Physical activity, muscle function, falls and fractures

STUDY DESIGN: A thematic review. OBJECTIVES: To evaluate if physical activity enhances muscle strength, improves balance, and reduces the fall frequency and the fracture incidence. BACKGROUND: One of the major medical problems of today is the increasing incidence of fragility fractures. Muscle strength and fall is one of the major determinants of a fracture. If physical activity could increase muscle strength, improve balance and reduce the fall frequency, then training could be recommended as prevention for fractures. METHODS: The review used Medline (Pub Med) and the search words exercise, physical activity, muscle strength, balance, falls, fractures. Randomized controlled trials (RCT) were predominantly included, although this not is a systematic review. RESULTS: The evidence that physical activity modifies the risk factors for fall is compelling, although RCT with fractures as end point are lacking. Physical activity is associated with improved muscle strength, co-ordination and balance. Physical training increases muscle strength also in octogenarians by up to 200%, i.e. a much more pronounced effect than the corresponding increase in muscle volume or bone mass. There is also evidence that physical activity decreases the actual number of falls. Observational cohort and case-control studies imply that physical activity is associated with reduced hip fracture risk. If exercise reduces the number of vertebral fractures and other fragility fractures are less evaluated. CONCLUSIONS: Physical activity in older ages can be recommended to improve muscle strength and balance, to reduce the risk to fall and fractures, although the highest level of evidence - RCT with fracture as endpoint - is lacking

Sustainability of exercise-induced increases in bone density and skeletal structure

BACKGROUND: The prevalence of osteoporosis with related fragility fractures has increased during the last decades. As physical activity influences the skeleton in a beneficial way, exercise may hypothetically be used as a prophylactic tool against osteoporosis. OBJECTIVE: This review evaluates if exercise-induced skeletal benefits achieved during growth remain in a long-term perspective. DESIGN: PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content (BMC), bone mineral density (BMD) and skeletal structure. We based our inferences on publications with the highest level of evidence, particularly randomised controlled trials (RCT). RESULTS: Benefits in BMD achieved by exercise during growth seem to be eroded at retirement, but benefits in skeletal structure may possibly be retained in a longer perspective. Recreational exercise seems to at least partially maintain exercise-induced skeletal benefits achieved during growth. CONCLUSIONS: Exercise during growth may be followed by long-term beneficial skeletal effects, which could possibly reduce the incidence of fractures. Exercise during adulthood seems to partly preserve these benefits and reduce the age-related bone loss

Physical activity increases bone mass during growth

BACKGROUND: The incidence of fragility fractures has increased during the last half of the 1990's. One important determinant of fractures is the bone mineral content (BMC) or bone mineral density (BMD), the amount of mineralised bone. If we could increase peak bone mass (the highest value of BMC reached during life) and/or decrease the age-related bone loss, we could possibly improve the skeletal resistance to fracture. OBJECTIVE: This review evaluates the importance of exercise as a strategy to improve peak bone mass, including some aspects of nutrition. DESIGN: PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content, bone mineral density, BMC, BMD, skeletal structure and nutrition. We included studies dealing with exercise during growth and young adolescence. We preferably based our inferences on randomised controlled trials (RCT), which provide the highest level of evidence. RESULTS: Exercise during growth increases peak bone mass. Moderate intensity exercise intervention programs are beneficial for the skeletal development during growth. Adequate nutrition must accompany the exercise to achieve the most beneficial skeletal effects by exercise. CONCLUSION: Exercise during growth seems to enhance the building of a stronger skeleton through a higher peak bone mass and a larger bone size

Patients with shoulder impingement remain satisfied 6 years after arthroscopic subacromial decompression: A prospective study of 46 patients

Background Although arthroscopic subacromial decompression (ASD) is a common procedure for treatment of shoulder impingement, few long term results have been published. In this prospective study, we determined whether the high degree of patient satisfaction at 6 months postoperatively reported by us earlier remained at the 6-year follow-up. Patients and methods We originally reported high patient satisfaction 6 months after ASD for shoulder impingement in 50 prospectively studied patients using the Disability of the Arm Shoulder and Hand questionnaire (DASH) and the Visual Analog Scale (VAS). Patients with associated shoulder disorders were excluded. The surgeons were experienced shoulder arthroscopists. 6 years after surgery, the DASH questionnaire and the VAS were sent to these 50 patients. 2 patients had other medical problems of the upper extremity that affected the DASH and VAS scores, 1 patient was lost to follow-up, and another refused to participate. Thus, 46 patients with a mean age of 55 (33-78) years were included in this 6-year evaluation. Results The considerable improvement in both the DASH score and the VAS that was observed 6 months after surgery persisted or had even improved 6 years after surgery. Interpretation Properly selected patients with shoulder impingement treated with ASD remain satisfied 6 years after surgery

Long-term outcome of displaced radial neck fractures in adulthood: 16–21 year follow-up of 5 patients treated with radial head excision

Background There have been no reports on the long-term outcome of radial neck Mason type IIIb fractures in adults

Värdering av förvaltningsfastigheter -En studie om vilka parametrar som är viktiga vid värdering av förvaltningsfastigheter

Detta är en kandidatuppsats i företagsekonomi med inriktning på externredovisning vid Göteborgs Universitet. Den är författad av Jonas Winberg och Anders Nordqvist med handledning av Professor Thomas Polesie. Bakgrunden till vår forskning, och problematiken, ligger i att det idag inte är alldeles lätt att värdera förvaltningsfastigheter, det finns en uppsjö av värden för en och samma fastighet. Vilket värde är mest korrekt och vilka parametrar ligger till grund för värderingen? Att fånga de viktigaste parametrarna som ligger till grund för värderingen kan ibland vara svårt. Långt ifrån alla kan mätas i monetära termer. De olika intressenterna som idag finns ligger också som en stor påverkande faktor för värderingen och detta resulterar i olika marknadsvärden för olika användare. Syftet med uppsatsen är att undersöka vilka parametrar som är viktigast vid värdering av förvaltningsfastigheter. Uppsatsen syftar också till att få en större allmän kunskap om värdering av förvaltningsfastigheter. Vi har valt att avgränsa oss till ett företag från varje perspektiv som bedriver verksamhet i Sverige. Med det menas att en bank intervjuats, en revisionsbyrå och ett förvaltningsföretag. Svenska marknaden och främst Göteborgsregionen har legat som grund för uppsatsen. Avgränsning har även gjorts då vi endast har studerat förvaltningsfastigheter och inte rörelsefastigheter. Vi kan slutligen konstatera att värdering av förvaltningsfastigheter inte alltid är simpelt. Vi har kommit fram till att de två viktigaste parametrarna som ligger till grund för marknadsvärdering är användningsområdet för byggnaden samt dess läge. Detta för att dessa variabler är väldigt svåra att förändra, samt att riskerna associerade med fastigheten till stor del beror på dessa. Revisionsbolag, banker och förvaltningsföretag kan konstateras ha liknande tillvägagångsätt vid värdering men med sin egen prägel. Man bör också ställa sig kritisk till många värderingar och noggrant granska dem, då de ofta är orealiserade. Vidare forskning behövs för att få en bättre uppfattning om ämnet. Framför allt kan en kvantitativ studie vara av intresse

Upper Secondary School Science Teachers’ Values in Sweden : What Decides What is Taught?

There is a substantial literature in science education research showing that many students experience a lack of relevance in science education. For this reason, science teachers’ selection ofcontent and the way content is treated when exposed to students for learning purposes is animportant part of the problem. In this connection, research show that science teachers’ valuesstrongly infuence several aspects of teaching and learning science. Therefore, science teachers’values are important to investigate, to be empirically informed and to be able to develop scienceeducation. Accordingly, there is an increased volume of research studies about teachers’ values in science education and their efects. The study presented here is part of a larger nationalexploration of biotechnology education in upper secondary schools in Sweden and contributesby showing variation in teachers’ values and relations with practice. Theoretically, the studyis rooted in a philosophy of science recognizing the potential importance of teachers’ nonepistemic values. Empirically, it is based on surveyed upper secondary school biology teachers’ views of the importance of including value-laden topics in their science teaching. Theirresponses were analyzed by latent profle analysis and non-parametric testing, to assess the variation in their views and explore associations with several explanatory factors. The results showthat the surveyed teachers could be divided into two distinct groups: one favoring inclusion ofvalue-laden topics in their teaching and another (smaller group) opposed to it. The result alsoshows a variation in teachers’ selection of topics to teach and their teaching approach, as theformer group were more inclined than the latter to include value-laden aspects in their teaching which contributes to the research literature. Furthermore, experienced science teachers wereoverrepresented in the group holding more negative views, a result not reported elsewhere inthe research literature. The importance of the results is discussed in relation with the theoreticalframing of non-epistemic values and points out the importance to further investigate underlyingcauses to science teachers’ expressed values and ways that they might vary temporally togetherwith ways that they cluster, as they are shown to be grouped. The result is also discussed in relation with practice in being able to make use of the evidence to develop science education