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| 2. |
- Hedenstierna, Göran, 1941-, et al.
(författare)
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Higher age and obesity limit atelectasis formation during anaesthesia : an analysis of computed tomography data in 243 subjects
- 2020
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Ingår i: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:3, s. 336-344
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Tidskriftsartikel (refereegranskat)abstract
- Background: General anaesthesia is increasingly common in elderly and obese patients. Greater age and body mass index (BMI) worsen gas exchange. We assessed whether this is related to increasing atelectasis during general anaesthesia.Methods: This primary analysis included pooled data from previously published studies of 243 subjects aged 18-78 yr, with BMI of 18-52 kg m(-2). The subjects had no clinical signs of cardiopulmonary disease, and they underwent computed tomography (CT) awake and during anaesthesia before surgery after preoxygenation with an inspired oxygen fraction (FIO2) of >0.8, followed by mechanical ventilation with FIO2 of 0.3 or higher with no PEEP. Atelectasis was assessed by CT.Results: Atelectasis area of up to 39 cm(2) in a transverse scan near the diaphragm was seen in 90% of the subjects during anaesthesia. The log of atelectasis area was related to a quadratic function of (age+age(2)) with the most atelectasis at similar to 50 yr (r(2)=0.08; P<0.001). Log atelectasis area was also related to a broken-line function of the BMI with the knee at 30 kg m(-2) (r(2)=0.06; P<0.001). Greater atelectasis was seen in the subjects receiving FIO2 of 1.0 than FIO2 of 0.3-0.5 (12.8 vs 8.1 cm(2); P<0.001). A multiple regression analysis, including a quadratic function of age, a broken-line function of the BMI, and dichotomised FIO2 (0.3-0.5/1.0) adjusting for ventilatory frequency, strengthened the association (r(2)= 0.23; P<0.001). PaO2 decreased with both age and BMI.Conclusions: Atelectasis during general anaesthesia increased with age up to 50 yr and decreased beyond that. Atelectasis increased with BMI in normal and overweight patients, but showed no further increase in obese subjects (BMI >= 30 kg m(-2)). Therefore, greater age and obesity appear to limit atelectasis formation during general anaesthesia.
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- Häggström, J, et al.
(författare)
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A Longitudinal Study of Peripheral and Central Auditory Function in Alzheimer's Disease and in Mild Cognitive Impairment
- 2018
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Ingår i: Dementia and geriatric cognitive disorders extra. - : S. Karger AG. - 1664-5464. ; 8:3, s. 393-401
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background/Aim:</i></b> Central auditory processing disorder (CAPD) might precede the onset of Alzheimer’s disease (AD). A method of evaluating CAPD is the dichotic digits test (DDT). The aim was to address this in a longitudinal setting. <b><i>Methods:</i></b> A total of 136 individuals were assessed with peripheral and central hearing tests at baseline and at 5-year follow-up. <b><i>Results:</i></b> Subjects with AD showed a significant decline in DDT scores of the right ear from baseline to follow-up. The other groups retained high DDT scores. Peripheral auditory function declined as expected according to age. <b><i>Conclusions:</i></b> Our study indicates that DDT performance reflects an ongoing process resulting in dementia.
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- Milton, A., et al.
(författare)
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Development of an ICU discharge instrument predicting psychological morbidity : a multinational study
- 2018
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Ingår i: Intensive Care Medicine. - : Springer. - 0342-4642 .- 1432-1238. ; 44:12, s. 2038-2047
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To develop an instrument for use at ICU discharge for prediction of psychological problems in ICU survivors.Methods: Multinational, prospective cohort study in ten general ICUs in secondary and tertiary care hospitals in Sweden, Denmark and the Netherlands. Adult patients with an ICU stay12h were eligible for inclusion. Patients in need of neurointensive care, with documented cognitive impairment, unable to communicate in the local language, without a home address or with more than one limitation of therapy were excluded. Primary outcome was psychological morbidity 3months after ICU discharge, defined as Hospital Anxiety and Depression Scale (HADS) subscale score11 or Post-traumatic Stress Symptoms Checklist-14 (PTSS-14) part B score>45.Results: A total of 572 patients were included and 78% of patients alive at follow-up responded to questionnaires. Twenty percent were classified as having psychological problems post-ICU. Of 18 potential risk factors, four were included in the final prediction model after multivariable logistic regression analysis: symptoms of depression [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.10-1.50], traumatic memories (OR 1.44, 95% CI 1.13-1.82), lack of social support (OR 3.28, 95% CI 1.47-7.32) and age (age-dependent OR, peak risk at age 49-65years). The area under the receiver operating characteristics curve (AUC) for the instrument was 0.76 (95% CI 0.70-0.81).Conclusions: We developed an instrument to predict individual patients' risk for psychological problems 3months post-ICU, http://www.imm.ki.se/biostatistics/calculators/psychmorb/. The instrument can be used for triage of patients for psychological ICU follow-up.Trial registration: The study was registered at clinicaltrials.gov, NCT02679157.
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| 5. |
- Östberg, AL, et al.
(författare)
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A gender perspective of self-perceived oral health in adolescents : associations with attitudes and behaviours
- 2001
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Ingår i: Community Dental Health. - : World Dental Press; 1998. - 0265-539X. ; 18:2, s. 110-116
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population. Design A census survey. Self-reported questionnaires were answered anonymously in a standardised manner in classrooms. Attitudes studied included the importance of sound teeth and feelings towards visits to the dentist. Behaviours were represented by floss usage and sweets consumption. Setting All senior and upper secondary level schools in Skaraborg County, Sweden. Subjects 17,280 students, aged 13-18 years, Outcome measures Self-perceived oral health. represented by a single-item rating: satisfaction with the appearance of the teeth: self-assessed gum bleeding and a perceived oral health (POH) index. Results Recognising sound teeth as important was a predominating attitude among the respondents (boys 94%, girls 97%) and was significantly associated with a good perceived oral health overall. Individuals who experienced visits to dentist as unpleasant (boys 36%, girls 43%) were less likely to perceive good oral health as single-item rated (OR for boys 0.55[0.49, 0.63], girls 0.40[0.34, 0.47]). Regular use of floss had a small protective effect on bleeding gums. Daily sweets consumption showed a significant and inverse association with self-perceived oral health as single-item rated (OR for boys 0.53[0.44, 0.66], girls 0.49[0.40, 0.60]). Girls, more often than boys, perceived their oral health to be good, except in the perception of the appearance of their teeth. Conclusions It is concluded that the strong associations between attitudes and self-perceived oral health should be recognised in strategies for oral health promotion and that gender differences must be considered.
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| 7. |
- Östberg, Anna-Lena, et al.
(författare)
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A gender perspective of self-perceived oral health in adolescents. Associations with attitudes and behaviours
- 2001
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Ingår i: Community Dental Health.
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population.Design A census survey. Self-reported questionnaires were answered anonymously in a standardised manner in classrooms. Studied attitudes included the importance of sound teeth and feelings towards visits to the dentist. Behaviours were represented by floss usage and sweets consumption. Setting All senior and upper secondary level schools in Skaraborg County, Sweden. Subjects 17,280 students, aged 13 18 years.Outcome measures Self-perceived oral health, represented by a single-item rating; satisfaction with the appearance of the teeth; self-assessed gum bleeding; and a perceived oral health (POH) index.Results Recognising sound teeth as important was a predominating attitude among the respondents (boys 94%, girls 97%) and was significantly associated with a good perceived oral health in all aspects. Individuals who experienced visits to dentist as unpleasant (boys 36%, girls 43%) were less likely to perceive good oral health as single-item rated (OR for boys 0.55[0.49,0.63] and for girls 0.40[0.34,0.47]). Regular use of floss did not prevent bleeding gums. Daily sweets consumption showed a significant and inverse association with self-perceived oral health as single-item rated (OR for boys 0.53[0.44,0.66], girls 0.49[0.40,0.60). Girls, more often than boys, perceived their oral health to be good, except in the perception of the appearance of their teeth. Conclusions It is concluded that the strong associations between attitudes and self-perceived oral health should be recognised in strategies for oral health promotion and that gender differences must be considered.
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| 8. |
- Östberg, Anna-Lena, 1949-, et al.
(författare)
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Adolescents perceptions of oral health and influencing factors : A qualitative study
- 2002
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Ingår i: Acta Odontolologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 60:3, s. 167-173
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Tidskriftsartikel (refereegranskat)abstract
- Accounts of self-perceptions of oral health have hitherto been rare, although they are of great interest for strategies in health promotion. The objective of this study was to increase our knowledge of adolescents perceptions of oral health and influencing factors.Semi-structured interviews of 17 Swedish adolescents were performed. Criteria for strategic sampling were age (15, 18 years), gender (male, female), and dental health (healthy, unhealthy). Data were analyzed according to the constant comparative method. Areas of focus were general oral health, personal oral health, dental care, and life-style issues.Oral health awareness was generally low among the informants. Two categories of oral health were identified: action (the physical things we do to effect the condition of our mouths) and condition (the physical status of the mouth). Conditional aspects were most frequent in evaluations of personal oral health. The informants considered their possibilities to influence oral health limited. Perceptions of influences on oral health were related to personal and professional care, social support and impact, and external factors. Concern for oral health was derived as the core category in perceived influence on oral health. This study indicates that it is important to find factors that enhance adolescents awareness of their own resources and to seek mechanisms that govern internalization. There is a need to find strategies to convey such knowledge to the intermediaries: the dental personnel and the parents.
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| 9. |
- Östberg, Anna-Lena, et al.
(författare)
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Adolescents Perceptions of Oral Health and Influencing Factors
- 2001
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Konferensbidrag (refereegranskat)abstract
- Introduction: Accounts on self-perceptions of oral health have hitherto been rare, although of great interest for strategies in health promotion. Purpose: The objective of this study was to increase the knowledge on adolescents perceptions of oral health and influencing factors.Methods: Semistructured interviews of 17 Swedish adolescents were performed. Criteria for strategic sampling were age (15, 18 years), gender (male, female), and dental health (healthy, unhealthy). Data were analysed according to the constant comparative method. Areas of focus were general oral health, personal oral health, life-style issues and dental care.Results: The awareness of oral health was mostly low among the informants. Two categories of oral health were identified, action and condition. Conditional aspects were most frequent in evaluations of personal oral health. Possibilities to influence oral health were considered limited. Perceptions of influences on oral health were related to personal and professional care, social support and impact, and external factors. Gender differences were indicated in health consciousness. Concern for oral health was denoted the core category of perceived influence.
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| 10. |
- Östberg, Anna-Lena, 1949-, et al.
(författare)
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Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents
- 1999
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 57:4, s. 231-236
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Tidskriftsartikel (refereegranskat)abstract
- A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior, and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR)= 5.8[3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR=1.7[1.4-2.1) and the older (OR=2.4[1.9-3.1]) adolescents. Conclusion: Most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys
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