Search

Significant bone loss occurs in approximately half of patients undergoing allogeneic hematopoietic cell transplant [HCT] within the first 6-12 months. We are evaluating approaches to preventing and treating this loss. We track bone health in all HCT patients in a one year period. Bone health is evaluated by DEXA scans pre-HCT, 6 and 12 months post-transplant. Labs are also followed at the same time points: vitamin D, calcium, alk phos, TSH, osteocalcin CTX. The patients are placed on calcium and vitamin D supplementation according to levels pre-HCT. Depending on patients pre-HCT DEXA scores, those at high risk may receive a dose of zoledronic acid. HCT patients may receive these infusions at 6 and 12 months post-transplant depending on their DEXA scores. Patients who are osteopenic pre-HCT will also be referred to a bone health specialist. An up to date spreadsheet prompts us to check bone markers and DEXA scans pre-HCT and at day 180 and 360 milestones. Data collection is almost complete. Preliminary analysis indicates an improvement of vitamin D levels post-HCT and successfully identifying patients that may benefit from pre-HCT bisphosphate therapy, thereby improving the bone health of HCT patients. Patients benefit from earlier nurse practitioner managed interventions for bone health post-HCT. Further studies could help identify patients who would benefit from earlier interventions. We plan on integrating these findings with survivorship careplans and milestone visits. [ABSTRACT FROM AUTHOR]

Background: Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement.Methods: HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school.Discussion: Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs. [ABSTRACT FROM AUTHOR]