Bone mineral density in relation to medical and lifestyle risk factors for osteoporosis in premenopausal, menopausal and postmenopausal women in general practice

Background: Interest in the prevention of osteoporosis is increasing and thus there is a need for an acceptable osteoporosis prevention programme in general practice. AIM. A study was undertaken to identify a cohort of middle-aged women attending a general practice who would be eligible for a longitudinal study looking at bone mineral density, osteoporosis and the effectiveness of hormone replacement therapy. This study aimed to describe the relationship between medical and lifestyle risk factors for osteoporosis and the initial bone density measurements in this group of women. METHOD. A health visitor administered a questionnaire to women aged between 48 and 52 years registered with a Belfast general practice. The main outcome measures were menopausal status, presence of medical and lifestyle risk factors and bone mineral density measurements. RESULTS. A total of 358 women our of 472 (76%) took part in the study which was conducted in 1991 and 1992. A highly significant difference was found between the mean bone mineral density of premenopausal, menopausal and postmenopausal women within the narrow study age range, postmenopausal women having the lowest bone mineral density. A significant relationship was found between body mass index and bone mineral density, a greater bone mineral density being found among women with a higher body mass index. Risk factors such as smoking and sedentary lifestyle were common (reported by approximately one third of respondents) but a poor relationship was found between these two and all the other risk factors and bone mineral density in this age group. CONCLUSION. Risk of osteoporosis cannot be identified by the presence of risk factors in women aged between 48 and 52 years. In terms of a current prevention strategy for general practice it would be better to take a population-based approach except for those women known to be at high risk of osteoporosis: women with early menopause or those who have had an oophorectomy.

Use of Gypsum and CKD to enhance early age strength of High Volume Fly Ash (HVFA) pastes

Use of higher proportions of fly ash as a cement replacement in concrete has obvious environmental and performance benefits but high volumes of fly ash are not commonly used due to perceived lower early age strengths. In this investigation, addition of cement kiln dust (CKD) and gypsum to activate the fly ash was studied and the proportions used in the paste mixes were designed to optimize the mixture ingredients to achieve the highest early age compressive strength. Change of mineral phase composition and micro structure of the composites was analyzed. It was found that CKD was much more effective in activating the fly ash than gypsum. Appreciable early age compressive strengths were achieved for fly ash contents up to 60% of the binder and these observations were supported by analysis of the mineral phases.