| 1. |
- Fadl, Helena, 1965-, et al.
(author)
-
Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
- 2019
-
In: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
-
Journal article (peer-reviewed)abstract
- Background The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden () is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches. Methods This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January-December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included. Discussion The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.
|
|
| 2. |
- Petersson, Christer, et al.
(author)
-
Ett kvartssekel med föräldragrupper i barnhälsovården - var står vi idag?
- 2005
-
In: Läkartidningen. - 0023-7205. ; 102:39, s. 6-2754
-
Journal article (peer-reviewed)abstract
- En trygg föräldrarelation, präglad av värme och rimliga gränser, är en viktig förutsättning för barns hälsa och välfärd och för att de senare i livet ska kunna samspela förtroendefullt med omgivningen. Inom hälso- och sjukvården finns idag en omfattande verksamhet, exempelvis öppna föräldragrupper, vars syfte är att ge stöd i föräldraskapet. En aktuell rapport från Folkhälsoinstitutet visar att en stor del av denna verksamhet fortfarande saknar vetenskaplig evidens, men också att tillgången på evidens ökat dramatiskt under de senaste 10–15 åren. Här redovisas resultaten från tre lokala studier av föräldragrupper inom barnhälsovården, vilka exemplifierar resultaten i Folkhälsoinstitutets rapport.
|
|
| 3. |
- Petersson, Kerstin, et al.
(author)
-
What is good parental education?
- 2004
-
In: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 18:1, s. 82-89
-
Journal article (peer-reviewed)abstract
- The aim of the study was to highlight the experiences and expectations of Swedish parents with respect to general parental education within child healthcare. Interviews were carried out with 25 parents who had attended education sessions. With a few exceptions the fathers did not take part, and those mothers who did comprised a relatively highly educated group; their views therefore predominate in this study. Socially vulnerable parents such as the unemployed and immigrants took part more sporadically in the meetings, which is why less material is available from these groups. The arrangement and analysis of the material was done using qualitative content analysis. We identified two main categories of importance: 'parental education content' and 'parental education structure'. The parents were on the whole satisfied with the content with respect to the child's physical and psychosocial development. On the other hand, first-time parents expressed a degree of uncertainty with respect to the new parent roles and parent relation and they thought that the education should place more emphasis on the interplay between the parents and between child and parents. The degree of confidence in the nurse as group leader was mainly high. The parents thought that the groups functioned well socially and were satisfied with the organization of the meetings. They did, however, demand clearer structure and framework with respect to the content. Since the aim of legally established parental education is to improve the conditions of childhood growth and to provide support to parents, it must be considered especially important to provide resources so that the socially vulnerable groups in the community may also be reached.
|
|
| 4. |
- Pigg, Maria, et al.
(author)
-
Diagnostic yield of conventional radiographic and cone-beem computed tomographic images in patients with atypical odontalgia
- 2011
-
In: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 12:44, s. 1092-1101
-
Journal article (peer-reviewed)abstract
- Abstract AIM: To investigate whether the additional diagnostic yield of a cone-beam computed tomography (CBCT) examination over conventional radiographs in patients primarily suspected of having atypical odontalgia (AO) improves differentiation between AO and symptomatic apical periodontitis (SAP) in patients with severe chronic intraoral pain. METHODOLOGY: In this clinical study, 25 patients (mean age 54 ± 11 years, range 34-72) participated; 20 were diagnosed with AO and 5 with SAP. All patients were recruited from the clinics of the Faculty of Odontology, Malmö University. AO inclusion criteria were chronic pain (>6 months) in a region where a tooth had been endodontically or surgically treated, with no pathological cause detectable in clinical or radiologic examinations. SAP inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in clinical and radiographic examinations. Assessments comprised a self-report questionnaire on pain characteristics, a comprehensive clinical examination and a radiographic examination including panoramic and intraoral radiographs and CBCT images. The main outcome measure was periapical bone destruction. RESULTS: Sixty per cent of patients with AO had no periapical bone destructions detectable with any radiographic method. Overall, CBCT rendered 17% more periapical bone destructions than conventional radiography. Average pain intensity in patients with AO was 5.6 (± 1.8) on a 0-10 numerical rating scale, and average pain duration was 4.3 (± 5.2) years. CONCLUSION: Cone-beam computed tomography improves identification of patients without periapical bone destruction, which may facilitate differentiation between AO and SAP.
|
|
| 5. |
- Rawski, A. A., et al.
(author)
-
The major factors that influence endodontic retreatment decisions
- 2003
-
In: Swedish Dental Journal. - 0347-9994. ; 27:1, s. 23-29
-
Journal article (peer-reviewed)abstract
- The presence of a new or persistent periapical radiolucency adjacent to a rootfilled tooth is often used as a criterion of endodontic treatment "failure". However, clinicians' suggested management of such cases is subject to substantial interindividual variation. Several components that might influence endodontic retreatment decision making have been explored, but data on which factors dentists actually think they consider, are missing. The aim was to interview 20 general dental practitioners (GDPs) and 20 endodontists about factors they thought would influence the prescription of endodontic retreatment. Six simulated cases were presented as cartoons accompanied with a clinical history. In two of the cases the teeth were planned to serve as an abutment tooth in a fixed prosthodontic construction. The status of the periapical bone tissue and the quality of rootfilling seal were varied. Between 1 and 6 factors per case were reported to influence decision making. In cases not planned to serve as abutment teeth most dentists considered that the periapical condition was the most important factor, whilst they considered the fixed prosthodontic construction to be the most important factor in cases planned as abutment teeth. Generally, endodontists seem to be more inclined to retreat and act on the mere presence of a periapical lesion regardless of size than GDPs. In a real clinical setting in direct contact with patients, additional factors like economy and patients' preferences might be expected to exert a major influence. The majority of the dentists stated that they thought that their colleagues would make similar decisions as they did themselves.
|
|
| 6. |
- Rämgård, Margareta, et al.
(author)
-
Developing health and social care planning in collaboration
- 2015
-
In: Journal of Interprofessional Care. - : Informa Healthcare. - 1356-1820 .- 1469-9567. ; 29:4, s. 354-358
-
Journal article (peer-reviewed)abstract
- Collaboration between different professions in community care for older people is often both difficult and complex. In this project, a participatory action research (PAR) was conducted in order to support the professions involved in the care for older people to develop individualized health and social care plans. Cases from daily work were discussed in different professional groups over a period of one year. A key finding was that lack of knowledge regarding the other professions' field of expertise and their underlying professional culture and values was a barrier in their collaboration. However, as the continuous reflective dialogue process progressed, the participants began to reflect more about the importance of collaboration as a prerequisite to achieve the best possible care for the recipient. This process of reflection led to the often complex needs of the care recipients being given a more central position and thus care plans being better tailored to each person's needs.5
|
|
| 7. |
|
|
| 8. |
- Thulesius, Hans, et al.
(author)
-
Learner-centred education in end-of-life care improved well being in home care staff: a prospective controlled study.
- 2002
-
In: Palliative Medicine. - : SAGE Publications. - 1477-030X .- 0269-2163. ; 16:4, s. 54-347
-
Journal article (peer-reviewed)abstract
- The aim of this controlled study was to evaluate a 1-year learner-centred educational project in end-of-life care for home care staff in a rural district of Sweden. Another rural district in the same region served as a control area. A 20-item questionnaire measuring attitudes towards end-of-life care was designed, and the Hospital Anxiety and Depression (HAD) scale was used to measure mental well being. Increased agreement to 18 of 20 attitude statements was seen in the education group, while 2 of 20 items showed a decreased agreement in the control group. Test retest reliability of the 20-item questionnaire was good (r =0.92). The total HAD score decreased from 8.3 pretest to 5.3 post-test in the education group (95% CI=2.1– 3.7; P<0.001), and was 6.8 for both years in the control group. Our study shows that a comprehensive educational programme not only improved attitudes towards end-of-life care, but also the mental well being of the home care staff.
|
|
| 9. |
- Wolf, Eva, et al.
(author)
-
Long-term follow-up by means of a questionnaire of 109 patients with long-lasting orofacial pain.
- 2002
-
In: Swedish Dental Journal. - 0347-9994. ; 26:3, s. 125-34
-
Journal article (peer-reviewed)abstract
- The aims were to follow-up, analyse and compare the pain status after 4-9 years with that at the baseline examination of 109 consecutive patients referred to the Pain Group at the Faculty of Odontology in Malmö, Sweden during the period 1988-1993 due to long-lasting orofacial pain. A further aim was to identify predictive factors of significance for pain alteration. 85 (78%) women with a median age of 51 years and 24 (22%) men with a median age of 60 years were included in the study. A survey of the pain status at the follow-up was conducted by means of a mailed questionnaire. The questionnaire covered the following aspects: pain alteration, pain intensity, pain location, medication and education. After one reminder, the non-responding patients were called for a telephone interview. A response level of 85% was obtained. Significant improvements were noted by the patients in the answers of the questionnaire in mainly three areas; the patients answered individually that pain relief had occurred, pain intensity rated on the VAS was lower at follow-up compared to the baseline examination and a decrease in drug use was reported. The responses indicated pain relief for 75% of the patients. However, only 27% of the patients experienced total disappearance of pain. Medication at baseline with opioids, muscle relaxants with central effect, antidepressants, neuroleptics, hypnotics or sedatives was found to be a predictive factor for persistent pain.
|
|
| 10. |
|
|
