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Sökning: LAR1:gu > (2010) > Tidskriftsartikel > Malmö universitet

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  • Bjorndal, L, et al. (författare)
  • Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy
  • 2010
  • Ingår i: European Journal of Oral Sciences. - 0909-8836. ; 118:3, s. 290-297
  • Tidskriftsartikel (refereegranskat)abstract
    • Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI ()22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.
  • Brogardh-Roth, Susanne, et al. (författare)
  • Dental fear and anxiety and oral health behaviour in 12-to 14-year-olds born preterm
  • 2010
  • Ingår i: INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY. - 0960-7439. ; 20:6, s. 391-399
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: An enhanced frequency of cognitive and behavioural disturbances has been reported in preterm children. It is not known if this affects their perceptions of or behaviour in the dental care situation. HYPOTHESIS: The hypotheses were that preterm (PT) children aged 12-14 years more often exhibit dental fear and anxiety (DFA) than full-term controls (C), while no differences were expected regarding oral health behaviour. METHODS: One hundred and nine PT and 108 C children took part in the present questionnaire study. DFA was assessed using the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). In addition the questionnaire covered items including satisfaction with received dental care, oral health behaviour and medical health. RESULTS: The children's CFSS-DS scores revealed no differences between the PT and C groups. Regarding oral health behaviour there were no differences, except that PT children more often used dental floss and extra fluoride supplements. PT children reported more medical health problems than C children. CONCLUSIONS: Preterm (PT) children 12- to 14-years-old, as well as C of same age group, seem to be satisfied with their dental care and display low prevalence of DFA. Still, a higher frequency of medical health problems in the PT children suggests that these children should be regarded as potential risk patients for oral health problems.
  • Carlson, Elisabeth, et al. (författare)
  • "This is nursing": Nursing roles as mediated by precepting nurses during clinical practice
  • 2010
  • Ingår i: NURSE EDUCATION TODAY. - 0260-6917. ; 30:8, s. 763-767
  • Tidskriftsartikel (refereegranskat)abstract
    • In nursing education, it has been argued that professional socialization is facilitated by clinical experiences where students work together with precepting nurses. However, few studies found have focused on how nurses think and act as preceptors, hence providing a base for professional socialization to occur. Therefore; this study aimed to describe how preceptors mediated nursing as a profession to undergraduate nursing students during clinical practice. This was an ethnographic study guided by symbolic interactionism. A purposeful sampling of 13 precepting nurses was observed during the field work period. In addition, 16 staff nurses, purposively selected, and experienced in precepting, participated in focus group interviews. All text from field notes and interviews were read as a whole and analyzed following the ethnographic approach. Findings illustrated how nursing was mediated as the medical-technical, the administrative, and the caring role. Preceptors aimed for professionalism in their students by teaching the students to reflect on what they can do independently as nurses. Preceptors strived to verbalise their practical knowledge to make theory explicit and contextualize to student nurses. This knowledge can guide implementation of preceptor programmes focusing on the meaning and implications of professionalism.
  • Carlson, Elisabeth, et al. (författare)
  • Time to precept: supportive and limiting conditions for precepting nurses.
  • 2010
  • Ingår i: JOURNAL OF ADVANCED NURSING. - 0309-2402. ; 66:2, s. 432-441
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This paper is a report of a study describing conditions for precepting in a Swedish clinical context from the perspective of precepting nurses. BACKGROUND: Clinical practice is a complex part of nursing education, and registered nurses who are acting as preceptors for nursing students face a number of challenges that need to be addressed during the precepting process. METHOD: An ethnographic approach guided by symbolic interactionism was used. Data were collected by participant observation and focus group interviews over a ten-month period in 2006-2007. Participants were selected by purposive sampling of 13 staff nurses who were preceptors during the field work period. In addition, 16 staff nurses, experienced in precepting, were purposively selected for four focus groups. FINDINGS: Precepting was found to be a complex function for nurses, influenced by conditions that could be both supportive and limiting in nature. Three themes described these conditions: organization, comprising clinical responsibilities and routines; collaboration, focusing on professional relations and interactions; and the personal perspective, comprising preceptors' experiences, need for feed back and notions of benefits. Time as a limiting condition reappeared through all categories. CONCLUSION: It is important to raise the issue of time and its impact on the precepting process. Precepting needs to be further discussed in terms of an integrated nursing competence prioritized by all stakeholders involved in clinical practice. Therefore; efforts should be made to plan nurses' clinical work so that allocated time for precepting can be facilitated.
  • Chávez de Paz, Luis, 1974-, et al. (författare)
  • The effects of antimicrobials on endodontic biofilm bacteria
  • 2010
  • Ingår i: Journal of Endodontics. - Elsevier. - 1878-3554. ; 36:1, s. 70-77
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction In the present study, confocal microscopy, a miniflow cell system, and image analysis were combined to test in situ the effect of antimicrobials and alkali on biofilms of Enterococcus faecalis, Lactobacillus paracasei, Streptococcus anginosus, and Streptococcus gordonii isolated from root canals with persistent infections. Methods Biofilms formed for 24 hours were exposed for 5 minutes to alkali (pH = 12), chlorhexidine digluconate (2.5%), EDTA (50 mmol/L), and sodium hypochlorite (1%). The biofilms were then characterized by using fluorescent markers targeting cell membrane integrity (LIVE/DEAD) and metabolic activity (5-cyano-2,3-ditolyl tetrazolium chloride and fluorescein diacetate). In addition, the biofilm architecture and the extent to which coating of the substrate surface with collagen influenced the resistance pattern to the chemicals were also analyzed. Results NaOCl (1%) affected the membrane integrity of all organisms and removed most biofilm cells. Exposure to EDTA (50 mmol/L) affected the membrane integrity in all organisms but failed to remove more than a few cells in biofilms of E. faecalis, L. paracasei, and S. anginosus. Chlorhexidine (2.5%) had a mild effect on the membrane integrity of E. faecalis and removed only 50% of its biofilm cells The effects were substratum-dependent, and most organisms displayed increased resistance to the antimicrobials on collagen-coated surfaces. Conclusions The biofilm system developed here was sensitive and differences in cell membrane integrity and removal of biofilm cells after exposure to antimicrobials commonly used in endodontics was discernible.
  • Corvellec, Hervé, et al. (författare)
  • The moral responsibility of project selectors
  • 2010
  • Ingår i: International Journal of Project Management. - Elsevier. - 0263-7863. ; 28:3, s. 212-219
  • Tidskriftsartikel (refereegranskat)abstract
    • Managers who select projects have a moral responsibility. The purpose of this paper is to present a template to assess this responsibility so that it can be put into practice. Responsibility is here defined as a combination of attributability—what choices the project manager can ultimately be praised or blamed for, and of accountability—what choices the project manager has to be prepared to answer for. The template combines these two aspects of responsibility with the project selection process divided into three phases: initialization phase, appraisal phase, and decision phase. Various moral philosophers are used to highlight the moral issues at stake for each of these two dimensions of responsibility at each stage of the project selection process. Concluding remarks underlines the need for project selectors to adapt to the specific context when they use the template.
  • Eliasson, Alf, 1959-, et al. (författare)
  • The precision of fit of milled titanium implant frameworks (I-Bridge) in the edentulous jaw.
  • 2010
  • Ingår i: Clinical implant dentistry and related research. - 1708-8208. ; 12:2, s. 81-90
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: New computer numeric controlled (CNC)-milled frameworks for implant-supported prostheses have been introduced. However, no data are available on the precision of fit of these new frameworks. PURPOSE: The purpose of this study is to evaluate the precision of fit of a new CNC-milled framework technique (I-Bridge, Biomain AB, Helsingborg, Sweden) using Brånemark System (Nobel Biocare AB, Göteborg, Sweden) and NobelReplace (Nobel Biocare AB) system implants. MATERIALS AND METHODS: Ten test frameworks were fabricated for one master model for each implant system. Five additional frameworks were fabricated for five different models simulating clinical cases as controls (Brånemark System). The distortion of implant center point positions was measured in x-, y-, and z-axes and in three dimensions by using a contact-type coordinate measuring machine and a computer program developed specifically for this purpose. Mann-Whitney U-test was used to compare differences of distortion within and between the groups. RESULTS: The maximal distortion in arch width (x-axis) and curvature (y-axis) was within 71 and 55 microm for all frameworks, respectively. The mean distortion in absolute figures in x-, y-, z-axes and three dimensions was for "clinical control" frameworks 23, 26, 4, and 34 microm as compared with less than 12, 12, 2, and 17 microm for Brånemark and NobelReplace frameworks, respectively. Control frameworks showed significantly (p < .05) greater mean and range of distortions in x- and y-axes and in three dimensions compared with test frameworks. CONCLUSION: All measured frameworks presented signs of misfit, indicating that no framework had a "passive fit." Frameworks produced in a more routine clinical environment seem to present greater levels of distortion as compared with frameworks produced in a strict test situation. However, all measured frameworks presented levels of precision of fit within limits considered to be clinically acceptable in earlier studies of frameworks placed on abutments.
  • Jansson, Inger, et al. (författare)
  • Factors and conditions that influence the implementation of standardized nursing care plans
  • 2010
  • Ingår i: Open Nursing Journal. - Hilversum : Bentham Science Publishers. - 1874-4346. ; 4, s. 25-34
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale and aim: There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the “Promotion Action on Research Implementation in Health Services framework” (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.Method. We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.Result: In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.Conclusions: Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.
  • Johansson, Lars-Åke, 1950-, et al. (författare)
  • Maxillary sinus floor augmentation and simultaneous implant placement using locally harvested autogenous bone chips and bone debris: a prospective clinical study.
  • 2010
  • Ingår i: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. - 1531-5053. ; 68:4, s. 837-44
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract PURPOSE: The aim of this study was to prospectively evaluate the status of implants, marginal bone loss, and outcome of maxillary sinus floor augmentation in patients undergoing maxillary sinus lift and simultaneous implant placement with the use of bone grafts harvested adjacent to the actual surgical site. MATERIALS AND METHODS: Patients in need of maxillary sinus floor augmentation to enable implant placement were enrolled in 2 different groups. In group A, a "bone trap" was used to harvest bone debris during implant preparation with additional bone collected by further drilling adjacent to the implant sites. In group B, a "bone scraper" was used to harvest cortical bone chips from the zygomatic buttress and from the lateral sinus wall before opening of a bony window. All patients were provided a fixed partial denture after a healing period of 3 to 6 months. A total of 61 patients with 81 Straumann implants (Institut Straumann AG, Basel, Switzerland) were assessed, with 17 patients (20 implants) in group A and 44 patients (61 implants) in group B. RESULTS: One implant was lost (in group B) before loading. The survival rate after a follow-up of 12 to 60 months was 98.8%. There was no significant difference in marginal bone loss on the mesial and distal sides of the implant when baseline to 1-year registration was compared with baseline to final registration. During the same time, graft height decreased significantly on the distal apical side of the implants. CONCLUSIONS: Bone grafts can be locally harvested at the site of the maxillary sinus augmentation procedure to enable placement, successful healing, and loading of 1 to 3 implants.
  • Klingberg, G, et al. (författare)
  • Specialist paediatric dentistry in Sweden 2008-a 25-year perspective
  • 2010
  • Ingår i: INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY. - 0960-7439. ; 20:5, s. 313-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Paediatric dentistry in Sweden has been surveyed four times over the past 25 years. During this period postgraduate training, dental health, and the organization of child dental care have changed considerably. Aim. To investigate services provided by specialists in paediatric dentistry in Sweden in 2008, and to compare with data from previous surveys. Design. The same questionnaire was sent to all 30 specialist paediatric dental clinics in Sweden that had been used in previous surveys. Comparisons were made with data from 1983, 1989, 1996 and 2003. Results. Despite an unchanged number of specialists (N = 81 in 2008), the number of referrals had increased by 16% since 2003 and by almost 50% since 1983. There was greater variation in reasons for referrals. The main reason was still dental anxiety/behaviour management problems in combination with dental treatment needs (27%), followed by medical conditions/disability (18%), and high caries activity (15%). The use of different techniques for conscious sedation as well as general anaesthesia had also increased. Conclusions. The referrals to paediatric dentistry continue to increase, leading to a heavy work load for the same number of specialists. Thus, the need for more paediatric dentists remains.
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