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[Abstract] Objective. To determine and analyse the organisational approach adopted by Spanish rheumatologists to osteoporosis (OP) to define strategic priorities. Material and method. A group of experts designed a questionnaire on OP in the rheumatologist practice. The survey was sent to the Spanish Society of Rheumatology (SER) members. Through the Delphi round, strategic priorities were agreed upon in OP. Results. The priorities are: 1) The SER should promote the inclusion of OP in 100% of the services and expand the training offer; 2) Rheumatology services should promote the role of the nurse in OP, promote quality indicators and referral protocols agreed with primary care in addition to promoting their training in this area; 3) The SER and Rheumatology services should promote electronic consultation, OP monographic clinics and participation in Fracture Liaison Service units. Conclusions. Strategic priorities in OP help identify areas of improvement at organisational, structural and quality standards level in this pathology. [Resumen] Introducción. Los estudios de opinión sobre la percepción del reumatólogo de la práctica asistencial en osteoporosis (OP) pueden ayudar a identificar áreas de mejora en la gestión de esta patología. Objetivo. Conocer y analizar el enfoque organizativo que adoptan los reumatólogos españoles ante la OP para definir prioridades estratégicas y establecer unos estándares de calidad. Material y método. Un grupo de expertos diseñó una encuesta sobre creencias y conductas en OP en la práctica del reumatólogo. La encuesta se remitió a los socios de la Sociedad Española de Reumatología (SER). Mediante ronda Delphi se consensuaron las prioridades estratégicas en OP. Resultados. El grupo de expertos consensuó como prioridades estratégicas en OP: 1) La SER debería impulsar la inclusión de la OP en el conjunto de prestaciones de todos los servicios de reumatología, así como ampliar la oferta formativa específica para médicos y enfermeras; 2) Los servicios de reumatología debieran fomentar el papel de la enfermera en OP, impulsar la implantación y el seguimiento de indicadores de calidad e implantar protocolos de derivación consensuados con atención primaria además de impulsar su formación en este área; 3) La SER y los servicios de reumatología deberían impulsar la implantación de la consulta electrónica y la consulta monográfica o dedicada a OP así como la participación del reumatólogo en unidades de fractura Fracture Liaison Service (FLS). Conclusiones. Las prioridades estratégicas en OP derivadas de la encuesta a los reumatólogos españoles ayudan a identificar las áreas de mejora a nivel organizativo, estructural y de estándares de calidad en esta patología.

The 1991 explosive eruptions of Hudson volcano in southern Chile produced 2.7 km3 (dense rock equivalent) of basalt and trachyandesite tephra during the period August 8-15. The initial basaltic phase (phase I, August 8-9) produced a maximum column height of 12 km above sea level (ASL) and tephra fallout was directed to the north and northeast by the prevailing winds. The paroxysmal trachyandesitic phase (phase II, August 12-15) involved at least three separate events with a maximum ∼ 18-km-high (ASL) eruption column inferred from satellite temperature data. During the initial 24 h of this phase the plume was advected almost directly south, before swinging towards the east as the wind changed direction. The plume was ultimately directed to the southeast and stayed relatively fixed at this bearing for the remainder of the eruption. These temporal variations in the main dispersal direction during the earlier stages of the phase II eruption produced a much wider overall deposit than would be expected from a plume with a relatively fixed transport direction (e.g., latter stages of phase II). The Lagrangian ash tracking model PUFF was utilized to simulate the 1991 explosive eruptions and was able to successfully reproduce the aerial distribution and temporal evolution of the plumes. The optimal agreement between the observed and simulated plumes occurs when the highest concentration of ash particles coincides with the tropopause, a height that is typically lower than the maximum observed column heights for the 1991 eruptions. Gravitational settling of the laterally spreading umbrella region (e.g., Pinatubo 1991) may result in the concentration of ash at this level. This may account for differences in column height estimates between ground- or satellite-based and lithic-based models. The plume associated with the paroxysmal phase (August 12-15, 1991) produced a multilayered deposit composed of alternating layers of fine ash and pumice lapilli. The highly stratified nature of the fall deposit is likely the result of multiple eruptive events coupled with a time varying wind field. A strongly changing wind direction that occurred during the earlier stages of the paroxysmal eruption could have produced variations in the dominant grain size being deposited between fine ash and pumice lapilli during individual eruptive sequences. Fil: Kratzmann, David J.. University of Rhode Island; Estados Unidos Fil: Carey, Steven N.. University of Rhode Island; Estados Unidos Fil: Fero, Julie. University of Rhode Island; Estados Unidos Fil: Scasso, Roberto Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Geociencias Básicas, Aplicadas y Ambientales de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Geociencias Básicas, Aplicadas y Ambientales de Buenos Aires; Argentina Fil: Naranjo, Jose Antonio. Servicio Nacional de Geología y Minería; Chile