Research priorities in light of current trends in microsurgical training: revalidation, simulation, cross-training, and standardisation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly citedPlastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training

Longitudinal changes in physical activity level, body mass index, and oxygen uptake among Norwegian adolescents

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Obesity prevalence in a cohort of women in early pregnancy from a neighbourhood perspective

<p>Abstract</p> <p>Background</p> <p>The evidence of an association between neighbourhood deprivation and overweight is established for different populations. However no previous studies on neighbourhood variations in obesity in pregnant women were found. In this study we aimed to determine whether obesity during early pregnancy varied by neighbourhood economic status.</p> <p>Methods</p> <p>A register based study on 94,323 primiparous pregnant women in 586 Swedish neighbourhoods during the years 19922001. Multilevel technique was used to regress obesity prevalence on socioeconomic individual-level variables and the neighbourhood economic status. Five hundred and eighty-six neighbourhoods in the three major cities of Sweden, Stockholm, Göteborg and Malmö, during 19922001, were included. The majority of neighbourhoods had a population of 4 00010 000 inhabitants.</p> <p>Results</p> <p>Seven per cent of the variation in obesity prevalence was at the neighbourhood level and the odds of being obese were almost doubled in poor areas.</p> <p>Conclusion</p> <p>Our findings supports a community approach in the prevention of obesity in general and thus also in pregnant women.</p

Association between Physical Activity and Cardiovascular Risk in Chinese Youth Independent of Age and Pubertal Stage

<p>Abstract</p> <p>Background</p> <p>Childhood and adolescence are critical periods of habit formation with substantial tracking of lifestyle and cardiovascular risk into adulthood. There are various guidelines on recommended levels of physical activity in youth of school-age. Despite the epidemic of obesity and diabetes in China, there is a paucity of data in this regard in Chinese youth. We examined the association of self-reported level of physical activity and cardiovascular risk in Hong Kong Chinese youth of school-age.</p> <p>Methods</p> <p>This was a cross-sectional study conducted in 2007-8 in a school setting with 2119 Hong Kong Chinese youth aged 6-20 years. Physical activity level was assessed using a validated questionnaire, CUHK-PARCY (The Chinese University of Hong Kong: Physical Activity Rating for Children and Youth). A summary risk score comprising of waist circumference, blood pressure, fasting plasma glucose and lipids was constructed to quantify cardiovascular risk.</p> <p>Results</p> <p>In this cohort, 21.5% reported high level of physical activity with boys being more active than girls (32.1% versus 14.1%, p < 0.001). Regression analysis showed physical activity level, sex and pubertal stage were independently associated with cardiovascular risk score.</p> <p>Conclusion</p> <p>Self-reported level of physical activity is associated with cardiovascular risk factors in Chinese youth after adjusting for sex and pubertal stage.</p

The elite cross-country skier : Clinical and sports related functional tests, dance training, injuries and self-related health

The general aim of this thesis was to study cross-country skiers regarding the effect of dance training on joint mobility and muscle flexibility of the spine, hip and ankle and on speed and agility. Another aim was to perform test-retests of joint mobility and muscle flexibility of the hip and of sports related functional tests. A further aim was to compare high school students with age matched cross-country skiers concerning physical health, activity and location for possible symptoms/injuries. Finally, the aim was to study back pain regarding influence on skiing in high school cross-country skiers. Athletes aged 11 years (8 boys, 3 girls) completed four different test sessions for two sports related functional tests, emphasising speed and agility, the slalom-test and the hurdle-test. No significant differences were found between testing sessions for either the slalom-test (p=0.99) or the hurdle-test (p=0.96). Healthy athletic volunteers (5 males, 5 females) on average 30±16 years performed four joint motion and muscle flexibility tests at three times with one day intervals. The results using intra class correlation coefficients showed the following values 0.99 (knee flexion with hip extended), 0.88 (hip extension with knee extended), 0.93 (hip flexion with knee extended), and 0.53 (a combination of abduction and external rotation of the hip). Subsequently, three out of the four tests showed a good reliability. A group of young (aged 12-15 years) cross-country skiers (n=10) performed dance training during 8 months. Another aged matched group of cross-country skiers (n=10) served as a reference group. Before, during and after the intervention period joint mobility and muscle flexibility of the spine, hip and ankle as well as sports related functional tests were performed in all skiers from both groups. The results showed improvements in speed, agility and range of motion of the spine in most of the studied parameters. A group of elite cross-country skiers (aged 19±3.9 years) either performed additional preseason dance training for 3 months (n=16) or served as a reference group (n=10). Before and after the intervention period joint mobility and muscle flexibility of the spine, hip and ankle and sports related functional tests were performed in all skiers. Prior to dance training the intervention group showed a slight impairment of range of motion of the spine and the relationship between kyphosis of the thoracic and lordosis of the lumbar spine compared with the reference group. After dance training these parameters were improved and a tendency towards a positive effect on back pain was also found. Using a questionnaire cross-country skiers from ski high schools (n=120) were found to be considerably more physical active in as well other sports as skiing when compared with age matched ordinary high school students (n=993). In comparison with controls a higher number of ski high school students described themselves to be physically healthy. Half of the cross-country ski students complained of back problems, mainly low back pain, while skiing and above all during diagonal skiing

The effect of pre-season dance training on physical indices and back pain in elite cross-country skiers: a prospective controlled intervention study

Objective: To evaluate the effect of pre-season dance training on back pain, joint mobility, and muscle flexibility, and on speed and agility in elite cross-country skiers. Methods: 26 skiers participated (mean (SD) age, 19 (3.9) years). An intervention group (n = 16) had 12 weeks of dance training; a control group (n = 10) did not dance; otherwise both groups followed a similar pre-season physical training programme. Joint mobility and muscle flexibility of the spine, hip, and ankle were measured. Two sports related functional tests (slalom and hurdle) were also done. All measurements/tests were carried out before and after the dancing period. Results: Four (of six) subjects from the intervention group who initially complained of ski related back pain did not report back pain after the dance training; the three subjects with back pain from the control group were unchanged. At study onset the intervention group had a slightly impaired range of motion in the spine compared with the control group. After dance training, there was a better relation between kyphosis of the thoracic spine and lordosis of the lumbar spine, and a 7.1° increase in hip flexion with the knee extended (p = 0.02). In the control group hip extension decreased by 0.08 m on average (p = 0.01). No positive effects of dance training on sports related functional tests were observed. Conclusions: Preseason dance training improved the range of hip motion and joint mobility and the flexibility of the spine. These improvements might explain the reduction in ski related back pain in the intervention group