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  • Klingberg, Gunilla, 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.
  • Sjöblom, Ingela, et al. (författare)
  • A provoking choice-Swedish women's experiences of reactions to their plans to give birth at home
  • 2012
  • Ingår i: Women and Birth. - Elsevier. - 1871-5192. ; 25:3, s. E11-E18
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The home birth rate in Sweden is less than 1 in 1000, and home birth is not included within the health care system. This study describes women's experiences concerning reactions to their decision to give birth at home. Design and setting: A nationwide survey (SHE - Swedish Homebirth Experience) in Sweden was conducted between 1992 and 2005 whereas 735 women had given birth to 1038 children. Of 1038 questionnaires 1025 were returned. Measurements: In the questionnaires an open-ended question asked women to report their experience of reactions to their decision to give birth at home The question was answered by 594 women, and data were analysed using content analysis. Findings: The analysis yielded one overarching theme; "To be faced with fear for life and death'' including being exposed to reactions about risks. This describes attitudes of professionals and family towards life and death and suggests perceptions of risk and fear of unexpected events. Four main categories were identified; Seen as an irresponsible person, Met with emotional arguments, Exposed to persuasion and Alienation. Conclusion: Women who plan for a home birth were confronted with negative attitudes and persuasion to make them change their mind. This made them feel alienated, and they searched for support among like-minded. Negative attitudes from health care professionals may erode their confidence in conventional health services and turn them towards other options. Implication for practice: Women who want to give birth at home should be given evidence-based information about risks and benefits. Enhanced knowledge among public and professionals about home births would improve the options for respectful encounters. (C) 2011 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
  • Andersson, Bodil T., et al. (författare)
  • Radiographers' areas of professional competence related to good nursing care
  • 2008
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 22:3, s. 401-409
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.
  • Torstensson Levander, Marie, et al. (författare)
  • Mentally disordered criminal offenders: Legal and criminological perspectives
  • 2009
  • Ingår i: International journal of law and psychiatry. - 0160-2527. ; 32:6, s. 377-382
  • Tidskriftsartikel (refereegranskat)abstract
    • Legal research in Sweden has traditionally focused on a systematization of the legal rules and their practical application, while the task of studying the effects of the application of the laws has been handed over to other branches of the social sciences. In contrast, new legal theories focusing on proactive and therapeutic dimensions in law have gained increasing attention in the international arena. These approaches may be better suited for evaluating legislation governing compulsory psychiatric care. Theoretical discussions and studies of causal mechanisms underlying criminal behaviour, as well as the implementation and value of instruments for predicting behaviour, are relevant to contemporary criminological research. Criminal behaviour varies across different groups of perpetrators, and the causes can be sought in the interplay between the individual and social factors. Multi-disciplinary efforts, integrating research from forensic psychiatry, psychology, sociology, and criminology, would be beneficial in leading to a better understanding of the causes underlying criminal behaviour.
  • Petersson, Gunnel H, et al. (författare)
  • Comparing caries risk factors and risk profiles between children and elderly.
  • 2004
  • Ingår i: Swedish dental journal. - 0347-9994. ; 28:3, s. 119-28
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of this study were to compare the caries risk profiles of children and elderly, the actual annual caries increment and the impact of some selected caries related factors. Another aim was to find out if there were gender differences among the participants. The risk profiles were created by a computerised risk assessment program, the Cariogram, which evaluates data and presents the weighted and summarized result as one figure, illustrating the ‘percent chance of avoiding caries’ in the future. Methods: The Cariogram was earlier evaluated in two longitudinal studies for its capacity to assess caries risk. One study comprised about 400 children, 10-11 years of age and the other study included about 150 elderly (age 55, 65 and 75). At baseline, information on past caries experience, diet, oral hygiene and use of fluoride was obtained. Saliva analyses included mutans streptococci and lactobacilli, buffering capacity and secretion rate. The caries risk was assessed and the participants were divided into five groups according to the calculated Cariogram risk profiles. After two and five years, respectively, caries was re-evaluated and the incidence was compared with the predictions. Results: The Cariogram risk predictions were statistically in agreement with the actual caries increment. Fifty percent of the children, but only two percent of the elderly appeared in the lowest caries risk group. Of the elderly, 26.4% belonged to the highest caries risk group versus 3.1% of the children. The median value ‘chance of avoiding caries’ was 44% for the elderly and 80% for the children. The main Cariogram sectors contributing to the observed higher caries risk among elderly was the bacterial components in combination with higher susceptibility. Individual factors contributing significantly to the higher risk profiles for the adults compared to the children were higher plaque scores, higher counts of mutans streptococci and lower buffering capacity. Conclusion: comparing the risk profiles of the children and the elderly showed that the elderly were at a higher risk developing caries lesions. Overall one may say that the risk for caries, as assessed by the Cariogram, was twice as high for the elderly.
  • Bjorndal, Lars, 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.
  • Klingberg, Gunilla, 1960-, et al. (författare)
  • Aspects on dental hard tissues in primary teeth from patients with Ehlers-Danlos syndrome.
  • 2009
  • Ingår i: International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. - 1365-263X. ; 19:4, s. 282-90
  • Tidskriftsartikel (refereegranskat)abstract
    • Ehlers-Danlos syndrome (EDS) is a rare hereditary condition affecting connective tissues and dental hard tissues. HYPOTHESES: Primary enamel and dentine from EDS patients were expected to differ from those of healthy subjects regarding morphology and chemical composition. DESIGN: Forty-seven exfoliated primary teeth from 25 patients with EDS were investigated. Morphology was studied using a polarized light microscope, scanning electron microscope, and X-ray microanalysis. Comparisons were made with 36 primary teeth from 36 healthy patients. RESULTS: Morphological analysis of enamel in EDS teeth showed a high frequency of postnatally hypomineralized enamel and postnatally located incremental lines, whereas dentine was normal in all patients. Chemical analysis could not reveal any differences between EDS and control patients except for lower content of C and a higher Ca/P ratio in the enamel in the EDS teeth, indicating porous enamel. Regarding dentine, EDS teeth had a lower content of C, and a higher content of Ca, P, and O. Ratios for Ca/C and Ca/O were also higher compared with controls. CONCLUSIONS: There are several aberrations of booth enamel and dentine in primary teeth from patients with EDS. These could explain the occurrence of both more dental caries and tooth fractures in patients with EDS.
  • Dahlström, M, et al. (författare)
  • Impact of polymer surface affinity of novel antifouling agents
  • 2004
  • Ingår i: Biotechnology and Bioengineering. - 1097-0290. ; 86:1, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • In a previous study we found two agents, the 2-agonist medetomidine ((±)-4-[1-(2,3-dimethylphenyl)ethyl]-1H-imidazole) and the 2-agonist clonidine (2-(2,6-dichloroanilino)-2-imidazoline), that specifically and efficiently impede settlement of the barnacle Balanus improvisus, one of the most serious biofouling organisms in Swedish waters. Medetomidine, but not clonidine, is known to adsorb to solid polystyrene (PS) surfaces in the presence of salt, a feature that is of particular interest in attempts to develop an efficient antifouling surface. We show that medetomidine, but not clonidine, has a significant ability to adsorb to untreated (hydrophobic) PS in two different incubation media: filtered seawater (FSW) and deionized water (mQ). At negatively charged (hydrophilic) PS, medetomidine displays a strong interaction with the surface in both incubation media. At the hydrophilic PS, clonidine also displays a significant interaction with the surface when incubated in mQ and a weaker, but not significant, interaction when incubated in FSW. By studying the effects of time, incubation media, and pH on the adsorption of medetomidine and clonidine, we suggest that medetomidine is associated to hydrophobic PS by means of hydrophobic interactions, while the adsorption of medetomidine and clonidine to hydrophilic PS contains elements of electrostatic interaction. Using time-of-flight secondary ion mass spectroscopy (TOF-SIMS) we detected only weak signals from medetomidine on the hydrophobic PS surfaces, while strong medetomidine signals were observed on hydrophilic PS. This suggests that the adsorbed medetomidine, to a greater extent, desorbed from the hydrophobic rather than from the hydrophilic PS surfaces during exposure to vacuum. The strong surface affinity of medetomidine on both types of surfaces and the preserved antifouling activity are valuable features in designing a marine coating.
  • Ernberg, Malin, et al. (författare)
  • Examina och utbildning inom svensk odontologisk forskning
  • 2003
  • Ingår i: Tandläkartidn. ; 9, s. 54-59
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • En internationell utvärdering visade för några år sedan att Sverige riskerar att förlora sin position som världsledande nation inom odontologisk forskning. För att få en uppfattning om förändringarna inom forskarutbildningen och den postdoktorala meriteringen samlades data för 1990–2001 in från fakulteterna, Statistiska Centralbyrån samt Högskoleverket. Avsikten var att undersöka antalet forskarutbildade tandläkare, mångfalden bland doktoranderna och de som disputerat samt deras nuvarande anställningsform. Materialet jämfördes sedan med tidigare data. I medeltal avlade 25 personer per år doktorsexamen åren 1990–2001. Antalet har minskat under senare år. En majoritet av dem som avlade doktorsexamen hade odontologisk bakgrund. Relativt få har meriterat sig för en fortsatt akademisk karriär. 32 studerande påbörjade forskarutbildning åren 1991–2001. Andelen doktorander med annan akademisk grundexamen än odontologisk ökar. Sedan 1999 har forskningsvolymen minskat med motsvarande en hel fakultets forskningsvolym. Vi drar därför slutsatsen att kunskapsutvecklingen inom svensk odontologi riskerar att stagnera samt att fakulteternas behov av lärare till högre akademiska tjänster liksom folktandvårdens behov av handledare inom specialistutbildningen inte kommer att kunna tillgodoses i framtiden.
  • Fröjd, Victoria, et al. (författare)
  • Effect of nanoporous TiO2 coating and anodized Ca2+ modification of titanium surfaces on early microbial biofilm formation.
  • 2011
  • Ingår i: BMC oral health. - 1472-6831. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The soft tissue around dental implants forms a barrier between the oral environment and the peri-implant bone and a crucial factor for long-term success of therapy is development of a good abutment/soft-tissue seal. Sol-gel derived nanoporous TiO2 coatings have been shown to enhance soft-tissue attachment but their effect on adhesion and biofilm formation by oral bacteria is unknown. METHODS: We have investigated how the properties of surfaces that may be used on abutments: turned titanium, sol-gel nanoporous TiO2 coated surfaces and anodized Ca2+ modified surfaces, affect biofilm formation by two early colonizers of the oral cavity: Streptococcus sanguinis and Actinomyces naeslundii. The bacteria were detected using 16S rRNA fluorescence in situ hybridization together with confocal laser scanning microscopy. RESULTS: Interferometry and atomic force microscopy revealed all the surfaces to be smooth (Sa?0.22 ?m). Incubation with a consortium of S. sanguinis and A. naeslundii showed no differences in adhesion between the surfaces over 2 hours. After 14 hours, the level of biofilm growth was low and again, no differences between the surfaces were seen. The presence of saliva increased the biofilm biovolume of S. sanguinis and A. naeslundii ten-fold compared to when saliva was absent and this was due to increased adhesion rather than biofilm growth. CONCLUSIONS: Nano-topographical modification of smooth titanium surfaces had no effect on adhesion or early biofilm formation by S. sanguinis and A. naeslundii as compared to turned surfaces or those treated with anodic oxidation in the presence of Ca2+. The presence of saliva led to a significantly greater biofilm biovolume but no significant differences were seen between the test surfaces. These data thus suggest that modification with sol-gel derived nanoporous TiO2, which has been shown to improve osseointegration and soft-tissue healing in vivo, does not cause greater biofilm formation by the two oral commensal species tested than the other surfaces.
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