Global learnings

OSTEOPOROSIS

2009-03-03T01:16:00.000-08:00

What is osteoporosis?

Osteoporosis is a condition that causes bones to become more porous (less solid and less dense), which gradually makes them weaker and more brittle. "Osteo" means bone, and "porosis" means porous.

Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, and wrist. These fractures can be disabling and may make it hard for you to live on your own.

Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone mass or density). As a result, bones become thinner and less dense, so that even a minor bump or accident can cause serious fractures. These are known as fragility or minimal trauma fractures.

Any bone can be affected by osteoporosis, but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis usually has no signs or symptoms until a fracture happens - this is why osteoporosis is often called the 'silent disease'.

Fractures due to osteoporosis (osteoporotic fractures) can lead to changes in posture (eg developing a stoop or Dowager's hump in your back), muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.

Every 8 minutes, someone is admitted to an Australian hospital with an osteoporotic fracture. This is expected to rise to every 3 - 4 minutes by the year 2021, as the population ages and the number of osteoporotic fractures increase.

The Fracture Cascade

About 50% of people with one fracture due to osteoporosis will have another. The risk of future fractures rises with each new fracture, the 'cascade effect'.

The 'cascade effect' means that women who have suffered a fracture in their spine are over 4 times more likely to have another fracture within the next year, compared to women who have never had an osteoporotic fracture.

People who have had two or more osteoporotic fractures are up to 9 times more likely to have another fracture, rising to an 11 times greater risk for people who have had three or more fractures, compared to someone who has not had one.

1 in 2 women and 1 in 3 men over 60 years will have an osteoporotic fracture in Australia.

Two thirds of fractures of the spine are not identified or treated, even though they nearly all cause pain and some disability. Often people believe that the symptoms of spine fracture back pain, height loss or rounding of the spine are just due to 'old age'. However, for many people, osteoporotic fractures can be prevented, or at least your risk of having further fractures greatly reduced.

To stop the fracture cascade, it is essential that osteoporotic fractures are identified and treated as quickly as possible.

Osteoporosis affects millions of older adults. It usually strikes after age 60. It’s most common in women, but men can get it too.

What causes osteoporosis?

Osteoporosis is caused by a lack of bone strength or bone density. As you age, your bones get thinner naturally. But some things can make you more likely to have the severe bone thinning of osteoporosis. These things are called risk factors. Some risk factors you can change. Others you can't change.

Risk factors you can't change include:

Your age. Your risk for osteoporosis goes up as you get older.
Being a woman who has gone through menopause. After menopause, the body makes less estrogen. Estrogen protects the body from bone loss.
Your family background. Osteoporosis tends to run in families.
Having a slender body frame.
Your race. People of European and Asian background are most likely to get osteoporosis.

Risk factors you can change include:

Smoking.
Not getting enough exercise.
Drinking too much alcohol.
Not getting enough calcium, vitamin D, and phosphorus in the things you eat or from supplements.

What are the symptoms?

Osteoporosis can be very far along before you notice it. Sometimes the first sign is a broken bone in your hip, spine, or wrist after a bump or fall.

As the disease gets worse, you may have other signs, such as pain in your back. You might notice that you are not as tall as you used to be and that you have a curved backbone.

How is osteoporosis diagnosed?

Your doctor will ask about your symptoms and do a physical exam. You may also have a test that measures your bone thickness (bone density test) and your risk for a fracture.

If the test finds that your bone thickness is less than normal but is not osteoporosis, you may have osteopenia, a less severe type of bone thinning.

It’s important to find and treat osteoporosis early to prevent bone fractures. The United States Preventive Services Task Force advises routine bone density testing for women age 65 and older. If you have a higher risk for fractures, it’s best to start getting the test at age 60.

How is it treated?

Treatment for osteoporosis includes medicine to reduce bone loss and to build bone thickness. Medicine can also give you relief from pain caused by fractures or other changes to your bones.

It’s important to take both calcium and vitamin D supplements along with any medicine you take for the disease. You need both of these supplements to build strong, healthy bones.

You can slow osteoporosis with new, healthy habits. If you smoke, quit. Get plenty of exercise. Walking, jogging, dancing, and lifting weights can make your bones stronger. Eat a healthy mix of foods that include calcium and vitamin D. Try dark green vegetables, yogurt, and milk (for calcium). Eat eggs, fatty fish, and fortified cereal (for vitamin D).

Making even small changes in how you eat and exercise, along with taking medicine, can help prevent a broken bone.

When you have osteoporosis, it’s important to protect yourself from falling. Reduce your risk of breaking a bone by making your home safer. Make sure there’s enough light in your home. Remove throw rugs and clutter that you may trip over. Put sturdy handrails on stairs.

LINUX

2009-02-26T06:26:00.000-08:00

Linux (often pronounced LIH-nuhks with a short "i") is a Unix-like operating system that was designed to provide personal computer users a free or very low-cost operating system comparable to traditional and usually more expensive Unix systems.
Linux is a remarkably complete operating system, including a graphical user interface, an X Window System, TCP/IP, the Emacs editor, and other components usually found in a comprehensive Unix system. Although copyrights are held by various creators of Linux's components, Linux is distributed using the Free Software Foundation's copyleft stipulations that mean any modified version that is redistributed must in turn be freely available.

The Linux System

The central nervous system of Linux is the kernel, the operating system code which runs the whole computer. The kernel is under constant development and is always available in both the latest stable release and the latest experimental release. Progress on development is very fast, and the recent 2.6-series kernels are simply amazing on all counts. The kernel design is modular, so that the actual OS code is very small yet able to load whatever functionality it needs when it needs it. Because of this, the kernel remains small and fast yet highly extensible, in comparison to other operating systems which slow down the computer and waste memory by loading everything all the time, whether it is needed or not.

Linux systems excel in many areas, ranging from end-user concerns such as stability, speed, and ease of use, to serious concerns such as development and networking. Nowadays, Linux even offers a wide variety of free and commercial productivity packages such as the OpenOffice suite which can import and export files from other platforms, including Windows and MacOS.

Stability

Linux has long been praised for its stability--Linux boxes are known for running months or even years at a time without crashing, freezing, or having to be rebooted. Linux users sometimes poke fun at other, less stable operating systems, by way of screensavers like BSOD (Blue Screen of Death, which displays crash screens from various other platforms).

Linux is extremely secure compared to other platforms. Viruses and Trojan Horse programs are practically non-existent. Linux servers practically run the World Wide Web, so one cannot argue that there are so few malicious programs for Linux because it represents an insignificant number of target machines.

Speed

So much of the web is built on Linux that the acronym LAMP has emerged. LAMP represents Linux, Apache (web server), MySQL (database) and PHP (web application language). This acronym may need to be changed eventually due to the rapid growth of PostgreSQL, Ruby, and Java on Linux web servers.

Unlike some commercial operating systems, no free Linux distributions impose any artificial constraints on how you use the operating system. There are no arbitrary limits to the number of user accounts you can create, the number of simultaneous connections your Linux-based web server can handle, or arbitrary limits any other Linux resources.

Linux machines are known to be extremely fast, because the operating system is very efficient at managing resources such as memory, CPU power, and disk space. NASA, Sandia, Fermilabs and many others have built very powerful yet inexpensive supercomputers by creating clusters of Linux boxes running in parallel. Clusters of Linux systems have been responsible for rendering the graphics for movies like Shrek, Titanic, and many others.

Many high-profile organizations have adopted Linux. For example, visit the NOAA (the National Weather Service at www.srh.noaa.gov) and you can thank Linux for the weather reports you will see online.

Graphical Interface

Linux has dozens of different, highly configurable graphical interfaces (known as window managers) which run on top of Xorg, a free implementation of the X Window System. The most popular complete desktop environments at present are KDE (the K Desktop Environment) and GNOME (the GNU Network Object Model Environment). These offer the point-and-click, drag-and-drop functionality associated with other user-friendly environments (for example, Macintosh). Both can be configured to look and feel like other environments such as Windows or Mac, and KDE is remarkably extensible. Even complex tasks like system administration, package installation, upgrading, and network configuration can be done easily through graphical programs. Almost all programs that work with one window manager work with all the others, so you don't need to feel like you must pick your favorite desktop environment based on your favorite applications.

Xorg now supports 3-D windowing environments such as Beryl and Compiz for amazing visual effects, and most people won't have to upgrade their computers in order to take advantage of these enhancements.

Software Development

Programmers often find that the Linux development environment is second to none--a good thing for end users who depend on these software developers to provide free software. Nearly all development software for Linux is free and covered under the GNU Public License, which guarantees that it will always remain free. Linux systems come standard with C and C++ compilers and an assembler, and usually include Pascal, FORTRAN, compiled Java, Perl, Python, and BASIC implementations as well. In addition, modern languages like Ruby and classic languages like LISP are all available, fully functional and completely free.

Linux runs two of the most popular development environments, Eclipse and KDevelop, and you can use these environments to with just about any programming language available. These two development tools support web application development, but there are additional free/open source highly sophisticated development tools dedicated to building web applications.

In addition, the source code for nearly any Linux program is freely available (and often included by default). This not only means that bugs are discovered and corrected almost immediately, but development of software proceeds at a much faster pace than one finds even at extremely successful commercial software houses. This phenomenon is called Open Source and is the subject of much discussion and amazement in the business world, the computer world, and the press.

The Open Source nature of Linux also makes it ideal for embedded and specialized systems (routers, cell phones, multimedia entertainment centers, point-of-sale systems), because there's no limit to what you can do to customize Linux for your special needs.

Networking

Networking comes naturally to Linux. Probably all networking protocols in use on the Internet are native to UNIX and/or Linux, so one can expect that UNIX and Linux would network better than any other platforms. Setting up a network on a Linux machine is surprisingly simple, because Linux handles most of the work.

A large part of the Web is running on Linux boxes, especially because of the Apache Web Server which dramatically defeated its commercial competitors, proving the effectiveness and viability of the Open Source approach.

Productivity

Productivity software availability has exploded in recent years, and commercial developers have been producing excellent software for the Linux platform. The Firefox browser, Opera, and Mozilla are freely available (with some licensing restrictions) as well as the OpenOffice productivity suite, KOffice and a host of others, which often come standard on Linux distributions. Many distributors package commercial software with their distributions, and many commercial producers offer free downloads for Linux. Linux productivity packages can usually read and write files from productivity packages on other platforms; Linux has always been at the leading edge of compatibility and openness.

Linux happily coexists on the same machine as other operating systems including Windows or Mac OSX, and Linux easily accesses the files stored by other operating systems. You can use one of many virtualization techniques to run Linux and Windows or any other operating system (even another version of Linux) on the same machine, simultaneously. You can run many Windows programs on Linux via Wine, or commercial helper products such as Crossover Office or Cedega, both of which even support the popular game Word of Warcraft! There are countless Linux distributions which run beautifully from a CD or DVD without the need to install the operating system. This makes it possible for new Linux users to see if they like Linux without erasing their old OS or having to buy another computer.

Longevity

The open source nature of Linux guarantees it is here to stay, and the amazing growth of Linux over the past years bears that out. Best of all, as long as you stick with a truly free/open source operating system like Linux and truly free/open source applications, you can never get locked into depending on any particular vendor. Linux puts you in control of what you do with your software, how, when and if you choose to change or upgrade it.

Tuberculosis ( TB )

2008-04-15T07:06:00.000-07:00

Tuberculosis (TB) is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes or talks. If you have been exposed, you should go to your doctor for tests. You are more likely to get TB if you have a weak immune system.

Symptoms of TB in the lungs may include

A bad cough that lasts 3 weeks or longer
Weight loss
Coughing up blood or mucus
Weakness or fatigue
Fever and chills
Night sweats

If not treated properly, TB can be deadly. You can usually cure active TB by taking several medicines for a long period of time. People with latent TB can take medicine so that they do not develop active TB.

There is also a group of organisms referred to as atypical tuberculosis. These involve other types of bacteria that are in the Mycobacterium family. Often, these organisms do not cause disease and are referred to a "colonizers," because they simply live alongside other bacteria in our bodies without causing damage. At times, these bacteria can cause an infection that is sometimes clinically like typical tuberculosis. When these atypical mycobacteria cause infection, they are often very difficult to cure. Often, drug therapy for these organisms must be administered for one and a half to two years and requires multiple medications.

How does a person get TB?

A person can become infected with tuberculosis bacteria when he or she inhales minute particles of infected sputum from the air. The bacteria get into the air when someone who has a tuberculosis lung infection coughs, sneezes, shouts, or spits (which is common in some cultures). People who are nearby can then possibly breathe the bacteria into their lungs. You don't get TB by just touching the clothes or shaking the hands of someone who is infected. Tuberculosis is spread (transmitted) primarily from person to person by breathing infected air during close contact.

There is a form of atypical tuberculosis, however, that is transmitted by drinking unpasteurized milk. Related bacteria, called Mycobacterium bovis, cause this form of TB. Previously, this type of bacteria was a major cause of TB in children, but it rarely causes TB now since most milk is pasteurized (undergoes a heating process that kills the bacteria).