| 1. |
- Nystedt, Astrid, et al.
(författare)
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Epidural analgesia for pain relief in labour and childbirth - a review with a systematic approach.
- 2004
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Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 13:4, s. 455-66
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Clinical ambiguity concerning effects of epidural analgesia for pain relief in labour seems to reflect a need for evidence-based knowledge for midwives. AIMS: This study aimed to review, with a systematic approach, the literature about effects and risks associated with the use of epidural analgesia for pain relief in labour and childbirth. DESIGN: A structured question was formulated and used for deriving search terms, establishing the inclusion of certain criteria and retrieving articles, i.e. what are the effects of epidural analgesia for pain relief in labour and childbirth? References were obtained through searches using MeSH-terms in Medline and Subheadings (SH) in CINAHL (e.g. Obstetrical Analgesia combined either with psychology or adverse effects and together with, Dystocia, Caesarean Section, Infant Newborn and Breastfeeding). The articles were divided into prospective randomized trials (C), non-randomized prospective studies (P) and retrospective studies (R). Scientific quality of the studies was assessed on a three-grade scale: high scientific quality (I), moderate scientific quality (II) or low scientific quality (III). RESULTS: Twenty-four articles were retrieved and systematically assessed. Seven studies were judged as high quality, 15 as moderate quality and two as low quality. The majority of studies appraised in this review failed to obtain or establish a cause and effect relationship. According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth. RELEVANCE TO CLINICAL PRACTICE: Midwives and doctors can recommend this form of pain relief. However, information about possible associations with adverse effects in mothers and infants must be provided to expectant couples.
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| 2. |
- Petersson, Gunnel H, et al.
(författare)
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Comparing caries risk factors and risk profiles between children and elderly.
- 2004
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Ingår i: Swedish dental journal. - 0347-9994. ; 28:3, s. 119-28
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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.
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| 3. |
- Mejàre, I, et al.
(författare)
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Caries incidence and lesion progression from adolescence to young adulthood : a prospective 15-year cohort study in Sweden.
- 2004
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Ingår i: Caries Res. - 0008-6568. ; 38:2, s. 130-41
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Tidskriftsartikel (refereegranskat)abstract
- The objectives were (1) to assess caries development, including the incidence and rate of lesion progression, in a Swedish cohort from adolescence to young adulthood and (2) to compare the caries incidence rates in adolescents with those of young adults. The original material consisted of 536 children aged 11-13 years at baseline. This cohort had been followed through annual bitewing radiographs to 21-22 years of age. In 1998-1999, 250 of these individuals were re-examined at the age of 26-27, and the new caries data were added to the original data. The results showed that fewer new enamel lesions developed on approximal surfaces during young adulthood than during adolescence; the caries incidence rates for enamel lesions decreased from 4.3 in the age group 12-15 years to 2.7 new caries lesions/100 surface-years in the age group 20-27 years. The same applied to the rate of lesion progression, where the corresponding values from the enamel-dentin border to the outer dentin were 32.5 for the youngest and 10.9 new lesions/100 surface-years for the oldest age group. The caries incidence of outer dentin lesions on approximal surfaces was low but increased from 0.2 in the age group 12-15 years to 0.9 new outer dentin lesions/100 surface-years in the age group 20-27 years. The incidence rates varied considerably between different tooth surfaces. Also for occlusal surfaces, fewer new dentin lesions developed during young adulthood than during adolescence; the incidence was 2.0 new dentin lesions/100 surface-years in the youngest age group and 0.7 during young adulthood. At the age of 13, the proportion of DFS of occlusal surfaces predominated over DFS of approximal surfaces but at the age of 26-27 the proportions of occlusal and approximal DFS were almost equal.
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| 4. |
- Sjögren, Göran, et al.
(författare)
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A 10-year prospective evaluation of CAD/CAM-manufactured (Cerec) ceramic inlays cemented with a chemically cured or dual-cured resin composite
- 2004
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Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 17:2, s. 241-246
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The present follow-up study was carried out to evaluate the performance of Class II Cerec inlays after 10 years of clinical service. MATERIALS AND METHODS: Sixty-six Class II CAD/CAM ceramic inlays were placed in 27 patients. Each patient received at least one inlay luted with a dual-cured resin composite and one inlay luted with a chemically cured resin composite. At the 10-year recall, 25 (93%) patients with 61 (92%) inlays were available for evaluation using a slight modification of the USPHS criteria. RESULTS: Fifty-four (89%) of the 61 inlays reevaluated still functioned well at the 10-year recall. During the follow-up period, seven (11%) of the inlays required replacement because of: four inlay fractures, one cusp fracture, endodontic problems in one case, and postoperative symptoms in one case. All the replaced inlays had been luted with the dual-cured resin composite. The fractured inlays were all placed in molars. The estimated survival rate after 10 years was 89%, 77% for the dual-cured resin composite-luted inlays and 100% for the chemically cured resin composite-luted ones. The difference was statistically significant. CONCLUSION: Patient satisfaction with and acceptance of the Cerec inlays were high, and the performance after 10 years of clinical service was acceptable, especially regarding the inlays luted with the chemically cured resin composite. The properties of the luting agents seem to affect the longevity of the type of ceramic inlays evaluated.
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| 5. |
- Ullbro, Christer, et al.
(författare)
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Tissue plasminogen activator (t-PA) and placental plasminogen activator inhibitor (PAI-2) in gingival crevicular fluid from patients with Papillon-Lefèvre syndrome
- 2004
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Ingår i: Journal of Clinical Periodontology. - 0303-6979. ; 31:9, s. 708-712
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Numerous patients with Papillon–Lefèvre syndrome (PLS) express a severe periodontal inflammation that results in premature loss of deciduous and permanent teeth. The plasminogen activating (PA) system is involved in physiological and pathological processes including epithelial healing, extracellular proteolysis and local inflammatory reactions. The aim of the study was to explore a possible role of the PA system in patients with PLS.Material and Methods: Samples of gingival crevicular fluid (GCF) were collected from areas with gingival infection in 20 patients with PLS and in 20 healthy controls. The concentration of tissue plasminogen activator (t-PA) and inhibitor (PAI-2) was measured with ELISA.Results: The median level of PAI-2 was significantly higher (p<0.01) in PLS patients than in the controls, while the median value of t-PA did not differ between the groups. No difference in t-PA or PAI-2 levels was found regarding age, gender or presence of active periodontal disease.Conclusion: The findings indicate an atypical activity of the PA system with a disturbed epithelial function in PLS patients, suggesting that the periodontal destruction seen in patients with PLS is secondary to a hereditary defect in the defense system.
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| 6. |
- Ekborg, Margareta
(författare)
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How student teachers use scientific conceptions to discuss a complex environmental issue
- 2003
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Ingår i: Journal of Biological Education;3. - Institute of Biology. - 0021-9266. ; 37:3, s. 126-132
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Tidskriftsartikel (refereegranskat)abstract
- This paper focuses upon the extent to which student teachers develop conceptual understanding about key scientific principles through their training, and the extent to which they can deploy this knowledge in discussions of complex environmental issues. All students involved in the teacher-training programme answered a questionnaire -- before and after their first term of the programme -- in which their conceptions of respiration and photosynthesis were tested. 15 students were also interviewed about a newspaper article that discusses the ethicality of using surplus heat from a crematorium in the far heating system. They were asked to comment on the article, to pose questions about the issue and explicitly asked what happens to the bodies if either combusted or buried. The first results show that some students, though not the majority, develop their ability to answer conceptual questions about scientific content as a result of their first science course. However, even among these students, the task of deploying this conceptual understanding in discussions of complex, socially relevant questions proved very difficult. Most students expressed personal opinions without using scientific arguments. It may be that the students have not developed the ability to recognise and distinguish different contexts or that the learning situation has not been challenging enough.
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