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PubMed1996

Factors associated with tuberculin reactivity among children in United Arab Emirates.

A cross-sectional survey of tuberculin skin reactivity was conducted in Al-Ain, United Arab Emirates (U.A.E.) between January and June 1994, to find out the prevalence rate of tuberculosis infection. A pre-designed questionnaire was used to collect details of BCG scar, age, sex, residence area, nationality, education, type of house, number of rooms, family size and household contact history of tuberculosis. A total of 785 students were screened, of whom 547 gave a history of BCG vaccination in the past and 238 were BCG-negative. Among BCG-negative children aged 5-11 years and 12-15 years, only 6.5% and 9.3%, respectively, had a positive Mantoux reaction--a rate lower than most Third World countries, but higher than developed countries where under 2% of children are tuberculin reactors. A general linear model with positive Mantoux reaction as the dependent variable was fitted to the data to examine the joint effect of age, sex, residential area, number of rooms at home, family size and BCG vaccine history. The Mantoux reaction was entered as positive and a number of statistically significant associations were found between positive Mantoux test > 10 mm and: age (P = 0.0018); sex (P = 0.0281); residential area (P < 0.0001); number of rooms (P = 0.0017); and BCG vaccine history (P < 0.0001). However, family size did not have any statistical effect on tuberculin testing (Mantoux test > 10 mm). The prevalence (8%) in the 5-14 years age group puts U.A.E. between low (2%) and middle (14%) prevalence countries, according to the classification of the International Union Against Tuberculosis. This calls for continuation of free treatment of active cases and increased efforts towards screening of contacts.

Adolescent↗
PubMed1998

Delivery room analgesia: an analysis of maternal satisfaction.

On the first post-partum day, 324 mothers completed a questionnaire designed to assess maternal perception of delivery room experience. Antenatal pain expectation, actual pain severity, analgesia received, as well as maternal satisfaction and choice of analgesia for future deliveries were recorded. Forty-five percent of primiparae and 36% of multiparae reported that they anticipated suffering extreme pain during delivery. The incidence of unbearable pain was similar among patients who received no analgesia or intravenous pethidine but significantly (P<0.0001) higher when compared to epidural analgesia. During the first stage of labour, continuous epidural analgesia was associated with severe or unbearable pain in 51% and 58% of primiparae and multiparae, respectively. The incidence of severe or unbearable pain during the second stage of labour was 43% and 46% for primiparae and multiparae, respectively. Patient satisfaction with epidural analgesia did not correlate with subjective pain scores. Among mothers who received continuous epidural analgesia 70% described their experience as good or excellent and 65.8% indicated that they would request similar pain relief in the future. Despite advances in obstetric analgesia, women anticipate and actually experience severe pain during childbirth. However, due to psychological and cultural factors, as well as possible post-partum euphoria, satisfaction with the delivery room experience is high.

Journal Article↗
PubMed1997

Prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital.

The aim of this study was to investigate the prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital, using the Hospital Anxiety and Depression Scale (HADS), the EORTC QLQ-C33 and an ad hoc designed questionnaire. In addition, information about the patients' malignant disease and treatment was obtained. The prevalence of anxiety and depression among 716 evaluable patients was 13% and 9% respectively, as assessed with HADS. In hospitalised patients, the risk of psychiatric distress was approximately twice that of patients in the outpatient clinic. Female patients reported significantly more anxiety than men. Patients < 30 or > 70 years old expressed less anxiety than all other patients. Age or gender had no influence on the occurrence of depression. Impaired ability to continue professional work and/or daily life activities, impaired social life and previous psychiatric problems were significantly correlated with anxiety and depression as were impaired physical function, fatigue and pain. The prevalence of depression, but not anxiety, increased in the presence of distant metastases, with less than a month since diagnosis, and with relapse or progression. In the logistic regression analysis, a history of previous psychiatric problems and impaired social life were correlated with both anxiety and depression. Female gender, impaired physical activity and impaired social role function were additional predictive parameters for anxiety, whereas fatigue predicted depression. Careful attention should be paid to cancer patients displaying these problems in order to diagnose and treat depression and anxiety disorders.

Adolescent↗
PubMed1999

Attitudes to evidence on complementary medicine: the perspective of British healthcare purchasers.

OBJECTIVES: To determine the attitude of those who make decisions on the allocation of health-care resources (health-care purchasers/commissioners) towards the relative importance of different types of evidence on complementary medicine. DESIGN: Questionnaire study of GPs and Directors of Public Health. SETTING: General practices in the UK and Directors of Public Health of Health Authorities in the Greater London region. SUBJECTS: 500 randomly selected general practices in 10 randomly selected UK regions, 100 randomly selected general practices who had previously referred to the Royal London Homoeopathic Hospital and all 28 directors of public health of health authorities in the Greater London region. MAIN OUTCOME MEASURE: Importance of the following on a four point scale ranging from 0 (not important) to 3 (very important): randomized clinical trials, audit outcome data from homoeopathic hospitals, uncontrolled outcome studies, patient satisfaction, patient demand, economic evaluation, colleagues' views, expert opinion, theoretical understanding, laboratory research, safety and availability of literature. RESULTS: 462 general practitioners and 19 Directors of Health Authorities responded. Safety data and randomised clinical trials were considered very important, colleagues' views and patient demand as slightly important, uncontrolled outcome studies as not important. The remaining aspects were considered to be important. Differences between the categories of respondents were small. CONCLUSIONS: While randomized clinical trials remain very important, more emphasis should be placed on further substantiating the safety and value for money of complementary medicine in 'real world' clinical settings.

Attitude of Health Personnel↗
PubMed2002

Acceptance of gene therapy by the heart surgery patient.

OBJECTIVE: The aim of the present study was to evaluate the attitude of cardiac surgery patients towards gene therapeutic approaches to heart disease. METHODS: One hundred and fifty patients having undergone coronary artery bypass grafting (n=97), valvular operations (n=40) or combined procedures (n=13) were personally interviewed prior to discharge using a self designed questionnaire. RESULTS: Seventeen percent of the surveyed patients were unable to complete the interview because of total non-understanding of the topic. Of the remaining patients, 33% could basically define the term 'gene'. After explanation of gene therapy principles 70% believed that gene therapy protocols had already been started clinically. Fifty-two percent would accept enrollment in a clinical trial (85% in cases of otherwise incurable disease). If clinical gene transfer would be carried out 73% of patients would accept adenovirus as a vector, 94 and 80%, respectively, would accept catheter-based intervention or surgery for performance of gene therapy. Fifty-four percent would agree to a prophylactic gene therapy protocol. CONCLUSIONS: We conclude that the general attitude of heart surgery patients regarding gene therapy is positive. A considerable number of patients are unable to understand the basic principles of gene therapy. These data can be useful for planning of clinical gene therapy trials and show potential difficulties in obtaining informed consent.

Adult↗
PubMed1998

Adolescent preferences for rooming during hospitalization.

PURPOSE: To determine adolescents' rooming preferences during hospitalization. METHODS: A questionnaire designed by the authors was administered to 95 adolescents (59 inpatients and 36 outpatients) in 1996. Differences between groups were analyzed by Chi-square. RESULTS: The adolescents were equally divided between a preference to room alone (40%) or with one other person (39%). Fewer adolescents (20%) preferred more than one other roommate. When analyzed by gender, females were significantly more likely than males to prefer to room alone [53% vs. 28% (chi(2) = 5.34; p < 0.05)]. The majority of both inpatient and outpatient groups (93%) indicated a preference for a companion-in particular their mother-to stay with them overnight in the hospital during medically difficult times. CONCLUSIONS: These findings support our recommendation that there should be equal numbers of single and double rooms in adolescent inpatient units to accommodate these divided preferences among adolescents. Individual adolescent rooming preferences should be elicited and honored whenever feasible.

Adolescent↗
PubMed1996

A survey of methods used for cardiac risk assessment prior to major vascular surgery.

OBJECTIVES: To assess the frequency with which various methods of cardiac risk assessment are used prior to major vascular surgery and the way in which patients considered to the "high" risk are managed. DESIGN: Questionnaire survey. SETTING: Great Britain and Northern Ireland. MATERIALS: Vascular Surgeons who are current members of the Vascular Surgical Society of Great Britain and Northern Ireland. CHIEF OUTCOME MEASURES: Number of respondents reporting routine or frequent use of particular investigations and methods of management. MAIN RESULTS: Of 246 respondents, 52% had access to a high dependency unit and 77% used intensive therapy units routinely following aortic reconstruction. Some measure of ejection fraction was the most common investigation and was used routinely prior to aortic reconstruction by 35% and often by 33% of respondents, this being more frequent in respondents from teaching hospitals and those carrying out a greater number of reconstructions. Calculated clinical risk indices were rarely used. The identification of high risk patients led to referral to a cardiologist for 90% of respondents and influenced the choice of anaesthetist for 50%. CONCLUSIONS: It is concluded that there is considerable variation in practice, but that those who carry out more vascular surgery are more aggressive in their assessment of cardiac risk prior to reconstruction.

Aorta↗
PubMed1995

Radiographic examination of children. A survey of prescribing practices of general dentists.

OBJECTIVE: The purpose of this article was to assess the radiographic prescribing practices of a sample of general practitioners for the pediatric dental patients in relation to current guidelines. STUDY DESIGN: Questionnaires were mailed to a sample of 963 dentists. The adjusted response was 80%. RESULTS: For the new patient under age 6, slightly more than two thirds of respondents reported the use of selective radiography. For ages 6 to 14 years, a slight majority chose a protocol of survey radiography. Of those who used a predetermined protocol, 69% chose "bite-wings only" for the child under 6 years, whereas for the child 6 to 14 years, the protocol of choice was a complete radiographic survey, predominantly the panoramic/bite-wing. For recall patients in both age groups, less than 1% of dentists used survey radiography. CONCLUSION: From our results, we concluded that the majority of dentists followed the guideline for children under 6 years. However, for children in the transitional dentition years, our respondents choices were divided between selective or survey radiography. The ambiguity in the wording or interpretation of the guideline for this age group may have contributed to this result.

Adolescent↗
PubMed1996

Long-term follow-up of modified condylotomy for internal derangement of the temporomandibular joint.

OBJECTIVES: The purpose of this study was to evaluate disk position and patient response 10 years after modified condylotomy for symptomatic reducing disk displacement. STUDY DESIGNS: Questionnaires and invitations to return for examination and temporomandibular joint magnetic resonance imaging were mailed to 39 consecutive patients 10 years after modified condylotomy. RESULTS: On a 10-point scale the mean pain experienced by the 17 respondents (27 joints) to the questionnaire was 2.0. Ninety percent of 20 joints (12 patients) examined were free of tenderness to palpation. Magnetic resonance imaging in 10 patients (17 joints) showed disk reduction in 59%, displacement with reduction in 29%, and displacement without reduction in 12%. Eighty-five percent of the joints met American Association of Oral and Maxillofacial surgeons criteria for a successful therapeutic outcome. CONCLUSIONS: The study suggests a role for modified condylotomy in the long-term management of symptoms associated with reducing disk displacement. Further, modified condylotomy can frequently reverse an internal derangement and seems to protect against the natural progression of osteoarthrosis.

Adult↗
PubMed2000

Effect of topical nasal azelastine on the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.

BACKGROUND: Recent data suggested that daytime somnolence in patients with allergic rhinitis was secondary to disrupted sleep caused by nasal congestion. Medications, which decreased congestion, would be expected to improve sleep and daytime somnolence. Previously, we demonstrated that nasal steroids improved all three symptoms. The effect of topical nasal antihistamines on these symptoms has yet to be studied. OBJECTIVE: The objective of this 8-week, double-blind, placebo-controlled study was to determine whether topical nasal azelastine was effective at decreasing congestion, daytime somnolence, and improving sleep. METHODS: We recruited 24 subjects with perennial allergic rhinitis and randomized them in a double-blinded, crossover fashion, to receive placebo or azelastine two sprays BID, using Balaam's design. Questionnaires, daily diary, and Epworth Sleepiness Scale were used as tools. The last 2 weeks of each 4-week treatment period were summarized, scored, and compared by PROC MIXED in SAS. RESULTS: The analysis of the Rhinitis Severity Score showed significant improvement only of rhinorrhea in the azelastine group (P = .03). The symptom severity of nasal congestion and daytime somnolence was not significantly different between placebo and azelastine. Subjects considered azelastine effective at improving their sleep (P = .04), but daytime somnolence (P = .06) and congestion (P = .09) were not statistically improved. CONCLUSION: Azelastine is effective in reducing rhinorrhea and improving sleep quality. We were unable to demonstrate that azelastine can significantly reduce the severity of congestion or daytime somnolence.

Administration, Topical↗
PubMed1997

Asthma and allergy avoidance knowledge and behavior in postpartum women.

OBJECTIVE: Based on family history, infants may be classified as "high risk" or "low risk" for the development of allergy or asthma. Failure to breast-feed and early exposure to cigarette smoke or aeroallergens increase the risk of developing asthma or allergy. Since we suspect that physicians seldom educate mothers on reducing environmental exposures in the postnatal period, we sought to determine the level of maternal knowledge as well as actual avoidance behaviors with respect to these risk factors in high risk and low risk families. DESIGN: Questionnaire administered by a research assistant. SETTING: Obstetrics unit of two tertiary care general hospitals. PATIENTS: A sample of 194 postpartum women with uncomplicated pregnancies, interviewed after 24-hours postpartum. MAIN OUTCOME MEASURES: (1) Parental history of asthma, allergy or eczema; (2) potential for infant exposure to environmental risk factors for asthma and allergy, as indicated by history of avoidance practices in the home; (3) parental knowledge of risk factors for asthma or allergy; and (4) physician advise on avoidance. RESULTS: Of 194 women interviewed, a history of doctor-diagnosed asthma, allergy/allergic rhinitis or eczema in either parent was reported by 122 (high risk group). The remaining 72 patients had no history of atopy (low risk group). Of those in the high risk group, 10% of mothers smoked during pregnancy, and about 25% were exposed to second hand smoke on a daily basis. Most of the mothers in the high risk group planned to breast feed (89%). A large number of patients in the high risk group reported potential risk factors for allergy/asthma in their home environments. These included animals in the household (36%), dusty environments (10%) carpeting (47%), cigarette smoke (18%), and others. Despite these risks, only 13% of patients reported being educated by their physicians on improving their home environment. Exposures to environmental risk factors were not different between low and high risk groups. Similarly, knowledge of environmental risk factors and avoidance behaviors were not significantly different between low and high risk groups. CONCLUSIONS: Many mothers whose infants are at high risk of developing asthma or allergies are not aware of and do not practice avoidance of risk factors. Physicians involved in prenatal care of women with a family history of atopy and asthma should offer advice on reducing exposure to potential risk factors and how to modify their environment in ways that can potentially decrease the risk of asthma or allergy prevalence and severity.

Adult↗
PubMed2001

Sexual abuse knowledge base among residents in family practice, obstetrics/gynecology, and pediatrics.

STUDY OBJECTIVE: To investigate resident physician knowledge about sexual abuse prevalence and understanding about potential perpetrators. DESIGN: Questionnaires were mailed to program directors in family practice, obstetrics and gynecology, and pediatric residency programs. PARTICIPANTS: The questionnaires were distributed to senior residents in their final months prior to graduation. INTERVENTIONS: Residents were asked to fill out the questionnaire anonymously and return it to our institution in the prepaid envelope provided. MAIN OUTCOME MEASURES: Demographic characteristics and knowledge of sexual abuse prevalence and perpetrator characteristics were assessed. Chi-square contingency table analysis was used to compare responses of the three specialties. RESULTS: The overwhelming majority (98.8%) of residents correctly identified a family member as the individual most likely to sexually abuse a child. Approximately half of the residents knew the correct prevalence of sexual abuse among females and among males. There was a weak understanding of the potential youthfulness of juvenile offenders. CONCLUSION: We believe that resident understanding of sexual abuse prevalence and about the youthfulness of juvenile offenders can be improved in all three specialties.

Adult↗
PubMedDate not supplied

Evaluating the use and quality of pharmacy drive-up services.

OBJECTIVE: To evaluate the use and quality of pharmacy drive-up services; specifically, to assess patients' and pharmacists' views of the drive-up and determine the implications for assuring or improving the quality of the services provided. DESIGN: Questionnaires developed for patients and pharmacists addressed aspects of pharmacy drive-up services. The patient questionnaire asked about prescription information and drive-up use, satisfaction with pharmacy services, importance of patronage factors, comfort in using the drive-up, and comparison of drive-up and in-store visits. The pharmacist questionnaire was similar in content, but also contained open-ended questions pertaining to the provision of pharmaceutical care at the drive-up pharmacy. SETTING: Six pharmacies in Central Iowa. PARTICIPANTS: A sample of patients who had received at least one prescription from a participating pharmacy in the previous 30 days; pharmacists from participating pharmacies. MAIN OUTCOME MEASURES: Responses from users and nonusers of the pharmacy drive-up. RESULTS: Both users and nonusers of the drive-up indicated that pharmacist-linked services--those that entail direct pharmacist-patient contact and are closely associated with the ideals of pharmaceutical care--may be provided better in-store. The pharmacists also indicated that these services were provided better in-store and mentioned other ways in which drive-up services may detract from patient care. CONCLUSION: As pharmacist-linked services become more important in health care, and as drive-up pharmacy services increase in popularity, the compatibility of drive-up service with a greater emphasis by pharmacists on patient care will increasingly become an issue. To allay potential concerns and improve the quality of service, pharmacists need to take additional steps to assess drive-up patients' level of familiarity with their medications, require patients to come into the pharmacy periodically, and, where necessary, provide alternative services at the drive-up.

Adult↗
PubMedDate not supplied

[Knowledge and application level of the Ramsay Scale by Mexican nurses specialized in intensive care].

INTRODUCTION: Among the intensive care specialized nursing staff, knowing the sedation level of the patient under their responsibility is of crucial importance. The present study evaluated the knowledge that nurses specialized in intensive care (NSIC) have on the Ramsay Scale (RS) and the way in which they apply it. MATERIAL AND METHODS: Those personnel who were developing their activity in the intensive care units (ICU) of four public hospitals of the cities of Merida, Yucatan, Mexico were enrolled during May 2003. The information was obtained by applying an expressly designed questionnaire that contained both demographic endpoints (age, years of experience as NSIC and type of ICU) and those related with the RS (clinical components that it evaluates, operative definitions, frequency of use per week or day). 95% (95% CI) confidence intervals were applied and odds ratio (OR) was used to determined the likelihood of the event. RESULTS: Of the 60 nurses interviewed, 75% did not know the RS. Age was a significant factor associated with its knowledge, since 11 of 23 with an age equal to or less than 38 years (47.8%) and 4 of 37 over 38 years (10.8%) knew what it evaluated (OR of 4 for the group of lower age, 95% CI 1.5 to 12.3, p = 0.002). Of 15 NSIC who knew what it evaluated, 9 (60%) also knew its operative definitions, and stated that they applied it adequately per day. CONCLUSIONS: In this sample, there is an elevated percentage of NSIC who did not know the RS. Age was the factor associated with lack of knowledge.

Adult↗
PubMed2004

'Thinking outside the box': complementary and alternative therapies use in paediatric oncology patients.

The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among children with cancer who had received or were receiving treatment at a large hospital in the UK, including the identification of the most commonly used therapies and parental motives for doing so. Using a cross-sectional survey design, questionnaires were sent to parents of paediatric patients diagnosed with cancer. Of the 49 respondents, 32.7% reported using some type of CAM. The most commonly used therapies included multivitamins, aromatherapy massage, diets and music as therapy. Most children had used more than one therapy. Many of the factors that motivated parents to use CAM were related to helping or supporting their child's medical treatment. The main benefits identified from using CAM included increased confidence, pain relief and relaxation. The longer the time since diagnosis the more children tended to use CAM. The reasons for parents not using CAM included the child doing well and therefore not seeing the need for CAM use; not being aware of CAM; CAM not being offered and lack of information available. Parents identified a need for more information to be available both at ward level and for information about CAM to be discussed by medical staff, particularly at the start of treatment. The results indicate that CAM is frequently used by children and young people with cancer and that their use plays a substantial role in helping children through their conventional cancer treatment.

Adolescent↗
PubMedDate not supplied

Scheuermann kyphosis: long-term follow-up.

BACKGROUND CONTEXT: There is considerable controversy as to the optimal treatment of Scheuermann kyphosis. Proposed modalities have included exercise, bracing and surgery. PURPOSE: The purpose of this study was to document the functional capacity and radiographic findings in adults who have been previously treated for Scheuermann kyphosis. STUDY DESIGN: A cohort study of all patients with Scheuermann kyphosis treated in a single institution using three different treatment modalities: exercise and observation, Milwaukee bracing and surgical fusion using the Harrington Compression System. PATIENT SAMPLE: Sixty-three patients were evaluated at a mean of 14 years after treatment (10 to 28 years). OUTCOME MEASURES: Two different functional evaluation instruments were used. Radiographic evaluation was carried out in 38 patients (60%). METHODS: Patient interviews were conducted using a specially designed questionnaire. Patients were then asked to undergo standing radiographs. Patients were divided into groups depending on the location of their kyphosis and the manner in which they had been treated. Standard statistical analysis was then carried out. RESULTS: At time of follow-up evaluation there were no differences in marital status, general health, education level, work status, degree of pain and functional capacity between the various curve types, treatment modality and degree of curve. Patients treated by bracing or surgery did have improved self-image, which they attributed to their treatment. Patients with kyphotic curves exceeding 70 degrees at follow-up had an inferior functional result. At time of final follow-up there were no statistical differences in degree of kyphosis and mode of treatment. CONCLUSIONS: By carefully selecting the appropriate treatment for patients with Scheuermann kyphosis on the basis of the patient's age, spinal deformity and the severity of back pain, it is possible to achieve a similar functional result at long-term follow-up. Despite different treatment protocols, patients with Scheuermann kyphosis tend to achieve a similar functional result at long-term follow-up.

Adult↗
PubMed2004

Stratification of bone fracture risk in patients with celiac disease.

BACKGROUND AND AIMS: Our objective in this cross-sectional, case-control study was to gain insight into celiac osteopathy by examining a well-defined cohort of patients with a wide clinical spectrum of the disease. METHODS: We studied 148 unselected celiac patients and 296 (1:2) age- and sex-matched controls diagnosed with functional gastrointestinal disorders. Based on the clinical history, 53% were classically symptomatic, 36% had subclinical celiac disease, and 11% were silent, detected by screening. The fracture information was obtained through an in-person interview using a pre-designed questionnaire. RESULTS: Classically symptomatic patients had an increased number of fractures in the peripheral skeleton (47%) compared with age- and sex-matched controls (15%; odds ratio, 5.2; 95% confidence interval, 2.8-9.8). However, fractures in subclinical/silent celiac cases (20%) were no different from those in controls (14%; odds ratio, 1.7, 0.7-4.4). Compared with the subclinical/silent group, a significantly greater prevalence of fractures was detected in classically symptomatic patients (odds ratio, 3.6, 1.7-7.5). Compared with controls, celiac disease patients had significantly more fractures produced by mild trauma (P < 0.01), but there were no differences in the severity of trauma events that induced fractures. Mean bone density femoral neck z score was higher for subclinical/silent cases compared with classically symptomatic patients (P < 0.05). CONCLUSIONS: Celiac patients show a very wide variation in fracture risk, with increased risk in classically symptomatic patients. Diagnostic and therapeutic strategies to prevent bone loss and fracture should be preferentially used in the subgroup of patients with classic clinical disease.

Adolescent↗
PubMed2002

Relationship between physical activity and bone mineral status in young adults: the Northern Ireland Young Hearts Project.

Physical activity during the first three decades of life may increase peak bone mass and reduce future osteoporosis risk. The aim of this study was to determine the extent to which different components of physical activity may influence bone mineral status within a representative population sample of young men and women. Bone mineral density (BMD) and content (BMC) were determined at the lumbar spine and femoral neck in 242 men and 212 women, aged 20-25 years, by dual-energy X-ray absorptiometry. Physical activity was assessed by a self-report questionnaire designed to measure the frequency and duration of physical activity and its components (i.e., work, non-sports leisure, sports-related activities, and peak strain sports activities). Potential confounding factors such as height, weight, diet, and smoking habits were also assessed. In multivariate linear regression models, sports activity and peak strain sports activity undertaken by men were strongly associated with both lumbar spine BMD (beta = 0.35 [0.21, 0.49] and beta = 0.31 [0.17, 0.44], respectively) and BMC (beta = 0.33 [0.21, 0.45] and beta = 0.26 [0.14, 0.38], respectively) and femoral neck BMD (beta = 0.35 [0.21, 0.48] and beta = 0.27 [0.14, 0.40], respectively) and BMC (beta = 0.32 [0.19, 0.44] and beta = 0.29 [0.17, 0.41], respectively) (all p < 0.01), but work and non-sports leisure activities were not. In women, there were no associations between bone measurements and any component of physical activity. In models involving all subjects the gender/sports activity, but not the gender/peak strain, interaction term was statistically significant. Sports activity explained 10.4% of the observed variance in lumbar spine BMD in men, but <1% in women. These results demonstrate the importance of sports activities, especially those involving high peak strain, in determining peak bone status in young men. Failure to observe this association in women reflects their lower participation in such activities, but they may have the same capacity to benefit from these activities as men. Intervention studies are warranted to determine whether peak bone density in women can be improved by participating, during childhood and adolescence, in sports activities involving high peak strain.

Absorptiometry, Photon↗