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- Berglund, Anders, et al.
(author)
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Bisfenol A i dentala material : Socialstyrelsens systematiska översikter
- 2012
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Reports (peer-reviewed)abstract
- Användningen av kvicksilver förbjöds den 1 juli 2009 och det innebar även ett förbud mot att använda tandfyllningsmaterialet dentalt amalgam. En in-vändning mot att ersätta tandamalgam med kvicksilverfria alternativ är att alternativen kan innehålla andra potentiellt hälso-och miljöfarliga ämnen. Syftet med rapporten är därför att kartlägga den vetenskapliga litteraturen och ge vägledning rörande bisfenol A (BPA) och bisfenol A dimetakrylat (Bis-DMA), ämnen som rapporterats förekomma i dentala polymerbaserade material. Med dentala polymerbaserade material avses i rapportenmaterial för kompositfyllningar, resinmodifierade glasjonomerfyllningar, fissurför-seglingsmaterial, kompositcement och ortodontiska cement. Det som stude-ras i kartläggningen är innehåll av BPA och Bis-DMA i dentala polymerba-serade material, frisättningen av BPA och Bis-DMA till saliv och andra vätskor och halter av BPA och Bis-DMA i blod och urin efter behandling med dentala polymerbaserade material. Vidare omfattar kartläggningen om-vandling av monomerer i dentala material till BPA samt hälsorelaterade effekter av BPA och Bis-DMA frisatt från polymerbaserade dentala materi-al. Kartläggningen visar att:•det sannolikt finns BPA eller Bis-DMA som förorening i mycket låga halter i vissa dentala polymerbaserade material och dessa monomerer skulle sannolikt kunna frisättas till saliv från nygjorda fissurförseglingar och fyllningar,•Bis-DMA under vissa förhållanden sannolikt kan omvandlas till BPA. Om detta kan ske i munnen har inte visats i några vetenskapliga studier,•inga vetenskapliga studier har hittats som visar att Bisfenol A –glycidyl dimetakrylat (Bis-GMA), en mycket vanlig monomer i dentala polymer-baserade material, skulle kunna omvandlas till BPA,•om frisättningen av BPA och Bis-DMA från dentala material har en ef-fekt på hälsan eller inte går inte att bedöma utifrån funna studier då det vetenskapliga underlaget är mycket bristfälligt.Trots att det saknas vetenskapligt stöd för om det finns hälsorelaterade ris-ker kopplat till BPA i tandmaterial bedömdes det vara viktigt att kunna ge professionen vägledning i frågan. Därför genomfördes en jämförelse mellan en så kallad ”worst-case exponering”för BPA från dentala polymerbaserade material och ett tolerabelt dagligt intagframtaget av EU. Worst-case expo-neringen baserades på scenariot att allt material löses upp i munnen inom 4 år och att frisatt BPA tas upp fullständigt. Den kliniska erfarenheten visar att dagens fyllningar inte löses upp i någon större utsträckning efter fyra år vil-ket i detta exempel ger en kraftigt överskattad exponering Jämförelsenvi-sade att om det finns en exponering av BPA från dentala polymerbaserade material, är den mycket lägre än det av EU framtagna tolerabla dagliga inta-get av BPA.
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2. |
- Domeij, Helena, et al.
(author)
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Experiences of living with fetal alcohol spectrum disorders : a systematic review and synthesis of qualitative data
- 2018
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In: Developmental Medicine & Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 60:8, s. 741-
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Research review (peer-reviewed)abstract
- Aim: To identify and assess available evidence from qualitative studies exploring experiences of individuals living with fetal alcohol spectrum disorders (FASD) or those living with a child with FASD, as well as experiences of interventions aimed at supporting individuals with FASD and their families.Method: A systematic literature search was conducted in six electronic databases: PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Scopus. Included studies were analysed using manifest content analysis. Methodological limitations and confidence in the evidence were assessed using a modified version of the Critical Appraisal Skills Programme and the Grading of Recommendations, Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative Research approach respectively.Results: Findings from 18 studies show that individuals with FASD experience a variation of disabilities, ranging from somatic problems, high pain tolerance, destructive behaviour, hyperactivity, and aggressiveness, to social problems with friendship, school attendance, and maintenance of steady employment. Most studies reported parents’ experiences with FASD; parenting was viewed as a lifelong engagement and that the whole family is isolated and burdened because of FASD. People with FASD feel that their difficulties affect their daily life in a limiting way and make them feel different from others.Interpretation: From the perspective of primarily parents, individuals with FASD and their parents face many different difficulties, for which they need societal support.
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3. |
- Domeij, Helena
(author)
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Expression and regulation of MMP-1 and MMP-3 in human gingival fibroblasts
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Matrix metalloproteinases (MMPs) are a group of proteolytic enzymes collectively responsible for the metabolism of extra cellular matrix components. Disturbance of the physiological balance between MMPs and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs), is implicated in several inflammatory diseases characterized by tissue degradation. Enhanced expression of MMPs including MMP-1 and MMP-3 is demonstrated in gingival connective tissue of individuals with periodontal diseases, but the underlying mechanisms are not well understood. The general aim of this thesis was to investigate the expression and regulation of MMP-1 and MMP-3 as well as their inhibitor TIMP- 1 in human gingival fibroblasts in response to cell interactions with monocytes or to inflammatory mediators. The effect of cell interactions between gingival fibroblasts and monocytes on the expression of MMP-1 and TIMP-1 was studied using a co-culture model, where the cells were cultured either in direct cell-to-cell contact or separated by a membrane to prevent cell contact. Cell interactions of fibroblasts and monocytes stimulated the expression of MMP-1 and TIMP-1 in the fibroblasts as well as in the co-culture medium. The stimulatory effect of cell interactions of fibroblasts and monocytes on the expression of MMP-1 was partly dependent on cell-to-cell contact as well as on the number of fibroblasts and monocytes in the co-cultures. The increased expression of MMP-1 in the fibroblasts was mediated partly by the adhesion molecule inter-cellular adhesion molecule-1 (ICAM-1) and the signal pathway p38 mitogen activated protein kinase (p38 MAPK). Furthermore, the expression of MMP-1 was reduced in the presence of dexamethasone and doxycycline. The effect of cytokines on the expression of MMP-1 and MMP-3 was investigated by culturing the gingival fibroblasts in the absence or presence of interleukin-1beta (IL-1beta), tumor necrosis factor a (TNFalpha) or epidermal growth factor (EGF). These cytokines stimulated the expression of MMP-1 as well as MMP-3 in a time-dependent manner. Furthermore, the stimulatory effect of IL-1beta OBS 1 P and TNFalpha on MMP-1 and MMP-3 expression was mediated partly by the signal transduction pathways tyrosine kinase and p38 MAPK. The expression of MMP-1 and TIMP-1 in gingival fibroblasts was also stimulated by the protein kinase C (PKC) activator phorbol 12-myristate 13-acetate (PMA). The PMA stimulated MMP-1 expression was synergistically upregulated by IL-10 as well as by the Ca2+-ionophore A23187. However, the expression of TIMP-1 was not upregulated by the cytokine IL-1beta and reduced by the Ca2+-ionophore. In summary, this thesis demonstrates that cell interactions between gingival fibroblasts and monocytes result in enhanced expression of MMP-1 and TIMP-1 in human gingival fibroblasts and that ICAM-1 and p38 MAPK are involved in the stimulated MMP-1 expression. Expression of MMP-1 and MMP-3 in gingival fibroblasts is also stimulated by the cytokines IL-1beta, TNFalpha and EGF and partly regulated by p38 MAPK, tyrosine kinase and PKC. The stimulatory effect of monocytes and inflammatory mediators on the expression of MMP-1 and MMP-3 in gingival fibroblasts may contribute to tissue degradation in periodontal diseases.
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- Helgesson, Gert, et al.
(author)
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Ethical aspects of diagnosis and interventions for children with fetal alcohol Spectrum disorder (FASD) and their families
- 2018
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In: BMC Medical Ethics. - : BIOMED CENTRAL LTD. - 1472-6939. ; 19
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Journal article (peer-reviewed)abstract
- Background: Fetal alcohol spectrum disorders (FASD) is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD.Methods: Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series of discussions with experts in the field, published literature, and medical ethicists.Results: Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the socia ! services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. Conclusions: The value for the concerned individuals of obtaining a FASD-related description of their condition - for instance, in terms of wellbeing - is not established. Nor is it established that allocating resources based, on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs.
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8. |
- Hellberg, Christel, et al.
(author)
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Evidence and evidence gaps in assessments and interventions in areas related to social work research and practice – an overview of four evidence maps : [Vetenskapligt kunskapsläge om utredning och insatser i socialt arbete och forskning –en sammanställning av fyra kartläggningar]
- 2023
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In: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 26:5, s. 882-895
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Journal article (peer-reviewed)abstract
- This overview of four evidence maps is based on systematic reviews of assessment and interventions in social work practice. The aim was to investigate the evidence and evidence gaps within four important areas for social work research and practice. Descriptive data on search strategies and domains were collected from four evidence maps, on Social Assistance, Substance Dependence, Care for older adults respectively for persons with disabilities. The scientific quality and scientific evidence were assessed. Key findings were summarised by analyzing and discussing common and specific elements in the evidence maps. The overview was undertaken in close collaboration between researchers with expertise in the field and a government agency. The overview identified both evidence and evidence gaps with respect to effects and experiences of interventions and assessment methods in four evidence maps. Evidence maps provide a comprehensive picture of the state of social services research and can thereby be of use to both researchers and practitioners, and in the production of evidence based social work.
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9. |
- Klingberg, Gunilla, et al.
(author)
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How old are you? : a systematic review investigating the relationship between age and mandibular third molar maturity
- 2023
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:5, s. 1-14
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Research review (peer-reviewed)abstract
- Introduction and objective: Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years.Methods: The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H).Results: A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment.Conclusion: The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.
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10. |
- Landeman, Marc, 1990-
(author)
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Markåtkomstersättning
- 2022
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Doctoral thesis (other academic/artistic)abstract
- How to compensate landowners when they suffer a compulsory acquisition of their property is a long-standing problem. In general, the subject is usually stated as a two-sided problem. First, it is a fairness problem regarding what measuring instrument should be used to decide a fair amount of compensation to the landowner. Second, it concerns how the chosen measuring instrument should be applied in practice from a legal point of view. The main purpose of the thesis is to reconstruct the compensation system. Broad questions addressed include how the market value should be determined, what efficiency and fairness requirements the compensation has in this context, and how the conditions of different situations affect the view of what is an efficient and fair compensation. The thesis uses a mixed-method that contains a legal dogmatic method, as well as a law and economics, and a fairness approach. The thesis finds that the market value can, in an economic context, only be determined as a range of probable prices and the result is largely influenced by the appraiser. To determine the market value of real property one needs to use qualitative approaches, even though the result is a quantitative measure. From a legal point of view, the court has to decide the specific price within the range that corresponds to the legal market value. To approach this problem, the court needs to use the underlying purposes of the compensation, such as full compensation and the general sense of justice. From a fairness perspective, both the legislator and the courts have modified the compensation rules in order to fulfil other goals that go beyond the economic market value. One key finding is that the market value in a legal context has a much higher degree of flexibility than in an economic context. Another key finding is that the design of the rules matters for the overall utility of society since an unfair system will generate demoralization costs. Therefore, the thesis argues that an adequate design of the compensation system has to take in to account the differences between different situations, since these differences decide what can be considered an adequate compensation. Overall, the thesis concludes that the current system should differentiate how the compensation has to be determined between different situations to a much larger extent. Thus, the extent to which a specific level of compensation achieves legal and societal goals depends on the situation.
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12. |
- Morén, Elisabeth, et al.
(author)
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The Effect of Domiciliary Professional Oral Care on Root Caries Progression in Care-Dependent Older Adults : A Systematic Review
- 2023
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In: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 12:7
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Journal article (peer-reviewed)abstract
- With care dependency, untreated root caries lesions (RCLs) and irregular dental visits are common. RCLs, if left untreated, could lead to pain, tooth loss, difficulties eating, and impact on general health. Therefore, there is a need for prevention and effective treatment for RCLs, and especially in those with care dependency. The aim of this systematic review was to investigate the effect of domiciliary professional oral care on root caries development and progression, in comparison with self-performed or nurse-assisted oral care. A literature search was conducted in four databases in November 2022. Two authors independently screened the literature throughout the review process. Five of the identified studies were found to be relevant. Four of these were assessed as having moderate risk of bias and were included in the review, while one study had high risk of bias and was excluded from further analyses. Due to heterogenicity of the included studies (and of the interventions and outcomes), no meta-analysis or synthesis without meta-analysis (SWiM) was performed. The participation of dental personnel performing mechanical plaque removal and fluoride, or chlorhexidine application seems beneficial for care-dependent older adults with risk of RCLs development and progression. However, future studies are needed.
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