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									    Connecting Science to People

Janet S. Austin, Ph.D.
Director, Office of Communications and Public Liaison
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health
Connecting Science to
   Communication Objectives

   • Make medical
     research personally
   • Serve as trusted
     source of health
   • Explain NIH’s role in
     medical research
     NIH Resource:
NIH Web Site, www.nih.gov
NIH Resource:
Other NIH Web Sites


Connecting Science to People
 NIAMS Mission
 • The mission of the National Institute of
   Arthritis and Musculoskeletal and Skin
   Diseases, a component of the U. S.
   Department of Health and Human
   Services’ National Institutes of Health, is to
 • research into the causes, treatment, and
   prevention of arthritis and musculoskeletal
   and skin diseases,
 • the training of basic and clinical scientists
   to carry out this research, and
 • the dissemination of information on
   research progress in these diseases.
Connecting Science to People

         “Our research belongs ultimately to the

         American people, for whom we serve as

         stewards in improving the public's


                           Stephen I. Katz, M.D., Ph.D.
                           NIAMS Director
  What OCPL Does
• Publications       • Web management
                     • Communications
• Feature writing      support
                     • Clearinghouse
• Media liaison        contract
• Inquiry response   • Multicultural health
• Outreach
                     • Web content
• Public liaison
OCPL Staff
• Writer-editors
• Public affairs specialists
• Health educators
• Public liaison officer
• Web manager
• Information assistants
• Support staff
• Project officers
       Points of Service
• NIAMS Office of Communication and
  Public Liaison (OCPL)

• NIAMS Information Clearinghouse

• NIH Osteoporosis and Related Bone
  Diseases~National Resource Center
Publications: Production and
         • Handouts on Health

         • Questions and Answers series

         • Fact Sheets

         • Special publications (e.g., Progress and

         • Easy-to-read, bilingual, and Spanish

         • Information packets

         • Newsletters: Shorttakes, IRPartners, E-Blast
             Public Liaison
• Outreach to constituency
• Contact for constituent
  referral for Members of
• Liaison to NIAMS
• Public contact for policy
Web Content Management
              • Web design

              • Web policy

              • Information

              • Technology

              • Inquiry

              • Content
Information Development and
Guiding Principles:
• Provide culturally appropriate, audience-specific
  educational materials written in plain language
• Routinely review and revise existing materials
• Facilitate rigorous review of NIAMS materials by the
  scientific and lay communities
• Work collaboratively with other NIH/DHHS
  organizations, voluntary and professional groups, and
  universities and medical centers in developing materials
• Effectively use intermediaries for distribution, including
  faith- and community-based organizations, NIAMS
  partners, the Federal Consumer Information Center, and
  health professionals
Arthritis Overview
     What is Arthritis and Rheumatic

 Rheumatic diseases involve the muscle, joints,
  and bones. There are over 100 rheumatic

 Arthritis literally means joint inflammation.

 Many rheumatic diseases cause inflammation
  of joints and also muscle, bones, and other
  supporting structures.
                Diagnosing Arthritis
 Early diagnosis and
  treatment is important.

 Diagnosis can be difficult
  because some symptoms
  and signs are common to
  many different diseases.

 It may take more than one
  office visit for the doctor to
  make an accurate
                 Treating Arthritis
Treatment Goals:

   Relieve pain
   Control inflammation
   Slow down or stop joint damage
   Improve well-being and ability to function
   Prevent disability
         Ways to Treat Arthritis

 Lifestyle changes

 Medications

 Surgery

 Complementary and alternative
  medicine and nutritional supplements
             Lifestyle changes
 Healthful diet and weight control

 Exercise

 Rest and relief

 Non-drug pain relief
           Healthful Diet and
            Weight Control

 An overall nutritious diet is important

 Weight loss can reduce stress on weight-
  bearing joints

 Limit or avoid consuming alcohol

 A dietitian can help
 Reduces joint pain

 Helps maintain healthy

 Increases flexibility,
  muscle strength, cardiac
  fitness, and endurance

 Ask a doctor or physical
  therapist what exercises
  are best for you
               Rest and Relief
 Learn your body’s signals on when to stop or slow down

 Rest helps reduce joint inflammation and fights fatigue

 Short breaks better than prolonged time in bed

 Splints or braces can take pressure off joints

 Assistive devices helps reduce joint stress
       Non-Drug Pain Relief

 Relaxation, distraction, visualization

 Heat and cold treatments

 Massage


  Analgesics        Nonsteroidal    Biological
     (pain               Anti-      response
   relievers)       Inflammatory    modifiers

                     Hyaluronic     Modifying
Corticosteroids      acid          Antirheumati
                     products        c Drugs
     Questions to Ask Your Doctor
            or Pharmacist
 How often should I take this medicine?

 Should I take this medicine with food or between

 What side effects might occur?

 Should I take this medicine with the other
  prescription medicines I take?

 Is this medication safe considering other medical
  conditions I have?
Surgery is used to:
   Reduce pain
   Improve the affected joint’s function
   Improve ability to perform daily activities

Things to consider
     Level of disability
     Intensity of pain
     Age
     Occupation
     Level of interference with the patient’s lifestyle
         Complementary and
         Alternative Therapies
Ongoing research on therapies for
 people with osteoarthritis:
   Acupuncture
   Nutritional supplements
     Glucosamine and chondroitin sulfate
     Vitamins D
     Green tea
 NIAMS Arthritis Research

OAI                  CARRA


     Osteoarthritis Initiative (OAI)

• A Public-Private Partnership
• Funded by 7 NIH Components, the FDA and
  several pharmaceutical companies
• Includes 4,800 participants at risk for
  developing knee OA
   • To create research resources to aid in the
     identification and evaluation of biomarkers
     for OA
   • To further drug development and improve
     public health
   North American Rheumatoid Arthritis
         Consortium (NARAC)

• A multicenter group that seeks to
  identify RA susceptibility genes

• Recent discoveries include the
  identification of susceptibility genes
  common to people with RA and
  lupus, and identifying a new RA
  susceptibility gene region
    Childhood Arthritis & Rheumatology
        Research Alliance (CARRA)

NIAMS supports many CARRA studies,

• Trial of Early Aggressive Therapy in
  Juvenile Idiopathic Arthritis
    NIAMS Intramural Research
         Program (IRP)
• NIAMS Community Health Center
  (Cardozo area of Washington, D.C.)
• NIAMS Pediatric Rheumatology
• NIAMS Cartilage Biology and
  Orthopaedics Branch
• NIAMS Arthritis and Rheumatism
For more information

                           2 AMS Circle
                    Bethesda, MD 20892 - 3676

                       Phone: 301-495-4484
    NIAMS             Toll Free: 877-226-4267
                  Email: NIAMSInfo@mail.nih.gov
Osteoporosis Overview
         Why Are Healthy Bones

• Strong bones support us and allow us to

• Bones are a storehouse for vital minerals

• Strong bones protect our heart, lungs,
  brain and other organs

• Osteoporosis is defined as a skeletal
  disorder characterized by compromised
  bone strength predisposing to an increased
  risk of fracture.

   Osteoporosis Prevention, Diagnosis, and Therapy. NIH
     Consens Statement 2000 March 27-29; 17(1): 1-36.

• In the United States 8 million women and 2
  million men have osteoporosis

• An additional 34 million Americans
  currently have low bone mass

• One out of two women and one out of four
  men aged 50 years and older will suffer an
  osteoporosis-related fracture in their
       Osteoporosis risk factors that you
               cannot change

• Gender – risk is greater for women

• Age - the older you are, the greater your risk

• Body size - Small, thin-boned women are at greater

• Ethnicity - Caucasian and Asian women are at highest
  risk. African American and Hispanic women have a
  lower but significant risk.

• Family history - Fracture risk may be due, in part, to
          Osteoporosis risk factors
           that you can change

• Sex hormones - Abnormal absence of menstrual
  periods (amenorrhea), low estrogen level
  (menopause), and low testosterone level in men.

• Anorexia nervosa - increases risk

• Calcium and vitamin D intake - A lifetime diet low
  in calcium and vitamin D.

• Medication use - Long-term use of glucocorticoids
  and some anticonvulsants and others.
           Osteoporosis risk factors
            that you can change

• Physical Activity - An inactive lifestyle or extended
  bed rest tends to weaken bones.

• Cigarette smoking - Cigarettes are bad for bones
  as well as the heart and lungs.

• Alcohol intake - Excessive consumption increases
  the risk of bone loss and fractures.
DXA: The Gold

•Bisphosphonates - Bisphosphonates slow the bone
breakdown process. Healthy bones are in a state of continuous breakdown and
rebuilding. As you get older, and especially after menopause when your estrogen
levels decrease, the bone breakdown process accelerates. When bone rebuilding
fails to keep pace, bones deteriorate and become weaker. Bisphosphonates
basically put a brake on that.

•Raloxifene - Raloxifene is in a class of medications called
selective estrogen receptor modulators (SERMs). Raloxifene prevents and treats
osteoporosis by mimicking the effects of estrogen (a female hormone produced
by the body) to increase the density (thickness) of bone.

•Calcitonin - Calcitonin is a medicine that slows the rate of bone
loss and relieves bone pain.

•Teriparatide - Teriparatide contains a synthetic form of natural
human hormone called parathyroid hormone (PTH). It works by causing the body
to build new bone and by increasing bone strength and density (thickness).

•Estrogen/Hormone Therapy
    Universal Steps for Strong
• A diet rich in calcium and
  vitamin D

•Regular weight-bearing activity

•Healthy lifestyle

• Food sources are recommended
     Dairy products
     Fortified foods
     Green vegetables

• Supplements are often necessary
              How Much Calcium?
Age                  Amount
0-6 months           210 mg/day
7-12 months          270 mg/day
1-3 years            500 mg/day
4-8 years            800 mg/day
9-18 years           1300 mg/day
19-50 years          1000 mg/day
Over 50 years        1200 mg/day
               Vitamin D

•Necessary for the absorption of

•Synthesized in skin on exposure to
   sunlight or ingested in foods such
   egg yolks, fish, liver, or

•Fortified milk, cereals and orange
      Vitamin D: The Sunshine

•According to National Osteoporosis
Foundation, usually 10-15 minutes
exposure of hands, arms and face
two to three times a week (depending
on one's skin sensitivity) is enough to
satisfy the body's vitamin D
           Physical Activity

• Weight-bearing (walking, stair
  climbing, dancing)
• Tai chi – enhances muscle function
  and balance
• Avoid exercises that involve:
     Forward flexion of the spine
     Bending from the waist
     Twisting or jerking the spine
      Keep one foot on the ground
Osteoporosis Research
Good Vibrations
Can vibrations build bone
    and reduce fat?
NIH-NASA Partnership
Mr. OS
NIH Senior Health.gov
                        2 AMS Circle
                 Bethesda, MD 20892-3676
                    Phone: 202–223–0344
                  Toll Free: 800–624–BONE
   NIH               TTY: 202-466-4315
ORBD~NRC             Fax: 202-293-2356
            Email: NIAMSBoneInfo@mail.nih.gov
           Website: http://www.niams.nih.gov//bone/

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