| 1. |
- Bjorndal, Lars, et al.
(författare)
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Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy
- 2010
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 118:3, s. 290-297
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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.
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| 2. |
- Ekdahl, Lena, et al.
(författare)
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Acupuncture treatment of pregnant women with low back and pelvic pain - an intervention study
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 24:1, s. 175-182
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe patients' experience of acupuncture treatment in low back and pelvic pain during pregnancy. Design: An intervention study carried out between September 2000 and December 2001, involving 40 pregnant women. Participants: The study population consisted of healthy pregnant women presenting with low back and pelvic pain at maternity health care centres within a defined area in southern Sweden. Intervention: Two groups of women received acupuncture treatment from gestational week 20 (group 1) or week 26 (group 2) respectively, for a period of 6 weeks divided into eight sessions of 30 minutes each. Measurements: Pain assessment was carried out using Pain-O-Meter and visual analogue scale (POM-VAS), Short-Form McGill Questionnaire (SF-MPQ), Short-Form-36: Health Survey Questionnaire (SF-36), followed by telephone interviews 2-3 months after delivery. Findings: The results of POM-VAS, SF-MPQ and SF-36 showed a relief of pain in both groups. In group 2, an improvement in several SF-36 variables was noted in spite of increased physical restrictions. Telephone interviews confirmed that expectations of treatment were fulfilled. Using content analysis the main category, limitations in daily life, was identified, with subcategories pain, and psychological well-being. Conclusion: It may be advantageous to begin acupuncture therapy later in pregnancy to maximise pain relief.
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| 3. |
- Gunnarsson, Anna Birgitta, 1958-, et al.
(författare)
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Client perceptions of the Tree Theme Method™ : a structured intervention based on storytelling and creative activities
- 2010
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 17:3, s. 200-208
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Tidskriftsartikel (refereegranskat)abstract
- The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: “From feeling a pressure to perform to becoming focused and expressive”, “Expressing oneself and one's life situation led to awakening of memories and feelings”, “New perspectives of self-image, everyday life and relations to others”, “Story-making led to shaping and reconstructing one's life story”, “Interaction was of importance when reconstructing one's life story” and, finally, “The attitude of the occupational therapist was of importance for the development of the therapeutic relationship”. There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client–therapist relationship.
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| 4. |
- Handlin, Linda
(författare)
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Human-Human and Human-Animal Interaction : Some Common Physiological and Psychological Effects
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present thesis was to investigate hormonal and physiological effects in mothers during a breastfeeding session and in dogs and their owners in response to short-term interaction. In study one, sixty-six mothers receiving either exogenous oxytocin infusion and/or epidural analgesia (EDA) during labor or intramuscular oxytocin injection post partum were studied. Oxytocin, prolactin, adrenocorticotrophic hormone (ACTH) and cortisol levels, as well as blood pressure were measured during a breastfeeding session two days after birth. In response to breastfeeding two days after birth, the mothers displayed a pulsatile release of oxytocin and increasing prolactin levels. In addition, the activity in the HPA-axis was reduced and maternal blood pressure decreased. The results also show that EDA administration in combination with oxytocin during labor resulted insignificantly lower oxytocin levels and higher cortisol levels, as well as higher bloodpressure in response to breastfeeding two days after birth, compared to EDA administration alone. In addition, oxytocin infusions dose-dependently lowered the mothers’ endogenous oxytocin levels two days after birth. In study two, ten female dog owners and their male Labrador dogs participated, together with ten controls. Their levels of oxytocin, cortisol and insulin, as well as their heart rate, were measured. The connection between the quality of the dogowner relationship and hormone levels was also explored. Short-term interaction between dogs and their owners resulted in oxytocin release in both species and their cortisol levels and heart rate were also affected. Oxytocin levels and positive attitudes regarding the dog-owner relationship were positively correlated. In conclusion, both human-human and human-animal interactions induce oxytocin release and promote oxytocin mediated effects, such as decreasing cortisol levels and blood pressure. In addition, social interaction and oxytocin levels arepositively related.
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| 5. |
- Hegaard, Hanne Kristine, et al.
(författare)
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Experiences of physical activity during pregnancy in Danish nulliparous women with a physically active life before pregnancy. A qualitative study
- 2010
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study was to elucidate experiences and views of leisure time physical activity during pregnancy in nulliparous women who were physically active prior to their pregnancy. Methods: A qualitative study was conducted by means of personal interviews. Nineteen women, all with a moderate pre-pregnancy level of physical activity but with different levels of physical activity during pregnancy, participated in the study. Content analysis was applied. Results: In the analyses of experiences and views of physical activities during pregnancy, four categories and nine sub-categories were developed: Physical activity as a lifestyle (Habit and Desire to continue), Body awareness (Pregnancy-related discomfort, Having a complicated pregnancy and A growing body), Carefulness (Feelings of worry and Balancing worry and sense of security) and Sense of benefit (Feelings of happiness and Physical well-being). Conclusion: As other studies have also shown, women find that the discomfort and complications associated with pregnancy, the growing body, and a sense of insecurity with physical activity are barriers to maintaining former levels of physical activity. This study adds a new perspective by describing women's perceptions of these barriers and of overcoming them - thus, when pregnant, the majority of the women do not cease to be physically active but continue to be so. Barriers are overcome by applying one's own experience, looking to role models, mirroring the activities of other pregnant women and following the advice of experts (midwives/physiotherapists). Women then continue to be physically active during pregnancy, most often to a lesser extent or in alternative activities, and derive considerable enjoyment and physical well-being from this.
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| 6. |
- Hegaard, Hanne Kristine, et al.
(författare)
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The association between leisure time physical activity in the year before pregnancy and pre-eclampsia.
- 2010
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Ingår i: Journal of Obstetrics and Gynaecology. - : Informa UK Limited. - 1364-6893 .- 0144-3615. ; 30:1, s. 21-24
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Tidskriftsartikel (refereegranskat)abstract
- In order to investigate the association between leisure time physical activity in the year before pregnancy and pre-eclampsia, stratifying for maternal BMI, a prospective study was carried out from 1996 to 1998. Pregnant women attending their first antenatal care visit, were invited to participate in the study. Inclusion criteria: Danish-speaking, > OR =18 years of age, gestational age <22 weeks, no psychiatric disease, or abuse. The participants (n = 2,793) self-filled a questionnaire at 12-18 gestational weeks. Leisure time physical activity was categorised as sedentary, light and moderate-to-heavy. The results showed that pre-eclampsia occurred in 4.2%, 4.2% and 3.1% of women with sedentary, light and moderate-to-heavy leisure time physical activity, respectively. Although we found a tendency towards a lower risk of pre-eclampsia in women with the highest degree of physical activity during leisure time, especially in overweight women, no significant associations were found. It was concluded that leisure time physical activity the year before pregnancy does not protect against pre-eclampsia.
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| 7. |
- Petersson, Pia, et al.
(författare)
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Local interpretations of health policy concepts : the exemple of Närsjukvård in Sweden
- 2010
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Annan publikation (populärvet., debatt m.m.)abstract
- Health care systems in Europe face many challenges requiring greater integration of health and social care. The health policy response in government financed health systems has varied but a consistent feature has been continual change in an attempt to secure greater efficiencies and to meet patient expectations concerning service quality. This paper explores the manifestation of this phenomenon in a subregion of Sweden, where a new concept ‘Närsjukvård’ (literally Nearby Care) was introduced. Method: Data was collected through interviews and questionnaires. A convenience sample of 57 practitioners and managers was interviewed. A questionnaire with four statements based upon the findings from the interviews was answered by 1361 practitioners, managers and politicians working in primary health care, in municipalities and in hospitals. Results: The findings illustrated that the concept was interpreted as; accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. The study revealed different understanding and interpretations partly depending on the respondents’ professional domain and their organisational elonging. Conclusion: A prerequisite for creating a common meaning to the expression ‘Närsjukvård’ is that activities that help the creation of meaning are offered at and between all domain levels and organisations.
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| 8. |
- Saldert, Charlotta, 1966, et al.
(författare)
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Interaction in conversation in Huntington´s disease: An activity-based analysis and the conversation partner's view of change
- 2010
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Ingår i: Journal of Interactional Research in Communication Disorders. - 2040-5111. ; 1:2, s. 169-197
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Tidskriftsartikel (refereegranskat)abstract
- This study explores how conversational interaction is affected in a progressive neurological disease and what changes in the communication are reported by significant others in a questionnaire. Three dyads, each consisting of a person with Huntington’s disease and a conversational partner, were video-recorded, and the conversations were analysed with respect to the parameters in the questionnaire and also with the method Activity-based Communication Analysis. The analyses revealed that several important aspects of communication were affected by the disease in each of the three cases presented here. Most, but not all, of these changes in communication were also reported by the significant other in the questionnaire. These results show that it is important to look out for possible communication problems when managing individuals with Huntington’s disease. The questionnaire utilized in this study, with some modifications, seems to be a promising instrument for use in a clinical setting.
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| 9. |
- Sandgren, Anna, 1970-
(författare)
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Deciphering Unwritten Rules : Patients, relatives and nurses in palliative cancer care
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on palliative cancer care in acute care hospitals and home care settings. The overall aim was to generate a grounded theory explaining the latent patterns of behavior of patients, relatives and nurses. The thesis includes one population-based study with cross-sectional design and four classic grounded theory studies.Study I was conducted in two acute care hospitals. In this 5-year follow-up study, the proportion of hospitalized palliative cancer patients had decreased. The patients were older with more symptoms and care needs per patient. In both years, the most common symptoms were pain and deterioration and the most common cancer sites were prostate and colorectal. The results showed that associations between symptoms, care needs and cancer site were mostly weak.In study II, striving for emotional survival emerged as the pattern of behavior through which nurses in acute care hospitals deal with their main concern, the risk of being emotionally overloaded. Striving for emotional survival involves emotional shielding, emotional processing and emotional postponing. In study III, doing good care emerged as the pattern of behavior through which nurses in home care deal with their main concern, their desire to give good care. Doing good care involves three different caring behaviors: anticipatory caring, momentary caring and stagnated caring. In study IV, living on hold emerged as the pattern of behavior through which patients and relatives deal with their main concern, being put on hold. Living on hold involves three modes: fighting, adjusting and surrendering.The overall theory, deciphering unwritten rules, explains how patients, relatives and nurses are dealing with the uncertainty of how to act and behave. Deciphering unwritten rules involves figuring out, deliberating, maneuvering and evaluating.In conclusion, this thesis demonstrates the complexities of palliative cancer care and the importance of knowledge, resources and counseling. Patients should be cared for at the right care level according to their care needs and the care focus should be on treating symptoms irrespective of the diagnosis. The palliative care approach therefore needs to be implemented in all caring contexts with dying people.
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| 10. |
- Sandgren, Anna, 1970-, et al.
(författare)
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Living on hold in palliative cancer care
- 2010
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Ingår i: The Grounded Theory Review. - Mill Valley, CA : Sociology Press. - 1556-1542 .- 1556-1550. ; 9:1, s. 79-100
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to develop a classic grounded theory of palliative cancer patients and their relatives in the context of home care. We analyzed interviews and data related to the behaviour of both patients and relatives. “Living on hold” emerged as the pattern of behaviour through which the patients and relatives deal with their main concern, being put on hold. Living on Hold involves three modes: Fighting, Adjusting and Surrendering. Mode being may change during a trajectory depending on many different factors. There are also different triggers that can start a reconciling process leading to a change of mode. This means that patients and relatives can either be in the same mode or in different modes simultaneously. More or less synchronous modes may lead to problems and conflicts within the family, or with the health professionals.
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