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Biomedical subjects

D Travers-Gustafson

Publications and source records attributed to D Travers-Gustafson.

5 recordsLinked to original sources
PubMed1997

Divorcing and building a new life.

The purpose of this study was to provide a qualitative description of women's experiences of divorcing and building a new life. Interviews with 10 divorced women were conducted, transcribed, and analyzed using the constant comparative method. Four phases were identified in the process of divorcing and building a new life: the emotional divorce, making the decision, pulling apart, and moving beyond. Feelings and coping strategies reported by the participants are described.

Adaptation, Psychological↗
PubMed1995

Ultrasound, densitometry, and extraskeletal appendicular fracture risk factors: a cross-sectional report on the Saunders County Bone Quality Study.

The Saunders Bone Quality Study was designed to determine the feasibility of ultrasonic bone measurement, at the patella, as a predictor of low-trauma fractures in a rural population-based study. At the first visit of this 4-year longitudinal study, anthropometric and clinical measurements and medical, surgical and fracture histories were obtained for the 1428 participants 9899 women and 529 men). Explored risk factors for low-trauma fractures included age, sex, calcium intake, alcohol and caffeine ingestion, tobacco use, body mass and grip strength, age of menopause, estrogen replacement therapy, propensity to fall, distal radius and ulna bone mineral content, and bone density. Forward multivariate logistic regression analysis showed that lower ultrasound values are more consistently associated with reported low-trauma appendicular fractures than the commonly reported forearm absorptiometry measures of radius mineral content and density. When ultrasound, age, and the extra skeletal risk factors were included in an additional multivariate model, only age and ultrasound were significantly associated with appendicular fracture history in women (P = 0.0003), whereas only ultrasound was associated in the men (P = 0.001). We conclude that ultrasound is a better measure as association with reported low-trauma fractures than the commonly reported forearm SPA measures. Even after adjustment for many of the extra skeletal risk factors, low AVU is highly associated with low-trauma fracture status for both men and women.

Age Factors↗
PubMed1995

Cortical ultrasound velocity as an indicator of bone status.

Normative population data are reported here for velocity of ultrasound in tibial cortical bone in a population-based sample of both men and women (n = 371). The cortical measurement is highly precise with reproducibility of the order of 0.5%. As with heel and patellar trabecular velocity, tibial cortical velocity declines with age from the fourth through the ninth decades. The rate is 1.7 m/s per year in men and 4.1 m/s per year in women. Tibial cortical velocity values correlate with patellar velocity and with forearm mineral, with correlation coefficients ranging from + 0.46 to + 0.54 in women and + 0.27 to + 0.43 in men (P < 0.002 for all). Tibial velocity averaged 77-104 m/s lower (2-3%: equal to about 1 SD of the young adult normal distribution) in individuals with a history of low-energy appendicular fractures (P < 0.05), and the difference remained significant after adjusting for age. However, there were no perceptible differences in tibial velocity for those with and without vertebral fractures. Odds ratios derived from logistic regression showed an approximate twofold increase in likelihood of low-energy appendicular fracture for every standard deviation decrement in velocity. Comparison of tibial velocity with patellar velocity and forearm density in the same individuals revealed tibial velocity to be more strongly associated with appendicular fractures than patellar velocity for women and about the same for men, and less strongly associated than patellar velocity for vertebral fractures. We conclude that tibial cortical velocity provides useful information about bone status in populations at risk for osteoporosis, and seems particularly well suited for assessing appendicular fracture risk.

Absorptiometry, Photon↗
PubMed1994

Velocity of ultrasound and its association with fracture history in a rural population.

The authors set out to determine the distribution of bone quality, as measured by ultrasound, in a rural Nebraska population of women and men. Noninstitutionalized residents of Saunders County, Nebraska, who were age 50 years or older as of January 1, 1992, were enumerated. From this sampling frame, a randomized proportionate stratified sample was selected. The response rate to this random sampling was 58%. Bone quality was measured using the apparent velocity of ultrasound (AVU) through the patella. In addition to demographic information, participants were asked to describe all fractures that had occurred since age 40 years. Fractures were classified as resulting from low or high trauma. Like bone mass, previously studied extensively, AVU was lower among successively older strata for both sexes. AVU discriminated between those with and those without low-trauma or any fractures for both sexes, whether unadjusted or adjusted for nonresponse. AVU is a faster, cheaper, and less time-consuming procedure than bone mass. The measuring device is portable and is well suited for population-based studies. It remains to be determined, by prospective methods, whether AVU is a predictor of low-trauma or osteoporotic fracture in this population.

Accidental Falls↗