Occupational status among adult survivors following allo-SCT.

Being in work or the equivalent is an important goal after allo-SCT and is used as an indicator of recovery. The aim was to elucidate occupational status and factors associated with work among SCT survivors. Adults in working age with a haematological disease (n=177) were followed up within a median of 8 (range 28) years post allo-SCT. Predictors of not being in work at all or working part-time because of sick leave, disability pension or early old-age pension were analyzed using logistic regression analyses. At diagnosis, 82% of the participants were working full-time and 2% were on sick leave or old-age pension. At follow-up, 52% were working full-time, 27% were working part-time and 17% were on sick leave, disability pension or old-age pension. Not working at all was associated with multi-morbidity (P=0.01) and poorer health (P=0.00). Working part-time was associated with a higher age at diagnosis (P=0.00), being a woman (P=0.03), being born abroad (P=0.03) and multi-morbidity (P=0.00). In conclusion, the majority of survivors were in paid work at follow-up; however, a substantial number were not working or worked part-time.

Women's reflections and actions regarding working after breast cancer surgery - a focus group study.

BACKGROUND: To better understand processes affecting return to work (RTW) after breast cancer, more knowledge from the perspective of sickness absentees is warranted. Still, research based on women's own reasoning and actions in RTW is very scarce. This study aims to elucidate how women with breast cancer reflect and act on work-related issues. MATERIAL AND METHODS: Thematic analyses of data from four focus group interviews with 23 women who had had breast cancer surgery in the previous 3-13 months were carried out. RESULTS: The five following themes of reflections regarding RTW were identified: 'health and functioning', 'self-esteem/integrity', 'value of work', 'relationships at work', and 'social circumstances'. These reflections were associated with the three identified themes of actions taken by the women: 'to work or to be sickness absent', 'to adjust work according to own needs or not', and 'to disclose or to hide one's cancer'. There was a distinct difference between women who experienced work as a source of well-being and those who needed a respite from work. CONCLUSION: This study adds knowledge to the process of RTW after breast cancer and focuses on factors that lead the women to an active role in this process. We point to the interplay between women's own preferences, perceived competence, outer opportunities, and the actions each woman take with regard to RTW, which need to be recognized by all stakeholders involved. Furthermore, it continues to be essential to address the specific issue of disclosure in the workplace because this may be distressing for women.

Fluoride-supplemented milk inhibits acid tolerance in root caries biofilms.

In this study we investigated the effect of fluoride on plaque acid tolerance. The test group consumed 200 ml of milk supplemented with 5 mg F/l as NaF once a day, the milk control group drank 200 ml of unsupplemented milk, and the no-milk control group did not consume milk in this manner. Plaque samples were taken at baseline and after 15 months. The proportion of acid-tolerant bacteria in plaque was estimated using LIVE/DEAD® BacLight™ staining after exposure to pH 3.5 for 2 h. The fluoride group showed a statistically significant decrease in plaque acid tolerance compared to baseline. This study shows that daily intake of fluoride in milk reduces plaque acid tolerance.

Health-related quality of life and distress in cancer patients: results from a large randomised study.

To compare the effectiveness of individual support, group rehabilitation and a combination of the two in improving health-related quality of life (HRQOL) and psychological well-being in cancer patients during 24 months after diagnosis, as compared with standard care (SC). Furthermore, to compare the study sample and a random sample of the Swedish population with regard to HRQOL. A total of 481 consecutive patients, newly diagnosed with cancer, were randomly assigned to one of the four alternatives. Data on HRQOL and psychological well-being were collected at baseline and after 3, 6, 12 and 24 months. The interventions did not improve HRQOL or psychological well-being, as compared with SC. At 3 months, the study sample reported an HRQOL comparable with the normal population. Many cancer patients are able to manage their cancer-related concerns with the support available from SC. However, it is reasonable to assume that the findings suffer from a lack of data from especially vulnerable patients and a possible Hawthorne effect. It cannot be concluded that cancer patients have no need for additional psychosocial interventions. Future projects should include screening and target interventions for those at risk for significant and prolonged psychological distress.

Inhibition of enamel lesion formation by fluoridated milk assessed by laser fluorescence--an in vitro study.

The aim of this study was to investigate the effect of fluoridated milk on enamel lesion formation as assessed by laser fluorescence (LF). The material consisted of 18 extracted premolar teeth that were cut in mesial-distal direction and pairwise assigned to either test or control samples in an experimental caries model. The teeth were exposed to a low-pH 5% cellulose gel for 4 h, 5 days per week immediately followed by a 4-h period in either fluoridated (5 ppm, test) or nonfluoridated milk (control). In the meantime, the specimens were stored in pooled human-stimulated whole saliva in room temperature. All teeth were examined by visual inspection with a magnifying glass and by LF readings (DIAGNOdent) at baseline and after 2 and 4 weeks. The baseline LF readings ranged from 3 to 7 with a mean value of 5.6+/-0.9. The mean values increased with time in both groups but the increase was more marked in the control teeth, 8.7+/-2.3 vs 12.8+/-3.3 after 4 weeks, this difference being statistically significant (p<0.01). The visual examination could not distinguish between the test or control samples after 2 and 4 weeks, respectively. The findings indicated that fluoride added to milk may to some extent counteract enamel lesion formation as assessed by LF in an experimental caries model.

Prediction of vitamin A, vitamin E, selenium and zinc status of periparturient dairy cows using blood sampling during the mid dry period.

Vitamins A and E, and the trace elements selenium (Se) and zinc (Zn) are essential for the health and performance of dairy cows. Their concentrations often decrease around calving and extra supplementation is sometimes recommended at that time. However, the need for this varies, for example depending on quantity and quality of feedstuffs in the diet. The aim of this study was to measure the concentrations of serum vitamin A (S-vit A) and vitamin E (S-vit E), plasma Se (P-Se) and serum Zn (S-Zn) in blood samples taken at several time points from one month before to one month after calving, and to evaluate if a blood sample taken during the mid dry period can accurately predict the blood concentration at calving and early lactation. Dairy cows on 3 different feeding regimens during the dry period were included in the study. A significant decrease in the concentrations of S-vit A and S-vit E, and S-Zn, was observed at calving, and P-Se was significantly lower during the dry period and at calving than in early lactation. The blood concentrations of S-vit E and P-Se in the mid dry period significantly predicted the occurrence of values considered marginal or deficient at the time of calving. The data indicate that a mid dry period concentration of > or = 5.4 mg/l of S-vit E and > or = 0.09 mg/l of P-Se will result in a 90% chance that the cow stays above marginal levels at calving given that a feed of the same quality is offered.

Transmission of an inhomogeneous plane wave through an electrically small aperture in a perfectly conducting plane screen.

Most solutions for electromagnetic diffraction by a circular aperture in a perfectly conducting plane screen are for an incident homogeneous (propagating) plane wave. When the aperture is electrically small (dimensions small compared to the wavelength), the well-known transmission coefficient behaves as the fourth power of the diameter/wavelength. We consider the case in which the incident field is an inhomogeneous (evanescent) plane wave. Numerical calculations for the electrically small circular aperture show that the transmission coefficient for an inhomogeneous plane wave can be substantially greater than for a homogeneous plane wave at the same frequency. This observation may be helpful in explaining the increased transmission recently reported for electrically small apertures in plane screens with modifications. The numerical calculations for the electrically small aperture are in agreement with results from approximate analytical expressions that are based on the equivalent electric and magnetic dipole moments for the electrically small complementary disk.

Role of evanescent waves in power calculations for counterpropagating beams.

A general expression is obtained for the time-average power passing through a plane transverse to the direction of propagation for two counterpropagating electromagnetic beams. Each beam is represented by its plane-wave spectrum, which contains both propagating and evanescent plane waves. The expression clearly shows that, under certain conditions, the evanescent plane waves contribute to the time-average power passing through the plane. This is in contrast to the case of a single electromagnetic beam, in which only the propagating plane waves contribute to the time-average power passing through the plane. The utility of the expression is demonstrated with a practical example: a line current placed over a dielectric slab. Here the counterpropagating beams are the incident and reflected fields in the region between the current and the slab. The expression is applied to a plane in this region, and it is used to determine the time-average power associated with the evanescent waves passing through this plane. This power is then shown to be equal to the time-average power carried by the guided modes of the slab.

Is blood pressure at 68 an independent predictor of cognitive decline at 81? Results from follow-up study "Men born in 1914", Malmö, Sweden.

One hundred and sixty-eight men who were participants in the study "Men born in 1914" had their blood pressure and cognitive function examined when they were 68 years old. They were then re-examined at the age of 81. Decline on five standardized cognitive tests at the age of 81 years was studied in relation to four levels of baseline blood pressure at the age of 68. Results from multivariate analyses suggested that blood pressure, when studied in conjunction with other factors related to cognitive function, contribute to a rather modest extent and not unambiguously to the variability in cognitive decline. When decline on each separate test had been combined into a composite measure, where equal weight had been given to memory, crystallized and fluid abilities, it was shown that hypertension stage 2 (SBP 160-179 mmHg or DBP 100-109 mmHg) was associated with greater levels of overall decline. Hypertension stage 3 (SBP > or =180 mmHg or DBP > or =110 mmHg), on the other hand, was associated with lower levels of overall decline. Depressive symptoms at follow-up had a negative effect on cognitive levels and were discussed as potential confounders of hypertension-related cerebral lesions.

Three-dimensional electromagnetic diffraction of a Gaussian beam by a perfectly conducting half-plane.

Formulas are derived for the diffraction of a three-dimensional electromagnetic Gaussian beam by a perfectly conducting half-plane. The beam can be incident from any direction, and the main component of the electric field can point in any direction on the plane of the beam waist. The center of the beam waist is on the edge of the half-plane. The incident beam is constructed as a superposition of plane waves, and the total diffracted field is obtained from a superposition of the diffracted fields that are due to each plane wave. Physical constraints that limit the size and direction of the beam relative to the half-plane are described and incorporated into the theory. The scattered field in the far zone is obtained by asymptotic evaluation of the general formulas. Graphical results for the near-field as well as far-field patterns are presented and discussed.

Fluoride concentrations in saliva and dental plaque in young children after intake of fluoridated milk.

This study determined fluoride (F) concentrations in whole saliva and dental plaque after intake of fluoridated milk using a randomised crossover experimental design. Eighteen healthy children (6-8 years) were subjected to each of four different 3-day drinking regimens: (a) 200 ml F-free tap water; (b) 200 ml tap water with 1.0 mg F; (c) 200 ml standard milk, and (d) 200 ml standard milk with 1.0 mg F. A washout period of 7 days was organised between the different drinking regimens. All children used F-free toothpaste prior to and during the trial and were instructed to avoid F-rich food and drinks. F concentration in unstimulated whole saliva was determined at baseline and after 15 and 120 min and in plaque samples at baseline and after 2 h. The mean baseline values ranged from 0.01 to 0.02 mg F/l in saliva and between 10.4 and 14.2 mg F/l in dental plaque. A statistically significant (p < 0.05) increase of F was disclosed in saliva 15 min after drinking F-containing milk and water (0.052 and 0.058 mg F/l, respectively). After 2 h, the salivary F(-) concentrations were back to baseline values. In the plaque, however, a statistically significant (p < 0.01) twofold increase was found at 2 h after the intake of fluoridated milk and water, respectively. The results indicate that consumption of fluoridated milk contributes to a F storing process with significantly elevated F concentrations in dental plaque up to 2 h after intake. Further studies are required to determine the 'therapeutic concentration' of F in dental plaque after intake of fluoridated milk.

A comparison of cognitive ability in normotensive and hypertensive 68-year-old men: results from population study "men born in 1914," in Malmö, Sweden.

Hypertension and its consequences on cognition was analyzed using data from the study "Men born in 1914" in Malmö, Sweden, a prospective cohort study of cardiovascular disease. The baseline examinations took place in 1982/83 where 500 men participated in extensive medical and social examinations. A neuropsychological investigation was completed including five standardized cognitive tests. The specific purpose of the study was to investigate whether hypertension was associated with cognitive performance. By the use of multiple regression analyses, normal blood pressure and three stages of hypertension were analyzed in relation to test performance. Hypertension Stage 3 was associated with lower performance on tests measuring psychomotor speed and visuospatial memory, whereas hypertension Stage 1 was associated with higher performance on tests measuring verbal ability and constructional ability. The associations were unconfounded by clinical manifestations of atherosclerosis, history of stroke, depressive mood, and antihypertensive drug treatment.

Adaptive behavior in stressful situations and stroke incidence in hypertensive men: results from prospective cohort study "men born in 1914" in Malmö, Sweden.

BACKGROUND AND PURPOSE: Although hypertension is a major risk factor for stroke, many hypertensive persons remain healthy. The aim of the present study was to analyze whether adaptation in a stressful situation was associated with the incidence of stroke in hypertensive men. METHODS: Two hundred thirty-eight hypertensive men were followed from baseline in 1982/1983 until first stroke, death, or December 31, 1996. Adaptation to stress was studied with the serial Color-Word Test. In the Regression dimension, 4 patterns of adaptation could be distinguished according to mastering of the test. Successful mastering of the test was shown in stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns, and fluctuating difficulty that increased during testing in cumulative-dissociative patterns. The patterns were compared regarding stroke incidence. RESULTS: Forty-three men experienced a stroke during follow-up. Stroke rates per 1000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative patterns, 16.2 for men with dissociative patterns, and 31.2 for men with cumulative-dissociative patterns. Multivariate analysis, adjusted for relevant cerebrovascular risk factors, showed that the cumulative-dissociative pattern of the Regression dimension was associated with an increased risk of stroke during follow-up (relative risk 3.00, 95% CI 1.32 to 6.81). CONCLUSIONS: The specific behavior pattern, characterized by the greatest difficulties in managing the test, was associated with incidence of stroke in hypertensive men. One interpretation is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.

Changes in some blood micronutrients, leukocytes and neutrophil expression of adhesion molecules in periparturient dairy cows.

Dairy cows are highly susceptible to infectious diseases, like mastitis, during the period around calving. Although factors contributing to increased susceptibility to infection have not been fully elucidated, impaired neutrophil recruitment to the site of infection and changes in the concentrations of some micronutrients related with the function of the immune defence has been implicated. Most of the current information is based on studies outside the Nordic countries where the conditions for dairy cows are different. Therefore, the aim of the study was to evaluate changes in blood concentrations of the vitamins A and E, the minerals calcium (Ca), phosphorous (P), and magnesium (Mg), the electrolytes potassium (K) and sodium (Na) and the trace elements selenium (Se), copper (Cu) and zinc (Zn), as well as changes in total and differential white blood cell counts (WBC) and expression of the adhesion molecules CD62L and CD18 on blood neutrophils in Swedish dairy cows during the period around calving. Blood samples were taken from 10 cows one month before expected calving, at calving and one month after calving. The results were mainly in line with reports from other countries. The concentrations of vitamins A and E, and of Zn, Ca and P decreased significantly at calving, while Se, Cu, and Na increased. Leukocytosis was detected at calving, mainly explained by neutrophilia, but also by monocytosis. The numbers of lymphocytes tended to decrease at the same time. The mean fluorescent intensity (MFI) of CD62L and CD18 molecules on blood neutrophils remained constant over time. The proportion of CD62L+ neutrophils decreased significantly at calving. The animals were fed according to, or above, their requirements. Therefore, changes in blood levels of vitamins, minerals and trace elements were mainly in response to colostrum formation, changes in dry matter intake, and ruminal metabolism around calving. Decreased levels of vitamins A and E, and of Zn at calving might have negative implications for the functions of the immune defence. The lower proportion of CD62L+ neutrophils at calving may result in less migration of blood neutrophils into the tissues, and might contribute to the increased susceptibility to infections at this time.

Reversal of primary root caries using dentifrices containing 5,000 and 1,100 ppm fluoride.

This study compared the ability of two sodium fluoride dentifrices, one containing 5,000 ppm fluoride (Prevident 5000 Plus) and the other 1,100 ppm fluoride (Winterfresh Gel), to reverse primary root caries lesions (PRCLs). A total of 201 subjects with at least one PRCL each entered the study and were randomly allocated to use one of the dentifrices. After 6 months, 186 subjects were included in statistical analyses. At baseline and after 3 and 6 months, the lesions were clinically assessed and their electrical resistance measured using an electrical caries monitor. After 3 months, 39 (38.2%) of the 102 subjects in the 5,000 ppm F- group and 9 (10.7%) of 84 subjects using the 1,100 ppm F- dentifrice, had one or more PRCLs which had hardened (p = 0.005). Between baseline and 3 months, the log10 mean +/- SD resistance values of lesions for subjects in the 1,100 ppm F- group had decreased by 0.06+/-0.55, whereas those in the 5,000 ppm F- group had increased by 0.40+/-0.64 (p<0.001). After 6 months, 58 (56.9%) of the subjects in the 5,000 ppm F- group and 24 (28.6%) in the 1,100 ppm F- group had one or more PRCLs that had become hard (p = 0.002). Between baseline and 6 months, the log10 mean +/- SD resistance values of lesions for subjects in the 1,100 ppm F- group decreased by 0.004+/-0.70, whereas in the 5,000 ppm F- group, they increased by 0.56+/-0.76 (p<0.001). After 3 and 6 months, the distance from the apical border of the root caries lesions to the gingival margin increased significantly in the 5,000 ppm F- group when compared with the 1,100 ppm F- group. The plaque index in the 5,000 ppm F- group was also significantly reduced when compared with the 1,100 ppm F- group. The colour of the lesions remained unchanged. It was concluded that the dentifrice containing 5,000 ppm F- was significantly better at remineralising PRCLs than the one containing 1,100 ppm F-.

Group rehabilitation for cancer patients: satisfaction and perceived benefits.

Satisfaction with a group rehabilitation programme (GR) was evaluated in a heterogeneous group of cancer patients. Of the patients that were invited, 67% (N = 132) participated in the GR. The GR included eight sessions plus one booster-session, each including information and/or cognitive-behavioural techniques combined with physical training and relaxation and started approximately 4 months after diagnosis. Men and women participated to the same extent. A mailed questionnaire was used to assess patients' satisfaction, perceived benefits and level of difficulty of the GR components. The majority of patients stated that the number of sessions and timing of the GR was adequate. The usefulness of the GR components were rated in the following descending order: relaxation, physical training, encountering others in the same situation, breathing exercises, information and cognitive-behavioural skills. Patients were more satisfied with diagnosis-specific group meetings than with those including several diagnoses. Assessment of patient satisfaction seems appropriate to elucidate patient priorities.

Effect of quarterly treatments with a chlorhexidine and a fluoride varnish on approximal caries in caries-susceptible teenagers: a 3-year clinical study.

The aim of this study was to compare the effect of two different dental varnishes on approximal caries incidence in teenagers with proven caries susceptibility during a 3-year period. Two hundred 13- to 14-year-old subjects exhibiting at least two approximal enamel caries lesions were selected to take part in the study. One hundred and eighty subjects participated after informed consent and were randomly assigned to two equally sized groups. One group was treated with a fluoride varnish (FV, Fluor Protector) containing 0.1% F every 3rd month and the participants of the other group were treated in the same mode with a chlorhexidine varnish (CV, Cervitec((R))) containing 1% chlorhexidine and 1% thymol. In total, each subject was treated 12 times during the experimental period. Approximal caries including enamel lesions (DMFS(appr)) were recorded from four bitewing radiographs exposed at the start and end of the study. The mean (+/-SD) caries prevalence at baseline was 2.2+/-3.4 in the FV group and 2.5+/-4.0 in the CV group. After 3 years, the average approximal caries incidence was 2.7+/-3.1 and 3.1+/-3.5 in the FV and CV groups, respectively. The differences at baseline and after 3 years were not statistically significant. In conclusion, treatments every 3rd month with either a fluoride- or a chlorhexidine/thymol-containing varnish showed a promising effect with low approximal caries incidence and progression in teenagers with proven caries susceptibility.

Effectiveness of two fluoride dentifrices to arrest root carious lesions.

PURPOSE: To compare the effectiveness of Prevident 5000 Plus (5,000 ppm F) and Colgate Winterfresh Gel (1100 ppm F) to arrest root carious lesions. MATERIALS AND METHODS: 201 subjects with at least one root carious lesion were recruited from dental school patients. They were randomly assigned to use either Prevident 5000 Plus (5000 ppm F) or Colgate Winterfresh Gel (1100 ppm F) as sodium fluoride in the same silica base. Measurements of lesion hardness, area, distance from the gingival margin, cavitation and plaque were recorded at baseline and after 3 months by a single examiner. RESULTS: After 3 months 38% of subjects using Prevident 5000 Plus and 10% using Winterfresh Gel had one or more lesions that had become hard (P < 0.001). Non-cavitated lesions at baseline were more likely to become hard than cavitated lesions. Compared to the Winterfresh group there was significant increase in the distance from the base of the lesion to the gingival margin and plaque scores were reduced in those using Prevident 5000 Plus.

Lead poisoning in woodpeckers in Sweden.

Lead poisoning was demonstrated in two gray-headed woodpeckers (Picus canus) and one white-backed woodpecker (Dendrocopus leucotos) in Sweden; they had liver lead levels between 9.4 and 26.2 mg(-1) wet weight. At necropsy one gray-headed woodpecker showed signs of emaciation and the other one had severe traumatic injuries, caused by a cat. The white-backed woodpecker died in the transportation box during a translocation program. The source of the lead could not be determined, but it was suspected that it may have originated from lead pellets shot into trees and picked out by the woodpeckers during food search.

Interdental caries incidence and progression in relation to mutans streptococci suppression after chlorhexidine-thymol varnish treatments in schoolchildren.

The aim of this study was to evaluate interdental caries incidence and progression in relation to the effect of antibacterial varnish treatments in schoolchildren anticipated at caries risk. After a screening procedure, 110 healthy children (8-10 years) with moderate and high counts of salivary mutans streptococci (MS) were invited to join a 2-year longitudinal study. At baseline, MS were enumerated at all mesial interdental sites of the first permanent molars with a chair-side technique. The children were then treated 3 times within 2 weeks by interdental spot applications with a 1% chlorhexidine/thymol-containing varnish (Cervitec). Follow-up samples of saliva and plaque were collected 1, 3, 6, and 12 months after onset of treat. Caries prevalence, incidence and progression of the selected approximal surfaces were scored from bitewing radiographs exposed at baseline and after 2 years. Sixty-three children of the same age formed a non-varnish-treated reference group. Reduction of caries incidence and progression was dearly dependent on the outcome of the antibacterial treatment. A significantly (P< 0.01) higher progression score was found among children who exhibited a less marked suppression of interdental MS levels compared with those with high suppression and the children of the reference group. The results suggest that a suppression of MS in interdental plaque may be an important event to prevent and arrest approximal caries development in schoolchildren at risk. Monitoring the effect of antibacterial agents in a site-specific way could therefore be advocated.