Spilleklar : en studie av et oppvarmingsprogram for skadeforebygging i jentefotball

Spilleklar (The 11+) is a comprehensive warm-up programme developed to prevent injuries by improving strength, awareness and neuromuscular control during static and dynamic movements. Its effect was tested in a cluster randomised study of 13-17 year old female football players. For one football season the intervention teams used the complete exercise programme as their warm up for every training session and the running exercises as part of their warm up before every match (65 clubs, 1055 players), whereas the control teams continued to use their ordinary warm-up exercises (60 clubs, 837 players). The primary outcome was defined as an injury to the lower extremity (foot, ankle, lower leg, knee, thigh, groin, and hip). Exposure (participation in training and match), injuries, and to what extent the warm-up programme was carried out in each session (intervention clubs) was reported by coaches on weekly registration forms. A call center was established to record all injuries and contact coaches who were late on mailing the weekly registration forms. Every injured player was contacted by telephone to answer questions about the injury based on a standardised injury questionnaire. Although our primary outcome (an injury to the lower extremity) did not reach statistical significance, there was a significant reduction in several secondary outcome variables, including the rate of severe injuries, overuse injuries, and injuries overall. The risk of injury was reduced by one third and severe injuries by as much as one half among female footballers using the comprehensive warm-up programme

Destructive leadership. : Importance of power and values when leaders bully in organizations. A literature study

Målet med dette arbeidet er å få kunnskaper om lederes mobbing, relatere det til konseptet destruktiv ledelse, og undersøke hvilken betydning makt og verdier kan ha i denne prosessen. Hensikten er å bruke kunnskapen til å bekjempe mobbing. Metode: Dette er en litteraturstudie med et systemteoretisk perspektiv. Mobbingen blir sett på som en dynamisk prosess med interaksjon mellom lederen som mobber, mobbeofferet, arbeidsgruppen og organisasjonen, hvor de alle inngår i et flerdimensjonalt system. Det er lagt stor vekt på å presisere begrepene. Resultater: Det er funnetgode holdepunkter for å hevde at ledere som mobber utøveren meget skadelig form for ledelse. I denne prosessen som har en tendens til å eskalere over tid, spiller makt og verdier en viktig rolle. Ledere med en psykopatisk personlighet kan praktisere ledelse på en måte som får store negative konsekvenser for organisasjonen og de ansatte, og slike personer har en tendens til å misbruke makt. De kan likevel bli ansatt som ledere fordi de har egenskaper som organisasjonen søker og setter pris på. Det er ikke enighet om at mobbing er en uetisk handling. Litteraturen viser at enkelte ledere bruker mobbing strategisk for å oppnå egne fordeler, eller for kontrollere eller straffe de ansatte. Mobbing kan inngå i en bevisst ”organisasjonspolitikk” som blir aksepterti visse organisasjoner. Bedriftsetikk ser i mange sammenhenger ut til å være et begrep uten forpliktende innhold. Det er undersøkt hvordan begrepene managementideologi, instrumentell rasjonalitet og paradokser kan påvirkelederes mobbing. Managementideologien som gjennomsyrer synet på ledelse i store deler av samfunnet, i offentlige organisasjoner i form av New Public Management, er preget av instrumentelle verdier og en utilitaristisk etikk. Dette kan stå i motsetning til den grunnleggende respekt for mennesket som er et fundament i Emmanuel Kants etikk. Konklusjon:Studiet viser atlederes mobbingav ansatte er et meget utbredt og alvorlig problem som er svært ødeleggende for personer og organisasjoner. Det er dermed et betydelig folkehelseproblem.Objectives: This study aimed to gain insight into the process of leaders bullying their subordinates, relate it to the concept of destructive leadership, and examinethe role of power and values in this process. The overall aim was to provide knowledge about how toreduce bullying. Method: This literature study looked at workplace bullying from the perspective of systems theory. Bullying is seen as a dynamic process characterized by interactions between the perpetrator, the victim, the workgroup, and the organization. The author has given priority toprecision of concept definitions. Results: The literature suggests that leaders who bully practicea very destructive form of leadership. Powerand values play an important rolein the bullying process, which tends to escalate over time.Leaders with a psychopathic personality practicea leadership style that may have serious negative consequences for the organization and its employees. Although psychopathic leaders often misuse power they may retain their leadership role because they seem to have personality traits the organization seeks and appreciates. Interestingly, the author found no agreement about bullying being an immoral act. The literature shows that some leaders use bullying strategically for personal gain or to control or punish employees. Bullying may be part of the organization politics accepted by some organizations,and business ethics often sees to be a concept without areal obligation. An overview discusse show the concepts of management ideology, instrumental rationality and paradoxes may affect leaders ́bullying and harassment. Instrumental values and utilitarian ethics dominate the management ideology that strongly influences leadership in a large part of society, and in public organizations such as New Public Management.This is often in opposition to the fundamental respect for the person that is central to the ethics of Emmanuel Kant. Conclusions: This study shows thatorganization leaders who bully their subordinates representa large and serious problem, with very destructive consequences for persons and organizations. Bullying is thus an important public health problemISBN 978-91-86739-83-6</p

Implantation of retropupillary iris-claw lenses: A review on surgical management and outcomes

Iris-claw lenses have gained increasing popularity over the last years and are by many surgeons regarded as viable options in eyes with insufficient capsular or zonular support. The iris-claw lens has two haptics with fine fissures for folding (enclavating) the mid-peripheral part of the iris stroma and can either be placed in front of or posterior to the iris. In particular, the retropupillary implantation has been increasingly chosen probably due to having an anatomical position similar to that of the crystalline lens. The present review is based on a literature review and also on the authors’ clinical experience with this lens, and it focuses on surgical techniques and outcomes especially related to the characteristics of this lens, having haptics with claws that fixate the lens to the posterior iris. Implanting retropupillary iris-claw lenses has a relatively short learning curve, and there are only few complications reported during surgery. Retropupillary iris-claw lenses have demonstrated generally favourable efficiency and safety. However, the outcomes are probably more influenced by the reason for surgery and eye comorbidity than the lens itself. Albeit seldom reported, the postoperative complications have mostly been related to atrophy of the iris at the site of the haptics, or IOL decentration or disenclavation of one of the haptics. To date, however, there are few randomized clinical trials comparing this lens to other lens alternatives in eyes exhibiting insufficient capsular or zonular support for placing the lens in the ciliary sulcus. In the future, prospective studies with large samples should be performed to gain insights into the long-term safety of retropupillary placed iris-claw lenses, and for comparisons with the various other techniques of lens fixation

Prevalence of keratoconus in persons with Down syndrome: a review

Purpose Keratoconus is a vision-threatening condition, and there is a need for knowledge about the occurrence in subgroups of the population. The progression of the disease can be effectively stopped, and vision may be restored, if keratoconus is diagnosed at an early stage. The purpose of this review was to evaluate the literature of the prevalence of keratoconus in persons with Down syndrome.Methods We conducted a literature review of keratoconus prevalence in persons with Down syndrome. A thorough search was performed in Pubmed (Medline), and the quality of evidence was evaluated.Results The literature review identified 20 relevant studies, which reported keratoconus in 0%–71% of persons with Down syndrome. These studies varied greatly in design, patient selection, sample sizes and mean age, and the quality of evidence concerning estimates for the prevalence of keratoconus was generally evaluated as low. Most studies that included adults reported high prevalences of keratoconus–in many studies more than 10-fold the prevalence in the general population. No large screening studies in persons with Down syndrome were identified.Conclusions The present review showed that the prevalence of keratoconus in persons with Down syndrome is higher than in the general population. However, estimates from previous studies vary widely. Screening for keratoconus in this group should be considered

Prevalence of Keratoconus in Persons with down Syndrome in a National Registry in Norway

Keratoconus is an eye condition with distinctive corneal characteristics, including thinning and a conical shape of the cornea. Keratoconus was previously considered rare; however, in recent studies, a prevalence of 0.2% to 0.3% has been reported1 and, in some studies, an even higher prevalence. An association of keratoconus with Down syndrome has been shown,2,3 although the exact reason remains unknown. In some studies, investigators have reported frequencies of keratoconus in persons with Down syndrome of 0% to 71%2-5; however, most have been limited by small sample sizes and biased patient selection. The aim of the present study was to estimate the prevalence of keratoconus among persons with Down syndrome in Norway

High intraocular pressure in eyes with late in-the-bag intraocular lens dislocation

The frequency of late in-the-bag intraocular lens (IOL) dislocation has increased over the past decades. Important predisposing factors are pseudoexfoliation syndrome (PXF), myopia, previous vitreoretinal surgery, and trauma,1–3 and there is also an association with glaucoma.1–4 Furthermore, some studies report high intraocular pressure (IOP) in eyes with IOL dislocation despite no known glaucoma.1–5 Accordingly, it has been speculated whether the dislocation can cause an IOP increase. In a recent study addressing the association between high IOP and spontaneous in-the-bag IOL dislocation, Lorente Bulnes et al.6 found a significant trend toward higher IOP when a lower grade of dislocation was diagnosed. They suggested that movement of the loosened IOL in mild dislocation might cause iris chafing. The aim of the present analysis was to evaluate the possible association between the IOP at diagnosis and the grade of IOL dislocation in a large clinical trial

Long-Term Outcomes after Surgery for Late In-The-Bag Intraocular Lens Dislocation: A Randomized Clinical Trial

Purpose To compare the long-term efficacy and safety of 2 operation methods for late in-the-bag intraocular lens (IOL) dislocation. Design Prospective, randomized, parallel group surgical clinical trial. Methods During a 3-year period, 104 patients (104 eyes) were assigned one group for IOL repositioning by scleral suturing (n = 54) or one group for IOL exchange by retropupillary fixation of an iris claw IOL (n = 50). A single surgeon performed all operations using an anterior approach. Patients were examined before surgery and at 6 months and 1 and 2 years after surgery. The present study included the 66 patients (63%) who completed the 2-year follow-up, and the main outcaome measurement was corrected distance visual acuity (CDVA) 2 years after surgery. Results After 2 years, the mean CDVA was 0.20 ± 0.29 logarithm of the minimum angle of resolution (logMAR) units (range, −0.18 to 1.10) in the repositioning group and 0.22 ± 0.30 logMAR (range, −0.10 to 1.22) in the exchange group (P = .69). A CDVA of 20/40 or better was achieved by 76% of all patients. Four eyes (12%) had cystoid macular edema in the repositioning group compared with 5 eyes (15%) in the exchange group. Two eyes underwent redislocation (1 in each group). There were no cases of endophthalmitis or retinal detachment. Conclusions There were no significant differences between the visual acuity using IOL repositioning and that using IOL exchange 2 years after surgery. The two methods were equally efficient and safe from a long-term perspective and are both considered acceptable treatments

Repositioning surgery of different intraocular lens designs in eyes with late in-the-bag intraocular lens dislocation

Purpose: To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. Setting: Patients referred to Oslo University Hospital Oslo, Norway. Design: Prospective cohort study. Methods: The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by 1 surgeon. The following IOL designs were repositioned: 1-piece foldable (n = 17), 3-piece foldable (n = 28), plate-haptic (n = 8), and 1-piece rigid (n = 1) IOLs. Patients were evaluated comprehensively preoperatively and at 6 months (80%), 1 year (67%), and 2 years (61%) postoperatively. The main outcome measures were efficacy regarding corrected distance visual acuity (CDVA) and spherical equivalent (SE) and safety regarding complications. Results: Postoperative visual acuity was similar for different IOL designs. The mean SE change to final observation was −0.08 (95% CI, −0.93 to 0.77) in the 1-piece IOL group (n = 11) and −0.98 (−1.73 to −0.23) in the 3-piece IOL group (n = 18) (P = .11). Regarding safety, no patients had uveitis–glaucoma–hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece IOL group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. Conclusions: Repositioning surgery of 1-piece IOLs seems as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation

Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial

Purpose: To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation. Methods: In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months. Results: The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was −1.6 ± 1.6 D after IOL repositioning and −0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of −0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients. Conclusions: Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability