Changes of nursing organization in a surgical department: effects on work satisfaction and quality of care

• ? The aim of the study was to evaluate the effects of an organizational change programme in a surgical department in Sweden (the introduction of modular nursing) on the nursing staffs perception of job satisfaction and quality of care, and to identify factors which promote or hinder this organizational change.
• ? Planning and implementation of the change programme took about 1 year and comprised structural changes and staff training.
• ? Assessments of job satisfaction and quality of care were made immediately before, and 1 year after, implementation of the change programme. Data were collected from the staff of two wards.
• ? Virtually no statistically significant changes were found when looking at the department as a whole. However, considerable differences were noted between the two wards, particularly in the following areas: relationships with colleagues, identification and commitment, and perceived quality of care.
• ? The quality of the interpersonal relationships, and the leadership of the wards' head nurses, appeared to be crucial determinants of the outcome.

     

Prevalence of dental fluorosis in children taking part in an oral health programme including fluoride tablet supplements from the age of 2 years

International Journal of Paediatric Dentistry 2010; 20: 347–352 Aim. To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2–5 years, including fluoride tablets from the age of 2 years. Design. The study group consisted of 135 10‐ to 11‐year‐old children who had participated in the programme, including parent education, tooth‐brushing instruction and prescribed fluoride tablets (0.25 mg NaF) (2–3 years: 1 tablet/day; 3–5 years: 2 tablets/day). The prevalence of dental fluorosis in the study group was compared with that in a nonintervention reference group consisting of 129 children of the same ages. The analysis was based on photos of the permanent maxillary front teeth using the Thylstrup & Fejerskov (TF) Index. Results. No statistically significant difference in prevalence of dental fluorosis was seen between the two groups. Forty‐three percent of the children in the study group and 38% in the reference group had fluorosis, the majority of a mild nature (TF‐score 1). None had a TF score above 2. The pattern was the same after correction for parent reported intake of tablets at 3 and 5 years of age. Conclusion. Introduction of fluoride tablets at the age of 2 years did not result in increased prevalence of dental fluorosis.     

Radiographic assessment of dental anomalies in patients with ectopic maxillary canines

Background.  The aetiology of palatally and labially located ectopic maxillary canines is multifactorial. Accordingly, early prediction of this eruptional disturbance is in most cases not possible.
Aim.  The purpose of this study was to analyse dental deviations in cases with either palatal or labial ectopic canines.
Design.  Panoramic and intra-oral radiographs from 50 patients with palatally located (38 females and 12 males) and 19 patients with labially located ectopic canines (11 females and 8 males), aged 10 years, 2 months–18 years, 1 month, were analysed. Dental deviations registered were crown and root malformations, agenesis, and eruption deviations. Registrations were performed in the maxillary incisor field and in the dentition in general.
Results.  The study documented that palatally as well as labially located ectopic canines can occur in dentitions without other dental deviations. Dental deviations occurred in approximately two-thirds of all cases, more often in females and in cases with palatally located canines. More than half of the females with palatally located canines had deviations in the maxillary incisors and in the dentition in general.
Conclusion.  Dental deviations may be considered a risk factor for maxillary canine ectopia. Early identification of patients at risk and appropriate interceptive treatment may reduce ectopic eruption of maxillary canines.     

Serum levels of IgG subclasses in relation to IgE and atopic disease in early infancy

The levels of IgG1, IgG2, IgG3, and IgG4 were analysed by ELISA in cord serum and in serum samples collected at 6 and 18 months of age from infants whose mothers were atopic. None of the four IgG subclasses was significantly influenced on any sampling occasion by infant atopy, gender, month of birth, maternal IgE or maternal diet during pregnancy and early lactation. However, at 18 months of age, significantly higher levels of IgG1 (P less than 0.05) and of IgG4 (P less than 0.01) were found in infants with an elevated IgE (greater than or equal to 8.0 kU/l) than in those with a lower level. A weak positive correlation (rs = 0.26; P = 0.05) between IgE and IgG4 was also observed. Despite the fact that the serum levels of IgG4 at 18 months were significantly higher (P less than 0.01) among infants with positive IgE-RAST (greater than or equal to 0.15 PRU/ml) to ovomucoid or beta-lactoglobulin, our data suggest that the the concentration of IgG4 relates more to the level of IgE than to the clinical symptoms of atopy. Determination of IgG subclasses seems to be of limited value for prediciting atopy during early infancy.     

Existence and Uniqueness of Solutions to the Multispecies Virtual Population Analysis Equations

This paper deals with the question of existence and uniquenessof solutions of multispecies virtual population analysis equationsfor predator–systems. By formulating the question as afized-point problem for a certain function F, it is shown thatat least one solution always exits. By using Brouwer degree,sufficient conditions for uniqueness are derived which are morelikely to be satisfied than those based on the requirement thatF be a contraction. Some of these are formulated as inequlitieswhich could be verified in the course of solving the equationsnumerically.