[Doubtful advertisement on an antiepileptic agent].
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Advertising↗
Biomedical subjects
B Söderfeldt
Publications and source records attributed to B Söderfeldt.
Influence of dental care systems on dental status. A comparison between two countries with different systems but similar living standards.
OBJECTIVE: To evaluate the influence of two different dental care systems on dental status, taking into account relevant socio-economic factors. BASIC RESEARCH DESIGN: Questionnaire studies on randomly sampled subjects in Denmark and Sweden using questionnaire forms as identical as possible with regard to the different languages. SETTING: The studies were performed late in 1998 in both countries. PARTICIPANTS: Questionnaires were sent to 1,175 subjects aged 45-69 years in Denmark (response rate 73%) and to 1,001 subjects aged 55-79 years in Sweden (response rate 67%). MAIN OUTCOME MEASURES: Questions about dental status and about socioeconomic factors and attitudes toward dental care were included. In logistic regression models, various dichotomies of dental conditions were used as dependent variables. State (Denmark vs. Sweden) was used as an independent variable together with socioeconomic factors and attitudes. RESULTS: There were great differences between the countries in dental status. In the regression model with 'wearing removable denture(s)' as the dependent variable, state was the strongest predictor with an OR of above 4.1 for Denmark compared to Sweden. much stronger than variables such as age, income, education and residence. CONCLUSION: The results indicate that the Swedish dental care system has been superior to the Danish one regarding dental status in middle aged and older populations in these two countries.
Age Factors↗
The cognitive neuroscience of signed language.
The present article is an assessment of the current state of knowledge in the field of cognitive neuroscience of signed language. Reviewed lesion data show that the left hemisphere is dominant for perception and production of signed language in aphasics, in a fashion similar to spoken language aphasia. Several neuropsychological dissociations support this claim: Non-linguistic visuospatial functions can be dissociated from spatial functions and general motor deficits can be dissociated from execution of signs. Reviewed imaging data corroborate the lesion data in that the importance of the left hemisphere is re-confirmed. The data also establish the role of the right hemisphere in signed language processing. Alternative hypotheses regarding what aspects of signed language processing are handled by the right hemisphere are currently tested. The second section of the paper starts by addressing the role that early acquisition of signed and spoken language play for the neurofunctional activation patterns in the brain. Compensatory cognitive and communicative enhancements have also been documented as a function of early sign language use, suggesting an interesting interaction between language and cognition. Recent behavioural data on sign processing in working memory--a cognitive system important for language perception and production suggest e.g. phonological loop effects analogous to those obtained for speech processing. Neuroimaging studies will have to address this potential communality.
Functional Laterality↗
Explanatory models for clinical and subjective indicators of periodontal disease in an adult population.
BACKGROUND: The aim of this study was to analyze indicators of periodontal disease using: (1) community periodontal index of treatment needs (CPITN), (2) subjectively reported change of front teeth position, and 3) subjectively reported gingival bleeding. METHOD: These 3 indicators were used in models with explanatory variables from 4 domains: (A) socio-economic attributes, (B) general health and health-related lifestyle, (C) dental attitudes and behaviors, and (D) dental status expressed as (number of teeth and DFT) for the clinically-determined dependent variables. In 1992, the study was carried out cross-sectionally in all 50-year olds in 2 Swedish counties using a questionnaire (n=6343) and clinical investigation of a 20 % sub-sample (n= 1040). RESULTS: Multiple and logistic regression analysis showed that explanatory patterns varied for the clinical and subjective indicators. Use of tobacco had strong effects in all models as did high care utilization. There were few associations with socio-economic attributes. The 2 subjective indicators "changed front position" and "gingival bleeding" associated with attitudes, behaviors and subjective health. Number of teeth and DFT covaried with clinical indicators. CONCLUSIONS: The main conclusions from this study are: (1) that it is possible to find multivariate models with acceptable goodness of fit for prediction of occurrence of periodontal indicators, and (2) that the lack of relation between social attributes and the disease gives arguments for a biological provenance of periodontitis.
Attitude to Health↗
Dentist-related factors influencing the amount of prosthodontic treatment provided.
OBJECTIVES: To evaluate, using multivariate methods, the associations between indicators of the amount of prosthodontic treatment and dentist-related factors. METHODS: Questionnaires were sent to a random sample of 2,059 general dentists, response rate was 76%. Two indicators of prosthodontic activity were used as dependent variables: 1) reported weekly working hours used for prosthodontics and 2) reported numbers of produced single crowns, fixed partial dentures, and removable dentures. Independent variables were 'social and demographic attributes', 'job situation' and 'attitudes of dentists'. Multiple regression analysis was used in models with continuous dependent variables and logistic regression analysis for categorical dependent variables. RESULTS: 'Weekly working hours used for dental care of adults' showed a strong association in all models with the dependent variable 'weekly working hours used for prosthodontics'. Male dentists provided more prosthodontic services than female dentists, even if reporting less time used for prosthodontics. Private practitioners produced more fixed prosthodontics than dentists employed in the public dental health service. Dentists in the public dental health service reported a higher production of removable dentures than private practitioners. CONCLUSION: The results indicate that factors, besides those in the rational clinical model for decision-making, e.g. gender and delivery system, play a role in the provision of prosthodontic services.
Adult↗
Dental conditions in middle-aged and older people in Denmark and Sweden: a comparative study of the influence of socioeconomic and attitudinal factors.
In 1998-99 two parallel questionnaire studies were performed in Denmark and Sweden. In Denmark the age group was 45-69 years and in Sweden 55-79 years. One aim was to study the influence of socioeconomic and attitudinal factors on dental status in the two countries. For the comparable age groups 55-69 years there was a striking difference in dental conditions between the countries. In Sweden, 72% had either all teeth remaining, missing teeth replaced by fixed prosthodontics, or only one or two single missing teeth not replaced. The corresponding figure for Denmark was 44%. Among Danes, 34% were wearing removable denture(s) or were edentulous in one jaw or both jaws, compared with 15%, among Swedes. In logistic regression models, higher income and longer education were significantly associated with the best dental status categories in Denmark but not in Sweden. In the model with wearing removable denture(s) as the dependent variable, lower income and lower education level showed a significant influence for the Danes. In Sweden, lower income showed a significant influence but education level was insignificant. In both Denmark and Sweden, a positive attitude toward the importance of dental appearance was associated with an increased risk of wearing removable denture(s).
Aged↗
Social equality and dental conditions--a study of an adult population in Southern Sweden.
This study aimed to: describe dental conditions--focusing on prosthodontic variables--in relation to social conditions in the late 1990s in an adult population of Southern Sweden, evaluate if a change could be traced in the pattern of socioeconomic influences on dental conditions, and study if various attitudes toward dental care were associated with social as well as dental conditions. The study was based on questionnaire responses. Significant differences in dental conditions and denture prevalence were found for age and education. To a majority of the sample it was very important to have own teeth and/or fixed restorations and the opportunity to attend regular dental care. The cost for dental care was very important for 52% of the sample especially for men, those with low education, and those wearing removable denture. Need for dental care that could not be provided for because of the costs was experienced by 9%. Eighteen percent stated that they once or more had refrained from dental care because of the cost. Those with removable dentures and low education dominated. Besides socioeconomic differences in dental conditions, there were sociodental differences in attitudes concerning the importance of costs, self-estimated needs, and cost-barriers for dental care.
Adult↗
Fluoride use by gender, age and dental fear among patients in a private practice.
The present study involved 145 consecutive self-referred patients (89 women, 56 men) at a private general practice, aimed at identifying whether differences in anxiety levels between women and men were related to self-administered fluoride prevention. Use of fluoride was assessed using a questionnaire to the use of tablets, rinse or other methods in addition to fluoride toothpaste. In logistic regression models, with fluoride use as the dependent variable, neither dental anxiety, measured by the Dental Anxiety Scale or by the Dental Fear Survey, nor age, were related to the use of fluorides. However, there was an association with gender. Thus, women used prophylactics 3.5-3.9 times as often as men. Women also expressed higher overall levels of dental fear. The probability in logit calculations for use of fluoride was highest (18%) for 30 year old women with a high DAS score. Additional surveys and research are needed in relation to the patient's cognition, attitude and behaviour towards oral disease, in order to enhance the success of preventive methods of oral disease and management of dental fear.
Adolescent↗
The factor structure of the dental fear survey applied to private general practice patients awaiting dental treatment.
OBJECTIVES: Factor analysis of the Dental Fear Survey (DFS), applied to patients awaiting dental treatment in an average private practice general dental clinic in comparison to other analyses. METHOD: A combination of secondary and primary data. The latter were obtained from 145 consecutive self-referred patients (89 women, 56 men, aged between 17 and 82 years) at a private dental clinic, responding to an anonymous questionnaire. In analyses, principal components and principal axes factor analysis were used with varimax and oblimin rotations. Cronbach's alpha was calculated. RESULTS: There were differences in factor loading patterns between materials. No generally valid pattern could be discerned. Congruence between materials was higher for communalities. Oblimin rotation resulted in highly correlated factors. Excluding items with lower loadings yielded a clear one-factor solution. Cronbach's alpha was very high (0.96) for a one-factor solution on the primary material. CONCLUSIONS: The DFS may well be used as a measure of dental fear, but the dimensionality of the measure is more doubtful according to the present result. The DFS could be reduced to a unidimensional measure. In the clinical situation, a short measure such as the Dental Anxiety Scale (DAS) could be used for screening, giving guidance about whether the patient is afraid. For those with higher scores on the DAS, the DFS could be used for purposes of greater discrimination.
Adolescent↗
A multilevel analysis of factors affecting pocket probing depth in patients responding differently to periodontal treatment.
3 distinct levels are involved in the periodontal inflammatory process: site, tooth, and individual. By focusing attention on the levels in the population, multilevel or hierarchical modelling (MLM) enables the researcher to understand where and how the effects at the levels involved are occurring. The aim of this paper is therefore to analyse the progression of periodontal disease using analytical models that consider the level hierarchy. 22 patients with periodontitis, in previous reports described as either non-responsive or responsive to periodontal treatment, were investigated. In the multilevel modelling method (MLM), the site pocket probing depth (PPD) is summarised in 3 parameters: the overall mean, the between-individual variance, and the within-individual, between-site variance. The model can readily be extended to include independent variables for sites, teeth and individuals. If these variables are important determinants of PPD, their inclusion in the model will lead to a reduction in residual variances between sites, teeth and individuals. The PPDs were used for construction of a PPD change variable (cPPD). This variable, together with the final registrations of PPD (fPPD) alone, were used as dependent variables in the MLM. Independent predictor variables, 12 on site-level, 3 on tooth-level, and 19 on individual-level, were constructed. The total number of sites assessed was 2236 distributed on 559 teeth in 22 subjects. Initially, a fixed, fully unconditional model (models A and E) was assessed, where no predictor variables were specified at any level. Different random-intercept models (B-D, F-H) were then calculated where the independent variables were inserted in blocks relating to each level. The variance components at all 3 levels were significantly larger than zero. This indicates that MLM is recommended for analysing the present data. The inserted predictors showed 100% sensitivity relating to the subject-level variance. Subsequent testing of the patient with disease or at high risk of disease would have to focus on diagnostic tests aimed at the individual teeth and sites. These tests would need to have a balance of sensitivity and specificity. Thus, by using multilevel modelling, the theoretical understanding of important factors in the pathogenesis of periodontitis is stimulated.
Adult↗
The microbiota of periodontal pockets with different depths in therapy-resistant periodontitis.
This study presents the composition of the cultivable microbiota colonising periodontal pockets of different depths among 2 patient-groups classified as non-responsive (NR-group; 11 participants) or responsive (R-group; 10 participants) to periodontal treatment. Microbiological samples from three types of pocket (< 4 mm deep A-samples; 4-5 mm B-samples; > 5 mm C-samples) were analysed by cultural methods for putative periodontitis pathogens, microbial groups constituting > or = 5% of the total cultivable flora and opportunistic pathogens. Actinomyces naeslundii, A. israelii, Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros, anaerobic streptococci and facultative anaerobic streptococci were most prevalent. Actinobacillus actinomycetemcomitans, Staphylococcus aureus, enteric rods and yeasts were less prevalent. The periodontitis pathogens Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia and Peptostreptococcus micros constituted together (on average) < or = 23% of the viable counts in the A- and B-samples of both patient groups and in the C-samples of the R-group. In the C-samples of the NR-group their mean counts were 45%. Correlations were found between smoking habits and the five pathogens in the C-samples and in pooled pocket depth samples. The results show that groups of periodontopathogens should be considered a causal factor in therapy-resistant periodontitis. Further, smoking and deep pockets can enhance a shift in the balance of the subgingival microflora predisposing a site to disease and a susceptible host may be the pre-requisite to therapy-resistant periodontitis.
Actinomyces↗
A speechreading expert: the case of MM.
The present case study of MM, who acquired both sign language and spoken language in her early preschool years-and then reached the normal milestones of development in each language--revealed that her speechreading expertise is associated with cognitive functions such as high working memory capacity and phonological skills. Her cognitive profile is in accord with previous case studies of extremely good speechreading skill. MM's enhanced right prefrontal/frontal cerebral blood flow activation during speechreading seems to be indicative of efficient visual scanning, but it is also possibly due to her strategy for phonological decoding of visual speech.
Adult↗
Explanatory models for clinically determined and symptom-reported caries indicators in an adult population.
The aim of the present study was to analyze possible indicators of: (i) relative number of decayed and filled teeth, (ii) relative number of decayed teeth, (iii) subjectively reported toothache, and (iv) sensitive teeth, and to find explanatory models for these phenomena. Independent variables from three domains were used: (i) socio-economic factors, (ii) general health and health-related lifestyle, and (iii) dental attitudes and behaviors. The study basis was validated questionnaires from all 50-year-olds in 2 Swedish counties (n = 8888), response rate 71% (n = 6343). For a 20% subsample (58% participation) the DFT and DT were determined by calibrated dentists. Analyses were done with logistic and multiple regression. The variables born outside Sweden, gender, education, shift work, satisfaction with dental care, fear and care utilization were associated with DFT/number of teeth. For DT/number of teeth, the direction of association was reversed for the variables born outside Sweden and gender. Social class, education, general health, and use of tobacco were further covariates. Good oral hygiene gave a lower ratio of DT. For the logistic regression model of toothache, residence in cities and satisfaction with dental care had lower probability for toothache reports, while born outside Sweden, mouth dryness, use of pharmaceuticals, tobacco, fear, and high utilization increased this probability. In general, the association pattern was as could be expected: immigrants, working class, low education, smoking, dissatisfaction with dental treatment and low utilization all appeared as risk factors for both the clinically determined caries indicators, but not necessarily for subjective symptom reports. Only fear of dental treatment showed a consistent positive association with all the indicators.
Attitude to Health↗
Congruence between self-reported and actually provided prosthodontic services among Swedish dentists.
The purpose of this study, comprising two parts, was to investigate the congruence between answers given by general dentists in questionnaires concerning prosthodontic services and the recorded information on the services actually performed by each dentist. In Part I it is investigated whether questionnaire reports of weekly working hours devoted to prosthodontics can be used as indicators of actual prosthodontic production. Part II deals with the dentists' self-reported numbers of single crowns, fixed partial dentures (FPDs), and removable dentures. These reported services are compared with the services actually provided. Part I: A regression analysis indicates a lacking precision for the individual dentist, indicated by a relatively low explained variance (R2 = 0.20). However, a highly significant association is seen between the two production measures (P = 0.000). Part II: The congruence between stated and actually provided services is higher for single crowns and removable dentures than for FPDs. Bivariate regression models are statistically significant for all three services. In Part II, the reported weekly working hours used for prosthodontics covaries significantly with prosthodontic production, but the association is not as strong as in Part I. Although the precision in both Part I and Part II is low for the individual dentist, the questionnaire measure is found to be useful as an indicator in a population of dentists. It is concluded that the questionnaire data can be used as reasonably valid expressions of prosthodontic activity in population-oriented analyses among general dentists.
Crowns↗
Perceived control systems, work conditions, and efficiency among Swedish dentists: interaction between two sides of human resource management.
Two aspects of Human Resource Management (HRM), a main trend in modern personnel management, are considered in this study: A 'hard' version stressing performance monitoring and competition, and a 'soft' version stressing communication with employees. The aim of the investigation was to examine whether these two aspects of modern management are reflected in dentists' perceptions of differences in work conditions compared with other professionals. A questionnaire was answered by 312 publicly employed dentists and 3,600 other professionals in Sweden. The response rate was 66-77%. Effects from HRM on work, conditions and perceived efficiency were confirmed. The interaction effects, reflecting the duality of HRM, resulted in poorer work conditions, e.g. worse balance between effort and reward and worse opportunities for developing competence and collaboration in the workplace. This pertains especially in the case of dentists, where the positive effects of 'soft' HRM did not compensate for the negative effects of 'hard' HRM. Dentists in Sweden's Public Dental Health Service appear as a vulnerable group among Swedish professionals.
Attitude of Health Personnel↗
Quality of life in newly-debuted epilepsy. An empirical study.
OBJECTIVES: This study aimed to illuminate adult's experienced quality of life in newly-debuted epilepsy and to test the American instrument Quality of Life Index (QLI) for the first time on an epilepsy population. A second aim was to find appropriate questions to measure patient perceptions in epilepsy. MATERIAL AND METHODS: All persons 18-65 fulfilling criteria (n = 41) and diagnosed during a 15-month period at 2 Swedish hospitals, answered questionnaires (n = 37/41) on quality of life and perceptions of epilepsy. RESULTS: Patients experienced the highest quality in the "Family" domain and the lowest in the "Psychological/spiritual". Significant correlations were found between quality of life and experienced change of life situation, own perceptions of epilepsy, seizure frequency after diagnosis, gender and side effects from antiepileptic drugs. The QLI was well applicable on people with epilepsy. CONCLUSIONS: Data indicates that debut of epilepsy has an evident impact on quality of life and a more extensive study is required.
Adolescent↗
Attitudes to and experience of dental care among 50-year-olds in two Swedish counties.
The aim of this study was to investigate attitudes to and experiences of dental care in a population, born 1942. The following items were studied: opinions of general and oral health, attitudes to and experiences of dental care, dental care habits, experiences of latest visit to a dentist, tobacco habits and use of various dental hygiene articles. A cross-sectional mail questionnaire was sent in 1992 to all 50-year-olds in two Swedish counties, Orebro and Ostergotland, totally 8888 persons; the response rate was 71%. Of the population 89%, indicated good health. Satisfaction with dental care was high, 94%. 26% stated attendance to a dentist twice or more per year, and 64% at least once a year. As to expenses, 78% paid less than 1000 SEK the last year. Concerning the latest visit, 38% reported painless treatment, 37% no inconvenience, and 55% good care. The duration of the latest visit included on an average 27 min in travel time, 7 min in waiting time and 27 min in treatment time. Information about oral hygiene was given to 29% and about cost for treatment to 47% of the interviewed. There were 28% daily smokers. Snuff was daily used by 10% of the males. Toothbrushing twice a day with fluoride toothpaste seemed to be the standard oral hygiene procedure and was reported by 80% of the respondents.
Attitude to Health↗
[Traumatology for amateurs--physicians as private persons in serious accidents].
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Accidents, Traffic↗