Exercise and bone health across the lifespan

With ageing, bone tissue undergoes significant compositional, architectural and metabolic alterations potentially leading to osteoporosis. Osteoporosis is the most prevalent bone disorder, which is characterised by progressive bone weakening and an increased risk of fragility fractures. Although this metabolic disease is conventionally associated with ageing and menopause, the predisposing factors are thought to be established during childhood and adolescence. In light of this, exercise interventions implemented during maturation are likely to be highly beneficial as part of a long-term strategy to maximise peak bone mass and hence delay the onset of age- or menopause-related osteoporosis. This notion is supported by data on exercise interventions implemented during childhood and adolescence, which confirmed that weight-bearing activity, particularly if undertaken during peripubertal development, is capable of generating a significant osteogenic response leading to bone anabolism. Recent work on human ageing and epigenetics suggests that undertaking exercise after the fourth decade of life is still important, given the anti-ageing effect and health benefits provided, potentially occurring via a delay in telomere shortening and modification of DNA methylation patterns associated with ageing. Exercise is among the primary modifiable factors capable of influencing bone health by preserving bone mass and strength, preventing the death of bone cells and anti-ageing action provided

Image as Authority in the Writings of John Chrysostom

grantor: University of St. Michael's CollegeThere is an ongoing debate regarding Chrysostom's understanding of image. Certain modern scholars such as Elizabeth Clark insist that Chrysostom viewed the male alone to be in God's image. Others, such as Valarie Karras, insist that Chrysostom always believed that woman was created in the image of God. This investigation supports the second point of view, as Chrysostom's views on woman are examined by taking into account the era in question: pre-lapsarian, post-lapsarian, Christian or Escatological. Chrysostom's interpretation of Galatians 3:28, 1 Corinthians 11:3–16, and Ephesians 5:21–33 express his views of man and woman in the post-lapsarian and Christian eras. In the post-lapsarian era, Chrysostom viewed the image as being “amputated” with woman now being subject to her husband. Whereas the authority given to both man and woman to rule is natural , the authority of the husband over his wife is elective , and not innate to the human condition. The image of the authority established a relationship of master/steward between God and his creature; Chrysostom believed that for all who are baptized in Christ a new image established a relationship of father/child. In the Christian era (which co-exists with the post-lapsarian era) baptized children of God are given full authority and power to become what they are originally called to be: like God, and eternally with him in the eschatological era. All Christians are again equal in status before God; however, the husband remaining head of his wife is called to image Christ who is the head of the Church. However, the Christian marriage can only be beneficial if the persons involved live as virgins do, without cares for worldly things. As it is difficult for Christian marriages to refrain from such cares, virginity was seen as the better state for a Christian. Chrysostom saw the celibates of the church as having greater authority over their own person. Whereas all baptized Christians are equal in the sight of God the Father having become coheirs with Christ for the Kingdom that is to come, virgins have the power to more easily foretaste that Kingdom in the present.Ph.D

Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study

Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario’s family physicians (FPs). Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk). Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted.Peer Reviewe

Current physical activity is independently associated with cortical bone size and bone strength in elderly Swedish women

Physical activity is believed to have the greatest effect on the skeleton if exerted early in life, but whether or not possible benefits of physical activity on bone microstructure or geometry remain at old age has not been investigated in women. The aim of this study was to investigate if physical activity during skeletal growth and young adulthood or at old age was associated with cortical geometry and trabecular microarchitecture in weight‐bearing and non–weight‐bearing bone, and areal bone mineral density (aBMD) in elderly women. In this population‐based cross‐sectional study 1013 women, 78.2 ± 1.6 (mean ± SD) years old, were included. Using high‐resolution 3D pQCT (XtremeCT), cortical cross‐sectional area (Ct.CSA), cortical thickness (Ct.Th), cortical periosteal perimeter (Ct.Pm), volumetric cortical bone density (D.Ct), trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were measured at the distal (14% level) and ultra‐distal tibia and radius, respectively. aBMD was assessed using DXA (Hologic Discovery A) of the spine and hip. A standardized questionnaire was used to collect information about previous exercise and the Physical Activity Scale for the Elderly (PASE) was used for current physical activity. A linear regression model (including levels of exercise during skeletal growth and young adulthood [10 to 30 years of age], PASE score, and covariates) revealed that level of current physical activity was independently associated with Ct.CSA (β = 0.18, p < 0.001) and Ct.Th (β = 0.15, p < 0.001) at the distal tibia, Tb.Th (β = 0.11, p < 0.001) and BV/TV (β = 0.10, p = 0.001) at the ultra‐distal tibia, and total hip aBMD (β = 0.10, p < 0.001). Current physical activity was independently associated with cortical bone size, in terms of thicker cortex but not larger periosteal circumference, and higher bone strength at the distal tibia on elderly women, indicating that physical activity at old age may decrease cortical bone loss in weight‐bearing bone in elderly women. © 2016 American Society for Bone and Mineral Research