Zoledronic acid once-yearly : what role in the prevention of non-vertebral osteoporotic fractures?

Osteoporosis is the most common bone disease. Low levels of oestrogens or testosterone are risk factors for primary osteoporosis. The most common cause of secondary osteoporosis is glucocorticoid treatment, but there are many other secondary causes of osteoporosis. Osteoporosis can be secondary to anti-oestrogen treatment for hormone-sensitive breast cancer and to androgen-deprivation therapy for prostate cancer. Zoledronic is the most potent bisphosphonate at inhibiting bone resorption. In osteoporosis, zoledronic acid increases bone mineral density for at least a year after a single intravenous administration. The efficacy and safety of extended release (once-yearly) zoledronic acid in the treatment of osteoporosis is reviewed.

Cigarette smoking in young adults : the influence of the HTR2A T102C polymorphism and punishment sensitivity

Background: The C allele of a common polymorphism of the serotonin 2A receptor (HTR2A) gene, T102C, results in reduced synthesis of 5-HT2A receptors and has been associated with current smoking status in adults. The -1438A/G polymorphism, located in the regulatory region of this gene, is in linkage disequilibrium with T102C, and the A allele is associated with increased promoter activity and with smoking in adult males. We investigated the contributions of the HTR2A gene, chronic psychological stress, and impulsivity to the prediction of cigarette smoking status and dependence in young adults. Methods: T102C and -1438A/G genotyping was conducted on 132 healthy Caucasian young adults (47 smokers) who completed self-report measures of chronic stress, depressive symptoms, impulsive personality and cigarette use. Results: A logistic regression analysis of current cigarette smoker user status, after adjusting for gender, depressive symptom severity and chronic stress, indicated that the T102C TT genotype relative to the CC genotype (OR = 7.53), and lower punishment sensitivity (OR = 0.91) were each significant predictive risk factors. However, for number of cigarettes smoked, only lower punishment sensitivity was a significant predictor (OR = 0.81). Conclusions: These data indicate the importance of the T102C polymorphism to tobacco use but not number of cigarettes smoked for Caucasian young adults. Future studies should examine whether this is explained by effects of nicotine on the serotonin system. Lower punishment sensitivity increased risk of both smoking and of greater consumption, perhaps via a reduced sensitivity to cigarette health warnings and negative physiological effects.

Vitamin D and injury prevention

Vitamin D, along with calcium, may help decrease the risk of falls and fractures in older adults. Sunlight and other sources of ultraviolet radiation are not recommended because they increase the risk of skin cancers and sun-induced eye disorders. Rather, vitamin D and calcium needs should be met through foods and dietary supplements. As a preventive measure to reduce the risk of falls and fractures, it is recommended that older adults meet the 2005 Dietary Guidelines and consume 1000 IU of vitamin D, preferably as vitamin D3.

Associations among smoking status, lifestyle and lipoprotein subclasses

BACKGROUND: The relationship between cigarette smoking and cardiovascular disease is well established, yet the underlying mechanisms remain unclear. Although smokers have a more atherogenic lipid profile, this may be mediated by other lifestyle-related factors. Analysis of lipoprotein subclasses by the use of nuclear magnetic resonance spectroscopy (NMR) may improve characterisation of lipoprotein abnormalities. OBJECTIVE: We used NMR spectroscopy to investigate the relationships between smoking status, lifestyle-related risk factors, and lipoproteins in a contemporary cohort. METHODS: A total of 612 participants (360 women) aged 40–69 years at baseline (199021994) enrolled in the Melbourne Collaborative Cohort Study had plasma lipoproteins measured with NMR. Data were analysed separately by sex. RESULTS: After adjusting for lifestyle-related risk factors, including alcohol and dietary intake, physical activity, and weight, mean total low-density lipoprotein (LDL) particle concentration was greater for female smokers than nonsmokers. Both medium- and small-LDL particle concentrations contributed to this difference. Total high-density lipoprotein (HDL) and large-HDL particle concentrations were lower for female smokers than nonsmokers. The proportion with low HDL particle number was greater for female smokers than nonsmokers. For men, there were few smoking-related differences in lipoprotein measures. CONCLUSION: Female smokers have a more atherogenic lipoprotein profile than nonsmokers. This difference is independent of other lifestyle-related risk factors. Lipoprotein profiles did not differ greatly between male smokers and nonsmokers.

Cyberbullying prevention : one primary school’s approach

Bullying in all its forms including cyberbullying is a continuing problem in schools. Given the severe consequences it can have on students (socially, psychologically and physically) it is not surprising that a number of intervention programs have been developed, with most advocating a whole school approach. The current study compared students’ self-reports on bullying between schools with and without a Philosophy for Children (P4C) approach. A sample of 35 students in the P4C school and a matched sample of 35 students in other schools between the ages of 10 and 13 completed the Student Bullying Survey. Results indicated that while there were significant differences in incidences of face-to-face bullying, there were similar results from both cohorts in relation to cyberbullying. Both groups of students felt that teachers were more likely to prevent face-to-face bullying than cyberbullying. Findings indicate that teachers and guidance counsellors need to be as overt in teaching strategies about cyberbullying as they are in teaching strategies about reducing face-to-face bullying.

The Early Prevention of Obesity in CHildren (EPOCH) collaboration : an individual patient data prospective meta-analysis

Background: Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs) of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD) prospective meta-analysis (PMA). An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design: The Early Prevention of Obesity in CHildren (EPOCH) Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI) z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children’s dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants) will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion: Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number: ACTRN12610000789066

Using TAM to examine consumer acceptance of a mobile phone assisted smoking cessation program in Australia

This paper study examines Australian smokers’ perceptions of a potential SMS-assisted smoking cessation program. Using TAM we tested perceived ease of use, perceived usefulness and subjective norms on intentions to use this cessation program if it was available. Findings show that perceived usefulness and subjective norms were the significant predictors of intentions to use. Perceived ease of use did not directly influence this outcome instead it has an indirect influence through perceived usefulness. These preliminary findings can be built upon through introducing additional variables to help practitioners better understand consumer acceptance when marketing e-health programs such as this.

Patient preference for falls prevention in hospitals revealed through willingness-to-pay, contingent valuation survey

Rationale, aims and objectives: Patient preference for interventions aimed at preventing in-hospital falls has not previously been investigated. This study aims to contrast the amount patients are willing to pay to prevent falls through six intervention approaches. ----- ----- Methods: This was a cross-sectional willingness-to-pay (WTP), contingent valuation survey conducted among hospital inpatients (n = 125) during their first week on a geriatric rehabilitation unit in Queensland, Australia. Contingent valuation scenarios were constructed for six falls prevention interventions: a falls consultation, an exercise programme, a face-to-face education programme, a booklet and video education programme, hip protectors and a targeted, multifactorial intervention programme. The benefit to participants in terms of reduction in risk of falls was held constant (30% risk reduction) within each scenario. ----- ----- Results: Participants valued the targeted, multifactorial intervention programme the highest [mean WTP (95% CI): $(AUD)268 ($240, $296)], followed by the falls consultation [$215 ($196, $234)], exercise [$174 ($156, $191)], face-to-face education [$164 ($146, $182)], hip protector [$74 ($62, $87)] and booklet and video education interventions [$68 ($57, $80)]. A ‘cost of provision’ bias was identified, which adversely affected the valuation of the booklet and video education intervention. ----- ----- Conclusion: There may be considerable indirect and intangible costs associated with interventions to prevent falls in hospitals that can substantially affect patient preferences. These costs could substantially influence the ability of these interventions to generate a net benefit in a cost–benefit analysis.

Creating an effective prevention curriculum to reduce transport risks and injuries

Adolescent injury is a significant health concern and can be a result of the adolescents engagement in transport-related behaviours. There is however significant planning and formative research needed to inform prevention programme design. This presentation reports on the development and evaluation of a curriculum programme that was shown to be effective in reducing transport-related risks and injuries. Early adolescents report injuries resulting from a number of transport-related behaviours including those associated with riding a bicycle, a motorcycle, and as a passenger (survey of 209 Year 9 students). In focus groups, students (n=30) were able to describe the context of transport risks and injuries. Such information provided evidence of the need for an intervention and ecologically valid data on which to base programme design including insights into the language, culture and development of adolescents and their experiences with transport risks. Additional information about teaching practices and implementation issues were explored in interviews with 13 teachers. A psychological theory was selected to operationalise the design of the programmes that drew on such preparatory data. The programme, Skills for Preventing Injury in Youth was evaluated with 197 participating and 137 control students (13–14 year olds). Results showed a significant difference between the intervention and control groups from baseline to 6-month follow-up in a number of transport-related risk behaviours and transport-related injuries. The programme thus demonstrated potential in reduce early adolescents transport risk behaviours and associated harm. Discussion will involve the implications of the development research process in designing road safety interventions.