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An interdisciplinary knowledge translation intervention in long-term care: study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature124096
Source
Implement Sci. 2012;7:48
Publication Type
Article
Date
2012
Author
Courtney C Kennedy
George Ioannidis
Lora M Giangregorio
Jonathan D Adachi
Lehana Thabane
Suzanne N Morin
Richard G Crilly
Sharon Marr
Robert G Josse
Lynne Lohfeld
Laura E Pickard
Susanne King
Mary-Lou van der Horst
Glenda Campbell
Jackie Stroud
Lisa Dolovich
Anna M Sawka
Ravi Jain
Lynn Nash
Alexandra Papaioannou
Author Affiliation
Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada. kennedyc@hhsc.ca
Source
Implement Sci. 2012;7:48
Date
2012
Language
English
Publication Type
Article
Keywords
Bone Density Conservation Agents - administration & dosage - therapeutic use
Calcium - administration & dosage
Dietary Supplements
Drug Utilization
Fractures, Bone - prevention & control
Homes for the Aged - organization & administration
Humans
Information Dissemination
Inservice training
Leadership
Long-Term Care - organization & administration
Nursing Homes - organization & administration
Ontario
Osteoporosis - prevention & control
Pilot Projects
Reminder Systems
Translational Medical Research - organization & administration
Vitamin D - administration & dosage - therapeutic use
Abstract
Knowledge translation (KT) research in long-term care (LTC) is still in its early stages. This protocol describes the evaluation of a multifaceted, interdisciplinary KT intervention aimed at integrating evidence-based osteoporosis and fracture prevention strategies into LTC care processes.
The Vitamin D and Osteoporosis Study (ViDOS) is underway in 40 LTC homes (n = 19 intervention, n = 21 control) across Ontario, Canada. The primary objectives of this study are to assess the feasibility of delivering the KT intervention, and clinically, to increase the percent of LTC residents prescribed =800 IU of vitamin D daily. Eligibility criteria are LTC homes that are serviced by our partner pharmacy provider and have more than one prescribing physician. The target audience within each LTC home is the Professional Advisory Committee (PAC), an interdisciplinary team who meets quarterly. The key elements of the intervention are three interactive educational sessions led by an expert opinion leader, action planning using a quality improvement cycle, audit and feedback reports, nominated internal champions, and reminders/point-of-care tools. Control homes do not receive any intervention, however both intervention and control homes received educational materials as part of the Ontario Osteoporosis Strategy. Primary outcomes are feasibility measures (recruitment, retention, attendance at educational sessions, action plan items identified and initiated, internal champions identified, performance reports provided and reviewed), and vitamin D (=800 IU/daily) prescribing at 6 and 12 months. Secondary outcomes include the proportion of residents prescribed calcium supplements and osteoporosis medications, and falls and fractures. Qualitative methods will examine the experience of the LTC team with the KT intervention. Homes are centrally randomized to intervention and control groups in blocks of variable size using a computer generated allocation sequence. Randomization is stratified by home size and profit/nonprofit status. Prescribing data retrieval and analysis are performed by blinded personnel.
Our study will contribute to an improved understanding of the feasibility and acceptability of a multifaceted intervention aimed at translating knowledge to LTC practitioners. Lessons learned from this study will be valuable in guiding future research and understanding the complexities of translating knowledge in LTC.
Notes
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PubMed ID
22624776 View in PubMed
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Daily physical education in the school curriculum in prepubertal girls during 1 year is followed by an increase in bone mineral accrual and bone width--data from the prospective controlled Malmö pediatric osteoporosis prevention study.

https://arctichealth.org/en/permalink/ahliterature29209
Source
Calcif Tissue Int. 2006 Feb;78(2):65-71
Publication Type
Article
Date
Feb-2006
Author
O. Valdimarsson
C. Linden
O. Johnell
P. Gardsell
M K Karlsson
Author Affiliation
Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Malmö University Hospital, Malmö SE-205 02, Sweden. ornolfur.valdimarsson@med.lu.se
Source
Calcif Tissue Int. 2006 Feb;78(2):65-71
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Body mass index
Bone Density
Bone and Bones - anatomy & histology - chemistry - physiology
Child
Curriculum
Densitometry, X-Ray
Exercise
Female
Femur Neck - anatomy & histology - chemistry - physiology
Fractures, Bone - prevention & control
Humans
Leg Bones - anatomy & histology - chemistry - physiology
Longitudinal Studies
Lumbar Vertebrae - anatomy & histology - chemistry - physiology
Osteoporosis - physiopathology - prevention & control
Research Support, Non-U.S. Gov't
Schools
Sweden
Abstract
The aim of this study was to evaluate a general school-based 1-year exercise intervention program in a population-based cohort of girls at Tanner stage I. Fifty-three girls aged 7-9 years were included. The school curriculum-based exercise intervention program included 40 minutes/school day. Fifty healthy age-matched girls assigned to the general school curriculum of 60 minutes physical activity/week served as controls. Bone mineral content (BMC, g) and areal bone mineral density (aBMD, g/cm(2)) were measured with dual X-ray absorptiometry (DXA) of the total body (TB), lumbar spine (L2-L4 vertebrae), third lumbar vertebra (L3), femoral neck (FN), and leg. Volumetric bone mineral density (g/cm(3)) and bone width were calculated at L3 and FN. Total lean body mass and total fat mass were estimated from the TB scan. No differences at baseline were found in age, anthropometrics, or bone parameters when the groups were compared. The annual gain in BMC was 4.7 percentage points higher in the lumbar spine and 9.5 percentage points higher in L3 in cases than in controls (both P
PubMed ID
16467972 View in PubMed
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Determinants of acceptance of a community-based program for the prevention of falls and fractures among the elderly.

https://arctichealth.org/en/permalink/ahliterature52349
Source
Prev Med. 2001 Aug;33(2 Pt 1):115-9
Publication Type
Article
Date
Aug-2001
Author
E R Larsen
L. Mosekilde
A. Foldspang
Author Affiliation
Department of Orthopaedic Surgery, Randers Central Hospital, Randers, Denmark. erl@inet.uni2.dk
Source
Prev Med. 2001 Aug;33(2 Pt 1):115-9
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Age Distribution
Aged
Aged, 80 and over
Community Health Services - organization & administration
Consumer Participation
Denmark
Female
Fractures, Bone - prevention & control
Geriatrics
Humans
Logistic Models
Male
Marital status
Registries
Sex Distribution
Abstract
BACKGROUND: Low-energy fractures among the elderly may be prevented by measures aimed at reducing the risk of falling or increasing the strength of the skeleton. Acceptance of these interventions in the target population is necessary for their success. METHODS: The total elderly population in a Danish municipality 7,543 community-dwelling persons aged 66+ years, were offered participation in one of three intervention programs: 2,550 persons were offered a home safety inspection, evaluation of prescribed medicine, and identification of possible health and food problems (Program I); 2,445 persons were offered 1000 mg of elemental calcium and 400 IU (10 microg) of vitamin D(3) per day in combination with evaluation of prescribed medicine (Program II); and 2,548 persons were offered a combination of the two programs (Program III). Acceptance was defined as willingness to receive an introductory visit by a nurse. RESULTS: Acceptance of Program I was 50%; of Program II, 56% (P
PubMed ID
11493044 View in PubMed
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Dietary intake of folate, but not vitamin B2 or B12, is associated with increased bone mineral density 5 years after the menopause: results from a 10-year follow-up study in early postmenopausal women.

https://arctichealth.org/en/permalink/ahliterature93785
Source
Calcif Tissue Int. 2008 Jan;82(1):1-11
Publication Type
Article
Date
Jan-2008
Author
Rejnmark L.
Vestergaard P.
Hermann A P
Brot C.
Eiken P.
Mosekilde L.
Author Affiliation
The Osteoporosis Clinic, Department of Endocrinology and Metabolism C, Aarhus Sygehus, Aarhus University Hospital, Aarhus Sygehus, Tage-Hansens Gade 2, DK-8000, Aarhus C, Denmark. rejnmark@post6.tele.dk
Source
Calcif Tissue Int. 2008 Jan;82(1):1-11
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adult
Bone Density - drug effects
Bone and Bones - drug effects - metabolism
Case-Control Studies
Cohort Studies
Cross-Sectional Studies
Denmark
Dietary Supplements
Female
Femur Neck - drug effects - radiography
Folic Acid - administration & dosage - metabolism
Follow-Up Studies
Food, Formulated
Fractures, Bone - prevention & control
Humans
Lumbar Vertebrae - drug effects - radiography
Middle Aged
Nutritional Requirements
Osteoporosis, Postmenopausal - prevention & control
Prospective Studies
Riboflavin - administration & dosage - metabolism
Time
Time Factors
Vitamin B 12 - administration & dosage - metabolism
Abstract
Folate, vitamin B2 (riboflavin), and vitamin B12 may affect bone directly or through an effect on plasma homocysteine levels. Previously, a positive association has been found between plasma levels and bone mineral density (BMD) as well as risk of fracture. However, there are limited data on whether dietary intakes affect bone. Our aim was to investigate whether intake of folate, vitamin B2) and vitamin B12, as assessed by food records affects BMD and fracture risk. In a population-based cohort including 1,869 perimenopausal women from the Danish Osteoporosis Prevention Study, associations between intakes and BMD were assessed at baseline and after 5 years of follow-up. Moreover, associations between intakes and 5- and 10-year changes in BMD as well as risk of fracture were studied. Intakes of folate, vitamin B2, and vitamin B12 were 417 (range 290-494) microg/day, 2.70 (range 1.70-3.16) mg/day, and 4.98 (range 3.83-6.62) microg/day, respectively, i.e., slightly above the intakes recommended by the United Nations Food and Agriculture Organization. At year 5, but not at baseline, cross-sectional analyses showed positive correlations between daily intake from diet and from diet plus supplements of folate and BMD at the femoral neck (P
PubMed ID
18175033 View in PubMed
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Effect of calcium on skeletal development, bone loss, and risk of fractures.

https://arctichealth.org/en/permalink/ahliterature50274
Source
Am J Med. 1991 Nov 25;91(5B):23S-28S
Publication Type
Article
Date
Nov-25-1991
Author
R P Heaney
Author Affiliation
Creighton University, Omaha, Nebraska.
Source
Am J Med. 1991 Nov 25;91(5B):23S-28S
Date
Nov-25-1991
Language
English
Publication Type
Article
Keywords
Bone and Bones - metabolism
Calcium - administration & dosage - metabolism
Female
Fractures, Bone - prevention & control
Humans
Menopause - metabolism
Osteoporosis, Postmenopausal - metabolism - prevention & control
Risk factors
Abstract
In assessing the role of calcium, it must be stressed that calcium is not the cause of bone health but simply a necessary condition for it. It is mechanical usage that is of primary importance for bone. In just the same way iron is essential for hemoglobin synthesis and protein is essential for muscle mass, but neither is sufficient by itself. What, then, ought we to expect from a high calcium intake? Can we prevent estrogen-withdrawal bone loss? No. Calcium is not a substitute for estrogen, anymore than it is a substitute for exercise. Will calcium slow the remodeling loss that occurs with aging? Yes, to some extent; as calcium slows remodeling, it will inevitably slow remodeling-related loss. But most importantly, a high calcium intake will prevent calcium-deficiency bone loss. The only question, therefore, is the extent to which calcium deficiency loss may contribute significantly to bone fragility in various populations. The bone loss and fracture data reviewed briefly here indicate that an important portion of the osteoporotic fracture burden is calcium-related. What that portion is will be a function of the fraction of the population with inadequate intakes in any given country. Better than half of all adult American women have calcium intakes less than 500 mg/day, whereas only a small fraction of Dutch or Danish women, for example, would be under that level. Hence, a population-wide program to increase calcium intake in the United States would be likely to yield a greater benefit than in either the Netherlands or Denmark. That does not mean, of course, that there could not be substantial benefit to individuals with low intakes in all countries. Calcium intakes of greater than or equal to 1,500 mg are both safe and natural. While not all bone loss and low trauma fractures are due to low calcium intake, some almost certainly are. Adaptation to low intakes does occur, but it is seldom sufficient to compensate for the low intake. We cannot easily distinguish those who need more calcium from those who need less, and for that reason it makes good sense to ensure an adequate calcium intake for the entire adult population. What should that intake be? During adolescence, 1,500 mg will come close to ensuring the achievement of genetically programmed levels of peak bone mass.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
1750413 View in PubMed
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Effects of adjuvant exemestane versus anastrozole on bone mineral density for women with early breast cancer (MA.27B): a companion analysis of a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature104716
Source
Lancet Oncol. 2014 Apr;15(4):474-82
Publication Type
Article
Date
Apr-2014
Author
Paul E Goss
Dawn L Hershman
Angela M Cheung
James N Ingle
Sundeep Khosla
Vered Stearns
Haji Chalchal
Kendrith Rowland
Hyman B Muss
Hannah M Linden
Judite Scher
Kathleen I Pritchard
Catherine R Elliott
Tanja Badovinac-Crnjevic
Jessica St Louis
Judith-Anne W Chapman
Lois E Shepherd
Author Affiliation
Massachusetts General Hospital, Boston, MA, USA. Electronic address: pgoss@partners.org.
Source
Lancet Oncol. 2014 Apr;15(4):474-82
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Androstadienes - adverse effects - therapeutic use
Antineoplastic Agents, Hormonal - adverse effects - therapeutic use
Aromatase Inhibitors - adverse effects - therapeutic use
Bone Density - drug effects
Bone Density Conservation Agents - therapeutic use
Bones of Lower Extremity - drug effects - radiography
Breast Neoplasms - drug therapy - enzymology - pathology
Calcium - therapeutic use
Canada
Chemotherapy, Adjuvant
Dietary Supplements
Diphosphonates - therapeutic use
Female
Fractures, Bone - prevention & control
Humans
Lumbar Vertebrae - drug effects - radiography
Middle Aged
Neoplasms, Hormone-Dependent - drug therapy - enzymology - pathology
Nitriles - adverse effects - therapeutic use
Postmenopause
Time Factors
Treatment Outcome
Triazoles - adverse effects - therapeutic use
United States
Vitamin D - therapeutic use
Abstract
Treatment of breast cancer with aromatase inhibitors is associated with damage to bones. NCIC CTG MA.27 was an open-label, phase 3, randomised controlled trial in which women with breast cancer were assigned to one of two adjuvant oral aromatase inhibitors-exemestane or anastrozole. We postulated that exemestane-a mildly androgenic steroid-might have a less detrimental effect on bone than non-steroidal anastrozole. In this companion study to MA.27, we compared changes in bone mineral density (BMD) in the lumbar spine and total hip between patients treated with exemestane and patients treated with anastrozole.
In MA.27, postmenopausal women with early stage hormone (oestrogen) receptor-positive invasive breast cancer were randomly assigned to exemestane 25 mg versus anastrozole 1 mg, daily. MA.27B recruited two groups of women from MA.27: those with BMD T-scores of -2·0 or more (up to 2 SDs below sex-matched, young adult mean) and those with at least one T-score (hip or spine) less than -2·0. Both groups received vitamin D and calcium; those with baseline T-scores of less than -2·0 also received bisphosphonates. The primary endpoints were percent change of BMD at 2 years in lumbar spine and total hip for both groups. We analysed patients according to which aromatase inhibitor and T-score groups they were allocated to but BMD assessments ceased if patients deviated from protocol. This study is registered with ClinicalTrials.gov, NCT00354302.
Between April 24, 2006, and May 30, 2008, 300 patients with baseline T-scores of -2·0 or more were accrued (147 allocated exemestane, 153 anastrozole); and 197 patients with baseline T-scores of less than -2·0 (101 exemestane, 96 anastrozole). For patients with T-scores greater than -2·0 at baseline, mean change of bone mineral density in the spine at 2 years did not differ significantly between patients taking exemestane and patients taking anastrozole (-0·92%, 95% CI -2·35 to 0·50 vs -2·39%, 95% CI -3·77 to -1·01; p=0·08). Respective mean loss in the hip was -1·93% (95% CI -2·93 to -0·93) versus -2·71% (95% CI -4·32 to -1·11; p=0·10). Likewise for those who started with T-scores of less than -2·0, mean change of spine bone mineral density at 2 years did not differ significantly between the exemestane and anastrozole treatment groups (2·11%, 95% CI -0·84 to 5·06 vs 3·72%, 95% CI 1·54 to 5·89; p=0·26), nor did hip bone mineral density (2·09%, 95% CI -1·45 to 5·63 vs 0·0%, 95% CI -3·67 to 3·66; p=0·28). Patients with baseline T-score of -2·0 or more taking exemestane had two fragility fractures and two other fractures, those taking anastrozole had three fragility fractures and five other fractures. For patients who had baseline T-scores of less than -2·0 taking exemestane, one had a fragility fracture and four had other fractures, whereas those taking anastrozole had five fragility fractures and one other fracture.
Our results demonstrate that adjuvant treatment with aromatase inhibitors can be considered for breast cancer patients who have T-scores less than -2·0.
Canadian Cancer Society Research Institute, Pfizer, Canadian Institutes of Health Research.
Notes
Comment In: Lancet Oncol. 2014 Apr;15(4):375-724636209
PubMed ID
24636210 View in PubMed
Less detail

Effects of physical exercise on bone mass, balance skill and aerobic capacity in women and men with low bone mineral density, after one year of training--a prospective study.

https://arctichealth.org/en/permalink/ahliterature50019
Source
Scand J Med Sci Sports. 1998 Oct;8(5 Pt 1):290-8
Publication Type
Article
Date
Oct-1998
Author
A C Kronhed
M. Möller
Author Affiliation
Primary Health Care Centre, Vadstena, Sweden.
Source
Scand J Med Sci Sports. 1998 Oct;8(5 Pt 1):290-8
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bone Density - physiology
Bone Remodeling - physiology
Bone and Bones - anatomy & histology
Densitometry, X-Ray
Disease
Exercise Therapy
Female
Fractures, Bone - prevention & control
Genetics
Humans
Incidence
Life Style
Male
Middle Aged
Muscle, Skeletal - physiology
Musculoskeletal Equilibrium - physiology
Occupations
Osteoporosis - prevention & control
Oxygen Consumption - physiology
Pharmaceutical Preparations - administration & dosage
Physical Fitness - physiology
Prospective Studies
Questionnaires
Range of Motion, Articular - physiology
Research Support, Non-U.S. Gov't
Sweden
Weight-Bearing - physiology
Abstract
Vadstena is a small community in the county of Ostergötland, Sweden, where a project began in 1989 to prevent osteoporosis and to lower the expected incidence of osteoporotic fractures. Persons aged 40-70 years who had a low bone mineral density (BMD) value at screening of the distal radius by single-photon absorptiometry (SPA) were invited to participate in a training study during one year. The definition of low BMD was a densitometry value below -1 SD (standard deviation) from a sex- and age-specific reference value (z-score). Fifteen persons wanted to exercise in a group and 15 persons wanted to become a control group. All participants answered a questionnaire about lifestyle, occupation, diseases, medication and heredity. Clinical tests were made regarding mobility of the joints and muscles, balance and physical fitness. BMD for the hip and the lumbar spine were assessed by dual-energy X-ray absorptiometry (DXA) before and after the investigation period. The training programme was carried out for 60 min twice a week during one year and had the intention to improve bone mass, muscle strength and flexibility, balance skill and aerobic capacity. After the training period there was a significant increase in BMD at the greater trochanter (P
PubMed ID
9809388 View in PubMed
Less detail

[Exercise for prevention of osteoporosis and other lifestyle-related diseases].

https://arctichealth.org/en/permalink/ahliterature134889
Source
Clin Calcium. 2011 May;21(5):722-9
Publication Type
Article
Date
May-2011
Author
Takao Suzuki
Author Affiliation
National Institute for Geriatrics and Gerontology.
Source
Clin Calcium. 2011 May;21(5):722-9
Date
May-2011
Language
Japanese
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Aging - physiology
Diabetes Mellitus - prevention & control
Dyslipidemias - prevention & control
Exercise - physiology
Fractures, Bone - prevention & control
Health promotion
Humans
Hypertension - prevention & control
Life Style
Meta-Analysis as Topic
Metabolic Syndrome X - prevention & control
Osteoporosis - prevention & control
Abstract
The prevalence of lifestyle-related diseases including hypertension, dyslipidemia (hyperlipidemia) and diabetes increases with aging, and all these conditions are risk factors of arteriosclerotic diseases such as cerebrovascular event (stroke) and myocardial infarction. The term "metabolic domino" has been used to describe the collective concept of the development and progression of these lifestyle-related diseases, the sequence of events, and the progression process of complications. Like the first tile of a domino toppling game, undesirable lifestyle such as overeating and underexercising first triggers obesity, and is followed in succession by onset of an insulin resistance state (underlied by a genetic background indigenous to Japanese) , hypertension, hyperlipidemia, and further postprandial hyperglycemia (the pre-diabetic state) , the so-called metabolic syndrome, at around the same time. On the other hand, apart from the other lifestyle-related diseases, the prevalence of osteoporosis also increases rapidly accompanying aging. Osteoporosis is known to be strongly related to disorders due to the metabolic domino such as arteriosclerosis and vascular calcification, and a new disease category called "osteo-vascular interaction" has attracted attention recently. Regarding "osteo-vascular interaction" , a close relation between bone density loss or osteoporotic changes and vascular lesion-associated lifestyle-related diseases such as hypertension, dyslipidemia and diabetes has been reported. Therefore, as a common preventive factor for bone mass loss or osteoporosis and lifestyle-related diseases including hypertension, dyslipidemia and diabetes (osteo-vascular interaction) , exercise has been recognized anew as an important non-pharmaceutical therapy that should take top priority. This article overviews the evidence of exercise therapy for the prevention of osteoporosis and other lifestyle-related diseases, from the viewpoint of health promotion, especially of the skeletal system (motor system) .
PubMed ID
21532123 View in PubMed
Less detail

Extract from the Norwegian National Report on Physical Activity and Health.

https://arctichealth.org/en/permalink/ahliterature15469
Source
Scand J Med Sci Sports. 2001 Aug;11(4):255-7
Publication Type
Article
Date
Aug-2001
Source
Scand J Med Sci Sports. 2001 Aug;11(4):255-7
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Adolescent
Aged
Aging - physiology
Asthma - prevention & control
Back Injuries - prevention & control
Body mass index
Child
Coronary Disease - prevention & control
Diabetes Mellitus, Type 2 - prevention & control
Energy intake
Energy Metabolism
Exercise
Female
Fractures, Bone - prevention & control
Habits
Health Behavior
Humans
Life Style
Male
Muscle, Skeletal - physiology
Neoplasms - prevention & control
Norway
Nutritional Status
Physical Endurance - physiology
Physical Fitness
Pregnancy
Pregnancy Complications - prevention & control
Risk factors
Abstract
In 1999 the National Council on Nutrition and Physical Activity in Norway appointed a committee to look into the relationship between health and physical activity, and to provide some guidelines to various populations regarding physical activity. The committee, which consisted of Sigmund B. Str?mme, Sigmund A. Anderssen, Ingvar Hjermann, Jorunn Sundgot-Borgen, Sigbj?rn Smeland, Sverre Maehlum, and Anita Andaas Aadland, produced a comprehensive 84-page report (rapport nr. 2/2000) on physical activity and health based on the currently available scientific evidence. An extract from the first part of the report, which concentrates on the significance of physical activity for various population groups follows below.
PubMed ID
11476433 View in PubMed
Less detail

Facial fractures and snowmobile accidents.

https://arctichealth.org/en/permalink/ahliterature249952
Source
Can J Surg. 1977 May;20(3):275-7
Publication Type
Article
Date
May-1977
Author
B M Rigg
Source
Can J Surg. 1977 May;20(3):275-7
Date
May-1977
Language
English
Publication Type
Article
Keywords
Accident prevention
Accidents, Traffic
Adolescent
Adult
Alcoholic Intoxication - complications
Child
Facial Bones - injuries
Female
Fractures, Bone - prevention & control
Head Protective Devices
Humans
Male
Maxillofacial Injuries - prevention & control
Middle Aged
Ontario
Abstract
Snowmobile accidents are now common in winter; there is a local pattern of facial fractures associated with accidents involving these machines. Facial fractures connected with snowmobile accidents over a period of two successive winters were reviewed; 14 were found to be of special interest because of their severity and localized extent. Compared with motor vehicle accidents most of these fractures were isolated; the patients often had suffered only minimal trauma elsewhere. After reviewing the histories of these patients it was clear that alcohol, night driving, inadequate facial protection and the use of unknown terrain were common precipitating factors. Elimination of these hazards and the use of appropriate protective head-gear would probably reduced the number and severity of such injuries.
PubMed ID
858100 View in PubMed
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