Comparative antibacterial effects of chlorhexidine and stannous fluoride-amine fluoride containing dental gels against salivary mutans streptococci

Abstract— Forty-five young adults were divided into three groups of equal size and given a professional toothcleaning (3 times during 1 wk) with dental gels containing either chlorhexidine (CHX, 1%), or a SnF₂-amine fluoride (AmF) combination (F⁻ content 1.20%). The control group received toothcleaning with a placebo gel. The study was done double blind. The number of salivary mutans streptococci was monitored for 11 wk after the gel treatment using both mitis-salivarius-bacitracin agar plates and the chairside method based on the adhesion of mutans streptococci on plastic strips (DentocuIt-SM Strip mutans). Professional toothcleaning with a CHX gel was clearly most effective ( P < 0.001) but the baseline levels of streptococci returned in 11 wk. SnF₂-AmF gel also reduced significantly ( P < 0.001) mutans streptococci but recolonization occurred already in 7 wk. Placebo gel, i.e. professional toothcleaning as such, did not show any statistically significant effect on the numbers of salivary mutans streptococci. None of the treatments affected the levels of lactobacilli or the total aerobic flora in saliva samples. Professional toothcleaning with a CHX gel, or with a SnF₂,-AmF gel, can be regarded as an alternative to the commonly used, but more patience demanding, application of gel in mouth trays at home for individuals with high caries activity.     

Disease-related distress among insulin-treated diabetic patients: Associations with health status, psychosocial factors and self-care practices

Background: Diabetes is a chronic illness that affects manydomains of life. This cross-sectional study examined disease-relateddistress and its associations with health and psychosocial factorsamong insulin-treated diabetic persons. Method: The sample (n=423)was drawn from the Social Insurance Institution's drug registry.Health indicators were duration of diabetes, complications,and glycaemlc control. Psychosocial measures included generaland diabetes-specific social support, diabetes locus of control(DLC), self-efficacy, diabetes health beliefs and self-carepractices and subjective health. Results: Most respondents reportedmoderate diabetes-related distress. In multi-variate analysis,severe diabetes distress was related to lower net benefits ofregimen (ß = –0.29, and p<0.001), poorerperceived health (ß = –0.25, and p<0.001),higher perceived threat of complications (ß = 0.19,and p<0.001), less adequate social support (ß =–0.16, and p<0.01), stronger beliefs in chance (ß= 0.15, and p<0.01) and internal DLC (ß = 0.11,and p<0.05) and more frequent exercising (ß = 0.10,and p<0.05). Conclusions: The results suggest that emotionaladjustment to diabetes is predominantly determined by diabetes-relatedcognitions and subjective health and to a lesser degree by objectivediabetes indlcators, which underlines the Importance of assistingthe patient with adjustment with the disease in health carecentres.     

Distribution and forms of iodine in human oral cavity

Neither iodinated proteins nor iodinated. low-molecular weight compounds (e.g. iodinated tyrosine derivatives) could be detected in concentrated human salivary supernatant by using the Ce(SO₄)₂-method either directly or after thin-layer chromatography. Salivary sediment contained free 1^? ions, loosely bound iodine (released with saline) and strongly bound iodine (released with sonication, detergent and acid hydrolysis). A positive correlation between salivary and crevicuiar excretion of l^? from plasma was observed. Thiocyanate ions, which competitively inhibit peroxidase-catalysed oxidation and iodination reactions and which are abundant in human saliva, possibly prevent the coupling of l^? to protein in vivo although some human salivary proteins are very susceptible to iodination in vitro.     

Effects of a β-blocking agent, timolol maleate, on saliva in healthy volunteers

Abstract — The effects of timolol maleate on the secretion and composition of human saliva were studied in vivo. Eight healthy volunteers received orally 10 mg timolol maleate. Stimulated parotid saliva samples, resting whole saliva samples, and blood samples were collected immediately before and four times after the drug intake at intervals of 1 h. The levels of total protein, lysozyme, IgA, IgG and IgM, salivary peroxidase, myeloperoxidase, lactoferrin, amylase, thiocyanate (SCN^-), and hypothiocyanite (OSCN^-) were analyzed from saliva samples. Drug levels were measured both from parotid saliva and blood samples. Results were compared to the analyses of the samples collected in a similar way but without administration of any drugs. Decreased levels of total protein, lactoferrin, amylase, and salivary peroxidase were observed in parotid saliva after a single oral dose of timolol maleate. No such decrease was found in lysozyme, myeloperoxidase, SCN-, OSCN-, or immunoglobulins. Salivary flow rate was not significantly changed after drug intake. The results suggest that the β-blocking drug may cause qualitative changes in the composition of saliva by inhibiting the synthesis and/or release of acinar proteins.     

Physical fitness in children with haemophilia and the effect of overweight

Summary.  Although children with haemophilia are advised to participate in physical activities, their physical fitness has not been studied in a large group. In addition, children with haemophilia may be at increased risk for becoming overweight as a result of inactivity because of joint bleedings or because of overprotection. This study aimed to assess physical fitness (aerobic capacity), joint status, muscle strength, quality of life (QoL), self-reported motor competence and also prevalence of overweight and its association with physical parameters. Weight and height were measured. Skin folds were measured unilaterally at biceps, triceps, subscapular and supra-iliac sites. Aerobic capacity was determined on a cycle ergometer or with a 6-min walk test (6MWT). Muscle strength and active range of motion of elbows, knees and ankle joints were measured. Self-reported motor competence was measured with the 'Competentie BelevingsSchaal voor Kinderen'. Joint pain was scored on a Visual Analogue Scale. The Haemo-QoL Index was used to measure QoL. In 158 Dutch boys with haemophilia, with a mean age of 12.7 years (SD 2.9), normal aerobic capacity and muscle strength were found. Joint pain was reported by 16% of the participants. The prevalence of overweight (16%) was slightly increased when compared with healthy Dutch boys (13.5%). Being overweight had a negative association with the 6MWT and QoL. Dutch children with haemophilia have normal aerobic exercise capacity and muscle strength. The majority also has normal joint mobility. Prevalence of overweight is slightly increased.     

Leadership styles of Finnish nurse managers and factors influencing it

Aim  The purpose of the present study was to explore nurse managers' perceptions of their leadership styles and factors influencing it.
Background  It is a challenge for nurse managers to retain nurses in hospitals and to ensure a high quality of care in nursing practice. Leadership style is an important part of leadership. Knowledge concerning nurse managers' resonant and non-resonant leadership styles provides nurse managers with tools to reflect on their own leadership style.
Method  Open-ended, tape-recorded interviews were conducted with 13 nurse managers from five Finnish hospitals and two long-term care facilities. The data were analysed using qualitative content analysis.
Results  Five categories of leadership style were discerned: visionary, coaching, affiliate, democratic, commanding. Factors that influence leadership style were identified: earlier superiors, values, information, cooperation, employees and education.
Conclusions  The results of this study show that Finnish nurse managers use both resonant and non-resonant leadership styles.
Implications for nursing management  The findings of this study show that nurse managers use a variety of leadership styles. The study demonstrates the importance of knowledge about leadership styles and factors influencing it among nurse managers providing future leadership and management education.     

Growth of 519 Small for Gestational Age Infants during the First Two Years of Life

ABSTRACT. The physical growth of 519 small for gestational age infants (SGA), with a birth weight below the 10th percentile on our own growth curve, born in the region of University Central Hospital of Turku during the period June 1,1981-May 31, 1982, was studied. The study population consists of 4 517 term, appropriate for gestational age (AGA) infants, 488 term SGA infants, 320 preterm AGA infants and 31 preterm SGA infants. The degree of intrauterine growth retardation (IUGR) seemed to have an effect on physical growth in term SGA infants. Those term SGA infants with a low Ponderal Index (PI) (type II) were taller and had a larger head circumference at the age of 24 months than term SGA infants with adequate PI (type I). Among the preterm SGA infants the degree of IUGR seemed to have no effect on later growth. Smoking is still one of the main risk factors associated with poor intrauterine growth. In this study we also found that smoking has an effect on later growth; the children of smoking mothers were smaller than those of non-smoking mothers in the AGA group. Among the SGA infants the infants of non-smoking mothers were bigger than those of smoking mothers. This difference could be explained by other factors associated with SGA. We found that in spite of the catch-up growth during the first months, 26% of the severely SGA infants (birth weight below the 2.5th percentile) still had a weight below the 2.5th percentile at the age of 24 months.     

Use of fluorides by Finnish adolescents

According to the recommendations of the National Board of Health in Finland fluoride tablets should be used daily from the age of 6 months to 15 yr in fluoride deficient areas. Topical fluorides are recommended in addition to systemic fluorides. The aim of this study was to analyze the use of fluoride tablets and topical fluorides by Finnish adolescents. Teenagers (n= 4705) representing Finnish youth aged 12, 14, 16 and 18 yr were sent mail questionnaires in February 1981. The response rate was 88%. The proportion of daily fluoride tablet users was 12% among 12-yr-old girls, 3% among 14-yr-old girls and among boys 10% and 4%, respectively. Fluoride rinses at home were used daily by only 1%. During the most recent school term, 34% had several times, and 8% once, participated in classroom fluoride rinsing. In the same period 14% had used fluoride gel several times, and 10% once. Thus despite dental health education, fluoride tablets and rinses are used very rarely at home by Finnish teenagers. The recommendations of the National Board of Health are far removed from the behavior of adolescents. Use of fluoride tablets and topical fluorides do not seem to be a practical alternative to drinking-water fluoridation, because of the low level of compliance.     

Bullying at school—an indicator of adolescents at risk for mental disorders

A number of 14–16 year old Finnish adolescents taking part in the School Health Promotion Study (n=8787 in 1995, n=17643 in 1997) were surveyed about bullying and victimization in relation to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. A total of 9 per cent of girls and 17 per cent of boys were involved in bullying on a weekly basis. Anxiety, depression and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Frequent excessive drinking and use of any other substance were most common among bullies and thereafter among bully-victims. Among girls, eating disorders were associated with involvement in bullying in any role, among boys with being bully-victims. Bullying should be seen as an indicator of risk of various mental disorders in adolescence.     

Causes of stillbirth: a clinicopathological study of 243 patients

Summary. The clinical and autopsy findings in all stillbirths during the years 1974—1979 at the Helsinki University Central Hospital were analysed. There were 243 stillborn infants of whom 200 died before labour. According to the autopsy findings asphyxia accounted for 38% and major malformations for 17% of the deaths, but because of fetal maceration no diagnosis could be made at autopsy in 43%. The cause of death suggested by the clinical findings was placental failure in 57%, cord complication in 12% and major malformations in 17%. The cause of death remained unsolved in 9%. The importance of routine ultrasound and a- fetoprotein screening for the detection of unrecognized risk patients is emphasized.