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1.
  • Nohlert, Eva, et al. (författare)
  • Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden : a randomized trial
  • 2009
  • Ingår i: BMC Public Health. - Stockholm : BioMed Central (BMC). - 1471-2458. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundTobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting.Methods300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT), whereas the other group was assigned to high intensity treatment (HIT) support. The main outcome measures included self-reported point prevalence and continuous abstinence (≥ 183 days) at the 12-month follow-up.ResultsFollow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02). There was a difference (not significant) between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%). However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23%) compared with available data assessing abstinence in smokers trying to quit without professional support.ConclusionScreening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The more extensive and expensive HIT-protocol should be offered to those who are unable to quit with the LIT approach in combination with other support.
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2.
  • Gauffin, Fredrika, et al. (författare)
  • Expresson of PTEN and SHP1, Ivestigated from Tissue Microarrays in Pediatric Acute Lymphoblastic, Leukemia
  • 2009
  • Ingår i: Pediatric Hematology & Oncology. - : Informa UK Limited. - 0888-0018 .- 1521-0669. ; 26:1, s. 48-56
  • Tidskriftsartikel (refereegranskat)abstract
    • PTEN and SHP1 are tumor suppressor genes involved in the regulation of cell cycle control and apoptosis. The authors investigated the protein expression of PTEN and SHP1, by immunohistochemistry in tissue microarrays from bone marrow samples in children, diagnosed with acute lymphoblastic leukaemia and nonmalignant controls. PTEN was overexpressed in diagnostic ALL samples, while SHP1 showed a low expression. Both proteins showed a significant difference in expression compared to nonmalignant controls. The roles of PTEN and SHP1 are not well investigated in pediatric leukemia and could in the future play a role as prognostic factors.
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3.
  • Fridberg, Marie, et al. (författare)
  • Protein expression and cellular localization in two prognostic subgroups of diffuse large B-cell lymphoma : higher expression of ZAP70 and PKC-beta II in the non-germinal center group and poor survival in patients deficient in nuclear PTEN
  • 2007
  • Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 48:11, s. 2221-2232
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients diagnosed with diffuse large B-cell lymphoma (DLBCL) show varying responses to conventional therapy, and this might be contributed to the differentiation stage of the tumor B-cells. The aim of the current study was to evaluate a panel of kinases (ZAP70, PKC-β I and II and phosphorylated PKB/Akt) and phosphatases (PTEN, SHP1 and SHP2) known to be frequently deregulated in lymphoid malignancies. De novo DLBCL cases were divided into two subgroups, the germinal center (GC) group (14/28) and the non-germinal center (non-GC) or activated B-cell (ABC) group (14/28). ZAP70 and PKC-β II were expressed in a significantly higher percentage of tumor cells in the clinically more aggressive non-GC group compared with the prognostically favourable GC group. Also, the subcellular localization of PKC-β I and II differed in DLBCL cells, with the PKC-β I isoform being expressed in both the cytoplasm and nucleus, while PKC-β II was found exclusively in the cytoplasm. Loss of nuclear PTEN correlated with poor survival in cases from both subgroups. In addition, five cell lines of DLBCL origin were analyzed for protein expression and for mRNA levels of PTEN and SHP1. For the first time, we show that ZAP70 is expressed in a higher percentage of tumor cells in the aggressive non-GC subgroup of DLBCL and that PKC-β I and II are differently distributed in the two prognostic subgroups of de novo DLBCL.
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4.
  • Wårdh, Inger, et al. (författare)
  • Which evidence has an impact on dentists' willingness to change their behavior?
  • 2009
  • Ingår i: Journal of Evidence-Based Dental Practice. - : Mosby. - 1532-3382 .- 1532-3390. ; 9:4, s. 197-205
  • Tidskriftsartikel (refereegranskat)abstract
    • There is some literature on how to find the best evidence for clinical practice but little is known about which evidence clinicians actually seek when they look for scientific support in changing behavior. The aim of this study was to explore which evidence has an impact on dentists' willingness to change their behavior by investigating the requirements for seeking and understanding new knowledge, as well as perceived barriers or motives for doing this. A postal questionnaire was analyzed according to demographic information, access to and use of a personal computer, postgraduate education activity, knowledge about evidence-based medicine and scientific terms, and seeking and grasping new and actual knowledge from 177 dentists. Fifteen of these dentists formed 3 focus groups that were interviewed about the areas in the questionnaire. First-order information, that was required in a short time, was sought by the nearest colleagues. Literature and Internet-based technology were second-order information, mainly sought by younger dentists. The people that were interviewed claimed that the real point of issue was to find new knowledge that could be transferred into practice. Many studies pointing to sometimes diverging results only seem to create confused professionals. To include some qualitative aspects in evidence-based reports could be a way of improving understanding and changing behavior in a favorable direction and perhaps also increase interest for new knowledge.
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5.
  • Dahlin, Moa Kindstrom, et al. (författare)
  • Mentally disordered criminal offenders : Legal and criminological perspectives
  • 2009
  • Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 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. 
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6.
  • Mohlin, Bengt, 1944, et al. (författare)
  • TMD in relation to malocclusion and orthodontic treatment.
  • 2007
  • Ingår i: The Angle orthodontist. - : The E. H. Angle Education and Research Foundation. - 0003-3219 .- 1945-7103. ; 77:3, s. 542-8
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this systematic literature review was to evaluate associations between different malocclusions, orthodontic treatment, and signs and symptoms of temporomandibular disorders (TMD). MATERIALS AND METHODS: This review was part of a project at the Swedish Council on Technology Assessment in Health Care focusing on malocclusion and orthodontic treatment from a health perspective. As a first step, the literature was searched in the Medline and Cochrane Library databases from 1966 to May 2003. A later update was made in January 2005. Human studies in English or in Scandinavian languages were included. RESULTS: Associations between certain malocclusions and TMD were found in some studies, whereas the majority of the reviewed articles failed to identify significant and clinically important associations. TMD could not be correlated to any specific type of malocclusion, and there was no support for the belief that orthodontic treatment may cause TMD. Obvious individual variations in signs and symptoms of TMD over time according to some longitudinal studies further emphasized the difficulty in establishing malocclusion as a significant risk factor for TMD. A considerable reduction in signs and symptoms of TMD between the teenage period and young adulthood has been shown in some recent longitudinal studies. CONCLUSIONS: Associations between specific types of malocclusions and development of significant signs and symptoms of TMD could not be verified. There is still a need for longitudinal studies.
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7.
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8.
  • Idvall, Ewa, et al. (författare)
  • Assessment of recovery after day surgery using a modified version of quality of recovery-40
  • 2009
  • Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 53:5, s. 673-677
  • Tidskriftsartikel (refereegranskat)abstract
    • A recent nationwide survey in Sweden found that day surgery accounts for 43% of all in-hospital procedures.1 Orthopaedic, general, and gynaecological procedures were the most common. About 40% of the day surgery units followed up with telephone calls within 1–2 days, and found pain to be the most common complaint. Quality of recovery had not been systematically evaluated with instruments tested for validity and reliability, and follow-ups beyond 2 days post-operative were not found.Quality of Recovery-40 (QoR-40)2,3 is a 40-item instrument to assess the quality of post-operative recovery. The instrument is divided into five dimensions; emotional state, physical comfort, psychological support, physical independence, and pain. These dimensions represent aspects of good-quality recovery after anaesthesia and surgery. QoR-40 has been used for patients undergoing different surgical procedures and tests for validity and reliability yielded initial support for the instrument. Myles et al.3 concluded that QoR-40 would be a useful outcome measure to assess the impact of changes in health care delivery on quality of care, but anaesthesia and surgery studies have rarely used this approach. Although QoR-40 has not been used exclusively for day surgery patients, some day surgery patients were included when the instrument was developed.2,3 Another study on day surgery patients4 used eight items from QoR-40 relevant to that study. In a systematic review of post-operative recovery outcomes measurements after ambulatory surgery, the QoR-40 was the only instrument that fulfilled the criteria that were set up but was not specifically designed for day surgery and anaesthesia.5 Another systematic review from 2008 also advises to use the QoR-40 in future validation and application studies.6 Day surgery is increasing, and it is important to measure the quality of care and the impact of change. When using an instrument such as QoR-40, each item must be carefully considered for the purpose and context it will be used in, especially when it differs from the original context, both concerning cultural differences between countries and the type of surgical procedure used. Therefore, our study created and used a modified version of the QoR-40 to measure the quality of recovery in day surgery patients. The study aimed to test this modified version in a Swedish context for day surgery patients, to assess the quality of recovery on days 1, 7, and 14 post-operative.
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9.
  • Nilsson, Ulrica, 1960-, et al. (författare)
  • Relation between personality and quality of postoperative recovery in day surgery patients
  • 2009
  • Ingår i: European Journal of Anaesthesiology. - : Wolters Kluwer. - 0265-0215 .- 1365-2346. ; 26:8, s. 671-675
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND OBJECTIVE: Personality factors have been found to influence long-term postoperative depressive symptoms, health and distress in inpatients. To our knowledge, no studies have analysed whether the personality traits of day surgery patients relate to postoperative recovery. Hence, this study aims to explore possible relationships between personality traits and the quality of postoperative recovery in patients undergoing day surgery.METHODS: Our study used a consecutive sample of 260 day surgery patients to explore possible relationships between personal traits, measured by a short Big Five scale, and postoperative recovery, measured by modified Quality of Recovery-40, on postoperative days 1, 7 and 14.RESULTS: We found a positive correlation in changes of 'physical independence' and 'extroversion' (r = 0.20; P = 0.010) and 'intellect' (r = 0.18; P = 0.021) on postoperative days 1 and 7. These correlations were not observed on postoperative day 14. With regard to the change between days 7 and 14, correlations were found between 'physical interdependence' and 'agreeableness' and between 'physical interdependence' and 'conscientiousness' (r = -0.17; P = 0.028-0.030 for both).CONCLUSION: Day surgery patients appear to be a homogenous group with stable personalities, demonstrating some minor correlations between personality traits and the quality of postoperative recovery on days 1, 7 and 14. However, further studies are needed.
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10.
  • Wallsten, Tuula, et al. (författare)
  • Patients' and next-of-kins' attitudes towards compulsory psychiatric care
  • 2008
  • Ingår i: Nordic Journal of Psychiatry. - Oslo : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 62:6, s. 444-449
  • Tidskriftsartikel (refereegranskat)abstract
    • The introduction of a new Civil Commitment Act in Sweden in 1992 involved a shift of emphasis from medical to judicial authority. Little is known about general patient attitudes to compulsory care. The aim of the study was to study possible differences in attitudes, before and after the mental health law reform, among involuntarily and voluntarily admitted patients and their next-of-kins towards involuntary psychiatric admission. Samples of 84 committed and 84 voluntarily admitted patients in 1991 and 118 committed and 117 voluntarily admitted patients in 1997-99 were interviewed within 5 days from admission and at discharge, or after 3 weeks of care. Samples of 64 next-of-kins to the committed patients and 69 next-of-kins to the voluntarily admitted patients in 1991, and 73 and 89 next-of-kins, respectively, in 1997-99 were interviewed approximately 1 month after the admission. Few changes in attitudes were found between the two study occasions. A majority of all patients stated that it should be possible to compulsorily admit patients, and a great majority of the patients and the next-of kins stated that decisions regarding compulsory admission should be taken by doctors. Most patients and next-of-kins regarded decisions about involuntary psychiatric care mainly as a medical matter. Strong support for coercion in order to protect the patient and others was found among next-of-kins. The law reform was not reflected in attitudinal differences.
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