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  • Adérn, B, et al. (författare)
  • Orsaker till remisser till bettfysiolog : en jämförelse mellan fyra specialistkliniker
  • 2003
  • Ingår i: Tandläkartidningen. - 0039-6982. ; 95:10
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Specialistinstanser i bettfysiologi möter i huvudsak patienter som har en långvarig och svårt smärtproblematik. Under 1900-talet har dock även behandling av obstruktiv sömnapné tillkommit. Ofta är det en läkare som remitterat patienten till den bettfysiologiska kliniken. Denna studie visar att bettfysiologen är en viktig länk mellan tandvården och sjukvården vid utredning och behandling av orofacial smärta. Syf-tet med studien var att jämföra orsakerna till remisser till bettfysiologi. En jämförelse gjordes mellan fyra specialistkliniker i bettfysiologi un-der en 4-månadersperiod år 2001. De flesta remitterade patienter var kvinnor i åldern 20 år och uppåt. Bland de remitterade kvinnorna var smärta den dominerande orsaken medan männen lika ofta remittera-des för sömnstörning som för smärta. 86 procent av patienterna som remitterats för smärta värderade smärtans intensitet som måttlig till väldigt svår. Hos 80 procent av dessa patienter var smärtan långvarig.
  • Adern, Bengt, et al. (författare)
  • Prevalence of temporomandibular dysfunction and pain in adult general practice patients
  • 2014
  • Ingår i: Acta Odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 72:8, s. 585-590
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To analyse the prevalence of temporomandibular disorders and related pain (TMD-pain) among adult recall patients in general dental practice. Materials and methods. From November 2006 to September 2008, all adults attending a Swedish Public Dental Service (PDS) clinic for recall examination were asked two standardized questions about temporomandibular pain and dysfunction. Mouth-opening capacity was measured. The responses to the questions and mouth-opening capacity were combined to give a TMD-pain score, on a scale of 0-3. The patients' acceptance of their TMD condition was also noted. Results. The subjects comprised 2837 adults (53% females, 47% men). Of the total sample, 4.9% reported a TMD-pain score of 1-3. The gender difference was significant: women predominated (p < 0.003). Forty-three per cent of those with TMD-pain scores of 1-3 (36% men, 47% women) considered that the condition warranted treatment, especially those registering a pain score (significant difference between pain and dysfunction groups, p < 0.000). Conclusions. The TMD-pain score shows promise as a useful instrument for detecting and recording TMD-pain. The prevalence of TMD disclosed in the study is high enough to be considered a public health concern. Most of the subjects with lower scores on the TMD-pain scale accepted their condition as not severe enough to require treatment.
  • Adern, Bengt, et al. (författare)
  • Self-reportance of temporomandibular disorders in adult patients attending general dental practice in Sweden from 2011 to 2013
  • 2018
  • Ingår i: Acta Odontologica Scandinavica. - TAYLOR & FRANCIS LTD. - 0001-6357 .- 1502-3850. ; 76:7, s. 530-534
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The study aim was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) and acceptance or nonacceptance of such disorders in adult patients attending all public dental health services in the County of Sormland, Sweden, during a 3-year period, 2011-2013.Methods: Two questions were asked about TMD and the voluntary mouth-opening capacity was measured. The results were registered in a score 0-3. The registration was completed with a question about each patient's acceptance or nonacceptance of their condition.Results: More than 73,000 registrations of the TMD condition were performed in general dental clinics from 2011 to 2013. The mean prevalence of a TMD score of 1-3 was 5% and was consistent over these years. Seventy percent of these patients were women. The peak prevalence of TMD was registered in patients aged 30-45years (38%), and the frequency declined in older age groups. Reduced voluntary mouth-opening capacity (<= 35 mm) was found in less than 2% of the participants. About one-fifth of the patients with a TMD-score of 1-3 did not accept their condition and wanted professional care. The frequency of nonacceptance of the condition increased with the severity of symptom score: 15%, 27%, and 49% for scores 1, 2, and 3, respectively.Conclusions: This study shows that the prevalence of self-reported TMD in adult patients was consistent from 2011 to 2013 and should be considered as a public health issue in Sweden. Patients with more severe TMD pain symptoms wanted care more frequent. The annual clinical calibrations should be continued to achieve an acceptable level of registration.
  • Andren, Ann, et al. (författare)
  • Effects of treatment with oral appliance on 24-h blood pressure in patients with obstructive sleep apnea and hypertension : a randomized clinical trial
  • 2013
  • Ingår i: Sleep and Breathing. - 1520-9512 .- 1522-1709. ; 17:2, s. 705-712
  • Tidskriftsartikel (refereegranskat)abstract
    • Continuous positive airway pressure treatment has been shown to lower blood pressure (BP) in patients with obstructive sleep apnea (OSA). The aims of the present pilot study were to evaluate the potential effects of oral appliance (OA) therapy on BP, to assess various outcome BP measures, and to inform sample size calculation. Seventy-two patients with OSA and hypertension were randomly assigned to intervention with either an OA with mandibular advancement (active group) or an OA without advancement (control group). Before and after 3 months of treatment, the patients underwent nocturnal somnographic registration and 24-h ambulatory BP monitoring. Among the various BP measures, the largest trend toward effect of OA treatment was seen in 24-h mean systolic BP with a 1.8 mmHg stronger BP reduction in the active group compared with controls. A stronger trend toward effect was seen in a subgroup with baseline ambulatory daytime mean systolic BP > 135/85 mmHg where the mean systolic BP fell, on average, 2.6 mmHg. Additional exclusion of patients with baseline apnea hypopnea index (AHI) a parts per thousand currency sign15 gave a significant reduction in mean systolic BP of 4.4 mmHg (P = 0.044) in the active group compared with controls. In patients with OSA and hypertension, OA treatment had a modest trend toward effect on reducing BP. A stronger trend toward treatment effect was seen after excluding patients with normal baseline ambulatory BP. Additional exclusion of patients with baseline AHI a parts per thousand currency sign15 showed a significant treatment effect. Data to inform sample size for an adequately powered randomized study are provided.
  • Andrèn, A, et al. (författare)
  • Effects on blood pressure after treatment of obstructive sleep apnoea with a mandibular advancement appliance - a three-year follow-up
  • 2009
  • Ingår i: Journal of Oral Rehabilitation. - 0305-182X .- 1365-2842. ; 36:10, s. 719-725
  • Tidskriftsartikel (refereegranskat)abstract
    • P>Obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder; it affects 4% of males and 2% of females. Hypertension has been shown to occur in 28-57% of OSA patients. There is a steady increase in evidence linking OSA to long-term cardiovascular morbidity including hypertension. The purpose of this study was to investigate whether mandibular advancement oral appliance (OA) treatment of OSA affects the patient's blood pressure (BP) in a 3-month and a 3-year perspective. Twenty-nine consecutive patients, with verified OSA defined as apnoea index (AI) > 5 per hour and/or apnoea/hypopnoea index (AHI) >= 10 per hour, received an OA as treatment. BP was measured on three occasions; before treatment, after 3 months of treatment, and after 3 years of treatment. BP was measured with an electronic blood pressure monitor. The treatment effect of OA was measured after 3 months by repeated somnographic registration while the patient was wearing the OA. A treatment response was defined as AHI < 10; this was achieved in 25 of 29 patients (86%) at the 3-month evaluation. Significant reductions in blood pressure were attained between baseline and the 3-month evaluation (P < 0 center dot 001) and these changes remained at the 3-year follow-up in both systolic BP of -15 center dot 4 +/- 18 center dot 7 mm Hg and diastolic BP of -10 center dot 3 +/- 10 center dot 0 mm Hg. OA therapy reduced blood pressure in both a 3-month and a 3-year perspective in patients with OSA.
  • Arousell, Jonna, 1985-, et al. (författare)
  • Does Religious Counselling on Abortion Comply with Sweden’s ‘Women‑Friendly’ Abortion Policies? A Qualitative Exploration Among Religious Counsellors
  • 2019
  • Ingår i: Sexuality & Culture. - 1095-5143 .- 1936-4822. ; 23:4, s. 1230-1249
  • Tidskriftsartikel (refereegranskat)abstract
    • The abortion discourse in Sweden is marked by historically liberal ideals about women’s inviolable right to make autonomous reproductive decisions. However, to respond to the increase in cultural and religious pluralism building up over several decades, religious organizations have been given opportunities to provide so-called spiritual care in affiliation with Swedish hospitals since the 1980s. In this study we asked: in what ways do religious counsellors, affiliated with Swedish hospitals, construct their ideas on abortion, and how well do their ideas comply with Sweden’s ‘women-friendly’ abortion policies? Through interviews with Protestant, Catho-lic, Muslim, and Buddhist religious counsellors, we wanted to empirically test the presumption underlying the decisions to grant space to religious actors in Swedish healthcare, i.e., that religious counselling serves to complement existing services. We found that it cannot be expected that religious advice on abortion will always comply with Swedish abortion law and with the women-friendly abortion policy that the Swedish state seeks to impose. When policy-makers open up possibilities for diverse norms on abortion to manifest in close affiliation with healthcare institutions, they must be aware that some religious counsellors argue that only God—and not the woman herself—can decide whether a woman can terminate a pregnancy. We argue that the findings in this study speaks to what researchers have referred to as the “diversity-equality paradox”, which highlights the tension between the promotion of religious ideas on abortion on the one hand and the promotion of liberal ideas about women’s reproductive freedom on the other.
  • Arousell, Jonna, 1985-, et al. (författare)
  • Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling A Discourse Analysis.
  • 2017
  • Ingår i: Qualitative Health Research. - 1049-7323 .- 1552-7557. ; 27:10, s. 1518-1528
  • Tidskriftsartikel (refereegranskat)abstract
    • In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers' ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women's possibilities to obtain adequate support. At the end of the article, we suggest how health care providers' reflexivity might be used as a working tool for increased awareness about the taken-for-granted cultural norms that exist in their clinical milieu.
  • Arvidsson, Anna, 1973-, et al. (författare)
  • Gauging the interests of birth mother and child a qualitative study of Swedish social workers' experiences of transnational gestational surrogacy
  • 2016
  • Ingår i: European Journal of Social Work. - 1369-1457 .- 1468-2664. ; 21:1, s. 86-99
  • Tidskriftsartikel (refereegranskat)abstract
    • Det finns få studier om hur socialarbetare handlägger ärenden som berör transnationellt surrogatmoderskap. Vår studie har för avsikt att bidra till att fylla detta tomrum. I Sverige är det inte tillåtet för sjukvården att utföra assisterad befruktning vid surrogatmoderskap. Detta har gjort att människor vänt sig utomlands för denna reproduktionsmetod, främst till Indien. Det finns inga lagar som reglerar surrogatmoderskap i Sverige, vilket har lett till svårigheter vid fastställande av rättsligt föräldraskap när föräldrarna återvänt med barnet. Denna kvalitativa intervjustudie med familjerättssekreterare har funnit att det finns rättslig osäkerhet och etiska frågeställningar som påverkar deras hantering av ärendet. Hur föräldraskap konstrueras i nuläget beror till stor del på enskilda familjerättssekreterares uppfattning om hur man bäst väger surrogatmammans intressen mot vad som är bäst för barnet. Avsaknad av riktlinjer och de etiska frågeställningarna har lett till osäker och olika hantering av ärendena, och en reglering behövs för att bättre skydda de inblandade och öka rättssäkerheten i handläggningen.
  • Arvidsson, Anna, 1973-, et al. (författare)
  • Views of Swedish commissioning parents relating to the exploitation discourse in using transnational surrogacy
  • 2015
  • Ingår i: PLoS ONE. - 1932-6203 .- 1932-6203. ; 10:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Transnational surrogacy, when people travel abroad for reproduction with the help of a surrogate mother, is a heavily debated phenomenon. One of the most salient discourses on surrogacy is the one affirming that Westerners, in their quest for having a child, exploit poor women in countries such as India. As surrogacy within the Swedish health care system is not permitted, Swedish commissioning parents have used transnational surrogacy, and the majority has turned to India. This interview study aimed to explore how commissioning parents negotiate the present discourses on surrogacy. Findings from the study suggest that the commissioning parents' views on using surrogacy are influenced by competing discourses on surrogacy represented by media and surrogacy agencies. The use of this reproductive method resulted, then, in some ambiguity. Although commissioning parents defy the exploitation discourse by referring to what they have learnt about the surrogate mother's life situation and by pointing at the significant benefits for her, they still had a request for regulation of surrogacy in Sweden, to better protect all parties involved. This study, then, gives a complex view on surrogacy, where the commissioning parents simultaneously argue against the exploitation discourse but at the same time are uncertain if the surrogate mothers are well protected in the surrogacy arrangements. Their responses to the situation endorse the need for regulation both in Sweden and India.
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