Effects of lifetime loading history on cortical bone density and its distribution in middle-aged and older men

We have reported previously that long-term participation of weight-bearing exercise is associated with increased QCT-derived cortical bone size and strength in middle-aged and older men, but not whole bone cortical volumetric BMD. However, since bone remodeling and the distribution of loading-induced strains within cortical bone are non-uniform, the aim of this study was to examine the effects of lifetime loading history on cortical bone mass distribution and bone shape in healthy community dwelling middle-aged and older men. We used QCT to assess mid-femur and mid-tibia angular bone mass distribution around its center (polar distribution), the bone density distribution through the cortex (radial distribution), and the ratio between the maximum and minimum moments of inertia (I_max/I_min ratio) in 281 men aged 50 to 79 years. Current (> 50 years) and past (13–50 years) sport and leisure time activity was assessed by questionnaire to calculate an osteogenic index (OI) during adolescence and adulthood. All men were then categorized into a high (H) or low/non impact (L) group according to their OI scores in each period. Three contrasting groups were then formed to reflect weight-bearing impact categories during adolescence and then adulthood: H–H, H–L and L–L. For polar bone mass distribution, bone deposition in the anterolateral, medial and posterior cortices were 6–10% greater at the mid-femur and 9–24% greater at mid-tibia in men in the highest compared to lowest tertile of lifetime loading (p < 0.01– < 0.001). When comparing the influence of contrasting loading history during adolescence and adulthood, there was a graded response between the groups in the distribution of bone mass at the anterior-lateral and posterior regions of the mid-tibia (H–H > H–L > L–L). For radial bone density distribution, there were no statistically significant effects of loading at the mid-femur, but a greater lifetime OI was associated with a non-significant 10–15% greater bone density near the endocortical region of the mid-tibia. In conclusion, a greater lifetime loading history was associated with region-specific adaptations in cortical bone density.

Consumer health ICT and the patient in the middle : adopter and/or influencer?

ICT can play a vital role in facilitating quality care and support for people living with chronic illness. Recently, there has been a proliferation of ICT-enabled consumer health devices. These devices can enable individual patients more precise monitoring and control of chronic conditions, and can generate information and statistics for analysis by health professionals. The adoption of the ICT-enabled consumer technologies by patients often relies on the co-adoption of related innovations, work practices, analytical tools and information systems by their health professionals. In healthcare, adoption is influenced by other stakeholders such as health insurers, the patient's family, chronic disease support groups, etc. This paper addresses the individual adoption of ICT-enabled innovations when multiple stakeholders are involved. We report on a case study of the adoption of ICT-enabled “smartpumps” by pregnant women with Type 1 diabetes. We find that the patient should be theorised as adopter, but also as influencer under certain conditions. We develop propositions to explain adoptive behaviour as the adopter/influencer seeks to achieve congruence of interests in a stakeholder network. Our findings help explain why the adoption of ICT-enabled health innovations can occur swiftly in some situations, yet proceed slowly in others.

Renaturalising : Lacan's ethics and Nietzsche's critique of platonism

‬This thesis examines how Lacan's ethics of psychoanalysis might contribute to our understanding of Nietzsche's critique of Platonism.

Late Middle Permian (Guadalupian) fusuline fauna from the Gyanyima area of Burang County, Tibet, China and its paleobiogeographic implications

Numerous Permian limestone blocks exposed along the Yarlung-Zangbo Suture Zone have been named Tibetan facies exotic limestone blocks or Chitichun-type Permian deposits.The Gyanyima limestone block,one of those limestone blocks,is located in Burang County,southwestern Tibet.Fusulines are abundant in the Gyanyima limestone block especially for Middle Permian Xilanta Formation.The fusuline fauna comprises 10 genera,respectively Neoschwagerina, Yangchienia, Armenina, Verbeekina, Paraverbeekina, Kahlerina, Lantschichites, Codonofusiella,Chusenella, Nankinella.This fauna indicates a Midian age(Late Guadalupian or Lengwuan age of South China) in terms of the coexistence of Kahlerina, Lantschichites, Codonofusiella and Neoschwagerina.

Late Guadalupian (Middle Permian) Fusuline fauna from the Xiala formation in Xainza county, central Tibet : implication of the rifting time of the Lhasa Block

A fusuline fauna consisting of 9 species of 4 genera from the Xiala Formation of the Mujiucuo section, Xainza County, Tibet, China is described. The fusuline fauna is dominated by Nankinella and Chusenella and indicates a Midian (Late Guadalupian) age. The earliest record of fusuline fauna during the Midian in the Lhasa Block suggests that the block rifted later than the Qiangtang Block to the north and the Baoshan and Tengchong blocks to the east, all of which yield much earlier fusuline faunas of Yakhtashian (Artinskian) age, but had drifted away from Gondwana to a relatively warm temperate zone in the Late Guadalupian (Middle Permian).

Middle Permian (Guadalupian) Fusulines from the Xilanta formation in the Gyanyima area of Burang County, southwestern Tibet, China

This paper reports a diversified fusuline fauna from the Middle Permian (Guadalupian) Xilanta Formation in the Gyanyima area, Burang County, southwestern Tibet, China. Nine genera, Lantschichites, Kahlerina, Nankinella, Yangchienia, Chusenella, Verbeekina, Armenina, Paraverbeekina and Neoschwagerina are recognized.Anew species Yangchienia gyanyimaensis n. sp. is established. This fauna indicates a Midian age in terms of the coexistence of Kahlerina, Lantschichites and Neoschwagerina. Paleobiogeographically, the fauna closely resembles that from the Lasaila exotic limestone block of Tibet, both resemble the fusuline assemblages known from the western Cimmerian continents in the Western Tethys Province. However, the absence of Afghanella and Sumatrina in the fauna suggests that the Gyanyima limestone block as well as the Lasaila exotic limestone block, the Batain plain of Oman and the Salt Range of Pakistan, were affected by relatively cool water during the Middle Permian.

Influencing health equity : role of the effective consumer scale in measuring skills and abilities in a middle income country

The 2008 World Health Report emphasizes the need for patient-centered primary care service delivery models in which patients are equal partners in the planning and management of their health. It is argued that this involvement will lead to improved management of disease, improved health outcomes and patient satisfaction, better informed decision-making, increased compliance with healthcare decisions, and better resource utilization. This article investigates the domains captured by the Effective Consumer Scale (EC-17) in relation to vulnerable population groups that experience health inequity. Particular focus is paid to the domain of health literacy as an area fundamental to patients’ involvement in managing their condition and negotiating the healthcare system. In examining the possible influence of Outcome Measures in Rheumatology Clinical Trials (OMERACT) on health equity, we used the recent translation and validation of the EC-17 scale into Spanish and tested Argentina as an example. Future plans to use the EC-17 with vulnerable groups include formal collaboration and needs assessment with the community to tailor an intervention to meet its needs in a culturally relevant manner. Some systematic reviews have questioned whether interventions to improve effective consumer skills are appropriate in vulnerable populations. We propose that these populations may have the most to gain from such interventions since they might be expected to have relatively lower skills and health literacy than other groups.

An investigation of middle secondary students' mathematical conceptions of rate

This study identified four educationally critical aspects of ‘rate’ through analysis of phenomenographic, video-recorded interviews with Year 10 students. Further analysis indicated understandings in one representation or context were not necessarily transferable.

Meaningful mathematics in the middle years

This paper describes an action research project that investigated issues concerning the teaching and learning of numeracy in the middle years. Building on research concerning the middle years of schooling, and their own experience of teaching mathematics in years 5 - 8, a group of teachers, drawn from four schools, trialed strategies intended to improve the engagement, attitudes and outcomes of their students in mathematics. The group recommended at the end of the study that mathematics needs to be meaningful for young adolescents. The concept of meaningful mathematics is explored through a description of the actions and findings of the teachers participating in this project.