gravity forward increasing the frequency of falling over. However, the relation of vertebral deformities with risk of fracture was independent of frequency of falling. Secondly, and we believe more likely, vertebral deformities may reflect impaired bone strength in the whole skeleton since the relation was independent of bone mineral density. We conclude that by assessing the degree of spinal deformity patients with a fourfold increased risk of future non-vertebral fractures can be identified.1 Cooper C, Campion G, Melton U III. Hip fractures in the elderly: a world-wide projection. Osteoporosis Int 1992;2:285-9. 2 Consensus development conference: prophylaxis and treatment of osteoporosis. We wish to use the information from our study to try to improve our language service. We have produced audio tapes of some information3 and are also working on video tapes in different languages. We believe that producing information in these forms is a better use of resources than simply providing written information. If written information is often unhelpful in the elective setting it will be more so in the acute setting. Purchasers should therefore recognise the value of interpreting services in areas such as labour suites and casualty units. They must also realise, however, that these services would need to be adequately resourced.We acknowledge the help of the liaison workers

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