Surveillance of atypical femoral fractures in a nationwide fracture register

Background and purpose — To continuously assess the incidence of atypical femoral fractures (AFFs) in the population is important, to allow the evaluation of the risks and benefits associated with osteoporosis treatment. Therefore, we investigated the possibility to use the Swedish Fracture Register (SFR) as a surveillance tool for AFFs in the population and to explore means of improvement. Patients and methods — All AFF registrations in the SFR from January 1, 2015 to December 31, 2018 were enrolled in the study. For these patients, radiographs were obtained and combined with radiographs from 176 patients with normal femoral fractures, to form the study cohort. All images were reviewed and classified into AFFs or normal femur fractures by 2 experts in the field (gold-standard classification) and 1 orthopedic resident educated on the specific radiographic features of AFF (educated-user classification). Furthermore, we estimated the incidence rate of AFFs in the population captured by the register through comparison with a previous cohort and calculated the positive predictive value (PPV) and, where possible, the inter-observer agreement (Cohen’s kappa) between the different classifications. Results — Of the 178 available patients with AFF in the SFR, 104 patients were classified as AFF using the goldstandard classification, and 89 using the educated-user classification. The PPV increased from 0.58 in the SFR classification to 0.93 in the educated-user classification. The interobserver agreement between the gold-standard classification and the educated-user classification was 0.81. Interpretation — With a positive predictive value of 0.58 the Swedish Fracture Register outperforms radiology reports and reports to the Swedish Medical Products Agency on adverse drug reactions as a diagnostic tool to identify atypical femoral fractures.

Fundus Examination in Pediatric Patients Using Indirect Ophthalmoscopy

The goal of this chapter is to provide the clinician with an understanding of binocular indirect ophthalmoscopy (BIO) and helpful clinical techniques for success in examining the fundus of the pediatric patient, including scleral depression. The challenging technique to examine the premature infant at risk for retinopathy of prematurity will be explained in detail, including the standard classification of the disease with photos depicting the different location and stages of disease. BIO with the addition of scleral indentation helps the clinician diagnose and locate lesions that may otherwise go undetected, such as retinal holes, tears, or vitreoretinal adhesions. Complete examination of the fundus of a child is no less important than of any other patient who seeks eye care but often requires efficiency and precision (as well as many human arms). Time is a rate limiting aspect when examining children so preparation and experience will lead to success.

International science and education classification: The place of library science

Through the Order of the RF Ministry of Science and Higher Education of February 24, 2021, on the Nomenclature of Scientific Professions to be awarded academic degrees, the speciality 05.25.03 «Library science, bibliography, and bibliology» was excluded from this nomenclature. The concerns arouse that this speciality might be excluded from the educational programs. The post-graduate programs is to become the third level of higher education. One more attempt should be made to stand for our profession by referring to global precedents, i. e. to the International Standard Classification of Education (ISCE), adopted by the UNESCOGeneral Assembly in 2011, and to FOS (Revised field of science and technology, classification in the Frascati manual). The latter is the international classification of science and technology adopted and approved by 75% world countries to represent scientific disciplines and to unify world statistical data. In both classifications, library science is specified as an independent discipline within the social sciences unit.

Measuring the telework potential of jobs: evidence from the International Standard Classification of Occupations

The coronavirus disease (COVID-19) pandemic has triggered and accelerated the shift of firms and businesses to adopt flexible alternative work arrangements such as teleworking or working from home (WFH) set-ups. To effectively transition to the ‘new normal’ of work, this paper measures the telework potential of jobs or the degree to which a job can be feasibly done at home or offsite. Using the task-based framework, this paper constructs continuous ‘teleworkability’ indices by implementing a classification process of the occupational tasks listed in the International Standard Classification of Occupations 2008 (ISCO-08) and based on the telework indicators in the literature. The correlates of these indices are estimated. Also, the indices are applied to Philippine occupations. The primary contribution of this paper is the set of ‘teleworkability’ indices for all 427 occupations (4-digit ISCO) to describe the telework potential of jobs in countries which pattern their local occupational codes to ISCO-08.

Zwischenfach: Paradox or Paradigm?

<p>Singers within the operatic world are expected to conform to the strict limits and dictates of the Fachsystem. Casting directors and opera companies prefer to be informed of which particular ‘Fach-box’ you tick when auditioning and it is becoming increasingly important for career advancement and name recognition to remain within that box. Yet what happens when your voice does not operate strictly within the predetermined requirements of a particular box? Or if the vocal category you supposedly assume is already ambiguous and contentious? Jennifer Allen’s DMA thesis, An Analysis and Discussion of Zwischenfach Voices, provides invaluable critical insight surrounding this enigmatic concept of voice categorisation. Allen argues that despite advances within vocal pedagogy, there remains a ‘gray area’ within the discussion. This elusiveness, to which Allen refers, pertains directly to the Zwischenfach voice type. Translated literally from German, the word Zwischen means ‘between’ and ‘Fach’ refers specifically to vocal specialisation as a way of categorising singers according to the weight, range and colour of their voices. Thus, in its most basic form, a Zwischenfach voice denotes a voice that lies between the vocal categories of soprano and mezzo-soprano. However, whilst Dr Rudolf Kloiber’s Handbuch der Oper (a staple for the operatic world) provides a definitive guide to vocal categorisation and continues to influence casting throughout Germany and Europe, the corresponding American Boldrey Guide acknowledges Zwischenfach as a voice that cannot be classified precisely in one particular Fach or another. This lack of uniform approach highlights not only the potential flexibility of this voice, but also the paradoxical nature of attempting to define a voice that defies standard classification. Indeed, as a young singer currently singing high mezzo-soprano repertoire, I have found the Zwischenfach labelling to be a paradox, for the upper extension of my voice also enables me potentially to sing some soprano roles. Therefore, is it conceivable to postulate that this term is a misnomer and merely highlights the issues associated with being constrained within the Fachsystem? In order to come to terms with these issues, then, my analysis of Zwischenfach labelling requires a separation of voice categorisation and the Fachsystem and an ongoing critique of these systems throughout my exegesis. In an attempt to determine its practicalities, the limits that it can impose, and how its boundaries have not always functioned so neatly, my critique focuses on elements such as convenience, marketability and professional development and life. An exploration of the relevance of aspects such as range, tessitura, passaggi, timbre, agility, physical characteristics, pitch of the speaking voice, and scientific tests is also necessary. Once a definition of Zwischenfach is established, I consider the “in between” nature of this vocal category as I investigate roles that develop out of this into the realm of the heavier, more dramatic voice. Finally, I explore the implications of switching between Fächer and divulge how I incorporate the contradictions within this category with the successful management of the label. The piecing together of existing scholarship surrounding this field of research and the practical application to my own expanding repertoire is invaluable in facilitating the expansion of my knowledge in regard to my own progression through Zwischenfach repertoire and roles.</p>

Zwischenfach: Paradox or Paradigm?

<p>Singers within the operatic world are expected to conform to the strict limits and dictates of the Fachsystem. Casting directors and opera companies prefer to be informed of which particular ‘Fach-box’ you tick when auditioning and it is becoming increasingly important for career advancement and name recognition to remain within that box. Yet what happens when your voice does not operate strictly within the predetermined requirements of a particular box? Or if the vocal category you supposedly assume is already ambiguous and contentious? Jennifer Allen’s DMA thesis, An Analysis and Discussion of Zwischenfach Voices, provides invaluable critical insight surrounding this enigmatic concept of voice categorisation. Allen argues that despite advances within vocal pedagogy, there remains a ‘gray area’ within the discussion. This elusiveness, to which Allen refers, pertains directly to the Zwischenfach voice type. Translated literally from German, the word Zwischen means ‘between’ and ‘Fach’ refers specifically to vocal specialisation as a way of categorising singers according to the weight, range and colour of their voices. Thus, in its most basic form, a Zwischenfach voice denotes a voice that lies between the vocal categories of soprano and mezzo-soprano. However, whilst Dr Rudolf Kloiber’s Handbuch der Oper (a staple for the operatic world) provides a definitive guide to vocal categorisation and continues to influence casting throughout Germany and Europe, the corresponding American Boldrey Guide acknowledges Zwischenfach as a voice that cannot be classified precisely in one particular Fach or another. This lack of uniform approach highlights not only the potential flexibility of this voice, but also the paradoxical nature of attempting to define a voice that defies standard classification. Indeed, as a young singer currently singing high mezzo-soprano repertoire, I have found the Zwischenfach labelling to be a paradox, for the upper extension of my voice also enables me potentially to sing some soprano roles. Therefore, is it conceivable to postulate that this term is a misnomer and merely highlights the issues associated with being constrained within the Fachsystem? In order to come to terms with these issues, then, my analysis of Zwischenfach labelling requires a separation of voice categorisation and the Fachsystem and an ongoing critique of these systems throughout my exegesis. In an attempt to determine its practicalities, the limits that it can impose, and how its boundaries have not always functioned so neatly, my critique focuses on elements such as convenience, marketability and professional development and life. An exploration of the relevance of aspects such as range, tessitura, passaggi, timbre, agility, physical characteristics, pitch of the speaking voice, and scientific tests is also necessary. Once a definition of Zwischenfach is established, I consider the “in between” nature of this vocal category as I investigate roles that develop out of this into the realm of the heavier, more dramatic voice. Finally, I explore the implications of switching between Fächer and divulge how I incorporate the contradictions within this category with the successful management of the label. The piecing together of existing scholarship surrounding this field of research and the practical application to my own expanding repertoire is invaluable in facilitating the expansion of my knowledge in regard to my own progression through Zwischenfach repertoire and roles.</p>

An Analysis of Traditional Ecological Knowledge's Status and its Conservation Options

<p>The value of Traditional Ecological Knowledge (TEK) has been recognised and discussed widely in the literature and in public media over the last six decades. Over the same time period, the declining trend in TEK has been frequently reported across multiple case studies in every major region of the globe. As a result, a great number of international agreements (e.g. the Convention on Biological Diversity and the Declaration on the Rights of Indigenous Peoples) have been established in attempt to protect indigenous rights. However, in many cases these agreements have not transformed into concrete TEK conservation actions at the ground level. Several key literature gaps are identified through this research: the lack of a review of 1) global patterns in the status of TEK; 2) threats to TEK; 3) TEK conservation options; 4) the lack of standard classification systems of TEK threats and conservation actions; 5) the status of TEK and conservation of TEK in Inner Mongolia China is largely unknown to the outside world; and 6) the limited understanding of the role of government policy on TEK trajectories in Inner Mongolia. To develop TEK threat and conservation action typologies is one major target of this research. This is because a standard classification system provides a common language for practitioners to identify problems and solutions, and to communicate across projects. More importantly, it provides a tool for identifying global patterns of TEK and creating a global network and common databases for TEK monitoring, thus to inform conservation actions. However, such a system is missing from the current literature. Part one of this research applied a mixture of quantitative and qualitative methods, including a global survey (n=137), its follow-up interviews (n=46), and a comprehensive literature review (n=152). The qualitative data analysis produced 1) a typology of TEK threats; 2) an analysis of the complex causal web among all TEK threats; 3) a typology of conservation actions; 4) the triggers and barriers to TEK conservation success; and 5) three design principles for effective TEK conservation. The quantitative data analysis explored 1) the responses’ geographical distribution; 2) the overall trend of TEK change; and 3) the significance of different categories of TEK threats and conservation options. Part two of this research is a case study in Inner Mongolia with two critical outputs: 1) an examination of the impact of Chinese government policies on traditional resource management institutions over time; and 2) an application of the TEK typologies to analyse the current status of TEK and possible interventions in Inner Mongolia. The study applied three qualitative research methods: semi-structured interviews (n=91), group discussion (n=5 with 64 participants), and participant observation (eight weeks). The study found that in general government policies (from the1950s – 2007) had negatively affected Mongolian TEK and almost destroyed traditional institutions. However, the new Cooperative Law (2007) may positively impact local TEK by supporting community cooperative organisations and their activities of revitalising traditional herding practices, collective working relationships and traditional leadership. Through applying the typologies to the case study, this research provides a model of how to identify TEK threats and design conservation actions in real-world situations. Three core messages emerged from this research: 1) dealing with TEK threats and applying TEK conservation have to take a social-ecological system approach, in which social, political, cultural, economic and ecological aspects are all embedded; 2) the design and implementation of TEK conservation have to be cross-scale arrangements, in which the institutions from the local level up to the national and international levels are accommodated; and 3) power relations are at the core of achieving sustainable resource management and effective community empowerment. The cooperation between different levels of organisations and among different groups at the same levels requires appropriate power sharing. In a word, TEK is a complex, dynamic and systematic issue, TEK threats take place at multiple levels simultaneously. Therefore, to deal with TEK threats needs a complex, adaptive and systematic approach with holistic worldviews as the intellectual foundation.</p>

An Analysis of Traditional Ecological Knowledge's Status and its Conservation Options

<p>The value of Traditional Ecological Knowledge (TEK) has been recognised and discussed widely in the literature and in public media over the last six decades. Over the same time period, the declining trend in TEK has been frequently reported across multiple case studies in every major region of the globe. As a result, a great number of international agreements (e.g. the Convention on Biological Diversity and the Declaration on the Rights of Indigenous Peoples) have been established in attempt to protect indigenous rights. However, in many cases these agreements have not transformed into concrete TEK conservation actions at the ground level. Several key literature gaps are identified through this research: the lack of a review of 1) global patterns in the status of TEK; 2) threats to TEK; 3) TEK conservation options; 4) the lack of standard classification systems of TEK threats and conservation actions; 5) the status of TEK and conservation of TEK in Inner Mongolia China is largely unknown to the outside world; and 6) the limited understanding of the role of government policy on TEK trajectories in Inner Mongolia. To develop TEK threat and conservation action typologies is one major target of this research. This is because a standard classification system provides a common language for practitioners to identify problems and solutions, and to communicate across projects. More importantly, it provides a tool for identifying global patterns of TEK and creating a global network and common databases for TEK monitoring, thus to inform conservation actions. However, such a system is missing from the current literature. Part one of this research applied a mixture of quantitative and qualitative methods, including a global survey (n=137), its follow-up interviews (n=46), and a comprehensive literature review (n=152). The qualitative data analysis produced 1) a typology of TEK threats; 2) an analysis of the complex causal web among all TEK threats; 3) a typology of conservation actions; 4) the triggers and barriers to TEK conservation success; and 5) three design principles for effective TEK conservation. The quantitative data analysis explored 1) the responses’ geographical distribution; 2) the overall trend of TEK change; and 3) the significance of different categories of TEK threats and conservation options. Part two of this research is a case study in Inner Mongolia with two critical outputs: 1) an examination of the impact of Chinese government policies on traditional resource management institutions over time; and 2) an application of the TEK typologies to analyse the current status of TEK and possible interventions in Inner Mongolia. The study applied three qualitative research methods: semi-structured interviews (n=91), group discussion (n=5 with 64 participants), and participant observation (eight weeks). The study found that in general government policies (from the1950s – 2007) had negatively affected Mongolian TEK and almost destroyed traditional institutions. However, the new Cooperative Law (2007) may positively impact local TEK by supporting community cooperative organisations and their activities of revitalising traditional herding practices, collective working relationships and traditional leadership. Through applying the typologies to the case study, this research provides a model of how to identify TEK threats and design conservation actions in real-world situations. Three core messages emerged from this research: 1) dealing with TEK threats and applying TEK conservation have to take a social-ecological system approach, in which social, political, cultural, economic and ecological aspects are all embedded; 2) the design and implementation of TEK conservation have to be cross-scale arrangements, in which the institutions from the local level up to the national and international levels are accommodated; and 3) power relations are at the core of achieving sustainable resource management and effective community empowerment. The cooperation between different levels of organisations and among different groups at the same levels requires appropriate power sharing. In a word, TEK is a complex, dynamic and systematic issue, TEK threats take place at multiple levels simultaneously. Therefore, to deal with TEK threats needs a complex, adaptive and systematic approach with holistic worldviews as the intellectual foundation.</p>