Calcium and bone health : position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia

This position statement was prepared by the Working Group of the Australian and New Zealand Bone and Mineral Society and Osteoporosis Australia. The final statement was endorsed by the Endocrine Society of Australia.

Currently, the balance of evidence remains in favour of fracture prevention from combined calcium and vitamin D supplementation in elderly men and women.

Adequate vitamin D status is essential for active calcium absorption in the gut and for bone development and remodelling.

In adults with a baseline calcium intake of 500–900 mg/day, increasing or supplementing this intake by a further 500–1000 mg/day has a beneficial effect on bone mineral density.

Calcium intake significantly above the recommended level is unlikely to achieve additional benefit for bone health.

Adaptive behaviour in Australia : what items are essential for assessing independent living?

Adaptive behaviour is important in the assessment of eligibility for intellectual disability services. However, there is some question about which behaviours should be assessed. The purpose of the present study was to clarify which everyday behaviours are considered essential for independent functioning by young adults in the Australian community. Parents, disability workers, and young adults judged the importance of 130 everyday behaviours. Items that assessed safety, health, self-care, functional literacy and numeracy, respecting others' rights, and day-to-day decisionmaking were most frequently rated as essential for independent functioning. Our findings raise important questions about the assessment of adaptive behaviour in Australia, and point to the need for a more valid approach to the measurement of adaptive behaviour for the purpose of eligibility assessment. The research provides a first step towards providing such a scale for use in the Australian context.

Applying a quality use of medicines framework to using essential oils in nursing practice

Nurses are increasingly incorporating complementary therapies into their practices. Aromatherapy is one of the most popular therapies. The basis of aromatherapy is essential oils, which are chemically active substances with a long history of safe traditional use and a growing evidence base to support their use in nursing care. In Australia, essential oils are classified and regulated under the same policies as conventional medicines such as the National Medicines Policy and the Quality Use of Medicines (QUM) framework applies. QUM is a framework for selecting and using medicines safely and effectively if medicines are indicated. The key elements of QUM are a systems-based approach to using medicines based on relevant evidence, partnerships, and informed client consent. Clients are placed at the centre of a QUM medication management process, which is consistent with holistic care. Applying a QUM approach to essential oil use, Quality Use of Essential Oils (QUEO), involves developing effective systems for managing essential oils from an holistic perspective that includes structured assessment and diagnostic processes to enable effective essential oil prescribing and outcome monitoring. In a QUEO approach, essential oils are integrated into the client's overall medication regimen and care plan rather than being used as ‘add-ons’. Adopting QUEO is consistent with the current national focus on the quality use of therapeutic substances, increases the profile of aromatherapy in nursing care and provides important information to guide future aromatherapy practices.

Optimization of MLP parameters on mineral potential mapping tasks

Mineral potential mapping is the process of combining a set of input maps, each representing a distinct geo-scientific variable, to produce a single map which ranks areas according to their potential to host deposits of a particular type. The maps are combined using a mapping function which must be either provided by an expert (knowledge-driven approach), or induced from sample data (data-driven approach). Current data-driven approaches using multilayer perceptrons (MLPs) to represent the mapping function have several inherent problems: they rely heavily on subjective judgment in selecting training data and are highly sensitive to this selection; they do not utilize the contextual information provided by unlabeled data; and, there is no objective interpretation of the values output by the MLP. This paper presents a novel approach which overcomes these three problems.

Comparison of MLP and Bayesian approaches on mineral prospectivity mapping tasks

Mineral Prospectivity Mapping is the process of combining maps containing different geoscientific data sets to produce a single map depicting areas ranked according to their potential to host mineral deposits of a particular type. This paper outlines two approaches for deriving a function which can be used to assign to each cell in the study area a value representing the posterior probability that the cell contains a deposit of the sought-after mineral. One approach is based on estimating probability density functions (pdfs); the second uses multilayer perceptrons (MLPs). Results are provided from applying these approaches to geoscientific datasets covering a region in North Western Victoria, Australia. The results demonstrate that while both the Bayesian approach and the MLP approach yield similar results when the number of input dimensions is small, the Bayesian approach rapidly becomes unstable as the number of input dimensions increases, with the resulting maps displaying high sensitivity to the number of mixtures used to model the distributions. However, despite the fact that Bayesian assigned values cannot be interpreted as posterior probabilities in high dimensional input spaces, the pixel favorability rankings produced by the two methods is similar.

Retention of essential amino acids during extrusion of protein and reducing sugars

This research investigates the retention of essential amino acid profiles of products during the extrusion of proteins and reducing sugars. Animal proteins (egg and milk protein at 10 and 30% levels) and reducing sugars (fructose and galactose at 0, 2, and 8% levels), with pregelatinized wheat flour, were extruded at 110 and 125 °C product temperatures and feed moistures of 19 and 23.5% for egg protein and 13.75 and 16% for milk protein. The nutritional property analyzed was essential amino acid retention, and sugar retention was also considered to understand the relationship of sugars with retention of amino acids. Lysine showed the lowest retention (up to 40%) of all the essential amino acids. Retention of other essential amino acids varied from 80 to 100% in most situations. Apart from lysine,  tryptophan, threonine, and methionine were found to be significantly changed (P < 0.05) with processing conditions. Increased protein and sugar levels resulted in a significant degradation of lysine. Greater lysine retention was found at a lower temperature and higher feed moisture. Results of sugar retention also showed similar patterns. The products made from fructose had greater lysine retention than products made from galactose with any type of protein. The outcomes of this research suggested that the combination of milk protein and fructose at a lower temperature and higher feed moisture is most favorable for developing high-protein extruded products.

Nutritional aspects of food extrusion: a review

Extrusion cooking, as a multi-step, multi-functional and thermal/mechanical process, has permitted a large number of food applications. Effects of extrusion cooking on nutritional quality are ambiguous. Beneficial effects include destruction of antinutritional factors, gelatinisation of starch, increased soluble dietary fibre and reduction of lipid oxidation. On the other hand, Maillard reactions between protein and sugars reduce the nutritional value of the protein, depending on the raw material types, their composition and process conditions. Heat-labile vitamins may be lost to varying extents. Changes in proteins and amino acid profile, carbohydrates, dietary fibre, vitamins, mineral content and some non-nutrient healthful components of food may be either beneficial or deleterious. The present paper reviews the mechanisms underlying these changes, as well as the influence of process variables and feed characteristics. Mild extrusion conditions (high moisture content, low residence time, low temperature) improve the nutritional quality, while high extrusion temperatures (200 °C), low moisture contents (<15%) and/or improper formulation (e.g. presence of high-reactive sugars) can impair nutritional quality adversely. To obtain a nutritionally balanced extruded product, careful control of process parameters is essential.

Impact of ripening stages of banana flour on the quality of extruded products

The study investigated the physical, nutritional and sensory properties of different ripening stages of banana during extrusion processing in combination with rice flour to develop quality snack products. Dehydrated banana flours at ripening stages 4, 5 and 6 (peel colour) were mixed separately at 40% banana to 60% rice flour levels. The mixtures were extruded through a twin-screw extruder at 120 °C barrel temperature, 220 and 260 r.p.m, screw speed and 12% feed moisture. Increase in ripeness indicated negative effect on expansion and water absorption capacity while increasing the water solubility index and moisture retention (wet basis) of the products. Protein and mineral (except for zinc and copper) content of the products were significantly different (P < 0.05) from 4 to 6 of the ripening stages. Most of the essential amino acids in the extruded products increased significantly (P < 0.05) at the ripening stage of 6. All the products were within the acceptable range in the 9-point Hedonic scale showing the best texture and flavour scores for stage 4 and 6, respectively. The extruded products show potential as snack products because of their nutritional quality and sensory acceptability.

Changes in body composition as determinants of longitudinal changes in bone mineral measures in 8 to 26 year old female twins

Between 1990 and 1998, we conducted a longitudinal study of 286 female twins aged 8 to 25 years at baseline (60 monozygotic (MZ) pairs, 44 dizygotic (DZ) pairs and 78 unpaired twins), measured on average 2.4 times (range 2–6) with an average of 1.8 years between measurements (range 0.7–6.7 years). Areal bone mineral density (ABMD) at the lumbar spine, total hip and femoral neck, total body bone mineral content (BMC), total body soft tissue composition (lean mass and fat mass) were measured by dual-energy X-ray absorptiometry, and height and menarchial status were also recorded. Median annual changes in height were negligible at 4 years post-menarche. During the “linear growth” period up to 4 years post-menarche, ABMD at the lumbar spine, total hip and femoral neck increased with annual change in lean mass by 1.7 (S.E. 0.1), 1.4 (0.1) and 1.0 (0.1) percent per kilogram per year, respectively (all p<0.001), independently of changes in fat mass or height. During the “post-linear growth” period, ABMD at the total hip and femoral neck increased with annual change in fat mass by 0.3 (0.1) and 0.5 (0.1) percent per kilogram per year (all p<0.01), independent of change in lean mass. Annual changes in total body BMC were associated with annual changes in lean mass (1.9 (0.2) percent per kilogram), in fat mass (1.3 (0.2) percent per kilogram) and in height (0.7) (0.2) percent per centimeter) during linear growth, and in fat mass (1.0 (0.1)) and lean mass (0.6 (0.1)) percent per kilogram post-linear growth (all p<0.001). We conclude that changes in bone mineral measures are strongly associated with changes in lean mass during linear growth, while post-linear growth, changes in fat mass are the predominant, although weaker, predictor. These findings suggest that the strong cross-sectional association between bone mineral measures and lean mass is established during growth and development, and that fat mass emerges as a more powerful determinant of bone change in healthy adult females.