Consensus of Official Position of IOF/ISCD FRAX Initiatives in Asia-Pacific Region.

The fracture risk assessment tool (FRAX(®)) has been developed for the identification of individuals with high risk of fracture in whom treatment to prevent fractures would be appropriate. FRAX models are not yet available for all countries or ethnicities, but surrogate models can be used within regions with similar fracture risk. The International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) are nonprofit multidisciplinary international professional organizations. Their visions are to advance the awareness, education, prevention, and treatment of osteoporosis. In November 2010, the IOF/ISCD FRAX initiative was held in Bucharest, bringing together international experts to review and create evidence-based official positions guiding clinicians for the practical use of FRAX. A consensus meeting of the Asia-Pacific (AP) Panel of the ISCD recently reviewed the most current Official Positions of the Joint Official Positions of ISCD and IOF on FRAX in view of the different population characteristics and health standards in the AP regions. The reviewed position statements included not only the key spectrum of positions but also unique concerns in AP regions.

Static and dynamic shoulder stabilizer adaptations in javelin throwers: A preliminary study

BACKGROUND: Adaptations to Internal (IR) and external (ER) rotator shoulder muscles improving overhead throwing kinematics could lead to muscular strength imbalances and be considered an intrinsic risk factor for shoulder injury, as well as modified shoulder range of motion (RoM). OBJECTIVE: To establish profiles of internal and external rotation RoM and isokinetic IR and ER strength in adolescent- and national-level javelin throwers. METHODS: Fourteen healthy subjects were included in this preliminary cross-sectional study, 7 javelin throwers (JTG) and 7 nonathletes (CG). Passive internal and external rotation RoM were measured at 90 degrees of shoulder abduction. Isokinetic strength of dominant and non-dominant IR and ER was evaluated during concentric (60, 120 and 240 degrees/s) and eccentric (60 degrees/s) contractions by Con-Trex (R) dynamometer with the subject in a seated position with 45 degrees of shoulder abduction in the scapular plane. RESULTS: We reported significantly lower internal rotation and significantly higher external rotation RoM in JTG than in CG. Concentric and eccentric IR and ER strength were significantly higher for the dominant shoulder side in JTG (P < 0.05), without significant differences in ER/IR ratios. CONCLUSIONS: The main finding of this preliminary study confirmed static and dynamic shoulder stabilizer adaptations due to javelin throw practice in a population of adolescent- and national-level javelin throwers.

Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.