Equal treatment: no evidence of gender inequity in osteoporosis management in a coordinator-based fragility fracture screening program.

We evaluated gender imbalance in osteoporosis management in a provincial coordinator-based fracture prevention program and found no difference by gender in treatment of high-risk fragility fracture patients. This establishes that a systemic approach with interventions for all fragility fracture patients can eliminate the gender inequity that is often observed. INRODUCTION: The purpose of this study was to evaluate an Ontario-based fracture prevention program for its ability to address the well-documented gender imbalance in osteoporosis (OP) management, by incorporating its integrated fracture risk assessments within a needs-based evaluation of equity. METHODS: Fragility fracture patients (≥ 50 years) who were treatment naïve at screening and completed follow-up within 6 months of screening were studied. Patients who underwent bone mineral density (BMD) testing done in the year prior to their current fracture were excluded. All participants had BMD testing conducted through the Ontario OP Strategy Fracture Screening and Prevention program, thus providing us with fracture risk assessment data. Our primary study outcome was treatment initiation at follow-up within 6 months of screening. Gender differences were compared using Fisher's exact test, at p < 0.05. RESULTS: After adjusting for subsequent fracture risk, study participants did not show a statistically significant gender difference in pharmacotherapy initiation at follow-up (p > 0.05). 68.4% of women and 66.2% of men at high risk were treated within 6 months of screening. CONCLUSION: Needs-based analyses show no difference by gender in treatment of high-risk fragility fracture patients. An intensive coordinator-based fracture prevention model adopted in Ontario, Canada was not associated with gender inequity in OP treatment of fragility fracture patients after fracture risk adjustment.

The utilization of visual information in the control of reciprocal aiming movements.

Two experiments examined on-line processing during the execution of reciprocal aiming movements. In Experiment 1, participants used a stylus to make movements between two targets of equal size. Three vision conditions were used: full vision, vision during flight and vision only on contact with the target. Participants had significantly longer movement times and spent more time in contact with the targets when vision was available only on contact with the target. Additionally, the proportion of time to peak velocity revealed that movement trajectories became more symmetric when vision was not available during flight. The data indicate that participants used vision not only to 'home-in' on the current target, but also to prepare subsequent movements. In Experiment 2, liquid crystal goggles provided a single visual sample every 40 ms of a 500 ms duty cycle. Of interest was how participants timed their reciprocal aiming to take advantage of these brief visual samples. Although across participants no particular portion of the movement trajectory was favored, individual performers did time their movements consistently with the onset and offset of vision. Once again, performance and kinematic data indicated that movement segments were not independent of each other.

Chemical design of peripherally acting compounds.

1. Some guanidines, related in structure to mianserin and to 2-methyl-1,2,9,13b-tetrahydro-3H-dibenz[c,f]imadazo[1,5a] azepin-3-imine hydrobromide (WAL 801), have been synthesized and shown to be peripherally acting 5-HT2 antagonists. Structurally related compounds but not bearing a charged ionic group have been shown to have central activity. 2. Computer-aided molecular modelling has been used to establish a 5-HT2 pharmacophore. 3. The principle of exclusion from the CNS by incorporating a highly polar group to a biologically active molecule has been extended to the design and synthesis of a peripherally acting analgesic.