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- Leanderson, Charlotte, et al.
(författare)
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Musculoskeletal injuries in young ballet dancers
- 2011
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 19:9, s. 1531-1535
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of this study was to examine the incidence of musculoskeletal injuries, site and type of injury, and the most common injury diagnoses in young ballet dancers at the Royal Swedish Ballet School, a public school in Stockholm. Methods This retrospective study of 476 students (297 girls and 179 boys) aged 10-21 years was based on medical records for the period August 1988 to June 1995. Data on diagnosis, site of injury and type of injury were collected, and the injuries were classified as traumatic or due to overuse. Results In total, 438 injuries were recorded. The injury incidence rate was 0.8 per 1,000 dance hours in both female and male dancers and tended to increase with increasing age. Most injuries occurred as the result of overuse. Seventy-six per cent of all injuries occurred in the lower extremities. Ankle sprain was the most common traumatic diagnosis, while the most common overuse-related diagnosis was tendinosis pedis. A few gender differences were noted. Conclusions The findings of this study suggest that there is a need to apply primary injury prevention in young ballet dancers. Future studies could aim to identify (1) injury risk factors and (2) injury prevention programmes that are effective at reducing injury rates in young dancers. Level of evidence II.
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| 2. |
- Bengtsson, Torbjörn, et al.
(författare)
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The periodontal pathogen Porphyromonas gingivalis cleaves apoB-100 and increases the expression of apoM in LDL in whole blood leading to cell proliferation
- 2008
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Ingår i: Journal of Internal Medicine. - : Institutionen för medicin och hälsa. - 0954-6820 .- 1365-2796. ; 263:5, s. 558-571
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Several studies support an association between periodontal disease and atherosclerosis with a crucial role for the pathogen Porphyromonas gingivalis. This study aims to investigate the proteolytic and oxidative activity of P. gingivalis on LDL in a whole blood system by using a proteomic approach and analyze the effects of P. gingivalis-modifed LDL on cell proliferation.Methods: The cellular effects of P. gingivalis in human whole blood were assessed using lumi-aggregometry analyzing reactive oxygen species (ROS) production and aggregation. Blood was incubated for 30 min with P. gingivalis, whereafter LDL was isolated and a proteomic approach was applied to examine protein expression. LDL-oxidation was determined by analyzing the formation of protein carbonyls. The effects of P. gingivalis-modifed LDL on fibroblast proliferation were studied using the MTS-assay.Results: Incubation of whole blood with P. gingivalis caused an extensive aggregation and ROS-production, indicating platelet and leukocyte activation. LDL prepared from the bacteria-exposed blood showed an increased protein oxidation, elevated levels of apoM and formation of two apoB-100 N-terminal fragments. P. gingivalis-modified LDL markedly increased the growth of fibroblasts. Inhibition of gingipain R suppressed the modification of LDL by P. gingivalis.Conclusions: The ability of P. gingivalis to change the protein expression and the proliferative capacity of LDL may represent a crucial event in periodontitis-associated atherosclerosis.
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| 3. |
- Fröberg, Maria, et al.
(författare)
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Experiences of a student-run clinic in primary care : A mixed-method study with students, patients and supervisors
- 2018
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 36:1, s. 36-46
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore how a student-run clinic (SRC) in primary health care (PHC) was perceived by students, patients and supervisors.DESIGN: A mixed methods study. Clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T) assessed student satisfaction. Client satisfaction questionnaire-8 (CSQ-8) assessed patient satisfaction. Semi-structured interviews were conducted with supervisors.SETTING: Gustavsberg PHC Center, Stockholm County, Sweden.SUBJECTS: Students in medicine, nursing, physiotherapy, occupational therapy and psychology and their patients filled in questionnaires. Supervisors in medicine, nursing and physiotherapy were interviewed.MAIN OUTCOME MEASURES: Mean values and medians of CLES + T and CSQ-8 were calculated. Interviews were analyzed using content analysis.RESULTS: A majority of 199 out of 227 student respondents reported satisfaction with the pedagogical atmosphere and the supervisory relationship. Most of the 938 patient respondents reported satisfaction with the care given. Interviews with 35 supervisors showed that the organization of the SRC provided time and support to focus on the tutorial assignment. Also, the pedagogical role became more visible and targeted toward the student's individual needs. However, balancing the student's level of autonomy and the own control over care was described as a challenge. Many expressed the need for further pedagogical education.CONCLUSIONS: High student and patient satisfaction reported from five disciplines indicate that a SRC in PHC can be adapted for heterogeneous student groups. Supervisors experienced that the SRC facilitated and clarified their pedagogical role. Simultaneously their need for continuous pedagogical education was highlighted. The SRC model has the potential to enhance student-centered tuition in PHC. Key Points Knowledge of student-run clinics (SRCs) as learning environments within standard primary health care (PHC) is limited. We report experiences from the perspectives of students, their patients and supervisors, representing five healthcare disciplines. Students particularly valued the pedagogical atmosphere and the supervisory relationship. Patients expressed high satisfaction with the care provided. Supervisors expressed that the structure of the SRC supported the pedagogical assignment and facilitated student-centered tuition - simultaneously the altered learning environment highlighted the need for further pedagogical education. Student-run clinics in primary health care have great potential for student-regulated learning.
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| 4. |
- Gummesson, Christina, et al.
(författare)
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Entrustable professional activities (EPAs) for undergraduate medical education : development and exploration of social validity
- 2023
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Ingår i: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders.Aim: The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs.Method and material: In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed.Results: Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’.Conclusion: Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.
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| 5. |
- Leanderson, Charlotte
(författare)
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Musculoskeletal injuries and generalized joint laxity in ballet dancers
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To examine the incidence and type of musculoskeletal injuries in classical ballet dancers, to analyse these injuries in relation to absence from performance, and to identify dancers at risk of frequent injuries in a Swedish professional ballet company (study I). To analyse spinal sagittal mobility and joint laxity in young Swedish ballet dancers in comparison with controls (study II). To assess the incidence of musculoskeletal injuries, the site and type of injury, and the most common injury diagnoses in young ballet dancers at the Royal Swedish Ballet School in Stockholm, Sweden (study III). To investigate age- and gender-specific associations between joint hypermobility, generalized joint laxity and musculoskeletal injuries in young Swedish ballet dancers (study IV). Methods: In study I, 98 professional ballet dancers (48 men, 50 women, average age 28.3, range 17– 47) at the Royal Swedish Ballet in Stockholm were studied in a combined retro-prospective way. All injuries for which the dancers sought medical care during Aug 1988–Jun 1993 at the in-house outpatient clinic were registered. Injury incidence rates per 1,000 activity hours were calculated and 2 test and unpaired t-test were used for statistical analyses. In study II, 23 dance students (11 boys, 12 girls) in 4th grade at the Royal Swedish Ballet School in Stockholm, and 36 controls at a public Swedish school were examined regarding spinal configuration in standing. The spinal sagittal mobility was measured by use of De Brunner’s kyphometer and Myrin’s inclinometer. Joint mobility was measured and registered by employing a modified form of the Contompasis method. For comparison between dancers and the controls, the student’s t-test was used. In Study III, 476 students (297 girls and 179 boys) aged 10–21 at the Royal Swedish Ballet School in Stockholm made up the study group. A 7 year (August 1988 to June 1995) retrospective analysis of medical records in the school orthopaedic outpatient clinic was undertaken. Data on diagnosis, site of injury and type of injury were collected, and the injuries were classified as traumatic or due to overuse. Injury incidence rates per 1,000 activity hours were calculated. Statistical differences for the total injury incidence rates between genders, age groups, and for type of injury were calculated and t-test was used to test statistically significant differences between proportions. In study IV, 216 (130 girls, 86 boys) ballet students in 4th grade were examined while entering the Royal Swedish Ballet School between Aug 1988 and Jun 1995. Joint mobility was measured applying the modified Contompasis method and the results were subdivided into three groups based on the score obtained. Medical records were analysed and all injuries for the period were registered. Injury incidence rates per 1,000 activity hours were calculated. For statistics a conditional risk set model using Cox regression was employed. Results: In study I, 95% of the 98 dancers suffered an injury when employed for one year or more. The dancers incurred 390 injuries over the 5-year study period i.e., 0.6 inj/1,000 activity hours. Most injuries were due to overuse and located in the foot and ankle region. The injury profile differed significantly between the genders and between younger and older dancers. Female dancers more frequently suffered overuse injuries while male dancers more frequently suffered knee injuries. Ankle sprain was the most common diagnosis, mostly occurring among dancers <26 years. In study II, the ballet dancers were found to have a less prominent thoracic kyphosis, lumbar lordosis, and showed a higher incidence of joint mobility. In Study III, the injury incidence was 0.8/1,000 hours of activity and the injury incidence tended to increase with increasing age. The injury panorama in the younger dancers resembled those in professional adult dancers in study I. Most injuries occurred due to over-use, ankle sprain was the most common traumatic injury and tendinosis pedis the most common overuse injury. Study IV showed that more female dancers (32.3%) than male dancers (15.1%) had a manifest generalized joint laxity (GJL). A significantly increased injury risk was found among students with GJL (hazard ratio=1.62, 95% CI=1.09–2.39) Higher age implied an increased injury risk and interaction tests revealed a particularly increased injury risk among those >10 years with manifest GJL. Conclusions: Musculoskeletal injuries are common in both young and adult ballet dancers. The association between GJL and injury risk in young ballet dancers implies that there is a need for screening programmes regarding GJL and appliance of primary prevention in order to prevent musculoskeletal injuries in young ballet dancers.
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