Low handgrip strength is a predictor of osteoporotic fractures: Cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study

Handgrip strength (HGS) is a potentially useful objective parameter to predict fracture since it is an indicator of general muscle strength and is associated with fragility and propensity to fall. Our objective was to examine the association of HGS with fracture, to evaluate the accuracy of HGS in predicting incident fracture, and to identify subjects at risk of fracture. We analyzed a cross-sectional cohort with 2,793 subjects (1,217 men and 1,576 women aged 50-101 years) and a subset of 1,702 subjects which were followed for a total of 4,855 person-years. The primary outcome measures were prevalent fractures and incident major fragility fractures. Each standard deviation (SD) reduction in HGS was associated with a 1.24-fold increased odds for major clinical fractures even after adjustment for other clinical factors. A similar result was obtained in the prospective cohort with each SD reduction in HGS being associated with a 1.57-fold increased hazard ratio of fracture even after adjustment for clinical factors. A combination of HGS and femoral neck bone mineral density (FN BMD) T-score values (combined T-score), together with other clinical factors, had a better predictive power of incident fractures than FN BMD or HGS T-score alone with clinical factors. In addition, combined T-score has better sensitivity and specificity in predicting incidence fractures than FN BMD alone. This study is the first study to compare the predictive ability of HGS and BMD. We showed that HGS is an independent risk factor for major clinical fractures. Compared with using FN BMD T-score of -2.5 alone, HGS alone has a comparable predictive power to BMD, and the combined T-score may be useful to identify extra subjects at risk of clinical fractures with improved specificity. © The Author(s) 2011.published_or_final_versionSpringer Open Choice, 21 Feb 201

Raising happy children who succeed in school: Lessons from china and the united states

Chinese children outperform their American counterparts in the academic arena. Although many aspects of Chinese and American children's environments likely contribute to this achievement gap, a key aspect may be learning-related parenting (e.g., assisting children with homework and responding to children's performance). In this article, we review differences in Chinese and American learning-related parenting, with attention to the trade-offs of each culture's style for children's academic and emotional functioning. We consider an integrated style of parenting combining the strengths of the Chinese and American styles to facilitate children's academic and emotional functioning. © 2014 The Society for Research in Child Development

Bone mineral density and serum osteoprotegerin levels in pre- and postmenopausal women

Poster presentations: Poster 3Introduction: Osteoprotegerin (OPG) is an essential regulator of bone turnover through its suppression on osteoclastogenesis. Findings from previous studies of serum OPG and bone mineral density (BMD) in humans have been conflicting. The objective of this study was to identity factors associated with serum OPG levels and to determine its effect on BMD in pre- and post- menopausal women. Methods: This is a part of the Hong Kong Osteoporosis Study. 2,343 community-dwelling, treatment and hormonal therapy naive female subjects aged 18 or above were recruited (679 premenopausal women, mean age 36.7±8.8 years; 1,664 postmenopausal women, mean age 62.6±8.5 years). Baseline demographic characteristics, serum biochemistry, hormonal profile and fasting serum OPG levels were obtained. Baseline BMD at the spine and hip were measured. Results: Serum OPG levels was correlated with age in both pre- and post-menopausal women (premenopause r=0.208, postmenopause r=0.258, both p<0.0001). After adjusting for age, OPG levels were positively correlated with serum estradiol (r=0.100, p<0.05) and negatively with follicular stimulating hormone (FSH, r=-0.114, p<0.01) in premenopausal but not postmenopausal women. In premenopausal women, higher serum OPG levels were associated with higher age- and BMI-adjusted BMD (spine r=0.147, p<0.05; femoral neck r=0.138, p<0.05; total hip r=0.148, p<0.05). In postmenopausal women, age-adjusted OPG showed no correlation with BMD in the linear regression model. However, a negative correlation was observed between OPG in quartiles and hip BMD (p-tread <0.01), but not spine BMD. Conclusions: Serum OPG level is an independent factor associated with higher BMD in pre-menopausal women. However it’s protective effect on BMD is not significant in post-menopausal women with low bone mass.The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010

Parental involvement in primary school education: its relationship with children’s academic performance and psychosocial competence through engaging children with school

The benefits of parental involvement in children’s education have been well established but increasing evidence suggests that overparenting may have adverse effects on children. The question of whether excessive parental involvement hinders children’s academic and psychosocial development warrants further investigations. This study examined the associations of parental educational involvement at home and in school with academic performance and psychological health of 507 Chinese Grade 3 schoolchildren in Hong Kong. Parents reported on their level of involvement in children’s schooling and their children’s psychosocial issues. Children were surveyed to determine their school engagement, and their Chinese language and mathematics attainment was assessed. We also explored the underlying mechanism by testing children’s engagement with school as a mediator of the relationships. Our results showed that home-based parental educational involvement was positively associated with children’s language competence and psychosocial wellbeing, and the associations were linked through engaging children with school. However, the benefits reached a plateau at higher level of parental involvement in children’s learning at home. School-based parental involvement had an indirect effect on children’s prosocial behavior through school engagement. These findings highlight the significance of optimal level of parental involvement in children’s education at home for children’s development