Hip dysplasia is not uncommon but frequently overlooked: a cross-sectional study based on radiographic examination of 1,870 adults.

Background and purpose - Hip dysplasia in adults is a deformity in which the acetabulum inadequately covers the femoral head. The prevalence is sparingly described in the literature. We investigated the prevalence in Malmö (Sweden) and assessed whether the condition was recognized in the radiology reports.Subjects and methods - All pelvic radiographs performed in Malmö during 2007-2008 on subjects aged 20-70 years with a Swedish personal identity number were assessed. 1,870 digital radiographs were eligible for analysis. The lateral center-edge angle (LCEA) and acetabular index angle (AIA) were measured. Hip dysplasia was defined as an LCEA ≤ 20°. Intraclass correlation coefficients (ICC) for intra-observer measurements ranged from 0.87 (AIA, 95% CI 0.78-0.93) to 0.98 (LCEA, CI 0.97-0.99).Results - The prevalence of hip dysplasia (LCEA ≤ 20°) was 5.2% (CI 4.3-6.3), (98/1,870). There was no statistically significant difference between the sexes for either prevalence of hip dysplasia or mean LCEA. The mean AIA was 0.9° (CI 0.3-1.3) higher in men (4.1 SD 5.5) compared with women (3.2 SD 5.4). The radiologists had reported hip dysplasia in 7 of the 98 cases.Interpretation - The prevalence of hip dysplasia in Malmö (Sweden) is similar to previously reported data from Copenhagen (Denmark) and Bergen (Norway). Our results indicate that hip dysplasia is often overlooked by radiologists, which may influence patient treatment.

Developing transformative capacity through systematic assessments and visualization of urban climate transitions.

Transforming cities into low-carbon, resilient, and sustainable places will require action encompassing most segments of society. However, local governments struggle to overview and assess all ongoing climate activities in a city, constraining well-informed decision-making and transformative capacity. This paper proposes and tests an assessment framework developed to visualize the implementation of urban climate transition (UCT). Integrating key transition activities and process progression, the framework was applied to three Swedish cities. Climate coordinators and municipal councillors evaluated the visual UCT representations. Results indicate that their understanding of UCT actions and implementation bottlenecks became clearer, making transition more governable. To facilitate UCT, involving external actors and shifting priorities between areas were found to be key. The visual UCT representations improved system awareness and memory, building local transformative capacity. The study recommends systematic assessment and visualization of process progression as a promising method to facilitate UCT governance, but potentially also broader sustainability transitions.

A qualitative study of young women's experiences of recovery from bulimia nervosa.

AIM: To describe experiences of recovery from bulimia nervosa among young adult women. BACKGROUND: Most studies into recovery from eating disorders focus on anorexia nervosa, although some include both anorexia and bulimia nervosa. Recovery has been described as beginning with renewed self-esteem. DESIGN: Qualitative interview study. METHODS: Fourteen women were invited to participate; five women, between 23-26 years of age, who assessed themselves as healthy for at least 2 years agreed to take part in narrative interviews. Tape-recorded interviews lasting 45-60 minutes (median 49 minutes) were conducted from February-April 2010 and transcribed verbatim. Data were analysed using qualitative content analysis. FINDINGS: The interviews revealed four themes in recovery from bulimia nervosa: feeling stuck in bulimia nervosa, getting ready to change, breaking free of bulimia nervosa and grasping a new reality, each comprising two or more subthemes. The process of recovery was not linear, but rather went back and forth between progress and relapse. The women expressed strong ambivalence about leaving the illness behind. An important part of their recovery was their ability to accept themselves. It was essential for their recovery to be supported in developing a unique explanation of the cause of their illness. CONCLUSION: Women's ability to recover from bulimia nervosa and take control over their lives is based on their self-efficacy. Effective care should therefore strive to strengthen women's beliefs in their own abilities, to instil hope for recovery and thus to bolster their self-efficacy.