| 1. |
- Canales, Giancarlo De La Torre, et al.
(författare)
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The role of tryptophan and its derivatives in musculoskeletal pains : A systematic review and meta-analysis
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842.
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Forskningsöversikt (refereegranskat)abstract
- Background: Studies present ambiguous findings regarding the role of tryptophan and its metabolites, kynurenine and serotonin in chronic musculoskeletal pain. This systematic review aimed to investigate the expression of tryptophan and its metabolites, serotonin and kynurenine in patients with local and generalized chronic musculoskeletal pain in comparison with pain-free controls.Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL) and Web of Science for clinical and observational trials from the beginning of each database to 21 April 2023. Out of 6734 articles, a total of 17 studies were included; 12 studies were used in the meta-analysis of serotonin, 3 regarding tryptophan and 2 studies for a narrative synthesis regarding kynurenine. Risk of bias was assessed using the quality assessment tool for observational cohort and cross-sectional studies of the National Heart, Lung, and Blood Institute, while the certainty of evidence was by GRADE.Results: All included studies showed a low risk of bias. The meta-analysis showed lower blood levels of tryptophan (p < .001; very low quality of evidence) and higher blood levels of serotonin (p < .001; very low-quality evidence) in patients with generalized musculoskeletal pain, when compared to pain-free individuals. In local chronic musculoskeletal pain, there were higher blood levels of serotonin (p=.251; very low quality of evidence) compared to pain-free individuals. Regarding kynurenine, the studies reported both higher and lower blood levels in generalized chronic musculoskeletal pain compared to pain-free individuals.Conclusions: The blood levels of tryptophan and its metabolites serotonin and kynurenine seem to influence chronic musculoskeletal pain.
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| 2. |
- Christidis, Nikolaos, et al.
(författare)
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Early steps towards professional clinical note-taking in a Swedish study programme in dentistry
- 2022
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Higher education tends to focus on academic writing only, instead of emphasizing that professional texts are also used as a basis for communication in contexts with a variety of participators. When it comes to clinical notes, research is scarce and focused on technology and informatics. Therefore, the aim was to explore dental students’ clinical notes, and specifically which aspects of the clinical notes characterizes clinical notes that are not sufficient enough for professional purposes.Methods The object of analysis was the student’s written completion of a teacher constructed protocol regarding oral mucosa, the dental apparatus including pathology on tooth level, oral hygiene, and a validated international clinical examination protocol of the temporomandibular region. The study was framed within the New Literacy Studies approach, and the clinical notes were analyzed using thematic analysis.Results Within the clinical notes three themes were identified; a) familiar content; b) familiar content in new context; and c) new content. The forms of notes could refer to either categorizational clinical notes or descriptive clinical notes. Most students were able to write acceptable clinical notes when the content was familiar, but as soon as the familiar content was in a new context the students had difficulties to write acceptable notes. When it comes to descriptive notes students suffered difficulties to write acceptable notes both when it came to familiar content, or familiar content in a new context.Conclusions Taken together, the results indicate that students have difficulties writing acceptable notes when they are novices to the content or context, making their notes either insufficient, too short or even wrong for professional purposes. With this in mind, this study suggests that there is a need to strengthen the demands on sufficient professional quality in clinical notes and focus on clinical notes already in the early stages of the different medical educations.
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| 3. |
- Christidis, Nikolaos, et al.
(författare)
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Pharmacological Treatments of Temporomandibular Disorders : A Systematic Review Including a Network Meta-Analysis
- 2023
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Ingår i: Drugs. - : Springer. - 0012-6667 .- 1179-1950.
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD.METHOD: An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane's tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE).RESULTS: When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose.CONCLUSIONS: The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient's individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches.
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| 4. |
- Christidis, Nikolaos, et al.
(författare)
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Psychological treatments for temporomandibular disorder pain—A systematic review
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:7, s. 1320-1336
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Forskningsöversikt (refereegranskat)abstract
- Objective: Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective.Materials and Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE.Results: The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD.Conclusion:This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.
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| 5. |
- Christidis, Nikolaos, et al.
(författare)
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Swedish dental students’ clinical notes and reflections as part of a case-based examination – challenges for undergraduate education
- 2023
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Ingår i: Medical Research Archives. - : European Society of Medicine. - 2375-1916 .- 2375-1924. ; 11:10
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Tidskriftsartikel (refereegranskat)abstract
- Clinical records are the basis for clinical reasoning, diagnostics, treatment planning, and management as well as for management of the patient and the outcome of the treatment, and therefore an important aspect of health professionals’ work. Several articles emphasize the importance of adequate and correct content in these records. Previous research shows that even health professionals need to improve the content and structure of their clinical records, for them to give the information needed for various needs. The focus of this article are the clinical records of undergraduate dental students. The aim of the study was to explore patterns of adequate and inadequate content in clinical notes of undergraduate dental students in their final year of education. Secondly, whether these results could provide insights for development of health professions education.Data comprised of 33 cased-based examinations collected during January 2020 at the University Dental Clinic, Department of Dental Medicine, Karolinska Institutet, in Huddinge Sweden. Also, data included teachers’ assessment of these examinations. The texts were analyzed with thematic analysis.Analytical results showed three themes. The first theme, (i) Professional content knowledge, concerned information in patient history, status, diagnostics and treatment plan, and an information ambiguity. The theme also included the students' use of professional terminology and the choice of articles to support reflections. The second theme (ii) incomplete method of investigation involved the actual patient interview, but also students’ various misunderstandings of the template. The third theme was (iii) Academic formalities. This theme concerned students' understanding of the purpose of referencing and its function, but also a non-use of references, the use of irrelevant references, errors in the given citation style, and an incorrect structure of the text according to the template. In conclusion, results showed the need for continuous training in clinical note-taking and reflections during dental students' professional education. In this training, teachers’ assessment is important for students' development of professional literacy and professional judgment. Also, a continuous reminder of science and proven experience as the basis for the profession which is also made visible through academic formalities.
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| 6. |
- De la Torre Canales, Giancarlo, et al.
(författare)
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Botulinum toxin-a for the treatment of myogenous temporomandibular disorders : an umbrella review of systematic reviews
- 2024
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Ingår i: Drugs. - : Adis. - 0012-6667 .- 1179-1950.
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Forskningsöversikt (refereegranskat)abstract
- Objective: Temporomandibular disorders (TMDs) encompass several conditions that cause pain and impair function of the masticatory muscles (M-TMDs) and temporomandibular joints. There is a large interest among clinicians and researchers in the use of botulinum toxin-A (BoNT-A) as a treatment for M-TMD. However, due to the lack of consistent evidence regarding the efficacy as well as adverse events of BoNT-A, clinical decision making is challenging. Therefore, this umbrella review aimed to systematically assess systematic reviews (SRs) evaluating BoNT-A treatment effects on pain intensity, mandibular movements, and adverse events in patients with M-TMDs.Method: An electronic search was undertaken in the databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Epistemonikos, ClinicalTrials.gov, and ICTRP to identify SRs investigating BoNT-A effects on M-TMDs, published from the inception of each database until 6 December 2023. The quality of evidence was rated according to the critical appraisal checklist developed by the umbrella review methodology working group. Only high-quality SRs were included.Results: In total, 18 SRs were included. BoNT-A was shown to be more effective than placebo to reduce pain intensity, but not compared to standard treatments. Additionally, BoNT-A was not superior to placebo or standard treatments regarding improvement of mandibular movements. BoNT-A was considered to have a higher risk for adverse events on muscle and bony tissue compared with other treatments.Conclusion: The synthesis in this umbrella review provides the highest level of evidence present. Taken together, there are indications of effectiveness of BoNT-A for treatment of M-TMDs, supported by moderate evidence. However, considering the risk of causing serious adverse events, treatment with BoNT-A is recommended to be the last treatment alternative.
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| 7. |
- Ho, Yuh-Shan, et al.
(författare)
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Research focuses and trends in literacy within education : A bibliometric analysis
- 2023
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Ingår i: Cogent Education. - : Taylor & Francis. - 2331-186X. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to conduct a bibliometric analysis including citation performance in the research topic of literacy within education, by using an innovative method including details of article title, author keyword, KeyWords Plus, and abstracts. This novel study is to our knowledge, the first of its kind within the field of literacy and can therefore provide valuable insights for professionals and others interested in literacy in terms of who and what to read, and where to focus. Data were retrieved 17 December 202217 December 2022 from the Social Sciences Citation Index (SSCI) of Clarivate Analytics for studies published from 1992 to 2021. To evaluate research trends, the distribution of keywords in the article title and author‑selected keywords was used. The search yielded 539 documents in SSCI, of which 489 were document-type “articles”. These articles were published in 142 journals. The analysis of the articles showed that “academic writing,” “higher education,” “writing,” and “assessment” are the most used keywords by the authors. The most frequently cited study was published in 1998 by Lea and Street. Most articles were published in English and originated in the USA and the UK. Most studies in the field of professional literacy are produced in the USA and UK, that is, countries with a long tradition of research in professional education and having English as the main language. Most publications are single-country productions because literacy, to a high extent, are local in nature.
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| 8. |
- Lindberg, Viveca, 1954-, et al.
(författare)
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Characteristics of dental note taking : a material based themed analysis of Swedish dental students
- 2020
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Background: The transition from upper secondary to higher education and from higher education to professional practice requires that students adapt to new literacy practices, academic and professional. However, there is a gap of knowledge regarding literacy practices in dental education. Therefore, the aim of this study was to identify what characterizes dental students’ notetaking and secondarily to determine what dental students express regarding their notetaking.Methods: To analyze students’ perspectives about the purposes of notetaking and to examine their written notes in depth, three volunteer students, out of the 24 students that voluntarily and anonymously handed in their notes, were interviewed. The three undergraduate dental students that participated in this material-based, semi-structured interview study, framed within a New Literacy Studies approach, were on their third year (6th semester). The focus of these material-based interviews was on each student’s notes. Questions prepared for semi-structured interviews were open-ended and allowed for individual follow-up questions related to the interviewee’s answer. To analyze the outcome of the interviews a thematic analysis was used.Results: From the material-based interviews eight themes that relate to what, how and for what purpose students write were discerned. These eight themes include professional vocabulary, core content as well as clinical examples that belong to what students read and write; multimodal accentuation as well as synthesis that belong to how students read and write; and mnemonic strategies, academic purposes, and professional purposes that belong to for what purpose students read and write.Conclusions: Findings from the interviews indicate that the digital development, offering a variety of available tools, has expanded the notion of notetaking. This study identified that dental students’ notetaking has changed during their education from initially being synchronous, to also include multimodal and asynchronous writing, making notetaking more of a writing practice. Further, students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter, but also in relation to their experiences during clinical training. Although, our hypothesis was that the main purpose of notetaking and writing was to pass their course examinations, this study showed that students that were half-way through their dental education, are aware that literacy practices are for learning for their future profession, and not only for passing their exams.
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| 9. |
- Lindberg, Viveca, 1954-, et al.
(författare)
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Higher education for professional and/or academic literacy?
- 2019
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Konferensbidrag (refereegranskat)abstract
- As in other professional programmes within academia, part of the learning outcomes relates to content like anatomy and physiology, others relate to tools, and materials used for dental work and their properties – in everyday terminology the ‘theoretical’ aspects of dental work. Other learning outcomes relate to what a dentist does – the ‘practical’ (clinical) aspects of dental knowledge. Aspects of these are both understanding patient needs, hands-on-skills, being able to construct an anamnesis and explain oral conditions, treatment need and prognosis (Kurz, Draper & Silverman, 2016). Furthermore, as becoming a dentist requires attending an educational programme, reading and writing, i.e. literacy competences, are seen as self-evident aspects of contemporary education. While it seems obvious that it takes time to become a skilled dentist and a degree is the necessary beginning in this direction, it seems less obvious that it also takes time to become a skilled writer in academia. But future dentists not only examine or repair their clients’ teeth. Part of a dentist’s everyday work is also to document examinations and treatment, prescribe medicines, but also to communicate with other professionals about clients that may need complementary or specialist treatment. Transition from higher education to work requires that students can cope also with the literacy practices of the profession. Studies with this focus show that although a person may be a successful student, (s)he isn’t necessarily well acquainted with the kinds of literacy demands that (s)he will encounter when entering the world of work (Ask, 2017; Dias et al., 1999). Since the 1980s there has been a growing interest in literacy practices, that is, what people read and write in specific activities, how people are expected to read and write (what qualifies as an acceptable text) and for what purposes representatives for the activity read and write. Our focus is on literacy practices in professional higher education, since these prepare for professional as well as for academic writing. On the one hand, students in professional higher education write as part of their studies, but part of professional higher education there also is a practicum or clinical part (what this part is called varies between programmes). During this part students also write, but the purpose for writing is not necessarily the same.The issue for this paper is firstly, to analyse one of the Swedish dental programmes in relation to its design in relation to possible content of relevance for academic and professional literacy, and secondly to explore the literacy practices of the first two modules of a course, specifically from the perspective of students: what do they read and write, how do they read the texts related to this module, how do they write, and what purposes do they express for their reading and writing?In Sweden previous research concerns professional education for engineers (Hållsten, 2008; Berthén, Eriksson & Lindberg, 2006), teachers (Ask, 2007; Blåsjö 2007) and policemen (Ask, 2014). Furthermore, the academic literacy has been studied by Blåsjö (2004) and (Hagström 2005). Our study aligns with the theoretical framings for such studies – text-cultures (Bazerman, 1995), the New Literacy Tradition (NLS) (Street, 2003) with specific focus on literacy in higher education (Jones, Turner & Street, 1999; Lea & Street, 1998, 2006) as well as literacy at work (Barton, Hamilton & Ivanič, 2000). Activity theory has also been used by e.g. Dias and Freedman (1999) in relation to professional higher education and corresponding work (see also Engeström, 1998).Methods/methodologyIn line with studies framed by NLS, ethnographic mapping of literacy events - what students read or wrote, and text-related communication (Barton 2007; Karlsson 2006; Street 2003) informed the data produced. They comprise of the following:Formal documents: the curriculum for the study programme in dentistry as well as the curriculum for the modules Orofacial pan and jaw function 1 and 2 Course literature (recommended however not compulsory): Jeffrey P Okeson (Ed.) (2013). Management of temporomandibular disorders and occlusion. 7th Ed. St. Louis: Mosby. The book is on 488 pages (of which approx. 100 pages consist of references). Of the 68 students, 16 bought the book. Teaching material: hand-outs (copies of lecturers’ power-points) to students. Power-points for all lectures are based on core content from the book. Students' notes (N=10), all anonymised. In total, 68 students attended the modules. The group pf students was informed about the study and or interest in having copies of their notes but that participation was voluntary.Audio-recordings of the lectures (N=8) – permission given by the two teachers – with the microphone placed close to the teacher. The audio-recordings were complemented by field-notes from one or two researchers attending each lectureMultiple-choice tests and students’ results (although not used for this paper).Complementary to the multiple-choice test there were three mandatory clinical skills demonstrations. For the clinical skills demonstration, no documentation was demanded of the students. The teacher filled in a template for each student, based on observation of students’ performances.Video-recorded, material based thematic interviews with students. During one of the final lectures, students were asked if they could consider being interviewed based on their notes from the lectures. All three student that registered were interviewed. The video recording focused only on students’ notes and their hands, the main point with this procedure was to capture if and when a student pointed at some specific part of their notes.Data was processed and analysed in the following steps: The formal documents were read in order to identify parts of the programme and curricula were academic and/or professional literacy was likely to occur. For this part, the dental researchers in the group necessary. Secondly, the teaching material provided by the two teachers (hand-outs of their Power-point presentations) were compared to students’ notes in order to identify what kinds of notes students made. Thirdly, the interviews with students about their were analysed (this part is still in progress).Expected outcomes/preliminary results/implications The analysis of the programme showed that there, in principle, are several options for addressing both academic and professional literacy. During the first semester the curriculum indicates that students are expected to read academic articles. Attention should be paid both to the content and the structures of these articles. During the following semesters, professional literacy is focused in terms of communication with clients, colleagues and teams of various professions, but also written documentation for various professional purposes. From the sixth semester, academic writing is introduced. In parallel, more complex professional communication and documentation becomes part of the curriculum.The analysis of students’ notes was performed by two researchers, one specialized in dentistry and the other in pedagogy, for reasons of double-control. Both researchers had participated in data collection and observation of lectures. This analysis was developed and tried out based on randomly selected notes from one student before the main analysis of all student texts. The initial analytical template of the student texts was then compared to the main analysis, and the congruency was satisfactory. We found that some students took notes in hand-writing, while others took digital notes. In relation to what was noted, we found three types of notes: 1) copied text from teachers’ power-points, 2) re-formulated text in teachers’ power-points, and 3) written complementing text. The amount of each type pf notes was then estimated and patterns of the three types of notes (copied, re-formulated, or complementary) for each student were mapped and patterns were then constructed into profiles for students’ note-taking. The result of this analysis was used for developing some of the questions for the thematic interviews with students. Preliminary findings of the interviews show that students are aware of professional as well as of academic writing throughout the programme.
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| 10. |
- Lindberg, Viveca, 1954-, et al.
(författare)
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Literacy as part of professional knowing in a Swedish dental education
- 2021
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Academic reading and writing are seen as self-evident literacy competences in most contemporary higher educations, however, whether students also are introduced to professional literacy of relevance for dentistry during their education is a question. The purpose of this study is to analyze one of the Swedish dental programmes, with respect to its design, in relation to possible content of relevance for academic and professional literacy. Secondarily, to identify and analyze Swedish dental students’ writing in an academic setting, i.e. what these students are expected to read and write, and how they write.Methods: Data, for this ethnographically inspired case-study, was produced by observations and audio-recordings of lectures, copies of teachers’ handouts and of volunteering students’ notes, and a multiple-choice-test. Dataanalysis was made in five steps, starting with macro-level data, i.e. curriculum and syllabuses, followed by the syllabuses for the two observed modules, the teacher-provided material, analysis of the students’ notes, while in the fifth and final step, the results from the previous steps were compared, to find patterns of what students were expected to read and write, and what in the teacher-provided multimodal material that was emphasized in teachers’ talk.Results: This study showed that students were engaged in several types of literacy events, such as reading, finding and watching videos on their learning platform, writing, and following instructions. The study also showed that there is a recurrent academic content comprised of anatomy, physiology and pathology, while the professional content comprised of patient communication and anamnesis. Further, an integrated content was found and was initiated in teacher-constructed PowerPoints and by student-questions. Note-taking patterns varied between individual students, but the general pattern for this group of students were the use of complementary notes. This type of note-taking was used to make available further descriptions of the teacher-constructed text in PowerPoints, but also an independent text describing pictures shown on teachers’ PowerPoints or the blackboard.Conclusion: Findings from the present study reveal that students either copy text from teachers’ PowerPoint-slides, re-formulate text from teachers’ PowerPoint-slides, or write complementing text to teachers’ PowerPoint-slides. Further, the students individually choses type of note-taking based on situation. The study also revealed that the academic literacy – in the two modules during the fifth and sixth semesters of a dental education analyzed – mainly has a professional basis for reading, writing, and communication purposes. The study also showed that academic and professional literacy are closely connected through recurrent integration.
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