Search

Objectives: Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients’ self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed. Methods: A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new “traffic light” colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants. Results: Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF “traffic light” system. The association between dentists’ and participants’ estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = −0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS. Conclusions: Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Abstract Objectives Patient‐centered approach can offer valuable information in improving dental care, but literature is scarce. This study aimed to evaluate self‐reported factors beneficial for attendance in dental care. Material and Methods Survey data were collected during the summer of 2020 comprising both structured questionnaires and an open question on factors considered beneficial for dental attendance. Voluntary patients over 15 years of age (n = 196, 98%) agreed to fill the questionnaires, and n = 112 of them (57%) also gave open commentary in an urgent dental care clinic, City of Oulu, Finland, comprising the study population. Dental fear was assessed by Modified Dental Anxiety Scale (MDAS) sum scores (min 5, max 25). All utterances (n = 181) on an open question were evaluated by inductive content analysis to create sub‐ and main categories. Covid‐19 pandemic case counts in Finland were low at the time of the survey, but their effect on seeking dental care was asked. The distribution of patients was evaluated by cross‐tabulation, considering their age, gender, and dental fear status; the significance level was p 9) reported more often factors related to personnel and treatment (p = .03). Of all participants, 17% reported seeking less dental care during the pandemic. Conclusions Patients value dental personnel and treatment‐related factors, specifically those with fear.

Abstract Background Dental fear may lead to avoidance of regular dental treatment. The scope of this long-term practe-based study was to monitor the dental attendance of patients who received chair-side dental and fear treatment. Methods In 2000–2006, patients in the City of Oulu, Finland, received treatment for dental fear in the Clinic for Fearful Dental Patients (CFDP) from primary health care dentists trained on this subject. Of the originally treated patients (n = 163), 152 (93%) with sufficient information in dental records made up the study population. Information on their age and sex was available. The number of dental examinations, emergency visits and missed appointments was collected covering the follow-up period of 10 years 2006–2016. For analyses, data were dichotomized according to age at baseline and preliminary outcome baseline condition of dental fear treatment evaluated in 2006. To investigate association further, Poisson regression as well as binary logistic regression models were conducted. As register keeper, the City of Oulu gave permission for this retrospective data-based study. Results Patients receiving dental fear treatment at younger age (2–10 y) had significantly more dental examinations than those treated at > 10 years. Preliminary success was associated with the number of examinations, but not with emergency visits and missed appointments. Sex was not a significant factor in later dental attendance. There was an association between few dental examinations and dental emergency care need with unsuccessful baseline outcome of dental fear treatment. Conclusions Successful dental fear treatment especially at an early age is beneficial for future dental attendance measured by the number of examinations and consequently, less need for emergency care than in the opposite case. Successful fear treatment has positive impact on later dental care and regular dental attendance.

Abstract Elevated concentrations of dissolved organic carbon (DOC) promote browning of lakes, which alters the physicochemical properties of water and ecosystem functioning. However, browning‐induced changes in basal production of polyunsaturated fatty acids from the n‐3 and n‐6 families (n‐3 and n‐6 PUFA) in lakes are not fully understood. The concentrations of PUFA, which are micronutrients required to maintain growth and reproduction of consumers, have been suggested to either rise or decline in seston as a response to lake browning. Elevated DOC concentrations may also promote bacterial biomass and production and thus potentially increase the concentration of bacterial fatty acids (BAFA) in seston. We analyzed phytoplankton, bacteria and heterotroph biomasses, the taxonomic composition of phytoplankton, and the concentrations and mass fractions of bioseston PUFA, BAFA, eicosapentaenoic, and docosahexaenoic acids in ten boreal lakes in eastern Finland, with DOC concentration ranging from 2.8 to 18.7 mg/L. Our results showed that the abundance of PUFA in seston depended on the responses of phytoplankton biomass and community composition to lake browning. Lake browning increased seston PUFA and BAFA concentrations (expressed as µg/L) but not the contents (expressed as µg/mg bioseston C). Although low DOC lakes had a favorable phytoplankton community (in terms of PUFA content), the phytoplankton biomass in these oligotrophic lakes was so low that the concentration of PUFA remained low compared to high DOC lakes. The increasing concentration of PUFA in bioseston along the DOC gradient was mainly due to the increasing biomass of nuisance alga Gonyostomum semen. However, Gonyostomum may be too large for small‐sized zooplankton to ingest, and thus, the trophic transfer of PUFA may be impaired. The trajectories for lake browning and the basal production of PUFA also may depend on the source of carbon and associated nutrient loading; DOC and nutrient loading from agricultural areas may promote cyanobacteria dominance and decrease PUFA availability in lakes, while DOC runoff from more acidic and nutrient‐poor peatlands may promote Gonyostomum dominance and increase seston PUFA concentration.

Cyanobacteria dominance and warming have been suggested to decrease the production of polyunsaturated fatty acids (PUFA) in freshwater ecosystems. Physiological adaptations of poikilothermic animals to higher temperatures may further decrease PUFA levels in aquatic food webs. We conducted diet manipulation experiments to investigate the combined effects of dietary PUFA and warming on the proportions of eicosapentaenoic acid (EPA) and arachidonic acid (ARA) in Chironomus riparius. The experimental diet consisted of a nontoxic cyanobacterium Microcystis, which contained C20 PUFA: 20:3n-3, 20:4n-3, and 20:3n-6, but no EPA or ARA. Additionally, we used TetraMin® fish flakes as a control treatment. A temperature increase from 20 °C to 25 °C decreased the proportion of n-3 C20 PUFA and the n-3/n-6 ratio in Microcystis. Diet manipulation experiments indicated that Chironomus desaturated dietary C20 precursors to EPA and ARA, but warming decreased this bioconversion and resulted in lower levels of EPA and ARA in Chironomus. Warming did not alter the proportions of EPA and ARA in Chironomus larvae if these PUFA were readily available in the diet (TetraMin® control treatment). In conclusion, warming and cyanobacteria dominance may decrease the production and trophic transfer of physiologically important PUFA in freshwaters by (1) decreasing the n-3/n-6 ratio and the abundance of n-3 C20 precursors in Microcystis, and (2) decreasing the bioconversion of n-3 and n-6 C20 precursors to EPA and ARA in chironomids. These changes may have cascading effects throughout the food web and decrease the content of EPA in fish, potentially affecting its availability to humans.

Aim. Purpose of this practice and data-based study was to evaluate the outcome of dental fear treatment of patients referred to the Clinic for Fearful Dental Patients (CFDP) in the primary oral health care, City of Oulu, Finland, during period 2000–2005. Methods. A psychological approach including behavioral interventions and cognitive behavioral therapy (BT/CBT) was used for all participants combined with conscious sedation or dental general anesthesia (DGA), if needed. The outcome was considered successful if later dental visits were carried out without any notifications in the patient records of behavioral problems or sedation. Data collection was made in 2006; the average length of the observation period from the last visit in the CFPD to data collection was 2 y 3 m (SD 1 y 5 m). All information was available for 163 patients (mean age 8.9 y at referral). Study population was dominated by males (58.0%). Cause for referrals was mostly dental fear (81.0%) or lack of cooperation. Results. The success rate was 69.6% among females and 68.1% among males. Success seemed to be (p=0.053) higher for those treated in ≤12 years compared with the older ones. The participants, without need for dental general anesthesia (DGA) in the CFDP, had significantly a higher success rate (81.4%) compared with those who did (54.8%, p

Fish are an important source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for birds, mammals and humans. In aquatic food webs, these highly unsaturated fatty acids (HUFA) are essential for many physiological processes and mainly synthetized by distinct phytoplankton taxa. Consumers at different trophic levels obtain essential fatty acids from their diet because they cannot produce these sufficiently de novo. Here, we evaluated how the increase in phosphorus concentration (eutrophication) or terrestrial organic matter inputs (brownification) change EPA and DHA content in the phytoplankton. Then, we evaluated whether these changes can be seen in the EPA and DHA content of piscivorous European perch (Perca fluviatilis), which is a widely distributed species and commonly consumed by humans. Data from 713 lakes showed statistically significant differences in the abundance of EPA- and DHA-synthesizing phytoplankton as well as in the concentrations and content of these essential fatty acids among oligo-mesotrophic, eutrophic and dystrophic lakes. The EPA and DHA content of phytoplankton biomass (mg HUFA g−1) was significantly lower in the eutrophic lakes than in the oligo-mesotrophic or dystrophic lakes. We found a strong significant correlation between the DHA content in the muscle of piscivorous perch and phytoplankton DHA content (r = 0.85) as well with the contribution of DHA-synthesizing phytoplankton taxa (r = 0.83). Among all DHA-synthesizing phytoplankton this correlation was the strongest with the dinoflagellates (r = 0.74) and chrysophytes (r = 0.70). Accordingly, the EPA + DHA content of perch muscle decreased with increasing total phosphorus (r2 = 0.80) and dissolved organic carbon concentration (r2 = 0.83) in the lakes. Our results suggest that although eutrophication generally increase biomass production across different trophic levels, the high proportion of low-quality primary producers reduce EPA and DHA content in the food web up to predatory fish. Ultimately, it seems that lake eutrophication and brownification decrease the nutritional quality of fish for human consumers. Keywords: DOC, Phosphorus, Phytoplankton, Aquatic food webs, Perch, EPA, DHA, Environmental change, Human nutrition

Cities are at the heart of global challenges and its solutions. When occupying only 3% of Earth’s land, they are both the engines of economic growth with 80% of the global GDP but at the same time cities are emitting 75% of global green house gases. The aim of this paper was to focus on how different city development programs have been developing and how they are supporting the city’s strategic goals. This paper has shown self-assessment results of 37 projects from four different programs in the city of Tampere. The projects were evaluated against five themes: people, planet, propagation, governance and scalability/replicability. The results showed that the environmental indicators had high scores. Also, the governance focus had a high scores in most of the projects. The people focus was highest in project themes on smart cities. Some of the ecological projects were in nature very technical, which is the reason why they did not score that high in people theme. The results showed clearly that the scalability and replicability are becoming very important elements in the existing and coming projects in cities. This could be also clearly seen in the analyses where the scalability and replicability of the different projects has been important in last 5-10 years and it seem that especially in the recent years the importance has a high impact. From our study we could initially conclude that the program based approach in city’s economic development seems to provide one strand of continuation in implementation of the city’s economic development policy and that the impact of its implementation improves. The hierarchical roles of different sets of projects as well as that of the sub-ecosystems that have carried out the project(s) indicates that the ecosystem approach is a useful one. The results also highllighted the role of programs as platforms for innovation and co-creation between citizens, companies, research organizations and public sector. In these ecosystems value is created to all stakeholders. The value may be direct financial value but may well be also indirect such as R&D related, community value etc. The role of the cities is very important in this ecosystem value creation as they are considered to be a neutral body with focus on the public interest, not a vested one. As the role of cities is growing to be paramount also in innovation, this should be reflected in regional, national and EU level innovation policies, funding schemes and regulations as well as in execution of innovations.

The taxon specificity of fatty acid composition in algal classes suggests that fatty acids could be used as chemotaxonomic markers for phytoplankton composition. The applicability of phospholipid‐derived fatty acids as chemotaxonomic markers for phytoplankton composition was evaluated by using a Bayesian fatty acid‐based mixing model. Fatty acid profiles from monocultures of chlorophytes, cyanobacteria, diatoms, euglenoids, dinoflagellates, raphidophyte, cryptophytes and chrysophytes were used as a reference library to infer phytoplankton community composition in five moderately humic, large boreal lakes in three different seasons (spring, summer and fall). The phytoplankton community composition was also estimated from microscopic counts. Both methods identified diatoms and cryptophytes as the major phytoplankton groups in the study lakes throughout the sampling period, together accounting for 54–63% of the phytoplankton. In addition, both methods revealed that the proportion of chlorophytes and cyanobacteria was lowest in the spring and increased towards the summer and fall, while dinoflagellates peaked in the spring. The proportion of euglenoids and raphidophytes was less than 8% of the phytoplankton biomass throughout the sampling period. The model estimated significantly lower proportions of chrysophytes in the seston than indicated by microscopic analyses. This is probably because the reference library for chrysophytes included too few taxa. Our results show that a fatty acid‐based mixing model approach is a promising tool for estimating the phytoplankton community composition, while also providing information on the nutritional quality of the seston for consumers. Both the quantity and the quality of seston as a food source for zooplankton were high in the spring; total phytoplankton biomass was ~56 μg C L−1, and the physiologically important polyunsaturated fatty acids 20:5n‐3 and 22:6n‐3 comprised ~22% of fatty acids.

Small humic forest lakes often have high contributions of methane-derived carbon in their food webs but little is known about the temporal stability of this carbon pathway and how it responds to environmental changes on longer time scales. We reconstructed past variations in the contribution of methanogenic carbon in the pelagic food web of a small boreal lake in Finland by analyzing the stable carbon isotopic composition (δ13C values) of chitinous fossils of planktivorous invertebrates in sediments from the lake. The δ13C values of zooplankton remains show several marked shifts (approx. 10 ‰), consistent with changes in the proportional contribution of carbon from methane-oxidizing bacteria in zooplankton diets. The results indicate that the lake only recently (1950s) obtained its present state with a high contribution of methanogenic carbon to the pelagic food web. A comparison with historical and palaeobotanical evidence indicates that this most recent shift coincided with agricultural land-use changes and forestation of the lake catchment and implies that earlier shifts may also have been related to changes in forest and land use. Our study demonstrates the sensitivity of the carbon cycle in small forest lakes to external forcing and that the effects of past changes in local land use on lacustrine carbon cycling have to be taken into account when defining environmental and ecological reference conditions in boreal headwater lakes.