Adaptive and maladaptive aspects of dependency: an integrative review.

Although dependence in adults has typically been viewed as a flow or deficit in functioning, a review of the literature reveals that high levels of dependency are associated with both positive and negative qualities on the part of the dependent person. Studies confirming this association are discussed, along with the theoretical and practical implications of their findings.

Attitudes and knowledge about preventive dental care in Chilean refugees in Sweden.

The aim of this study was to evaluate the effects of a simplified oral health programme on attitudes to and knowledge of preventive dentistry. The subjects were Chilean refugees and the programme was delivered at one or two sessions in the form of group information/discussion. Because of increasing immigration, Sweden has become a multicultural society. The number of non-Nordic immigrants has doubled in the past decade. The major refugee groups have come from Iran, Chile and Poland. The subjects comprised 193 Chilean refugees: 106 in a single-visit group and 87 in a two-visit group. The oral health programme was completed by 94 and 65 subjects respectively and was evaluated after 6 months. Positive effects were discernible in attitudes to and knowledge of preventive dentistry, particularly with respect to oral hygiene. A key to success may have been group discussion in which the refugees could relate oral health problems to their own ethnic group. This could have an important function in bridging cultural, linguistic and situational barriers. Different forms of outreach programmes for oral health via groups, organisations or authorities in close contact with refugees shortly after arrival in Sweden are proposed. This approach may be particularly effective in a multicultural society and also in the context of the turbulent conditions the newly-arrived refugee experiences.

Simplified preventive dentistry program for Chilean refugees: effectiveness of one versus two instructional sessions.

A simplified dental health program for newly arrived refugees was evaluated. The efficacy of presenting the program in one instructional session or two was compared. 193 Chilean refugees, granted residency in Stockholm in Spring 1981 or in Spring 1982, participated. The subjects were divided into two groups. One group received a dental health program only at the first visit, in conjunction with the baseline examination, and the other group was recalled for a further session 3 months after the baseline examination. Both groups were recalled for evaluation 6 months after the initial visit. At follow-up the groups comprised 94 and 65 subjects respectively. The mean relative reductions in gingivitis (relating GBI reduction to baseline GBI) were 33.2% (95% < I: 29.1 to 37.3%) in the single-visit group and 40.5% (95% < I: 35.9 to 45.8%) in the two-visit group. The reduction in periodontal pocket depth was mainly a reduction of shallow pockets. The maximum effect was attained after one instructional session.

An estimation of dental treatment needs in two groups of refugees in Sweden.

The aim of this study was to estimate dental treatment need in groups of Chilean and Polish refugees in Sweden. Of the Nordic countries, Sweden accepts the greatest number of refugees. An average of 5000 refugees arrived annually in 1981-85, increasing to 15,000 during 1986-87. Refugees and their families now comprise 93% of non-Nordic immigration. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm was selected for this study. Dental treatment needs were calculated in accordance with CPITN and the working study of Swedish dentistry, which formed the basis for the Swedish scale of dental fees for the National Dental Insurance Scheme. The estimated mean treatment time (+/- SD) in the Chilean sample was 6.9 +/- 2.3 h and in the Polish group 8.4 +/- 3.0; in comparison with estimated treatment needs in a Swedish material, both would be classified as extreme risk groups. There was no correlation between the number of months in Sweden and the estimated treatment needs. The results indicate a cumulative, unmet need for dental care in these groups. Barriers to ensuring adequate health care for immigrants persist; special outreach programmes, conducted by dental health personnel, may be an effective means of introducing immigrants to the Swedish dental care system.

Dental health status in two groups of refugees in Sweden.

The aim of this study was to determine dental health status in two separate groups of Chilean and Polish refugees in Sweden. In Scandinavia, Sweden has the largest number of immigrants--1 million out of a population of 8.3 million. Since 1975, most immigrants have been refugees and their families. During 1978-82 Sweden granted residency to 20,000 refugees, the two largest groups being Chileans and Poles. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm were selected for this study. The investigation consisted of a questionnaire followed by clinical examination, including roentgenograms. The average age was 34.0 years in the Chilean group and 34.8 years in the Polish group. The Chileans had been in Sweden for 17.3 months on an average and the Poles for 16.0 months. The Chileans had an average of 10.0 carious surfaces, D(s), and the Poles 11.3. Gingivitis was recorded in 87% of the total number of sites examined in the Chilean group. The corresponding figure in the Polish group was 79%. Of the Chileans 36.5% and of the Poles 32.5% had periodontal pockets measuring more than 5 mm. The results indicate that, when compared with Swedish individuals of a corresponding age, the refugee groups have a high prevalence of caries and periodontal disease.