Official Positions for FRAX® clinical regarding international differences from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

Osteoporosis is a serious worldwide epidemic. Increased risk of fractures is the hallmark of the disease and is associated with increased morbidity, mortality and economic burden. FRAX® is a web-based tool developed by the Sheffield WHO Collaborating Center team, that integrates clinical risk factors, femoral neck BMD, country specific mortality and fracture data and calculates the 10 year fracture probability in order to help health care professionals identify patients who need treatment. However, only 31 countries have a FRAX® calculator at the time paper was accepted for publication. In the absence of a FRAX® model for a particular country, it has been suggested to use a surrogate country for which the epidemiology of osteoporosis most closely approximates the index country. More specific recommendations for clinicians in these countries are not available. In North America, concerns have also been raised regarding the assumptions used to construct the US ethnic specific FRAX® calculators with respect to the correction factors applied to derive fracture probabilities in Blacks, Asians and Hispanics in comparison to Whites. In addition, questions were raised about calculating fracture risk in other ethnic groups e.g., Native Americans and First Canadians. In order to provide additional guidance to clinicians, a FRAX® International Task Force was formed to address specific questions raised by physicians in countries without FRAX® calculators and seeking to integrate FRAX® into their clinical practice. The main questions that the task force tried to answer were the following: The Task Force members conducted appropriate literature reviews and developed preliminary statements that were discussed and graded by a panel of experts at the ISCD-IOF joint conference. The statements approved by the panel of experts are discussed in the current paper.

FRAX(®) Clinical Task Force of the 2010 Joint International Society for Clinical Densitometry & International Osteoporosis Foundation Position Development Conference.

The World Health Organization fracture risk assessment tool, FRAX(®), is an advance in clinical care that can assist in clinical decision-making. However, with increasing clinical utilization, numerous questions have arisen regarding how to best estimate fracture risk in an individual patient. Recognizing the need to assist clinicians in optimal use of FRAX(®), the International Osteoporosis Foundation (IOF) in conjunction with the International Society for Clinical Densitometry (ISCD) assembled an international panel of experts that ultimately developed joint Official Positions of the ISCD and IOF advising clinicians regarding FRAX(®) usage. As part of the process, the charge of the FRAX(®) Clinical Task Force was to review and synthesize data surrounding a number of recognized clinical risk factors including rheumatoid arthritis, smoking, alcohol, prior fracture, falls, bone turnover markers and glucocorticoid use. This synthesis was presented to the expert panel and constitutes the data on which the subsequent Official Positions are predicated. A summary of the Clinical Task Force composition and charge is presented here.

Copresence video conference mediated interaction

Abstract

Church and people in Britain and Scandinavia -konferenssi Yorkissa

Hanna-Maija Ketola & Mika Nokelainen

Clinical review: Update on neurally adjusted ventilatory assist - report of a round-table conference.

ABSTRACT: Conventional mechanical ventilators rely on pneumatic pressure and flow sensors and controllers to detect breaths. New modes of mechanical ventilation have been developed to better match the assistance delivered by the ventilator to the patient's needs. Among these modes, neurally adjusted ventilatory assist (NAVA) delivers a pressure that is directly proportional to the integral of the electrical activity of the diaphragm recorded continuously through an esophageal probe. In clinical settings, NAVA has been chiefly compared with pressure-support ventilation, one of the most popular modes used during the weaning phase, which delivers a constant pressure from breath to breath. Comparisons with proportional-assist ventilation, which has numerous similarities, are lacking. Because of the constant level of assistance, pressure-support ventilation reduces the natural variability of the breathing pattern and can be associated with asynchrony and/or overinflation. The ability of NAVA to circumvent these limitations has been addressed in clinical studies and is discussed in this report. Although the underlying concept is fascinating, several important questions regarding the clinical applications of NAVA remain unanswered. Among these questions, determining the optimal NAVA settings according to the patient's ventilatory needs and/or acceptable level of work of breathing is a key issue. In this report, based on an investigator-initiated round table, we review the most recent literature on this topic and discuss the theoretical advantages and disadvantages of NAVA compared with other modes, as well as the risks and limitations of NAVA.

Aplicación de realidad aumentada para dispositivos móviles destinada a espacios culturales. Ejemplo de desarrollo: Museu Episcopal de Vic

Proyecto de aplicación para dispositivos móviles que utiliza la Realidad Aumentada (RA) para contextualizar obras artísticas. Es un producto pensado para museos y galerías pero también para espacios exteriores que posean elementos de valor cultural. Sin embargo, y para servir de ejemplo se ha aplicado en seis piezas destacadas del Museo Episcopal de Vic. Aunque en Europa y EE.UU. los museos ya están innovando en este terreno, en España, que es donde se enmarca el proyecto, existe una carencia de elementos de mediación cultural como estos; sobre todo en los museos de arte donde las obras acostumbran a presentarse despojadas de cualquier herramienta que proporcione información complementaria. Existe, por tanto, una descontextualización del arte que crea barreras para el entendimiento del público general. De esta situación de carencia parte el objetivo principal del producto, el de aprovechar las posibilidades de la RA para mejorar la experiencia y el diálogo entre el visitante y la obra, aportando conocimiento y fomentando el aprendizaje.

Informe sobre la 63a IFLA Conference (Copenhaguen, setembre de 1997)

La conferència anual de l'IFLA (International Federation of Library Associations and Institutions) -enguany la 63a- va tenir lloc a Copenhaguen, Dinamarca, entre el 30 d'agost i el 6 de setembre de 1997. Els congressos de l'IFLA tenen un contingut professional que abraça tots els àmbits de la biblioteconomia. Durant la setmana que dura el congrés les diverses seccions, taules rodones i altres grups en què s'organitza l'entitat mantenen reunions tancades en les quals es revisen els objectius del grup i els treballs duts a terme durant l'any, es planifiquen nous projectes i es preparen les properes reunions. Així mateix, cada grup organitza sessions obertes i seminaris en els quals es presenten treballs i es debaten qüestions professionals.