992 resultados para Osteoporosis prevention


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 Abstract
Children’s reports of high family conflict consistently predict poor outcomes. The study identified criteria for high family conflict based on prospective prediction of increased risk for childhood depression. These criteria were subsequently used to establish the prevalence of high family conflict in Australian communities and to identify community correlates suitable for targeting prevention programs. Study 1 utilised a longitudinal design. Grade 6 and 8 students completed a family conflict scale (from the widely used Communities That Care survey) in 2003 and depression symptomotology were evaluated at a 1-year follow-up (International Youth Development Study, N = 1,798). Receiver-operating characteristic analysis yielded a cut-off point on a family conflict score with depression symptomatology as a criterion variable. A cut-off score of 2.5 or more (on a scale of 1 to 4) correctly identified 69 % with depression symptomology, with a specificity of 77.2 % and sensitivity at 44.3 %. Study 2 used data from an Australian national survey of Grade 6 and 8 children (Healthy Neighbourhoods Study, N = 8,256). Prevalence estimates were calculated, and multivariate logistic regression with multi-level modelling was used to establish factors associated with community variation in family conflict levels. Thirty-three percent of Australian children in 2006 were exposed to levels of family conflict that are likely to increase their future risk for depression. Significant community correlates for elevated family conflict included Indigenous Australian identification, socioeconomic disadvantage, urban and state location, maternal absence and paternal unemployment. The analysis provides indicators for targeting family-level mental health promotion programs.

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Objective:

Prevention strategies have made a major contribution to the considerable successes in reductions in cardiovascular disease and cancer mortality seen in recent decades. However, in the field of psychiatry, similar population-level initiatives in the prevention of common mental disorders, depression and anxiety, are noticeably lacking. This paper aims to provide a brief overview of the existing literature on the topic of the prevention of common mental disorders and a commentary regarding the way forward for prevention research and implementation.

Methods:
This commentary considers what we currently know, what we might learn from the successes and failures of those working in prevention of other high prevalence health conditions, and where we might go from here. Taking cognisance of previous preventive models, this commentary additionally explores new opportunities for preventive approaches to the common mental disorders.

Results:
The consensus from a large body of evidence supports the contention that interventions to prevent mental disorders across the lifespan can be both effective and cost-effective. However, funding for research in the area of prevention of common mental disorders is considerably lower than that for research in the areas of treatment, epidemiology and neurobiology. Thus, there is a clear imperative to direct funding towards prevention research to redress this imbalance. Future prevention interventions need to be methodologically rigorous, scalable to the population level and include economic evaluation. Evidence-based knowledge translation strategies should be developed to ensure that all stakeholders recognise preventing mental disorders as an imperative, with appropriate resources directed to this objective.

Conclusion:
There has been a recent expansion of research into potentially modifiable risk factors for depression, and it is now timely to make a concerted effort to advance the field of prevention of common mental disorders.

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Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) within centers, via an eight item closed-ended social network questionnaire. Questionnaire data were collected from (17/20; response rate 85%) long day care center staff. Social network density and centrality statistics were calculated, using UCINET social network software, to examine the role of networks in obesity prevention. Results. “Degree” (influence) and “betweeness” (gatekeeper) centrality measures of staff inter-relationships about physical activity, dietary, and policy information identified key players in each center. Network density was similar and high on some relationship networks in both centers but markedly different in others, suggesting that the network tool identified unique center social dynamics. These differences could potentially be the focus of future team capacity building. Conclusion. Social network analysis is a feasible and useful method to identify existing obesity prevention networks and key personnel in long day care centers.

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Background:  Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the ‘holistic’ approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people.

Methods/design: A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed.

Discussion: This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing diversity in exercise programs targeting seniors recognises the heterogeneity of multicultural populations and may further increase the number of taking part in exercise.

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Objective : To investigate the relationship between socioeconomic status (SES) and reported perceptions of quality of life (QOL) in a cross-sectional population-based analysis of a representative sample of Australian men.

Methods : In 917 randomly recruited men aged 24–92 years, we measured QoL in the domains of physical health, psychological health, environment and social relationships, using the Australian World Health Organization Quality of Life Instrument (WHOQOL-BREF). Residential addresses were cross-referenced with Australian Bureau of Statistics 2006 census data to ascertain SES. Participants were categorised into lower, mid, or upper SES based on the Index of Relative Socioeconomic Disadvantage and Advantage (IRSAD), the Index of Economic Resources (IER), and the Index of Education and Occupation (IEO). Lifestyle and health information was self-reported.

Results : Males of lower SES reported poorer satisfaction with physical health (OR=0.6, 95%CI 0.4–0.9, p=0.02), psychological health (OR=0.4, 95%CI 0.3–.7, <0.001) and environment (OR=0.5, 95%CI 0.3–0.7, p<0.001), although not social relationships (p=0.59). The poorest QOL for each domain was observed in the lower and upper SES groups, representing an inverse U-shaped pattern of association; however, statistical significance was only observed for psychological  health (OR=0.5, 95%CI 0.4–0.7, p<0.001). These relationships were similar for IEO  and IER.

Conclusions : Men from lower and upper SES groups have lower QOL compared to their counterparts in the mid SES group.

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Objective: Osteoarthritis (OA) most commonly affects the patellofemoral compartment of the knee, and is a major cause of pain and disability. Structural changes that evolve prior to the onset of symptoms can be visualised using magnetic resonance imaging (MRI). There is little known information about the role of adiposity on the early structural changes in the patella cartilage in younger, asymptomatic adult females.

Methods: One hundred and sixty asymptomatic women (20–49 years) participating in the Geelong Osteoporosis Study underwent knee MRI (2006–8). Weight and body mass index (BMI) were measured 10 years prior (1994–7, baseline) and at the time of MRI (current), with change over the period calculated (current–baseline). Relationships between measures of adiposity and patella cartilage volume and defects were examined.

Results: After adjustment for age and patella bone volume, there was a reduction of 13 ml (95% confidence interval (95% CI), −25.7, −0.55) in patella cartilage volume for every 1 unit increase in current BMI, and a reduction of 27 ml (95% CI −52.6, −1.5) per BMI unit increase over 10 years (P=0.04 for both). No significant association was observed between baseline BMI and patella cartilage volume (P=0.16). Increased baseline and current weight and BMI were associated with increased prevalence of patella cartilage defects (all P<0.001).

Conclusions: Adiposity and weight gain during midlife are associated with detrimental structural change at the patella in young to middle-aged healthy non-osteoarthritic women. Maintaining a healthy weight and avoiding weight gain in younger asymptomatic women may be important in the prevention of patellofemoral OA.

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The threat that malware poses to RFID systems was identified only recently. Fortunately, all currently known RFID malware is based on SQLIA. Therefore, in this chapter we propose a dual pronged, tag based SQLIA detection and prevention method optimized for RFID systems. The first technique is a SQL query matching approach that uses simple string comparisons and provides strong security against a majority of the SQLIA types possible on RFID systems. To provide security against second order SQLIA, which is a major gap in the current literature, we also propose a tag data validation and sanitization technique. The preliminary evaluation of our query matching technique is very promising, showing 100% detection rates and 0% false positives for all attacks other than second order injection.

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Financial abuse of older people too often lives ‘in the shadows, hidden by fear and shame’. This and the protective love between family members can screen changes that are critical to an older person’s financial and living arrangements. Rather than a single event, it is usually a series of well-intentioned but ill-considered financial acts, which at some point tips over into abuse interwoven with an intricate web of family relationships. Was a transfer of title or a loan to an adult child really misappropriation? Has thoughtlessness become undue influence or even theft? 

Seniors’ support agencies find that older people call for help after they have transferred money or property in the expectation of future housing and care from a younger family member. By then the money has usually gone, relationships have been destroyed and serious issues of health and homelessness have arisen. These situations are preventable and this is core to Seniors Rights Victoria’s legal education project – the prevention of financial abuse of older people in situations where assets have been transferred in exchange for care.
This paper is the third of three publications produced for this project. The previous two were: ‘Assets for Care: A Guide for Lawyers to Assist Clients at Risk of Financial Abuse’, and a guide for older people: ‘Care for Your Assets: Money, Ageing and Family. Each of these publications reflects the experience and knowledge of Seniors Rights Victoria and the service’s rights-based, preventive approach. Prevention of financial abuse helps avoid deep personal anguish and can lessen the burden on services that respond to elder abuse.
An examination of current law and its effectiveness together with discussion of and recommendations for law and policy reform, relevant to ‘assets for care’ scenarios, are this paper’s focus. Although some reform approaches are worthwhile, many shortcomings are systemic and cannot be dealt with through law reform alone, particularly given people’s reluctance to seek legal recourse for these complex and intensely personal family issues.