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  1. Article ; Online: Facilitators for use of oral healthcare services among people with substance use disorders: a qualitative study in Norway.

    Carlsen, Siv-Elin Leirvaag / Isaksen, Katja / Åstrøm, Anne Nordrehaug / Fadnes, Lars Thore

    Acta odontologica Scandinavica

    2022  Volume 80, Issue 7, Page(s) 513–521

    Abstract: Objective: Opioid maintenance treatment (OMT) patients in Norway are eligible for free oral healthcare services; however, oral health morbidity remains high and the uptake of services among this patient group is low. As knowledge of the reasons for the ... ...

    Abstract Objective: Opioid maintenance treatment (OMT) patients in Norway are eligible for free oral healthcare services; however, oral health morbidity remains high and the uptake of services among this patient group is low. As knowledge of the reasons for the low uptake of services among OMT patients is insufficient, this study adopted a qualitative approach to explore this from the perspectives of patients and dental healthcare workers (DHWs).
    Material and methods: Through focus group and individual interviews, data were collected from 63 participants: 30 patients receiving OMT and 33 DHWs. Key themes were identified through a thematic analysis.
    Results: Teeth were a significant factor in OMT patients' quality of life and recovery. Accompaniment to scheduled dentist appointments was identified as a facilitator by both the patients and the DHWs. The dentist-patient relationship was also seen as an important facilitator of dental treatment; DHWs with previous experience of treating OMT patients were valued by patients because of their high verbal and non-verbal communication.
    Conclusions: Helping OMT patients attend dental appointments, improving the dentist-patient relationship, and expanding stakeholders' knowledge of OMT patients' right to oral healthcare services may increase the uptake and benefits of dental healthcare services among OMT patients. The current support framework within the OMT system has the potential to increase the communication and efficiency of dental healthcare services available to patients undergoing OMT.
    MeSH term(s) Delivery of Health Care ; Humans ; Norway ; Opiate Substitution Treatment ; Qualitative Research ; Quality of Life ; Substance-Related Disorders
    Language English
    Publishing date 2022-02-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 210362-x
    ISSN 1502-3850 ; 0001-6357
    ISSN (online) 1502-3850
    ISSN 0001-6357
    DOI 10.1080/00016357.2022.2041719
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Non-financial barriers in oral health care: a qualitative study of patients receiving opioid maintenance treatment and professionals' experiences.

    Carlsen, Siv-Elin Leirvaag / Isaksen, Katja / Fadnes, Lars Thore / Lygren, Ole Jørgen Scheie / Åstrøm, Anne Nordrehaug

    Substance abuse treatment, prevention, and policy

    2021  Volume 16, Issue 1, Page(s) 44

    Abstract: Background: People with substance use disorders often have poor oral health, which can negatively impact their quality of life. Since 2005, patients receiving opioid maintenance treatment (OMT) in Norway have been eligible for free oral health care ... ...

    Abstract Background: People with substance use disorders often have poor oral health, which can negatively impact their quality of life. Since 2005, patients receiving opioid maintenance treatment (OMT) in Norway have been eligible for free oral health care services offered through public oral health clinics. Despite a large need for oral health services amongst patients in OMT, figures suggest that the use of these services is low amongst this patient group. It has been unclear which barriers that contribute to this. This qualitative study explores the underlying barriers to the use of oral health care services amongst patients in OMT, from the perspective of the patients as well as dental health care workers (DHW).
    Methods: Through a combination of focus group interviews and individual interviews, data were collected from 63 participants; 30 patients in OMT and 33 DHW. Thematic analysis identified key themes for the use (or not) of oral health care services amongst patients in OMT.
    Results: Both individual and structural barriers prevent OMT patients from using the free oral health care services offered to them. These barriers include struggling to attend appointments, anxiety and fear of dentists, discrepancies between patients' expectations and the services offered and perceived stigma. OMT patients' lack of information regarding their rights and access to oral health services was also a barrier, as was DHWs' lack of knowledge and information of the OMT system and what they can offer patients.
    Conclusions: OMT patients face several barriers in accessing and using oral health care services. However, through a number of relatively simple measures, it is possible that the use of oral health services amongst OMT patients can be increased.
    MeSH term(s) Delivery of Health Care ; Health Services Accessibility ; Humans ; Opiate Substitution Treatment ; Oral Health ; Qualitative Research ; Quality of Life
    Language English
    Publishing date 2021-05-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2222956-5
    ISSN 1747-597X ; 1747-597X
    ISSN (online) 1747-597X
    ISSN 1747-597X
    DOI 10.1186/s13011-021-00379-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Intraocular pressure changes over 21 years - a longitudinal age-cohort study in northern Sweden.

    Åström, Siv / Stenlund, Hans / Lindén, Christina

    Acta ophthalmologica

    2014  Volume 92, Issue 5, Page(s) 417–420

    Abstract: Purpose: To follow intraocular pressure (IOP) and the influence of pseudoexfoliation (PEX) and cataract extraction in an age-cohort in northern Sweden; patients were followed prospectively for 21 years from age 66 to 87 years.: Methods: Three Hundred ...

    Abstract Purpose: To follow intraocular pressure (IOP) and the influence of pseudoexfoliation (PEX) and cataract extraction in an age-cohort in northern Sweden; patients were followed prospectively for 21 years from age 66 to 87 years.
    Methods: Three Hundred and thirty-nine individuals, randomly selected from an age-cohort born in 1915 underwent ophthalmological examination including measurement of IOP with Goldmann applanation tonometry, screening for PEX and glaucoma. Follow-up examinations were performed three times with 7-year intervals. Medical records were reviewed for dates of cataract surgery and glaucoma treatment. A linear mixed model was used to analyse the impact of sex, eye (right/left), PEX, cataract extraction and time on IOP.
    Results: Without cataract surgery, the IOP from age of 66 to 87 years, increased by 0.05 mmHg/year (p < 0.001). If cataract surgery was included in the model, no significant change in IOP over time was found. The estimated contribution of PEX to IOP was +2.05 mmHg (p < 0.001), and the contribution of cataract surgery was -2.13 mmHg (p < 0.001). The mean IOP in women was 1.22 mmHg higher than in men (p = 0.001).
    Conclusion: A small but statistically significant increase in IOP with age was detected when excluding eyes that had undergone cataract surgery. PEX was associated with a higher IOP and cataract extraction with a lower.
    MeSH term(s) Aged ; Aged, 80 and over ; Aging/physiology ; Cataract Extraction ; Cohort Studies ; Exfoliation Syndrome/epidemiology ; Exfoliation Syndrome/physiopathology ; Female ; Follow-Up Studies ; Glaucoma, Open-Angle/epidemiology ; Glaucoma, Open-Angle/physiopathology ; Humans ; Intraocular Pressure/physiology ; Male ; Prospective Studies ; Sweden/epidemiology ; Tonometry, Ocular
    Language English
    Publishing date 2014-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2408333-1
    ISSN 1755-3768 ; 1755-375X
    ISSN (online) 1755-3768
    ISSN 1755-375X
    DOI 10.1111/aos.12232
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diagnosed open-angle glaucoma in screened versus unscreened subjects--a long-term age cohort study.

    Åström, Siv / Stenlund, Hans / Lindén, Christina

    Acta ophthalmologica

    2014  Volume 92, Issue 6, Page(s) 501–506

    Abstract: Purpose: To investigate and compare the cumulative incidence of diagnosed open-angle glaucoma (OAG) in an age cohort of elderly people, of which one group was screened.: Methods: Cohort study comprising all 856 individuals born in 1915 and living in ... ...

    Abstract Purpose: To investigate and compare the cumulative incidence of diagnosed open-angle glaucoma (OAG) in an age cohort of elderly people, of which one group was screened.
    Methods: Cohort study comprising all 856 individuals born in 1915 and living in the municipality of Skellefteå in1981. A randomly selected subgroup of the cohort (40%) was repeatedly screened, and suspected OAG cases were followed until 2002 for the development of OAG. Medical records were collected and analysed for OAG. The numbers of OAG cases were compared between the screened group and the remaining part of the cohort (the unscreened group).
    Results: The cohort consisted of 339 screened and 517 unscreened persons. Before 1981, there were six known cases of OAG in the screened group and nine cases in the unscreened group. During the follow-up from 1981 to 2002, there were 33 new cases in the screened group and 31 new cases of OAG in the unscreened group. The incidence of diagnosed OAG in women was higher in the screened group than in the unscreened group, incidence rate ratio = 1.94 (p = 0.035). In contrast, the cumulative incidence of diagnosed OAG in men was similar in the two groups (p = 0.58). For the whole population, there was no significant difference (p = 0.053).
    Conclusion: In this population with a high prevalence of PEX and increased risk for glaucoma, there was a non-significant difference between the screened and unscreened groups regarding the proportion of diagnosed OAG. The failure to reach significance may be due to the limited sample size. OAG was diagnosed twice as often among women in the screened group than in the unscreened group.
    MeSH term(s) Age Distribution ; Aged ; Aged, 80 and over ; Cohort Studies ; Exfoliation Syndrome/complications ; Female ; Glaucoma, Open-Angle/diagnosis ; Glaucoma, Open-Angle/epidemiology ; Humans ; Incidence ; Intraocular Pressure ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Sex Distribution ; Sweden/epidemiology ; Tonometry, Ocular
    Language English
    Publishing date 2014-09-18
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2408333-1
    ISSN 1755-3768 ; 1755-375X
    ISSN (online) 1755-3768
    ISSN 1755-375X
    DOI 10.1111/aos.12291
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Incidence and prevalence of pseudoexfoliation and open-angle glaucoma in northern Sweden: I. Baseline report.

    Aström, Siv / Lindén, Christina

    Acta ophthalmologica Scandinavica

    2007  Volume 85, Issue 8, Page(s) 828–831

    Abstract: Purpose: To evaluate the prevalence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) among 66-year-old people in the municipality of Skellefteå in northern Sweden.: Methods: A population-based study comprising 339 individuals, ... ...

    Abstract Purpose: To evaluate the prevalence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) among 66-year-old people in the municipality of Skellefteå in northern Sweden.
    Methods: A population-based study comprising 339 individuals, representing 40% of the age group and 87% of those randomly selected. The examination included tonometry, dilated slit-lamp biomicroscopy, optic disc evaluation and a visual field analysis if glaucoma was suspected.
    Results: The overall prevalence of PEX syndrome was 23%[95% confidence interval (CI): 20-26%], 29% (CI: 24-34%) in women and 15% (CI: 10-19%) in men (P < 0.01). The intraocular pressure (IOP) in PEX eyes was higher (17.3 mmHg, SD 4.5 mmHg) than in eyes without PEX [15.7 mmHg, SD 3.7 mmHg; P < 0.001]. IOP exceeded 22 mmHg in 17% (CI: 11-23%) of the PEX eyes and in 3.0% (CI: 1.9-4.1%) of the non-PEX eyes. Seven individuals (2.1%) had OAG. Six were associated with PEX, i.e. 7.7% of the PEX individuals.
    Conclusion: PEX syndrome is common in northern Sweden, affecting every fourth individual reaching the age of 66 years. The prevalence in women is twice that in men. Elevated IOP is roughly six times more frequent in eyes with PEX than in eyes without PEX syndrome. The prevalence of OAG is 2.1%.
    MeSH term(s) Aged ; Exfoliation Syndrome/complications ; Exfoliation Syndrome/epidemiology ; Female ; Glaucoma, Open-Angle/complications ; Glaucoma, Open-Angle/epidemiology ; Glaucoma, Open-Angle/physiopathology ; Humans ; Incidence ; Intraocular Pressure ; Male ; Prevalence ; Sex Distribution ; Sweden/epidemiology
    Language English
    Publishing date 2007-12
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1230907-2
    ISSN 1600-0420 ; 1395-3907
    ISSN (online) 1600-0420
    ISSN 1395-3907
    DOI 10.1111/j.1600-0420.2007.00992.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Incidence and prevalence of pseudoexfoliations and open-angle glaucoma in northern Sweden: II. Results after 21 years of follow-up.

    Aström, Siv / Stenlund, Hans / Lindén, Christina

    Acta ophthalmologica Scandinavica

    2007  Volume 85, Issue 8, Page(s) 832–837

    Abstract: Purpose: To prospectively evaluate the prevalence and incidence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) with and without PEX and to evaluate PEX as a risk factor for glaucoma in a population born in 1915 and living in the ... ...

    Abstract Purpose: To prospectively evaluate the prevalence and incidence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) with and without PEX and to evaluate PEX as a risk factor for glaucoma in a population born in 1915 and living in the municipality of Skellefteå in northern Sweden.
    Methods: A randomized population study comprising 339 individuals. The cohort was followed for 21 years at 7 year intervals. The examination included tonometry, dilated slit-lamp biomicroscopy, optic disc evaluation and, if glaucoma was suspected, a visual field analysis.
    Results: The prevalence of PEX increased from 23%[95% confidence interval (CI): 20-26] at 66 years of age to 61% (CI 50-71) at 87 years. The annual incidence of PEX was 1.8% (CI 1.3-2.4). In the group of subjects with unilateral PEX, 55% converted to bilateral PEX during follow-up. The prevalence of OAG was 2.1% (CI 0.8-4.3%) at 66 years of age and 25% (CI 16-35) at 87 years. Of the glaucoma cases, 59% had PEX. There was no difference in incidence between the sexes. The annual incidence of PEX and OAG did not increase with time. The overall annual incidence of OAG was 0.9% (CI 0.6-1.3%) [0.5% (CI 0.2-0.9) without PEX and 2.1% (CI 1.2-3.3) with PEX]. PEX increased the risk of glaucoma four fold in both sexes. There was no significant difference in mortality between individuals with or without PEX.
    Conclusion: PEX syndrome and OAG are common in the north of Sweden. Prevalences increase with age. PEX increases the risk of glaucoma four fold. The consequences of this situation demand guidelines for handling patients with PEX, with or without other risk factors. In order to issue guidelines, more information is needed on the impact of the disease on the general health in the ageing population.
    MeSH term(s) Age Distribution ; Aged, 80 and over ; Cohort Studies ; Exfoliation Syndrome/complications ; Exfoliation Syndrome/epidemiology ; Female ; Follow-Up Studies ; Glaucoma, Open-Angle/complications ; Glaucoma, Open-Angle/epidemiology ; Glaucoma, Open-Angle/etiology ; Humans ; Incidence ; Male ; Prevalence ; Prospective Studies ; Risk Factors ; Sex Distribution ; Sweden/epidemiology
    Language English
    Publishing date 2007-12
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1230907-2
    ISSN 1600-0420 ; 1395-3907
    ISSN (online) 1600-0420
    ISSN 1395-3907
    DOI 10.1111/j.1600-0420.2007.00980.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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