Primary health care

Osteoporosis is a major health problem in postmenopausal women (PMW) Exercise training is considered a cost-effective strategy to prevent osteoporosis in middle aged-older people The purpose of this study is to summarize the effect of exercise on BMD among PMW A comprehensive search of electronic databases was conducted through PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest and Primo BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) femoral neck (FN) and/or total hip were considered as outcome measures After categorization, statistical methods used to combine data and compare subgroups 75 studies were included in this systematic review and meta-analysis The pooled number of participants was 5300 (intervention group: 2901, control group: 2399) The majority of studies employed weight bearing aerobic exercise, dynamic resistance exercise or a combination of both The pooled estimate of random effect analysis was SMD=037, 95%-CI: 025-050, SMD=033, 95%-CI: 023-043, and SMD=040, 95%-CI: 028-051 for LS, FN, and total Hip-BMD respectively In the present meta-analysis, there was a significant (p<0001), but rather low effect (SMD= 033-040) of exercise on BMD at LS and proximal femur We further observed a large variation among the single study findings, with highly effective studies but also studies that trigger significant negative results This finding can be largely attributed to differences among the exercise protocols of the studies We conclude that the true effect of exercise on bone is diluted by a considerable amount of studies with inadequate exercise protocols

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Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women: A Systematic Review and Meta-Analysis of Intervention Studies.

Cervical cancer screening programs.

The aging of America.

This volume summarizes the current scientific evidence and identifies research priorities needed to decrease social inequalities in cancer. The publication, based on the expert knowledge of more than 70 international scientists from multiple disciplines, undertakes a populations-within-populations approach, highlighting the large variations in cancer incidence, survival, and mortality that exist between countries and, within countries, between social groups. Several factors may lead individuals with low social status to adopt unhealthy behaviors, to be exposed to a wider range and a higher intensity of cancer risk factors, and to have reduced access to health-care services, compared with their fellow citizens. A special focus is given to how the phenomenon of inequalities in cancer evolves and is reshaped over time, driven by economic, social, political, legislative, and technological forces; it affects everyone, but the most disadvantaged individuals are particularly hard hit. This IARC Scientific Publication was developed to serve as a reference for policy-makers and public health officials, linking to specific examples of interventions that may reduce future inequalities in cancer.

Reducing social inequalities in cancer: evidence and priorities for research

We investigate, both theoretically and numerically, the knotting probabilities after a local strand passage is performed in an unknotted self-avoiding polygon (SAP) on the simple cubic lattice. In the polygons studied, it is assumed that two polygon segments have already been brought close together for the purpose of performing a strand passage. This restricts the polygons considered to those that contain a specific pattern called Θ at a fixed location; an unknotted polygon containing Θ is called a Θ-SAP. It is proved that the number of n-edge Θ-SAPs grows exponentially (with n) at the same rate as the total number of n-edge unknotted SAPs (those with no prespecified strand passage structure). Furthermore, it is proved that the same holds for subsets of n-edge Θ-SAPs that yield a specific after-strand-passage knot-type. Thus, the probability of a given after-strand-passage knot-type does not grow (or decay) exponentially with n. Instead, it is conjectured that these after-strand-passage knot probabilities approach, as n goes to infinity, knot-type dependent amplitude ratios lying strictly between 0 and 1. This conjecture is supported by numerical evidence from Monte Carlo data generated using a composite (aka multiple) Markov chain Monte Carlo BFACF algorithm developed to study Θ-SAPs. A new maximum likelihood method is used to estimate the critical exponents relevant to this conjecture. We also obtain strong numerical evidence that the after-strand-passage knotting probability depends on the local structure around the strand-passage site. If the local structure and the crossing sign at the strand-passage site are considered, then we observe that the more 'compact' the local structure, the less likely the after-strand-passage polygon is to be knotted. This trend for compactness versus knotting probability is consistent with results obtained for other strand-passage models; however, we are the first to note the influence of the crossing-sign information. We use two measures of 'compactness': one involves the size of a smallest polygon that contains the structure and the other is in terms of an 'opening' angle. The opening angle definition is consistent with one that is measurable from single molecule DNA experiments. The theoretical and numerical approaches presented here are more broadly applicable to other SAP models.

Knotting probabilities after a local strand passage in unknotted self-avoiding polygons

Which chiral knots can be unknotted in a single step by a + to − (+−) crossing change, and which by a − to + (−+) crossing change? Numerical results suggest that if a knot with 6 or fewer crossings can be unknotted by a +− crossing change then it cannot be unknotted by a −+ one, and vice versa. However, we exhibit one chiral 8-crossing knot and one chiral 9-crossing knot which can be unknotted by either crossing change. Furthermore, we address the question analytically using results of Taniyama and Traczyk. We apply Taniyama’s classification of unknotting operations to chiral rational knots and fully classify all those which, in a single step, can be unknotted by either type of crossing change; the first of these is 813. As a corollary, we obtain Stoimenow’s result that all chiral twist knots can be unknotted by only one of the two crossing change types, +− or −+. Thus, as was observed numerically, all chiral knots with unknotting number one, and seven or fewer crossings, can be unknotted by only one of the two crossing change types. Traczyk’s results allow us to address the question for some non-rational chiral unknotting number one knots with 9 or fewer crossings, however, for others the question remains open. We propose a numerical approach for investigating the latter type of knot. We also discuss the implications of our work in the context of DNA topology.

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Signed Unknotting Number and Knot Chirality Discrimination via Strand Passage

Background: Office workers face workplace-related health issues, including stress and back pain, resulting in considerable cost to businesses and health care systems. Workplace health promotion attempts to prevent these health issues, and the internet can be used to deliver workplace health promotion interventions to office workers. Data were provided by Fitbase GmbH, a German company, which specializes in workplace health promotion via the internet (Web-based health). The Web-based health intervention allowed workers to focus on different health categories by using information modules (reading health information) and/or completing practical exercises (guided, interactive health tutorials).
Objective: This study aimed to identify the extent to which office workers have workplace-related health issues, assess whether office workers who differ in their health focus also differ in their improved well-being, and assess whether completing practical exercises is associated with improved well-being compared with reading information modules.
Methods: Fitbase GmbH collected data for the period of February 2016 to May 2017 from health insurance employees undergoing Web-based health training in Hamburg, Germany. The data consisted of a needs assessment examining health issues faced by office workers, a wellness questionnaire regarding one’s perception of the Web-based health intervention, and activity logs of information modules and practical exercises completed. Through logistic regression, we determined associations between improved well-being from Web-based health training and differences in a worker’s health focus and a worker’s preferred intervention method.
Results: Nearly half of the office workers had chronic back pain (1532/3354) and felt tense or irritated (1680/3348). Over four-fifth (645/766) of the office workers indicated that the Web-based health training improved their well-being (P<.001). Office workers who preferred practical exercises compared with information modules had 2.22 times greater odds of reporting improved well-being from the Web-based health intervention (P=.01; 95% CI 1.20-4.11). Office workers with a focus on practical exercises for back health had higher odds of improved well-being compared with other health foci. Office workers focused on practical exercises for back pain had at least two times the odds of having their well-being improved from the Web-based health intervention compared with those focused on stress management (P<.001), mindfulness (P=.02), stress management/mindfulness (P=.005), and eye health (P=.003). No particular health focus was associated with improved well-being for the information modules.
Conclusions: Office workers frequently report having back pain and stress. A focus on Web-based health training via practical exercises and practical exercises for back health predict an improvement in office workers’ reported well-being.
Trial Registration:

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Occupational Health Needs and Predicted Well-Being in Office Workers Undergoing Web-Based Health Promotion Training: Cross-Sectional Study.

We investigate the knotting probability after a local strand passage is performed in an unknotted self-avoiding polygon on the simple cubic lattice. We assume that two polygon segments have already been brought close together for the purpose of performing a strand passage, and model this using Theta-SAPs, polygons that contain the pattern Theta at a fixed location. It is proved that the number of n-edge Theta-SAPs grows exponentially (with n) at the same rate as the total number of n-edge unknotted self-avoiding polygons, and that the same holds for subsets of n-edge Theta-SAPs that yield a specific after-strand-passage knot-type. Thus the probability of a given after-strand-passage knot-type does not grow (or decay) exponentially with n, and we conjecture that instead it approaches a knot-type dependent amplitude ratio lying strictly between 0 and 1. This is supported by critical exponent estimates obtained from a new maximum likelihood method for Theta-SAPs that are generated by a composite (aka multiple) Markov Chain Monte Carlo BFACF algorithm. We also give strong numerical evidence that the after-strand-passage knotting probability depends on the local structure around the strand passage site. Considering both the local structure and the crossing-sign at the strand passage site, we observe that the more "compact" the local structure, the less likely the after-strand-passage polygon is to be knotted. This trend is consistent with results from other strand-passage models, however, we are the first to note the influence of the crossing-sign information. Two measures of "compactness" are used: the size of a smallest polygon that contains the structure and the structure's "opening" angle. The opening angle definition is consistent with one that is measurable from single molecule DNA experiments.

Obesity in Canadian adults is showing upward trends. Consumption of whole-grains is one recommendation for the prevention of obesity. Despite the apparent nutritional and energy content differences between whole and refined grains, knowledge relating refined grains to weight gain in Canadian adults is scarce. The aim of this study was to assess the consumption of specific grain-based foods at the regional and national levels, and to evaluate the association between grain consumption with overweight or obesity in Canadian adults. We used the 2004 Canadian Community Health Survey data. The association between type of grain product consumed and Body Mass Index (BMI) in adults aged ≥19y was evaluated by logistic regression. The mean daily intake of whole grains (86 ± 1.9 g/day) was significantly less than refined grains (276.6 ± 3.8 g/day), which was different across provinces. After adjustment for caloric needs, male consumers showed significantly lower intake of whole grains than females. Accordingly, the incidence of overweight or obesity was higher in males than in females. Also, in comparison to whole grains, the consumption of refined grains was associated with a higher risk of overweight or obesity among adults. Canadians’ preference was refined grain products consumption, based on 2004 Health Survey, which was significantly associated with overweight/obesity. Hence, consumption of whole grains should be more effectively promoted rather than refined grain products to prevent obesity and its complications such as cardiovascular diseases and type 2 diabetes.

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Michael Szafron

Papers

Knotting probabilities after a local strand passage in unknotted self-avoiding polygons

Signed Unknotting Number and Knot Chirality Discrimination via Strand Passage

Occupational Health Needs and Predicted Well-Being in Office Workers Undergoing Web-Based Health Promotion Training: Cross-Sectional Study.

Knotting probabilities after a local strand passage in unknotted self-avoiding polygons

National pattern of grain products consumption among Canadians in association with body weight status