Suchergebnisse

AbstractIntroductionOral bisphosphonates are first‐line agents for treating osteoporosis in men, but there are no studies regarding efficacy of oral bisphosphonates for treatment of osteoporosis in ambulatory male adults with intellectual disability.MethodsNine adult males with intellectual disability and increased fracture risk had been treated with weekly or monthly oral bisphosphonates, vitamin D and calcium for 1–3 years. Post‐treatment bone mineral density (BMD), serum 25(OH)D, parathyroid hormone and C‐telopeptide of type I collagen were then determined for the first time.ResultsWeekly or monthly oral bisphosphonates were well tolerated and led to significant increases in BMD in all 9 individuals. Serum 25(OH)D level enhanced the "pecent increase of BMD" that occurred in response to bisphosphonate treatment (p < .05).ConclusionsWeekly or monthly oral bisphosphonates are well tolerated by ambulatory adult males with ID and are effective in increasing BMD. Higher serum levels of vitamin D appear to improve the efficacy of bisphosphonates and therefore reduce fracture risk in adult males with intellectual disability.

Purpose.The purpose of this review is to provide an overview of a wide range of potentially useful strategies to address the prevention of alcohol misuse among American Indians. This broad approach to the review is useful because the extreme heterogeneity of the American Indian population requires that health promotion professionals explore many options and tailor their activities to specific communities.Search Method.A literature search was initiated through MEDLINE using the following key words: prevention, alcohol, substance abuse, American Indian, and Native American. The search yielded 29 articles from the years 1982 through 1994. These articles, along with 45 previously identified in three overview articles, form the basis of the review and discussion in this paper.Summary of findings.As a group, American Indians experience many health problems that are related to alcohol misuse. Comparison of Indians to non-Indians shows that the age of first involvement with alcohol is younger, the frequency and amount of drinking is greater, and negative consequences are more common. Health promotion programs that address these issues must take into account American Indian heterogeneity and should use a comprehensive approach that addresses both heavy drinking and the sequelae of problems related to alcohol misuse.Major Conclusions.Important concepts for providing health promotion services to this population are: cultural relevance must be carefully planned and monitored; individuals in the local community must be involved; the drunken Indian stereotype must be addressed; and community empowerment should be an important goal.

There are those who believe that we are already doing all that is necessary in knowledge transfer, or that publications in academic journals will take care of the problem. Some even express alarm and concern lest knowledge be disseminated too rapidly or prematurely. Some of us, however, were led, encouraged, and stimulated by Howard Davis's vigor and enthusiasm to conceptualize this as a problem to be investigated and assessed in a scientific manner, and, further, as a social necessity and a responsibility, even as a challenge to channel our natural rebelliousness into developing a methodology for dealing with resistance to change and innovation.