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Food Insecurity Amongst Urban College Students, Gerron Scott Jun 2024

Food Insecurity Amongst Urban College Students, Gerron Scott

Journal of Higher Education & Student Affairs

Food insecurity is a growing concern among college students. With the rising food and housing costs, more students are going hungry. This narrative inquiry provides a greater understanding of food insecurity's impact on the college-going experience for urban students. Interviews were conducted with five college students who attend a large public urban university in the mid-Atlantic and use the on-campus food pantry. As a result of the narrative inquiry, six themes emerged. They are peer relationships, government assistance, cost of living, access to healthy food, institutional help, and navigating college. As a result of the study, there are several actionable …


Chromosome-Scale Assemblies And A Pangenome Reveal Ltr Repeat Dynamics As A Major Driver Of Genome Evolution In Chenopodium, Kate E. Jaggi Jun 2024

Chromosome-Scale Assemblies And A Pangenome Reveal Ltr Repeat Dynamics As A Major Driver Of Genome Evolution In Chenopodium, Kate E. Jaggi

Theses and Dissertations

The genus Chenopodium, which comprises around 150 species globally, is characterized by its wide geographic distribution and ecological adaptability, particularly in temperate regions. Some species, such as Chenopodium quinoa and Chenopodium pallidicaule, have served as domesticated staple crops in the Andean region of South America for centuries, valued for their robust nutritional profile and adaptability to adverse environmental conditions. In contrast, wild Chenopodium species exhibit broad geographic distributions and diverse niche adaptations, functioning as reservoirs for beneficial traits, including disease resistance and climate hardiness, essential for enhancing domesticated crops through introgression and breeding efforts. However, taxonomic classification within the genus …


A Modelled Estimate Of Food Access Within Countries Shows That Inequality Within Countries Has Increased Despite Rising Equality Between Countries, Juan Diego Martinez, Navin Ramankutty, Zia Mehrabi, Tom W. Hertel Jun 2024

A Modelled Estimate Of Food Access Within Countries Shows That Inequality Within Countries Has Increased Despite Rising Equality Between Countries, Juan Diego Martinez, Navin Ramankutty, Zia Mehrabi, Tom W. Hertel

Department of Agricultural Economics Faculty Publications

Global food calorie supply per person is more than 2900 kcal per day on average, but we have failed to ensure equitable access to these calories. Yet how uneven food access is within countries has remained poorly understood, as has the progress made over the past five decades on closing the access gap. Using publicly available data, we developed a theoretically-grounded statistical model to estimate the cross-national relationship between average per capita expenditure and per capita food availability and used this to estimate within-country access to food for income deciles in 135 countries. We find that, from 1961 to 2013, …


Effectual Entrepreneurship In Action: Twelve Men And The Rebirth Of Arctic Cat Snowmobiles, Tom Clement Jun 2024

Effectual Entrepreneurship In Action: Twelve Men And The Rebirth Of Arctic Cat Snowmobiles, Tom Clement

Journal of Business & Entrepreneurship

In 1981, the largest snowmobile manufacturer, Arctic Enterprises, Inc., makers of Arctic Cat snowmobiles, declared bankruptcy and eventually ceased operations. This case tells the story of the rebirth of Arctic Cat snowmobiles when twelve former Arctic Enterprises founders, executives, and employees launched the startup Arctco Inc. in 1983. These twelve men relied heavily on the five principles of effectual entrepreneurship, which were first articulated 20 years after the failure of Arctic Enterprises. Students will learn the inside story of Arctco and retroactively apply the principles of effectual entrepreneurship to one of the rarest business scenarios: a publicly traded firm with …


The Effectiveness Of Pressure Injury Prevention Through Educational Intervention Within The Long-Term Care Setting, Ashley Nunley Jun 2024

The Effectiveness Of Pressure Injury Prevention Through Educational Intervention Within The Long-Term Care Setting, Ashley Nunley

Doctor of Nursing Practice Projects

The prevalence of pressure injuries, particularly in older adults, continues to be disturbingly high, especially in those suffering from chronic diseases and frailty, bringing a higher awareness of applied preventive and therapeutic measures (Jaul et al., 2019). In long-term care nurses, will an educational, evidenced-based pressure ulcer prevention program impact health outcomes by increasing nurses’ knowledge, compared to no intervention over four weeks? The Pieper-Zulkowski Pressure Ulcer/Injuries Knowledge Test was used to evaluate the nurse's pressure injury knowledge pre- and post-educational intervention. The paired t-test was used to analyze the pre-and post-test data from the educational intervention. This DNP project …


The Flourishing Gut Cookbook, Mackenzie C. Stanley, Brittany Lopez-Itingen Jun 2024

The Flourishing Gut Cookbook, Mackenzie C. Stanley, Brittany Lopez-Itingen

Department of Nutrition Student Projects

Herbs and spices have been used in herbal medicine for thousands of years, and yet these therapeutic approaches used to heal from within are foreign to many Americans. We have decided to create a cookbook utilizing 5 evidence-based gut-healing herbs and spices in hopes to provide tangible recipes to promote gut health. The cookbook will also provide an educational opportunity that will speak to the benefits of each herb or spice in the recipe. Background We have decided to pursue a cookbook as a result of our love of cooking and interest in herbal medicine. We want to learn more …


School Counselor's Experiences In Providing Services To High School Students Enrolled In Accelerated Academic Programs, Pamela Denise Gardner Jun 2024

School Counselor's Experiences In Providing Services To High School Students Enrolled In Accelerated Academic Programs, Pamela Denise Gardner

Walden Dissertations and Doctoral Studies

Students enrolled in accelerated academic programs are not immune to mental health concerns that other students may face. Despite the increasing evidence that perfectionism is correlated with psychological distress among adolescents, there is a gap in the literature on how interventions developed for use in adolescent populations may affect this relationship. Knowledge of the influence, if any, of interventions may help school counselors to better understand these students’ experiences and counseling requirements. The purpose of this qualitative, phenomenological study was to learn more about counselors’ experiences with students in accelerated academic programs. The participants comprised eight counselors recruited from a …


Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor Jun 2024

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …


School Counselor's Experiences In Providing Services To High School Students Enrolled In Accelerated Academic Programs, Pamela Denise Gardner Jun 2024

School Counselor's Experiences In Providing Services To High School Students Enrolled In Accelerated Academic Programs, Pamela Denise Gardner

Walden Dissertations and Doctoral Studies

Students enrolled in accelerated academic programs are not immune to mental health concerns that other students may face. Despite the increasing evidence that perfectionism is correlated with psychological distress among adolescents, there is a gap in the literature on how interventions developed for use in adolescent populations may affect this relationship. Knowledge of the influence, if any, of interventions may help school counselors to better understand these students’ experiences and counseling requirements. The purpose of this qualitative, phenomenological study was to learn more about counselors’ experiences with students in accelerated academic programs. The participants comprised eight counselors recruited from a …


Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor Jun 2024

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …


Mitigating Toxic Metal Exposure Through Leafy Greens: A Comprehensive Review Contrasting Cadmium And Lead In Spinach, Angelia L. Seyfferth, Matthew A. Limmer, Benjamin R. Runkle, Rufus L. Chaney Jun 2024

Mitigating Toxic Metal Exposure Through Leafy Greens: A Comprehensive Review Contrasting Cadmium And Lead In Spinach, Angelia L. Seyfferth, Matthew A. Limmer, Benjamin R. Runkle, Rufus L. Chaney

Biological Sciences Faculty Publications and Presentations

Metals and metalloids (hereafter, metal(loid)s) in plant-based foods are a source of exposure to humans, but not all metal(loid)-food interactions are the same. Differences exist between metal(loid)s in terms of their behavior in soils and in how they are taken up by plants and stored in the edible plant tissue/food. Thus, there cannot be one consistent solution to reducing toxic metal(loid)s exposure to humans from foods. In addition, how metal(loid)s are absorbed, distributed, metabolized, and excreted by the human body differs based on both the metal(loid), other elements and nutrients in the food, and the nutritional status of the human. …


Modern Trail Of Tears: The Commodification Of First Foods And Medicines In Relation To Food Apartheid And Genocide Of Indigenous Peoples, Darius Mani Yaw Jun 2024

Modern Trail Of Tears: The Commodification Of First Foods And Medicines In Relation To Food Apartheid And Genocide Of Indigenous Peoples, Darius Mani Yaw

University Honors Theses

I am asking you to share in a cultural conversation with me. I will use different fonts in order to express my autobiographical and ethnographic Indigenous story separate from traditional academic writing This will not be a traditional thesis by any means of academic writing; this will also be a living document in a format of a cited reflection in order to continue the conversation not only through my Indigenous Research but also through community, and ideally will create everlasting solutions. However, this will be an introduction into my Indigenous writing and Indigenous voice.

I will be discussing the next …


Removal As A Control Method For Trachemys Scripta Elegans And The Response Of Chrysemys Picta Bellii, Jacob Swanson Jun 2024

Removal As A Control Method For Trachemys Scripta Elegans And The Response Of Chrysemys Picta Bellii, Jacob Swanson

University Honors Theses

The red-eared slider is considered one of the most ubiquitous freshwater turtles globally. Several key ecological advantages and life history traits of this species jointly impact growth rates and survivorship of native freshwater turtles where sympatry occurs. Evaluation of current management actions for red-eared slider turtles is limited, resulting in a paucity of information to guide management for the species and conservation of declining native freshwater turtles. We used previously collected mark-recapture and removal sampling data from sites with sympatric populations of red-eared slider and western painted turtles. We examined the effects of control (trapping and removal) of red-eared sliders …


The Cost Of Healthy Eating, Diana Prychyna Jun 2024

The Cost Of Healthy Eating, Diana Prychyna

University Honors Theses

Background: Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure, utilized 'Self-Care Coaches' who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During telehealth calls, we observed gaps in self-care for retired older adults (62+), …


Collective Case Study Career Critique Of Social Entrepreneurs Who Are Gifted Adults, Joi Lin Jun 2024

Collective Case Study Career Critique Of Social Entrepreneurs Who Are Gifted Adults, Joi Lin

Electronic Theses and Dissertations

This dissertation describes a qualitative research study that grows our understanding of the career development experiences, supports, and barriers of social entrepreneurs who are gifted adults (SEGA) so that we may nurture the career development of future SEGA. Research questions for this study probed the career development experiences, supports, and barriers of SEGA and the shared social value they create. The conceptual frameworks for this study are the ecological model for human development (Bronfenbrenner, 1979); the theory of positive disintegration (Dąbrowski, 1964/2016); social cognitive career theory (SCCT; Lent et al., 1994); the perceived instructional arc (Uhrmacher et al., 2017); and …


Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore Jun 2024

Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore

Doctor of Nursing Practice Projects

Type 2 diabetes is a prevalent chronic disorder that is associated with defects in the metabolism of glucose. The management of type 2 diabetes depends on patients’ adherence to self-care activities. However, patients at the project site reported poor glycemic control, which increased their risk of diabetes complications. The purpose of this quality improvement project was to educate nursing staff on the use of diabetes logbooks to improve self-care among African Americans with type 2 diabetes and thereafter have the nursing staff educate diabetic patients. A quasi-experimental pre-post-intervention design involving 30 African American adults (mean age 43.70 years) with uncontrolled …


Technology And Homelessness: How Website Design And Blockchain Technology Could Impact The Unhoused, Casey Pratt Jun 2024

Technology And Homelessness: How Website Design And Blockchain Technology Could Impact The Unhoused, Casey Pratt

Undergraduate Theses, Capstones, and Recitals

Although technology could be used to combat inequality, it is instead increasing it. This paper discusses how the unhoused population suffers at the hand of technological inequality despite being relatively offline. It presents theories on how this would change if we reapproached how technology is used to assist the unhoused. It suggests implementing blockchain as a resource as well as modifying the websites built to assist in accessing benefits. Employees at shelters are interviewed for this paper about their experiences with using digital resources to rehouse and restabilize the vulnerable. They are asked how the sites can be improved for …


The Effects Of Wildfire Burn Severity On Bee And Wasp Communities Two Decades Post-Fire, Alaina K. Smith Jun 2024

The Effects Of Wildfire Burn Severity On Bee And Wasp Communities Two Decades Post-Fire, Alaina K. Smith

Electronic Theses and Dissertations

While fire is a natural disturbance in many global ecosystems, anthropogenic changes are affecting fire frequency, severity, and seasonality. Disturbances like wildfire affect bee and wasp communities, but recent meta-analyses are conflicted about whether fire harms or benefits insect pollinators. We investigated the lasting effects of wildfire burn severity on wild bee communities and floral resource availability across different burn severities in two-mixed severity fires that burned >20 years ago. We found that high severity fire has positive effects on bee diversity that are associated with severity-mediated changes to the floral community. We also studied the effects of wildfire burn …


A Critical Policy Analysis Of Universal Preschool In Colorado: Its Roots, Intentions, And Development, Jamita Horton Jun 2024

A Critical Policy Analysis Of Universal Preschool In Colorado: Its Roots, Intentions, And Development, Jamita Horton

Electronic Theses and Dissertations

High-quality preschool experiences are essential for preparing four-year-old children for a successful transition to kindergarten, benefiting them academically, emotionally, socially, and physically. However, access to such preschools remains limited, particularly for children from marginalized communities. This qualitative critical policy analysis examines transitioning from the targeted Colorado Preschool Program (CPP) to a universal preschool approach through the 2022 Colorado House Bill 1295: Department of Early Childhood and Universal Preschool Program. Drawing on Young and Diem's (2017) framework for critical policy analysis, this study explores the roots, development, and potential implications of the universal preschool policy.

This study analyzes documents and audio …


Validating The Use Of Body Mass Index With Computed Tomography In A Racially And Ethnically Diverse Cohort Of Patients Admitted With Sars- Cov-2, Patricia Sheean, Paula O'Connor, Cara Joyce, Amy Wozniak, Vasilios Vasilopoulos, Jared Seigal, Perry Formanek Jun 2024

Validating The Use Of Body Mass Index With Computed Tomography In A Racially And Ethnically Diverse Cohort Of Patients Admitted With Sars- Cov-2, Patricia Sheean, Paula O'Connor, Cara Joyce, Amy Wozniak, Vasilios Vasilopoulos, Jared Seigal, Perry Formanek

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Body mass index (BMI) is criticized for being unjust and biased in relatively healthy racial and ethnic groups. Therefore, the current analysis examines if BMI predicts body composition, specifically adiposity, in a racially and ethnically diverse acutely ill patient population.

Methods: Patients admitted with SARS‐CoV‐2 having an evaluable diagnostic chest, abdomen, and/or pelvic computed tomography (CT) study (within 5 days of admission) were included in this retrospective cohort. Cross‐sectional areas (centimeters squared) of the subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT) were quantified. Total adipose tissue (TAT) was calculated as sum of these …


The Best Interests Of The Immigrant Child In Asylum Cases: What Is The Answer?, Elizabeth Avila Jun 2024

The Best Interests Of The Immigrant Child In Asylum Cases: What Is The Answer?, Elizabeth Avila

University of Dayton Law Review

No abstract provided.


Deciphering The Microbial Fingerprint Of Covid-19: A Multi-Layered Exploration Of The Oral And Gut Microbiome Dysbiosis, Iman Mostafa Sultan Jun 2024

Deciphering The Microbial Fingerprint Of Covid-19: A Multi-Layered Exploration Of The Oral And Gut Microbiome Dysbiosis, Iman Mostafa Sultan

Theses and Dissertations

The impact of SARS-CoV-2 infection on the human microbiome remains a dynamic and intricate puzzle. This study delves deeper into this mystery by revisiting the oral and gut microbial compositions of 53 COVID-19 patients before and after viral clearance, alongside comparisons to 76 healthy individuals. Through a comparative lens, we have emploed two distinct differential abundance methods – DeSeq2 and ANCOM – while drawing upon the thorough SILVA database encompassing the full-length 16S rRNA gene. The analysis underscores the crucial role of a diverse methodological choir in microbiome research. In certain instances, the congruence between DeSeq2 and ANCOM may exhibit …


Pacing Beside The Pool: Coaching Champion Writers To A Strong Finish In Clinic (Without Jumping In And Finishing For Them), Hillary A. Wandler Jun 2024

Pacing Beside The Pool: Coaching Champion Writers To A Strong Finish In Clinic (Without Jumping In And Finishing For Them), Hillary A. Wandler

The Journal of Law Teaching and Learning

No abstract provided.


You Are What You Eat, Which Is Hopefully Something: Minimum Weight Regulations For High School And Intercollegiate Wrestlers, Timothy Fiorta Jun 2024

You Are What You Eat, Which Is Hopefully Something: Minimum Weight Regulations For High School And Intercollegiate Wrestlers, Timothy Fiorta

Denver Sports & Entertainment Law Journal

No abstract provided.


Should The Government Flex Its Muscles And Regulate Steroids In Baseball - Weakness In The Public Health Argument, Connor Williams Jun 2024

Should The Government Flex Its Muscles And Regulate Steroids In Baseball - Weakness In The Public Health Argument, Connor Williams

Denver Sports & Entertainment Law Journal

The government's response to steroid abuse has been simultaneously hyperbolic and inadequate. The legislative and executive branches have attempted to address the problem of abuse of performance-enhancing drugs by adolescents by focusing their venom primarily on A) steroids, and B) baseball players. I argue that this artificially narrows the larger public health conversation that we should be having as a society if, in fact, we determine that adolescent steroid abuse is a problem worth addressing.

There are several flaws in the government's line of thinking in addressing this issue: 1) it has overstated the problem of adolescent steroid abuse, 2) …


Bifidobacterium Bacteremia Following Gastrointestinal (Gi) Procedures: A Case Report Of An Unusual Infection And Review Of The Literature, Sheza Malik, Hajra Khan, Ali S. Mohamed, Gaby Razzouk Jun 2024

Bifidobacterium Bacteremia Following Gastrointestinal (Gi) Procedures: A Case Report Of An Unusual Infection And Review Of The Literature, Sheza Malik, Hajra Khan, Ali S. Mohamed, Gaby Razzouk

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Bifidobacterium is a rare cause of bacteremia that mostly affects extremes of ages with the majority of cases seen in premature infants. This report details a case of bacteremia caused by Bifidobacterium in a 75-year-old male patient. Our patient was admitted after a mechanical fall resulting in subdural and subarachnoid hemorrhage. His hospital course was complicated by swallowing problems and ultimately needed the placement of a gastrojejunal (GJ) tube for nutrition. He subsequently developed Bifidobacterium bacteremia. It was presumed that the GJ tube was the cause of bacterial translocation into the bloodstream due to invasion of the mucosal barrier. …


Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo Jun 2024

Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo

Advances in Clinical Medical Research and Healthcare Delivery

Introduction:

Acute esophageal necrosis (AEN), is a rare disorder with an estimated incidence of 0.01-0.28%. It typically affects the distal third of the esophagus. Approximately 90% of patients with acute esophageal necrosis present with upper gastrointestinal (GI) bleeding, primarily due to ischemic insult or severe hemodynamic compromise. In this report, we describe a case in which the patient presented with odynophagia and dysphagia, but without upper GI bleeding. The patient exhibited pan mucosal involvement of the esophagus, which extended to the gastric antrum.

Case: A 55-year-old man with a history of type 2 diabetes mellitus and substance abuse presented with …


The Perceptions Of Different Disciplines On Early Childhood Interprofessional Teams Involving Occupational Therapy Services, Jessica Martinez-Peraza, Natalie Milliken, Bonnie Riley Jun 2024

The Perceptions Of Different Disciplines On Early Childhood Interprofessional Teams Involving Occupational Therapy Services, Jessica Martinez-Peraza, Natalie Milliken, Bonnie Riley

Student Journal of Occupational Therapy

This phenomenological study was conducted to explore how professionals identify the roles of occupational therapy practitioners and other pediatric professionals on early childhood interprofessional teams. The use of surveys and interviews revealed three themes: 1) the role of occupational therapy encompasses more than what is perceived to be their role, 2) collaboration must be initiated, as it can be influenced by the setting, and 3) different professionals have the shared goal of promoting child health outcomes, but conflict can arise during collaboration. It was recognized that early childhood professionals would like to collaborate more with each member on the interprofessional …


Strength Training Versus Aerobic Exercise On Glycemic Control In Adults With Type 1 Diabetes, Elizabeth Encarnacion Jun 2024

Strength Training Versus Aerobic Exercise On Glycemic Control In Adults With Type 1 Diabetes, Elizabeth Encarnacion

Yale School of Medicine Physician Associate Program Theses

Poorly controlled Type 1 Diabetes can lead to micro- and macrovascular complications (retinopathy, neuropathy, cardiovascular disease), but managing glycosylated hemoglobin A1c levels can decrease incidence rates. However, current guidelines recommending exercise for management have low evidence ratings, and less than one third of adults achieve target hemoglobin A1c levels. For those looking to begin an exercise regimen, it is unclear which type of exercise is best for maintaining glycemic control. This study will compare the effectiveness of thrice-weekly (45-minute) sessions for 12 months of aerobic exercise versus strength training against a non-exercise control group in non-active Type 1 Diabetic adults. …


Nutrition Education To Prevent Bone Stress Injuries In Collegiate Male Athletes: A Randomized Trial, Brianna Brite Jun 2024

Nutrition Education To Prevent Bone Stress Injuries In Collegiate Male Athletes: A Randomized Trial, Brianna Brite

Yale School of Medicine Physician Associate Program Theses

Male Athlete Triad is a syndrome of three interrelated conditions, low energy availability, functional hypogonadism and low bone mineral density, leading to adverse outcomes including bone stress injuries. Evidence-based techniques for preventing bone stress injury in those at risk for Male Athlete Triad have not been identified in existing research. Nutrition education programs can increase athletes’ energy intake and subsequently, energy availability. Therefore, we seek to determine whether a nutrition education program will reduce the incidence of bone stress injuries among collegiate athletes at risk for Male Athlete Triad. Our randomized controlled trial will assess the relative risk of bone …