Medicine (Northwest Academic Centre) - Theses
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ItemLong term effects of dietary calcium intake on fractures, mortality, cardiovascular diseases and abdominal aortic calcification: a prospective cohort study( 2014)High calcium intake can prevent age-related bone loss; however, its efficacy in fracture prevention is not clear. Some recent studies have associated calcium supplementation with adverse cardiovascular events (CVE). Scientific evidence on the long term effects of dietary calcium intake (DCI) and fracture or CVD risk lacks consistency.
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ItemBarriers and enablers in the treatment and prevention of osteoporosis: exploring knowledge, beliefs, attitudes and cultural models among consumers and medical practitioners( 2011)This study explored knowledge, beliefs, attitudes and cultural models of osteoporosis, in the context of health communication. The purpose of the study was to generate new knowledge that may contribute towards development of health communications about osteoporosis. The study was conducted within the Geelong Osteoporosis Study, in south-eastern Australia, and involved consultation with fracture patients, community members, general medical practitioners and orthopaedic surgeons. The study’s qualitative methodology was predicated upon the medical literature regarding osteoporosis and fragility fracture, and contemporary social and theoretical discourses on the body, health, illness, disease and risk. Materials included brief interviews, in-depth interviews, focus groups and field notes, and the data from each participant type were subjected to two methods of analysis from: thematic analysis, domain analysis, framework analysis, analytic comparison and case study analysis. There was widespread uncertainty among women and men in the study as to the nature and definition of osteoporosis as well as its management and prevention. The doctor–patient relationship was suggested as an important source of health information and education for men, while the women cited a wide range of sources, including libraries, the internet and the media, among their preferences for seeking information about osteoporosis. Gender was a critical factor in the framing of communications regarding osteoporosis, as was paradigmatic perspective. The GPs were ambivalent in their beliefs and attitudes about osteoporosis and its investigation and management; they did not consistently investigate for osteoporosis, though when they did so they recognised that effective investigative technologies and treatment options were available. Their ambivalence derived from structural factors, such as financial barriers (real or perceived) to investigation and adverse media reports about osteoporosis medications. The GPs were confident in the efficacy of the medications they were prescribing to prevent fracture. This confidence was not shared among the orthopædic surgeons, who were more confident about patient adherence to prescribed osteoporosis medications. The study identified the cultural model ‘Osteoporosis has low salience’: consumers saw osteoporosis as something that caused women to be ‘bent over’ in old age, while fracture patients thought of it as a risk of future fracture and the attendant pain, loss of mobility etc. The medical professionals viewed osteoporosis as risk for fracture: to orthopædic surgeons it presented an endpoint at which they had a specific role to play (the repair of fracture), whereas to GPs it represented yet another chronic disease of which they needed to be vigilant in their limited encounters with patients. The study was significant, being the first qualitative investigation of osteoporosis and fragility fracture from multiple perspectives in Geelong. Its results are significant in that they: contribute new knowledge to a field currently lacking in empirical data, namely regarding osteoporosis in men; point to deficits in consumer knowledge about osteoporosis as a health condition; highlight medical practitioners’ concerns about the investigation and management of osteoporosis; and provide valuable inputs into practical considerations in the development of health messages about osteoporosis and related fracture, for both consumers and health professionals.