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Objective To investigate the associations between low and high concentrations of baseline serum 25-hydroxyvitamin D [25( OH)D] and all-cause mortality in very old (≥85 years) men and women over 6 years. Design, setting and subjects Prospective mortality data from 775 participants in the Newcastle 85+ Study were analysed for survival in relation to 25( OH)D (season-specific quartiles and predefined cut-off values) and sex using Cox proportional hazards models. The models were fitted to the entire and restricted (nonusers of vitamin D-containing supplements and medication) cohorts. Results For the entire cohort, mortality was higher in both the lowest and highest 25( OH)D season-specific quartiles [ SQ1: hazard ratio ( HR) 1.31, 95% confidence interval ( CI) 1.01-1.69, P = 0.04; SQ4: HR 1.44, 95% CI 1.12-1.85, P = 0.004] compared with the combined middle quartiles ( SQ2 + SQ3), after adjustment for sociodemographic factors. The increased risk for the highest quartile remained significant after further adjustment for lifestyle variables ( SQ4: HR 1.37, 95% CI 1.06-1.77, P = 0.02) and was seen only in women in sex-specific analyses. Similarly, in sensitivity analyses with predefined 25( OH)D cut-off values, the highest 25( OH)D concentration (≥75 nmol L−1) was associated with a 2.4-fold increased risk of mortality in women (restricted cohort) after adjusting for all covariates. Conclusion Low and high season-specific 25( OH)D quartiles were associated with increased risks of mortality over 6 years in the very old; this effect was particularly noticeable in women, including those who reported taking vitamin D-containing supplements/medication. [ABSTRACT FROM AUTHOR]

This review article examines the epidemiology and pathogenesis of back pain and vertebral fractures in osteoporosis, reviewing the management of pain in patients with vertebral fractures and the direct and indirect effect of osteoporosis treatments on back pain. The management of patients with vertebral fractures has largely concentrated on the prevention of further fractures by the treatment of underlying osteoporosis, with drug treatment for acute and chronic back pain and the non-pharmacological management of vertebral fractures receiving less attention. Emerging evidence suggests that, in addition to reducing the incidence of vertebral fractures, calcitonin, intravenous bisphosphonates and teriparatide may also have a direct effect on bone pain. Targeted analgesia, tailored to individual need is often required in both the acute and chronic phases following vertebral fracture. Vertebroplasty and kyphoplasty have also been approved for use in the management of vertebral fractures and may prove useful in selected patients unresponsive to conventional pain relief. There is some evidence to support the use of individualised tailored exercise programmes aimed at strengthening back muscles to maintain bone density and reduce further fracture incidence. In addition the use of specific orthoses may help to reduce kyphosis, improve mobility and reduce pain. Chronic back pain associated with vertebral fracture provides a great challenge to health care professionals and the patient. This demands a combination of options, including not only therapeutic interventions, but also physiotherapy, psychological support and patient education. [ABSTRACT FROM AUTHOR]

Utilizes data from Tanzania to illustrate the patterns of disease between urban and rural dwellers. Transition from communicable disease to non-communicable disease (NCD) as the primary cause of death in sub-Saharan Africa by 2020; Prevalence of NCD in village and city; Role of adaptation in the development of NCD.

A letter to the editor is presented in response to the article "Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients," by J Bone Miner Res in the February 25, 2010 issue.

An introduction to the journal is presented in which the editor discusses two reports published within the issue such as a paper by Roman Romero-Ortuno and colleagues on a data offering insight into plasma 250HD levels in Irish community-dwelling older people and a paper from V. G. M. Chel and colleagues on the impact of ultraviolet B (UVB) exposure on vitamin D status in eight psycho-geriatric nursing home residents.

The author examines vitamin D deficiency in older people based on several studies. He discusses the impact of vitamin D deficiency on bone health recognised in children in the early 20th century. He provides an overview of a study on the effects of calcium and vitamin D supplementation in nursing home residents. He notes that the effectiveness of vitamin D supplementation does not appear to be consistent.

The article comments on studies regarding vitamin D supplementation in elderly care home residents. The incidence of fractures in elderly care home residents is cited. The benefit of vitamin D supplementation is proved by a trial involving women living in French nursing homes. The importance of combining calcium with vitamin D supplementation is discussed.

There is evidence that the prevalence of certain non-communicable diseases, such as diabetes and hypertension, is increasing rapidly in parts of sub-Saharan Africa. Others, such as asthma and epilepsy, are known to be common but to be poorly managed. This paper describes a project, funded by the Department for International Development of the British Government, which aims to provide costed and evaluated treatment packages for use at primary health care level, methods and materials for evaluating the quality of non-communicable disease care, and a protocol for the assessment for national opportunities for the prevention of hypertension, heart disease and diabetes. Methods are being developed and piloted in urban and rural Tanzania and Cameroon. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, 132-135 (2012) Abstract Aims The Diabetes UK good clinical practice guidelines for care home residents were revised in 2010. In this study, we examined current care against these standards and sought the views of residents on their diabetes. Methods Mixed methods (qualitative and quantitative), including interviews with residents, carers and staff, participant record reviews and focus group discussions were used to gather data in care homes in Newcastle upon Tyne. Results Thirty-one residents from seven care homes participated. Eighty-seven per cent of residents had probable dementia (based on abbreviated mental test score or clock-drawing test). Weight, body mass index and blood pressure were satisfactorily monitored. Glucose monitoring took place in all residents who received insulin, but was monitored unnecessarily in those with diet-controlled diabetes (63%). The majority of residents (90%) had seen a chiropodist and had received eye screening (> 80%) recently. Only one of the care homes had staff that had diabetes training. Residents reported little knowledge of diabetes management. However, when asked what they knew about diabetes, comments included 'It's a common thing... like cancer'; '[I would have liked a] plain language explanation of diabetes' and 'They told me they could control it by diet, and then it was tablets, then insulin. They didn't explain why.' Conclusions In Newcastle upon Tyne care homes there is good care provided but also evidence of inadequacies. Despite high levels of dementia, many patients have strong and valid opinions about their disease and the care they receive. Despite the challenges, we believe that residents must be included in discussions about service development. [ABSTRACT FROM AUTHOR]

The article provides details of a study on the health of rural migrants of Tanzania. It reports that people migrating from rural to urban Tanzania suffer from hypertension, weight gain, chloresterol and triglycerides. The study was conducted on adults from Dar es Salaam in the age group of 15-49 years. The author opines that these observations require further study for a better understanding of the environmental and genetic bases that influence these changes.