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Syftet med studien var att undersöka självupplevd oral hälsa (SPOH) och faktorer som påverkar den, i en vuxen population i Kalmar län, Sverige. Studien är en del av en epidemiologisk studie som genomfördes under 2010-2012. Urvalet för denna studie bestod av 380 slumpvis utvalda personer som deltog i en omfattande klinisk undersökning och svarade på en enkät. Enkäten bestod av 56 frågor angående bl.a. patientens självupplevda orala hälsa och socioekonomiska situation. Den studerade populationen bestod av 189 kvinnor (49,9%) och 190 män (50,1%). Individerna var 20-90 år, med en genomsnittlig ålder av 52 år. Självupplevd oral hälsa definierades statistiskt utifrån en av frågorna i enkäten: självupplevd oral hälsa jämfört med jämnåriga, och benämndes SPOH. De kliniska variabler som analyserades var antal egna tänder, DMFT (Decayed, Missed, Filled Teeth), tandluckor och riskbedömning (summa av tandläkarens bedömning av kariesrisk, parodontal risk, teknisk risk och allmän risk). Bakgrundsvariablerna var ålder, kön, utbildning och etnicitet. Bivariata korrelationer och en regressionsanalys utfördes med SPOH som beroende variabel och med bakgrundsfaktorer och kliniska variabler som oberoende variabler. Signifikanta korrelationer påvisades mellan SPOH och ålder (p<0,01), DMFT (p<0,01), antal egna tänder (p<0,01) och tandläkarens riskbedömning (p<0,01). Högre SPOH korrelerade med ökande ålder, fler egna tänder och lägre DMFT. En överensstämmelse mellan tandläkarens bedömning av patientens orala status och SPOH påvisades i sambandet mellan dessa två variabler, vilket indikerar att högre bedömd risk är förknippat med en lägre SPOH. / The aim of this study was to investigate self-perceived oral health (SPOH) and factors affecting it, among adults in the Swedish county of Kalmar. The study is part of an epidemiologic study conducted in 2010-2012. The sample for this study was comprised of 380 individuals, randomly selected, who participated in a clinical examination with a concomitant questionnaire. The questionnaire consisted of 56 questions concerning e.g. patient perception of oral health and socio-economic situation. The final study population consisted of 189 women (49.9%) and 190 men (50.1%). The individuals were 20-90 years, with a mean age of 52 years. Self-perceived oral health was statistically defined by one question of the questionnaire: self-assessed oral health as compared to contemporaries of the same age, and termed SPOH. The clinical variables analysed were number of own teeth, DMFT (Decayed, Missed, Filled Teeth), gaps between teeth and risk assessment (sum of the dentists assessment of caries risk, periodontal risk, technical risk and general risk). The background variables were age, gender, education and ethnicity. Bivariate correlations and regression analyses were conducted with SPOH as dependent variable, and with background factors and clinical variables as independent variables. Significant correlations were found between SPOH and age (p<0.01), DMFT score (p<0.01), number of own teeth (p<0.01) and the dentists’ risk assessment (p<0.01). Higher SPOH was associated with increased age, increased number of own teeth and decreased DMFT. A consistency between the clinician’s assessment of the patient’s oral status and SPOH was shown in the correlation between these two variables, which implies that a higher risk assessment is associated with a lower SPOH.

The primary aim of this research was the development of a typology of respondents based on their "control identity"– i.e., perceived sense of control over themselves, their environment, and aspects of their health, including perceived vulnerability to disease and perceived value of health promotion. Testicular cancer and testicular self examination (TSE) were selected as the disease focus, with the realization that, if successful, the typology could be applied across a variety of diseases. The constructs of "realistic vs. unrealistic control" and "internal vs. external locus of control" provided the theoretical foundation to initially define the control-identity types that were then verified through cluster/segmentation analyses. Testicular cancer rates are rising among 15-54 year old men with the majority of those cases affecting males under the age of 35. Regular screening techniques for the disease, most notably testicular self-examination, are rarely performed among surveyed males. If testicular cancer is caught in its early stages, the survival rate is approximately 95%; however, if diagnosed in later stages, survival rates drop below 50%. The lack of published psychosocial behavioral research in this area has contributed to a general misunderstanding by men of the disease and its preventative/screening measures. If continued, this lack of screening for testicular cancer can only lead to increasing incidence and mortality rates. This exploratory study developed a Control Identity Survey, a 41-item questionnaire soliciting information on perceived vulnerability, value of health promotion, health control beliefs, and intention to perform testicular self-examination (TSE). The survey was administered via in-person and internet data collection methods to 300 men between the ages of 18-35. A principal components factor analysis of the survey’s key control variables (realistic vs. unrealistic illusory control constructs and internal v. external locus of control) defined the underlying structure of the data. The resulting factors were then used to create indices for use in the cluster analysis process. From this cluster analysis, control-identity groups were identified and profiled. Given the control-identity types, perceptual mapping techniques were then applied to model how each type of respondent perceives their vulnerability to testicular cancer, the value of testicular self-examination, and overall health control beliefs. This study equated perceptions with an individuals’ ‘outcome expectancy’, or attitude. The findings confirmed the following: •The hypothesized four-group control-identity typology was verified among men based on the variables of health control beliefs, perceived vulnerability, and perceived value of health promotion. The groups were labeled: 1) Realistic Externals, 2) Realistic Internals, 3) Unrealistic Internals, 4) Unrealistic Externals. •Unrealistic Externals perceive the value of TSE to be significantly lower than other types. •Unrealistic Externals perceived their control over health outcomes to be lower than all other types. •Each control-identity type structures perceptions of health control beliefs, vulnerability, and the value of health promotion similarly in a 3-dimensional perceptual mapping space, but the location of “self” within the concept set differs by control-identity type. •Realistic Internals scored the highest among types on value of health promotion, but not significantly so compared to the other groups, with the exception of the Unrealistic Externals, who least value health promotion. •The two “Realistic” types (Internal & External) scored significantly higher on perceived Vulnerability than did the two "Unrealistic" types (Internal & External), with the "Internals" v. "Externals" not differing significantly. •Unrealistic Internals scored highest on perceived self-efficacy (I-Control), but not significantly higher than Realistic Internals, which appears consistent with the fact that "internals" have a higher sense of health-related self-efficacy than do "externals". •Implications for social marketing and for the development of future behavioral intervention strategies are suggested. The methods used in this research could have wide application across the cancer continuum from primary prevention and screening to treatment and end-of-life decisions. From this research, it is clear that men differ significantly in their “control identity”-- the extent to which they perceive themselves as having an internal v. external and/or realistic vs. unrealistic sense of control over their health. Consistently, the control-types differed on perceptions of their own vulnerability to disease, their perceived value of health promotion, and their individual health control beliefs. The resulting typology appears to have exceptional potential for future research across a variety of health related behaviors and diseases. As well, the typology holds promise as a cost-effective way to tailor evidence-based decision aids for each of the control-identities. Since there is little reported success in promoting sustainable TSE among males, it is suggested that building on the control-identity approach will aid testicular cancer and TSE researchers in developing more effective, tailored messages for their study designs. / Public Health

American Civil War officer preparation activities were rooted in the broader practices of antebellum military education as applied at West Point, other military academies, and the state militia system. The arrival of black troops in the Union Army led to a radical, if temporary, transformation in the Army's process for the selection and preparation of officers—but only for the white officers who served with black regiments. Overtly political or casual processes of the early Civil War were replaced in many cases by formal examinations and the centralized review of results, operating in parallel with more traditional political patronage systems of appointment. This study uses the experiences of officers from several black infantry regiments, and particularly the 41st U.S. Colored Infantry from the East and the 100th U.S.C.I. from the West, to illustrate how leaders for black units were chosen, prepared, examined, commissioned, and continued their military education. It focuses on the experiences of the officers, along with the contextual environments of antebellum education, slavery, racism, tactics, and bureaucracy in which they served. / Ph. D.

No / This session considers the double contrast barium enema examination (DCBE) in investigation of bowel pathology and discusses its place alongside other imaging modalities and alternative investigations. Tips on equipment use, technique and reporting will be offered.

Yes / The Addenbrooke’s Cognitive Examination (ACE-111) is a neuropsychological test used in clinical practice to inform a dementia diagnosis. The ACE-111 relies on standardized administration so that patients’ scores can be interpreted by comparison with normative scores. The test is delivered and responded to in interaction between clinicians and patients, which places talk-in-interaction at the heart of its administration. In this article, conversation analysis (CA) is used to investigate how the ACE-111 is delivered in clinical practice. Based on analysis of 40 video/audio-recorded memory clinic consultations in which the ACE-111 was used, we have found that administrative standardization is rarely achieved in practice. There was evidence of both (a) interactional variation in the way the clinicians introduce the test and (b) interactional non-standardization during its implementation. We show that variation and interactional non-standardization have implications for patients’ understanding and how they might respond to particular questions. / Partially funded by a grant by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Program (Grant Reference Number PB-PG-0211-24079).