With respect to the role of drinking water, changing of water sources to deep well water has been reported to decrease the X-ray metaphyseal detection rate in different settings. In general, the effect of preventive measures however remains controversial, due to methodological problems (no randomised controlled trials), lack of documentation, or, as discussed above, inconsistency of results. Treatment
Treatment of KBD is palliative. Surgical corrections have been made with success by Chinese and Russian orthopedists. By the end of 1992, Médecins Sans Frontières—Belgium started a physical therapy programme aiming at alleviating the symptoms of KBD patients with advanced joint impairment and pain (mainly adults), in Nyemo county, Lhasa prefecture. Physical therapy had significant effects on joint mobility and joint pain in KBD patients. Later on (1994–1996), the programme has been extended to several other counties and prefectures in Tibet. Epidemiology
Kashin–Beck disease occurrence is limited to 13 provinces and two autonomous regions of China. It has also been reported in Siberia and North Korea, but incidence in these regions is reported to have decreased with socio-economic development. In China, KBD is estimated to affect some 2 million to 3 million people across China, and 30 million are living in endemic areas. Life expectancy in KBD regions has been reported to be significantly decreased in relation to selenium deficiency and Keshan disease (endemic juvenile dilative cardiomyopathia). The prevalence of KBD in Tibet varies strongly from valley to valley, and village to village.
Dolphin fathers help in the care of the young. Newborns are held on the surface of the water by both parents until they are ready to swim on their own. A number of bird species have active, caring fathers who assist the mothers, such as the waterfowls mentioned above. Apart from humans, fathers in few primate species care for their young. Those that do are tamarins and marmosets. Particularly strong care is also shown by siamangs where fathers carry infants after their second year. In titi and owl monkeys fathers carry their infants 90% of the time with "titi monkey infants developing a preference for their fathers over their mothers". Silverback gorillas have less role in the families but most of them serve as an extra protecting the families from harm and sometimes approaching enemies to distract them so that his family can escape unnoticed.Many species, though, display little or no paternal role in caring for offspring. The male leaves the female soon after mating and long before any offspring are born. It is the females who must do all the work of caring for the young. A male bear leaves the female shortly after mating and will kill and sometimes eat any bear cub he comes across, even if the cub is his. Bear mothers spend much of their cubs early life protecting them from males. (Many artistic works, such as advertisements and cartoons, depict kindly "papa bears" when this is the exact opposite of reality.)