagers. The study aims to extend...

  5. 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...

  6. 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.

  7. The population health record: concepts, definition, design, and implementation.

    Science.gov (United States)

    Friedman, Daniel J; Parrish, R Gibson

    2010-01-01

    In 1997, the American Medical Informatics Association proposed a US information strategy that included a population health record (PopHR). Despite subsequent progress on the conceptualization, development, and implementation of electronic health records and personal health records, minimal progress has occurred on the PopHR. Adapting International Organization for Standarization electronic health records standards, we define the PopHR as a repository of statistics, measures, and indicators regarding the state of and influences on the health of a defined population, in computer processable form, stored and transmitted securely, and accessible by multiple authorized users. The PopHR is based upon an explicit population health framework and a standardized logical information model. PopHR purpose and uses, content and content sources, functionalities, business objectives, information architecture, and system architecture are described. Barriers to implementation and enabling factors and a three-stage implementation strategy are delineated. PMID:20595299

  8. The bone care nurse project.

    Science.gov (United States)

    Casentini, Cristiana; Chiaramonti, Giuseppe; Amedei, Antonietta; Cioppi, Federica; Falchetti, Alberto; Masi, Laura; Brandi, Maria Luisa

    2011-01-01

    In today's society, citizens are called to play an increasingly active role in decision planning related to the various aspects of work, social and political life. This trend has been also confirmed in the health's field. In fact, the citizen is also required to have the skills to take responsibility for his/her own health, to have knowledge of the health care system, understand the advice and instructions of health professionals, actively participating with them in the therapeutical path. The lack or an inadequate level of these skills will affect both the health of the individual and the costs related to the National Health System. The nursing staff that interfaces between physicians and patients plays a key role in health's promotion as an important determinant of health and welfare of the patient-citizen. With regard to osteoporosis, due to better knowledge of its determining causes, it is now possible an easy access to diagnosis and treatment options before fragility fractures occur, providing a real prevention to such complications. Prevention must be addressed to two different, but related, objectives: 1) prevention of osteoporosis; and 2) prevention of fragility fractures in patients with osteoporosis. In the context of both primary and secondary prevention, the nurse can better informed the patients and/or citizens about either the risks related to an inappropriate behavior or situations and events particularly dangerous to health, as well as provide information to simply and effectively implement protective measures. This project aims to raise awareness and create competent and specialized nurse figures, with a good understanding of the bone diseases, through the organization of seminars and training courses. Thus, it will be create clinical pathways and welfare in which the figure of the "Bone Care Nurse" will be responsible for administration of questionnaires relating to lifestyle and, for patients in drug treatment, questionnaires designed to assess

  9. [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.

  10. 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.

  11. 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.

  12. 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.

  13. 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)

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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. PMID:27577366

  20. 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...

  1. 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...

  2. Molecular interactions in biomineralized hydroxyapatite amino acid modified nanoclay: In silico design of bone biomaterials

    International Nuclear Information System (INIS)

    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 PO43− 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 PO43− 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

  3. 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.

  4. 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...... of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group's involvement...

  5. Designing and Evaluating Health Promotion Programs: Simple Rules for a Complex Issue

    OpenAIRE

    Pronk, Nicolaas P.

    2003-01-01

    Health improvement planning models exist to support strategic management of health improvement efforts and to guide program administrators in taking a comprehensive approach to health promotion planning from problem identification to program evaluation and diffusion. This article outlines a model which follows four simple steps to program design and four simple steps to program evaluation. The first phase is characterized as the 4-Ss of program design, which includes size, scope, scalability,...

  6. Imaging of Bone Marrow.

    Science.gov (United States)

    Lin, Sopo; Ouyang, Tao; Kanekar, Sangam

    2016-08-01

    Bone marrow is the essential for function of hematopoiesis, which is vital for the normal functioning of the body. Bone marrow disorders or dysfunctions may be evaluated by blood workup, peripheral smears, marrow biopsy, plain radiographs, computed tomography (CT), MRI and nuclear medicine scan. It is important to distinguish normal spinal marrow from pathology to avoid missing a pathology or misinterpreting normal changes, either of which may result in further testing and increased health care costs. This article focuses on the diffuse bone marrow pathologies, because the majority of the bone marrow pathologies related to hematologic disorders are diffuse. PMID:27444005

  7. 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...

  8. 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...

  9. Relationship between pulmonary function and bone mineral density in the Korean National Health and Nutrition Examination Survey

    Science.gov (United States)

    Lee, In Seon; Leem, Ah Young; Lee, Sang Hoon; Rhee, Yumie; Ha, Yoon; Kim, Young Sam

    2016-01-01

    Background/Aims: Osteoporosis is common in chronic obstructive pulmonary disease (COPD) patients. The relationship between osteoporosis and COPD has been primarily reported in patients with moderate to severe COPD, but there is no report in the general population. The aim of this study is to investigate the relationship between bone mineral density (BMD) and lung function in the general Korean population. Methods: This study was based on data acquired from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES IV and V), conducted from 2008 to 2010. The study population included 4,501 subjects (aged ≥ 50 years) who underwent both spirometry and BMD. The study populations were divided into two groups by sex to correct for the effects of gender on BMD. All female participants were postmenopausal women. Results: The BMD values of the femur neck, total femur, and L-spine tended to decrease with degree of airflow limitation in both genders. To correct confounding factors, data were analyzed and adjusted for age, body mass index, fat free mass index, body fat percentage, smoking amount, parathyroid hormone levels, daily calcium and phosphorus intake, and alkaline phosphatase (ALP) levels. While the BMD of the femur neck, total femur, and L-spine was reduced significantly as age and ALP increased, the correlation between airway obstruction and BMD of all regions disappeared in both genders. Conclusions: In the general population aged 50 years and older, diminution of BMD is not associated with airway obstruction. Further investigation along other factors is needed to determine the possible role of pulmonary function and BMD. PMID:27604798

  10. Designing National Regimes that Promote Public Health Objectives

    OpenAIRE

    Gehl Sampath, Padmashree

    2003-01-01

    The Agreement on Trade Related Aspects on Intellectual Property Rights, 1995, has introduced several mandatory changes to patent protection on pharmaceuticals that can affect health care and delivery in developing countries. The potential detrimental impacts of such IPR protection raise three major concerns for developing countries in the area of public health: (a) How can developing countries deal with price increases that can result from increased patent protection to ensure access to and a...

  11. 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.

  12. Sustainable Material Selection of Toxic Chemicals in Design and Manufacturing From Human Health Impact Perspective

    OpenAIRE

    Yuan, Chris; Dornfeld, David

    2009-01-01

    Toxic chemicals used in product design and manufacturing are grave concerns due to their significant impact on human health. Sustainable material selections are needed by industry to reduce the overall impact of toxic chemicals in both design and manufacturing. In this paper, we integrate the human health impact assessment into standard material selection process for developing a sustainable material selection metric for decision support in design and manufacturing. A schematic method is pres...

  13. Guided Discussion and Activities in English for Future Health Professionals: Relationships between Nursing and Community Design

    OpenAIRE

    Wiltshire,Timothy L.; Mogami,Tamiko; Kevin M,Leyden; Maeta,Michio

    2008-01-01

    Recent interest in community design has become evident in medical circles. Relationships between a community’s design, its function, and citizens’ health are an increasing concern for people who care about the quality of human life. Among these people, an influential group is health professionals. They can play a great part in how a community can be constructed or (re)designed to afford better living conditions in society. To develop a sense of the importance of involvement in community plann...

  14. Bones, brains and B-vitamins : the impact of vitamin B12, folate and homocysteine on bone health and cognitive function in elderly

    OpenAIRE

    Wijngaarden, van, G.J.

    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 this might reduce the risk for several age-related conditions. This thesis focuses on two health outcomes frequently associated with elevated homocysteine levels and low levels of vitamin B12 and folate: osteoporosi...

  15. Design and Development of Learning Objects for Health Professionals.

    Science.gov (United States)

    Cilene Ferreira Pacheco, Katia; Schenk de Azambuja, Marcelo

    2016-01-01

    Infectious diseases have been re-emerging in developed and underdeveloped countries. In Brazil, the increasing incidence of communicable diseases is ongoing. This new reality generates the need to update the professionals of the sector, in order to make them capable of dealing with such important problem of public health. Educational actions through the usage of the learning objects can contribute to a review and an adoption of effective and safer public health practices. Thus, this scenario leads to the proposal to disseminate knowledge based on the development of learning objects concerning surveillance and prevention of communicable diseases to primary care providers, specifically community health agents. Learning Objects are interactive tools based on web which support specific learning conceptions enhancing, expanding and guiding the learners cognitive process, and when they are combined with other objects may create an efficient and flexible learning environment. PMID:27332447

  16. 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...... 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...... 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...

  17. Effects of the circuit box jumping on bone resorption, health-related to physical fitness and balance in the premenopausal women.

    Science.gov (United States)

    Anek, Achariya; Kanungsukasem, Vijit; Bunyaratavej, Narong

    2011-10-01

    The purpose of this research is to develop a circuit box jumping exercise program and to examine the effects of the circuit box jumping exercise program on bone formation, bone resorption, health related to physical fitness and balance of the premenopausal females. The samples consisted of 57 female volunteers from Chulalongkorn University, aged between 35-45. The subjects were divided into two groups: 28 females in the experimental group and 29 females in the control group by the simple random sampling method. The experimental group participated in the circuit box jumping exercise program while wearing heart rate monitors. The exercise speed was determined by the rhythm of the music. The experimental group completed two circuits of jumping at 6 stations with 10 jumps per station three times per week, for a period of twelve weeks. Each jumping box at Station 1 and 4 was 10 cm. high; the boxes at Station 2 and 5 were 15 cm. high; and at Station 3 and 6, the boxes were 20 cm. in height. The intensity is 60%-80% of a maximum heart rate. The control group did not participate in the circuit box jumping exercise program. The collected data before and after the experiment were the results of the physiology test, the biochemical bone markers, the health related physical fitness and the balance ability. The collected data were compared and analyzed by the mean and standard deviation. The differences of the tests are statistically significant at the .05 level. The results of the present study are as follows; 1. After the 12-week experiment training, the findings indicated that the mean scores on bone resorption (beta-Crosslaps) of the experimental group and the control group were significantly different at 0.05 level. In addition, the findings showed that the percentage changes on bone resorption (beta-Crosslaps) variance of the experiment group reduced by -25.6528%, while that of the control group reduced by -0.5933%. Bone formation (PINP/beta-Crosslaps) in the circuit box

  18. 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. PMID:27220014

  19. 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.

  20. Case Study: Impact of Inter- and Intra-Day Energy Parameters on Bone Health, Menstrual Function, and Hormones in an Elite Junior Female Triathlete.

    Science.gov (United States)

    Vescovi, Jason D; VanHeest, Jaci L

    2016-08-01

    This observational case study examined the association of inter- and intraday energy intake and exercise energy expenditure with bone health, menstrual status and hematological factors in a female triathlete. The study spanned 7 months whereby energy intake and exercise energy expenditure were monitored three times (13 d); 16 blood samples were taken, urinary hormones were assessed for 3 months, and bone mineral density was measured twice. Energy availability tended to be sustained below 30 kcal/kg FFM/d and intraday energy intake patterns were often "back-loaded" with approximately 46% of energy consumed after 6 p.m. Most triiodothyronine values were low (1.1-1.2nmol/L) and supportive of reduced energy availability. The athlete had suppressed estradiol (105.1 ± 71.7pmol/L) and progesterone (1.79 ±1.19nmol/L) concentrations as well as urinary sex-steroid metabolites during the entire monitoring period. Lumbar spine (L1-L4) bone mineral density was low (age-matched Z-score -1.4 to -1.5). Despite these health related maladies the athlete was able to perform typical weekly training loads (swim: 30-40 km, bike: 120-300 km, run 45-70 km) and was competitive as indicated by her continued improvement in ITU World Ranking during and beyond the assessment period. There is a delicate balance between health and performance that can become blurred especially for endurance athletes. Education (athletes, coaches, parents) and continued monitoring of specific indicators will enable evidence-based recommendations to be provided and help reduced the risk of health related issues while maximizing performance gains. Future research needs to longitudinally examine how performance on standardized tests in each discipline (e.g., 800-m swim, 20-km time trial, 5-km run) is impacted when aspects of the female athlete triad are present. PMID:26696652

  1. 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.

  2. 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.

  3. The future of global health cooperation: designing a new World Health Organization.

    Science.gov (United States)

    Forss, K; Stenson, B; Sterky, G

    1996-06-01

    This article discusses some needed changes to the functioning and management of the World Health Organization (WHO). WHO is unable to meet new challenges and needs reform. The Executive Board of WHO initiated an internal review in 1992 that led to a management-related focus, while informal groups within the agency tackled funding constraints. Some governments and nongovernmental groups have proposed reorganization of international health assistance. The authors urge that the public health sector and researchers join the reform effort. WHO was established in 1948 and was the sole global health agency. The demand for greater international health cooperation has increased over time. WHO is an association of sovereign states. WHO demonstrated success in eliminating smallpox, promotion of health policy, collection and dissemination of epidemiologic information, and establishment of standards in health care and medical ethics. WHO staff comprises about 5000 persons. The annual budget is too small at about US$900 million. In 1995 only 56% of receipts were collected. WHO's constitution mandates complete health for all, but there has been a widening gap between rich and poor and those with access to health services and those without. Absolute and relative poverty are the main determinants of premature mortality and ill health. The major challenge for health policy is this disparity; the focus of international collaboration should be on this issue. The machine metaphor of organizational structure no longer works in today's world. The authors propose that WHO limit functions in health development and create a full mandate for dealing with determinants of health. WHO should be participatory, open to constituents, autonomous, and flexible. Member states must be more powerful in policy formulation. Program implementation should occur in independent programs in a decentralized system. PMID:12291612

  4. 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.

  5. 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

  6. 同种异体骨切割设备夹持装置的设计%Design of Gripping Device of Allogeneic Bone Cutting Equipment

    Institute of Scientific and Technical Information of China (English)

    方新果; 萨拉; 赵改平; 王晨曦; 柏磊磊

    2014-01-01

    Based on bionic principle and the mechanics analysis of bone implant materials,a mechanics model for hand clamping structure with six degrees of freedom is established and a gripping device for bone cutting is designed. It is suitable for the processing of bone materials of irregular shapes and can meet requirements for va-rious specific clinic products. In addition,the operation safety and the efficiency of bone material utilization are both improved.%根据对骨植入材料的力学分析,从仿生学原理入手,建立六自由度的手夹持结构的力学模型,设计了骨切割设备夹持手机械结构。它能适应不规则形状骨材料的加工,满足临床对不同规格产品的需求,可提高操作的安全性、骨料的利用率。

  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 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.

  8. 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.

  9. Maternal serum retinal and β-carotene concentrations and neonatal bone mineralization

    DEFF Research Database (Denmark)

    Handel, Mina N.; Moon, Rebecca J.; Titcombe, Philip;

    2016-01-01

    the associations between maternal serum retinol and β-carotene concentrations during late pregnancy and offspring bone mineralization assessed at birth with the use of dual-energy X-ray absorptiometry. Design: In the Southampton Women’s Survey mother-offspring birth cohort, maternal health, lifestyle, and diet...... were assessed prepregnancy and at 11 and 34 wk of gestation. In late pregnancy, maternal serum retinol and β-carotene concentrations were measured. Offspring total body bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were measured within 2 wk after birth. Results: In total...

  10. 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

  11. 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....

  12. The Design of Health Care Management Program for Chinese Health Care Professionals

    Science.gov (United States)

    Qiu, Xiao Ling

    2008-01-01

    Business education has been booming in China due to the increasing demand of business graduates since China's economic reform. Chinese health care professionals are eager for business education to improve their competencies. The purpose of the study was to investigate the determinants of a successful health care management program for Chinese…

  13. Green Tea and Bone metabolism

    OpenAIRE

    Shen, Chwan-Li; Yeh, James K.; Cao, Jay; Wang, Jia-Sheng

    2009-01-01

    Osteoporosis is a major health problem in both elderly women and men. 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 mitigating bone loss of this population and decreasing their risk of osteoporotic fractures. This review describes the effect of green tea or its bioactive components on bone health, with an emphasis on: (...

  14. 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

  15. The Australian Defence Force Mental Health Prevalence and Wellbeing Study: design and methods

    OpenAIRE

    Van Hooff, Miranda; McFarlane, Alexander C; Christopher E. Davies; Searle, Amelia K.; Fairweather-Schmidt, A Kate; Verhagen, Alan; Benassi, Helen; Stephanie E Hodson

    2014-01-01

    Background: The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population.Objective: The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods, and identify specific occupational factors that influence mental health. This paper describes the design, sampling strategies, and methodology used in this study.Method: At Phase 1, approximately ...

  16. Taking the stairs instead: The impact of workplace design standards on health promotion strategies

    OpenAIRE

    Marian Tye; Jonine Jancey; Sarah McGann

    2013-01-01

    AbstractBackground Comprehensive health promotion in Western Australia has been conducted from the point of views of policy development, promotion, education and service delivery. Much of this recent work has been focused on supporting workplaces – but there has yet to be any real focus on the design of the actual physical workplace environment from a health promotion perspective. Aims This paper is aimed at highlighting the gap in health promotion knowledge by addressing how the disciplines ...

  17. Designing Iranian Model to Assess the Level of Health System Responsiveness

    OpenAIRE

    Askari, Roohollah; Arab, Mohammad; Rashidian, Arash; Akbari-Sari, Ali; Hosseini, Seyed Mostafa; Gharaee, Hojat

    2016-01-01

    Background: Given the rapid pace of changes in community health needs and the mission of healthcare organizations to provide and promote the community’s health, the growing need to increase health system responsiveness to people as a key element of observance and fulfillment of justice is felt more than ever. Objectives: This study was aimed at designing the native model of responsiveness for Iran and to validate the aspects of the proposed model. Materials and Methods: Our study had a cross-...

  18. On the Utility of E-Health Business Model Design Patterns

    OpenAIRE

    Sprenger, Michaela; Mettler, Tobias

    2016-01-01

    New information technologies are not only enabling new health services, but also innovative business models. As the business model defines how value is created, delivered, as well as captured by an e-health service, it is key to the service’s economic success. However, business professionals responsible for developing e-health services often feel overwhelmed when it comes to the design of a corresponding business model because they lack the respective knowledge and experience. In this situati...

  19. 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...

  20. 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...

  1. 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....

  2. 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.…

  3. 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

  4. 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.

  5. 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 (technology, and frequency of smoking. Conclusions Future mHealth cessation aids should be designed with an understanding of smokers’ needs and preferences for these tools. Doing so does not guarantee treatment effectiveness, but balancing user preferences with best-practice treatment considerations could enhance program adoption and improve treatment outcomes. Grounded in the perspectives of smokers, we identify several design considerations, which should be prioritized when designing future mHealth cessation tools and which warrant additional empirical validation. PMID:27496593

  6. 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...

  7. 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.

  8. Body composition and bone density reference data for Korean children, adolescents, and young adults according to age and sex: results of the 2009-2010 Korean National Health and Nutrition Examination Survey (KNHANES).

    Science.gov (United States)

    Kang, Min Jae; Hong, Hyun Sook; Chung, Seung Joon; Lee, Young Ah; Shin, Choong Ho; Yang, Sei Won

    2016-07-01

    We established the timing of peak bone mass acquisition and body composition maturation and provide an age- and sex-specific body composition and bone density reference database using dual-energy X-ray absorptiometry in Korean subjects 10-25 years of age. Reference percentiles and curves were developed for bone mineral content (BMC), bone mineral density (BMD) of the whole body, the lumbar spine, and the femoral neck, and for fat mass (FM) and lean mass (LM) of 1969 healthy participants (982 males) who participated in the 2009-2010 Korean National Health and Nutrition Examination Survey. Additionally, bone mineral apparent density (BMAD), FM index, and LM index were calculated to adjust for body size. BMC and BMD at all skeletal sites as well as LM increased with age, reaching plateaus at 17-20 years of age in females and 20-23 years of age in males. The femoral neck was the first to reach a bone mass plateau, followed by the lumbar spine and then the whole body. Spine BMAD increased with age in both sexes, but femoral and whole-body BMAD remained the same over time. Females displayed a dramatic increase in FM during puberty, but the FM of males decreased until mid-puberty. These findings indicate that bone health and body composition should be monitored using a normal reference database until the late second to early third decade of life, when statural growth and somatic maturation are completed. PMID:26056024

  9. 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. PMID:27515144

  10. 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)…

  11. 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 ...

  12. 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 ...

  13. 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. PMID:24986104

  14. 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.

  15. Nanocomposites and bone regeneration

    Science.gov (United States)

    James, Roshan; Deng, Meng; Laurencin, Cato T.; Kumbar, Sangamesh G.

    2011-12-01

    This manuscript focuses on bone repair/regeneration using tissue engineering strategies, and highlights nanobiotechnology developments leading to novel nanocomposite systems. About 6.5 million fractures occur annually in USA, and about 550,000 of these individual cases required the application of a bone graft. Autogenous and allogenous bone have been most widely used for bone graft based therapies; however, there are significant problems such as donor shortage and risk of infection. Alternatives using synthetic and natural biomaterials have been developed, and some are commercially available for clinical applications requiring bone grafts. However, it remains a great challenge to design an ideal synthetic graft that very closely mimics the bone tissue structurally, and can modulate the desired function in osteoblast and progenitor cell populations. Nanobiomaterials, specifically nanocomposites composed of hydroxyapatite (HA) and/or collagen are extremely promising graft substitutes. The biocomposites can be fabricated to mimic the material composition of native bone tissue, and additionally, when using nano-HA (reduced grain size), one mimics the structural arrangement of native bone. A good understanding of bone biology and structure is critical to development of bone mimicking graft substitutes. HA and collagen exhibit excellent osteoconductive properties which can further modulate the regenerative/healing process following fracture injury. Combining with other polymeric biomaterials will reinforce the mechanical properties thus making the novel nano-HA based composites comparable to human bone. We report on recent studies using nanocomposites that have been fabricated as particles and nanofibers for regeneration of segmental bone defects. The research in nanocomposites, highlight a pivotal role in the future development of an ideal orthopaedic implant device, however further significant advancements are necessary to achieve clinical use.

  16. Engaging Nurses in the Design and Adoption of mHealth Tools for Care Coordination.

    Science.gov (United States)

    Murphy, Judy

    2016-01-01

    This panel will share ideas for the Nursing Informatics Specialists in the audience on how mHealth tools are being designed and used for clinical practice, education and research. They will describe specific mHealth projects they are involved in, give practical examples, and provide tangible tactics for nurses to make a difference. They will provide insight into new technology and standards developments that make it easy to connect the mobile app ecosystem - from open application program interfaces (APIs), to traditional health information technology tools like Electronic Health Records (EHRs). PMID:27332334

  17. Design of a community-based intergenerational oral health study: “Baby Smiles”

    OpenAIRE

    Milgrom, Peter; Riedy, Christine A.; Weinstein, Philip; Mancl, Lloyd A.; Garson, Gayle; Huebner, Colleen E; Smolen, Darlene; Sutherland, Marilynn

    2013-01-01

    Background Rural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care. The Baby Smiles study was designed to increase low-income pregnant women’s utilization of dental care, increase young children’s dental care utilization, and improve home oral health care practices. Methods/design Baby Smiles was a five-year, four-site randomized intervention trial with a 2 × 2 factorial design. Four hundred participants were rand...

  18. Vitamin D supplementation review and recommendations for women diagnosed with breast or ovary cancer in the context of bone health and cancer prognosis/risk.

    Science.gov (United States)

    Martin-Herranz, Ana; Salinas-Hernández, Pedro

    2015-10-01

    Vitamin D review and supplementation recommendations for women diagnosed with breast or ovary cancer have been defined in the context of bone health and cancer prognosis/risk taking as reference wider cancer patients and postmenopausal women. This specific group has been selected due to its higher osteoporosis risk versus postmenopausal women. Early vitamin D supplementation could help maintain bone health, as well as potentially enhance cancer survival rate. Factors considered for supplementation include daily dose, periodicity, chemical form, administration, and serum levels. Sufficient vitamin D serum levels are recommended to be above 30 ng/ml (75 nmol/l). Maintenance oral supplementation equivalent to a minimum daily dosage of 800-1000 IU (20-25 μg) cholecalciferol provided in a daily to monthly bases is preferred, also advised to start with higher dosages when vitamin D serum levels are ng/ml (25 nmol/l). Calcidiol supplementation is more effective, making it advantageous for cases with very low or difficult to raise vitamin D serum levels. PMID:26068240

  19. 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.

  20. Building communication strategy on health prevention through the human-centered design

    OpenAIRE

    Karine de Mello Freire; Caio Marcelo Miolo de Oliveira

    2016-01-01

    It has been identified a latent need for developing efficient communication strategies for prevention of diseases and also, design as a potential agent to create communications artifacts that are able to promote self-care. In order to analyze a design process that develops this kind of artifact, an action research in IAPI Health Center in Porto Alegre was done. The action’s goal was to design a strategy to promote self-care to prevent cervical cancer. The process was conducted ...

  1. Impacto dos nutrientes na saúde óssea: novas tendências Nutrients impact on bone health: new trends

    Directory of Open Access Journals (Sweden)

    Glaucia Queiroz Morais

    2007-07-01

    this peak. In adult age, individuals who reached a high PBM will have a low risk of developing bone metabolic diseases when aging. Nutrients exert intense and wide-ranging effects on skeletal structures. Some of them have been consistently related with bone health, such as calcium, phosphorus and vitamin D. However, it has been suggested that other nutrients are essential for normal bone metabolism: proteins, lipids, potassium, vitamins K and A, and sodium chloride. The influence of interactions between these nutritional factors, environment, lifestyle, and heredity will help understand the complex development of osteoporosis and subsequent fractures. In addition, energy deficits can lead to reduced bone mass, in view of endocrine-metabolic disorders caused by food deprivation. This review aims at clarifying the impact of nutrients and of calories intake on the bones during different stages in life, describing possible interactions among nutrients and how these could affect bone and mineral homeostasis.

  2. 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.

  3. 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

  4. 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

    , 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...

  5. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... HPSAs were revised and published on March 2, 1989, in Federal Register (54 FR 8735). The criteria for psychiatric HPSAs were expanded to mental health HPSAs on January 22, 1992 (57 FR 2473). Currently-funded PHS... lists published in the Federal Register on November 3, 2011 (76 FR 68198). The lists include...

  6. 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.

  7. Taking the stairs instead: The impact of workplace design standards on health promotion strategies

    Directory of Open Access Journals (Sweden)

    Marian Tye

    2013-01-01

    Full Text Available AbstractBackground Comprehensive health promotion in Western Australia has been conducted from the point of views of policy development, promotion, education and service delivery. Much of this recent work has been focused on supporting workplaces – but there has yet to be any real focus on the design of the actual physical workplace environment from a health promotion perspective. Aims This paper is aimed at highlighting the gap in health promotion knowledge by addressing how the disciplines of architecture and health promotion can work together to challenge the regulations that dictate design practice and ultimately bridge that gap for long-term change. The overarching aim is to undertake further evidenced-based research that will inform best practice in the planning and design of workplaces to reduce sedentary behaviour and increase opportunities for physical activity. Method Within this wide objective this paper focuses in particular on the idea of stairs-versus-lift movement strategies within office buildings. By examining building design guidelines from a health promotion perspective we expose a central dichotomy, where health promotion posters say “Take the stairs instead” whereas the language of building design suggests that the lift is best. Results From a design point of view, the National Codes of Construction (NCC, formally known as the Building Codes of Australia (BCA, the essential technical regulation for all building design and construction, primarily addresses the concepts of ‘egress’ and ‘travel distance’ for escape in the event of fire, and building access in terms of universal access. Additionally, The Property Council of Australia’s Guide to Office Building Quality prioritises lift performance criteria along with the quality and experience of lift use as a major grading factor. There is no provision in either set of standards for staircase quality and experience. Conclusion The stairs, despite being promoted

  8. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  9. 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.

  10. Immediate loading short implants inserted on low bone quantity for the rehabilitation of the edentulous maxilla using an All-on-4 design.

    Science.gov (United States)

    Maló, P; de Araújo Nobre, M A; Lopes, A V; Rodrigues, R

    2015-08-01

    More studies evaluating the outcome of short-length dental implants in immediate loading are needed. To evaluate the use of short-length tapered implants in immediate loading for complete edentulous maxillae rehabilitations using an All-on-4 design. This retrospective clinical study included a cohort of 43 patients with 172 implants (74 short-length implants) inserted in low bone quantity. The patients were followed between 4 months and 6 years (average = 3 years). Outcome measures were implant survival, marginal bone remodelling, biological and mechanical complications. Two patients with four short-length implants were lost to follow-up during the first year. Three short and three long implants failed in four patients, rendering an overall cumulative survival rate implant and patient level, respectively, of 95.7% and 95.1% for short implants, 100% for regular implants and 96.6% and 95.2% for long implants. The average marginal bone remodelling at 1 and 3 years was 0.97 and 1.25 mm for the short implants, 0.82 and 0.87 mm for regular implants and 0.87 and 0.98 mm for long implants. Three patients presented 4 short-length implants with peri-implant pockets (3 implants in 2 patients were pseudo-pockets). Mechanical complications were registered in 13 patients (7 provisional prostheses fractures and 6 abutment screw loosening). All complications were treated successfully. Within the limitations of this clinical study, the short-term outcome of fixed prosthetic complete edentulous maxillae rehabilitations supported by short-length implants inserted in low bone quantity areas is viable. Long-term clinical studies are necessary for evaluating the outcome of these implants. PMID:25757870

  11. 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 (games or other rewarding incentives to encourage program use differed by age group. Based on quantitative analysis of surveys, participants rated the importance of select design features significantly differently (Pvideos and posting on social media. Communicating with stop-smoking experts was rated more important than communicating with family and friends about quitting (P=.03). Perceived importance of various design features varied by age, experience with technology, and frequency of smoking. Conclusions Future mHealth cessation aids should be designed with an understanding of smokers’ needs and preferences for these tools. Doing so does not guarantee treatment effectiveness, but balancing user preferences with best-practice treatment considerations could enhance program adoption and improve treatment outcomes. Grounded in the perspectives of smokers, we identify several design considerations, which should be prioritized when designing future mHealth cessation tools and which

  12. 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.

  13. 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

  14. 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.

  15. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children.

    Directory of Open Access Journals (Sweden)

    Francesco Gianfagna

    Full Text Available Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2 ± 1.8 years from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714, was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ= -1.8, p=0.006. Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0-43.9%, the CCT haplotype (frequency=39.7% was associated with lower SI values (dominant model, Δ= -1.0, p=0.04 as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4% showed much lower SI than non-carriers (Δ= -3.9, p<0.0001; p for interaction=0.025. The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p=0.01. This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls.

  16. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children.

    Science.gov (United States)

    Gianfagna, Francesco; Cugino, Daniela; Ahrens, Wolfgang; Bailey, Mark E S; Bammann, Karin; Herrmann, Diana; Koni, Anna C; Kourides, Yiannis; Marild, Staffan; Molnár, Dénes; Moreno, Luis A; Pitsiladis, Yannis P; Russo, Paola; Siani, Alfonso; Sieri, Sabina; Sioen, Isabelle; Veidebaum, Toomas; Iacoviello, Licia

    2013-01-01

    Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2 ± 1.8 years) from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet) and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714), was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ= -1.8, p=0.006). Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0-43.9%), the CCT haplotype (frequency=39.7%) was associated with lower SI values (dominant model, Δ= -1.0, p=0.04) as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4%) showed much lower SI than non-carriers (Δ= -3.9, p<0.0001; p for interaction=0.025). The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p=0.01). This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls. PMID:23936460

  17. 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

  18. Bone Cancer

    Science.gov (United States)

    ... cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy, and radiation therapy. Because bone cancer can come back after treatment, regular follow-up visits are important. NIH: National ...

  19. Wnt Signaling in Bone

    Science.gov (United States)

    Kubota, Takuo; Michigami, Toshimi; Ozono, Keiichi

    2010-01-01

    Wnt signaling is involved not only in embryonic development but also in maintenance of homeostasis in postnatal tissues. Multiple lines of evidence have increased understanding of the roles of Wnt signaling in bone since mutations in the LRP5 gene were identified in human bone diseases. Canonical Wnt signaling promotes mesenchymal progenitor cells to differentiate into osteoblasts. The canonical Wnt/β-catenin pathway possibly through Lrp6, a co-receptor for Wnts as well as Lrp5, in osteoblasts regulates bone resorption by increasing the OPG/RANKL ratio. However, endogenous inhibitors of Wnt signaling including sclerostin block bone formation. Regulation of sclerostin appears to be one of the mechanisms of PTH anabolic actions on bone. Since sclerostin is almost exclusively expressed in osteocytes, inhibition of sclerostin is the most promising design. Surprisingly, Lrp5 controls bone formation by inhibiting serotonin synthesis in the duodenum, but not by directly promoting bone formation. Pharmacological intervention may be considered in many components of the canonical Wnt signaling pathway, although adverse effects and tumorigenicity to other tissues are important. More studies will be needed to fully understand how the Wnt signaling pathway actually influences bone metabolism and to assure the safety of new interventions. PMID:23926379

  20. 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

  1. A designated centre for people with disabilities operated by Health Service Executive, Cavan

    LENUS (Irish Health Repository)

    Allen, Finbarr

    2011-03-14

    Population trends suggest that the Irish population is ageing, and that this population will have substantial treatment needs. These patients will be better informed than previous generations, and will demand treatment aimed at preserving a natural dentition. This will impact upon delivery of oral healthcare and manpower planning needs to consider how to address the increased demand for dental care. Poor oral health is associated with systemic health problems, including cardiovascular disease, respiratory disease and diabetes mellitus. It also has a negative impact upon quality of life, and the World Health Organisation has encouraged public healthcare administrators and decision makers to design effective and affordable strategies for better oral health and quality of life of older adults, which, in turn, are integrated into general health management programmes. Treatment concepts such as minimally invasive dentistry and the shortened dental arch concept are discussed in the context of these demographic changes and recommendations.

  2. 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

  3. 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.

  4. Towards the Design of 3D Fiber-Deposited Poly(ε-caprolactone)/lron-Doped Hydroxyapatite Nanocomposite Magnetic Scaffolds for Bone Regeneration.

    Science.gov (United States)

    De Santis, Roberta; Russo, Alessandro; Gloria, Antonio; D'Amora, Ugo; Russo, Teresa; Panseri, Silvia; Sandri, Monica; Tampieri, Anna; Marcacci, Maurilio; Dediu, Valentin A; Wilde, Colin J; Ambrosio, Luigi

    2015-07-01

    In the past few years, researchers have focused on the design and development of three-dimensional (3D) advanced scaffolds, which offer significant advantages in terms of cell performance. The introduction of magnetic features into scaffold technology could offer innovative opportunities to control cell populations within 3D microenvironments, with the potential to enhance their use in tissue regeneration or in cell-based analysis. In the present study, 3D fully biodegradable and magnetic nanocomposite scaffolds for bone tissue engineering, consisting of a poly(ε-caprolactone) (PCL) matrix reinforced with iron-doped hydroxyapatite (FeHA) nanoparticles, were designed and manufactured using a rapid prototyping technique. The performances of these novel 3D PCL/FeHA scaffolds were assessed through a combination of theoretical evaluation, experimental in vitro analyses and in vivo testing in a rabbit animal model. The results from mechanical com- pression tests were consistent with FEM simulations. The in vitro results showed that the cell growth in the magnetized scaffolds was 2.2-fold greater than that in non-magnetized ones. In vivo experiments further suggested that, after only 4 weeks, the PCL/FeHA scaffolds were completely filled with newly formed bone, proving a good level of histocompatibility. All of the results suggest that the introduction of magnetic features into biocompatible materials may confer significant advantages in terms of 3D cell assembly. PMID:26307846

  5. Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework

    Science.gov (United States)

    Lilienthal, Anneliese; Shluzas, Lauren Aquino; Masiello, Italo; Zary, Nabil

    2015-01-01

    Background Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. Objective This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs’ rational use of antibiotics. Methods The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. Results The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories—situated, experiential, and transformative learning—provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners’ personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level

  6. 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

  7. 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.

  8. 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.

  9. Are Biophilic-Designed Site Office Buildings Linked to Health Benefits and High Performing Occupants?

    OpenAIRE

    Tonia Gray; Carol Birrell

    2014-01-01

    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 int...

  10. Wear, bone density, functional outcome and survival in vitamin E-incorporated polyethylene cups in reversed hybrid total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Veen Hugo C

    2012-09-01

    Full Text Available Abstract Background Aseptic loosening of total hip arthroplasties is generally caused by periprosthetic bone resorption due to tissue reactions on polyethylene wear particles. In vitro testing of polyethylene cups incorporated with vitamin E shows increased wear resistance. The objective of this study is to compare vitamin E-stabilized highly cross-linked polyethylene with conventional cross-linked polyethylene in “reversed hybrid” total hip arthroplasties (cemented all-polyethylene cups combined with uncemented femoral stems. We hypothesize that the adjunction of vitamin E leads to a decrease in polyethylene wear in the long-term. We also expect changes in bone mineral density, less osteolysis, equal functional scores and increased implant survival in polyethylene cemented cups incorporated with vitamin E in the long-term. Design A double-blinded randomized controlled trial will be conducted. Patients to be included are aged under 70, suffer from non-inflammatory degenerative joint disease of the hip and are scheduled for a primary total hip arthroplasty. The study group will receive a reversed hybrid total hip arthroplasty with a vitamin E-stabilized highly cross-linked polyethylene cemented cup. The control group will receive a reversed hybrid total hip arthroplasty with a conventional cross-linked polyethylene cemented cup. Radiological follow-up will be assessed at 6 weeks and at 1, 3, 5, 7 and 10 years postoperatively, to determine polyethylene wear and osteolysis. Patient-reported functional status (HOOS, physician-reported functional status (Harris Hip Score and patients’ physical activity behavior (SQUASH will also be assessed at these intervals. Acetabular bone mineral density will be assessed by dual energy X-ray absorptiometry (DEXA at 6 weeks and at 1 year and 2 years postoperatively. Implant survival will be determined at 10 years postoperatively. Discussion In vitro results of vitamin E-stabilized polyethylene are promising

  11. 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

  12. Lessons of Researcher-Teacher Co-design of an Environmental Health Afterschool Club Curriculum

    Science.gov (United States)

    Hundal, Savreen; Levin, Daniel M.; Keselman, Alla

    2014-06-01

    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) students' understanding of environmental health, (2) use of electronic resources, and (3) argumentation skills. The process included researcher-led sessions emphasizing the importance of argumentation to science and teacher-led curriculum design sessions. The qualitative analysis of the meetings and teacher interview transcripts suggests that while teachers viewed argumentation as important, its practice was relegated to the background by the focus on student engagement and perceived logistical and systemic constraints. The paper concludes that in addition to stressing relevance of argumentation to science learning, researchers involved in co-design need to emphasize the potential of argumentation to engage students and to fit into science curriculum. The analysis also reveals teacher-participants' views of environmental health as an important area of middle school education, relevant to students' lives, linkable to the existing curriculum, essential for informed citizenship, and capable of inspiring interest in science. These findings underscore the importance of integrating environmental health into science education and advocating for its inclusion in informal and formal educational settings.

  13. 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?

  14. Designing Health Websites Based on Users’ Web-Based Information-Seeking Behaviors: A Mixed-Method Observational Study

    Science.gov (United States)

    Pang, Patrick Cheong-Iao; Verspoor, Karin; Pearce, Jon

    2016-01-01

    Background Laypeople increasingly use the Internet as a source of health information, but finding and discovering the right information remains problematic. These issues are partially due to the mismatch between the design of consumer health websites and the needs of health information seekers, particularly the lack of support for “exploring” health information. Objective The aim of this research was to create a design for consumer health websites by supporting different health information–seeking behaviors. We created a website called Better Health Explorer with the new design. Through the evaluation of this new design, we derive design implications for future implementations. Methods Better Health Explorer was designed using a user-centered approach. The design was implemented and assessed through a laboratory-based observational study. Participants tried to use Better Health Explorer and another live health website. Both websites contained the same content. A mixed-method approach was adopted to analyze multiple types of data collected in the experiment, including screen recordings, activity logs, Web browsing histories, and audiotaped interviews. Results Overall, 31 participants took part in the observational study. Our new design showed a positive result for improving the experience of health information seeking, by providing a wide range of information and an engaging environment. The results showed better knowledge acquisition, a higher number of page reads, and more query reformulations in both focused and exploratory search tasks. In addition, participants spent more time to discover health information with our design in exploratory search tasks, indicating higher engagement with the website. Finally, we identify 4 design considerations for designing consumer health websites and health information–seeking apps: (1) providing a dynamic information scope; (2) supporting serendipity; (3) considering trust implications; and (4) enhancing interactivity

  15. A conceptual curriculum framework designed to ensure quality student health visitor training in practice.

    Science.gov (United States)

    Hollinshead, Jayne; Stirling, Linda

    2014-07-01

    This paper describes the challenges faced by a trust in England following the introduction of the Health Visitor Implementation Plan. Two practice education facilitators designed a conceptual curriculum framework to ensure quality student health visitor education in practice. This curriculum complimented the excellent academic course already delivered by the University. A justification is provided for the design of the curriculum framework, including a rationale for the introduction of specific training sessions. Student and practice teacher feedback demonstrate the success of the introduction of this programme to ensure the development of student health visitors fit for practice. The conclusion places emphasis on the importance of continuous evaluation of the training programme to meet the needs of the students and the service. PMID:25167726

  16. 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.

  17. Effects of age, sex, and ethnicity on bone health status of the elderly in Kuala Lumpur, Malaysia

    OpenAIRE

    Chin, Kok-Yong

    2016-01-01

    Kok-Yong Chin,1 Alia Annessa Ain Kamaruddin,2 Nie Yen Low,2 Soelaiman Ima-Nirwana1 1Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, 2ASASIpintar, PERMATApintar National Gifted Centre, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia Background: Osteoporosis is a significant health problem in the developing countries and its prevalence data are important for the estimation of health care burden and policy making. ...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 21 CFR 888.3000 - Bone cap.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone cap. 888.3000 Section 888.3000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3000 Bone cap. (a) Identification. A bone cap is a...

  3. Food and Your Bones

    Science.gov (United States)

    ... Store Shopping Cart Home › Patients › Treatment › Nutrition Nutrition Food For Thought Quiz True or false: Prunes contain ... health. True False View Answers Loading ... Sponsored by: Food and Your Bones – Osteoporosis Nutrition Guidelines The food ...

  4. 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.

  5. A Review of Design and Policy Interventions to Promote Nurses' Restorative Breaks in Health Care Workplaces.

    Science.gov (United States)

    Nejati, Adeleh; Shepley, Mardelle; Rodiek, Susan

    2016-02-01

    The nursing profession in the United States is on the precipice of a crisis. Nurses are essential to the health care industry, and maintaining quality nursing care is a primary concern of today's health care managers. Health care facilities report high rates of staff burnout and turnover, and interest in the nursing profession among younger students is declining. Health care leaders must improve nurses' job satisfaction, performance, and retention. However, they often overlook the need for nurses' respite and underestimate the value of well-designed staff break areas. An exhaustive and systematic literature search was conducted in the summer of 2014, and all studies found on the topic were reviewed for their relevance and quality of evidence. The existing literature about the main causes of nurses' fatigue, barriers that prevent nurses from taking restorative breaks, and consequences of nurses' fatigue for staff, patient, and facility outcomes demonstrates the pressing need for interventions that improve nurses' working conditions. Additional literature on the restorative effects of breaks and the value of well-designed break areas indicates that efforts to improve breakroom design can play an important role in improving nurses' job satisfaction and performance. PMID:26814229

  6. PCASSO: a design for secure communication of personal health information via the internet.

    Science.gov (United States)

    Baker, D B; Masys, D R

    1999-05-01

    The Internet holds both promise and peril for the communications of person-identifiable health information. Because of technical features designed to promote accessibility and interoperability rather than security, Internet addressing conventions and transport protocols are vulnerable to compromise by malicious persons and programs. In addition, most commonly used personal computer (PC) operating systems currently lack the hardware-based system software protection and process isolation that are essential for ensuring the integrity of trusted applications. Security approaches designed for electronic commerce, that trade known security weaknesses for limited financial liability, are not sufficient for personal health data, where the personal damage caused by unintentional disclosure may be far more serious. To overcome these obstacles, we are developing and evaluating an Internet-based communications system called PCASSO (Patient-centered access to secure systems online) that applies state of the art security to health information. PCASSO includes role-based access control, multi-level security, strong device and user authentication, session-specific encryption and audit trails. Unlike Internet-based electronic commerce 'solutions,' PCASSO secures data end-to-end: in the server; in the data repository; across the network; and on the client. PCASSO is designed to give patients as well as providers access to personal health records via the Internet. PMID:10219949

  7. 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.

  8. 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

  9. [Bone diseases].

    Science.gov (United States)

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  10. The study design and characteristics of the Danish national health interview surveys

    DEFF Research Database (Denmark)

    Ekholm, Ola; Hesse, Ulrik; Davidsen, Michael;

    2009-01-01

    AIMS: The Danish National Institute of Public Health, University of Southern Denmark has carried out national representative health interview surveys among adult Danes in 1987, 1994, 2000 and 2005. The aim of this study is to describe the characteristics of the design, including the response rates...... at the respondent's home. Following the interview in 1994, 2000 and 2005, all respondents were asked to complete a self-administered questionnaire. RESULTS: The response rate for the face-to-face interview fell from 79.9% in 1987 to 66.7% in 2005 and the response rate for the self-administered questionnaire from 68...

  11. 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

  12. 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.

  13. 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.

  14. 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.

    2013-01-01

    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. PMID:24499843

  15. Optical fiber based sensing system design for the health monitoring of multi-layered pavement structure

    Science.gov (United States)

    Liu, Wanqiu; Wang, Huaping; Zhou, Zhi; Li, Shiyu; Ni, Yuanbao; Wang, Geng

    2011-11-01

    This paper introduces an optical fiber based sensing system design for multi-layered pavement structural health monitoring. The co-line and integration design of FBG (Fiber Bragg Gating) sensors and BOTDR (Brillouin Optical Time Domain Reflectometry) sensors will ensure the large scale damage monitoring and local high accurate strain measurement. The function of pavement structure multi-scale shape measurement will provide real time subgrade settlement and rutting information. The sensor packaging methodology and strain transfer problem of the system will also be discussed in this paper. Primary lab tests prove the potential and feasibility of the practical application of the sensing system.

  16. 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.

  17. 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.

  18. Talking Bones.

    Science.gov (United States)

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  19. Bone Markers

    Science.gov (United States)

    ... bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker for bone resorption. It is ... resorption include: N-telopeptide (N-terminal telopeptide of type 1 collagen (NTx)) – a peptide fragment from the amino terminal ...

  20. 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.

  1. 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.

  2. Bone Density Testing: An Under-Utilised and Under-Researched Health Education Tool for Osteoporosis Prevention?

    Directory of Open Access Journals (Sweden)

    Graeme Jones

    2010-09-01

    Full Text Available Feedback of fracture risk based on bone mineral density (BMD is an under-explored potential osteoporosis education intervention. We performed a randomised controlled trial of either an osteoporosis information leaflet or small group education (the Osteoporosis Prevention and Self-Management Course (OPSMC, combined with individualised fracture risk feedback in premenopausal women over two years. Women with a mean T-score at spine and hip of < 0 were informed they were at higher risk of fracture in later life and those with T-score ≥ 0 were informed they were not. Women receiving feedback of high fracture risk had a greater increase in femoral neck, but not lumbar spine, BMD compared to the low risk group (1.6% p.a. vs. 0.7% p.a., p = 0.0001. Participation in the OPSMC had no greater effect on BMD than receiving the leaflet. Femoral neck BMD change was associated with starting calcium supplements (1.3% p.a., 95% CI +0.49, +2.17 and self-reported physical activity change (0.7% p.a., 95% CI +0.22, +1.22. Mother’s report of increasing their children’s calcium intake was associated with receiving the OPSMC (OR 2.3, 95% CI 1.4, 3.8 and feedback of high fracture risk (OR 2.0, 95% CI 1.2, 3.3. Fracture risk feedback based on BMD could potentially make an important contribution to osteoporosis prevention but confirmation of long-term benefits and cost effectiveness is needed before implementation can be recommended.

  3. Latin American Study of Nutrition and Health (ELANS): rationale and study design

    OpenAIRE

    M. Fisberg; Kovalskys, I.; Gómez, G.; Rigotti, A; Cortés, L. Y.; Herrera-Cuenca, M.; Yépez, M. C.; Pareja, R. G.; Guajardo, V.; I.Z. Zimberg; Chiavegatto Filho, A. D. P.; Pratt, M.; Koletzko, B; Tucker, K L; ,

    2016-01-01

    Background Obesity is growing at an alarming rate in Latin America. Lifestyle behaviours such as physical activity and dietary intake have been largely associated with obesity in many countries; however studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The aim of this study is to present the design rationale of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutrición y Salud (ELANS) w...

  4. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A

    1999-01-01

    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone....... The weak response at the distal forearm during antiresorptive treatment has restricted the use of bone densitometry at this region. We describe a new model for bone densitometry at the distal forearm, by which the response obtained is comparable to the response in other regions where bone densitometry...... is much more expensive and technically complicated. By computerized iteration of single X-ray absorptiometry forearm scans we defined a region with 65% trabecular bone. The region was analyzed in randomized, double-masked, placebo- controlled trials: a 2-year trial with alendronate (n = 69), a 1-year...

  5. Seasonal variation in 25(OHD at Aberdeen (57°N and bone health indicators--could holidays in the sun and cod liver oil supplements alleviate deficiency?

    Directory of Open Access Journals (Sweden)

    Alexandra Mavroeidi

    Full Text Available Vitamin D has been linked with many health outcomes. The aim of this longitudinal study, was to assess predictors of seasonal variation of 25-hydroxy-vitamin D (25(OHD (including use of supplements and holidays in sunny destinations at a northerly latitude in the UK (57°N in relation to bone health indicators. 365 healthy postmenopausal women (mean age 62.0 y (SD 1.4 had 25(OHD measurements by immunoassay, serum C-telopeptide (CTX, estimates of sunlight exposure (badges of polysulphone film, information regarding holidays in sunny destinations, and diet (from food diaries, including use of supplements such as cod liver oil (CLO at fixed 3-monthly intervals over 15 months (subject retention 88% with an additional 25(OHD assessment in spring 2008. Bone mineral density (BMD at the lumbar spine (LS and dual hip was measured in autumn 2006 and spring 2007 (Lunar I-DXA. Deficiency prevalence (25(OHD<25 nmol/L was reduced in women who went on holiday to sunny destinations 3 months prior to their visit, compared to women who did not go on holidays [5.4% vs. 24.6% in Spring (p<0.001 and 3.8% vs. 25.6% in Winter (p = 0.001, respectively]. Similarly deficiency was lower amongst those who took CLO supplements compared to women that did not consume these supplements [2.0% vs. 23.7% in Spring (p = 0.001 and 4.5% vs. 24.8% in winter (p = 0.005, respectively]. There was no seasonal variation in CTX; 25(OHD predicted a small proportion (1.8% variation of LS BMD in spring 2007 [unstandardized β (SE: 0.039 (0.016, p = 0.017]. Seasonal variation of 25(OHD had little effect on BMD and no effect on CTX. It appears that small increments in vitamin D (e.g. those that can be achieved by cod liver oil supplements of 5 µg/day are sufficient to ensure that 25(OHD is above 25 nmol/L for most people throughout the year. Similarly, holidays in sunny destinations show benefit.

  6. 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.

  7. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

    Science.gov (United States)

    Murcott, W J

    2014-09-01

    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  8. Strategic relevance and accountability expectations: new perspectives for health care information technology design.

    Science.gov (United States)

    Tan, J K; Modrow, R E

    1999-05-01

    In this article, we discuss the traditional systems analysis perspective on end-user information requirements analysis and extend it to merge with the new accountability expectations perspective to guide the future planning and design of health organization information systems. Underlying the strategic relevance of health care information technology (HCIT) are three critical questions: (1) What is the ideal HCIT model for the health organization in terms of achieving strategic expertise and competitive advantage? Specifically, how does this model link industry performance standards with organizational performance and accountability expectations? (2) How should the limitations of past HCIT models be reconciled to the benefits presented by the superior arrangement of the ideal model in the context of changing accountability expectations? (3) How should alternative HCIT solutions be evaluated in light of evidence-based accountability and organizational performance benchmarking? Insights into these questions will ensure that health care managers, HCIT practitioners and researchers can continue to focus on the most critical issues in harnessing today's fast-paced changing technologies for evolving strategically relevant, performance-based health organization systems. PMID:10387658

  9. Peer-to-peer computing in health-promoting voluntary organizations: a system design analysis.

    Science.gov (United States)

    Irestig, Magnus; Hallberg, Niklas; Eriksson, Henrik; Timpka, Toomas

    2005-10-01

    A large part of the health promotion in today's society is performed as peer-to-peer empowerment in voluntary organisations such as sports clubs, charities, and trade unions. In order to prevent work-related illness and long-term sickness absence, the aim of this study is to explore computer network services for empowerment of employees by peer-to-peer communication. The 'technique trade-off method was used for the analysis of the system design. A Critical Incident Technique questionnaire was distributed to a representative sample of trade union shop stewards (n = 386), and focus-group seminars were arranged where a preliminary set of requirements was discussed. Seven basic requirements were identified and matched to a set of 12 design issues for computer network services, allocating a subset of design issues to each requirement. The conclusion is that the systems design displays an inexpensive and potentially feasible method for peer-to-peer computing in voluntary health-promoting organisations. PMID:16180479

  10. Sexual health of ethnic minority MSM in Britain (MESH project: design and methods

    Directory of Open Access Journals (Sweden)

    Low Nicola

    2010-07-01

    Full Text Available Abstract Background Men who have sex with men (MSM remain the group most at risk of acquiring HIV infection in Britain. HIV prevalence appears to vary widely between MSM from different ethnic minority groups in this country for reasons that are not fully understood. The aim of the MESH project was to examine in detail the sexual health of ethnic minority MSM living in Britain. Methods/Design The main objectives of the MESH project were to explore among ethnic minority MSM living in Britain: (i sexual risk behaviour and HIV prevalence; (ii their experience of stigma and discrimination; (iii disclosure of sexuality; (iv use of, and satisfaction with sexual health services; (v the extent to which sexual health services (for treatment and prevention are aware of the needs of ethnic minority MSM. The research was conducted between 2006 and 2008 in four national samples: (i ethnic minority MSM living in Britain; (ii a comparison group of white British MSM living in Britain; (iii NHS sexual health clinic staff in 15 British towns and cities with significant ethnic minority communities and; (iv sexual health promotion/HIV prevention service providers. We also recruited men from two "key migrant" groups living in Britain: MSM born in Central or Eastern Europe and MSM born in Central or South America. Internet-based quantitative and qualitative research methods were used. Ethnic minority MSM were recruited through advertisements on websites, in community venues, via informal networks and in sexual health clinics. White and "key migrant" MSM were recruited mostly through Gaydar, one of the most popular dating sites used by gay men in Britain. MSM who agreed to take part completed a questionnaire online. Ethnic minority MSM who completed the online questionnaire were asked if they would be willing to take part in an online qualitative interview using email. Service providers were identified through the British Association of Sexual Health and HIV (BASHH and

  11. Exercise Brings Bone Benefits that Last

    Science.gov (United States)

    ... Talk Health Capsules Exercise Brings Bone Benefits that Last Paralyzed Men Regain Movement Featured Website: Mental Health Topics Past Issues Most Viewed May 2014 Print RSS Find us on Facebook External link, please review our exit ...

  12. A designated centre for people with disabilities operated by Health Service Executive, Meath

    LENUS (Irish Health Repository)

    Wasserman, Danuta

    2010-04-13

    Abstract Background There have been only a few reports illustrating the moderate effectiveness of suicide-preventive interventions in reducing suicidal behavior, and, in most of those studies, the target populations were primarily adults, whereas few focused on adolescents. Essentially, there have been no randomized controlled studies comparing the efficacy, cost-effectiveness and cultural adaptability of suicide-prevention strategies in schools. There is also a lack of information on whether suicide-preventive interventions can, in addition to preventing suicide, reduce risk behaviors and promote healthier ones as well as improve young people\\'s mental health. The aim of the SEYLE project, which is funded by the European Union under the Seventh Framework Health Program, is to address these issues by collecting baseline and follow-up data on health and well-being among European adolescents and compiling an epidemiological database; testing, in a randomized controlled trial, three different suicide-preventive interventions; evaluating the outcome of each intervention in comparison with a control group from a multidisciplinary perspective; as well as recommending culturally adjusted models for promoting mental health and preventing suicidal behaviors. Methods and design The study comprises 11,000 adolescents emitted from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the scientific coordinating center. Each country performs three active interventions and one minimal intervention as a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents, and screening for at-risk adolescents by health professionals. Structured questionnaires are utilized at baseline, 3- and 12-month follow-ups in order to assess changes. Discussion Although it has been reported that suicide

  13. Designing an Operational Planning Model for Level-one Iranian Primary Health Care Systems

    Directory of Open Access Journals (Sweden)

    Amir-Ashkan Nasiripour

    2008-01-01

    Full Text Available Introduction: This research was performed in 2008 in order to design an operational planning model for Iranian primary health care systems at level one. Methods: In this applied study, which was done in a descriptive and cross-sectional manner, some countries and international organizations which had comprehensive planning systems and some local organizations were studied. The required data from the selected countries were collected through data collection forms, and for local organizations, the data were collected through interview, and the initial model was presented accordingly. The model was tested via Delphi technique and taking the authorities’ views into account, the required changes were made and the ultimate model was prepared. Results: All the studied overseas and indigenous organizations had programming systems. However, none of the level-one Iranian primary health care units had a coherent planning system, and they did not follow any specific models. Since 2008, the model of operational planning has also been utilized by Iranian Ministry of Health, Care and Medical Education at headquarters levels; however, there was no model at lower levels especially in rural and urban health care centers. In all selected countries, the model of programs included title, objectives or expected results, schedule, activities, budget system and evaluation and monitoring indexes. Though these parts existed in the common models in Iran, no scientific basis could be observed in compiling the operational programs. The mechanism of designing the initial suggested operational planning had eight stages, but after three stages of reviewing by authorities, seven stages were ratified. Conclusion: Utilizing the suggested operational planning model can enhance the level-one performance indicators of health care networks in Iran

  14. Building communication strategy on health prevention through the human-centered design

    Directory of Open Access Journals (Sweden)

    Karine de Mello Freire

    2016-03-01

    Full Text Available It has been identified a latent need for developing efficient communication strategies for prevention of diseases and also, design as a potential agent to create communications artifacts that are able to promote self-care. In order to analyze a design process that develops this kind of artifact, an action research in IAPI Health Center in Porto Alegre was done. The action’s goal was to design a strategy to promote self-care to prevent cervical cancer. The process was conducted from the human centered design approach - HCD, which seeks to create solutions desirable for people and feasible for organizations from three main phases: a Hear, in which inspirations are originated from stories collected from people; b Create, which aims to translate these knowledge into prototypes; and, c Deliver, where the prototypes are tested and developed with users. Communication strategies were supported by design studies about visual-verbal rhetoric. As results, this design approach has shown adequate to create communication strategies targeted at self-care behaviors, aiming to empower users to change their behavior.

  15. Designing Patient-facing Health Information Technologies for the Outpatient Settings: A Literature Review

    Directory of Open Access Journals (Sweden)

    Yushi Yang

    2016-04-01

    Full Text Available Introduction: The implementation of health information technologies (HITs has changed the dynamics of doctor–patient communication in outpatient settings. Designing patient-facing HITs provides patients with easy access to healthcare information during the visit and has the potential to enhance the patient-centred care.   Objectives: The objectives of this study are to systematically review how the designs of patient-facing HITs have been suggested and evaluated, and how they may potentially affect the doctor–patient communication and patient-centred care.   Method: We conducted an online database search to identify articles published before December 2014 relevant to the objectives of this study. A total of nine papers have been identified and reviewed in this study.   Results: Designing patient-facing HITs is at an early stage. The current literature has been exploring the impact of HITs on doctor–patient communication dynamics. Based on the findings of these studies, there is an emergent need to design more patient-centred HITs. There are also some papers that focus on the usability evaluation of some preliminary prototypes of the patient-facing HITs. The design styles of patient-facing HITs included sharing the health information with the patients on: (1 a separate patient display, (2 a projector, (3 a portable tablet, (4 a touch-based screen and (5 a shared computer display that can be viewed by both doctors and patients. Each of them had the strengths and limitations to facilitate the patient-centred care, and it is worthwhile to make a comparison of them in order to identify future research directions.   Conclusion: The designs of patient-facing HITs in outpatient settings are promising in facilitating the doctor-patient communication and patient engagement. However, their effectiveness and usefulness need to be further evaluated and improved from a systems perspective.

  16. How Persuasive are Serious Games, Social Media and mHealth Technologies for Vulnerable Young Adults? Design Factors for Health Behavior and Lifestyle Change Support: Sexual Health Case. Proceedings Third International Workshop on Behavior Change Support Systems (BCSS 2015)

    NARCIS (Netherlands)

    Kulyk, Olga; Gemert-Pijnen, van Lisette; Daas, den Chantal; David, Silke; Kelders, Saskia; Kulyk, Olga; Gemert-Pijnen, van Lisette; Oinas-Kukkonen, Harri

    2015-01-01

    Modern eHealth technologies, such as serious games, social media and mobile applications addressing health behavior support are evolving rapidly. High-risk young adults with low educational background and of foreign origin could especially benefit from personalized health technologies, designed for

  17. Designing better medicines delivery in the UK National Health Services (NHS

    Directory of Open Access Journals (Sweden)

    P. John Clarkson

    2009-11-01

    Full Text Available Background: Prescribed medicines are delivered through a variety ofroutes to patients in the UK National Health Service (NHSand are regulated by a host of health and trade related policy and law. These ensure the efficient and safe supply of medicines of appropriate quality from the pharmaceutical manufacturer through to the end-user, the patient. However, persisting medication errors and therecent discovery of counter feit medicines in the bona fide supply chain have meant there are growing concerns aboutthe timely, accurate and safe supply of medicines in the NHS. Methods: This study undertakes a systems design approach to processmodelling and understanding three key supply routes fromthe manufacturer through to the patient, across bothprimary and secondary care. A systems design approachwas deployed to investigate complex interactions betweenprofessionals, products and processes to improve patient safety in collaboration with twenty five clinical and non-linical stakeholders across the supply chain and six enduser patients.Results: Several system process models were developed from the literature, field observations and alongside the interviewees. The results reveal that risk to medication safety is perceived as occurring most at the patient-end ofthe medicines supply chain: the pharmacy and the ward.There are differences observed in the responses ofinterviewees when they engage with system models.Conclusions: This paper reflects on the use of a systems design, a mainly engineering approach, to understanding a health care domain problem of medication errors. The approach provided an enhanced insight into the complex set of system factors and interactions involved in generating medication errors. This study is among the first to develop asystems-wide view of the medicines supply process ‘as-is’and identify opportunities for re-design to improve patient safety.

  18. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    Science.gov (United States)

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities. PMID:27168895

  19. Relationship between Blood Mercury Concentration and Bone Mineral Density in Korean Men in the 2008–2010 Korean National Health and Nutrition Examination Survey

    Science.gov (United States)

    Kim, Yang Hee; Seo, Min Seok; Yim, Hyung Ji; Cho, Mi Ra

    2016-01-01

    Background The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters. Methods A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria. Results After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables. Conclusion High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD. PMID:27688860

  20. Designing a model for trauma system management using public health approach: the case of Iran.

    Science.gov (United States)

    Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

    2012-01-01

    Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

  1. Effectiveness of a developmental curricular design to graduate culturally competent health practitioners.

    Science.gov (United States)

    Boggis, Debra

    2012-01-01

    With the goal to facilitate cultural competency development of students enrolled in graduate-level health professional education, this study examined the effectiveness of a curricular program guided by the Intercultural Developmental Continuum (IDC) as measured by the Intercultural Developmental Inventory (IDI). The IDI was administered to 17 occupational therapy (OT) students and a control group of 25 non-OT health professional students upon matriculation into their respective programs of graduate study and again upon completion of 3 years of study. OT students participated in a cultural curricular design guided by the IDC, while the control group participated in cultural study not guided by the IDC. Though OT students did not show a significant change in overall developmental orientation mean scores from pre-test to post-test (t = 0.847, p = 0.41), the results indicate that the designed intercultural curriculum increased intercultural competence among those OT students who began their program with the monocultural mindset of polarization (an "us vs. them" evaluative viewpoint) and moved to the interculturally transitional mindset of minimization (recognizing cultural commonalities and elimination of the "us vs. them" mindset). The control group showed a significant decrease in developmental orientation mean scores at post-test (t = 6.1, p competency of OT students, appears to have mitigated a decrease in competence. Results suggest that the cultural challenges that students face appear to be considerable and, without targeted, integrated intercultural preparation, can overwhelm new health professionals' intercultural capability. PMID:22968776

  2. A designated centre for people with disabilities operated by Health Service Executive, Donegal

    LENUS (Irish Health Repository)

    Murray, Elizabeth

    2010-10-20

    Abstract Background The past decade has seen considerable interest in the development and evaluation of complex interventions to improve health. Such interventions can only have a significant impact on health and health care if they are shown to be effective when tested, are capable of being widely implemented and can be normalised into routine practice. To date, there is still a problematic gap between research and implementation. The Normalisation Process Theory (NPT) addresses the factors needed for successful implementation and integration of interventions into routine work (normalisation). Discussion In this paper, we suggest that the NPT can act as a sensitising tool, enabling researchers to think through issues of implementation while designing a complex intervention and its evaluation. The need to ensure trial procedures that are feasible and compatible with clinical practice is not limited to trials of complex interventions, and NPT may improve trial design by highlighting potential problems with recruitment or data collection, as well as ensuring the intervention has good implementation potential. Summary The NPT is a new theory which offers trialists a consistent framework that can be used to describe, assess and enhance implementation potential. We encourage trialists to consider using it in their next trial.

  3. Effectiveness of a developmental curricular design to graduate culturally competent health practitioners.

    Science.gov (United States)

    Boggis, Debra

    2012-01-01

    With the goal to facilitate cultural competency development of students enrolled in graduate-level health professional education, this study examined the effectiveness of a curricular program guided by the Intercultural Developmental Continuum (IDC) as measured by the Intercultural Developmental Inventory (IDI). The IDI was administered to 17 occupational therapy (OT) students and a control group of 25 non-OT health professional students upon matriculation into their respective programs of graduate study and again upon completion of 3 years of study. OT students participated in a cultural curricular design guided by the IDC, while the control group participated in cultural study not guided by the IDC. Though OT students did not show a significant change in overall developmental orientation mean scores from pre-test to post-test (t = 0.847, p = 0.41), the results indicate that the designed intercultural curriculum increased intercultural competence among those OT students who began their program with the monocultural mindset of polarization (an "us vs. them" evaluative viewpoint) and moved to the interculturally transitional mindset of minimization (recognizing cultural commonalities and elimination of the "us vs. them" mindset). The control group showed a significant decrease in developmental orientation mean scores at post-test (t = 6.1, p competency of OT students, appears to have mitigated a decrease in competence. Results suggest that the cultural challenges that students face appear to be considerable and, without targeted, integrated intercultural preparation, can overwhelm new health professionals' intercultural capability.

  4. Designing a Model for Trauma System Management Using Public Health Approach: The Case of Iran

    Directory of Open Access Journals (Sweden)

    Farzad Panahi

    2012-01-01

    Full Text Available Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

  5. Designing a patient-centered personal health record to promote preventive care

    Directory of Open Access Journals (Sweden)

    Krist Alex H

    2011-11-01

    Full Text Available Abstract Background Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Methods Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. Results The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices. Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results

  6. [Curriculum design of the Master's in Public Health program via the inservice education system. The Working Group of the Innovation Program in Health Systems and Professional Training].

    Science.gov (United States)

    1995-01-01

    This article presents the curriculum design process experience of the School of Public Health of Mexico's In-Service Master of Public Health Program, offered through the distance education model. The Program was created as a response to the Mexican health system's human resources training needs, with the purpose of contributing to the health services decentralization process, the strengthening of managerial skills of local health district managers, and to the professionalization of public health. The Program's design and development are based on a distance education system as an alternative to the traditional training models. The distance education model offers the possibility to train human resources on their job, to link permanently theory and practice, and to improve, in the short-term, the professional performance of students. The curriculum design process included the analysis of the student's training needs based on their professional profile, the type of plan of study that could take into account those training needs, and of the advisers and tutor's required profile, educational background, and job experience. The different disciplines were grouped around the knowledge objects, and not around independent courses. The health planning process was taken as a central axis and conductive line for integrating the thematic contents. The Master's plan of study was conformed by four stages: health diagnosis, formulation of the organized social response, implementation, and evaluation.

  7. Your Bones

    Science.gov (United States)

    ... a fall! If you play sports like football, soccer, lacrosse, or ice hockey, always wear all the ... to strengthen your bones is through exercise like running, jumping, dancing, and playing sports. Take these steps ...

  8. Using R in experimental design with BIBD: An application in health sciences

    Science.gov (United States)

    Oliveira, Teresa A.; Francisco, Carla; Oliveira, Amílcar; Ferreira, Agostinho

    2016-06-01

    Considering the implementation of an Experimental Design, in any field, the experimenter must pay particular attention and look for the best strategies in the following steps: planning the design selection, conduct the experiments, collect observed data, proceed to analysis and interpretation of results. The focus is on providing both - a deep understanding of the problem under research and a powerful experimental process at a reduced cost. Mainly thanks to the possibility of allowing to separate variation sources, the importance of Experimental Design in Health Sciences is strongly recommended since long time. Particular attention has been devoted to Block Designs and more precisely to Balanced Incomplete Block Designs - in this case the relevance states from the fact that these designs allow testing simultaneously a number of treatments bigger than the block size. Our example refers to a possible study of inter reliability of the Parkinson disease, taking into account the UPDRS (Unified Parkinson's disease rating scale) in order to test if there are significant differences between the specialists who evaluate the patients performances. Statistical studies on this disease were described for example in Richards et al (1994), where the authors investigate the inter-rater Reliability of the Unified Parkinson's Disease Rating Scale Motor Examination. We consider a simulation of a practical situation in which the patients were observed by different specialists and the UPDRS on assessing the impact of Parkinson's disease in patients was observed. Assigning treatments to the subjects following a particular BIBD(9,24,8,3,2) structure, we illustrate that BIB Designs can be used as a powerful tool to solve emerging problems in this area. Once a structure with repeated blocks allows to have some block contrasts with minimum variance, see Oliveira et al. (2006), the design with cardinality 12 was selected for the example. R software was used for computations.

  9. Green tea and bone metabolism.

    Science.gov (United States)

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

    2009-07-01

    Osteoporosis is a major health problem in both elderly women and men. 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 mitigating bone loss of this population and decreasing their risk of osteoporotic fractures. This review describes the effect of green tea or its bioactive components on bone health, with an emphasis on (i) the prevalence and etiology of osteoporosis; (ii) the role of oxidative stress and antioxidants in osteoporosis; (iii) green tea composition and bioavailability; (iv) the effects of green tea and its active components on osteogenesis, osteoblastogenesis, and osteoclastogenesis from human epidemiological, animal, as well as cell culture studies; (v) possible mechanisms explaining the osteoprotective effects of green tea bioactive compounds; (vi) other bioactive components in tea that benefit bone health; and (vii) a summary and future direction of green tea and bone health research and the translational aspects. In general, tea and its bioactive components might decrease the risk of fracture by improving bone mineral density and supporting osteoblastic activities while suppressing osteoclastic activities.

  10. The bone-anchored hearing aid : quality-of-life assessment

    NARCIS (Netherlands)

    Hol, Myrthe K S; Spath, Marian A; Krabbe, Paul F M; van der Pouw, Catharina T M; Snik, Ad F M; Cremers, Cor W R J; Mylanus, Emmanuel A M

    2004-01-01

    OBJECTIVES: To assess the impact of a bone-anchored hearing aid (BAHA) on the quality of life (QOL) of adults and to test the hypothesis that a BAHA improves QOL because otorrhea and/or skin irritations decrease. DESIGN: Prospective postal-based questionnaire study using validated health-related QOL

  11. Crew Health Care System (CHeCS) Design Research, Documentations, and Evaluations

    Science.gov (United States)

    CLement, Bethany M.

    2011-01-01

    The Crew Health Care System (CHeCS) is a group within the Space Life Science Directorate (SLSD) that focuses on the overall health of astronauts by reinforcing the three divisions - the Environmental Maintenance System (EMS), the Countermeasures System (CMS), and the Health Maintenance System (HMS). This internship provided opportunity to gain knowledge, experience, and skills in CHeCS engineering and operations tasks. Various and differing tasks allowed for occasions to work independently, network to get things done, and show leadership abilities. Specific exercises included reviewing hardware certification, operations, and documentation within the ongoing Med Kit Redesign (MKR) project, and learning, writing, and working various common pieces of paperwork used in the engineering and design process. Another project focused on the distribution of various pieces of hardware to off-site research facilities with an interest in space flight health care. The main focus of this internship, though, was on a broad and encompassing understanding of the engineering process as time was spent looking at each individual step in a variety of settings and tasks.

  12. Multimedia Health Records: user-centered design approach for a multimedia uploading service.

    Science.gov (United States)

    Plazzotta, Fernando; Mayan, John C; Storani, Fernando D; Ortiz, Juan M; Lopez, Gastón E; Gimenez, Gastón M; Luna, Daniel R

    2015-01-01

    Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.

  13. A mobile sensing system for structural health monitoring: design and validation

    International Nuclear Information System (INIS)

    This paper describes a new approach using mobile sensor networks for structural health monitoring. Compared with static sensors, mobile sensor networks offer flexible system architectures with adaptive spatial resolutions. The paper first describes the design of a mobile sensing node that is capable of maneuvering on structures built with ferromagnetic materials. The mobile sensing node can also attach/detach an accelerometer onto/from the structural surface. The performance of the prototype mobile sensor network has been validated through laboratory experiments. Two mobile sensing nodes are adopted for navigating on a steel portal frame and providing dense acceleration measurements. Transmissibility function analysis is conducted to identify structural damage using data collected by the mobile sensing nodes. This preliminary work is expected to spawn transformative changes in the use of mobile sensors for future structural health monitoring

  14. Lagrangian heuristic method for the wireless sensor network design problem in railway structural health monitoring

    Science.gov (United States)

    Hada, Akio; Soga, Kenichi; Liu, Ruoshui; Wassell, Ian J.

    2012-04-01

    In this paper, we study a design method for minimizing the total cost of a wireless sensor network (WSN) used for health monitoring of railway structures. First, we present the problem, that is to simultaneously determine the number of relays and their deployment locations, the transmission power level for each sensor and relay, and the routes for transferring sensor data to a gateway using multi-hop wireless communication. Second, we formulate this task as a mathematical programming problem, and to solve this problem, we propose a near optimal algorithm based on the Lagrangian heuristic method. Finally, we verify the effectiveness of our algorithm through computational experiments carried out using data acquired from a real WSN used for railway structural health monitoring.

  15. The effect of patulin on femoral bone structure in male rabbits

    Directory of Open Access Journals (Sweden)

    Veronika Kováčová

    2015-05-01

    Full Text Available A lot of kinds of crops are susceptible to fungal attack, leading to considerable financial losses and damage the health of humans and animals. Patulin, a toxic fungal metabolite, can be found mainly in apple and apple products, with much less frequent contamination in other food products. Because of its high incidence and harmful health effects, patulin belongs to a class of mycotoxins, which are strictly monitored. However, its effect on bone structure is still unknown. This study was designed to investigate the impact of patulin on femoral bone structure in adult male rabbits. Four month-old male rabbits were randomly divided into two groups of three animals each. Rabbits from the experimental group (group A, n=3 were intramuscularly administered with patulin at dose 10 μg.kg-1 body weight (b.w. twice a week for 4 weeks. The second group without patulin administration served as a control (group B, n=3. At the end of the experiment, body weight, femoral weight and length, cortical bone thickness and histological structure of femoral bones from all rabbits were determined. The results did not show any significant differences in body weight, femoral weight and length between experimental and control groups of rabbits. On the other hand, intramuscular application of patulin induced a significant increase in cortical bone thickness (p <0.05 and considerable changes in qualitative histological characteristics of compact bone in adult male rabbits. In patulin-intoxicated males, the primary vascular longitudinal bone tissue was absent near endosteal border. On the other hand, this tissue occurred near periosteum and also in the middle part of the femoral bone in these rabbits. The values for the primary osteons' vascular canals were significantly lower (p <0.05 in males exposed to patulin as compared to the control group. Based on these findings we can conclude that intramuscular patulin administration demonstrably influences cortical bone thickness

  16. Designing of Wireless Sensor Network Nodes to Detect Vibrational changes for Structural Health Monitoring Application

    Directory of Open Access Journals (Sweden)

    K. S. Raju

    2012-09-01

    Full Text Available The Structural Health Monitoring (SHM for building applications using wireless sensor networks is gaining a lot of interest now a day. The low power consumption, low cost and extendable network is a great challenge for designing and monitoring the building applications. Zigbee based on IEEE 802.15.4 characteristics are best suitable for SHM applications. In this paper Zigbee node is transferring the sensor data from sensor to the processing computer. A network has been designed with the coordinator and end device. End device will collect the data from the sensor and send the sensor data to the coordinator, through the coordinator data will be displayed by the processing computer. The prototype works as milestone for achieving the goal of transferring the sensor data with low power consumption.

  17. Intake of Novel Red Clover Supplementation for 12 Weeks Improves Bone Status in Healthy Menopausal Women

    Science.gov (United States)

    Thorup, Anne Cathrine; Lambert, Max Norman; Kahr, Henriette Strøm; Bjerre, Mette; Jeppesen, Per Bendix

    2015-01-01

    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 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. PMID:26265926

  18. Theory-Guided Materials Design of Multi-Phase Ti-Nb Alloys with Bone-Matching Elastic Properties

    Directory of Open Access Journals (Sweden)

    Jörg Neugebauer

    2012-10-01

    Full Text Available We present a scale-bridging approach for modeling the integral elasticresponse of polycrystalline composite that is based on a multi-disciplinary combination of(i parameter-free first-principles calculations of thermodynamic phase stability andsingle-crystal elastic stiffness; and (ii homogenization schemes developed forpolycrystalline aggregates and composites. The modeling is used as a theory-guidedbottom-up materials design strategy and applied to Ti-Nb alloys as promising candidatesfor biomedical implant applications. The theoretical results (i show an excellent agreementwith experimental data and (ii reveal a decisive influence of the multi-phase character ofthe polycrystalline composites on their integral elastic properties. The study shows thatthe results based on the density functional theory calculations at the atomistic level canbe directly used for predictions at the macroscopic scale, effectively scale-jumping severalorders of magnitude without using any empirical parameters.

  19. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute-Designated Comprehensive Cancer Center Network

    Energy Technology Data Exchange (ETDEWEB)

    Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rajagopalan, Malolan S.; Flickinger, John C.; Rakfal, Susan M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rodgers, Edwin [Via Oncology, Pittsburgh, PA (United States); Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

    2012-07-15

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute-Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10-14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1-5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1-5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1-1.4) for community and 1.3 (confidence interval, 1.1-1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with online clinical

  20. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute–Designated Comprehensive Cancer Center Network

    International Nuclear Information System (INIS)

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute–Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10–14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1–5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1–5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1–1.4) for community and 1.3 (confidence interval, 1.1–1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with

  1. Bone marrow transplant

    Science.gov (United States)

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  2. Sample Design and Cohort Selection in the Hispanic Community Health Study/Study of Latinos

    Science.gov (United States)

    LaVange, Lisa M.; Kalsbeek, William; Sorlie, Paul D.; Avilés-Santa, Larissa M.; Kaplan, Robert C.; Barnhart, Janice; Liu, Kiang; Giachello, Aida; Lee, David J.; Ryan, John; Criqui, Michael H.; Elder, John P.

    2010-01-01

    PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a multi-center, community based cohort study of Hispanic/Latino adults in the United States. A diverse participant sample is required that is both representative of the target population and likely to remain engaged throughout follow-up. The choice of sample design, its rationale, and benefits and challenges of design decisions are described in this paper. METHODS The study design calls for recruitment and follow-up of a cohort of 16,000 Hispanics/Latinos aged 18-74 years, with 62.5% (10,000) over 44 years of age and adequate subgroup sample sizes to support inference by Hispanic/Latino background. Participants are recruited in community areas surrounding four field centers in the Bronx, Chicago, Miami, and San Diego. A two-stage area probability sample of households is selected with stratification and over-sampling incorporated at each stage to provide a broadly diverse sample, offer efficiencies in field operations, and ensure that the target age distribution is obtained. CONCLUSIONS Embedding probability sampling within this traditional, multi-site cohort study design enables competing research objectives to be met. However, the use of probability sampling requires developing solutions to some unique challenges in both sample selection and recruitment, as described here. PMID:20609344

  3. Design, Implementation, and Lessons Learned from a Digital Storytelling Project in an Undergraduate Health Promotion Theory Course

    Science.gov (United States)

    Rimando, Marylen; Smalley, K. Bryant; Warren, Jacob C.

    2015-01-01

    This article describes the design, implementation and lessons learned from a digital storytelling project in a health promotion theory course. From 2011-2012, 195 health promotion majors completed a digital storytelling project at a Midwestern university. The instructor observed students' understanding of theories and models. This article adds to…

  4. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to carbonate and bicarbonate salts of sodium and potassium and maintenance of normal bone (ID 331, 1402) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    claims in relation to carbonate and bicarbonate salts of sodium and potassium and maintenance of normal bone. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references that EFSA has received from Member....../base balance and bone health” and “bone density/bone health”. The target population is assumed to be the general population. In the context of the proposed wordings, the Panel assumes that the claimed effects refer to the maintenance of normal bone by maintaining acid-base balance. The Panel considers that...... maintenance of normal bone is a beneficial physiological effect. No references were provided from which conclusions could be drawn for the scientific substantiation of the claim. On the basis of the data presented, the Panel concludes that a cause and effect relationship has not been established between the...

  5. Activity-Oriented Design of Health Pal: A Smart Phone for Elders' Healthcare Support

    Directory of Open Access Journals (Sweden)

    Fan Shih-Chen

    2008-01-01

    Full Text Available Wireless telephones and personal digital assistants are emerging, as the information hubs connect their human users with assorted electronic devices and the World Wide Web. As such, they quickly become the de facto basis for personalized information services. The Kannon project team at the National Chiao Tung University (NCTU in Taiwan is developing a ubiquitous service infrastructure for elders' healthcare support. Among their deliverables, there is a PDA Phone, christened Health Pal, which can communicate with Bluetooth/ZigBee devices, uni¬ver¬sal plug-and-play (UPnP e-home service platforms, and online healthcare providers to offer 24/7 healthcare services to elderly people. This paper presents the early results of this effort including the functional and operational concepts of Health Pal as well as the activity-oriented approach of its design. Preliminary results of its usefulness and usability evaluations are reported. A comparison of this platform against several similar prototypes was also included to illustrate the advantage of applying activity-oriented design approach to human-computer interactions.

  6. Activity-Oriented Design of Health Pal: A Smart Phone for Elders' Healthcare Support

    Directory of Open Access Journals (Sweden)

    Shih-Chen Fan

    2008-02-01

    Full Text Available Wireless telephones and personal digital assistants are emerging, as the information hubs connect their human users with assorted electronic devices and the World Wide Web. As such, they quickly become the de facto basis for personalized information services. The Kannon project team at the National Chiao Tung University (NCTU in Taiwan is developing a ubiquitous service infrastructure for elders' healthcare support. Among their deliverables, there is a PDA Phone, christened Health Pal, which can communicate with Bluetooth/ZigBee devices, uni¬ver¬sal plug-and-play (UPnP e-home service platforms, and online healthcare providers to offer 24/7 healthcare services to elderly people. This paper presents the early results of this effort including the functional and operational concepts of Health Pal as well as the activity-oriented approach of its design. Preliminary results of its usefulness and usability evaluations are reported. A comparison of this platform against several similar prototypes was also included to illustrate the advantage of applying activity-oriented design approach to human-computer interactions.

  7. What design features are used in effective e-health interventions? A review using techniques from Critical Interpretive Synthesis.

    Science.gov (United States)

    Morrison, Leanne G; Yardley, Lucy; Powell, John; Michie, Susan

    2012-03-01

    The effectiveness of e-health interventions varies greatly. Despite this, there has been relatively little formal consideration of how differences in the design of an intervention (i.e., how the content is delivered) may explain why some interventions are more effective than others. This review primarily examines the use of the Internet to provide educational and self-management interventions to promote health. The article develops hypotheses about how the design of these interventions may be associated with outcomes. In total, 52 published reports from both a diversity sample and a representative sample were reviewed using techniques from Critical Interpretive Synthesis. Four core interactive design features were identified that may mediate the effects of intervention design on outcomes: Social context and support, contacts with intervention, tailoring, and self-management. A conceptual framework to summarize the design of e-health interventions delivered using the Internet is proposed. The framework provides a guide for systematic research to identify the effects of specific design features on intervention outcomes and to identify the mechanisms underlying any effects. To optimize the design of e-health interventions more work is needed to understand how and why these design features may affect intervention outcomes and to investigate the optimal implementation and dosage of each design feature.

  8. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.

    2001-01-01

    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  9. CONSIDERATIONS REGARDING THE DESIGN OF FOOTWEAR WHICH ASSURES THE HEALTH OF THE FOOT

    Directory of Open Access Journals (Sweden)

    MĂRCUŞ Liviu

    2016-05-01

    Full Text Available The high demands for cheap footwear can only be satisfied by mass fabrication. Costumed footwear would represent a regress, despite the advantages that it brings. This paper regards mainly the demands that mass footwear requires, in order to maintain the health of the foot. The desire to maintain the foot shape and functionality requires certain last forms and fabrication algorithms. We analyze certain aspects referring to: the correct design of the inner sole, insuring the flexibility of the lower part of the footwear by choosing the right type of materials and confection systems, choosing the right height of the heel, setting the adequate shape by increasing the number of different shoe sizes. In order to give a loose space to the adults’ toes, where they are not pressed, but have a complete range of motion, the orthopedists and the last specialists have set several requirements for building the contour of the inner sole. The technique of building a bond between the footwear forepart and the inferior ensemble is dependent to the purpose and partially to the fashion demands of the shoe. The sole shape is influenced by the buyers, as seen by the development of the ex-flex footwear. There must be noted that in this case, the work of the model designer coincides with the exigencies of the specialist in footwear health. With the help of certain functional considerations and of several mechanical calculations, it can be proven that a heel with a height of 3 cm does not necessarily have a negative impact on the foot health. This is why even the orthopedics consider this limit as acceptable. Higher heels must be avoided if we want to maintain a normal function and development of the foot.

  10. Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya

    Science.gov (United States)

    Cole, Donald C.; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

    2016-01-01

    Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners’ meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. PMID:27003730

  11. Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya.

    Science.gov (United States)

    Cole, Donald C; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

    2016-06-01

    Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners' meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. PMID:27003730

  12. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    Directory of Open Access Journals (Sweden)

    van Dijk Frank JH

    2011-05-01

    Full Text Available Abstract Background Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS mental module may be an effective strategy to monitor and promote good (mental health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. Methods The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in

  13. Multifunctional and stable bone mimic proteinaceous matrix for bone tissue engineering

    OpenAIRE

    Won, J. E.; Yun, Y. R.; Jang, J. H.; S. H. Yang; Kim, J. H.; W. Chrzanowski; Wall, I. B.; Knowles, J. C.; Kim, H. W.

    2015-01-01

    Biomaterial surface design with biomimetic proteins holds great promise for successful regeneration of tissues including bone. Here we report a novel proteinaceous hybrid matrix mimicking bone extracellular matrix that has multifunctional capacity to promote stem cell adhesion and osteogenesis with excellent stability. Osteocalcin-fibronectin fusion protein holding collagen binding domain was networked with fibrillar collagen, featuring bone extracellular matrix mimic, to provide multifunctio...

  14. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands.

  15. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands. PMID:16998521

  16. Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats

    Directory of Open Access Journals (Sweden)

    Dausey David J

    2007-05-01

    Full Text Available Abstract Background Since 2001, state and local health departments in the United States (US have accelerated efforts to prepare for high-impact public health emergencies. One component of these activities has been the development and conduct of exercise programs to assess capabilities, train staff and build relationships. This paper summarizes lessons learned from tabletop exercises about public health emergency preparedness and about the process of developing, conducting, and evaluating them. Methods We developed, conducted, and evaluated 31 tabletop exercises in partnership with state and local health departments throughout the US from 2003 to 2006. Participant self evaluations, after action reports, and tabletop exercise evaluation forms were used to identify aspects of the exercises themselves, as well as public health emergency responses that participants found more or less challenging, and to highlight lessons learned about tabletop exercise design. Results Designing the exercises involved substantial collaboration with representatives from participating health departments to assure that the scenarios were credible, focused attention on local preparedness needs and priorities, and were logistically feasible to implement. During execution of the exercises, nearly all health departments struggled with a common set of challenges relating to disease surveillance, epidemiologic investigations, communications, command and control, and health care surge capacity. In contrast, performance strengths were more varied across participating sites, reflecting specific attributes of individual health departments or communities, experience with actual public health emergencies, or the emphasis of prior preparedness efforts. Conclusion The design, conduct, and evaluation of the tabletop exercises described in this report benefited from collaborative planning that involved stakeholders from participating health departments and exercise developers and

  17. What Is Bone?

    Science.gov (United States)

    ... by your browser. Home Bone Basics What Is Bone? Publication available in: PDF (57 KB) Related Resources ... Men, and Osteoporosis Osteoporosis Prevention For Your Information Bone Remodeling Throughout life, bone is constantly renewed through ...

  18. Calcium and bones

    Science.gov (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  19. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  20. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... is sent to a lab for examination. Bone biopsy may also be done under general anesthesia to ... remove the bone can be done if the biopsy exam shows that there is an abnormal growth ...

  1. Responsive Evaluation as a Guide to Design and Implementation: Case Study of an E-Health Learning System

    Science.gov (United States)

    Schaffer, Scott P.; Kim, Hannah

    2012-01-01

    Evaluation of the design and implementation of a web-based e-health application offers an opportunity to apply extensive research findings and evidence-based practices from the learning and performance literature. In this study, we examined how interactions between stakeholders influenced the design, implementation, and outcomes of an e-health…

  2. Coaching the process of designing a farm: Using the healthy human as a metaphor for farm health

    NARCIS (Netherlands)

    Bloksma, J.R.; Struik, P.C.

    2007-01-01

    This paper is on coaching farmers in (re)designing a farm. It describes how farmers can become inspired to design a sustainable farm by the way medical doctors look at the human being and his health. Sustainability in farm management is usually strived for in such a way that damage to People, Planet

  3. Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design.

    Science.gov (United States)

    Stusser, Rodolfo J; Dickey, Richard A

    2013-12-01

    In this evolving 'third era of health', one of the US Health Care Reform Act's goals is to effectively facilitate the primary care physician's ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient's health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician's clinical judgment, calculating a mathematical 'health equation' from each patient's EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors' assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner's best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and research. It could advance the approaches and focus of the 'eras of diseases', to the promising 'era of health', in an integrated, general approach to 'health.' PMID:24046235

  4. Clonal Characterization of Bone Marrow Derived Stem Cells and Their Application for Bone Regeneration

    OpenAIRE

    Xiao, Yin; Mareddy, Shobha; Crawford, Ross

    2010-01-01

    Tissue engineering allows the design of functionally active cells within supportive bio-scaffolds to promote the development of new tissues such as cartilage and bone for the restoration of pathologically altered tissues. However, all bone tissue engineering applications are limited by a shortage of stem cells. The adult bone marrow stroma contains a subset of nonhematopoietic cells referred to as bone marrow mesenchymal stem cells (BMSCs). BMSCs are of interest because they are easily isolat...

  5. Effects of thirty elements on bone metabolism.

    Science.gov (United States)

    Dermience, Michael; Lognay, Georges; Mathieu, Françoise; Goyens, Philippe

    2015-10-01

    The human skeleton, made of 206 bones, plays vital roles including supporting the body, protecting organs, enabling movement, and storing minerals. Bones are made of organic structures, intimately connected with an inorganic matrix produced by bone cells. Many elements are ubiquitous in our environment, and many impact bone metabolism. Most elements have antagonistic actions depending on concentration. Indeed, some elements are essential, others are deleterious, and many can be both. Several pathways mediate effects of element deficiencies or excesses on bone metabolism. This paper aims to identify all elements that impact bone health and explore the mechanisms by which they act. To date, this is the first time that the effects of thirty minerals on bone metabolism have been summarized. PMID:26302917

  6. Effects of Dairy Products Consumption on Health: Benefits and Beliefs--A Commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.

    Science.gov (United States)

    Rozenberg, Serge; Body, Jean-Jacques; Bruyère, Olivier; Bergmann, Pierre; Brandi, Maria Luisa; Cooper, Cyrus; Devogelaer, Jean-Pierre; Gielen, Evelien; Goemaere, Stefan; Kaufman, Jean-Marc; Rizzoli, René; Reginster, Jean-Yves

    2016-01-01

    Dairy products provide a package of essential nutrients that is difficult to obtain in low-dairy or dairy-free diets, and for many people it is not possible to achieve recommended daily calcium intakes with a dairy-free diet. Despite the established benefits for bone health, some people avoid dairy in their diet due to beliefs that dairy may be detrimental to health, especially in those with weight management issues, lactose intolerance, osteoarthritis, rheumatoid arthritis, or trying to avoid cardiovascular disease. This review provides information for health professionals to enable them to help their patients make informed decisions about consuming dairy products as part of a balanced diet. There may be a weak association between dairy consumption and a possible small weight reduction, with decreases in fat mass and waist circumference and increases in lean body mass. Lactose intolerant individuals may not need to completely eliminate dairy products from their diet, as both yogurt and hard cheese are well tolerated. Among people with arthritis, there is no evidence for a benefit to avoid dairy consumption. Dairy products do not increase the risk of cardiovascular disease, particularly if low fat. Intake of up to three servings of dairy products per day appears to be safe and may confer a favourable benefit with regard to bone health. PMID:26445771

  7. Bone graft revascularization strategies

    NARCIS (Netherlands)

    W.F. Willems

    2014-01-01

    Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

  8. Design and biomechanical study of bone cement injectable canulated pedicle screw%新型可注射骨水泥椎弓根螺钉的设计及生物力学研究

    Institute of Scientific and Technical Information of China (English)

    刘瑶瑶; 孙东; 罗飞; 张泽华; 代飞; 许建中

    2012-01-01

    目的 探讨一种新型可注射骨水泥椎弓根螺钉(bone cement injectable canulated pedicle screw,CICPS)的设计和生物力学性能,为骨质疏松脊柱疾病的内固定治疗提供一种安全有效的新选择. 方法 (1)在体外、骨质疏松松质骨模型和椎体标本内行骨水泥注射实验,X线片、CT观察骨水泥分布和钉-骨界面情况.(2)取10枚灌注骨水泥后的CICPS和普通椎弓根螺钉行剪切力试验.(3)在松质骨模型中用2~3ml骨水泥强化CICPS行轴向拔出力试验,与普通椎弓根螺钉进行比较. 结果 CICPS各个侧孔均有骨水泥流出,且仅分布于螺钉前部,弥散均匀广泛,未见骨水泥渗漏.CICPS的剪切力为(10600.8±360.1)N,普通螺钉为(15 458.1±311.4)N(P<0.05).CICPS的最大轴向拔出力为(209.3±13.3)N,普通螺钉为(27.0±5.0)N(P<0.05).结论 CICPS使骨水泥弥散均匀一致,减少骨水泥渗漏风险,并可显著提高骨质疏松椎体中椎弓根螺钉的把持力.CICPS具有良好的有效性和安全性,为其临床应用提供了理论基础.%Objective To investigate the design and mechanical properties of bone cement injectable canulated pedicle screw (CICPS) so as to provide a safe and effective internal fixation for osteoporotic spinal disorder. Methods ( 1 ) Bone cement injection test was performed in vitro,and within osteoporotic cancellous bone models and osteoporotic vertebrae respectively.The distribution of bone cement and screw-bone interface were observed by X-ray films and CT.(2) Ten CICPSs already injected with bone cement and ten conventional pedicle screws were respectively examined by shear strength test.(3) CICPS in the cancellous bone models was augmented with 2-3 ml of bone cement.Then,the maximum axial pull-out strength of the CICPS was measured and were compared with that of conventional screws. Results Bone cement overflowed from each side hole of the CICPS and distributed only around the front of screws in an even and extensive

  9. Cancer treatment-related bone disease

    OpenAIRE

    Brown, Sue A.; Guise, Theresa A.

    2009-01-01

    Bone health may be impaired in many patients being treated for cancer. Primary tumors that reside in or form metastases to bone can result in compromised skeletal integrity. It has also been increasingly recognized that patients undergoing therapies for treatment of cancer are at higher risk of bone loss. These include androgen-deprivation therapy for prostate cancer and aromatase inhibitor therapy for breast cancer among others. Hypogonadism induced by many of these cancer treatments results...

  10. Pregnancy, Breastfeeding, and Bone Health

    Science.gov (United States)

    ... Women Osteoporosis and African American Women Osteoporosis and Asian American Women Osteoporosis and Asian American Women ( 繁體中文 ) Osteoporosis and Hispanic Women Osteoporosis and Asian ...

  11. Towards Educational Electronic Health Records (EHRs): A Design Process for Integrating EHRs, Simulation, and Video Tutorials.

    Science.gov (United States)

    Shachak, Aviv; Elamrousy, Samer; Borycki, Elizabeth M; Domb, Sharon; Kushniruk, Andre W

    2016-01-01

    Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have limitations, such as a lack of dynamic interaction built-in that would mimic real-world use of these tools. To overcome this, the integration of eduEHRs with software and tools such as video simulations and tutorials has considerable promise. In this paper we describe a new design process for integrating EHRs, simulations, and video tutorials.

  12. Towards Educational Electronic Health Records (EHRs): A Design Process for Integrating EHRs, Simulation, and Video Tutorials.

    Science.gov (United States)

    Shachak, Aviv; Elamrousy, Samer; Borycki, Elizabeth M; Domb, Sharon; Kushniruk, Andre W

    2016-01-01

    Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have limitations, such as a lack of dynamic interaction built-in that would mimic real-world use of these tools. To overcome this, the integration of eduEHRs with software and tools such as video simulations and tutorials has considerable promise. In this paper we describe a new design process for integrating EHRs, simulations, and video tutorials. PMID:27577459

  13. Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

    Energy Technology Data Exchange (ETDEWEB)

    Adams, S.R.

    1985-10-01

    A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences.

  14. Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

    International Nuclear Information System (INIS)

    A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences

  15. Bone and Soft Tissue Ablation

    OpenAIRE

    Foster, Ryan C.B.; Joseph M Stavas

    2014-01-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft...

  16. Detection of minimal residual disease in patients with multiple myeloma using clonotype-specific PCR primers designed from DNA extracted from archival bone marrow slides.

    Science.gov (United States)

    Takamatsu, Hiroyuki; Ogawa, Yoshiyasu; Kobayashi, Noriko; Obata, Kazue; Narisawa, Tadashi; Nakayama, Kouji; Munemoto, Saori; Aoki, Go; Ohata, Kinya; Kumano, Yoshihisa; Ozaki, Jun; Murata, Ryoichi; Kondo, Yukio; Terasaki, Yasushi; Kurokawa, Toshiro; Miyamoto, Toshihiro; Shimizu, Naomi; Fukushima, Toshihiro; Yoshida, Akira; Ueda, Takanori; Yoshida, Takashi; Nakao, Shinji

    2013-10-01

    Polymerase chain reaction (PCR)-negative molecular complete remission (mCR) can be induced by stem cell transplantation in some patients with multiple myeloma (MM) and is associated with long-term progression-free survival (PFS). The detection of molecular minimal residual disease (MRD), however, requires fresh or frozen materials for designing clone-specific primers, which are not always readily available. In this study, we used DNA extracted from archival bone marrow (BM) slides for PCR to detect MRD in 50 patients with MM who received various induction therapies and autologous peripheral blood stem cell transplantation (ASCT). Clonotype-specific immunoglobulin (Ig) H PCR primers were prepared for 32 of 50 cases (64%) using BM slides, and for 9 of 14 cases (64%) using fresh BM cells. DNA in peripheral blood stem cell autografts of the 22 patients who achieved at least a partial response after ASCT was subjected to PCR to amplify clonotype-specific rearranged IgH gene sequences. The median PFS of the eight patients with MRD-positive autografts was 18 months, whereas that of 14 patients with MRD-negative autografts was not reached at a median follow-up of 27 months (p = 0.012). Post-ASCT PFS of the four patients who achieved mCR was 100% at a median follow-up of 47 months. These results indicate that archival BM slides can serve as a source of DNA for preparing clonotype-specific primers for MRD monitoring in patients with MM whose cryopreserved myeloma cells are not available for DNA preparation. Our results also suggest that patients with MM who received MRD-negative autografts and achieved mCR have a long PFS.

  17. Bone microdamage and cell apoptosis

    Directory of Open Access Journals (Sweden)

    Noble B.

    2003-12-01

    Full Text Available Accumulation of microdamage in bone leads to the reduced strength of our skeleton. In health, bone adapts to the prevailing mechanical needs of the organism and is also capable of self-repair, sensing, removing and replacing damaged or mechanically insufficient volumes of bone. In disease and old age these characteristics are reduced. In order to undertake both of the processes of functional adaptation and repair the bone resorbing and forming cells must be very accurately targeted to areas of physiological need. The mechanism by which cells are precisely targeted to areas requiring repair is both clinically relevant and poorly understood. The osteocyte has been assumed to play a role in sensing damage and signaling for its removal, due largely to its abundance throughout the mineralized bone matrix. However, until recently there has been little evidence that osteocyte function is modified in the vicinity of the microdamage. Here I outline the possibility that the targeted removal of bone containing microcracks might involve signals derived from the apoptotic death of the osteocyte. I shall discuss data that support or refute this view and will consider the possible molecular mechanisms by which controlled cell death might contribute to the signals for repair in the light of work involving cells in bone and other tissue systems.

  18. A systems engineering perspective on the human-centered design of health information systems.

    Science.gov (United States)

    Samaras, George M; Horst, Richard L

    2005-02-01

    The discipline of systems engineering, over the past five decades, has used a structured systematic approach to managing the "cradle to grave" development of products and processes. While elements of this approach are typically used to guide the development of information systems that instantiate a significant user interface, it appears to be rare for the entire process to be implemented. In fact, a number of authors have put forth development lifecycle models that are subsets of the classical systems engineering method, but fail to include steps such as incremental hazard analysis and post-deployment corrective and preventative actions. In that most health information systems have safety implications, we argue that the design and development of such systems would benefit by implementing this systems engineering approach in full. Particularly with regard to bringing a human-centered perspective to the formulation of system requirements and the configuration of effective user interfaces, this classical systems engineering method provides an excellent framework for incorporating human factors (ergonomics) knowledge and integrating ergonomists in the interdisciplinary development of health information systems. PMID:15694886

  19. Rationale and design considerations for a semantic mediator in health information systems.

    Science.gov (United States)

    Degoulet, P; Sauquet, D; Jaulent, M C; Zapletal, E; Lavril, M

    1998-11-01

    Rapid development of community health information networks raises the issue of semantic interoperability between distributed and heterogeneous systems. Indeed, operational health information systems originate from heterogeneous teams of independent developers and have to cooperate in order to exchange data and services. A good cooperation is based on a good understanding of the messages exchanged between the systems. The main issue of semantic interoperability is to ensure that the exchange is not only possible but also meaningful. The main objective of this paper is to analyze semantic interoperability from a software engineering point of view. It describes the principles for the design of a semantic mediator (SM) in the framework of a distributed object manager (DOM). The mediator is itself a component that should allow the exchange of messages independently of languages and platforms. The functional architecture of such a SM is detailed. These principles have been partly applied in the context of the HELIOS object-oriented software engineering environment. The resulting service components are presented with their current state of achievement. PMID:9865050

  20. Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory.

    Science.gov (United States)

    Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L

    2016-07-01

    The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility. PMID:26981844