Are Danish doctors comfortable teaching in English?

PubMed

Nilas, L; Løkkegaard, E C; Laursen, J B; Kling, J; Cortes, D

2016-08-27

From 2012-2015, the Departments of Obstetrics and Gynecology and of Pediatrics at the University of Copenhagen conducted a project, "Internationalization at Home ", offering clinical teaching in English. The project allowed international students to work with Danish speaking students in a clinical setting. Using semi-quantitative questionnaires to 89 clinicians about use of English and need for training, this paper considers if Danish clinical doctors are prepared to teach in English. The majority self-assessed their English proficiency between seven and eight on a 10 unit visual analogue scale, with 10 equivalent to working in Danish, while 15 % rated five or less. However, one-fourth found teaching and writing in English to be twice as difficult than in Danish, and 12 % rated all teaching tasks in English at four or less compared to Danish. The self-assessed need for additional English skills was perceived low. Teaching in English was rated as 30 % more difficult than in Danish, and a significant subgroup of doctors had difficulties in all forms of communication in English, resulting in challenges when introducing international students in non-native English speaking medical departments.

Conceptual framework for a Danish human biomonitoring program

PubMed Central

Thomsen, Marianne; Knudsen, Lisbeth E; Vorkamp, Katrin; Frederiksen, Marie; Bach, Hanne; Bonefeld-Jorgensen, Eva Cecilie; Rastogi, Suresch; Fauser, Patrik; Krongaard, Teddy; Sorensen, Peter Borgen

2008-01-01

The aim of this paper is to present the conceptual framework for a Danish human biomonitoring (HBM) program. The EU and national science-policy interface, that is fundamental for a realization of the national and European environment and human health strategies, is discussed, including the need for a structured and integrated environmental and human health surveillance program at national level. In Denmark, the initiative to implement such activities has been taken. The proposed framework of the Danish monitoring program constitutes four scientific expert groups, i.e. i. Prioritization of the strategy for the monitoring program, ii. Collection of human samples, iii. Analysis and data management and iv. Dissemination of results produced within the program. This paper presents the overall framework for data requirements and information flow in the integrated environment and health surveillance program. The added value of an HBM program, and in this respect the objectives of national and European HBM programs supporting environmental health integrated policy-decisions and human health targeted policies, are discussed. In Denmark environmental monitoring has been prioritized by extensive surveillance systems of pollution in oceans, lakes and soil as well as ground and drinking water. Human biomonitoring has only taken place in research programs and few incidences of e.g. lead contamination. However an arctic program for HBM has been in force for decades and from the preparations of the EU-pilot project on HBM increasing political interest in a Danish program has developed. PMID:18541069

Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

ERIC Educational Resources Information Center

Vitus, Kathrine

2010-01-01

This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

Danish auroral science history

NASA Astrophysics Data System (ADS)

Stauning, P.

2011-01-01

Danish auroral science history begins with the early auroral observations made by the Danish astronomer Tycho Brahe during the years from 1582 to 1601 preceding the Maunder minimum in solar activity. Included are also the brilliant observations made by another astronomer, Ole Rømer, from Copenhagen in 1707, as well as the early auroral observations made from Greenland by missionaries during the 18th and 19th centuries. The relations between auroras and geomagnetic variations were analysed by H. C. Ørsted, who also played a vital role in the development of Danish meteorology that came to include comprehensive auroral observations from Denmark, Iceland and Greenland as well as auroral and geomagnetic research. The very important auroral investigations made by Sophus Tromholt are outlined. His analysis from 1880 of auroral observations from Greenland prepared for the significant contributions from the Danish Meteorological Institute, DMI, (founded in 1872) to the first International Polar Year 1882/83, where an expedition headed by Adam Paulsen was sent to Greenland to conduct auroral and geomagnetic observations. Paulsen's analyses of the collected data gave many important results but also raised many new questions that gave rise to auroral expeditions to Iceland in 1899 to 1900 and to Finland in 1900 to 1901. Among the results from these expeditions were 26 unique paintings of the auroras made by the artist painter, Harald Moltke. The expedition to Finland was headed by Dan la Cour, who later as director of the DMI came to be in charge of the comprehensive international geomagnetic and auroral observations made during the Second International Polar Year in 1932/33. Finally, the article describes the important investigations made by Knud Lassen during, among others, the International Geophysical Year 1957/58 and during the International Quiet Sun Year (IQSY) in 1964/65. With his leadership the auroral and geomagnetic research at DMI reached a high international

The Danish oral health care service for children: an international appraisal.

PubMed

Davies, G N; Downer, M C; Holloway, P J

1983-09-01

The Danish children's oral health care service has been so successful in achieving its objectives that it will need to change and adapt in order to survive. It is suggested that the service should gradually become community-based rather than child-based. This process can be commenced by introducing treatment for the elderly, the handicapped and the indigent, converting the school clinics to municipal oral health units. Although it is important that private practice is maintained, private dentists should be encouraged to work in the system part-time, leading teams of supporting auxiliary personnel trained within an integrated system. Eventually, the facilities could form the basis of primary health care centres. The lessons to be learnt from the Danish experience have a wider application to other countries. In developing countries it is obvious that they should first place limited dental resources into public health prevention and only invest in expensive treatment clinics as funds become more available. Manpower planning should ensure that personnel are not overtrained for the needs of the community. In developed countries, increasingly more resources will need to be channelled into adult dental care, and dental education must lead the profession into this new era. Difficult though these changes will be, the stable relationships that have developed between the various arms of the service under the guidance of the Danish Dental Association, will ensure that the profession will survive and flourish for the benefit of the Danish people.

[The Danish debate on priority setting in medicine - characteristics and results].

PubMed

Pornak, S; Meyer, T; Raspe, H

2011-10-01

Priority setting in medicine helps to achieve a fair and transparent distribution of health-care resources. The German discussion about priority setting is still in its infancy and may benefit from other countries' experiences. This paper aims to analyse the Danish priority setting debate in order to stimulate the German discussion. The methods used are a literature analysis and a document analysis as well as expert interviews. The Danish debate about priority setting in medicine began in the 1970s, when a government committee was constituted to evaluate health-care priorities at the national level. In the 1980s a broader debate arose in politics, ethics, medicine and health economy. The discussions reached a climax in the 1990s, when many local activities - always involving the public - were initiated. Some Danish counties tried to implement priority setting in the daily routine of health care. The Council of Ethics was a major player in the debate of the 1990s and published a detailed statement on priority setting in 1996. With the new century the debate about priority setting seemed to have come to an end, but in 2006 the Technology Council and the Danish Regions resumed the discussion. In 2009 the Medical Association called for a broad debate in order to achieve equity among all patients. The long lasting Danish debate on priority setting has entailed only very little practical consequences on health care. The main problems seem to have been the missing effort to bundle the various local initiatives on a national level and the lack of powerful players to put results of the discussion into practice. Nevertheless, today the attitude towards priority setting is predominantly positive and even politicians talk freely about it. © Georg Thieme Verlag KG Stuttgart · New York.

Sport or School? Dreams and Dilemmas for Talented Young Danish Football Players

ERIC Educational Resources Information Center

Christensen, Mette Krogh; Sorensen, Jan Kahr

2009-01-01

Today's young semi-professional football players are expected to continue their education while honing their talents as footballers. This means they must balance the contradictory demands that come from their education establishments and their football clubs. The present study explores how young Danish male football talents experience and describe…

Management Control Systems and Clinical Experience of Managers in Public Hospitals

PubMed Central

Naranjo-Gil, David

2018-01-01

Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector. PMID:29673192

Management Control Systems and Clinical Experience of Managers in Public Hospitals.

PubMed

Lunkes, Rogério Joao; Naranjo-Gil, David; Lopez-Valeiras, Ernesto

2018-04-17

Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector.

Danish-Swedish windpower company founded in Denmark

NASA Astrophysics Data System (ADS)

Holmstrom, M.

1982-04-01

The Swedish General Electric Co. (ASEA) has founded a windpower company in cooperation with the Danish state and a Danish company. They expect to build 250 windpower plants through 1984. If a Swedish market opens a similar partner company is planned in Sweden.

Wilderness visitors, experiences, and visitor management

Treesearch

David N. Cole; Stephen F. McCool

2000-01-01

This paper provides an overview of the Wilderness science in a time of change conference-Volume 4: Wilderness visitors, experiences, and visitor management. Wilderness areas are managed to protect their wilderness character, but they also provide opportunities for recreation use. Decades ago, relatively few people sought wilderness experiences, and...

Wildlife management: Managing the hunt versus the hunting experience

NASA Astrophysics Data System (ADS)

Hammitt, William E.; McDonald, Cary D.; Noe, Francis P.

1989-07-01

Deer hunter satisfaction is investigated from two perspectives, (1) satisfaction with the hunt/harvest and (2) satisfaction with the overall hunting trip experience. Regression analysis is used to determine what variables best predict satisfaction with the hunt and the hunting experience. Results indicate that animal population variables (number of deer seen, shot at, bagged) are the best determinants of a quality deer hunt, while environmental (outdoors) and social (crowding and hunter behavior) are the best predictors of a quality hunting trip experience. Wildlife managers and researchers need to realize that deer hunters view the hunt/harvest as different from the hunting trip experience and need to manage for both aspects of hunter satisfaction.

Mortality in a cohort of Danish firefighters; 1970-2014.

PubMed

Petersen, Kajsa Ugelvig; Pedersen, Julie Elbæk; Bonde, Jens Peter; Ebbehøj, Niels Erik; Hansen, Johnni

2018-05-28

Occupational exposure of firefighters involves a complex range of potential health threats from toxic chemicals, shift work, extreme heat, physical and emotional strain. The aim of this study is to examine overall and disease-specific mortality among Danish firefighters. Through systematic collection of personnel and membership records from employers and trade unions, past and present male Danish firefighters were identified (n = 11,775). Using the unique Danish personal identification number, information on additional employment, vital status and cause of death was linked to each member of the cohort from the Supplementary Pension Fund Register, the Danish Civil Registration System and the Danish Register of Causes of Death. Standardized mortality ratios (SMRs) were calculated for specific causes of death using rates for two reference groups, a random sample of the male working population (n = 262,168) and the military (n = 396,739), respectively. Overall mortality was significantly reduced among the firefighters compared to both the sample of the working population and the military (SMR 0.74, 95% CI 0.69-0.78 and SMR 0.88, 95% CI 0.83-0.93). Further, the SMRs for endocrine diseases, mental disorders, non-traffic related accidents and other external causes were significantly lower against both reference groups. Death from stomach cancer was significantly increased among the full time firefighters, while part time/volunteer workers shared a significant increase in prostate cancer death compared to both references. Despite potential exposure to several occupational hazards, male Danish firefighters have a lower mortality than both the Danish working population in general and Danish military employees.

[Early achievements of the Danish pharmaceutical industry-6 Pharmacia].

PubMed

Grevsen, Jørgen V; Kruse, Edith; Kruse, Poul R

2014-01-01

The article series provides a written and pictorial account of the Danish pharmaceutical industry's products from their introduction until about 1950. Part 6 deals with products from A/S Pharmacia. A/S Pharmacia was established in Copenhagen in 1922 as a Danish limited company by the enterprising pharmacist Edward Jacobsen. Pharmacia was not Jacobsen's first pharmaceutical company as previously he had established a pharmaceutical agency already in 1913 which in 1919 was reorganized to a limited company by the name of A/S Edward Jacobsen. This agency was later extended to include a production of generics. Jacobsen remained the co-owner and manager of Pharmacia until 1934 where he resigned and established another company, A/S Ejco, for the manufacture of generics. It is worth mentioning that already in 1911 a Swedish pharmaceutical company was established named AB Pharmacia. Today we do not know whether Edward Jacobsen knew about this Swedish company. Later on in 1936 AB Pharmacia and A/S Pharmacia made a contract concerning mutual market sharing, and a research cooperation was brought about between the two companies which resulted in an increase of turnover for A/S Pharmacia. In 1955 the cooperation between the two companies was increased as the Swedish company joined as principal shareholder with the purpose of continuing and developing the Danish company as an independent pharmaceutical company with its own research and development as well as manufacture, control and marketing. Therefore Pharmacia in Denmark was able to establish a synthesis factory in Koge and move the domicile to new premises in Hillered. In 1993 Pharmacia was presented in a printed matter as "The largest Nordic pharmaceutical company" as a result of the merger between the Swedish Kabi Pharmacia, formerly established by a merger between Kabi Vitrum and AB Pharmacia, and the Italian Farmitalia Carlo Erba. Only two years later in 1995 Pharmacia merged with the American pharmaceutical company The

The Danish version of the questionnaire on pain communication: preliminary validation in cancer patients.

PubMed

Jacobsen, R; Møldrup, C; Christrup, L; Sjøgren, P; Hansen, O B

2009-07-01

The modified version of the patients' Perceived Involvement in Care Scale (M-PICS) is a tool designed to assess cancer patients' perceptions of patient-health care provider pain communication process. The objective of this study was to examine the psychometric properties of the shortened Danish version of the M-PICS (SDM-PICS). The validated English version of the M-PICS was translated into Danish following the repeated back-translation procedure. Cancer patients were recruited for the study from specialized pain management facilities. Thirty-three patients responded to the SDM-PICS, Danish Barriers Questionnaire II, Hospital Anxiety and Depression Scale, and Brief Pain Inventory Pain Severity Scale. A factor analysis of the SDM-PICS resulted in two factors: Factor one, patient information, consisted of four items assessing the extent to which the patient shared information with his/her health care provider, and Factor two, health care provider information, consisted of four items measuring the degree to which a health care provider was perceived as the one who shares information. Two separate items addressed the perceived level of information exchange between the patient and the health care provider. The SDM-PICS total had an internal consistency of 0.88. The SDM-PICS scores were positively related to pain relief and inversely related to the measures of cognitive pain management barriers, anxiety, and reported pain levels. The SDM-PICS seems to be a reliable and valid measure of perceived patient-health care provider communication in the context of cancer pain.

Community pharmacists as educators in Danish residential facilities: a qualitative study.

PubMed

Mygind, Anna; El-Souri, Mira; Pultz, Kirsten; Rossing, Charlotte; Thomsen, Linda A

2017-08-01

To explore experiences with engaging community pharmacists in educational programmes on quality and safety in medication handling in residential facilities for the disabled. A secondary analysis of data from two Danish intervention studies where community pharmacists were engaged in educational programmes. Data included 10 semi-structured interviews with staff, five semi-structured interviews and three open-ended questionnaires with residential facility managers, and five open-ended questionnaires to community pharmacists. Data were thematically coded to identify key points pertaining to the themes 'pharmacists as educators' and 'perceived effects of engaging pharmacists in competence development'. As educators, pharmacists were successful as medicines experts. Some pharmacists experienced pedagogical challenges. Previous teaching experience and obtained knowledge of the local residential facility before teaching often provided sufficient pedagogical skills and tailored teaching to local needs. Effects of engaging community pharmacists included in most instances improved cooperation between residential facilities and community pharmacies through a trustful relationship and improved dialogue about the residents' medication. Other effects included a perception of improved patient safety, teaching skills and branding of the pharmacy. Community pharmacists provide a resource to engage in educational programmes on medication handling in residential facilities, which may facilitate improved cooperation between community pharmacies and residential facilities. However, development of pedagogical competences and understandings of local settings are prerequisites for facilities and pharmacists to experience the programmes as successful. © 2016 Royal Pharmaceutical Society.

[The Danish Health Act and health-care services to undocumented migrants].

PubMed

Aabenhus, Rune; Hallas, Peter

2012-09-17

Health-care workers may experience uncertainty regarding legal matters when attending to medical needs of undocumented migrants. This paper applies a pragmatic focus when addressing the legal aspects involved in providing health-care services to undocumented migrants with examples from the Danish Health Act and international conventions. The delivery of medical care to vulnerable groups such as pregnant women and children is described.

EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

A cross-sectional study of psychosocial work environment and stress in the Danish symphony orchestras.

PubMed

Holst, Gitte Juel; Paarup, Helene M; Baelum, Jesper

2012-08-01

To investigate psychosocial work environment and stress in Danish symphony orchestra musicians. This was a cross-sectional questionnaire survey of psychosocial work factors and stress symptoms among 441 musicians in six Danish symphony orchestras. The response rate was 78% (n = 342). The questions were from COPSOQ (Copenhagen Psychosocial Questionnaire). Mean values of 19 COPSOQ-scales were compared by gender and instrument group. The results for the musicians were compared with results for the general Danish work force (COPSOQ database). Female musicians reported higher work demands and higher stress symptoms than their male colleagues. Between instrument groups, 2nd violinists seemed to be of particular risk compared with the other instrumental groups in aspects of work pace, work organization, and content, whereas 1st violinists perceived higher emotional stress compared with 2nd violinists. The musicians' experience of increased work demands as well as deteriorated, work organization and job content, interpersonal relations and leadership, and work-individual interface was significantly associated with increasing stress symptoms. Compared to the general workforce independently of gender, Danish symphony orchestra musicians reported higher emotional demands, lower influence, lower social support, lower sense of community, and lower job satisfaction. However, the musicians reported a higher commitment to the workplace. The findings indicate a more demanding psychosocial work environment exposure among symphony orchestra musicians than among Danish workers in general. Critical results are the relatively high work demands, low influence, and low social support, females being of higher risk than males.

[Quality management is associated with high quality services in health care].

PubMed

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

The Danish Adoption Register.

PubMed

Petersen, Liselotte; Sørensen, Thorkild I A

2011-07-01

The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia. The register encompass information on all 14,425 non-familial adoptions of Danish children legally granted in Denmark 1924-1947. It includes name and date of birth of each adoptee and his or her biological and adoptive parents, date of transfer to adoptive parents and date of formal adoption. The linkage to biological and adoptive parents is close to complete, even biological fathers are registered for 91.4% of the adoptees. Adoption registers are a unique source allowing disentangling of genetic and familial environmental influences on traits, risk of diseases, and mortality.

Translation, adaptation and validation of the American short form Patient Activation Measure (PAM13) in a Danish version.

PubMed

Maindal, Helle Terkildsen; Sokolowski, Ineta; Vedsted, Peter

2009-06-29

The Patient Activation Measure (PAM) is a measure that assesses patient knowledge, skill, and confidence for self-management. This study validates the Danish translation of the 13-item Patient Activation Measure (PAM13) in a Danish population with dysglycaemia. 358 people with screen-detected dysglycaemia participating in a primary care health education study responded to PAM13. The PAM13 was translated into Danish by a standardised forward-backward translation. Data quality was assessed by mean, median, item response, missing values, floor and ceiling effects, internal consistency (Cronbach's alpha and average inter-item correlation) and item-rest correlations. Scale properties were assessed by Rasch Rating Scale models. The item response was high with a small number of missing values (0.8-4.2%). Floor effect was small (range 0.6-3.6%), but the ceiling effect was above 15% for all items (range 18.6-62.7%). The alpha-coefficient was 0.89 and the average inter-item correlation 0.38. The Danish version formed a unidimensional, probabilistic Guttman-like scale explaining 43.2% of the variance. We did however, find a different item sequence compared to the original scale. A Danish version of PAM13 with acceptable validity and reliability is now available. Further development should focus on single items, response categories in relation to ceiling effects and further validation of reproducibility and responsiveness.

Learning and feedback from the Danish patient safety incident reporting system can be improved.

PubMed

Moeller, Anders Damgaard; Rasmussen, Kurt; Nielsen, Kent Jacob

2016-06-01

The perceived usefulness of incident reporting systems is an important motivational factor for reporting. The usefulness may be facilitated by well-established feedback mechanisms and by learning processes. The aim of this study was to investigate how feedback mechanisms and learning processes were implemented at four Danish hospital units all located in one of the five Danish regions. Based on the concepts of feedback and learning from incident processes, a questionnaire was developed and distributed to 335 patient safety representatives from 200 departments at four Danish hospital units in one of the five Danish regions. The study showed that external reporters were rarely contacted for dialogue, grouped front-line staff were sparsely involved in the learning process, few evaluated the effectiveness of implemented interventions and personal factors were frequently perceived as a primary contributory factor to these incidents. In contrast, the patient safety representatives perceived their competencies as sufficient for the job, internal reporters were often contacted for dialogue, evaluation was widely used and management supported the work with incident reports. The results of the study identified several shortcomings in the implementation of learning processes and feedback mechanisms. The apparent existence of a person-focused approach stands out as an element of notice. The insufficient implementation we observed indicates that there is room for improvement in the efforts made to maximise learning from incidents in the investigated population. not relevant. not relevant.

[100 years with certificates: Danish Society of Insurance Medicine 1902-2002].

PubMed

Permin, Henrik

2002-01-01

Danish Society of Insurance Medicine was formed in 1902 as an association between the Danish Society of Accident Insurance and the Danish Society of Life Insurance Medicine, both founded a year before. The purpose of the society is to apply and to further the scientific basis of insurance medicine. The meetings also play a role as a forum for discussions. The members of the society are all working part-time in an insurance company in Denmark (in contrast to many other countries where it is a full-time job). The members are mainly specialists in medicine and surgery. During the first half life of the society nearly all members were high-qualified doctors, i.e. professors and consultants at a university hospital in Copenhagen usually with a doctoral degree. These prominent doctors had a significant influence on insurance medicine in Denmark. The managing directors of the Insurance Companies were invited to the meetings. Many scientific works and textbooks were written on the subject. The society arranges two meetings yearly - one concerning with life insurance and one with accident-insurance medicine. Previously, the question put to the medical adviser was always "Which impairments can still be insured?", but today the question is the opposite "Which impairments are not insurable?" The members have increased to currently 112, still only men, but today the members are younger, comprise fewer professors and fewer with a doctoral degree. During the last 6 years, all interested members in the insurance companies have been invited to the meetings, providing a broader input for the discussions. The topic of the meeting is of current interest: new laws or a new treatment of a disease (medication, surgery) which has been introduced. One to three speakers open the meeting, followed by a discussion. The meetings are always concluded with a light meal and a glass of wine, in earlier days also with cigars and Danish schnaps. 190 meetings have been held during the last 100 years

Educational Ambassadors in the Danish Trade Union Movement

ERIC Educational Resources Information Center

Keil, Michael

2008-01-01

The concept of Educational Ambassadors is embedded within the so-called "Danish model" of industrial relations. The Danish industrial relations system is characterised by strong collective organisations with national coverage, which conclude the collective agreements for various industries or sectors and which are mostly grouped under…

Work assignments, delegation of tasks and job satisfaction among Danish dental hygienists.

PubMed

Hach, M; Aaberg, K B; Lempert, S M; Danielsen, B

2017-08-01

Recent legislation in Denmark has made it possible for dentists to delegate their tasks to dental hygienists. Previous studies have shown that Danish dental hygienists primarily were performing assignments within their own work field. These assignments include prophylaxis or instructing patients in oral health care. However, studies have also shown that Danish dental hygienists performed dental nurse assignments such as chair-side assistance, unit cleaning and disinfection of instruments. The objectives of this study were to investigate (i) the range of work assignments performed by Danish dental hygienists, (ii) the types of dentist tasks performed by Danish dental hygienists and (iii) job satisfaction among Danish dental hygienists. Dental hygienists graduating in 2004-2007 were invited to participate in this study. Participants answered an email-distributed questionnaire. The questionnaire consisted of questions regarding job satisfaction, assignments performed, postgraduate course attendance, receiving assistance from a dental nurse and which work assignments Danish dental hygienists wish to perform in the future. The results of this study showed that 90% of Danish dental hygienists were satisfied with their job and 52% were performing dentists' tasks. Among dentists' tasks performed by Danish dental hygienists, invasive caries therapy was the most frequently performed task. The type of assignments performed by Danish dental hygienists today appears to be changing compared to previous studies. From initially performing prophylaxis and chair-side assistance for the dentist, Danish dental hygienists today are performing a wider range of tasks which includes dentists' tasks. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nutrient pressures and ecological responses to nutrient loading reductions in Danish streams, lakes and coastal waters

NASA Astrophysics Data System (ADS)

Kronvang, Brian; Jeppesen, Erik; Conley, Daniel J.; Søndergaard, Martin; Larsen, Søren E.; Ovesen, Niels B.; Carstensen, Jacob

2005-03-01

The Danish National Aquatic Monitoring and Assessment Programme (NOVA) was launched in 1988 following the adoption of the first Danish Action Plan on the Aquatic Environment in 1987 with the aim to reduce by 50% the nitrogen (N) loading and by 80% the phosphorus (P) loading to the aquatic environment. The 14 years of experience gathered from NOVA have shown that discharges of total N (TN) and P (TP) from point sources to the Danish Aquatic Environment have been reduced by 69% (N) and 82% (P) during the period 1989 2002. Consequently, the P concentration has decreased markedly in most Danish lakes and estuaries. Considerable changes in agricultural practice have resulted in a reduction of the net N-surplus from 136 to 88 kg N ha-1 yr-1 (41%) and the net P-surplus from 19 to 11 kg P ha-1 yr-1 (42%) during the period 1985 2002. Despite these efforts Danish agriculture is today the major source of both N (>80%) and P (>50%) in Danish streams, lakes and coastal waters. A non-parametric statistical trend analysis of TN concentrations in streams draining dominantly agricultural catchments has shown a significant (p<0.05) downward trend in 48 streams with the downward trend being stronger in loamy compared to sandy catchments, and more pronounced with increasing dominance of agricultural exploitation in the catchments. In contrast, a statistical trend analysis of TP concentrations in streams draining agricultural catchments did not reveal any significant trends. The large reduction in nutrient loading from point and non-point sources has in general improved the ecological conditions of Danish lakes in the form of increased summer Secchi depth, decreased chlorophyll a and reduced phytoplankton biomass. Major changes have also occurred in the fish communities in lakes, with positive cascading effects on water quality. In Danish estuaries and coastal waters only a few significant improvements in the ecological quality have been observed, although it is expected that the

Attitudes toward Catheter Ablation for Atrial Fibrillation: A Nationwide Survey among Danish Cardiologists.

PubMed

Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis; Rodrigo-Domingo, Maria; Pehrson, Steen; Johannessen, Arne; Hansen, Peter Steen; Johansen, Jens Brock; Riahi, Sam

2015-10-01

Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians' attitudes toward catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish cardiologists toward catheter ablation for AF, using a nationwide survey. We developed a purpose-designed questionnaire to evaluate attitudes toward catheter ablation for AF that was sent to all Danish cardiologists (n = 401; response n = 272 (67.8%)). There was no association between attitudes toward ablation and the experience or age of the cardiologist with respect to patients with recurrent AF episodes with a duration of <48 hours or >7 days and/or need for cardioversion. The majority (69%) expected a recurrence of AF after catheter ablation in more than 30% of the cases. For patients with persistent longstanding AF with a duration of >1 year, the attitude toward ablation for longstanding AF was more likely to be positive with increasing age (P < 0.01) and years of experience of the cardiologist (P = 0.002). Danish cardiologists generally have a positive attitude toward catheter ablation for AF, maintain up-to-date knowledge of the procedure, and are aware what information on ablation treatment should be given to patients with AF. The cardiologists had a positive attitude toward ablation for AF in patients with AF episodes <48 hours and patients with episodes >7 days, or those who needed medical/electrical conversion, but a more negative attitude toward treating longstanding AF patients. © 2015 Wiley Periodicals, Inc.

Against all odds? Understanding the emergence of accreditation of the Danish hospitals.

PubMed

Triantafillou, Peter

2014-01-01

Despite intense critique from various parts of the medical professions, Danish hospitals have been subjected to a mandatory accreditation system known as the Danish Quality Model (Den Danske Kvalitetsmodel, DDKM) since 2009. The notion of government assemblage is employed to understand how and why, in the face of these obstacles, DDKM was ultimately implemented. It is argued that DDKM is the result of the emergence of hospital quality management assemblage in 1980s and 1990s made up by new methods of categorizing disease treatments, computerization of such treatments, concerns over cost-effectiveness, complaint registration, the availability of international hospital quality assessment systems, the mobilization of organized medical interest groups, and a tradition of consultative policymaking procedures. This assemblage was crucial for identifying quality as a problem in need of administrative intervention and for shaping the political struggle over how best to assure the quality of hospital services. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Danish Nonmelanoma Skin Cancer Dermatology Database.

PubMed

Lamberg, Anna Lei; Sølvsten, Henrik; Lei, Ulrikke; Vinding, Gabrielle Randskov; Stender, Ida Marie; Jemec, Gregor Borut Ernst; Vestergaard, Tine; Thormann, Henrik; Hædersdal, Merete; Dam, Tomas Norman; Olesen, Anne Braae

2016-01-01

The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen's disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen's disease, and 173 keratoakanthomas. The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance.

The Danish Testicular Cancer database.

PubMed

Daugaard, Gedske; Kier, Maria Gry Gundgaard; Bandak, Mikkel; Mortensen, Mette Saksø; Larsson, Heidi; Søgaard, Mette; Toft, Birgitte Groenkaer; Engvad, Birte; Agerbæk, Mads; Holm, Niels Vilstrup; Lauritsen, Jakob

2016-01-01

The nationwide Danish Testicular Cancer database consists of a retrospective research database (DaTeCa database) and a prospective clinical database (Danish Multidisciplinary Cancer Group [DMCG] DaTeCa database). The aim is to improve the quality of care for patients with testicular cancer (TC) in Denmark, that is, by identifying risk factors for relapse, toxicity related to treatment, and focusing on late effects. All Danish male patients with a histologically verified germ cell cancer diagnosis in the Danish Pathology Registry are included in the DaTeCa databases. Data collection has been performed from 1984 to 2007 and from 2013 onward, respectively. The retrospective DaTeCa database contains detailed information with more than 300 variables related to histology, stage, treatment, relapses, pathology, tumor markers, kidney function, lung function, etc. A questionnaire related to late effects has been conducted, which includes questions regarding social relationships, life situation, general health status, family background, diseases, symptoms, use of medication, marital status, psychosocial issues, fertility, and sexuality. TC survivors alive on October 2014 were invited to fill in this questionnaire including 160 validated questions. Collection of questionnaires is still ongoing. A biobank including blood/sputum samples for future genetic analyses has been established. Both samples related to DaTeCa and DMCG DaTeCa database are included. The prospective DMCG DaTeCa database includes variables regarding histology, stage, prognostic group, and treatment. The DMCG DaTeCa database has existed since 2013 and is a young clinical database. It is necessary to extend the data collection in the prospective database in order to answer quality-related questions. Data from the retrospective database will be added to the prospective data. This will result in a large and very comprehensive database for future studies on TC patients.

Intake of macro- and micronutrients in Danish vegans.

PubMed

Kristensen, Nadja B; Madsen, Mia L; Hansen, Tue H; Allin, Kristine H; Hoppe, Camilla; Fagt, Sisse; Lausten, Mia S; Gøbel, Rikke J; Vestergaard, Henrik; Hansen, Torben; Pedersen, Oluf

2015-10-30

Since information about macro- and micronutrient intake among vegans is limited we aimed to determine and evaluate their dietary and supplementary intake. Seventy 18-61 years old Danish vegans completed a four-day weighed food record from which their daily intake of macro- and micronutrients was assessed and subsequently compared to an age-range-matched group of 1,257 omnivorous individuals from the general Danish population. Moreover, the vegan dietary and supplementary intake was compared to the 2012 Nordic Nutrition Recommendations (NNR). Dietary intake differed significantly between vegans and the general Danish population in all measured macro- and micronutrients (p < 0.05), except for energy intake among women and intake of carbohydrates among men. For vegans the intake of macro- and micronutrients (including supplements) did not reach the NNR for protein, vitamin D, iodine and selenium. Among vegan women vitamin A intake also failed to reach the recommendations. With reference to the NNR, the dietary content of added sugar, sodium and fatty acids, including the ratio of PUFA to SFA, was more favorable among vegans. At the macronutrient level, the diet of Danish vegans is in better accordance with the NNR than the diet of the general Danish population. At the micronutrient level, considering both diet and supplements, the vegan diet falls short in certain nutrients, suggesting a need for greater attention toward ensuring recommended daily intake of specific vitamins and minerals.

Engineering data management: Experience and projections

NASA Technical Reports Server (NTRS)

Jefferson, D. K.; Thomson, B.

1978-01-01

Experiences in developing a large engineering data management system are described. Problems which were encountered are presented and projected to future systems. Business applications involving similar types of data bases are described. A data base management system architecture proposed by the business community is described and its applicability to engineering data management is discussed. It is concluded that the most difficult problems faced in engineering and business data management can best be solved by cooperative efforts.

LUCAS(™)2 in Danish Search and Rescue Helicopters.

PubMed

Winther, Kasper; Bleeg, René Christian

2016-01-01

Prehospital resuscitation is often challenging. Giving uninterrupted and effective compressions is relatively impossible during transportation. In 2012, The Royal Danish Air Force received a donation of 8 mechanical chest compression devices (LUCAS(™)2; Physio-Control/Jolife AB, Lund, Sweden) to be used onboard the Danish search and rescue (SAR) helicopters. The scope of this investigation was to establish whether or not mechanical chest compression devices should be considered a necessity onboard the Danish SAR helicopters. Data were compiled from SAR medical journals. From the data collected, observations were made as to when LUCAS(™)2 was used and what diagnosis the SAR physician made. One thousand ninety missions were registered in the 24-month research period, and LUCAS(™)2 was used in 25 missions. Cardiac emergencies amounted for 25% of the missions. The Danish SAR helicopters retrieved 33 drowned/hypothermic patients during the research period, and the LUCAS(™)2 was used in 11 of the patients requiring resuscitation. The LUCAS(™)2 was frequently used during other emergencies like sudden cardiac arrest. Cardiac emergencies were the predominant type of mission. LUCAS(™)2 is now considered mandatory on Danish SAR helicopters. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Self managing experiment resources

NASA Astrophysics Data System (ADS)

Stagni, F.; Ubeda, M.; Tsaregorodtsev, A.; Romanovskiy, V.; Roiser, S.; Charpentier, P.; Graciani, R.

2014-06-01

Within this paper we present an autonomic Computing resources management system, used by LHCb for assessing the status of their Grid resources. Virtual Organizations Grids include heterogeneous resources. For example, LHC experiments very often use resources not provided by WLCG, and Cloud Computing resources will soon provide a non-negligible fraction of their computing power. The lack of standards and procedures across experiments and sites generated the appearance of multiple information systems, monitoring tools, ticket portals, etc... which nowadays coexist and represent a very precious source of information for running HEP experiments Computing systems as well as sites. These two facts lead to many particular solutions for a general problem: managing the experiment resources. In this paper we present how LHCb, via the DIRAC interware, addressed such issues. With a renewed Central Information Schema hosting all resources metadata and a Status System (Resource Status System) delivering real time information, the system controls the resources topology, independently of the resource types. The Resource Status System applies data mining techniques against all possible information sources available and assesses the status changes, that are then propagated to the topology description. Obviously, giving full control to such an automated system is not risk-free. Therefore, in order to minimise the probability of misbehavior, a battery of tests has been developed in order to certify the correctness of its assessments. We will demonstrate the performance and efficiency of such a system in terms of cost reduction and reliability.

Association between nationality and occupational injury risk on Danish non-passenger merchant ships.

PubMed

Ádám, Balázs

2013-01-01

Maritime occupational accidents can be determined by several factors, among which human characteristics play a crucial role. Worker's safety behaviour depends on individual physical and mental characteristics as well as on his/her social and cultural background. The aim of this study is to investigate the frequency of workplace injuries in the Danish merchant fleet in the period 2010-2012, and to characterise its nationality dependence. Occupational injuries data reported from ships registered in the Danish International Ship Register to the Danish Maritime Authority were collected. Publicly available employment data were used to calculate the cumulative incidence rates for Danish, non-Danish European Union (EU) and non-EU employees working on non-passenger ships. Crude injury rates and rates adjusted for occupational status were statistically compared. The majority of accidents happened to Danish and non-EU workers on non-passenger ships. The injury rate varied around 70 per 1000 among Danish seafarers, while the rate for non-Danish employees was about 30 per 1000. Crude and adjusted relative risk was found significantly lower for EU (0.33-0.46;0.26-0.39) and for non-EU (0.41-0.53; 0.54-0.65) workers compared to Danish seafarers. The difference decreased, but remained significant in most cases for serious injuries. Occupational injury rates show considerable nationality differences as reported from non-passenger ships registered under the Danish flag. The differences can only be partly explained by varying reporting practices. The findings confirm the results of previous studies and point out the need for effective interventions in the high-risk groups.

Workforce gender, company size and corporate financial support are predictors of availability of healthy meals in Danish worksite canteens.

PubMed

Thorsen, Anne Vibeke; Lassen, Anne Dahl; Andersen, Jens Strodl; Mikkelsen, Bent Egberg

2009-11-01

Environmental strategies at worksites may help consumers change dietary behaviour towards a more healthy diet. The present study aimed to evaluate the availability of healthy meal options at Danish worksite canteens and to identify predictors of worksite canteens providing healthy meals. A self-administered questionnaire was randomly mailed to 1967 worksite canteen managers. Besides information and characteristics about the canteen and the worksite, the canteen managers specified the menus available. Two different health groups (Healthy and Less Healthy) were defined in three different meal categories (Sandwiches, Hot meals and Salads) as well as a combined category (Combined) combining all the three meal categories. The characteristics of the worksites were compared with regard to the different health groups. Randomly selected Danish worksite canteens. 553 Danish worksite canteen managers replied, resulting in a response rate of 29 %. Only 12 % of the canteens applied to the Healthy group combining all the three meal categories. In particular, worksites with more than 75 % female employees served healthy menus on a frequent basis. The size of the worksite was positively correlated with more healthy meal options. Furthermore, the present study suggests a positive relationship between corporate financial support and the availability of healthy meal options. Among the selected variables studied, workforce gender, company size and corporate financial support were significant predictors of the availability of healthy meal options in worksite canteens. More research is needed on the role that variance in organisation environment plays for the potential of worksite intervention, to make a difference in terms of healthy eating.

Comparative Analysis of U.S. and Danish Army Leader Development Strategies

DTIC Science & Technology

2012-06-08

Individualism (vs. Collectivism). (74) Is the society’s emphasis on the group ( collectivist ) or on the individual ( individualist ). Low characteristics...and tools to draw lessons learned for the Danish Armed Forces and the Danish Army in particular. Subsequently, the thesis applies a cultural ... cultural applicability test to assess whether the identified lessons learned from the U.S. Army Leader Development Strategy are applicable in a Danish

Strategy or No Strategy: Explaining the Absence of a Danish National Security Strategy

DTIC Science & Technology

2013-06-13

the very people who are trying to protect and advance Danish interests. These experiences have led me to explore and try to understand the absence...France (Jackson and Soerensen 2007). 4These effects are thoroughly described in complexity theory as in systems thinking . 8...literature fails to examine how alliance policies interact with strategic thinking , or how small states can apply strategy as a leverage to maximize

The effectiveness of the Danish Organic Action Plan 2020 to increase the level of organic public procurement in Danish public kitchens.

PubMed

Sørensen, Nina N; Tetens, Inge; Løje, Hanne; Lassen, Anne D

2016-12-01

To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before and after kitchen employees participated in conversion projects. Public kitchens participating in the nine organic food conversion projects under the Danish Organic Action Plan 2020, initiated during autumn 2012 and spring 2013 and completed in summer 2015. A total of 622 public kitchens. The average (median) increase in organic food percentage from baseline to follow-up was 24 percentage points (P<0·001) during an overall median follow-up period of 1·5 years. When analysing data according to public kitchen type, the increase remained significant for seven out of eight kitchens. Furthermore, the proportion of public kitchens eligible for the Organic Cuisine Label in either silver (60-90 % organic food procurement) or gold (90-100 % organic food procurement) level doubled from 31 % to 62 %, respectively, during the conversion period. Conversion project curriculum mostly included elements of 'theory', 'menu planning', 'network' and 'Organic Cuisine Label method' to ensure successful implementation. The study reports significant increases in the level of organic food procurement among public kitchens participating in the Danish Organic Action Plan 2020. Recommendations for future organic conversion projects include adding key curriculum components to the project's educational content and measuring changes in organic food percentage to increase the chances of successful implementation.

Statistical Learning in Emerging Lexicons: The Case of Danish

ERIC Educational Resources Information Center

Stokes, Stephanie F.; Bleses, Dorthe; Basboll, Hans; Lambertsen, Claus

2012-01-01

Purpose: This research explored the impact of neighborhood density (ND), word frequency (WF), and word length (WL) on the vocabulary size of Danish-speaking children. Given the particular phonological properties of Danish, the impact was expected to differ from that reported in studies on English and French. Method: The monosyllabic words in the…

Psychometric properties of the Danish student well-being questionnaire assessed in >250,000 student responders.

PubMed

Niclasen, Janni; Keilow, Maria; Obel, Carsten

2018-05-01

Well-being is considered a prerequisite for learning. The Danish Ministry of Education initiated the development of a new 40-item student well-being questionnaire in 2014 to monitor well-being among all Danish public school students on a yearly basis. The aim of this study was to investigate the basic psychometric properties of this questionnaire. We used the data from the 2015 Danish student well-being survey for 268,357 students in grades 4-9 (about 85% of the study population). Descriptive statistics, exploratory factor analyses, confirmatory factor analyses and Cronbach's α reliability measures were used in the analyses. The factor analyses did not unambiguously support one particular factor structure. However, based on the basic descriptive statistics, exploratory factor analyses, confirmatory factor analyses, the semantics of the individual items and Cronbach's α, we propose a four-factor structure including 27 of the 40 items originally proposed. The four scales measure school connectedness, learning self-efficacy, learning environment and classroom management. Two bullying items and two psychosomatic items should be considered separately, leaving 31 items in the questionnaire. The proposed four-factor structure addresses central aspects of well-being, which, if used constructively, may support public schools' work to increase levels of student well-being.

Automated support for experience-based software management

NASA Technical Reports Server (NTRS)

Valett, Jon D.

1992-01-01

To effectively manage a software development project, the software manager must have access to key information concerning a project's status. This information includes not only data relating to the project of interest, but also, the experience of past development efforts within the environment. This paper describes the concepts and functionality of a software management tool designed to provide this information. This tool, called the Software Management Environment (SME), enables the software manager to compare an ongoing development effort with previous efforts and with models of the 'typical' project within the environment, to predict future project status, to analyze a project's strengths and weaknesses, and to assess the project's quality. In order to provide these functions the tool utilizes a vast corporate memory that includes a data base of software metrics, a set of models and relationships that describe the software development environment, and a set of rules that capture other knowledge and experience of software managers within the environment. Integrating these major concepts into one software management tool, the SME is a model of the type of management tool needed for all software development organizations.

Relationships of efficiency to reproductive disorders in Danish milk production: a stochastic frontier analysis.

PubMed

Lawson, L G; Bruun, J; Coelli, T; Agger, J F; Lund, M

2004-01-01

Relationships of various reproductive disorders and milk production performance of Danish dairy farms were investigated. A stochastic frontier production function was estimated using data collected in 1998 from 514 Danish dairy farms. Measures of farm-level milk production efficiency relative to this production frontier were obtained, and relationships between milk production efficiency and the incidence risk of reproductive disorders were examined. There were moderate positive relationships between milk production efficiency and retained placenta, induction of estrus, uterine infections, ovarian cysts, and induction of birth. Inclusion of reproductive management variables showed that these moderate relationships disappeared, but directions of coefficients for almost all those variables remained the same. Dystocia showed a weak negative correlation with milk production efficiency. Farms that were mainly managed by young farmers had the highest average efficiency scores. The estimated milk losses due to inefficiency averaged 1142, 488, and 256 kg of energy-corrected milk per cow, respectively, for low-, medium-, and high-efficiency herds. It is concluded that the availability of younger cows, which enabled farmers to replace cows with reproductive disorders, contributed to high cow productivity in efficient farms. Thus, a high replacement rate more than compensates for the possible negative effect of reproductive disorders. The use of frontier production and efficiency/inefficiency functions to analyze herd data may enable dairy advisors to identify inefficient herds and to simulate the effect of alternative management procedures on the individual herd's efficiency.

NASA cryogenic fluid management space experiment efforts

NASA Technical Reports Server (NTRS)

Glover, Daniel

1991-01-01

A history of technological development for subcritical cryogenic fluid management (CFM) through space experiments is given for the period 1960 to 1990. Space experiments with liquid hydrogen were conducted in the early 1960s. Efforts since then have consisted of studies and designs of potential space experiments. A chronology of CFM space experiments and design efforts is included.

[Case management process identified from experience of nurse case managers].

PubMed

Park, Eun-Jun; Kim, Chunmi

2008-12-01

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Recruitment of ethnic minorities for public health research: An interpretive synthesis of experiences from six interlinked Danish studies.

PubMed

Nielsen, Annemette Ljungdalh; Jervelund, Signe Smith; Villadsen, Sarah Fredsted; Vitus, Kathrine; Ditlevsen, Kia; TØrslev, Mette Kirstine; Kristiansen, Maria

2017-03-01

This paper examines the importance of recruitment site in relation to the recruitment of ethnic minorities into health research. It presents a synthesis of experiences drawn from six interlinked Danish studies which applied different methods and used healthcare facilities and educational settings as sites for recruitment. Inspired by interpretive reviewing, data on recruitment methods from the different studies were synthesized with a focus on the various levels of recruitment success achieved. This involved an iterative process of comparison, analysis and discussion of experiences among the researchers involved. Success in recruitment seemed to depend partly on recruitment site. Using healthcare facilities as the recruitment site and healthcare professionals as gatekeepers was less efficient than using schools and employees from educational institutions. Successful study designs also depended on the possibility of singling out specific locations with a high proportion of the relevant ethnic minority target population. The findings, though based on a small number of cases, indicate that health professionals and healthcare institutions, despite their interest in high-quality health research into all population groups, fail to facilitate research access to some of the most disadvantaged groups, who need to be included in order to understand the mechanisms behind health disparities. This happens despite the genuine wish of many healthcare professionals to help facilitate such research. In this way, the findings indirectly emphasize the specific challenge of accessing more vulnerable and sick groups in research studies.

[The case manager--from words to deeds?].

PubMed

Lindegaard, Birthe Rosenkrantz; Qvist, Peter

2010-04-19

Allocation of a case manager is now mandatory for both in- and outpatients in Denmark. Case manager allocation is reported quarterly to the regions and results are generally satisfying. Knowledge about fulfillment of the case manager role is, however, sparse. This study aims to examine the degree of fulfillment of the case manager role for a sample of inpatients. Two medical and two surgical wards participated. Patients were interviewed in relation to discharge while staff assigned as case managers completed a survey. Both patients and case managers answered questions regarding the defined roles as case managers: Planning/coordination, continuous information and discharge planning. 107 of 125 eligible patients were interviewed. Only 25 declared themselves informed about the allocation of a case manager. The patients' assessment of the service provided by the staff in relation to case manager tasks was generally good, but the services were seldom provided by the named case manager. 22% of patients did not experience continuous information, while only 13% did not experience a generally coherent stay in hospital. 110 case managers completed the survey. Less than half felt themselves well informed about the case manager role. Only a few case managers feel that they succeed in fulfilling the role, particularly regarding the participation in discharge planning. There seems to be a need for a targeted effort to improve the conditions for case managers in Danish hospitals in order to meet the intentions of this initiative.

Career Transitions: The Experiences of Unemployed Women Managers

ERIC Educational Resources Information Center

Sheridan, Terry A.

2008-01-01

A sample of 45 women managers was surveyed in a qualitative study to explore their experiences of being unemployed. The sample was purposeful, and the data were collected on a website-based survey. The experience of unemployment for female managers was far different from what was previously presumed from research largely drawn from male …

Building a Propulsion Experiment Project Management Environment

NASA Technical Reports Server (NTRS)

Keiser, Ken; Tanner, Steve; Hatcher, Danny; Graves, Sara

2004-01-01

What do you get when you cross rocket scientists with computer geeks? It is an interactive, distributed computing web of tools and services providing a more productive environment for propulsion research and development. The Rocket Engine Advancement Program 2 (REAP2) project involves researchers at several institutions collaborating on propulsion experiments and modeling. In an effort to facilitate these collaborations among researchers at different locations and with different specializations, researchers at the Information Technology and Systems Center,' University of Alabama in Huntsville, are creating a prototype web-based interactive information system in support of propulsion research. This system, to be based on experience gained in creating similar systems for NASA Earth science field experiment campaigns such as the Convection and Moisture Experiments (CAMEX), will assist in the planning and analysis of model and experiment results across REAP2 participants. The initial version of the Propulsion Experiment Project Management Environment (PExPM) consists of a controlled-access web portal facilitating the drafting and sharing of working documents and publications. Interactive tools for building and searching an annotated bibliography of publications related to REAP2 research topics have been created to help organize and maintain the results of literature searches. Also work is underway, with some initial prototypes in place, for interactive project management tools allowing project managers to schedule experiment activities, track status and report on results. This paper describes current successes, plans, and expected challenges for this project.

Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system.

PubMed

Ankjaer-Jensen, Anni; Rosling, Pernille; Bilde, Lone

2006-08-01

This article aims to describe and assess the Danish case-mix system, the cost accounting applied in setting national tariffs and the introduction of variable, prospective payment in the Danish hospital sector. The tariffs are calculated as a national average from hospital data gathered in a national cost database. However, uncertainty, mainly resulting from the definition of cost centres at the individual hospital, implies that the cost weights may not fully reflect the hospital treatment cost. As variable prospective payment of hospitals currently only applies to 20% of a hospital's budget, the incentives and the effects on productivity, quality and equality are still limited.

Panel management, team culture, and worklife experience.

PubMed

Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin

2015-09-01

Burnout and professional dissatisfaction are threats to the primary care workforce. We investigated the relationship between panel management capability, team culture, cynicism, and perceived "do-ability" of primary care among primary care providers (PCPs) and staff in primary care practices. We surveyed 326 PCPs and 142 staff members in 10 county-administered, 6 university-run, and 3 Veterans Affairs primary care clinics in a large urban area in 2013. Predictor variables included capability for performing panel management and perception of team culture. Outcome variables included 2 work experience measures--the Maslach Burnout Inventory cynicism scale and a 1-item measure of the "do-ability" of primary care this year compared with last year. Generalized Estimation Equation (GEE) models were used to account for clustering at the clinic level. Greater panel management capability and higher team culture were associated with lower cynicism among PCPs and staff and higher reported "do-ability" of primary care among PCPs. Panel management capability and team culture interacted to predict the 2 work experience outcomes. Among PCPs and staff reporting high team culture, there was little association between panel management capability and the outcomes, which were uniformly positive. However, there was a strong relationship between greater panel management capability and improved work experience outcomes for PCPs and staff reporting low team culture. Team-based processes of care such as panel management may be an important strategy to protect against cynicism and dissatisfaction in primary care, particularly in settings that are still working to improve their team culture. (c) 2015 APA, all rights reserved).

Calcium in drinking water: effect on iron stores in Danish blood donors-results from the Danish Blood Donor Study.

PubMed

Rigas, Andreas S; Ejsing, Benedikte H; Sørensen, Erik; Pedersen, Ole B; Hjalgrim, Henrik; Erikstrup, Christian; Ullum, Henrik

2018-06-01

Studies confirm that calcium inhibits iron absorption. Danish tap water comes from groundwater, which contains varying amounts of calcium depending on the subsoil. We investigated the association of calcium in drinking water with iron levels in Danish blood donors. We used data on Danish blood donors including dietary and lifestyle habits, blood donation history, and physiologic characteristics including measures of ferritin levels along with information on area of residence from The Danish Blood Donor Study. Data on calcium levels in groundwater ("water hardness") were obtained through the Geological Survey of Denmark and Greenland. We performed multiple linear and logistic regression analyses to evaluate the effect of water hardness on ferritin levels and risk of having iron deficiency (defined as ferritin levels <15 ng/mL), stratified by sex. There was a significant negative association between water hardness and ferritin levels in both men and women. Risk of iron deficiency was correspondingly increased in both men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.14-2.12) and women (OR, 1.20; 95% CI, 1.03-1.40) with increasing water hardness. In analyses restricted to individuals who received supplemental iron tablets no significant association between groundwater hardness and ferritin levels was observed. As measured by ferritin levels, residential drinking water calcium content is associated with blood donors- iron levels and risk of iron deficiency. However, effect sizes are small. © 2018 AABB.

First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.

PubMed

Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold; Zemtsovski, Mikhail; Nilsson, Jens Christian; Seidelin, Casper Tobias; Perch, Michael; Iversen, Martin; Steinbrüchel, Daniel

2014-03-01

The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction. The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs. no funding was granted for the present paper. not relevant.

Management system for the SND experiments

NASA Astrophysics Data System (ADS)

Pugachev, K.; Korol, A.

2017-09-01

A new management system for the SND detector experiments (at VEPP-2000 collider in Novosibirsk) is developed. We describe here the interaction between a user and the SND databases. These databases contain experiment configuration, conditions and metadata. The new system is designed in client-server architecture. It has several logical layers corresponding to the users roles. A new template engine is created. A web application is implemented using Node.js framework. At the time the application provides: showing and editing configuration; showing experiment metadata and experiment conditions data index; showing SND log (prototype).

Integrating Work Experience and Management for College Bound Students

ERIC Educational Resources Information Center

Ryan, Leo V.; Coover, Thomas A.

1975-01-01

St. Viator High School, through a Business Management Seminar, converted job experiences into learning experiences by acknowledging the real value of the job as a laboratory for the study of principles of management and their application to the job. (Author/BP)

[The Danish Debate on Priority Setting in Medicine--An Update].

PubMed

Pornak, S C; Raspe, H

2015-09-01

In the last years, the Danish debate about priority setting in medicine has gained new strength. This paper shows the main focuses of the current discussion based on a research of Danish primary literature. For the first time since the 1990s the Danish Council of Ethics has been involved with priority setting in medicine in a project running from 2011 to 2013. The Council emphasises the importance of legitimate processes and calls for visible values and criteria. A focus of the debate is how to deal with new expensive drugs. Politicians, physicians, health economists and the Council of Ethics have called for a national institution for priority setting in medicine. They have mainly looked to the Norwegian National Council for Priority Setting in Health Care and the British National Institute for Health and Care Excellence for inspiration. The Danish Government considered establishing a national institute for priority setting, but the plans were not put into practice. In the year 2012 a new national project was launched to create clinical guidelines. Danish doctors welcome the guidelines as a good basis for priority setting. Just like in earlier Danish priority setting debates, a coordinating institution is lacking to bundle the discussion and keep it going. The debate seems to have come to an end once again. The fact that it was seriously considered to establish an institute for priority setting is a new development. It can be expected that the discussion will be resumed in the near future, possibly the idea of an institute for priority setting will be readopted. The general conditions for priority setting in health care have improved. © Georg Thieme Verlag KG Stuttgart · New York.

Danish VISA-A questionnaire with validation and reliability testing for Danish-speaking Achilles tendinopathy patients.

PubMed

Iversen, J V; Bartels, E M; Jørgensen, J E; Nielsen, T G; Ginnerup, C; Lind, M C; Langberg, H

2016-12-01

The VISA-A questionnaire has proven to be a valid and reliable tool for assessing severity of Achilles tendinopathy (AT). The aim was to translate and cross-culturally adapt the VISA-A questionnaire for a Danish-speaking AT population, and subsequently perform validity and reliability tests. Translation and following cross-cultural adaptation was performed as translation, synthesis, reverse translation, expert review, and pretesting. The final Danish version (VISA-A-DK) was tested for reliability on healthy controls (n = 75) and patients (n = 36). Tests for internal consistency, validity, and structure were performed on 71 patients. VISA-A-DK showed good reliability for patients (r = 0.80 ICC = 0.79) and healthy individuals (r = 0.98 ICC = 0.97). Internal consistency was 0.73 (Cronbach's alpha). The mean VISA-A-DK score in AT patients was 51 [47-55]. This was significantly lower than healthy controls with a score of 93 (90-95). Criterion validity was considered good when comparing the scores of the Danish version with the original version in both healthy individuals and patients. VISA-A-DK is a valid and reliable instrument and has shown compatible to the original version in assessment of AT patients. VISA-A-DK is a useful tool in the assessment of AT, both in research and in a clinical setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Spacelab cryogenic propellant management experiment

NASA Technical Reports Server (NTRS)

Cady, E. C.

1976-01-01

The conceptual design of a Spacelab cryogen management experiment was performed to demonstrate toe desirability and feasibility of subcritical cryogenic fluid orbital storage and supply. A description of the experimental apparatus, definition of supporting requirements, procedures, data analysis, and a cost estimate are included.

Increased AβPP processing in familial Danish dementia patients.

PubMed

Matsuda, Shuji; Tamayev, Robert; D'Adamio, Luciano

2011-01-01

An autosomal dominant mutation in the BRI2/ITM2B gene causes Familial Danish Dementia (FDD). We have generated a mouse model of FDD, called FDDKI, genetically congruous to the human disease. These mice carry one mutant and one wild type Bri2/Itm2b allele, like FDD patients. Analysis of FDDKI mice and samples from human patients has shown that the Danish mutation causes loss of Bri2 protein. FDDKI mice show synaptic plasticity and memory impairments. BRI2 is a physiological interactor of amyloid-β protein precursor (AβPP), a gene associated with Alzheimer's disease, which inhibits processing of AβPP. AβPP/Bri2 complexes are reduced in synaptic membranes of FDDKI mice. Consequently, AβPP metabolites derived from processing of AβPP by β-, α-, and γ-secretases are increased in Danish dementia mice. AβPP haplodeficiency prevents memory and synaptic dysfunctions, consistent with a role for AβPP-metabolites in the pathogenesis of memory and synaptic deficits. This genetic suppression provides compelling evidence that AβPP and BRI2 functionally interact. Here, we have investigated whether AβPP processing is altered in FDD patients' brain samples. We find that the levels of several AβPP metabolites, including Aβ, are significantly increased in the brain sample derived from an FDD patient. Our data are consistent with the findings in FDDKI mice, and support the hypothesis that the neurological effects of the Danish form of BRI2 are caused by toxic AβPP metabolites, suggesting that Familial Danish and Alzheimer's dementias share common pathogenic mechanisms.

A hindcast and forecast of management of agricultural nutrient losses in Denmark: a change in paradigm (Invited)

NASA Astrophysics Data System (ADS)

kronvang, B.; Blicher-Mathiesen, G.; Windolf, J.; Grant, R.

2013-12-01

Four major Action Plans on the Aquatic Environment have been implemented in Denmark since 1987 with the aim to reduce by 50% the nitrogen (N) loading and by 80% the phosphorus (P) loading to the aquatic environment. At the same time the Danish National Aquatic Monitoring and Assessment Programme (NOVA) was launched with the aim to follow the effects of the obligatory implemented management strategies in Danish agriculture. Monitoring of the effects took place in 5 small agricultural catchments in soil water, groundwater and surface waters with annual interviews of farmers practices at field level as well as a general monitoring of nutrient concentrations in groundwater, streams, rivers, lakes and estuaries all over Denmark. Considerable changes in agricultural practice (storage of slurry, ban on slurry spreading in autumn and winter, strict requirements to N-use in animal manure, N-norms to all crops to be fixed to 10% below economic optimum, etc.) have resulted in a reduction of the net N-surplus from 136 to 75 kg N ha-1 yr-1 (45%) and the net P-surplus from 19 to around 0 kg P ha-1 yr-1 (100%) during the period 1985-2011..Twenty-five years of experience gathered from NOVA have shown that the losses of total N (TN) and total P (TP) to the marine environment from both point sources and diffuse sources has decreased with 50% and 50%, respectively. The reduction in TN losses alone amounts to 40%, whereas no general reduction in TP from diffuse losses can be detected. Despite the great efforts in improving the management of N and P in Danish agriculture the sector is today still the major source of both N (80%) and P (50%) in Danish streams, lakes and coastal waters. The ecological conditions in Danish streams, lakes and estuaries are still below the at least good ecological quality required by the EU Water Framework Directive adopted in year 2000. As global demand for food is increasing the Danish Government last year initiated a commission to publish a white book on

An Early Danish Computer Game

NASA Astrophysics Data System (ADS)

Jørgensen, Anker Helms

This paper reports on the development of Nimbi, which is an early computer game implemented at the Danish Computer Company Regnecentralen in 1962-63. Nimbi is a variant of the ancient game Nim. The paper traces the primary origins of the development of Nimbi. These include a mathematical analysis from 1901 of Nim that “killed the game” as the outcome could be predicted quite easily; the desire of the Danish inventor Piet Hein to make a game that eluded such analyses; and the desire of Piet Hein to have computers play games against humans. The development of Nimbi was successful in spite of considerable technical obstacles. However, it seems that the game was not used for publicizing the capabilities of computers - at least not widely - as was the case with earlier Nim implementations, such as the British Nim-playing computer Nimrod in 1951.

Plastic litter from shotgun ammunition on Danish coastlines - Amounts and provenance.

PubMed

Kanstrup, Niels; Balsby, Thorsten J S

2018-06-01

Plastic litter in the marine environment is a major global issue. Discarded plastic shotgun ammunition shells and discharged wads are an unwelcome addition and feature among the top ten litter items found on reference beaches in Denmark. To understand this problem, its scale and origins, collections were made by volunteers along Danish coastal shorelines. In all 3669 plastic ammunition items were collected at 68 sites along 44.6 km of shoreline. The collected items were scored for characteristic variables such as gauge and length, shot type, and the legibility of text, the erosion, and the presence of metallic components. Scores for characteristics were related to the site, area, and season and possible influences discussed. The prevalence of collected plastic shotgun litter ranges from zero to 41 items per 100 m with an average of 3.7 items per 100 m. Most ammunition litter on Danish coasts originates from hunting on Danish coastal waterbodies, but a small amount may come from further afield. North Sea coasts are the most distinctive suggesting the possible contribution of long distance drift as well as the likelihood that such litter can persist in marine habitats for decades. The pathway from initial discard to eventual wash-up and collection depends on the physical properties of plastic components, marine tides and currents, coastal topography and shoreline vegetation. Judging from the disintegration of the cartridge and the wear and decomposition of components, we conclude that there is a substantial supply of polluting plastic ammunition materials that has and will accumulate. These plastic items pose a hazard to marine ecosystems and wash up on coasts for many years to come. We recommend that responsible managers, hunters and ammunition manufacturers will take action now to reduce the problem and, thereby, protect ecosystems, wildlife and the sustainability of hunting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

PubMed

Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

2017-05-01

The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Divorce or end of cohabitation among Danish women evaluated for fertility problems.

PubMed

Kjaer, Trille; Albieri, Vanna; Jensen, Allan; Kjaer, Susanne K; Johansen, Christoffer; Dalton, Susanne O

2014-03-01

Couples with fertility problems may experience marital or sexual distress which could potentially result in dissolved relationships. We investigated the likelihood of ending a relationship among women who did not have a child after a fertility evaluation. Longitudinal cohort study. Danish women ever referred for primary or secondary fertility problems to a public Danish hospital or private fertility clinic between 1990 and 2006. A total of 47,515 women. The data were linked to Danish administrative population-based registries containing demographic and socioeconomic information. Discrete-time survival models were used with person-period data. Each woman was followed from the year of her initial fertility evaluation through to 2007. Effects of parity after a fertility evaluation on the likelihood of ending a marital or cohabitation relationship. After up to 12 years of follow up, nearly 27% of the women were no longer living with the person with whom they had lived at the time of the fertility evaluation. Women who did not have a child after the evaluation had significantly higher odds ratios for ending a relationship up to 12 years after the evaluation (with odds ratios up to 3.13, 95% CI 2.88-3.41) than women who had a child, regardless of their parity before the evaluation. Parity after a fertility evaluation may be an important component in the longitudinal relationships of couples with fertility problems. Studies with detailed information on marital quality and relational well-being of couples with fertility problems are needed. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Data management for interdisciplinary field experiments: OTTER project support

NASA Technical Reports Server (NTRS)

Angelici, Gary; Popovici, Lidia; Skiles, J. W.

1993-01-01

The ability of investigators of an interdisciplinary science project to properly manage the data that are collected during the experiment is critical to the effective conduct of science. When the project becomes large, possibly including several scenes of large-format remotely sensed imagery shared by many investigators requiring several services, the data management effort can involve extensive staff and computerized data inventories. The OTTER (Oregon Transect Ecosystem Research) project was supported by the PLDS (Pilot Land Data System) with several data management services, such as data inventory, certification, and publication. After a brief description of these services, experiences in providing them are compared with earlier data management efforts and some conclusions regarding data management in support of interdisciplinary science are discussed. In addition to providing these services, a major goal of this data management capability was to adopt characteristics of a pro-active attitude, such as flexibility and responsiveness, believed to be crucial for the effective conduct of active, interdisciplinary science. These are also itemized and compared with previous data management support activities. Identifying and improving these services and characteristics can lead to the design and implementation of optimal data management support capabilities, which can result in higher quality science and data products from future interdisciplinary field experiments.

Bovine renal lipofuscinosis: prevalence, genetics and impact on milk production and weight at slaughter in Danish cattle.

PubMed

Agerholm, Jørgen S; Christensen, Knud; Nielsen, Søren Saxmose; Flagstad, Pia

2009-02-12

Bovine renal lipofuscinosis (BRL) is an incidental finding in cattle at slaughter. Condemnation of the kidneys as unfit for human consumption was until recently considered the only implication of BRL. Recent studies have indicated a negative influence on the health of affected animals. The present study investigated the prevalence, genetics and effect of BRL on milk yield and weight at slaughter. BRL status of slaughter cattle was recorded at four abattoirs during a 2-year-period. Data regarding breed, age, genetic descent, milk yield and weight at slaughter were extracted from the Danish Cattle Database. The prevalence of BRL was estimated stratified by breed and age-group. Furthermore, total milk yield, milk yield in last full lactation and weight at slaughter were compared for BRL-affected and non-affected Danish Holsteins and Danish Red cattle. 433,759 bovines were slaughtered and 787 of these had BRL. BRL was mainly diagnosed in Danish Red, Danish Holstein and crossbreds. The age of BRL affected animals varied from 11 months to 13 years, but BRL was rarely diagnosed in cattle less than 2 years of age.The total lifelong energy corrected milk (ECM) yields were 3,136 and 4,083 kg higher for BRL affected Danish Red and Danish Holsteins, respectively. However, the median life span of affected animals was 4.9 months longer, and age-corrected total milk yield was 1,284 kg lower for BRL affected Danish Red cows. These cows produced 318 kg ECM less in their last full lactation. Weight at slaughter was not affected by BRL status.The cases occurred in patterns consistent with autosomal recessive inheritance and several family clusters of BRL were found. Analysis of segregation ratios demonstrated the expected ratio for Danish Red cattle, but not for Danish Holsteins. The study confirmed that BRL is a common finding in Danish Holsteins and Danish Red cattle at slaughter. The disorder is associated with increased total milk yield due to a longer production life. However, a

Cancer incidence among Danish Seventh-day Adventists and Baptists.

PubMed

Thygesen, Lau Caspar; Hvidt, Niels Christian; Hansen, Helle Ploug; Hoff, Andreas; Ross, Lone; Johansen, Christoffer

2012-12-01

American Seventh-day Adventists have been reported to have lower cancer mortality and incidence than the general population. Adventists do not consume tobacco, alcohol or pork, and many adhere to a lacto-ovo-vegetarian lifestyle. Baptists discourage excessive use of alcohol and tobacco. In this study, we investigated whether the incidence of cancer in a large cohort of Danish Adventists and Baptists was different compared to the general Danish population. We followed 11,580 Danish Adventists and Baptists in the nationwide Danish Cancer Registry, which contains information on cases of cancer for 1943-2008. Cancer incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios (SIRs) with 95% confidence intervals (CIs), and within-cohort comparisons were made with a Cox model. Lower cancer incidences were observed for both Seventh-day Adventist men (SIR, 66; 95% CI, 60-72) and women (85; 80-91). The same result was observed for Baptists although not as low. The differences were most pronounced for smoking-related cancers such as those of the buccal cavity and lung (SIR, 20; 13-30 for Seventh-day Adventist men and 33; 22-49 for Seventh-day Adventist women). The incidences of other lifestyle-related cancers, such as of stomach, rectum, liver and cervix, were also decreased. In general, the SIRs were lower for men than for women, and Adventists had lower hazard rates than Baptists. Our findings point to the benefits of compliance with public health recommendations and indicate that lifestyle changes in the population might change the cancer risks of individuals. Copyright © 2012 Elsevier Ltd. All rights reserved.

Increased AβPP Processing in Familial Danish Dementia Patients

PubMed Central

Matsuda, Shuji; Tamayev, Robert; D’Adamio, Luciano

2013-01-01

An autosomal dominant mutation in the BRI2/ITM2B gene causes Familial Danish Dementia (FDD). We have generated a mouse model of FDD, called FDDKI, genetically congruous to the human disease. These mice carry one mutant and one wild type Bri2/Itm2b allele, like FDD patients. Analysis of FDDKI mice and samples from human patients has shown that the Danish mutation causes loss of Bri2 protein. FDDKI mice show synaptic plasticity and memory impairments. BRI2 is a physiological interactor of amyloid-β protein precursor (AβPP), a gene associated with Alzheimer’s disease, which inhibits processing of AβPP. AβPP/Bri2 complexes are reduced in synaptic membranes of FDDKI mice. Consequently, AβPP metabolites derived from processing of AβPP by β-, α-, and γ-secretases are increased in Danish dementia mice. AβPP haplodeficiency prevents memory and synaptic dysfunctions, consistent with a role for AβPP-metabolites in the pathogenesis of memory and synaptic deficits. This genetic suppression provides compelling evidence that AβPP and BRI2 functionally interact. Here, we have investigated whether AβPP processing is altered in FDD patients’ brain samples. We find that the levels of several AβPP metabolites, including Aβ, are significantly increased in the brain sample derived from an FDD patient. Our data are consistent with the findings in FDDKI mice, and support the hypothesis that the neurological effects of the Danish form of BRI2 are caused by toxic AβPP metabolites, suggesting that Familial Danish and Alzheimer’s dementias share common pathogenic mechanisms. PMID:21841249

Ethnic differences in leptin and adiponectin levels between Greenlandic Inuit and Danish children

PubMed Central

Munch-Andersen, Thor; Sorensen, Kaspar; Aachmann-Andersen, Niels-Jacob; Aksglaede, Lise; Juul, Anders; Helge, Jørn W.

2013-01-01

Objective In a recent study, we found that Greenlandic Inuit children had a more adverse metabolic profile than Danish children. Aerobic fitness and adiposity could only partly account for the differences. Therefore, we set out to evaluate and compare plasma leptin and adiponectin levels in Danish and Inuit children. Methods In total, 187 Inuit and 132 Danish children (5.7–17.1 years) had examinations of anthropometrics, body fat content, pubertal staging, fasting blood and aerobic fitness. Results Plasma leptin was higher in Danish boys [3,774 (4,741–3,005)] [pg/mL unadjusted geometric mean (95% CI)] compared to both northern [2,076 (2,525–1,706)] (p<0.001) and southern (2,515 (3,137–2,016)) (p<0.001) living Inuit boys and higher in Danish girls [6,988 (8,353–5,847)] compared to southern living Inuit girls [4,910 (6,370–3,785)] (p=0.021) and tended to be higher compared to northern living Inuit girls [5,131 (6,444–4,085)] (p=0.052). Plasma adiponectin was higher for both Danish boys [22,359 (2,573–19,428)] [ng/mL unadjusted geometric mean (95% CI)] and girls [26,609 (28,994–24,420)] compared to southern living Inuit boys [15,306 (18,406–12,728)] and girls [18,864 (22,640–15,717)] (both p<0.001), respectively. All differences remained after adjustment for body fat percentage (BF%), aerobic fitness, age and puberty. The leptin/adiponectin ratio was higher in Danish boys and tended to be higher in Danish girls compared to northern living Inuit boys and girls, respectively. These differences were eliminated after adjustment for BF%, aerobic fitness, age and puberty. Conclusions In contrast to our hypothesis, plasma leptin was higher in Danish children despite a more healthy metabolic profile compared to Inuit children. As expected, plasma adiponectin was lowest in Inuit children with the most adverse metabolic profile. PMID:23940841

Ethnic differences in leptin and adiponectin levels between Greenlandic Inuit and Danish children.

PubMed

Munch-Andersen, Thor; Sorensen, Kaspar; Aachmann-Andersen, Niels-Jacob; Aksglaede, Lise; Juul, Anders; Helge, Jørn W

2013-01-01

In a recent study, we found that Greenlandic Inuit children had a more adverse metabolic profile than Danish children. Aerobic fitness and adiposity could only partly account for the differences. Therefore, we set out to evaluate and compare plasma leptin and adiponectin levels in Danish and Inuit children. In total, 187 Inuit and 132 Danish children (5.7-17.1 years) had examinations of anthropometrics, body fat content, pubertal staging, fasting blood and aerobic fitness. Plasma leptin was higher in Danish boys [3,774 (4,741-3,005)] [pg/mL unadjusted geometric mean (95% CI)] compared to both northern [2,076 (2,525-1,706)] (p < 0.001) and southern (2,515 (3,137-2,016)) (p < 0.001) living Inuit boys and higher in Danish girls [6,988 (8,353-5,847)] compared to southern living Inuit girls [4,910 (6,370-3,785)] (p = 0.021) and tended to be higher compared to northern living Inuit girls [5,131 (6,444-4,085)] (p = 0.052). Plasma adiponectin was higher for both Danish boys [22,359 (2,573-19,428)] [ng/mL unadjusted geometric mean (95% CI)] and girls [26,609 (28,994-24,420)] compared to southern living Inuit boys [15,306 (18,406-12,728)] and girls [18,864 (22,640-15,717)] (both p < 0.001), respectively. All differences remained after adjustment for body fat percentage (BF%), aerobic fitness, age and puberty. The leptin/adiponectin ratio was higher in Danish boys and tended to be higher in Danish girls compared to northern living Inuit boys and girls, respectively. These differences were eliminated after adjustment for BF%, aerobic fitness, age and puberty. In contrast to our hypothesis, plasma leptin was higher in Danish children despite a more healthy metabolic profile compared to Inuit children. As expected, plasma adiponectin was lowest in Inuit children with the most adverse metabolic profile.

Activity Theories and the Ontology of Psychology: Learning from Danish and Russian Experiences.

PubMed

Mammen, Jens; Mironenko, Irina

2015-12-01

Psychology has permanent problems of theoretical coherence and practical, analytic and critical efficiency. It is claimed that Activity Theory (AT) with roots in a long European philosophical tradition and continued in Russian AT is a first step to remedy this. A Danish version of AT may have a key to exceed some, mostly implicit, ontological restrictions in traditional AT and free it from an embracement of functionalism and mechanicism, rooted in Renaissance Physics. The analysis goes back to Aristotle's understanding of the freely moving animal in its ecology and introduces some dualities in the encounter between subject and object which replace the dualistic dichotomies traditionally splitting Psychology in Naturwissenschaft vs. Geisteswissenshaft. This also implies a "Copernican turn" of Cartesian dualism. The perspectives are to give place for a phenomenology of meaning without cutting human psyche out of Nature and to open Psychology to its domain.

Do follow-on therapeutic substitutes induce price competition between hospital medicines? Evidence from the Danish hospital sector.

PubMed

Hostenkamp, Gisela

2013-06-01

The pricing of follow-on drugs, that offer only limited health benefits over existing therapeutic alternatives, is a recurring health policy debate. This study investigates whether follow-on therapeutic substitutes create price competition between branded hospital medicines. New follow-on drugs and their incumbent therapeutic competitors were identified from Danish sales and product registration data on hospital pharmaceuticals using medically relevant criteria. We examined whether follow-on drugs adopt lower prices than their incumbent competitors, and whether incumbent competitors react to entry of follow-ons through price adjustments using a random intercept panel model. We found no evidence that follow-on drugs adopt lower prices than their incumbent competitors. Furthermore, potentially due to low sample size, we found no evidence that prices for incumbent pioneer products were significantly reduced as a reaction to competition from follow-on drugs. Competition between patented therapeutic substitutes did not seem to increase price competition and containment of pharmaceutical expenditures in the Danish hospital market. Strengthening hospitals' incentives to consider the price of alternative treatment options paired with a more active formulary management may increase price competition between therapeutic substitutes in the Danish hospital sector in the future. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Semantic Categorization of Placement Verbs in L1 and L2 Danish and Spanish

ERIC Educational Resources Information Center

Cadierno, Teresa; Ibarretxe-Antuñano, Iraide; Hijazo-Gascón, Alberto

2016-01-01

This study investigates semantic categorization of the meaning of placement verbs by Danish and Spanish native speakers and two groups of intermediate second language (L2) learners (Danish learners of L2 Spanish and Spanish learners of L2 Danish). Participants described 31 video clips picturing different types of placement events. Cluster analyses…

Nature and Nationhood: Danish Perspectives

ERIC Educational Resources Information Center

Schnack, Karsten

2009-01-01

In this paper, I shall discuss Danish perspectives on nature, showing the interdependence of conceptions of "nature" and "nationhood" in the formations of a particular cultural community. Nature, thus construed, is never innocent of culture and cannot therefore simply be "restored" to some pristine, pre-lapsarian…

The African Union and Conflict Management

DTIC Science & Technology

2006-03-02

USAWC STRATEGY RESEARCH PROJECT THE AFRICAN UNION AND CONFLICT MANAGEMENT by Lieutenant Colonel Flemming Mathiasen Royal Danish Army Colonel Patrick...AUTHOR: Lieutenant Colonel Flemming Mathiasen TITLE: The African Union and Conflict Management FORMAT: Strategy Research Project DATE: 2 March 2006...WORD COUNT: 5850 PAGES: 28 KEY TERMS: African Union, Africa, Conflict Management , Capabilities CLASSIFICATION: Unclassified Africa is a continent with a

Is Danish Difficult to Acquire? Evidence from Nordic Past-Tense Studies

ERIC Educational Resources Information Center

Bleses, Dorthe; Basboll, Hans; Vach, Werner

2011-01-01

Cross-linguistic findings have shown that Danish children's early receptive vocabulary development is slower relative to children learning other languages. In this study, we examined whether Danish children's acquisition of inflectional past-tense morphology is delayed relative to Icelandic, Norwegian, and Swedish children. Our comparison of data…

The long-term financial consequences of breast cancer: a Danish registry-based cohort study.

PubMed

Jensen, Laura Schärfe; Overgaard, Charlotte; Bøggild, Henrik; Garne, Jens Peter; Lund, Thomas; Overvad, Kim; Fonager, Kirsten

2017-10-30

A breast cancer diagnosis affects an individual's affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that participated in the work force. We also examined the roles of sociodemographic factors and prior psychiatric medical treatment. This registry-based cohort study was based on information retrieved from linked Danish nationwide registries. We compared the incomes of 13,101 women (aged 30-59 years) diagnosed with breast cancer (exposed) to those of 60,819 women without breast cancer (unexposed). Changes in income were examined during a 10-year follow-up; for each follow-up year, we calculated the mean annual income and the relative change compared to the income earned one year prior to diagnosis. Expected changes in Danish female income, according to calendar year and age, were estimated based on information from Statistics Denmark. For exposed and unexposed groups, the observed income changes were dichotomized to those above and those below the expected change in income in the Danish female population. We examined the impact of breast cancer on income each year of follow-up with logistic regression models. Analyses were stratified according to educational level, marital status, and prior psychiatric medical treatment. Breast cancer had a temporary negative effect on income. The effect was largest during the first three years after diagnosis; thereafter, the gap narrowed between exposed and unexposed cohorts. The odds ratio for an increase in income in the cancer cohort compared to the cancer-free cohort was 0.81 (95% CI 0.77-0.84) after three years. After seven years, no significant difference was observed between cohorts. Stratified analyses demonstrated that the negative effect of breast cancer on income lasted longest among women with high educational levels. Being single or having

Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality: results from the Danish work environment cohort study.

PubMed

van der Ploeg, Hidde P; Møller, Simone Visbjerg; Hannerz, Harald; van der Beek, Allard J; Holtermann, Andreas

2015-06-02

Prolonged sitting has been negatively associated with a range of non-communicably diseases. However, the role of occupational sitting is less clear, and little is known on the changes of occupational sitting in a working population over time. The present study aimed to determine 1) temporal changes in occupational sitting time between 1990 and 2010 in the Danish workforce; 2) the association and possible dose-response relationship between occupational sitting time and all-cause mortality. This study analysed data from the Danish Work Environment Cohort Study (DWECS), which is a cohort study of the Danish working population conducted in five yearly intervals between 1990 and 2010. Occupational sitting time is self-reported in the DWECS. To determine the association with all-cause mortality, the DWECS was linked to the Danish Register of Causes of Death via the Central Person Register. Between 1990 and 2010 the proportion of the Danish workforce who sat for at least three quarters of their work time gradually increased from 33.1 to 39.1%. All-cause mortality analyses were performed with 149,773 person-years of observation and an average follow-up of 12.61 years, during which 533 deaths were registered. None of the presented analyses found a statistically significant association between occupational sitting time and all-cause mortality. The hazard ratio for all-cause mortality was 0.97 (95% CI: 0.79; 1.18) when ≥24 hr/wk occupational sitting time was compared to <24 hr/wk for the 1990-2005 waves. Occupational sitting time increased by 18% in the Danish workforce, which seemed to be limited to people with high socio-economic status. If this increase is accompanied by increases in total sitting time, this development has serious public health implications, given the detrimental associations between total sitting time and mortality. The current study was inconclusive on the specific role that occupational sitting might play in the increased all-cause mortality risk

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

PubMed Central

Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

2015-01-01

Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

PubMed

Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S; Wagner, Cordula; Bartels, Paul D; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

2015-01-01

Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture

Nurses’ Experiences of Managing and Management in a Critical Care Unit

PubMed Central

Ogle, K. Robyn; Glass, Nel

2014-01-01

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

Bayley-III: Cultural differences and language scale validity in a Danish sample.

PubMed

Krogh, Marianne T; Vaever, Mette S

2016-12-01

The purpose of this study was to investigate cultural differences between Danish and American children at 2 and 3 years as measured with the developmental test Bayley-III, and to investigate the Bayley-III Language Scale validity. The Danish children (N = 43) were tested with the Bayley-III and their parents completed an additional language questionnaire (the MacArthur-Bates CDI). Results showed that scores from the Danish children did not differ significantly from the American norms on the Cognitive or Motor Scale, but the Danish sample scored significantly higher on the Language Scale. A comparison of the Bayley-III Language subtests with the CDI showed that the two measures correlated significantly, but the percentile score from the CDI was significantly higher than the percentile score from the Bayley-III Language subtests. This could be because the two instruments measure slightly different areas of language development, or because the Bayley-III overestimates language development in Danish children. However, due to the limitations of the current study, further research is needed to clarify this issue. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Sharing reference data and including cows in the reference population improve genomic predictions in Danish Jersey.

PubMed

Su, G; Ma, P; Nielsen, U S; Aamand, G P; Wiggans, G; Guldbrandtsen, B; Lund, M S

2016-06-01

Small reference populations limit the accuracy of genomic prediction in numerically small breeds, such like Danish Jersey. The objective of this study was to investigate two approaches to improve genomic prediction by increasing size of reference population in Danish Jersey. The first approach was to include North American Jersey bulls in Danish Jersey reference population. The second was to genotype cows and use them as reference animals. The validation of genomic prediction was carried out on bulls and cows, respectively. In validation on bulls, about 300 Danish bulls (depending on traits) born in 2005 and later were used as validation data, and the reference populations were: (1) about 1050 Danish bulls, (2) about 1050 Danish bulls and about 1150 US bulls. In validation on cows, about 3000 Danish cows from 87 young half-sib families were used as validation data, and the reference populations were: (1) about 1250 Danish bulls, (2) about 1250 Danish bulls and about 1150 US bulls, (3) about 1250 Danish bulls and about 4800 cows, (4) about 1250 Danish bulls, 1150 US bulls and 4800 Danish cows. Genomic best linear unbiased prediction model was used to predict breeding values. De-regressed proofs were used as response variables. In the validation on bulls for eight traits, the joint DK-US bull reference population led to higher reliability of genomic prediction than the DK bull reference population for six traits, but not for fertility and longevity. Averaged over the eight traits, the gain was 3 percentage points. In the validation on cows for six traits (fertility and longevity were not available), the gain from inclusion of US bull in reference population was 6.6 percentage points in average over the six traits, and the gain from inclusion of cows was 8.2 percentage points. However, the gains from cows and US bulls were not accumulative. The total gain of including both US bulls and Danish cows was 10.5 percentage points. The results indicate that sharing reference

Experimenters' reference based upon Skylab experiment management

NASA Technical Reports Server (NTRS)

1974-01-01

The methods and techniques for experiment development and integration that evolved during the Skylab Program are described to facilitate transferring this experience to experimenters in future manned space programs. Management responsibilities and the sequential process of experiment evolution from initial concept through definition, development, integration, operation and postflight analysis are outlined and amplified, as appropriate. Emphasis is placed on specific lessons learned on Skylab that are worthy of consideration by future programs.

Diffusion of an e-learning programme among Danish General Practitioners: A nation-wide prospective survey

PubMed Central

Waldorff, Frans Boch; Steenstrup, Annette Plesner; Nielsen, Bente; Rubak, Jens; Bro, Flemming

2008-01-01

Background We were unable to identify studies that have considered the diffusion of an e-learning programme among a large population of general practitioners. The aim of this study was to investigate the uptake of an e-learning programme introduced to General Practitioners as part of a nation-wide disseminated dementia guideline. Methods A prospective study among all 3632 Danish GPs. The GPs were followed from the launching of the e-learning programme in November 2006 and 6 months forward. Main outcome measures: Use of the e-learning programme. A logistic regression model (GEE) was used to identify predictors for use of the e-learning programme. Results In the study period, a total of 192 different GPs (5.3%) were identified as users, and 17% (32) had at least one re-logon. Among responders at first login most have learnt about the e-learning programme from written material (41%) or from the internet (44%). A total of 94% of the users described their ability of conducting a diagnostic evaluation as good or excellent. Most of the respondents used the e-learning programme due to general interest (90%). Predictors for using the e-learning programme were Males (OR = 1.4, 95% CI 1.1; 2.0) and members of Danish College of General Practice (OR = 2.2, 95% CI 1.5; 3.1), whereas age, experience and working place did not seem to be influential. Conclusion Only few Danish GPs used the e-learning programme in the first 6 months after the launching. Those using it were more often males and members of Danish College of General Practice. Based on this study we conclude, that an active implementation is needed, also when considering electronic formats of CME like e-learning. Trial Registration ClinicalTrials.gov Identifier: NCT00392483. PMID:18439279

Management Development in Health Care: Exploring the Experiences of Clinical Nurse Managers

ERIC Educational Resources Information Center

Purcell, Laura; Milner, Brigid

2005-01-01

Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both…

Livestock drivers' knowledge about dairy cow fitness for transport - A Danish questionnaire survey.

PubMed

Herskin, M S; Hels, A; Anneberg, I; Thomsen, P T

2017-08-01

Dairy cows are transported by road to slaughter after their productive life. Cull cows are vulnerable to transport stress, and can only be transported when fit for the intended journey. However, the decision, as to whether a cow is fit is rather subjective and relies on the farmer and the livestock driver. Using a questionnaire survey, we aimed to describe knowledge about, and experiences with, dairy cow fitness for transport among Danish livestock drivers. During nine days of data collection at the three largest Danish cattle slaughterhouses, 66 drivers (55% of the national population of cattle drivers) answered a questionnaire (response rate: 97%). They were Danish males (mean age: 49years), of which 94% stated that they knew the rules regarding fitness for transport. More than half of the respondents said that physical conditions (light, space) before loading animals allowed proper assessment of fitness for transport, and 85% answered that time constraints were not a challenge for this. Thirty-five percent reported to be in doubt regarding fitness for transport of specific cows at least frequently, and given two specific questions on legislation concerning fitness for transport, only 52% of the respondents answered both correctly. The results add new knowledge about livestock drivers' approach to animal welfare. As drivers are held partly responsible for fitness for transport of animals sent to slaughter, and descriptions of fit/unfit are rather vague, livestock drivers seem to need additional education, training, assessment tools or feedback in order to optimize the welfare of animals to be transported. Copyright © 2017 Elsevier Ltd. All rights reserved.

Melanoma of the Skin in the Danish Cancer Registry and the Danish Melanoma Database: A Validation Study.

PubMed

Pedersen, Sidsel Arnspang; Schmidt, Sigrun Alba Johannesdottir; Klausen, Siri; Pottegård, Anton; Friis, Søren; Hölmich, Lisbet Rosenkrantz; Gaist, David

2018-05-01

The nationwide Danish Cancer Registry and the Danish Melanoma Database both record data on melanoma for purposes of monitoring, quality assurance, and research. However, the data quality of the Cancer Registry and the Melanoma Database has not been formally evaluated. We estimated the positive predictive value (PPV) of melanoma diagnosis for random samples of 200 patients from the Cancer Registry (n = 200) and the Melanoma Database (n = 200) during 2004-2014, using the Danish Pathology Registry as "gold standard" reference. We further validated tumor characteristics in the Cancer Registry and the Melanoma Database. Additionally, we estimated the PPV of in situ melanoma diagnoses in the Melanoma Database, and the sensitivity of melanoma diagnoses in 2004-2014. The PPVs of melanoma in the Cancer Registry and the Melanoma Database were 97% (95% CI = 94, 99) and 100%. The sensitivity was 90% in the Cancer Registry and 77% in the Melanoma Database. The PPV of in situ melanomas in the Melanoma Database was 97% and the sensitivity was 56%. In the Melanoma Database, we observed PPVs of ulceration of 75% and Breslow thickness of 96%. The PPV of histologic subtypes varied between 87% and 100% in the Cancer Registry and 93% and 100% in the Melanoma Database. The PPVs for anatomical localization were 83%-95% in the Cancer Registry and 93%-100% in the Melanoma Database. The data quality in both the Cancer Registry and the Melanoma Database is high, supporting their use in epidemiologic studies.

The experience of weight management in normal weight adults.

PubMed

Hernandez, Cheri Ann; Hernandez, David A; Wellington, Christine M; Kidd, Art

2016-11-01

No prior research has been done with normal weight persons specific to their experience of weight management. The purpose of this research was to discover the experience of weight management in normal weight individuals. Glaserian grounded theory was used. Qualitative data (focus group) and quantitative data (food diary, study questionnaire, and anthropometric measures) were collected. Weight management was an ongoing process of trying to focus on living (family, work, and social), while maintaining their normal weight targets through five consciously and unconsciously used strategies. Despite maintaining normal weights, the nutritional composition of foods eaten was grossly inadequate. These five strategies can be used to develop new weight management strategies that could be integrated into existing weight management programs, or could be developed into novel weight management interventions. Surprisingly, normal weight individuals require dietary assessment and nutrition education to prevent future negative health consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

"Make Sure Somebody Will Survive from This": Transformative Practices of Hope among Danish Organ Donor Families.

PubMed

Jensen, Anja M B

2016-09-01

Based on anthropological fieldwork among Danish organ donor families and hospital staff in neurointensive care units, this article explores the transformative practices of hope in Danish organ donation. Focusing on various phases of the organ donation process, I demonstrate how families and professionals practice hope in astounding ways: when hoping for organs, when hoping for the end of patient suffering, when hoping for the usability of the donor body, and when hoping to help future donor families by sharing painful experiences. By focusing on such practices and transformations of hope, this article sheds light on the social negotiations of life and death among families and staffs in medical contexts and describes how the dignity of the deceased donor and the usability of the donor body are closely connected in family attempts to make donation decisions meaningful during and after a tragic death. © 2016 by the American Anthropological Association.

Senior paediatric specialist registrars' experience in management.

PubMed

Bindal, Taruna; Wall, David; Goodyear, Helen M

2010-06-01

There is an increasing focus on trainees acquiring management skills which form part of college curricula and the guidance provided by the General Medical Council in the UK. To explore the managerial learning activities of senior paediatric specialist registrars (SpRs). Questionnaire study; West Midlands region, UK; senior paediatric SpRs in the last 2 years of training. A 17 item questionnaire was sent by post to all 45 paediatric SpRs in the last 2 years of training. A follow-up email was sent to non-responders. 87% (39/45) SpRs completed a questionnaire. All had participated in clinical managerial activities with 44% (17/39) doing >or=4 h per week. Popular activities were teaching and development of treatment guidelines. Non-clinical managerial experience, mainly rota management and teaching programme organisation, was limited with 64% (25/39) doing experience. SpRs rated clinical and non-clinical management training as important, but only a third felt confident in managing projects or leading change. Factors which inhibited management learning were shift patterns and being too busy. It is essential that trainees put managerial competencies in their personal development plans and have support from their supervisors to put this plan into action, including allocated time for management training and learning. At a trainee's annual review of progress, management competencies need to be considered as well as clinical work as these are needed for a smooth transition to a consultant post.

House dust in seven Danish offices

NASA Astrophysics Data System (ADS)

Mølhave, L.; Schneider, T.; Kjærgaard, S. K.; Larsen, L.; Norn, S.; Jørgensen, O.

Floor dust from Danish offices was collected and analyzed. The dust was to be used in an exposure experiment. The dust was analyzed to show the composition of the dust which can be a source of airborne dust indoors. About 11 kg of dust from vacuum cleaner bags from seven Danish office buildings with about 1047 occupants (12 751 m 2) was processed according to a standardized procedure yielding 5.5 kg of processed bulk dust. The bulk dust contained 130.000-160.000 CFU g -1 microorganisms and 71.000-90.000 CFU g -1 microfungi. The content of culturable microfungi was 65-123 CFU 30 g -1 dust. The content of endotoxins ranged from 5.06-7.24 EU g -1 (1.45 ng g -1 to 1.01 ng g -1). Allergens (ng g -1) were from 147-159 (Mite), 395-746 (dog) and 103-330 (cat). The macro molecular organic compounds (the MOD-content) varied from 7.8-9.8 mg g -1. The threshold of release of histamine from basophil leukocytes provoked by the bulk dust was between 0.3 and 1.0 mg ml -1. The water content was 2% (WGT) and the organic fraction 33%. 6.5-5.9% (dry) was water soluble. The fiber content was less than 0.2-1.5% (WGT) and the desorbable VOCs was 176-319 μg g -1. Most of the VOC were aldehydes. However, softeners for plastic (DBP and DEHP) were present. The chemical composition includes human and animal skin fragments, paper fibers, glass wool, wood and textilefibers and inorganic and metal particles. The sizes ranged from 0.001-1 mm and the average specific density was 1.0 g m -3. The bulk dust was resuspended and injected into an exposure chamber. The airborne dust was sampled and analyzed to illustrate the exposures that can result from sedimented dirt and dust. The airborne dust resulting from the bulk dust reached concentrations ranging from 0.26-0.75 mg m -3 in average contained 300-170 CFU m -3. The organic fraction was from 55-70% and the water content about 2.5% (WGT). The content of the dust was compared to the similar results reported in the literature and its toxic potency is

Associations between adherence to the Danish Food-Based Dietary Guidelines and cardiometabolic risk factors in a Danish adult population: the DIPI study.

PubMed

Arentoft, Johanne L; Hoppe, Camilla; Andersen, Elisabeth W; Overvad, Kim; Tetens, Inge

2018-03-01

Diet is recognised as one modifiable lifestyle factor for ischaemic heart disease (IHD). We aimed at investigating the associations between adherence to the Danish Food-Based Dietary Guidelines (FBDG) indicated by a Dietary Quality Index (DQI) and selected cardiometabolic risk factors in a cross-sectional study with 219 Danish adult participants (59 %women; age 31-65years) with a minimum of one self-rated risk marker of IHD. Information regarding diet was obtained using web-based dietary assessment software and adherence to the Danish FBDG was expressed by a DQI calculated from 5 food and nutrient indicators (whole grain, fish, fruit and vegetables, energy from saturated fat and from added sugar). Background information, blood samples and anthropometrics were collected and blood pressure was measured. Linear regression analyses were used to evaluate the association between DQI and cardiometabolic risk factors. DQI was inversely associated with LDL:HDL ratio and TAG (-0·089 per unit; 95 % CI -0·177, -0·002 and -5 % per unit; 95 % CI -9, 0, respectively) and positively associated with HDL-cholesterol (0·047 mmol/l per unit; 95 % CI 0·007, 0·088). For men, DQI was inversely associated with BMI (-3 %per unit; 95 % CI -5, -1), trunk fat (-1 % per unit; 95 % CI -2, -1), high-sensitivity C-reactive protein (-30 % per unit; 95 % CI -41, -16 %), HbA1c (-0·09 % per unit; 95 % CI -0·14, -0·04), insulin (-13 % per unit; 95 % CI -19, -7) and homoeostatic model assessment-insulin resistance (-14 % per unit; 95 % CI -21, -7). In women, DQI was positively associated with systolic blood pressure (2·6 mmHg per unit; 95 % CI 0·6, 4·6). In conclusion, higher adherence to the current Danish FBDG was associated with a more beneficial cardiometabolic risk profile in a Danish adult population with a minimum of one self-rated risk factor for IHD.

Hospital accreditation: staff experiences and perceptions.

PubMed

Bogh, Søren Bie; Blom, Ane; Raben, Ditte Caroline; Braithwaite, Jeffrey; Thude, Bettina; Hollnagel, Erik; Plessen, Christian von

2018-06-11

Purpose The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically. Design/methodology/approach In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis. Findings Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue. Practical implications Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives. Originality/value The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

Trends in the Danish work environment in 1990-2000 and their associations with labor-force changes.

PubMed

Burr, Hermann; Bjorner, Jakob B; Kristensen, Tage S; Tüchsen, Finn; Bach, Elsa

2003-08-01

The aims of this study were (i) to describe the trends in the work environment in 1990-2000 among employees in Denmark and (ii) to establish whether these trends were attributable to labor-force changes. The split-panel design of the Danish Work Environment Cohort Study includes interviews with three cross-sections of 6067, 5454, and 5404 employees aged 18-59 years, each representative of the total Danish labor force in 1990, 1995 and 2000. In the cross-sections, the participation rate decreased over the period (90% in 1990, 80% in 1995, 76% in 2000). The relative differences in participation due to gender, age, and region did not change noticeably. Jobs with decreasing prevalence were clerks, cleaners, textile workers, and military personnel. Jobs with increasing prevalence were academics, computer professionals, and managers. Intense computer use, long workhours, and noise exposure increased. Job insecurity, part-time work, kneeling work posture, low job control, and skin contact with cleaning agents decreased. Labor-force changes fully explained the decline in low job control and skin contact to cleaning agents and half of the increase in long workhours, but not the other work environment changes. The work environment of Danish employees improved from 1990 to 2000, except for increases in long workhours and noise exposure. From a specific work environment intervention point of view, the development has been less encouraging because declines in low job control, as well as skin contact to cleaning agents, were explained by labor-force changes.

Determinants for employer-paid health insurance coverage: a population-based study of the Danish labour force.

PubMed

Christensen, Ann; Søgaard, Rikke

2013-08-01

In 2002, the Danish tax law was changed, giving employees a tax exemption on supplemental, employer-paid health insurance. This might have conflicted with one of the key foundations of the healthcare system, namely equal access for equal needs. The aim of this study was to investigate determinants for employer-paid health insurance coverage. Because the policy change affected only people who were part of the labour force and because the public sector at that time had no tradition of providing fringe benefits, the analysis was restricted to the private labour force. The analysis was based on data from a range of Danish person-level and company-level registers (explanatory variables). These data were combined with information on insurance status obtained from the trade organisation for insurance (dependent variable). A logistic regression was performed to estimate the odds of having employer-paid health insurance coverage. The individuals who were most likely to be insured were those employed in foreign companies as mid-level managers within the field of building and construction. Other important variables were the number of persons employed in a company, gender, ethnicity, region of residence, years of education, and annual income. Both company and individual characteristics were found to be important and significant predictors for employer-paid health insurance coverage. The Danish tax exemption on private health insurance in the years 2002-12 thus seems to have led to inequality in employer-paid health insurance coverage.

Product line management in oncology: a Canadian experience.

PubMed

Wodinsky, H B; Egan, D; Markel, F

1988-01-01

More competition for finite resources and increasing regulation have led many hospitals to consider a strategic reorganization. Recently, one common reorganization strategy has been"product line management." Product line management can be broadly defined in terms of centralized program management, planning, and marketing strategies. In Canada, while strategic driving forces may be different, a product line management alternative has arisen in one of the most potentially complex product lines, cancer services. This article compares and contrasts the theoretical model for product line management development, with special reference to cancer services, to the experience of one Canadian medical center and cancer center.

Differences in stage of disease between migrant women and native Danish women diagnosed with cancer: results from a population-based cohort study.

PubMed

Norredam, Marie; Krasnik, Allan; Pipper, Christian; Keiding, Niels

2008-06-01

The aim of the study is to compare differences in cancer stage at diagnosis between migrant women and native Danish women. The stage is used as a clinical indicator of access to healthcare until the point of diagnosis. Refugees and family reunited migrants who received residence permits in Denmark from 1 January 1993 to 31 December 1999 were included and matched 1 : 4 on age and sex with a Danish-born reference population. Our final female population included 24 734 migrants and 123 670 controls. Civil registration numbers of the cohort were linked to the Danish Cancer Registry whereby cases were identified in the period 1.1.1993-31.12.2002. Only women from Eastern Europe and the Middle East were included. This amounted to 269 migrants and 1608 native Danes. Data from the Danish Cancer Registry included diagnosis, time of diagnosis and disease stage at diagnosis. Our initial analyses of migrant subgroups showed that migrant women had decreased odds ratios of being diagnosed at the local stage and increased odds of having unknown stage, although these tendencies were mainly not statistically significant. A subsequent analysis of an overall migrant effect on all cancer sites emphasized these tendencies. This analysis reached borderline significance for local versus nonlocal stage and significance for unknown versus known stage. Our results indicate that migrant women may experience barriers in access to healthcare until cancer diagnosis compared with Danish women. More research is, however, needed to confirm our results and to find out if they indicate general problems concerning migrants' access to healthcare in Denmark.

The COLD-SAT Experiment for Cryogenic Fluid Management Technology

NASA Technical Reports Server (NTRS)

Schuster, J. R.; Wachter, J. P.; Vento, D. M.

1990-01-01

Future national space transportation missions will depend on the use of cryogenic fluid management technology development needs for these missions. In-space testing will be conducted in order to show low gravity cryogenic fluid management concepts and to acquire a technical data base. Liquid H2 is the preferred test fluid due to its propellant use. The design of COLD-SAT (Cryogenic On-orbit Liquid Depot Storage, Acquisition, and Transfer Satellite), an Expendable Launch Vehicle (ELV) launched orbital spacecraft that will perform subcritical liquid H2 storage and transfer experiments under low gravity conditions is studied. An Atlas launch vehicle will place COLD-SAT into a circular orbit, and the 3-axis controlled spacecraft bus will provide electric power, experiment control, and data management, attitude control, and propulsive accelerations for the experiments. Low levels of acceleration will provide data on the effects that low gravity might have on the heat and mass transfer processes used. The experiment module will contain 3 liquid H2 tanks; fluid transfer, pressurization and venting equipment; and instrumentation.

The Danish Bereavement Response in 2015--Historic Development and Evaluation of Success

ERIC Educational Resources Information Center

Lytje, Martin

2018-01-01

In the 1980s, Norwegian researchers pioneered efforts towards developing school support for bereaved children. Eighteen years later, a Danish approach was created based on these foundations. This article explores the Danish school bereavement response plans (b-plans) and investigates their ability to support both teachers and bereaved children.…

The International Space of the Danish Testing Community in the Interwar Years

ERIC Educational Resources Information Center

Ydesen, Christian

2012-01-01

The focus of this article is to draw attention to the presence and importance of travelling ideas, knowledge, and practices in Danish history of educational testing. The article introduces and employs a spatial methodological approach in relation to the connections between the international testing community and the emerging Danish practice of…

Large-scale flow experiments for managing river systems

USGS Publications Warehouse

Konrad, Christopher P.; Olden, Julian D.; Lytle, David A.; Melis, Theodore S.; Schmidt, John C.; Bray, Erin N.; Freeman, Mary C.; Gido, Keith B.; Hemphill, Nina P.; Kennard, Mark J.; McMullen, Laura E.; Mims, Meryl C.; Pyron, Mark; Robinson, Christopher T.; Williams, John G.

2011-01-01

Experimental manipulations of streamflow have been used globally in recent decades to mitigate the impacts of dam operations on river systems. Rivers are challenging subjects for experimentation, because they are open systems that cannot be isolated from their social context. We identify principles to address the challenges of conducting effective large-scale flow experiments. Flow experiments have both scientific and social value when they help to resolve specific questions about the ecological action of flow with a clear nexus to water policies and decisions. Water managers must integrate new information into operating policies for large-scale experiments to be effective. Modeling and monitoring can be integrated with experiments to analyze long-term ecological responses. Experimental design should include spatially extensive observations and well-defined, repeated treatments. Large-scale flow manipulations are only a part of dam operations that affect river systems. Scientists can ensure that experimental manipulations continue to be a valuable approach for the scientifically based management of river systems.

Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases.

PubMed

Hald, Marianne; Arendrup, Maiken C; Svejgaard, Else L; Lindskov, Rune; Foged, Erik K; Saunte, Ditte Marie L

2015-01-01

Internationally approved guidelines for the diagnosis and management of Malassezia-related skin diseases are lacking. Therefore, a panel of experts consisting of dermatologists and a microbiologist under the auspices of the Danish Society of Dermatology undertook a data review and compiled guidelines for the diagnostic procedures and management of pityriasis versicolor, seborrhoeic dermatitis and Malassezia folliculitis. Main recommendations in most cases of pityriasis versicolor and seborrhoeic dermatitis include topical treatment which has been shown to be sufficient. As first choice, treatment should be based on topical antifungal medication. A short course of topical corticosteroid or topical calcineurin inhibitors has an anti-inflammatory effect in seborrhoeic dermatitis. Systemic antifungal therapy may be indicated for widespread lesions or lesions refractory to topical treatment. Maintenance therapy is often necessary to prevent relapses. In the treatment of Malassezia folliculitis systemic antifungal treatment is probably more effective than topical treatment but a combination may be favourable.

NASA cryogenic fluid management space experiment efforts, 1960-1990

NASA Technical Reports Server (NTRS)

Glover, Daniel

1991-01-01

A history of technological development for subcritical cryogenic fluid management (CFM) through space experiments is given for the period 1960 to 1990. Space experiments with liquid hydrogen were conducted in the early 1960's. Efforts since then have consisted of studies and designs of potential space experiments. A chronology of CFM space experiments and design efforts is included.

Clinicians' experiences of becoming a clinical manager: a qualitative study.

PubMed

Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

2012-11-22

There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals' decisions to engage in management. The aim of this study is to explore clinicians' journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. We found that there were three phases in clinicians' journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants' experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management "on the fly". Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Path dependency and social pressure seems to influence clinicians' decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary support functions are available locally, especially

Clinicians’ experiences of becoming a clinical manager: a qualitative study

PubMed Central

2012-01-01

Background There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals’ decisions to engage in management. The aim of this study is to explore clinicians’ journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. Methods We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. Results We found that there were three phases in clinicians’ journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants’ experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management “on the fly”. Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Conclusions Path dependency and social pressure seems to influence clinicians’ decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary

Feasibility of Representing a Danish Microbiology Model Using FHIR.

PubMed

Andersen, Mie Vestergaard; Kristensen, Ida Hvass; Larsen, Malene Møller; Pedersen, Claus Hougaard; Gøeg, Kirstine Rosenbeck; Pape-Haugaard, Louise B

2017-01-01

Achieving interoperability in health is a challenge and requires standardization. The newly developed HL7 standard: Fast Healthcare Interoperability Resources (FHIR) promises both flexibility and interoperability. This study investigates the feasibility of expressing a Danish microbiology message model content in FHIR to explore whether complex in-use legacy models can be migrated and what challenges this may pose. The Danish microbiology message model (the DMM) is used as a case to illustrate challenges and opportunities accosted with applying the FHIR standard. Mapping of content from DMM to FHIR was done as close as possible to the DMM to minimize migration costs except when the structure of the content did not fit into FHIR. From the DMM a total of 183 elements were mapped to FHIR. 75 (40.9%) elements were modeled as existing FHIR elements and 96 (52.5%) elements were modeled as extensions and 12 (6.6%) elements were deemed unnecessary because of build-in FHIR characteristics. In this study, it was possible to represent the content of a Danish message model using HL7 FHIR.

Mergers between Governmental Research Institutes and Universities in the Danish HE Sector

ERIC Educational Resources Information Center

Aagaard, Kaare; Hansen, Hanne Foss; Rasmussen, Jørgen Gulddahl

2016-01-01

This article presents an analysis of the mergers in the Danish Higher Education (HE)-sector with a particular emphasis on the 2007 mergers involving universities and Government Research Institutes (GRIs). Furthermore, it follows the post-merger processes up to 2014/2015 at two Danish universities and examines the consequences of the changes seen…

The Danish health system through an American lens.

PubMed

Davis, Karen

2002-02-01

The organization and financing of the Danish health care system was evaluated within the framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system and a 1-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. Primary care is much more accessible in Denmark than the USA. A mixed capitation-fee-for-service method of paying generalist physicians in Denmark ensures that everyone has a primary care physician and generalist physicians are responsive to providing services quickly, typically same-day appointments. An organized off-hours service ensures accessible care 24 h a day, 7 days a week. Denmark has the highest public satisfaction with health care, reflecting the value placed on accessibility of primary care. Inpatient hospital care consumes a disproportionate share of Danish health expenditures. Global hospital budgets provide little incentive for hospital or surgical productivity. Long waits for hospitalization, especially surgical procedures and cancellation of scheduled surgery, are a source of patient dissatisfaction. Women's health, patient health risk counseling and coordination of preventive and primary care are major weaknesses of the Danish health system. Patients have a choice of primary care physician within a given geographic area and may go to a hospital of their choice. However, patient surveys and feedback are underdeveloped and very little effort has been made to make services responsive to patients' preferences. While innovations in electronic prescribing are noteworthy, further development of health information technology is needed.

Labor-Management Cooperation: The American Experience.

ERIC Educational Resources Information Center

Siegel, Irving H.; Weinberg, Edgar

This book examines the wide range of opportunities, the attendant problems, and the potential benefits of labor-management cooperation. Cooperative arrangements are considered at different economic levels, and 65 cases are discussed. The first of 10 chapters sets up a conceptual framework for the review of American experience in cooperation.…

Annoying Danish Relatives: Comprehension and Production of Relative Clauses by Danish Children with and without SLI

ERIC Educational Resources Information Center

Jensen De Lopez, Kristine; Olsen, Lone Sundahl; Chondrogianni, Vasiliki

2014-01-01

This study examines the comprehension and production of subject and object relative clauses (SRCs, ORCs) by children with Specific Language Impairment (SLI) and their typically developing (TD) peers. The purpose is to investigate whether relative clauses are problematic for Danish children with SLI and to compare errors with those produced by TD…

Project management web tools at the MICE experiment

NASA Astrophysics Data System (ADS)

Coney, L. R.; Tunnell, C. D.

2012-12-01

Project management tools like Trac are commonly used within the open-source community to coordinate projects. The Muon Ionization Cooling Experiment (MICE) uses the project management web application Redmine to host mice.rl.ac.uk. Many groups within the experiment have a Redmine project: analysis, computing and software (including offline, online, controls and monitoring, and database subgroups), executive board, and operations. All of these groups use the website to communicate, track effort, develop schedules, and maintain documentation. The issue tracker is a rich tool that is used to identify tasks and monitor progress within groups on timescales ranging from immediate and unexpected problems to milestones that cover the life of the experiment. It allows the prioritization of tasks according to time-sensitivity, while providing a searchable record of work that has been done. This record of work can be used to measure both individual and overall group activity, identify areas lacking sufficient personnel or effort, and as a measure of progress against the schedule. Given that MICE, like many particle physics experiments, is an international community, such a system is required to allow easy communication within a global collaboration. Unlike systems that are purely wiki-based, the structure of a project management tool like Redmine allows information to be maintained in a more structured and logical fashion.

Appalachian residents’ experiences with and management of multiple morbidity

PubMed Central

Schoenberg, Nancy E.; Bardach, Shoshana H.; Manchikanti, Kavita N.; Goodenow, Anne C.

2011-01-01

Approximately three quarters of middle aged and older adults have at least two simultaneously occurring chronic conditions (“multiple morbidity” or MM), a trend expected to increase dramatically throughout the world. Rural residents, who tend to have fewer personal and health resources, are more likely to experience MM. To improve our understanding of the ways in which vulnerable, rural residents in the U.S. experience and manage MM, we interviewed twenty rural Appalachian residents with MM. We identified the following themes; (a) MM has multifaceted challenges and is viewed as more than the sum of its parts; (b) numerous challenges exist to optimal MM self-management, particularly in a rural, under-resourced context; however, (c) participants described strategic methods of managing multiple chronic conditions, including prioritizing certain conditions and management strategies and drawing heavily on assistance from informal and formal sources. PMID:21263063

Danish translation, cultural adaption and initial psychometric evaluation of the patient feedback form.

PubMed

Tolstrup, Lærke K; Pappot, Helle; Zangger, Graziella; Bastholt, Lars; Zwisler, Ann-Dorthe; Dieperink, Karin B

2018-04-27

No suitable Danish questionnaire exists to evaluate patient satisfaction with various patient reported outcome measures. Thus, the aim of this research project was to conduct a study on the translation and cultural adaption of an American patient reported experience measures questionnaire, "Patient Feedback Form", among Danish patients, and to examine selected psychometric properties within reliability. In the first phase of the study, the Patient Feedback Form was forward and backward translated following the methodology of existing guidelines. Subsequently, cognitive interviewing was performed with seven cancer patients and seven healthy persons (19-86 years old/6 men and 8 women) to ensure that questions were easy to understand and made sense to Danish interviewees. In the second phase, phone interviews were carried out with 95 prostate cancer patients after they had responded to the same Patient Feedback Form. Missing data was imputed using the Expectation-Maximization technique. To examine the structure of the questionnaire, an exploratory factor analysis was conducted. Cronbach's alpha was calculated to investigate internal consistency. There were only minor disagreements in the translation process, and the reconciliation went smoothly (phase 1). With regard to one item, however, it was difficult to reach a consensus. Through the qualitative validation process, the right solution was found. The results from the psychometric testing (phase 2) showed that four factors had an Eigen value > 1, but only one factor was extracted as the Scree plot had a clear "elbow", showing a one factor structure that explained 46.1% of the variance. The internal consistency was high as Cronbach's alpha was 0.89. The translated, culturally adapted, and validated version of the Patient Feedback Form seems to be suitable for measuring satisfaction with patient reported outcome measures in a Danish setting. While the results should be treated with caution due to the small sample

Community integration after deployment to Afghanistan: a longitudinal investigation of Danish soldiers.

PubMed

Karstoft, Karen-Inge; Armour, Cherie; Andersen, Søren B; Bertelsen, Mette; Madsen, Trine

2015-04-01

In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. In a prospective, longitudinal study of Danish soldiers deployed to Afghanistan in 2009 (N = 743), we assessed community reintegration difficulties 2.5 years after home coming (study sample: N = 454). Furthermore, symptoms of posttraumatic stress disorder (PTSD) were assessed before, during, and after deployment. Trajectories of PTSD symptoms from a previously published latent growth mixture modeling analysis were used to address whether community reintegration difficulties differ as a result of course and level of PTSD symptoms. Between 3.6 and 18.0% reported to have some, a lot, or extreme difficulties in reintegration domains such as interpersonal functioning, productivity, community involvement, and self-care. Mean level of reintegration difficulties differed significantly across six PTSD symptom trajectories (range 6.35-36.00); with more symptomatic trajectories experiencing greater community reintegration difficulties. Reintegration difficulties after deployment are present in less than 20% of Danish soldiers who return from Afghanistan. Difficulties are greater in individuals who follow symptomatic PTSD trajectories in the first years following deployment than in those who follow a low-stable trajectory with no or few symptoms.

Myeloproliferative Neoplasms in Danish Twins.

PubMed

Andersen, Michael Asger; Bjerrum, Ole Weis; Ranjan, Ajenthen; Skov, Vibe; Kruse, Torben A; Thomassen, Mads; Skytthe, Axel; Hasselbalch, Hans Carl; Christensen, Kaare

2018-01-01

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of diseases characterized by clonal hyperproliferation of immature and mature cells of the myeloid lineage. Genetic differences have been proposed to play a role in the development of MPNs. Monozygotic twin pairs with MPNs have been reported in a few case reports, but the MPN concordance pattern in twins remains unknown. All twin pairs born in the period 1900-2010 were identified in the nationwide Danish Twin Registry. Only pairs with both twins alive on January 1, 1977, and those born thereafter were included to allow identification in the Danish National Patient Registry. A total of 158 twin pairs were registered with an MPN diagnosis: 36 monozygotic, 104 dizygotic, and 18 pairs with unknown zygosity. MPNs were diagnosed in both twins in 4 pairs. The probandwise concordance rates for monozygotic twin pairs were higher than for dizygotic twin pairs (15 vs. 0%; p = 0.016). An estimated concordance rate of 15% (95% CI 0.059-0.31) is modest, but given the rarity of MPNs this finding is clinically relevant and provides further support for the role of genetic predisposition in the development of MPNs. © 2018 S. Karger AG, Basel.

Web-based learning in professional development: experiences of Finnish nurse managers.

PubMed

Korhonen, Teija; Lammintakanen, Johanna

2005-11-01

The aim of this article is to describe the nurse managers' expectations, attitudes and experiences on web-based learning before and after participation in a web-based course. Information technology has rapidly become more common in health care settings. However, little is known about nurse managers' experiences on web-based learning, although they have a crucial role in promoting the professional development of their staff. Diagnostic assignments (n = 18) written before and interviews (n = 8) taken after the web-based education. The data were analysed by inductive content analysis. Nurse managers found web-based education to be a suitable and modern method of learning. On the basis of their experience they found multiple ways to utilize web-based learning environments in health care. Information technology skills, equipment, support and time were considered essential in web-based learning. Additionally, they found that their own experience might lead to more widespread implementation of web-based learning in health care settings. Information technology skills of nurse managers and staff need to be developed in order to use information technology effectively. In order to learn in a web-based environment, everyone needs the opportunity and access to required resources. Additionally, nurse managers' own experiences are important to promote wider utilization of web-based learning.

Gastrointestinal nematodes and anthelmintic resistance in Danish goat herds☆

PubMed Central

Holm, Signe A.; Sörensen, Camilla R. L.; Thamsborg, Stig M.; Enemark, Heidi L.

2014-01-01

The prevalence of gastrointestinal parasites in Danish goats and the presence of anthelmintic resistance (AR) in 10 selected herds were investigated during April–September 2012. All Danish herds (n = 137) with 10 or more adult goats were invited to participate, and of these 27 herds met the inclusion criterion of more than 10 young kids never treated with anthelmintics. Questionnaire data on management were collected, and faecal samples from 252 kids were analysed by the McMaster technique. From all herds with a mean faecal egg count (FEC) above 300 eggs per g of faeces, pooled samples were stained with peanut agglutinin (PNA) for specific detection of Haemonchus contortus. Strongyle eggs were detected with an individual prevalence of 69%, including Nematodirus battus (3.6%) and other Nematodirus species (15.0%). Eimeria spp. were observed in 99.6% of the kids. H. contortus was found in 11 of 12 (92%) tested herds. Anthelmintics were used in 89% of the herds with mean treatment frequencies of 0.96 and 0.89 treatments per year for kids and adults, respectively. In 2011, new animals were introduced into 44% of the herds of which 25% practised quarantine anthelmintic treatments. In 10 herds the presence of AR was analysed by egg hatch assay and FEC reduction tests using ivermectin (0.3 mg/kg) or fenbendazole (10.0 mg/kg). AR against both fenbendazole and ivermectin was detected in seven herds; AR against fenbendazole in one herd, and AR against ivermectin in another herd. In conclusion, resistance to the most commonly used anthelmintics is widespread in larger goat herds throughout Denmark. PMID:25076056

Thermal energy management process experiment

NASA Technical Reports Server (NTRS)

Ollendorf, S.

1984-01-01

The thermal energy management processes experiment (TEMP) will demonstrate that through the use of two-phase flow technology, thermal systems can be significantly enhanced by increasing heat transport capabilities at reduced power consumption while operating within narrow temperature limits. It has been noted that such phenomena as excess fluid puddling, priming, stratification, and surface tension effects all tend to mask the performance of two-phase flow systems in a 1-g field. The flight experiment approach would be to attack the experiment to an appropriate mounting surface with a 15 to 20 meter effective length and provide a heat input and output station in the form of heaters and a radiator. Using environmental data, the size, location, and orientation of the experiment can be optimized. The approach would be to provide a self-contained panel and mount it to the STEP through a frame. A small electronics package would be developed to interface with the STEP avionics for command and data handling. During the flight, heaters on the evaporator will be exercised to determine performance. Flight data will be evaluated against the ground tests to determine any anomalous behavior.

Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002-2003.

PubMed

Mikkelsen, B E; Beck, A M; Lassen, A

2007-01-01

Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. The purpose of this study was to investigate whether the increased focus on nutritional problems in patients and nursing home residents has resulted in measurable progress. A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n=96) and nursing homes (n=898) in 1995 and 2002/3 (n=90) and (n=682), respectively. The study used compliance with selected issues in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food and nutrition contact persons, employing official recommendations and offering choice between three different menu energy levels. Hospitals had a higher compliance compared to nursing homes. In 1995, this was the case for all questions asked and differences were statistically significant. Also in 2002/3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results are analysed over the 8-year period. The only progress for nursing homes was that more homes had implemented feedback routines on acceptability of food service in 2002/3 than in 1995. The difference was statistically significant. For hospitals, however, no progress was found between 1995 and 2002/3. The attempts to improve the nutritional status of hospital patients and nursing home residents seem to have failed. Still, the initiatives taken to improve the situation seem relevant. Especially the nursing homes might

Genetic analysis of predicted fatty acid profiles of milk from Danish Holstein and Danish Jersey cattle populations.

PubMed

Hein, L; Sørensen, L P; Kargo, M; Buitenhuis, A J

2018-03-01

The objective of this study was to assess the genetic variability of the detailed fatty acid (FA) profiles of Danish Holstein (DH) and Danish Jersey (DJ) cattle populations. We estimated genetic parameters for 11 FA or groups of FA in milk samples from the Danish milk control system between May 2015 and October 2016. Concentrations of different FA and FA groups in milk samples were measured by mid-infrared spectroscopy. Data used for parameter estimation were from 132,732 first-parity DH cows and 21,966 first-parity DJ cows. We found the highest heritabilities for test day measurements in both populations for short-chain FA (DH = 0.16; DJ = 0.16) and C16:0 (DH = 0.14; DJ = 0.16). In DH, the highest heritabilities were also found for saturated FA and monounsaturated FA (both populations: 0.15). Genetic correlations between the fatty acid traits showed large differences between DH and DJ for especially short-chain FA with the other FA traits measured. Furthermore, genetic correlations of total fat with monounsaturated FA, polyunsaturated FA, short-chain FA, and C16:0 differed markedly between DH and DJ populations. In conclusion, we found genetic variation in the mid-infrared spectroscopy-predicted FA and FA groups of the DH and DJ cattle populations. This finding opens the possibility of using genetic selection to change the FA profiles of dairy cattle. The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Surveillance of maritime deaths on board Danish merchant ships, 1986-2009.

PubMed

Borch, Daniel F; Hansen, Henrik L; Burr, Hermann; Jepsen, Jørgen R

2012-01-01

A previous study demonstrated a high death rate among seafarers signed on Danish ships during the years 1986-1993. This study aimed to examine and analyse the subsequent development until 2009. A total of 356 fatalities were identified from data supplied from the Danish Maritime Authority, an insurance company, and other sources. Maritime deaths among seafarers signed on Danish ships comprise deaths from 1) accidents, suicides and homicides; and 2) disease on board. Deaths due to 2) occurring ashore within 30 days after signing off were included. The overall and mode-specific death rates were calculated for three eight-year observation periods. The rates for work-related fatal accidents were compared with the rates for land-based trades. All categories of maritime deaths were significantly reduced from 1986 to 2009 - in particular during the last eight-year period (Accidents 1986-1993: 66.6 per 100,000 person years, 2002-2009: 27.0 per 100,000 person years, diseases 49.5-26.1, suicides 14.4-7.8). In spite of the remarkable improvement since 1986, seafarers remain in 2002-2009 more than six times more likely to die from occupational accidents (including shipwrecks) than do workers ashore. The favourable trend of maritime deaths in the Danish merchant fleet may be due to 1) preventive measures - e.g. interventions relating to vessel safety, work environment, and improved medical care on board - and to 2) technological and organizational changes - e.g. newer and larger vessels in the Danish merchant fleet, changed composition of the workforce, and reduced shore leaves. The persisting excess risk warrants further preventive actions.

Danish Colorectal Cancer Group Database.

PubMed

Ingeholm, Peter; Gögenur, Ismail; Iversen, Lene H

2016-01-01

The aim of the database, which has existed for registration of all patients with colorectal cancer in Denmark since 2001, is to improve the prognosis for this patient group. All Danish patients with newly diagnosed colorectal cancer who are either diagnosed or treated in a surgical department of a public Danish hospital. The database comprises an array of surgical, radiological, oncological, and pathological variables. The surgeons record data such as diagnostics performed, including type and results of radiological examinations, lifestyle factors, comorbidity and performance, treatment including the surgical procedure, urgency of surgery, and intra- and postoperative complications within 30 days after surgery. The pathologists record data such as tumor type, number of lymph nodes and metastatic lymph nodes, surgical margin status, and other pathological risk factors. The database has had >95% completeness in including patients with colorectal adenocarcinoma with >54,000 patients registered so far with approximately one-third rectal cancers and two-third colon cancers and an overrepresentation of men among rectal cancer patients. The stage distribution has been more or less constant until 2014 with a tendency toward a lower rate of stage IV and higher rate of stage I after introduction of the national screening program in 2014. The 30-day mortality rate after elective surgery has been reduced from >7% in 2001-2003 to <2% since 2013. The database is a national population-based clinical database with high patient and data completeness for the perioperative period. The resolution of data is high for description of the patient at the time of diagnosis, including comorbidities, and for characterizing diagnosis, surgical interventions, and short-term outcomes. The database does not have high-resolution oncological data and does not register recurrences after primary surgery. The Danish Colorectal Cancer Group provides high-quality data and has been documenting an

Frameworks for defining and managing the wilderness experience

Treesearch

Robert E. Manning

2012-01-01

A large and growing body of research on outdoor recreation and the wilderness experience has been conducted over the nearly 50 years since passage of the Wilderness Act of 1964. A number of conceptual and empirical frameworks have emerged from this body of knowledge that can be used to help define and manage the wilderness experience.

Electrically Driven Thermal Management: Flight Validation, Experiment Development, Future Technologies

NASA Technical Reports Server (NTRS)

Didion, Jeffrey R.

2018-01-01

Electrically Driven Thermal Management is an active research and technology development initiative incorporating ISS technology flight demonstrations (STP-H5), development of Microgravity Science Glovebox (MSG) flight experiment, and laboratory-based investigations of electrically based thermal management techniques. The program targets integrated thermal management for future generations of RF electronics and power electronic devices. This presentation reviews four program elements: i.) results from the Electrohydrodynamic (EHD) Long Term Flight Demonstration launched in February 2017 ii.) development of the Electrically Driven Liquid Film Boiling Experiment iii.) two University based research efforts iv.) development of Oscillating Heat Pipe evaluation at Goddard Space Flight Center.

Culturally Relevant Management Education: Insights from Experience in Nunavut

ERIC Educational Resources Information Center

Wihak, Christine

2005-01-01

The author's experience with a Nunavut business management education program illustrates how to develop culturally relevant organizational behavior curriculum. The process initially involved interviews with Inuit Elders about culturally appropriate responses to scenarios of cultural conflicts in the workplace identified by Inuit managers. The…

The History We Need: Strategies of Citizen Formation in the Danish History Curriculum

ERIC Educational Resources Information Center

Jørgensen, Simon Laumann

2015-01-01

Teaching history in schools can be a significant policy instrument for shaping the identities of future citizens. The Danish curriculum for teaching history of 2009 aims at strengthening a sense of "Danishness" which calls for theoretical analysis. Focusing on this particular case, the paper develops a political theoretical frame for…

Subjective Experiences of Clients in a Voluntary Money Management Program.

PubMed

Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I

2013-01-01

A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients' day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients' day-to-day lives, and encouraging clients' control over their own affairs.

Subjective Experiences of Clients in a Voluntary Money Management Program

PubMed Central

Serowik, Kristin L.; Bellamy, Chyrell D.; Rowe, Michael; Rosen, Marc I.

2013-01-01

A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients’ day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients’ day-to-day lives, and encouraging clients’ control over their own affairs. PMID:24605071

The personal computer and GP-B management. [Gravity Probe experiment

NASA Technical Reports Server (NTRS)

Neighbors, A. K.

1986-01-01

The Gravity Probe-B (GP-B) experiment is one of the most sophisticated and challenging developments to be undertaken by NASA. Its objective is to measure the relativistic drift of gyroscopes in orbit about the earth. In this paper, the experiment is described, and the strategy of phased procurements for accomplishing the engineering development of the hardware is discussed. The microcomputer is a very convenient and powerful tool in the management of GP-B. It is used in creating and monitoring such project data as schedules, budgets, hardware procurements and technical and interface requirements. Commercially available software in word processing, database management, communications, spreadsheet, graphics and program management are used. Examples are described of the efficacy of the application of the computer by the management team.

Evaluating the biochemical methane potential (BMP) of low-organic waste at Danish landfills.

PubMed

Mou, Zishen; Scheutz, Charlotte; Kjeldsen, Peter

2014-11-01

The biochemical methane potential (BMP) is an essential parameter when using first order decay (FOD) landfill gas (LFG) generation models to estimate methane (CH4) generation from landfills. Different categories of waste (mixed, shredder and sludge waste) with a low-organic content and temporarily stored combustible waste were sampled from four Danish landfills. The waste was characterized in terms of physical characteristics (TS, VS, TC and TOC) and the BMP was analyzed in batch tests. The experiment was set up in triplicate, including blank and control tests. Waste samples were incubated at 55°C for more than 60 days, with continuous monitoring of the cumulative CH4 generation. Results showed that samples of mixed waste and shredder waste had similar BMP results, which was in the range of 5.4-9.1 kg CH4/ton waste (wet weight) on average. As a calculated consequence, their degradable organic carbon content (DOCC) was in the range of 0.44-0.70% of total weight (wet waste). Numeric values of both parameters were much lower than values of traditional municipal solid waste (MSW), as well as default numeric values in current FOD models. The sludge waste and temporarily stored combustible waste showed BMP values of 51.8-69.6 and 106.6-117.3 kg CH4/ton waste on average, respectively, and DOCC values of 3.84-5.12% and 7.96-8.74% of total weight. The same category of waste from different Danish landfills did not show significant variation. This research studied the BMP of Danish low-organic waste for the first time, which is important and valuable for using current FOD LFG generation models to estimate realistic CH4 emissions from modern landfills receiving low-organic waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of the organization and financing of the Danish health care system.

PubMed

Janssen, Richard

2002-02-01

The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on the reading of an extensive range of documents and literature on the Danish health care system, and a 1-week visit to health care authorities, providers and key persons. The present paper describes the main findings of one of the panel members. A quality assessment approach is combined with the principles of a SWOT analysis to assess the main features of the Danish health care system. In addition, a public health perspective has been used in judging the coherence of the subsystems of the health systems. It is concluded that the macro-efficiency of the health care system could be increased by improving the cooperation between the subsystems. The relatively high mortality rates suggest that greater input into health education programs could significantly improve the health status of the Danish population. Finally, it is suggested that the steering power of the public board be strengthened by transferring ownership of health care institutions to other hands (privatization).

Dementia and Traffic Accidents: A Danish Register-Based Cohort Study.

PubMed

Petersen, Jindong Ding; Siersma, Volkert; Nielsen, Connie Thurøe; Vass, Mikkel; Waldorff, Frans Boch

2016-09-27

As a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents. Our study aims to investigate the risk of road traffic-related accidents for people aged 65 years or older with a diagnosis of dementia in Denmark. We will conduct a nationwide population-based cohort study consisting of Danish people aged 65 or older living in Denmark as of January 1, 2008. The cohort is followed for 7 years (2008-2014). Individual's personal data are available in Danish registers and can be linked using a unique personal identification number. A person is identified with dementia if the person meets at least one of the following criteria: (1) a diagnosis of the disease in the Danish National Patient Register or in the Danish Psychiatric Central Research Register, and/or (2) at least one dementia diagnosis-related drug prescription registration in the Danish National Prescription Registry. Police-, hospital-, and emergency room-reported road traffic-related accidents occurred within the study follow-up are defined as the study outcome. Cox proportional hazard regression models are used for the main analysis. Our study protocol has 3 phases including data collection, data analysis, and reporting. The first phase of register-based data collection of 853,228 individual's personal information was completed in August, 2016. The next phase is data analysis, which is expected to be finished before December 2016, and thereafter writing publications based on the findings. The study started in January 2016 and will end in December 2018. This study covers the entire elderly population of Denmark, and thereby will avoid selection bias due to nonparticipation and loss to follow-up. Furthermore, this ensures that the study results are reliable and generalizable. However, underreporting of traffic-related accidents may occur, which will limit estimation

Dementia and Traffic Accidents: A Danish Register-Based Cohort Study

PubMed Central

Siersma, Volkert; Nielsen, Connie Thurøe; Vass, Mikkel; Waldorff, Frans Boch

2016-01-01

Background As a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents. Objective Our study aims to investigate the risk of road traffic-related accidents for people aged 65 years or older with a diagnosis of dementia in Denmark. Methods We will conduct a nationwide population-based cohort study consisting of Danish people aged 65 or older living in Denmark as of January 1, 2008. The cohort is followed for 7 years (2008-2014). Individual’s personal data are available in Danish registers and can be linked using a unique personal identification number. A person is identified with dementia if the person meets at least one of the following criteria: (1) a diagnosis of the disease in the Danish National Patient Register or in the Danish Psychiatric Central Research Register, and/or (2) at least one dementia diagnosis-related drug prescription registration in the Danish National Prescription Registry. Police-, hospital-, and emergency room-reported road traffic-related accidents occurred within the study follow-up are defined as the study outcome. Cox proportional hazard regression models are used for the main analysis. Results Our study protocol has 3 phases including data collection, data analysis, and reporting. The first phase of register-based data collection of 853,228 individual’s personal information was completed in August, 2016. The next phase is data analysis, which is expected to be finished before December 2016, and thereafter writing publications based on the findings. The study started in January 2016 and will end in December 2018. Discussion This study covers the entire elderly population of Denmark, and thereby will avoid selection bias due to nonparticipation and loss to follow-up. Furthermore, this ensures that the study results are reliable and generalizable. However, underreporting of traffic

Cancer incidence among Danish seafarers: a population based cohort study

PubMed Central

Kaerlev, L; Hansen, J; Hansen, H; Nielsen, P

2005-01-01

Aims: Seafarers aboard oil and chemical tankers may be exposed to many chemicals, including substances like benzene that are known to be carcinogenic. Other seafarers are exposed to engine exhaust, different oil products, and chemicals used aboard and some years ago asbestos was also used extensively in ships. The aim of this study was to study cancer morbidity among Danish seafarers in relation to type of ship and job title. Methods: A cohort of all Danish seafarers during 1986–1999 (33 340 men; 11 291 women) registered by the Danish Maritime Authority with an employment history was linked with the nationwide Danish Cancer Registry and followed up for cancer until the end of 2002. The number of person years at risk was 517 518. Standardised incidence ratios (SIR) were estimated by use of the corresponding national rates. Results: The SIR of all cancers combined was higher than expected: 1.26 (95% CI 1.19 to 1.32) for men and 1.07 (95% CI 0.95 to 1.20) for women. This was mainly due to an excess of cancer of the larynx, lung, tongue, mouth, pharynx, oesophagus, pancreas, kidney, urinary bladder, colon, and bone as well as skin melanomas among men (the three latter borderline significantly increased), and an excess of cancer of the lung, rectum, and cervix uteri among women. The differences in risk pattern for lung cancer between the different job categories among men ranged in terms of SIR from 1.2 (95% CI 0.9 to 1.7) (engine officers) to 2.3 (1.6 to 3.3) (engine room crew), and 4.1 (2.1 to 7.4) among maintenance crew. Non-officers had a 1.5 times higher lung cancer risk than officers. No increased occurrence of all lymphatic and haematopoietic malignancies combined was found for employees on tankers, but the number of cases was limited to a total of 7. Conclusions: Danish seafarers, especially men, face an increased overall cancer risk, in particular a risk for lung cancer and other tobacco associated cancers. PMID:16234401

Uterine bacterial flora in postpartum Danish Holstein dairy cows determined using DNA-based fingerprinting: correlation to uterine condition and calving management.

PubMed

Elkjær, K; Ancker, M-L; Gustafsson, H; Friggens, N C; Waldmann, A; Mølbak, L; Callesen, H

2013-04-01

The overall aim of this study was to describe uterine bacterial flora during the postpartum period in Danish Holstein cows using the Terminal Restriction Fragment Length Polymorphism (T-RFLP) method. This method produces a pattern of nucleic acid fragments from the microorganisms present, reflecting the "fingerprint" of the actual microbial flora. As well as characterizing changes in flora with time from calving and between herds, data were examined for strong relations between uterine bacterial flora, calving management and uterine condition. In total 125 Holstein cows from five herds were included, and for each cow calving management was recorded. Cows were clinically examined on average 8 (range 0-19) and 28 (range 22-38) days after calving, and a uterine sample was taken for bacterial identification using T-RFLP. Milk samples were taken weekly for progesterone analysis. Bacteria were found in all cows at both examinations, and the flora was composed of many species, including species not traditionally reported to be present in the bovine uterus. The bacterial composition differed according to days from calving and herd. In all five herds Fusobacterium necrophorum, Pseudomonas/Acinetobacter and Bacteroides/Sphingobacterium/Prevotellaceae were among the most common at both examinations. In four herds there was a percentage decrease of F. necrophorum from first to second examination, and in all herds there was a percentage increase of Pseudomonas/Acinetobacter from first to second examination. No differences in bacterial flora were found between cows with different uterine scores, which were influenced by herd, calving difficulty and retained placenta. Copyright © 2013 Elsevier B.V. All rights reserved.

A Conditions Data Management System for HEP Experiments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laycock, P. J.; Dykstra, D.; Formica, A.

Conditions data infrastructure for both ATLAS and CMS have to deal with the management of several Terabytes of data. Distributed computing access to this data requires particular care and attention to manage request-rates of up to several tens of kHz. Thanks to the large overlap in use cases and requirements, ATLAS and CMS have worked towards a common solution for conditions data management with the aim of using this design for data-taking in Run 3. In the meantime other experiments, including NA62, have expressed an interest in this cross- experiment initiative. For experiments with a smaller payload volume and complexity,more » there is particular interest in simplifying the payload storage. The conditions data management model is implemented in a small set of relational database tables. A prototype access toolkit consisting of an intermediate web server has been implemented, using standard technologies available in the Java community. Access is provided through a set of REST services for which the API has been described in a generic way using standard Open API specications, implemented in Swagger. Such a solution allows the automatic generation of client code and server stubs and further allows changes in the backend technology transparently. An important advantage of using a REST API for conditions access is the possibility of caching identical URLs, addressing one of the biggest challenges that large distributed computing solutions impose on conditions data access, avoiding direct DB access by means of standard web proxy solutions.« less

Self-efficacy in managing chronic respiratory disease: parents' experiences.

PubMed

Jones, Virginia; Whitehead, Lisa; Crowe, Marie Therese

2016-01-01

The aim of this study was to explore parent's sense of self-efficacy and the experiences that impact on this in relation to the management of their child's chronic respiratory disease. A qualitative study using a general inductive approach was taken. Semi-structured interviews with 23 parents were completed and thematic analysis employed to generate categories and themes. Parents described self-efficacy as important in their ability to maintain daily management of their child's health. The greatest impact on self-efficacy was an overwhelming sense of responsibility. Parents described an enduring sense of responsibility through ongoing vigilance and adherence to medical regimes. In order for parents to maintain self-efficacy in their care giving role, health professionals need an understanding of how best to support them to manage the sense of responsibility they experience.

Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.

PubMed

Fjølner, J; Greisen, J; Jørgensen, M R S; Terkelsen, C J; Ilkjaer, L B; Hansen, T M; Eiskjaer, H; Christensen, S; Gjedsted, J

2017-02-01

Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Japanese experiment module data management and communication system

NASA Astrophysics Data System (ADS)

Iizuka, Isao; Yamamoto, Harumitsu; Harada, Minoru; Eguchi, Iwao; Takahashi, Masami

The data management and communications system (DMCS) for the Japanese experiment module (JEM) being developed for the Space Station is described. Data generated by JEM experiments will be transmitted via TDRS (primary link) to the NASDA Operation Control Center. The DMSC will provide data processing, test and graphics handling, schedule planning support, and data display and facilitate subsystems, payloads, emergency operations, status, and diagnostics and healthchecks management. The ground segment includes a mainframe, mass storage, a workstation, and a LAN, with the capability of receiving and manipulating data from the JEM, the Space Station, and the payload. Audio and alert functions are also included. The DMCS will be connected to the interior of the module with through-bulkhead optical fibers.

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users.

PubMed

Olsen, Steen Østergaard; Lantz, Johannes; Nielsen, Lars Holme; Brännström, K Jonas

2012-09-01

The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users' ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5-8.8 dB. IOI-HA scores were not associated to ANL. Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.

Characterization of the genetic profile of five Danish dog breeds.

PubMed

Pertoldi, C; Kristensen, T N; Loeschcke, V; Berg, P; Praebel, A; Stronen, A V; Proschowsky, H F; Fredholm, M

2013-11-01

This investigation presents results from a genetic characterization of 5 Danish dog breeds genotyped on the CanineHD BeadChip microarray with 170,000 SNP. The breeds investigated were 1) Danish Spitz (DS; n=8), 2) Danish-Swedish Farm Dog (DSF; n=18), 3) Broholmer (BR; n=22), 4) Old Danish Pointing Dog (ODP; n=24), and 5) Greenland Dog (GD; n=23). The aims of the investigation were to characterize the genetic profile of the abovementioned dog breeds by quantifying the genetic differentiation among them and the degree of genetic homogeneity within breeds. The genetic profile was determined by means of principal component analysis (PCA) and through a Bayesian clustering method. Both the PCA and the Bayesian clustering method revealed a clear genetic separation of the 5 breeds. The level of genetic variation within the breeds varied. The expected heterozygosity (HE) as well as the degree of polymorphism (P%) ranked the dog breeds in the order DS>DSF>BR>ODP>GD. Interestingly, the breed with a tenfold higher census population size compared to the other breeds, the Greenland Dog, had the lowest within-breed genetic variation, emphasizing that census size is a poor predictor of genetic variation. The observed differences in variation among and within dog breeds may be related to factors such as genetic drift, founder effects, genetic admixture, and population bottlenecks. We further examined whether the observed genetic patterns in the 5 dog breeds can be used to design breeding strategies for the preservation of the genetic pool of these dog breeds.

Psychiatric disease incidence among Danish Seventh-day Adventists and Baptists.

PubMed

Thygesen, Lau Caspar; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Ross, Lone; Kessing, Lars Vedel; Hvidt, Niels Christian

2013-10-01

Previous studies suggest that religious practice can have a positive effect on mental health, but may also have potential for harm. In Denmark, unique possibilities are available for studying the influence of religious practice on mental health: Denmark is characterized as a secular society and it is possible to follow members of religious societies in nationwide registers. In this study, we follow a cohort of Danish Seventh-day Adventists (SDA) and Baptists in a nationwide psychiatry register and compare the incidence in this cohort with the general population. We followed a cohort of 5,614 SDA and 3,663 Baptists in the Danish Psychiatric Central Register, which contained information on psychiatric hospitalizations from 1970 to 2009. Psychiatric disease incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios and within-cohort comparisons were made with a Cox model. The cohort had decreased incidence of abuse disorders compared to the general population. Furthermore, among Baptists, decreased incidence of unipolar disorders among men and decreased incidence of schizophrenia among women were observed. Surprisingly, we observed an increased incidence rate of unipolar disorder among women. In this nationwide cohort study with 40 years of follow-up, we observed increased incidence rates of unipolar disorders among women and decreased rates of alcohol- and drug-related psychiatric disorders compared to the general Danish population. We have no mechanistic explanation for the increased incidence of unipolar disorders among women, but discuss several hypotheses that could explain this observation.

[Early achievements of the Danish pharmaceutical industry--3. Alfred Benzon].

PubMed

Grevsen, Jørgen V; Kirkegaard, Hanne; Kruse, Edith; Kruse, Poul R

2011-01-01

The article series provides a written and pictorial account of the Danish pharmaceutical industry's products from their introduction until about 1950. Part 3 deals with products from the company founded by Alfred Benzon in 1849. Alfred Nicolai Benzon owned the Swan Pharmacy in Copenhagen. In 1863 he started an independent company manufacturing branded pharmaceuticals, thus combining the pharmacy's activities with the wholesale business. The family owned the company until 1952, when it was converted into a foundation. After several restructuring rounds, the medicine production business continued as Benzon Pharma A/S until 1990, when Nycomed Pharma A/S bought up all the branded pharmaceuticals. As the first pharmaceutical company in Denmark, Alfred Benzon was an industrial frontrunner in the country at the time, supplying not only the domestic market but foreign markets as well. Alfred Benzon was the first Danish company to produce ether for anesthesia, and malt extract, a dietetic preparation. The high quality of both products made them valuable export articles. In the early 1890s, Alfred Benzon became the first Danish company to start the research-based production of extract of thyroid glands from slaughtered cattle. This was the beginning of a long-standing specialization in producing organotherapeutic substances from animal organs originating from Danish animal husbandry. In 1932 the company had 26 preparations of this type in its range, many of them on the market for several years. These medicine substances included iron preparations and effervescent salts followed by sulfonamides, synthetic hormones and a substance to counteract motion sickness.

The Danish health care system from a British perspective.

PubMed

Hurst, Jeremy

2002-02-01

The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weakness, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system, and a one-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. The dominance of tax financing helps to achieve control over the level of health care expenditure, as well as securing equity in financing the services. The reliance on local government for financing and running health care has both advantages and disadvantages, and the split between county and municipal responsibility leads to problems of co-ordination. The remuneration of general practitioners by a mix of capitation payment and fee for services has the advantage of capping expenditure whilst leaving the GPs with an incentive to compete for patients by providing them with good services. The GP service is remarkably economical. The hospital sector displays much strength, but there seem to be problems with respect to: (i) perceived lack of resources and waiting lists; (ii) impersonal care, lack of continuity of care and failures in communication between patients and staff; (iii) management problems and sometimes demotivated staff. The relationship between patients and providers is facilitated by free access to GPs and absence of any charges for hospital treatment. The biggest threat is continuation of avoidable illness caused by poor health habits in the population. The biggest opportunity is to strengthen public health measures to tackle these poor health habits.

Danish Breast Cancer Cooperative Group--DBCG: History, organization, and status of scientific achievements at 30-year anniversary.

PubMed

Blichert-Toft, Mogens; Christiansen, Peer; Mouridsen, Henning T

2008-01-01

DBCG (Danish Breast Cancer Cooperative Group) constitutes a multidisciplinary organization established in 1975 by the Danish Surgical Society. The purpose involves first and foremost a nation-wide standardization of breast cancer treatment based on novel therapeutic principles, collaboration between experts handling diagnostic work-up, surgery, radiotherapy, medical oncology, and basic research, and, further, complete registration of relevant clinical data in a national data base attached to DBCG. Data are processed by the Secretariat personnel composed of statisticians, data managers, and data secretaries making current analyses of outcome results feasible. DBCG is run by the Executive Committee consisting of expert members appointed by their respective society. From 1978 the DBCG project gained widely accession from participating units, and since then nearly all newly diagnosed breast cancer incident cases are reported and registered in the national data base. Today, the data base includes approximately 80 000 incidents of primary breast cancer. Annually, the Secretariat receives roughly 1.5 million parameters to be entered into the data base. Over time DBCG has generated seven treatment programmes including in situ lesions and primary invasive breast cancer. Probands are subdivided into risk groups based on a given risk pattern and allocated to various treatment programmes accordingly. The scientific initiatives are conducted in the form of register- and cohort analysis or randomized trials in national or international protocolized settings. Yearly, about 4 000 new incident cases of primary invasive breast cancer and about 200 in situ lesions enter the national programmes. Further, about 600 women with hereditary disposition of breast cancer are registered and evaluated on a risk scale. The main achievements resulted in a reduction of relative risk of death amounting up to 20% and increased 5-year overall survival ascending from 60% to roughly 80%. This article

Elaborating on theory with middle managers' experience implementing healthcare innovations in practice.

PubMed

Birken, Sarah A; DiMartino, Lisa D; Kirk, Meredith A; Lee, Shoou-Yih D; McClelland, Mark; Albert, Nancy M

2016-01-04

The theory of middle managers' role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers' experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers' experience in practice and (2) elaborate on the theory with examples from middle managers' experience overseeing innovation implementation in practice. Middle managers rated all of the theory's hypothesized four roles as "extremely important" but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory's hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance. Middle managers' experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

Preoperative airway assessment - experience gained from a multicentre cluster randomised trial and the Danish Anaesthesia Database.

PubMed

Nørskov, Anders Kehlet

2016-05-01

Difficulties with airway management in relation to general anaesthesia have been a challenge for the anaesthesiologist since the birth of anaesthesia. Massive landmark improvements have been made and general anaesthesia is now regarded as a safe procedure. However, rare, difficult airway management still occurs and it prompts increased risk of morbidity and mortality - especially when not anticipated. Several preoperative risk factors for airway difficulties have been identified, yet none have convincing diagnostic accuracy as stand alone tests. Combining several risk factors increase the predictive value of the test and multivariable risk models have been developed. The Simplified Airway Risk Index (SARI) is a predictive model developed for anticipation of a difficult direct laryngoscopy. However, neither the diagnostic accuracy of the SARI nor of any other model has been tested prospectively and compared with existing practice for airway assessment in a randomised trial setting. The first objective of this thesis was to quantify the proportion of unanticipated difficult intubation and difficult mask ventilation in Denmark. The second objective was to design a cluster randomised trial, using state of the art methodology, in order to test the clinical impact of using the SARI for preoperative airway assessment compared with a clinical judgement based on usual practice for airway assessment. Finally, to test if implementation of the SARI would reduce the proportion of unanticipated difficult intubation compared with usual care for airway assessment. This thesis is based on data from the Danish Anaesthesia Database (DAD). Paper 1 presents an observational cohort study on 188,064 patients who underwent tracheal intubation from 2008 to 2011. Data on the anaesthesiologists' preoperative anticipations of airway difficulties was compared with actual airway management conditions, thus enabling an estimation of the proportion of unanticipated difficulties with intubation

Managing occupations in everyday life for people with advanced cancer living at home.

PubMed

Peoples, Hanne; Brandt, Åse; Wæhrens, Eva E; la Cour, Karen

2017-01-01

People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed. To describe and explore how people with advanced cancer manage occupations when living at home. A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data. Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations. The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.

APP heterozygosity averts memory deficit in knockin mice expressing the Danish dementia BRI2 mutant.

PubMed

Tamayev, Robert; Matsuda, Shuji; Giliberto, Luca; Arancio, Ottavio; D'Adamio, Luciano

2011-05-17

An autosomal dominant mutation in the BRI2/ITM2B gene causes familial Danish dementia (FDD). Analysis of FDD(KI) mice, a mouse model of FDD genetically congruous to the human disease since they carry one mutant and one wild-type Bri2/Itm2b allele, has shown that the Danish mutation causes loss of Bri2 protein, synaptic plasticity and memory impairments. BRI2 is a physiological interactor of Aβ-precursor protein (APP), a gene associated with Alzheimer disease, which inhibits processing of APP. Here, we show that APP/Bri2 complexes are reduced in synaptic membranes of FDD(KI) mice. Consequently, APP metabolites derived from processing of APP by β-, α- and γ-secretases are increased in Danish dementia mice. APP haplodeficiency prevents memory and synaptic dysfunctions, consistent with a role for APP metabolites in the pathogenesis of memory and synaptic deficits. This genetic suppression provides compelling evidence that APP and BRI2 functionally interact, and that the neurological effects of the Danish form of BRI2 only occur when sufficient levels of APP are supplied by two alleles. This evidence establishes a pathogenic sameness between familial Danish and Alzheimer's dementias.

APP heterozygosity averts memory deficit in knockin mice expressing the Danish dementia BRI2 mutant

PubMed Central

Tamayev, Robert; Matsuda, Shuji; Giliberto, Luca; Arancio, Ottavio; D'Adamio, Luciano

2011-01-01

An autosomal dominant mutation in the BRI2/ITM2B gene causes familial Danish dementia (FDD). Analysis of FDDKI mice, a mouse model of FDD genetically congruous to the human disease since they carry one mutant and one wild-type Bri2/Itm2b allele, has shown that the Danish mutation causes loss of Bri2 protein, synaptic plasticity and memory impairments. BRI2 is a physiological interactor of Aβ-precursor protein (APP), a gene associated with Alzheimer disease, which inhibits processing of APP. Here, we show that APP/Bri2 complexes are reduced in synaptic membranes of FDDKI mice. Consequently, APP metabolites derived from processing of APP by β-, α- and γ-secretases are increased in Danish dementia mice. APP haplodeficiency prevents memory and synaptic dysfunctions, consistent with a role for APP metabolites in the pathogenesis of memory and synaptic deficits. This genetic suppression provides compelling evidence that APP and BRI2 functionally interact, and that the neurological effects of the Danish form of BRI2 only occur when sufficient levels of APP are supplied by two alleles. This evidence establishes a pathogenic sameness between familial Danish and Alzheimer's dementias. PMID:21587206

Non-operative management of blunt splenic injuries in a paediatric population: a 12-year experience.

PubMed

Kirkegård, Jakob; Avlund, Tue Højslev; Amanavicius, Nerijus; Mortensen, Frank Viborg; Kissmeyer-Nielsen, Peter

2015-02-01

Non-operative management (NOM) is now the primary treatment for blunt splenic injuries in children. Only one study has examined the use of NOM in a Scandinavian population. Thus, the purpose of this study is to report our experience in treating children with blunt splenic injuries with NOM at a Danish university hospital. We conducted a retrospective observational study of 34 consecutive children (aged 16 years or less) admitted to our level 1-trauma centre with blunt splenic injury in the 12-year period from 1 January 2001 to 31 December 2012. Data on patients and procedures were obtained by review of all medical records and re-evaluation of all initial computed tomographies (CT). We included 34 children with a median age of 10.5 years (67.6% males) in this study. All patients were scheduled for NOM, and two (5.9%) patients underwent splenic artery embolisation (SAE). Two (5.9%) patients later needed surgical intervention. The NOM success rate was 88% (95% confidence interval (CI): 73-97%) without SAE and 94% (95% CI: 80-99%) with SAE. We found no difference in the American Association for the Surgery of Trauma grade when comparing the initial CT evaluation (mean 2.59 ± 1.1) with the CT re-evaluation (mean 2.71 ± 0.94); p = 0.226. We demonstrated a high degree of success and safety of non-operative treatment in children with blunt splenic injury in a Scandinavian setting. Our results are comparable to international findings.

Turkish and Kurdish Speaking Teachers in the Danish Folkeskole: The Ambiguous Concept of Equality.

ERIC Educational Resources Information Center

Moldenhawer, Bolette

1999-01-01

Studied the functions of Turkish- and Kurdish-speaking teachers in the Danish "folkeskole" and their positions relative to other teachers in the system. Despite their Danish teaching qualifications, most still attend to the integration of Turkish- and Kurdish-speaking minority students and occupy a subordinate position to majority…

Adverse metabolic risk profiles in Greenlandic Inuit children compared to Danish children.

PubMed

Munch-Andersen, T; Sorensen, K; Andersen, L B; Aachmann-Andersen, N J; Aksglaede, L; Juul, A; Helge, J W

2013-06-01

During recent decades, the prevalence of metabolic morbidity has increased rapidly in adult Greenlandic Inuit. To what extent this is also reflected in the juvenile Inuit population is unknown. The objective was, therefore, in the comparison with Danish children, to evaluate metabolic profiles in Greenlandic Inuit children from the capital in the southern and from the northern most villages 187 Inuit and 132 Danish children were examined with anthropometrics, pubertal staging, fasting blood samples, and a maximal aerobic test. Both Inuit children living in Nuuk and the northern villages had significantly higher glucose, total cholesterol, apolipoprotein A1 levels, and diastolic blood pressure compared with Danish children after adjustment for differences in adiposity and aerobic fitness levels. The Inuit children living in Nuuk had significantly higher BMI, body fat %, HbA1 c, and significantly lower aerobic fitness and ApoA1 levels than northern living Inuit children. Greenlandic Inuit children had adverse metabolic health profile compared to the Danish children, the differences where more pronounced in Inuit children living in Nuuk. The tendencies toward higher prevalence of diabetes and metabolic morbidity in the adult Greenlandic Inuit population may also be present in the Inuit children population. Copyright © 2013 The Obesity Society.

Report on the activities of the Danish Atomic Energy Commission up to 31 March 1957

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1958-01-15

Activities of the Danish Atomic Energy Commission from its establishment in 1955 through March, 1957, are reported. The technical and administrative organization of the Commission are outlined. Contracts were signed for the purchase of two reactors. The site for a reactor research establishment was acquired on the Risoe Peninsula near Roskilde. Land for agricultural experiments was acquired nearby. Buildings and facilities were nearing completion by 1957. Training programs for personnel were held. Areas of international cooperation in the peaceful use of atomic energy are outlined. A statement of expenditures is included. (C.H.)

The Experience and Self-Management of Fatigue in Hemodialysis Patients

PubMed Central

Horigan, Ann E.; Schneider, Susan M.; Docherty, Sharron; Barroso, Julie

2013-01-01

Fatigue is a common and debilitating symptom for adult patients with end stage renal disease on hemodialysis and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. Currently, there is no description of the experience of fatigue for patients on hemodialysis living in the U.S., nor is there any description of the ways in which they manage their fatigue. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue. Several themes were identified which included: the nature of fatigue, management of fatigue, consequences of fatigue, and factors associated with fatigue. This information will be valuable to nephrology nurses as they continue to care for and educate patients on hemodialysis. PMID:23767335

Geodiversity of a large meander bend in the Little Belt strait in the inner Danish waters

NASA Astrophysics Data System (ADS)

Brandbyge Ernstsen, Verner; Øbro Hansen, Lars; Becker, Marius; Brivio, Lara; Vang, Torben; Lynnerup Trinhammer, Per; Andresen, Katrine Juul; Seidenkrantz, Marit-Solveig; Boldreel, Lars Ole; Bartholdy, Jesper

2017-04-01

The Little Belt strait in the inner Danish waters is characterised by a high biodiversity, and continuous monitoring of flora and fauna and the water quality is undertaken by the authorities. However, the surface sedimentology and geomorphology, i.e. elements of the geodiversity, are less well-constrained. The aim of this study is to investigate the surface sediment and morphology of a large meander bend (with a channel width of 1 km) located between the two bridges crossing the strait (a channel reach of 4 km) in order to assess a potential coupling between geodiversity and biodiversity. More specifically, the objectives are 1) to identify and classify morphological units for creating a geomorphological map, 2) to quantify surface material characteristics for creating a surface material map, and 3) to develop a conceptual model of the substrate and the morphology and morphodynamics in the meander bend between the two bridges in the strait. Preliminary results reveal a diverse morphology in the meander bend; and the annual morphological changes reveal complex sediment transport patterns along and across the bend. Likewise significant sediment sorting trends exist along and across the meander bend. Hence, the preliminary results indicate a high geodiversity in the strait. Acknowledgements The data were collected as part of the MSc course Marine Geoscience, a joint MSc course between the Department of Geosciences and Natural Resource Management at the University of Copenhagen and the Department of Geoscience at Aarhus University. Additional data were included from the research project Control in the Danish Straits 1 (CiDS-1) funded by the Danish Centre for Marine Research (PI Morten Holtegaard). Thanks to the crew on board RV Aurora.

Local Diversity and Identity versus Global Interactions: Changes in the Danish Higher Education System

ERIC Educational Resources Information Center

Langberg, Kamma; Schmidt, Evanthia Kalpazidou

2010-01-01

The Danish higher education system was until recent years characterized by local diversity. It comprised, in relation to the population size, a large number of rather small institutions and a large number of universities and other research institutions. Since 1990, the Danish higher education system has changed dramatically: The number of…

Comparison of Danish dichotomous and BI-RADS classifications of mammographic density.

PubMed

Hodge, Rebecca; Hellmann, Sophie Sell; von Euler-Chelpin, My; Vejborg, Ilse; Andersen, Zorana Jovanovic

2014-06-01

In the Copenhagen mammography screening program from 1991 to 2001, mammographic density was classified either as fatty or mixed/dense. This dichotomous mammographic density classification system is unique internationally, and has not been validated before. To compare the Danish dichotomous mammographic density classification system from 1991 to 2001 with the density BI-RADS classifications, in an attempt to validate the Danish classification system. The study sample consisted of 120 mammograms taken in Copenhagen in 1991-2001, which tested false positive, and which were in 2012 re-assessed and classified according to the BI-RADS classification system. We calculated inter-rater agreement between the Danish dichotomous mammographic classification as fatty or mixed/dense and the four-level BI-RADS classification by the linear weighted Kappa statistic. Of the 120 women, 32 (26.7%) were classified as having fatty and 88 (73.3%) as mixed/dense mammographic density, according to Danish dichotomous classification. According to BI-RADS density classification, 12 (10.0%) women were classified as having predominantly fatty (BI-RADS code 1), 46 (38.3%) as having scattered fibroglandular (BI-RADS code 2), 57 (47.5%) as having heterogeneously dense (BI-RADS 3), and five (4.2%) as having extremely dense (BI-RADS code 4) mammographic density. The inter-rater variability assessed by weighted kappa statistic showed a substantial agreement (0.75). The dichotomous mammographic density classification system utilized in early years of Copenhagen's mammographic screening program (1991-2001) agreed well with the BI-RADS density classification system.

Item analysis using Rasch models confirms that the Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules are valid and reliable.

PubMed

Nielsen, Julie Bøjstrup; Kyvsgaard, Julie Nyholm; Sildorf, Stine Møller; Kreiner, Svend; Svensson, Jannet

2017-03-01

Type 1 Diabetes (T1D) has a negative impact on psychological and overall well-being. Screening for Health-related Quality of Life (HrQoL) and addressing HrQoL issues in the clinic leads to improved well-being and metabolic outcomes. The aim of this study was to translate the generic and diabetes-specific validated multinational DISABKIDS® questionnaires into Danish, and then determine their validity and reliability. The questionnaires were translated using a validated translation procedure and completed by 99 children and adolescents from our diabetes-department; all diagnosed with T1D and were aged between 8 and 18 years old. The Rasch and the graphical log linear Rasch model (GLLRM) were used to determine validity. Monte Carlo methods and Cronbach's α were used to confirm reliability. The data did not fit a pure Rasch model but did fit a GLLRM when item six in the independence scale is excluded. The six subscales measure different aspects of HrQoL indicating that all the subscales are necessary. The questionnaire shows local dependency between items and differential item functioning (DIF). Therefore age, gender, and glycated hemoglobin (HbA1c) levels must be taken into account when comparing HrQoL between groups. The Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules provide valid and objective measurements with adequate reliability. These Danish versions are useful tools for evaluating HrQoL in Danish patients with T1D. However, guidelines on how to manage DIF and local independence will be required, and item six should be rephrased.

Sensemaking, Sensegiving and Strategic Management in Danish Higher Education

ERIC Educational Resources Information Center

Degn, Lise

2015-01-01

Strategic management and leadership has been a vital catchphrase in most European higher education reforms over the past decade, and has in many countries resulted in a strengthening of the top level management tiers. Rectors and Deans are increasingly tasked with the responsibility of turning HEIs into more active, entrepreneurial actors in…

The Danish Anaesthesia Database.

PubMed

Antonsen, Kristian; Rosenstock, Charlotte Vallentin; Lundstrøm, Lars Hyldborg

2016-01-01

The aim of the Danish Anaesthesia Database (DAD) is the nationwide collection of data on all patients undergoing anesthesia. Collected data are used for quality assurance, quality development, and serve as a basis for research projects. The DAD was founded in 2004 as a part of Danish Clinical Registries (Regionernes Kliniske Kvalitetsudviklings Program [RKKP]). Patients undergoing general anesthesia, regional anesthesia with or without combined general anesthesia as well as patients under sedation are registered. Data are retrieved from public and private anesthesia clinics, single-centers as well as multihospital corporations across Denmark. In 2014 a total of 278,679 unique entries representing a national coverage of ~70% were recorded, data completeness is steadily increasing. Records are aggregated for determining 13 defined quality indicators and eleven defined complications all covering the anesthetic process from the preoperative assessment through anesthesia and surgery until the end of the postoperative recovery period. Registered variables include patients' individual social security number (assigned to all Danes) and both direct patient-related lifestyle factors enabling a quantification of patients' comorbidity as well as variables that are strictly related to the type, duration, and safety of the anesthesia. Data and specific data combinations can be extracted within each department in order to monitor patient treatment. In addition, an annual DAD report is a benchmark for departments nationwide. The DAD is covering the anesthetic process for the majority of patients undergoing anesthesia in Denmark. Data in the DAD are increasingly used for both quality and research projects.

Older persons' lived experiences of depression and self-management.

PubMed

Holm, Anne Lise; Lyberg, Anne; Lassenius, Erna; Severinsson, Elisabeth; Berggren, Ingela

2013-10-01

Mental ill-health, such as depression in the elderly, is a complex issue that is influenced by the life-world perspective of older persons. Their self-management ability should be strengthened based on an understanding of their situation, perspectives, and vulnerability. The aim of this study was to explore and increase understanding of old persons' lived experiences of depression and self-management using an interpretative explorative design. Understanding was developed by means of hermeneutic interpretation. One theme, Relationships and Togetherness, and four subthemes, A Sense of Carrying a Shoulder Bag, Walking on Eggshells, Holding the Reins, and Estrangement--a Loss of Togetherness, emerged. A collaborative approach can be important for empowering older persons through self-development and management. Although the findings of the present study cannot be considered conclusive or definitive, they nevertheless contribute new knowledge of older persons' lived experiences of depression in everyday life.

Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

PubMed

Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

2014-12-15

The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Defining and managing the quality of wilderness recreation experiences

Treesearch

Robert E. Manning; David W. Lime

2000-01-01

There is a substantial body of scientific literature on defining and managing the quality of wilderness experiences. Two conceptual frameworks derived from this literature—carrying capacity and the Recreation Opportunity Spectrum (ROS)—suggest that wilderness recreation experiences can be defined through indicators and standards of quality, and that wilderness...

Experiment Management System for the SND Detector

NASA Astrophysics Data System (ADS)

Pugachev, K.

2017-10-01

We present a new experiment management system for the SND detector at the VEPP-2000 collider (Novosibirsk). An important part to report about is access to experimental databases (configuration, conditions and metadata). The system is designed in client-server architecture. User interaction comes true using web-interface. The server side includes several logical layers: user interface templates; template variables description and initialization; implementation details. The templates are meant to involve as less IT knowledge as possible. Experiment configuration, conditions and metadata are stored in a database. To implement the server side Node.js, a modern JavaScript framework, has been chosen. A new template engine having an interesting feature is designed. A part of the system is put into production. It includes templates dealing with showing and editing first level trigger configuration and equipment configuration and also showing experiment metadata and experiment conditions data index.

A Small Business Management Entrepreneurship Curriculum: A Dual Progression Experience.

ERIC Educational Resources Information Center

Kuratko, Donald; LaFollette, William R.

1986-01-01

Describes Ball State University's "dual progression" curriculum for the small business management program. The program seeks to combine the best elements of entrepreneurial theory with the difficult facets of practical experience. The five major component courses (small business ventures, entrepreneurship, management information systems,…

Cultural Bases of Risk Behavior: Danish Adolescents.

ERIC Educational Resources Information Center

Arnett, Jeffrey; Balle-Jensen, Lene

1993-01-01

Risk behavior was investigated among 1,053 Danish adolescents aged 12-20. Behaviors included those related to driving, sex, and marijuana and other drug use. Found driving a car while intoxicated was rare even among oldest adolescents, though the majority reported riding a bicycle while intoxicated. Participation in risk behavior was analyzed in…

Gender stereotyping in television advertisements: a study of French and Danish television.

PubMed

Furnham, A; Babitzkow, M; Uguccioni, S

2000-02-01

Two similar, but not identical, content analyses of the portrayals of men and women in French and Danish television advertisements are reported. By partially replicating and extending past investigations conducted in America, Australia, Britain, Hong Kong, Indonesia, Italy, Kenya, and New Zealand, it was predicted that there would be more gender stereotyping in French television advertisements and less gender stereotyping in Danish television advertisements. In the first study, 165 French television advertisements were analyzed by following established coding categories (A. Furnham & E. Skae, 1997; L. Z. McArthur & B. G. Resko, 1975). Contrary to prediction, the results showed that traditional gender role portrayal on French television was no different from that found in other countries. Separate statistical analyses were carried out for visually versus aurally classified central figures, yet this yielded relatively few significant differences. In the second study, a sample of 151 Danish advertisements was analyzed; results showed that Danish television was generally less gender stereotypic than French television in its portrayal of women. Exactly half (5) of the coding categories showed significant differences. Finally, an international statistical comparison between these two studies and similar research in Australia, Britain, and Italy was carried out. The methodological implications of these results are discussed as well as the theoretical issues arising from other studies of this sort.

Transportation Management For Corridors And Activity Centers: Opportunities And Experiences, Final Report

DOT National Transportation Integrated Search

1986-05-01

THIS REPORT CONSISTS OF TWO SECTIONS, TRANSPORTATION MANAGEMENT FOR CORRIDORS AND TRANSPORTATION MANAGEMENT FOR ACTIVITY CENTERS, THAT DESCRIBE TRANSPORTATION MANAGEMENT EXPERIENCES IN THE UNITED STATES. : CASE STUDIES ARE THE FOCUS OF EACH SECTIO...

Flight experience with flight control redundancy management

NASA Technical Reports Server (NTRS)

Szalai, K. J.; Larson, R. R.; Glover, R. D.

1980-01-01

Flight experience with both current and advanced redundancy management schemes was gained in recent flight research programs using the F-8 digital fly by wire aircraft. The flight performance of fault detection, isolation, and reconfiguration (FDIR) methods for sensors, computers, and actuators is reviewed. Results of induced failures as well as of actual random failures are discussed. Deficiencies in modeling and implementation techniques are also discussed. The paper also presents comparison off multisensor tracking in smooth air, in turbulence, during large maneuvers, and during maneuvers typical of those of large commercial transport aircraft. The results of flight tests of an advanced analytic redundancy management algorithm are compared with the performance of a contemporary algorithm in terms of time to detection, false alarms, and missed alarms. The performance of computer redundancy management in both iron bird and flight tests is also presented.

German experience in managing stormwater with green infrastructure

EPA Science Inventory

This paper identifies and describes experience with ‘green’ stormwater management practices in Germany. It provides the context in which developments took place and extracts lessons learned to inform efforts of other countries in confronting urban stormwater challenges. Our findi...

Experiment module concepts study. Volume 1: Management summary

NASA Technical Reports Server (NTRS)

1970-01-01

The minimum number of standardized (common) module concepts that will satisfy the experiment program for manned space stations at least cost is investigated. The module interfaces with other elements such as the space shuttle, ground stations, and the experiments themselves are defined. The total experiment module program resource and test requirements are also considered. The minimum number of common module concepts that will satisfy the program at least cost is found to be three, plus a propulsion slice and certain experiment-peculiar integration hardware. The experiment modules rely on the space station for operational, maintenance, and logistic support. They are compatible with both expendable and shuttle launch vehicles, and with servicing by shuttle, tug, or directly from the space station. A total experiment module program cost of approximately $2319M under the study assumptions is indicated. This total is made up of $838M for experiment module development and production, $806M for experiment equipment, and $675M for interface hardware, experiment integration, launch and flight operations, and program management and support.

Experience of hypertensive patients with self-management of health care.

PubMed

Balduino, Anice de Fátima Ahmad; Mantovani, Maria de Fátima; Lacerda, Maria Ribeiro; Marin, Maria José Sanches; Wal, Marilene Loewen

2016-11-01

The aim of this study was to interpret how hypertensive patients experience health care self-management. Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. Qualitative study. Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities. © 2016 John Wiley & Sons Ltd.

Development and validation of a brief, descriptive Danish pain questionnaire (BDDPQ).

PubMed

Perkins, F M; Werner, M U; Persson, F; Holte, K; Jensen, T S; Kehlet, H

2004-04-01

A new pain questionnaire should be simple, be documented to have discriminative function, and be related to previously used questionnaires. Word meaning was validated by using bilingual Danish medical students and asking them to translate words taken from the Danish version of the McGill pain questionnaire into English. Evaluative word value was estimated using a visual analog scale (VAS). Discriminative function was assessed by having patients with one of six painful conditions (postherpetic neuralgia, phantom limb pain, rheumatoid arthritis, ankle fracture, appendicitis, or labor pain) complete the questionnaire. We were not able to find Danish words that were reliably back-translated to the English words 'splitting' or 'gnawing'. A simple three-word set of evaluative terms had good separation when rated on a VAS scale ('let' 17.5+/-6.5 mm; 'moderat' 42.7+/-8.6 mm; and 'staerk' 74.9+/-9.7 mm). The questionnaire was able to discriminate among the six painful conditions with 77% accuracy by just using the descriptive words. The accuracy of the questionnaire increased to 96% with the addition of evaluative terms (for pain at rest and with activity), chronicity (acute vs. chronic), and location of the pain. A Danish pain questionnaire that subjects and patients can self-administer has been developed and validated relative to the words used in the English McGill Pain questionnaire. The discriminative ability of the questionnaire among some common painful conditions has been tested and documented. The questionnaire may be of use in patient care and research.

Managing recreation areas for quality user experiences: a theoretical framework

Treesearch

Thomas A. More; Gregory J. Buhyoff

1979-01-01

The production of opportunities for high-quality visitor experiences is a basic goal of recreation management. Recreation quality can be interpreted using concepts from psychological field theory to relate emotion to the strength of motivation. Applications to on-site management for recreation quality and use regulation are suggested.

The Danish Perspective on Baltic Security.

DTIC Science & Technology

1998-01-01

policy. This socialist wing mirrors a general reluctance in the population against engaging in a centralized federal European union. This reluctance...minister Andrei Kozyrev in 1993 that an effective presence in Kaliningrad is essential, and he characterized the area as the cornerstone of Russian...government and was able to heavily influence Denmark’s NATO policy. The socialist wing mirrors a general reluctance of the Danish populace to

Organization and financing of the Danish health care system.

PubMed

Christiansen, Terkel

2002-02-01

The present paper aims at giving a short overview of the organization and financing of the Danish health care system as of 1997-1998 when the SWOT panel evaluated the system. The overview follows the triangular model of a health care system. The Danish system is characterized by being decentralized and single-funded. The hospital sector is public, and hospitals are financed and run by the counties (with only a very small private hospital sector alongside). General practitioners are private entrepreneurs but work under contract for the counties. Hospitals are financed by global budgets, while general practitioners are paid by a mixed remuneration system of capitation fees and fee-for-service. During the past 20 years, the government has repeatedly imposed budget ceilings on the counties which has limited growth in the health care sector.

Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study.

PubMed

Longard, Julie; Twycross, Alison; Williams, Anna M; Hong, Paul; Chorney, Jill

2016-09-01

To understand parents' experiences of managing their child's postoperative pain at home. Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home. Participants were parents of 10 typically developing 5- and 6-year olds, who underwent (adeno)tonsillectomy, and experienced no complications leading to hospitalisation in the postoperative period. One-on-one interviews were conducted with parents within three months of their child's surgery. Interviews were transcribed verbatim and content analysis was used to identify themes in parents' experiences. All children experienced some postoperative pain. Parents' experiences of managing their child's pain were impacted by balancing the pros and cons of administering analgesic medications, managing the emotional and psychological effects of their child's pain, as well as parents' information needs. Most parents' information needs were met yet they still struggled to manage their child's pain. These findings provide insight into some of the barriers that make this process challenging for many families, and what health care centres can do to help support parents manage their child's postoperative pain at home. The results of this study may aid in the design of interventions that will support parents when managing their child's postoperative pain at home and thus improve children's experiences. © 2016 John Wiley & Sons Ltd.

Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R).

PubMed

Botti, Mari; Khaw, Damien; Jørgensen, Emmy Brandt; Rasmussen, Bodil; Hunter, Susan; Redley, Bernice

2015-08-01

This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), a measure of the quality of postoperative pain management used internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from 2 point prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients, respectively. Parallel analysis indicated 4- and 3-factor solutions for Danish and Australian patients, respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α = .54) and Australian (Cronbach α = .63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience," but not "pain management." This finding reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference, whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings with past research conducted in the United States and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience" but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted the difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R. Copyright © 2015

Opioids and Breast Cancer Recurrence: A Danish population-based cohort study

PubMed Central

Cronin-Fenton, D.P.; Heide-Jørgensen, U.; Ahern, T.P.; Lash, T.L.; Christiansen, P.M.; Ejlertsen, B.; Sjøgren, P.; Kehlet, H.; Sørensen, H.T.

2015-01-01

Background Opioids may alter immune function and thereby potentially affect cancer recurrence. We investigated the association between post-diagnosis opioid use and breast cancer recurrence. Methods We identified incident early-stage breast cancer patients, diagnosed 1996-2008 in Denmark, registered in the Danish Breast Cancer Cooperative Group Registry. Opioid prescriptions were ascertained from the Danish National Prescription Registry. Follow-up began on the date of breast cancer primary surgery and continued until breast cancer recurrence, death, emigration, ten years, or 31 July 2013, whichever occurred first. We used Cox regression models to compute hazard ratios (HRs) and 95% confidence intervals (95%CI) associating breast cancer recurrence with opioid prescription use overall, and by opioid type and strength, immunosuppressive effect, chronic use (>=6 months continuous exposure), and cumulative morphine-equivalent dose, adjusting for confounders. Results We identified 34,188 patients who together contributed 283,666 person-years of follow-up. There was no association between ever use of opioids and breast cancer recurrence (HRcrude=0.98, 95% CI=0.90 - 1.1, and HRadjusted=1.0, 95% CI=0.92 - 1.1), regardless of opioid type, strength, chronicity of use, and cumulative dose. Breast cancer recurrence rates were lower among users of strong but not weakly immunosuppressive opioids, possibly due to channeling bias among those with high competing risk as mortality was higher among users of this drug type. Conclusions This large prospective cohort study provided no clinically relevant evidence of an association between opioid prescriptions and breast cancer recurrence. Our findings are important to cancer survivorship, as opioids are frequently used to manage pain associated with comorbid conditions. PMID:26207518

Rationale, design, and baseline characteristics of the DANish randomized, controlled, multicenter study to assess the efficacy of Implantable cardioverter defibrillators in patients with non-ischemic Systolic Heart failure on mortality (DANISH).

PubMed

Thune, Jens Jakob; Pehrson, Steen; Nielsen, Jens Cosedis; Haarbo, Jens; Videbæk, Lars; Korup, Eva; Jensen, Gunnar; Hildebrandt, Per; Steffensen, Flemming Hald; Bruun, Niels Eske; Eiskjær, Hans; Brandes, Axel; Thøgersen, Anna Margrethe; Egstrup, Kenneth; Hastrup-Svendsen, Jesper; Høfsten, Dan Eik; Torp-Pedersen, Christian; Køber, Lars

2016-09-01

The effect of an implantable cardioverter defibrillator (ICD) in patients with symptomatic systolic heart failure (HF) caused by coronary artery disease is well documented. However, the effect of primary prophylactic ICDs in patients with systolic HF not due to coronary artery disease is much weaker. In addition, HF management has improved, since the landmark ICD trials and a large proportion of patients now receive cardiac resynchronization therapy (CRT) where the effect of ICD treatment is unknown. In the DANISH study, 1,116 patients with symptomatic systolic HF not caused by coronary artery disease have been randomized to receive an ICD or not, in addition to contemporary standard therapy. The primary outcome of the trial is time to all-cause death. Follow-up will continue until June 2016 with a median follow-up period of 5 years. Baseline characteristics show that enrolled patients are treated according to current guidelines. At baseline, 97% of patients received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 92% received a β-blocker, 58% a mineralocorticoid receptor antagonist, and 58% were scheduled to receive CRT. Median age was 63 years (range, 21-84 years) at baseline, and 28% were women. DANISH will provide pertinent information about the effect on all-cause mortality of a primary prophylactic ICD in patients with symptomatic systolic HF not caused by coronary artery disease on contemporary standard therapy including CRT. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding the Work-Life Experiences and Goals of Women Middle Managers in Higher Education

ERIC Educational Resources Information Center

Hankinson, Marie

2013-01-01

Middle managers in higher education hold diverse titles and perform a variety of roles. Women represent a large portion of this midlevel management, but there is limited research exploring their experiences. As a result, little is known about women middle managers' career trajectories and what effect their experiences have on their future career…

Women's experiences of three early miscarriage management options: a qualitative study.

PubMed

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-03-01

Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5-2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the 'baby'; and pain and bleeding. Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and problems from the women's point of view. Competence and caring from

Stages of Learning during a Self-Directed Stress Management Experience

ERIC Educational Resources Information Center

Larson, Karl L.

2015-01-01

Purpose: The purpose of the study was to document the stages of learning reflected through student journaling during a self-directed experience in stress management, and the relationship of those stages to a historical model. Methods: College students participating in a full-semester course in stress management theory were required to select a…

Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation.

PubMed

Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch; Christensen, Henrik Wulff

2016-01-01

Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. We designed a convergent parallel, mixed methods study. Our purposive sampling framework identified 11 chiropractic clinics from which we collected observational field notes, video recordings and face-to-face interviews. Data was collected between April 14(th) and June 26(th) 2014. We described the exteriors and interiors of all participant clinics, interviewed 32 staff members, 12 new patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic location, practice model and interior design may contribute to context effects and thus may influence value perception during the clinical encounter. The duration of hands-on treatment received from the chiropractor is not an apparent consumer focus point. Rather, through a seven stage clinical procedure patients value consultations with clinicians who demonstrate professional competence by effective communication diagnosis/management and facilitating satisfactory treatment outcomes. At least six

Instrument translation and initial psychometric evaluation of the Danish Body Image Quality of Life Inventory.

PubMed

Rasmussen, Trine Bernholdt; Berg, Selina Kikkenborg; Dixon, Jane; Moons, Philip; Konradsen, Hanne

2016-12-01

Negative body perception has been reported in a number of patient populations. No instrument in Danish for measuring body image-related concerns has been available. Without such an instrument, understanding of the phenomenon in Danish-speaking populations is limited. The purpose of the study was thus to translate and validate a Danish version of the Body Image Quality of Life Inventory (BIQLI), in order to obtain a valid instrument applicable for healthcare research. The study consisted of two phases: (i) instrument adaptation, including forward and back translation, expert committee comparisons and cognitive interviewing, and (ii) empirical testing of the Danish version (BIQLI-DA) with subsequent psychometric evaluation. Hypothesised correlations to other measures, including body mass index (BMI), Medical Outcome Short Form-8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 and Symptom Check List-90-Revised (SCL-90-R ® ) were tested. In addition, exploratory factor structure analysis (EFA) and internal consistency on item and scale level were performed. The adapted instrument was found to be semantically sound, yet concerns about face validity did arise through cognitive interviews. Danish college students (n = 189, 65 men, M age = 21.1 years) participated in the piloting of the BIQLI-DA. Convergent construct validity was demonstrated through associations to related constructs. Exploratory factor analysis revealed a potential subscale structure. Finally, results showed a high internal consistency (Cronbach's alpha = 0.92). Support for the validity of the BIQLI-DA might have been strengthened by repeating cognitive interviews after layout alterations, by piloting the instrument on a larger sample. This study demonstrated tentative support for the validity of the Danish Body Image Quality of Life (BIQLI-DA) and found the measure to be reliable in terms of internal consistency. Further exploration of response processes and construct

The Danish Neuro-Oncology Registry: establishment, completeness and validity.

PubMed

Hansen, Steinbjørn; Nielsen, Jan; Laursen, René J; Rasmussen, Birthe Krogh; Nørgård, Bente Mertz; Gradel, Kim Oren; Guldberg, Rikke

2016-08-30

The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database completeness of patient registration and validity of data. The completeness of the number of patients registered in the database was evaluated in the study period from January 2009 through December 2014 by comparing cases reported to the DNOR with the Danish National Patient Registry and the Danish Pathology Registry. The data validity of important clinical variables was evaluated by a random sample of 100 patients from the DNOR using the medical records as reference. A total of 2241 patients were registered in the DNOR by December 2014 with an overall patient completeness of 92 %, which increased during the study period (from 78 % in 2009 to 96 % in 2014). Medical records were available for all patients in the validity analyses. Most variables showed a high agreement proportion (56-100 %), with a fair to good chance-corrected agreement (k = 0.43-1.0). The completeness of patient registration was very high (92 %) and the validity of the most important patient data was good. The DNOR is a newly established national database, which is a reliable source for future scientific studies and clinical quality assessments among patients with gliomas.

Cross-cultural Adaption and Validation of the Danish Voice Handicap Index.

PubMed

Sorensen, Jesper Roed; Printz, Trine; Mehlum, Camilla Slot; Heidemann, Christian Hamilton; Groentved, Aagot Moeller; Godballe, Christian

2018-02-02

We aimed to assess psychometric properties, including internal consistency, reliability, and clinical validity of the Danish version of the Voice Handicap Index (VHI). A cross-sectional survey study was carried out. For validation, the existing nonvalidated Danish version of the VHI was used. Data from 208 patients with voice disorders of different etiology (neurogenic, functional, and structural) and a control group of 85 vocally healthy individuals were included. A test-retest reliability analysis of 42 patients and 45 control persons was performed. The internal consistency, test-retest reliability, and clinical validity of the questionnaire were assessed. Internal consistency was high with a Cronbach α >0.90 for both the patient and control group. Test-retest reliability measured as intraclass correlation coefficient was good with 0.93 (95% confidence interval [95% confidence interval]: 0.87-0.96) for patients and 0.78 (95% confidence interval: 0.63-0.87) for the control group which indicates sufficient reliability of the questionnaire. The Danish VHI has good clinical validity as it has a strong correlation between patient's perception of the severity of their voice disorder and the VHI score from the Spearman correlation of 0.69. The existing Danish version of the VHI has been thoroughly validated and found to be in line with the original VHI from Jacobsen et al. It showed good internal consistency, test-retest reliability, and clinical validity. It is suitable for use in daily practice and in research projects as it is able to assess patients' perception of their voice disorder severity. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Sharing reference data and including cows in the reference population improve genomic predictions in Danish Jersey

USDA-ARS?s Scientific Manuscript database

Small reference populations limit the accuracy of genomic prediction in numerically small breeds, such as the Danish Jersey. The objective of this study was to investigate two approaches to improve genomic prediction by increasing the size of the reference population for Danish Jerseys. The first ap...

UNIX-BASED DATA MANAGEMENT SYSTEM FOR PROPAGATION EXPERIMENTS

NASA Technical Reports Server (NTRS)

Kantak, A. V.

1994-01-01

This collection of programs comprises The UNIX Based Data Management System for the Pilot Field Experiment (PiFEx) which is an attempt to mimic the Mobile Satellite (MSAT) scenario. The major purposes of PiFEx are to define the mobile communications channels and test the workability of new concepts used to design various components of the receiver system. The results of the PiFex experiment are large amounts of raw data which must be accessed according to a researcher's needs. This package provides a system to manage the PiFEx data in an interactive way. The system not only provides the file handling necessary to retrieve the desired data, but also several FORTRAN programs to generate some standard results pertaining to propagation data. This package assumes that the data file initially generated from the experiment has been already converted from binary to ASCII format. The Data Management system described here consists of programs divided into two categories: those programs that handle the PiFEx generated files and those that are used for number-crunching of these files. Five FORTRAN programs and one UNIX shell script file are used for file manipulation purposes. These activities include: calibration of the acquired data; and parsing of the large data file into datasets concerned with different aspects of the experiment such as the specific calibrated propagation data, dynamic and static loop error data, statistical data, and temperature and spatial data on the hardware used in the experiment. The five remaining FORTRAN programs are used to generate usable information about the data. Signal level probability, probability density of the signal fitting the Rician density function, frequency of the data's fade duration, and the Fourier transform of the data can all be generated from these data manipulation programs. In addition, a program is provided which generates a downloadable file from the signal levels and signal phases files for use with the plotting routine

AMPS data management concepts. [Atmospheric, Magnetospheric and Plasma in Space experiment

NASA Technical Reports Server (NTRS)

Metzelaar, P. N.

1975-01-01

Five typical AMPS experiments were formulated to allow simulation studies to verify data management concepts. Design studies were conducted to analyze these experiments in terms of the applicable procedures, data processing and displaying functions. Design concepts for AMPS data management system are presented which permit both automatic repetitive measurement sequences and experimenter-controlled step-by-step procedures. Extensive use is made of a cathode ray tube display, the experimenters' alphanumeric keyboard, and the computer. The types of computer software required by the system and the possible choices of control and display procedures available to the experimenter are described for several examples. An electromagnetic wave transmission experiment illustrates the methods used to analyze data processing requirements.

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

PubMed

Oh, Jinjoo; Oh, Seieun

2017-12-01

The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

A hereditary disposition for bovine peripheral nerve sheath tumors in Danish Holstein cattle.

PubMed

Grossi, Anette B; Agerholm, Jørgen S; Christensen, Knud; Jensen, Henrik E; Leifsson, Páll S; Bendixen, Christian; Karlskov-Mortensen, Peter; Fredholm, Merete

2014-12-10

Peripheral nerve sheath tumors (PNSTs) are frequently found in Danish cattle at slaughter. Bovine PNSTs share several gross and histopathological characteristics with the PNSTs in humans with heritable neurofibromatosis syndromes. The aim of the present study was to investigate a possible hereditary disposition to PNSTs in dairy cattle by statistical analysis performed on data from 567 cattle with PNSTs. Furthermore, a preliminary genome-wide association study (GWAS) was performed on DNA isolated from 28 affected and 28 non-affected Holstein cows to identify loci in the bovine genome involved in the development of PNSTs. PNSTs were significantly more common in the Danish Holstein breed than in other breeds with 0.49% of Danish Holsteins slaughtered during an eight-year-period having PNSTs. PNSTs also occurred significantly more frequently in the offspring of some specific Holstein sires. Examination of three generation pedigrees showed that these sires were genetically related through a widely used US Holstein sire. The PNSTs included in GWAS were histologically classified as neurofibroma-schwannoma (43%), schwannoma (36%) and neurofibroma (21%) and derived from Holstein cows with multiple PNSTs. A single SNP on chromosome 27 reached genome-wide significance. Gross and histological characteristics of bovine PNSTs are comparable to PNSTs in humans (schwannomatosis). Danish Holsteins are genetically disposed to develop PNSTs but the examined materials are insufficient to allow determination of the mode of inheritance.

Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark.

PubMed

Cerdan, Jose; Catalan-Matamoros, Daniel; Berg, Sarah Warny

2017-12-01

To gain insight into the experiences of patients with long-term conditions enrolled in an online rehabilitation programme using a web portal. Danish outpatients were recruited from a rehabilitation department and were granted access to a web portal which included an online rehabilitation programme with key information, clinical advice, and self-management activities. After two weeks, patients were invited to participate in focus groups. A topic guide was used to explore this new online rehabilitation programme in relation to participants' experiences. Fourteen participants, ranging from 42 to 72 years old, were allocated into three focus groups. Participants mainly reported negative experiences by the following four themes: 'patients' experiences', 'technical aspects', 'areas for improvement', and 'digitalization added value'. Participants mainly reported negative experiences and suggested combining both face-to-face consultations with online care by user-friendly web portals. This will ensure a positive contribution from digital communication tools to rehabilitation. Patients' experiences should be considered in the design of web portals in rehabilitation which could help healthcare organizations when developing online rehabilitation programmes. Copyright © 2017 Elsevier B.V. All rights reserved.

Pastoral Techniques in the Modern Danish Educational System

ERIC Educational Resources Information Center

Nielsen, Klaus; Dalgaard, Susanne; Madsen, Sarah

2011-01-01

In recent years, therapeutic techniques have played an increasingly significant role in Danish educational thinking. One way in which this therapeutic thinking discloses itself is in the ever-growing use of educational-therapeutic games as part of the educational practice. Inspired by Foucault, we argue that educational-therapeutic games can be…

Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods.

PubMed

Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup; Halasa, Tariq; Rattenborg, Erik; Boes, Jaap; Enemark, Heidi Larsen; Thamsborg, Stig Milan

2017-11-09

The prevalence of bovine fasciolosis in Denmark is increasing but appropriate guidelines for control are currently lacking. In order to help develop a control strategy for liver fluke, a risk factor study of farm management factors was conducted and the utility of bulk tank milk (BTM ELISA) as a tool for diagnosis in Danish dairy cattle farms was assessed. This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013) using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola hepatica antibody levels in BTM. A case farm was defined as having a minimum of 3 incidents of liver condemnation due to liver fluke at slaughter (in any age group) during 2013, and control farms were located within 10 km of at least one case farm and had no history of liver condemnation due to liver fluke during 2011-2013. The selected farmers were interviewed over telephone about grazing and control practices, and BTM from these farms was collected and analysed by ELISA in 2014. The final complete dataset consisting of 131 case and 63 control farms was analysed using logistic regression. Heifers grazing on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test, time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Control of bovine fasciolosis in Denmark should target heifers and

Predictive value of stroke discharge diagnoses in the Danish National Patient Register.

PubMed

Lühdorf, Pernille; Overvad, Kim; Schmidt, Erik B; Johnsen, Søren P; Bach, Flemming W

2017-08-01

To determine the positive predictive values for stroke discharge diagnoses, including subarachnoidal haemorrhage, intracerebral haemorrhage and cerebral infarction in the Danish National Patient Register. Participants in the Danish cohort study Diet, Cancer and Health with a stroke discharge diagnosis in the National Patient Register between 1993 and 2009 were identified and their medical records were retrieved for validation of the diagnoses. A total of 3326 records of possible cases of stroke were reviewed. The overall positive predictive value for stroke was 69.3% (95% confidence interval (CI) 67.8-70.9%). The predictive values differed according to hospital characteristics, with the highest predictive value of 87.8% (95% CI 85.5-90.1%) found in departments of neurology and the lowest predictive value of 43.0% (95% CI 37.6-48.5%) found in outpatient clinics. The overall stroke diagnosis in the Danish National Patient Register had a limited predictive value. We therefore recommend the critical use of non-validated register data for research on stroke. The possibility of optimising the predictive values based on more advanced algorithms should be considered.

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

PubMed Central

2014-01-01

Background Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV. Methods Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. Results This study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. Conclusions It is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study. PMID:24893567

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study.

PubMed

Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

2014-06-03

Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women's views and attitudes are regarding being asked about IPV. Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. This study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. It is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.

Designing and Managing a Strategic Academic Alliance: An Australian University Experience

ERIC Educational Resources Information Center

Ryan, Lindsay; Morriss, Ross

2005-01-01

Purpose--This article outlines the experience and approach of an Australian university in developing and managing education program partnerships within industry. Design/methodology/approach--Describes how the university has established a specialist Strategic Partnerships unit for managing the customisation and delivery of postgraduate award…

The Danish Youth Cohort: characteristics of participants and non-participants and determinants of attrition.

PubMed

Vinther-Larsen, Mathilde; Riegels, Mette; Rod, Morten Hulvej; Schiøtz, Michaela; Curtis, Tine; Grønbaek, Morten

2010-08-01

The aim of this paper is to describe the design and methods used in the Danish Youth Cohort and to give a description of the study participants with special attention to a comparison between participants and non-participants regarding sociodemographic characteristics. A total of 1,945 schools were invited, out of which 506 participated. The participating 7th grades comprised a total of 12,498 responding adolescents. The response rate for the Danish Youth Cohort established in 2005 was 63%. The sample of 12,498 adolescents represents 18.2% of all pupils (n = 68,764) in the 7th grade (mean age: 13.4 years) in Danish schools in 2005. The cohort was followed up in spring 2006 and spring 2007, where the adolescents were in the 8th (mean age: 14.4 years) and 9th (mean age: 15.3 years) grades, respectively. We found that compared with non-participants the participants were significantly more likely to be girls, to be of Danish ethnicity, and to live in one-family houses. Furthermore, participants more often came from families with two or three children, were more likely to have parents with a high occupational status, parents who were married and parents with a higher total income. Loss to follow-up was only associated with adolescents' higher probability of drinking and use of tobacco, and none of the other factors were associated with attrition. The participants in the Danish Youth Cohort represent a great variety of different groups of socio-demographic factors, although they differ from non-participants as regards a range of socio-demographic factors. This should be taken into account in future analyses.

Universities in capacity building in sustainable development: focus on solid waste management and technology.

PubMed

Agamuthu, P; Hansen, Jens Aage

2007-06-01

This paper analyses some of the higher education and research capacity building experiences gained from 1998-2006 by Danish and Malaysian universities. The focus is on waste management, directly relating to both the environmental and socio-economic dimensions of sustainable development. Primary benefits, available as an educational legacy to universities, were obtained in terms of new and enhanced study curricula established on Problem-oriented Project-based Learning (POPBL) pedagogy, which strengthened academic environmental programmes at Malaysian and Danish universities. It involved more direct and mutually beneficial cooperation between academia and businesses in both countries. This kind of university reach-out is considered vital to development in all countries actively striving for global and sustainable development. Supplementary benefits were accrued for those involved directly in activities such as the 4 months of field studies, workshops, field courses and joint research projects. For students and academics, the gains have been new international dimensions in university curricula, enhanced career development and research collaboration based on realworld cases. It is suggested that the area of solid waste management offers opportunities for much needed capacity building in higher education and research, contributing to sustainable waste management on a global scale. Universities should be more actively involved in such educational, research and innovation programmes to make the necessary progress. ISWA can support capacity building activities by utilizing its resources--providing a lively platform for debate, securing dissemination of new knowledge, and furthering international networking beyond that which universities already do by themselves. A special challenge to ISWA may be to improve national and international professional networks between academia and business, thereby making education, research and innovation the key driving mechanisms in

Occupational accidents in the Danish merchant fleet and the nationality of seafarers.

PubMed

Adám, Balázs; Rasmussen, Hanna Barbara; Pedersen, Randi Nørgaard Fløe; Jepsen, Jørgen Riis

2014-01-01

The aim of the study was to examine occupational accidents reported from non-passenger merchant ships registered in the Danish International Ship Register in 2010-2012, with a focus on analysing nationality differences in the risk of getting injured in an accident. Data about notified occupational accidents were collected from notifications sent to the Danish Maritime Authority and from records of contact with Danish Radio Medical. Events were matched by personal identification and accident data to create a unified database. Stratified cumulative time spent on board by seafarers was used to calculate accident rates. Incidence rates of different nationalities were compared by Poisson regression. Western European seafarers had an overall accident rate of 17.5 per 100000 person-days, which proved to be significantly higher than that of Eastern European, South East Asian and Indian seaman (adjusted incidence rate ratio 0.53, 0.51 and 0.74, respectively), although differences decreased over the investigated period. Smaller but in most cases still significant discrepancies were observed for serious injuries. The back injury rate of Western European employees was found especially high, while eye injuries seem to be more frequent among South East Asian workers. The study identified substantial differences between nationalities in the rate of various accidents reported from merchant ships sailing under the Danish flag. The differences may be attributed to various factors such as safety behaviour. Investigation of special injury types and characterisation of effective elements of safety culture can contribute to the improvement of workplace safety in the maritime sector.

No-fault compensation for treatment injuries in Danish public hospitals 2006-12.

PubMed

Tilma, Jens; Nørgaard, Mette; Mikkelsen, Kim Lyngby; Johnsen, Søren Paaske

2016-02-01

We aimed to determine the incidence rate and time trend of approved treatment injuries in Danish public hospitals from 2006 to 2012 and also to identify independent predictors of severe treatment injuries among patient and system factors and characterize the injuries. We performed a nationwide, historical observational study on data from the Danish Patient Compensation Association, which receives all compensation claims from Danish health care. All approved closed claims of treatment injuries occurring in public hospitals 2006-12 were included. Health care activity information was obtained through Statistics Denmark. Incidence rates were determined as treatment injuries per year by population and by public hospital contacts. By using a multivariable logistic regression model, we calculated mutually adjusted odds ratios to assess the association between potential predictors and severe injuries among approved claims. We identified 10,959 approved treatment injury claims in 2006-12. The total payout was USD 339 million. The mean incidence rate medians were 27.9 injuries/100,000 inhabitants/year and 0.21 injuries/1000 public hospital contacts/year. These did not increase overtime. Severe injuries and preventable cases comprised 11.0 and 41.0%, respectively. Predictors of severe injury included age 0 and above 40 years, male gender and higher level of comorbidity. The incidence rate of approved closed claims at Danish public hospitals appears stable. A high proportion of injuries are preventable and both patient- and system-related factors may predict severe injuries. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Children With Type 1 Diabetes Mellitus: Self-Management Experiences in School.

PubMed

de Cássia Sparapani, Valéria; Liberatore, Raphael D R; Damião, Elaine B C; de Oliveira Dantas, Isa R; de Camargo, Rosangela A A; Nascimento, Lucila C

2017-08-01

Children with type 1 diabetes mellitus (T1DM) need to perform self-management activities at school and in other environments. Learning about their experiences at school is crucial to assist them in this challenging task. Qualitative interviews were conducted with children with T1DM, aged between 7 and 12. A scenario was created and puppets were used during the interviews to help the participating children to communicate about school, daily routines, and experiences in diabetes management. Data were collected over a period of 1 year and analyzed according to content analysis procedures. Nineteen children, 13 boys and 6 girls, at the mean age of 9.8 ± 1.8 years and mean time since diagnosis of 3.3 years, participated in the study. Three themes were identified: lack of information on T1DM, diabetes self-care at school, and support received by the children. The study provides useful information to understand the children's experiences in managing the disease at school. The partnership between school staff, health teams, children with T1DM, and their families need to be enhanced to promote appropriate strategies that improve the management of diabetes in this setting. © 2017, American School Health Association.

The Danish Organic Action Plan 2020: assessment method and baseline status of organic procurement in public kitchens.

PubMed

Sørensen, Nina N; Lassen, Anne D; Løje, Hanne; Tetens, Inge

2015-09-01

With political support from the Danish Organic Action Plan 2020, organic public procurement in Denmark is expected to increase. In order to evaluate changes in organic food procurement in Danish public kitchens, reliable methods are needed. The present study aimed to compare organic food procurement measurements by two methods and to collect and discuss baseline organic food procurement measurements from public kitchens participating in the Danish Organic Action Plan 2020. Comparison study measuring organic food procurement by applying two different methods, one based on the use of procurement invoices (the Organic Cuisine Label method) and the other on self-reported procurement (the Dogme method). Baseline organic food procurement status was based on organic food procurement measurements and background information from public kitchens. Public kitchens participating in the six organic food conversion projects funded by the Danish Organic Action Plan 2020 during 2012 and 2013. Twenty-six public kitchens (comparison study) and 345 public kitchens (baseline organic food procurement status). A high significant correlation coefficient was found between the two organic food procurement measurement methods (r=0·83, P<0·001) with measurements relevant for the baseline status. Mean baseline organic food procurement was found to be 24 % when including measurements from both methods. The results indicate that organic food procurement measurements by both methods were valid for the baseline status report of the Danish Organic Action Plan 2020. Baseline results in Danish public kitchens suggest there is room for more organic as well as sustainable public procurement in Denmark.

An Experiment on Enforcement Strategies for Managing a Local Environment Resource

ERIC Educational Resources Information Center

Murphy, James J.; Cardenas, Juan-Camilo

2004-01-01

Managing local environmental resources with moderately enforced government regulations can often be counterproductive, whereas nonbinding communications can be remarkably effective. The authors describe a classroom experiment that illustrates these points. The experiment is rich in its institutional settings and highlights the challenges that…

The Glen Canyon Dam Adaptive Management Program: An experiment in science-based resource management

NASA Astrophysics Data System (ADS)

kaplinski, m

2001-12-01

In 1996, Glen Canyon Dam Adaptive Management (GCDAMP) program was established to provide input on Glen Canyon Dam operations and their affect on the Colorado Ecosystem in Grand Canyon. The GCDAMP is a bold experiment in federal resource management that features a governing partnership with all relevant stakeholders sitting at the same table. It is a complicated, difficult process where stakeholder-derived management actions must balance resource protection with water and power delivery compacts, the Endangered Species Act, the National Historical Preservation Act, the Grand Canyon Protection Act, National Park Service Policy, and other stakeholder concerns. The program consists of four entities: the Adaptive Management Workgroup (AMWG), the Technical Workgroup (TWG), the Grand Canyon Monitoring and Research Center (GCMRC), and independent review panels. The AMWG and TWG are federal advisory committees that consists of federal and state resource managers, Native American tribes, power, environmental and recreation interests. The AMWG is develops, evaluates and recommends alternative dam operations to the Secretary. The TWG translates AMWG policy and goals into management objectives and information needs, provides questions that serve as the basis for long-term monitoring and research activities, interprets research results from the GCMRC, and prepares reports as required for the AMWG. The GCMRC is an independent science center that is responsible for all GCDAMP monitoring and research activities. The GCMRC utilizes proposal requests with external peer review and an in-house staff that directs and synthesizes monitoring and research results. The GCMRC meets regularly with the TWG and AMWG and provides scientific information on the consequences of GCDAMP actions. Independent review panels consist of external peer review panels that provide reviews of scientific activities and the program in general, technical advice to the GCMRC, TWG and AMWG, and play a critical

Caregiving and early infant crying in a danish community.

PubMed

Alvarez, Marissa

2004-04-01

Maternal caregiving and fussing/crying in Danish infants at 3, 6, and 12 weeks were examined using self-report scales and 24-hour behavior diaries. Mothers reported practices commonly associated with responsive caregiving: frequent feeding, prompt response to infant cries, and considerable time holding the infant. Fuss/cry durations peaked in the first 2 months, were highest in evenings, and decreased approximately 50% by 12 weeks. Fussing was the majority behavior, and 9.2% of the infants fussed and cried more than 3 hours per day. In contrast with other Western studies, 24-hour fuss/cry durations were lower, and fussing accounted for up to 80% of total distress. Danish caregiving practices may partially explain the lower durations of infant distress and the lower ratio of cry to fuss. However, some infants fuss/cry a great deal despite sensitive care, which may reflect individual differences in infant maturation of behavior regulation.

Incidence of cardiovascular disease in a historical cohort of Danish firefighters.

PubMed

Pedersen, Julie Elbæk; Ugelvig Petersen, Kajsa; Ebbehøj, Niels Erik; Bonde, Jens Peter; Hansen, Johnni

2018-05-01

Firefighters are exposed to multiple cardiovascular hazards, but few epidemiological studies have addressed their cardiovascular morbidity. The objective of this study was therefore to examine the incidence of cardiovascular diseases (CVD) in Danish firefighters. We used individual historical employment records on 11.691 male Danish firefighters supplied by trade unions and fire agencies. The Supplementary Pension Fund Register was used to establish two occupational reference groups (a random sample from the male employed population and military employees). Information on CVD incidence was retrieved from the nationwide Danish National Patient Registry. SIRs and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs. In comparison with the population sample, the age-adjusted and calendar time-adjusted SIR for all CVDs combined was increased in firefighters (SIR=1.10, 95% CI 1.05 to 1.15). The risk was also elevated for the most frequent outcomes, including angina pectoris (SIR=1.16, 95% CI 1.08 to 1.24), acute myocardial infarction (SIR=1.16, 95% CI 1.06 to 1.26), chronic ischaemic heart disease (SIR=1.15, 95% CI 1.06 to 1.24) and atrial fibrillation/flutter (SIR=1.25, 95% CI 1.14 to 1.36). This analysis showed the most elevated SIRs for CVD in full-time firefighters compared with part-time/volunteer firefighters. Both types of firefighters employed <15 years had an increased risk of CVD. Similar risk patterns appeared in comparisons with the military. Internal analysis supported external findings. The risk of overall CVD, including the most frequent subtypes was modestly increased in Danish firefighters and was most elevated in full-time firefighters compared with other male employees. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Danish Health Professionals' Experiences of Being Coached: A Pilot Study

ERIC Educational Resources Information Center

Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

2013-01-01

Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…

Women's experiences of three early miscarriage management options a qualitative study

PubMed Central

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-01-01

Background Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. Aim To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Design of study Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Setting Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Method Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5–2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Results Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the ‘baby’; and pain and bleeding. Conclusions Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and

Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa

PubMed Central

Daire, Judith; Gilson, Lucy

2014-01-01

In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager’s job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better

Clinical nursing leaders', team members' and service managers' experiences of implementing evidence at a local level.

PubMed

Kitson, Alison; Silverston, Heidi; Wiechula, Rick; Zeitz, Kathryn; Marcoionni, Danni; Page, Tammy

2011-05-01

To describe the experiences of 14 clinical nursing leaders introducing a knowledge translation (KT) project into one metropolitan acute care hospital in South Australia. The study also explored team members' and service managers' experiences. KT strategies assume that local (nursing) clinical leaders have the capacity and capability to champion innovation combining positional leadership roles (ward leader) with a project lead role. There is limited evidence to support these assumptions. Semi-structured interviews of clinical nursing leaders and managers were undertaken at month 4 and 12 of the project. Data were also collected from the interdisciplinary team members (n = 28). Clinical nursing leaders identified risks and anxieties associated with taking on an additional leadership role, whereas managers acknowledged the multiple pressures on the system and the need for local level innovation. Team members generally reported positive experiences. With support, clinical nursing leaders can effectively embrace KT project leadership roles that complement their positional leadership roles. Clinical nursing leaders' experiences differed from nursing and medical managers' experiences.   Managers need to be more attuned to the personal risks local leaders experience, providing support for leaders to experiment and innovate. Managers need to integrate local priorities with broader system wide agendas. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Career-Self Management and Entrepreneurship: An Experience with PhD Students

ERIC Educational Resources Information Center

Pinto, Joana Carneiro; do Ceu Taveira, Maria; Sa, Elisabete

2012-01-01

Introduction: This study presents an experience developed with PhD students aimed to analyze the extent to which career self-management should be approached along with entrepreneurship issues to promote students' career development. Method: An intervention group who attended a Career Self-Management Seminar (EG1), a comparison group who attended…

Individual and environmental risk factors for high blood lead concentrations in Danish indoor shooters.

PubMed

Grandahl, Kasper; Suadicani, Poul; Jacobsen, Peter

2012-08-01

International studies have shown blood lead at levels causing health concern in recreational indoor shooters. We hypothesized that Danish recreational indoor shooters would also have a high level of blood lead, and that this could be explained by shooting characteristics and the physical environment at the shooting range. This was an environmental case study of 58 male and female shooters from two indoor shooting ranges with assumed different ventilation and cleaning conditions. Information was obtained on general conditions including age, gender, tobacco and alcohol use, and shooting conditions: weapon type, number of shots fired, frequency of stays at the shooting range and hygiene habits. A venous blood sample was drawn to determine blood lead concentrations; 14 non-shooters were included as controls. Almost 60% of the shooters, hereof five out of 14 women, had a blood lead concentration above 0.48 micromol/l, a level causing long-term health concern. All controls had blood lead values below 0.17 micromol/l. Independent significant associations with blood lead concentrations above 0.48 micromol/l were found for shooting at a poorly ventilated range, use of heavy calibre weapons, number of shots and frequency of stays at the shooting range. A large proportion of Danish recreational indoor shooters had potentially harmful blood lead concentrations. Ventilation, amounts of shooting, use of heavy calibre weapons and stays at the shooting ranges were independently associated with increased blood lead. The technical check at the two ranges was performed by the Danish Technological Institute and costs were defrayed by the Danish Rifle Association. To pay for the analyses of blood lead, the study was supported by the The Else & Mogens Wedell-Wedellsborg Foundation. The Danish Regional Capital Scientific Ethics Committee approved the study, protocol number H-4-2010-130.

Japanese experiences of environmental management.

PubMed

Matsuo, T

2003-01-01

Japan experienced a very rapid industrialization and economic growth in the era of income doubling in 1960s and at the same time Japan experienced very severe damage from various types of environmental pollution. In this paper, historical development of population, GNP, energy consumption with classification of petroleum, coal and electric power, and CO2 emission are introduced as basic background data on Japanese development. The tragic experience of Minamata disease and Itai-itai disease caused by methyl mercury and cadmium, respectively, are introduced. In two tables, historical development of water pollution and air pollution are summarized. Regarding solid wastes management, the total mass balance in Japan and recent development in legislation framework for enhancement of recycling of wastes are introduced briefly.

Enhanced Capabilities for Subcritical Experiments (ECSE) Risk Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Urban, Mary Elizabeth

Risk is a factor, element, constraint, or course of action that introduces an uncertainty of outcome that could impact project objectives. Risk is an inherent part of all activities, whether the activity is simple and small, or large and complex. Risk management is a process that identifies, evaluates, handles, and monitors risks that have the potential to affect project success. The risk management process spans the entire project, from its initiation to its successful completion and closeout, including both technical and programmatic (non-technical) risks. This Risk Management Plan (RMP) defines the process to be used for identifying, evaluating, handling, andmore » monitoring risks as part of the overall management of the Enhanced Capabilities for Subcritical Experiments (ECSE) ‘Project’. Given the changing nature of the project environment, risk management is essentially an ongoing and iterative process, which applies the best efforts of a knowledgeable project staff to a suite of focused and prioritized concerns. The risk management process itself must be continually applied throughout the project life cycle. This document was prepared in accordance with DOE O 413.3B, Program and Project Management for the Acquisition of Capital Assets, its associated guide for risk management DOE G 413.3-7, Risk Management Guide, and LANL ADPM AP-350-204, Risk and Opportunity Management.« less

Chronic Neurodegenerative Illnesses and Epilepsy in Danish Adventists and Baptists: A Nationwide Cohort Study.

PubMed

Thygesen, Lau Caspar; Gimsing, Louise NØrreslet; Bautz, Andrea; Hvidt, Niels Christian; Johansen, Christoffer

2017-01-01

Limited knowledge of the influence of lifestyle risk factors and religious living on chronic neurological diseases exists. Seventh-day Adventists (SDA) do not consume tobacco, alcohol, or pork, and many adhere to lacto-ovo-vegetarian diet, and Baptists discourage excessive use of alcohol and tobacco. We investigated whether the incidence of four common chronic neurological illnesses: dementia, Alzheimer's disease, Parkinson's disease, and epilepsy in a large cohort of Danish Adventists and Baptists was different compared to the general Danish population. Three of the illnesses are neurodegenerative, whereas epilepsy can occur at any age. We compared hospital admission rates for some major neurological diseases among members of the Danish Religious Societies Health Study comprising 6,532 SDA and 3,720 Baptists with the general Danish population. Standardized incidence ratios (SIR) stratified by sex, age, and calendar time were calculated. SIR of dementia or Alzheimer's disease was significantly decreased for members of both communities (SDA, 0.78; 95% CI, 0.67-#x2013;0.90 and Baptists, 0.59; 0.47-#x2013;0.73). The SIRs of Parkinson's disease and epilepsy were not significantly different compared to the general population. We observe reduced incidence for dementia or Alzheimer's disease in a large cohort of members of two religious communities characterized by lifestyle recommendations. More studies are needed to disentangle the interaction between such lifestyle and other components of the religious belief system.

Hospitalizations among employees in the Danish hotel and restaurant industry.

PubMed

Hannerz, Harald; Tüchsen, Finn; Kristensen, Tage S

2002-09-01

The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. Cohorts of all 20-59-year-old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age-standardized hospitalization ratios (SHR) and time trends (1981-1997) for many different diagnoses. Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group.

Grazing management options in meeting objectives of grazing experiments

USDA-ARS?s Scientific Manuscript database

Decisions on which grazing management option to use in grazing experiments can be critical in meeting research objectives and generating information for the scientific community or technologies that meets the needs of forage-based enterprises. It is necessary to have an understanding of animal per...

Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa.

PubMed

Daire, Judith; Gilson, Lucy

2014-09-01

In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager's job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better

Investigating the influence of sea level oscillations in the Danish Straits on the Baltic Sea dynamics

NASA Astrophysics Data System (ADS)

Tikhonova, Natalia; Gusev, Anatoly; Diansky, Nikolay; Zakharchuk, Evgeny

2016-04-01

In this research, we study the influence of dynamic processes in the Danish Straits on the sea surface height (SSH) oscillations in the Baltic Sea. For this purpose, we use the model of marine and oceanic circulation INMOM (Institute of Numerical Mathematics Ocean Model). The simulations were carried out for the period 2009-2010, and the coastal station data were used for verification of SSH modelling quality. Comparison of the simulated data with the ones measured in the coastal points showed us that the model does not describe SSH variability in different areas of the Baltic Sea well enough, so in the following simulation series the in situ SSH data of the coastal measurements were assimilated at the open boundary in the Danish Straits. The results of the new simulation showed us that this approach significantly increases the SSH simulation quality in all areas of the sea, where the comparison was made. In particular, the correlation coefficients between the simulated and measured SSH data increased from 0.21-0.73 to 0.81-0.90. On the basis of these results, it has been suggested that the Baltic Sea SSH variability is largely determined by the influence of the dynamic processes in the Danish Straits, which can be represented as a superposition of oscillations of different space-time scales. These oscillations can either be generated in the straits themselves, or propagate from the North Sea. For verification of this hypothesis and assessment of the oscillation propagation distance in the Baltic Sea, the following experiment was performed. At the open boundary in the Danish Straits, the six harmonics were set with the following parameters: the periods are 1.5, 3.0, 6.0, 13.5, 40.5, and 121.5 days, and the amplitude for all the harmonics is 50 cm. The results showed us that the prescribed harmonic oscillations at the open boundary propagate into all areas of the sea without changing the frequency, but with decreasing amplitude. The decrease in amplitude is not

An expert system to advise astronauts during experiments: The protocol manager module

NASA Technical Reports Server (NTRS)

Haymann-Haber, Guido; Colombano, Silvano P.; Groleau, Nicolas; Rosenthal, Don; Szolovits, Peter; Young, Laurence R.

1990-01-01

Perhaps the scarcest resource for manned flight experiments - on Spacelab or on the Space Station Freedom - will continue to be crew time. To maximize the efficiency of the crew and to make use of their abilities to work as scientist collaborators as well as equipment operators, normally requires more training in a wide variety of disciplines than is practical. The successful application of on-board expert systems, as envisioned by the Principal Investigator in a Box program, should alleviate the training bottleneck and provide the astronaut with the guidance and coaching needed to permit him or her to operate an experiment according to the desires and knowledge of the PI, despite changes in conditions. The Protocol Manager module of the system is discussed. The Protocol Manager receives experiment data that has been summarized and categorized by the other modules. The Protocol Manager acts on the data in real-time, by employing expert system techniques. Its recommendations are based on heuristics provided by the Principal Investigator in charge of the experiment. This prototype was developed on a Macintosh II by employing CLIPS, a forward-chaining rule-based system, and HyperCard as an object-oriented user interface builder.

Postoperative pain management experiences among school-aged children: a qualitative study.

PubMed

Sng, Qian Wen; Taylor, Beverley; Liam, Joanne Lw; Klainin-Yobas, Piyanee; Wang, Wenru; He, Hong-Gu

2013-04-01

To explore postoperative pain management experiences among school-aged children. Ineffective postoperative pain management among children has been commonly reported. School-aged children are able to evaluate how their pain is managed and what their preferred strategies are. Most studies in pain management have adopted quantitative methods and have overlooked children's pain management experiences. This is a qualitative study using face-to-face interviews. Data were collected from 15 school-aged children admitted to a tertiary hospital in Singapore by in-depth interviews conducted between November 2010 and January 2011. Data were analysed by thematic analysis. Five themes were identified: children's self-directed actions to relieve their postoperative pain (e.g. using cognitive-behavioural methods of distraction and imagery, physical method of positioning, sleeping and drinking, seeking other people's help by informing parents and crying and using pain medications); children's perceptions of actions parents take for their postoperative pain relief (assessing pain, administering pain medications, using various cognitive-behavioural, physical methods and emotional support strategies, assisting in activities and alerting health professionals); children's perception of actions nurses take for their postoperative pain relief (administering medication, using cognitive-behavioural methods, emotional support strategies and helping with activities of daily living) and suggestions for parents (using distraction and presence) and nurses (administering medications, distraction and positioning) for their postoperative pain relief improvement. This study contributed to the existing knowledge about children's postoperative pain management based on their own experiences. Children, their parents and nurses used various strategies, including pain medication and non-pharmacological methods, especially distraction, for children's postoperative pain relief. This study provides evidence

Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

PubMed

Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

2014-01-01

In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

Wilderness experiences: what should we be managing for?

Treesearch

David N. Cole

2004-01-01

The U.S. Wilderness Act gives wilderness managers a challenging stewardship responsibility: to provide and/or protect opportunities for certain types of human experiences. The act states that wilderness “shall be administered for the use and enjoyment of the American people in such manner as will leave them unimpaired for future use and enjoyment as wilderness.” The...

Managing coastal area resources by stated choice experiments

NASA Astrophysics Data System (ADS)

Liu, Xin; Wirtz, Kai W.

2010-02-01

In many coastal regions, oil spills can be considered as one of the most important and certainly the most noticeable forms of marine pollution. Efficient contingency management responding to oil spills on waters, which aims at minimizing pollution effects on coastal resources, turns out to be critically important. Such a decision making highly depends on the importance attributed to different coastal economic and ecological resources. Economic uses can, in principal, be addressed by standard measures such as value added. However, there is a missing of market in the real world for natural goods. Coastal resources such as waters and beach cannot be directly measured in money terms, which increases the risk of being neglected in a decision making process. This paper evaluates these natural goods of coastal environment in a hypothetical market by employing stated choice experiments. Oil spill management practice in German North Sea is used as an example. Results from a pilot survey show that during a combat process, beach and eider ducks are of key concerns for households. An environmental friendly combat option has to be a minor cost for households. Moreover, households with less children, higher monthly income and a membership of environmental organization are more likely to state that they are willing to pay for combat option to prevent coastal resources from an oil pollution. Despite that choice experiments require knowledge of designing questionnaire and statistical skills to deal with discrete choices and conducting a survey is time consumed, the results have important implications for oil spill contingency management. Overall, such a stated preference method can offer useful information for decision makers to consider coastal resources into a decision making process and can further contribute to finding a cost-effective oil preventive measure, also has a wide application potential in the field of Integrated Coastal Zone Management (ICZM).

Experiences in managing the Prometheus Project

NASA Technical Reports Server (NTRS)

Lehman, David H.; Clark, Karla B.; Cook, Beverly A.; Gavit, Sarah A.; Kayali, Sammy A.; McKinney, John C.; Milkovich, David C.; Reh, Kim R.; Taylor, Randall L.; Casani, John R.

2006-01-01

Congress authorized NASA?s Prometheus Project in February 2003, with the first Prometheus mission slated to explore the icy moons of Jupiter. The Project had two major objectives: (1) to develop a nuclear reactor that would provide unprecedented levels of power and show that it could be processed safely and operated reliably in space for long-duration, deep-space exploration and (2) to explore the three icy moons of Jupiter - Callisto, Ganymede, and Europa - and return science data that would meet the scientific goals as set forth in the Decadal Survey Report of the National Academy of Sciences. Early in Project planning, it was determined that the development of the Prometheus nuclear powered Spaceship would be complex and require the intellectual knowledge residing at numerous organizations across the country. In addition, because of the complex nature of the Project and the multiple partners, approaches beyond those successfully used to manage a typical JPL project would be needed. This paper1 will describe the key experiences in managing Prometheus that should prove useful for future projects of similar scope and magnitude

The Emergence of the "s"-Genitive in Danish

ERIC Educational Resources Information Center

Perridon, Harry

2013-01-01

The -"s" genitives of English and Swedish play an important role in grammaticalization theory, as they are often used as counterexamples to the main tenet of that theory, viz. that grammatical change is unidirectional. In this paper I look at the emergence of the -"s" genitive in Danish, hoping that it may shed some new light on the evolution of…

Primary Care Physicians' Experience with Disease Management Programs

PubMed Central

Fernandez, Alicia; Grumbach, Kevin; Vranizan, Karen; Osmond, Dennis H; Bindman, Andrew B

2001-01-01

OBJECTIVE To examine primary care physicians' perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care. DESIGN Cross-sectional mailed survey. SETTING The 13 largest urban counties in California. PARTICIPANTS General internists, general pediatricians, and family physicians. MEASUREMENTS AND MAIN RESULTS Physicians' self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available 285 to (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%)) their practice satisfaction. CONCLUSIONS Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction. PMID:11318911

Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children: a cohort study.

PubMed

Moller, Sanne Pagh; Hjern, Anders; Andersen, Anne-Marie Nybo; Norredam, Marie

2016-04-01

Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48-0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47-0.50). Adjusting the analysis for parental income increased the HRs by 10-20 %. This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children. •Uptake of immunisation and child health examination is associated with low household income, unemployment and low educational status among the parents. •Uptake may be even lower among refugee families as they constitute a vulnerable group regarding access to healthcare. What is New: •Refugee children had lower uptake of immunisations and child health examinations compared to Danish-born children. •Several predictors of uptake were identified including region of origin and duration of residence.

Langley applications experiments data management system study. [for space shuttles

NASA Technical Reports Server (NTRS)

Lanham, C. C., Jr.

1975-01-01

A data management system study is presented that defines, in functional terms, the most cost effective ground data management system to support Advanced Technology Laboratory (ATL) flights of the space shuttle. Results from each subtask performed and the recommended system configuration for reformatting the experiment instrumentation tapes to computer compatible tape are examined. Included are cost factors for development of a mini control center for real-time support of the ATL flights.

Danish dementia mice suggest that loss of function and not the amyloid cascade causes synaptic plasticity and memory deficits

PubMed Central

Tamayev, Robert; Matsuda, Shuji; Fà, Mauro; Arancio, Ottavio; D’Adamio, Luciano

2010-01-01

According to the prevailing “amyloid cascade hypothesis,” genetic dementias such as Alzheimer’s disease and familial Danish dementia (FDD) are caused by amyloid deposits that trigger tauopathy, neurodegeneration, and behavioral/cognitive alterations. To efficiently reproduce amyloid lesions, murine models of human dementias invariably use transgenic expression systems. However, recent FDD transgenic models showed that Danish amyloidosis does not cause memory defects, suggesting that other mechanisms cause Danish dementia. We studied an animal knock-in model of FDD (FDDKI/+) genetically congruous with human cases. FDDKI/+ mice present reduced Bri2 levels, impaired synaptic plasticity and severe hippocampal memory deficits. These animals show no cerebral lesions that are reputed characteristics of human dementia, such as tangles or amyloid plaques. Bri2+/− mice exhibit synaptic and memory deficits similar to FDDKI/+ mice, and memory loss of FDDKI/+ mice is prevented by expression of WT BRI2, indicating that Danish dementia is caused by loss of BRI2 function. Together, the data suggest that clinical dementia in Danish patients occurs via a loss of function mechanism and not as a result of amyloidosis and tauopathy. PMID:21098268

Danish dementia mice suggest that loss of function and not the amyloid cascade causes synaptic plasticity and memory deficits.

PubMed

Tamayev, Robert; Matsuda, Shuji; Fà, Mauro; Arancio, Ottavio; D'Adamio, Luciano

2010-11-30

According to the prevailing "amyloid cascade hypothesis," genetic dementias such as Alzheimer's disease and familial Danish dementia (FDD) are caused by amyloid deposits that trigger tauopathy, neurodegeneration, and behavioral/cognitive alterations. To efficiently reproduce amyloid lesions, murine models of human dementias invariably use transgenic expression systems. However, recent FDD transgenic models showed that Danish amyloidosis does not cause memory defects, suggesting that other mechanisms cause Danish dementia. We studied an animal knock-in model of FDD (FDD(KI/+)) genetically congruous with human cases. FDD(KI/+) mice present reduced Bri2 levels, impaired synaptic plasticity and severe hippocampal memory deficits. These animals show no cerebral lesions that are reputed characteristics of human dementia, such as tangles or amyloid plaques. Bri2(+/-) mice exhibit synaptic and memory deficits similar to FDD(KI/+) mice, and memory loss of FDD(KI/+) mice is prevented by expression of WT BRI2, indicating that Danish dementia is caused by loss of BRI2 function. Together, the data suggest that clinical dementia in Danish patients occurs via a loss of function mechanism and not as a result of amyloidosis and tauopathy.

A SWOT analysis of the organization and financing of the Danish health care system.

PubMed

Christiansen, Terkel

2002-02-01

The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit.

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

Electrically Driven Single Phase Thermal Management: STP-H5 EHD Experiment

NASA Technical Reports Server (NTRS)

Didion, Jeffrey R.

2016-01-01

The Electrically Driven Single Phase Thermal Management: STP-H5 iEHDS Experiment is a technology demonstration of prototype proof of concept hardware to establish the feasilibilty and long term operation of this hardware. This is a structural thermal plate that will operate continuous as part of the STP-H5 ISEM experiment for up to 18 months. This presentation discusses the design, fabrication and environmental operational paramertes of the experiment hardware.

Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database.

PubMed

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert; Bjerrum, Lars

2017-06-01

To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Retrospective cohort register-based study including the Danish National Prescription Register. Population-based study of routine electronic antibiotic prescriptions from Danish general practice. All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions. A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n = 506.634), respiratory tract infections (n = 456.354) and unspecified infections (n = 416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon. Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable.

The Influence of Literacy on Patient-Reported Experiences of Diabetes Self-Management Support

PubMed Central

Wallace, Andrea S.; Carlson, John R.; Malone, Robb M.; Joyner, James; DeWalt, Darren A.

2010-01-01

Background Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. Objectives To identify factors associated with experiences of self-management support during primary care encounters. Method A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care [PACIC]) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. Results The PACIC ratings decreased with age (r = −0.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p = .010), and were greater for those with more education (F = 3.927, p = .009) and greater literacy skills (t = 3.839, p < .001). The ratings did not vary between racial (t = −1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by duration of diabetes (r = 0.052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. Discussion Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills. PMID:20808193

Night shift work and incidence of diabetes in the Danish Nurse Cohort.

PubMed

Hansen, Anne B; Stayner, Leslie; Hansen, Johnni; Andersen, Zorana J

2016-04-01

Night shift work has been associated with poor sleep, weight gain, metabolic syndrome, which are recognised risk factor for diabetes. However, only a few studies have examined the effect of shift work on diabetes risk. Here, we study the association between shift work and incidence of diabetes in Danish nurses. We used the Danish Nurse Cohort with 28,731 participating female nurses recruited in 1993 (19,898) or 1999 (8833), when self-reported baseline information on diabetes prevalence, lifestyle and working time were collected, and followed them in the Danish Diabetes Register for incidence of diabetes until 2013. Nurses reported whether they worked night, evening, rotating or day shifts. We analysed the association between working time and diabetes incidence using a Cox proportional hazards model adjusted for diabetes risk factors, separately with and without adjustment for body mass index (BMI) which might be an intermediate variable. Of 19,873 nurses who worked and were diabetes-free at recruitment, 837 (4.4%) developed diabetes during 15 years of follow-up. The majority of nurses (62.4%) worked day shifts, 21.8% rotating shift, 10.1% evening and 5.5% night shifts. Compared with nurses who worked day shifts, we found statistically significantly increased risk of diabetes in nurses who worked night (1.58; 1.25 to 1.99) or evening shifts (1.29; 1.04 to 1.59) in the fully adjusted models including BMI. Danish nurses working night and evening shifts have increased risk for diabetes, with the highest risk associated with current night shift work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Risk assessment of Salmonella in Danish meatballs produced in the catering sector.

PubMed

Møller, Cleide O de A; Nauta, Maarten J; Schaffner, Donald W; Dalgaard, Paw; Christensen, Bjarke B; Hansen, Tina B

2015-03-02

A modular process risk model approach was used to assess health risks associated with Salmonella spp. after consumption of the Danish meatball product (frikadeller) produced with fresh pork in a catering unit. Meatball production and consumption were described as a series of processes (modules), starting from 1.3kg meat pieces through conversion to 70g meatballs, followed by a dose response model to assess the risk of illness from consumption of these meatballs. Changes in bacterial prevalence, concentration, and unit size were modelled within each module. The risk assessment was built using observational data and models that were specific for Salmonella spp. in meatballs produced in the catering sector. Danish meatballs are often pan-fried followed by baking in an oven before consumption, in order to reach the core temperature of 75°C recommended by the Danish Food Safety Authority. However, in practice this terminal heat treatment in the oven may be accidentally omitted. Eleven production scenarios were evaluated with the model, to test the impact of heat treatments and cooling rates at different room temperatures. The risk estimates revealed that a process comprising heat treatment of meatballs to core temperatures higher than 70°C, and subsequent holding at room temperatures lower than 20°C, for no longer than 3.5h, were very effective in Salmonella control. The current Danish Food Safety Authority recommendation of cooking to an internal temperature of 75°C is conservative, at least with respect to Salmonella risk. Survival and growth of Salmonella during cooling of meatballs not heat treated in oven had a significant impact on the risk estimates, and therefore, cooling should be considered a critical step during meatball processing. Copyright © 2014. Published by Elsevier B.V.

Reformulations of practice: beyond experience in paramedic airway management.

PubMed

Mausz, Justin; Donovan, Seanan; McConnell, Meghan; Lapalme, Corey; Webb, Andrea; Feres, Elizabeth; Tavares, Walter

2017-07-01

"Deliberate practice" and "feedback" are necessary for the development of expertise. We explored clinical performance in settings where these features are inconsistent or limited, hypothesizing that even in algorithmic domains of practice, clinical performance reformulates in ways that may threaten patient safety, and that experience fails to predict performance. Paramedics participated in two recorded simulation sessions involving airway management, which were analyzed three ways: first, we identified variations in "decision paths" by coding the actions of the participants according to an airway management algorithm. Second, we identified cognitive schemas driving behavior using qualitative descriptive analysis. Third, clinical performances were evaluated using a global rating scale, checklist, and time to achieve ventilation; the relationship between experience and these metrics was assessed using Pearson's correlation. Thirty participants completed a total of 59 simulations. Mean experience was 7.2 (SD=5.8) years. We observed highly variable practice patterns and identified idiosyncratic decision paths and schemas governing practice. We revealed problematic performance deficiencies related to situation awareness, decision making, and procedural skills. There was no association between experience and clinical performance (Scenario 1: r=0.13, p=0.47; Scenario 2: r=-0.10, p=0.58), or the number of errors (Scenario 1: r=.10, p=0.57; Scenario 2: r=0.25, p=0.17) or the time to achieve ventilation (Scenario 1: r=0.53, p=0.78; Scenario 2: r=0.27, p=0.15). Clinical performance was highly variable when approaching an algorithmic problem, and procedural and cognitive errors were not attenuated by provider experience. These findings suggest reformulations of practice emerge in settings where feedback and deliberate practice are limited.

Danish A.I. field data with sexed semen.

PubMed

Borchersen, S; Peacock, M

2009-01-01

The objective of this study was to compare conception rates, non-return rates and sex ratios of sexed and conventional semen from the same sires in commercial dairy herds in Denmark. The semen was produced from three bulls from each of the three major dairy breeds in Denmark: Holstein, Jersey and Danish Red Dairy Breed (nine bulls total), in order to answer questions on breeds differences in field results. AI was performed by trained technicians using a minimum of 150 doses of sorted sperm and 50 control doses from each bull. During the trial, a total of 2087 doses were used in 63 herds. The trial showed that the conception rate using sorted semen was 5% points lower than with conventional doses for Danish Reds, 7% points for Jerseys, and 12% points for Holsteins. Translating this into non-return rate revealed differences of 10-20% points among bulls. These differences are thought to be a good indicator of what to expect from commercial use of sexed semen. The sex ratios varied from 89% to 93% female calves among breeds, which on average is consistent with the theoretical average sex ratio of 93% females considering the low number of inseminations.

Nurses' shop stewards and their collaboration with management.

PubMed

Hjalager, Anne-Mette; Lassen, Morten; Bilo, Tage

2009-01-01

This study investigates the collaboration between Danish nurses' shop stewai-ds and workplace management. The aim of the study is to track changes in workplace climate after a major structural reform of the health sector. The data source for the study is a comprehensive survey among union representatives in the health and care sectors. Generally, and not surprisingly, shops stewards maintain closer relations and a higher degree of loyalty to the nearest managers rather than management at higher levels in the hierarchy. It can also be demonstrated that more experienced shop stewards, those who have been employed in this position and in the workplace for the longest terms have more affirmative relations to management than less experienced shop stewards with shorter tenure. Those shop stewards who spend much time on the entitled duties are rewarded with positive collaboration with management. Hard times at the workplace and dissatisfied colleagues, who do not support their union representative, often result in less rewarding relations with management. Quite unexpectedly, the intensity of relations with management is not significantly related to structural or other changes that the workplace has experienced over the past two years. Changes are therefore accepted as inevitable and regular occurrences in the health sector. The response rate is very high in the survey. Further qualitative research may reveal details about the background and implications. PRACTICAL IMPLICATION: The study suggests that many shop stewards may suffer from a competence gap in terms of more advanced new public management strategies and tools. This gap has not yet been successfully filled by the services and training activities offered by the Danish Nurses Union. Results from the study are being taken on board in the union's strategies. The evidence is also helpful for the managers in the health sector, as they are seeking to develop a constructive the collaboration with the unions.

The role of patients' explanatory models and daily-lived experience in hypertension self-management.

PubMed

Bokhour, Barbara G; Cohn, Ellen S; Cortés, Dharma E; Solomon, Jeffrey L; Fix, Gemmae M; Elwy, A Rani; Mueller, Nora; Katz, Lois A; Haidet, Paul; Green, Alexander R; Borzecki, Ann M; Kressin, Nancy R

2012-12-01

Uncontrolled hypertension remains a significant problem for many patients. Few interventions to improve patients' hypertension self-management have had lasting effects. Previous work has focused largely on patients' beliefs as predictors of behavior, but little is understood about beliefs as they are embedded in patients' social contexts. This study aims to explore how patients' "explanatory models" of hypertension (understandings of the causes, mechanisms or pathophysiology, course of illness, symptoms and effects of treatment) and social context relate to their reported daily hypertension self-management behaviors. Semi-structured qualitative interviews with a diverse group of patients at two large urban Veterans Administration Medical centers. PARTICIPANTS (OR PATIENTS OR SUBJECTS): African-American, white and Latino Veterans Affairs (VA) primary care patients with uncontrolled blood pressure. We conducted thematic analysis using tools of grounded theory to identify key themes surrounding patients' explanatory models, social context and hypertension management behaviors. Patients' perceptions of the cause and course of hypertension, experiences of hypertension symptoms, and beliefs about the effectiveness of treatment were related to different hypertension self-management behaviors. Moreover, patients' daily-lived experiences, such as an isolated lifestyle, serious competing health problems, a lack of habits and routines, barriers to exercise and prioritizing lifestyle choices, also interfered with optimal hypertension self-management. Designing interventions to improve patients' hypertension self-management requires consideration of patients' explanatory models and their daily-lived experience. We propose a new conceptual model - the dynamic model of hypertension self-management behavior - which incorporates these key elements of patients' experiences.

Morphological Effects in Auditory Word Recognition: Evidence from Danish

ERIC Educational Resources Information Center

Balling, Laura Winther; Baayen, R. Harald

2008-01-01

In this study, we investigate the processing of morphologically complex words in Danish using auditory lexical decision. We document a second critical point in auditory comprehension in addition to the Uniqueness Point (UP), namely the point at which competing morphological continuation forms of the base cease to be compatible with the input,…

The Real Time Mission Monitor: A Situational Awareness Tool For Managing Experiment Assets

NASA Technical Reports Server (NTRS)

Blakeslee, Richard; Hall, John; Goodman, Michael; Parker, Philip; Freudinger, Larry; He, Matt

2007-01-01

The NASA Real Time Mission Monitor (RTMM) is a situational awareness tool that integrates satellite, airborne and surface data sets; weather information; model and forecast outputs; and vehicle state data (e.g., aircraft navigation, satellite tracks and instrument field-of-views) for field experiment management RTMM optimizes science and logistic decision-making during field experiments by presenting timely data and graphics to the users to improve real time situational awareness of the experiment's assets. The RTMM is proven in the field as it supported program managers, scientists, and aircraft personnel during the NASA African Monsoon Multidisciplinary Analyses experiment during summer 2006 in Cape Verde, Africa. The integration and delivery of this information is made possible through data acquisition systems, network communication links and network server resources built and managed by collaborators at NASA Dryden Flight Research Center (DFRC) and Marshall Space Flight Center (MSFC). RTMM is evolving towards a more flexible and dynamic combination of sensor ingest, network computing, and decision-making activities through the use of a service oriented architecture based on community standards and protocols.

Can smallpox response teams use the experience of disease management programs?

PubMed

Kozma, Chris M

2003-02-01

Any attempt to widely disperse smallpox vaccinations will necessitate educating people about the risks and benefits of vaccination. Most disease management programs have extensive experience in distributing educational materials and programs to health care workers and patients as well as in tracking response to interventions. Can this experience lend a hand in the event of widespread vaccination?

Course Management Systems in Higher Education: Understanding Student Experiences

ERIC Educational Resources Information Center

Yuen, Allan; Fox, Robert; Sun, Angie; Deng, Liping

2009-01-01

Purpose: The course management system (CMS), as an evolving tool and innovation, is increasingly used to promote the quality, efficiency and flexibility of teaching and learning in higher education. This paper aims to examine students' experiences of CMSs across faculties at a comprehensive university in Hong Kong. Design/methodology/approach:…

Payroll data based description of working hours in the Danish regions.

PubMed

Garde, Anne Helene; Hansen, Johnni; Kolstad, Henrik A; Larsen, Ann Dyreborg; Pedersen, Jacob; Petersen, Jindong Ding; Hansen, Åse Marie

2018-05-15

The aim was to describe the organization of working hours in the Danish regions according to sex, age and calendar year. Based on the Danish Working Hour Database (DWHD), individuals were classified according to schedules: Permanent day (57.8%), evening (1.7%), or night (1.2%); day/evening (22.0%); day/night (6.6%); evening/night (0.6%); and day/evening/night (10.2%). More men (9.1%) than women (5.9%) worked day/night, whereas more women (10.9%) than men (7.4%) worked day/evening/night. More young than older employees worked day/evening/night, and fewer worked permanent day or night. From 2008 to 2015 we observed a trend towards more employees working permanent day and fewer employees working other schedules. Altogether DWHD provides a strong tool in research on working hours.

Designing Forest Adaptation Experiments through Manager-Scientist Partnerships

NASA Astrophysics Data System (ADS)

Nagel, L. M.; Swanston, C.; Janowiak, M.

2014-12-01

Three common forest adaptation options discussed in the context of an uncertain future climate are: creating resistance, promoting resilience, and enabling forests to respond to change. Though there is consensus on the broad management goals addressed by each of these options, translating these concepts into management plans specific for individual forest types that vary in structure, composition, and function remains a challenge. We will describe a decision-making framework that we employed within a manager-scientist partnership to develop a suite of adaptation treatments for two contrasting forest types as part of a long-term forest management experiment. The first, in northern Minnesota, is a red pine-dominated forest with components of white pine, aspen, paper birch, and northern red oak, with a hazel understory. The second, in southwest Colorado, is a warm-dry mixed conifer forest dominated by ponderosa pine, white fir, and Douglas-fir, with scattered aspen and an understory of Gambel oak. The current conditions at both sites are characterized by overstocking with moderate-to-high fuel loading, vulnerability to numerous forest health threats, and are generally uncharacteristic of historic structure and composition. The desired future condition articulated by managers for each site included elements of historic structure and natural range of variability, but were greatly tempered by known vulnerabilities and projected changes to climate and disturbance patterns. The resultant range of treatments we developed are distinct for each forest type, and address a wide range of management objectives.

"Sleepless nights and sore operation site": patients' experiences of nursing pain management after surgery in Jordan.

PubMed

Shoqirat, Noordeen

2014-09-01

Internationally, it is agreed that pain management is a central component of nursing care. Although much has been written about pain prevalence among patients after surgery, research is scant on patients' experiences of nursing pain management and factors involved. This study explores patients' experiences of nursing pain management in Jordan and identifies contributing factors. A qualitative research design was used. Data were collected through focus group discussions (n = 4). A total of 31 patients were purposively selected. Two main themes emerged. The first theme was living in pain and comprised two categories: from sleep disturbances to the fear of addiction and from dependence to uncertainty. The second theme was about barriers that affect nursing pain management. Patients' experiences of nursing pain management were not up to their expectations; their needs were largely ignored and were dealt with in a mechanistic way. Barriers precipitating this situation were referred to in this study as the three "nots," including not being well-informed, not being believed, and not being privileged. The study concluded that patients' experiences of nursing pain management are a complex world that goes beyond medically orientated care. Nurses, therefore, are urged to look beyond standardized assessment tools and use patients' experiences and voices as valuable evidence contributing to more effective pain management. Unless this occurs in their daily encounters with patients, another decade will pass with little change in the practice of pain management. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Multiple myeloma among Danish women: employment history and workplace exposures.

PubMed

Pottern, L M; Heineman, E F; Olsen, J H; Raffn, E; Blair, A

1992-09-01

To investigate the role of employment history and workplace exposures as risk factors for multiple myeloma among women, a population-based case-control study using the Danish Cancer Registry data linkage system was conducted. All cases of myeloma diagnosed in Danish women between 1970 and 1984 (1,010 cases) and 4,040 age-matched women alive at the time of case-diagnosis were identified. Industrial histories from 1964 forward were obtained from the nationwide Pension Fund for 363 cases and 1,517 controls, and the most recent occupation on the tax record was available for 607 cases and 2,596 controls. Using industry/occupational-code combinations for the cases and controls who had industry employment, Danish industrial hygienists assessed the likelihood of exposure to 47 workplace substances. An increased myeloma risk (odds ratio [OR] = 1.2, 95 percent confidence interval [CI] = 1.0-1.5) was seen for women not in the Pension Fund, but who had an occupational title coded as 'Mrs/homemaker.' Nonsignificantly elevated risks of 1.3 or greater were observed for employment in: production of agricultural products; orchards/nurseries; spinning/weaving; other textile and plastics manufacturing; hotel, entertainment, and social services industries. Elevated, but nonsignificant risks were observed for possible and probable exposure to exhaust fumes, formaldehyde, wood dust, animals or animal products, and pesticides. The strongest association with myeloma was employment in the agricultural industry (OR = 1.5, CI = 0.8-2.8), however, the number of women who worked on family farms was unknown and could not be included in this risk estimate.

Study of airborne science experiment management concepts for application to space shuttle, volume 2

NASA Technical Reports Server (NTRS)

Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.

1973-01-01

Airborne research management and shuttle sortie planning at the Ames Research Center are reported. Topics discussed include: basic criteria and procedures for the formulation and approval of airborne missions; ASO management structure and procedures; experiment design, development, and testing aircraft characteristics and experiment interfaces; information handling for airborne science missions; mission documentation requirements; and airborne science methods and shuttle sortie planning.

Are green caterers more likely to serve healthy meals than non-green caterers? Results from a quantitative study in Danish worksite catering.

PubMed

Mikkelsen, Be; Bruselius-Jensen, M; Andersen, Js; Lassen, A

2006-10-01

The present study aimed to investigate whether organic conversion in catering has positive effects on the nutritional quality of menus offered. The methodology was based on a self-administered questionnaire. The self-declared priority given to the use of organic foods was measured as the basis for assigning catering managers to one of two groups: 'green' or 'non-green' caterers. These groups were then compared with regard to the relative nutritional quality of the menu options offered to customers. The study was carried out among randomly selected Danish worksite catering outlets. The subjects participating in the study comprised 526 Danish worksite catering managers. The results showed a strong correlation between caterers' 'green-ness' and the nutritional quality of the menu options offered. Green caters had more healthy options in their menus than non-green caters, which is likely to result in improved nutritional quality of the diets of end consumers. The reason for this may partly be the increased service training efforts that green caterers practise in order to be able to implement organic foods successfully. It may also be associated with the fact that the price premiums and availability of the organic products forces caterers to serve menus with higher amounts of root and non-green leafy vegetables, pulses and seasonal vegetables. The present findings suggest that organic conversion of public canteens may be a good opportunity to promote healthier eating in public catering.

Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study.

PubMed

Østergaard, Lauge; Adelborg, Kasper; Sundbøll, Jens; Pedersen, Lars; Loldrup Fosbøl, Emil; Schmidt, Morten

2018-05-30

The positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 - December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers. Medical records were reviewed. We calculated the positive predictive value according to admission length, and separately for patients with a cardiac implantable electronic device and a prosthetic heart valve using the Wilson score method. Among the 92 medical records available for review, the majority of the patients had admission length ⩾2 weeks. The positive predictive value increased with length of admission. In patients with admission length <2 weeks the positive predictive value was 65% while it was 90% for admission length ⩾2 weeks. The positive predictive value was 81% for patients with a cardiac implantable electronic device and 87% for patients with a prosthetic valve. The positive predictive value of the infective endocarditis diagnosis in the Danish National Patient Registry is high for patients with admission length ⩾2 weeks. Using this algorithm, the Danish National Patient Registry provides a valid source for identifying infective endocarditis for research.

NASA integrated vehicle health management technology experiment for X-37

NASA Astrophysics Data System (ADS)

Schwabacher, Mark; Samuels, Jeff; Brownston, Lee

2002-07-01

The NASA Integrated Vehicle Health Management (IVHM) Technology Experiment for X-37 was intended to run IVHM software on board the X-37 spacecraft. The X-37 is an unpiloted vehicle designed to orbit the Earth for up to 21 days before landing on a runway. The objectives of the experiment were to demonstrate the benefits of in-flight IVHM to the operation of a Reusable Launch Vehicle, to advance the Technology Readiness Level of this IVHM technology within a flight environment, and to demonstrate that the IVHM software could operate on the Vehicle Management Computer. The scope of the experiment was to perform real-time fault detection and isolation for X-37's electrical power system and electro-mechanical actuators. The experiment used Livingstone, a software system that performs diagnosis using a qualitative, model-based reasoning approach that searches system-wide interactions to detect and isolate failures. Two of the challenges we faced were to make this research software more efficient so that it would fit within the limited computational resources that were available to us on the X-37 spacecraft, and to modify it so that it satisfied the X-37's software safety requirements. Although the experiment is currently unfunded, the development effort resulted in major improvements in Livingstone's efficiency and safety. This paper reviews some of the details of the modeling and integration efforts, and some of the lessons that were learned.

Independent School Success Challenging the Danish Public School System

ERIC Educational Resources Information Center

Ringsmose, Charlotte

2013-01-01

Denmark has had a long history of placing a high priority on education and public schooling. It is a declared goal of the Danish welfare system to provide comprehensive schooling, where children from different socioeconomic backgrounds can go to school together and have the same opportunities through education. It is also a declared goal for…

Leadership Behaviors and Its Relation with Principals' Management Experience

ERIC Educational Resources Information Center

Mehdinezhad, Vali; Sardarzahi, Zaid

2016-01-01

This paper aims at studying the leadership behaviors reported by principals and observed by teachers and its relationship with management experience of principals. A quantitative method was used in this study. The target population included all principals and teachers of guidance schools and high schools in the Dashtiari District, Iran. A sample…

Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience.

PubMed

Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P

2018-01-01

Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey. Neurosurgery learners' anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive. Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.

The experience of scar management for adults with burns: An interpretative phenomenological analysis.

PubMed

Martin, C; Bonas, S; Shepherd, L; Hedges, E

2016-09-01

Burns can have both physical and psychological effects on individuals. Pressure garments and silicone gels are used to improve the aesthetic appearance and functions of the skin, but these treatments have been associated with various physical, emotional, sexual and social difficulties. Interpretative phenomenological analysis (IPA) was used to explore participants' experiences of scar management. IPA examines individual experiences before comparing results across cases, and is suited to capture the different ways in which individuals experience a phenomena as well as cautiously looking at patterns across cases. Eight burn patients who had experienced scar management, including pressure garments, were interviewed. Two superordinate themes were identified: Assimilation of Pressure Garment Identity, and Psychosocial Functions of the Pressure Garments. The findings offered insight into the positive and negative experiences of scar management, describing the diverse personal and social functions of the pressure garments and how they became integrated into participants' identities. By understanding the individual nature of these experiences, healthcare professionals can enhance support around these issues and potentially aid adherence to treatment. Further research with different demographic groups as well as for other burn treatments would be useful to develop and contextualise these findings. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Educators' experiences of managing students with ADHD: a qualitative study.

PubMed

Moore, D A; Russell, A E; Arnell, S; Ford, T J

2017-07-01

The symptoms of attention-deficit/hyperactivity disorder are associated with difficulty coping with the social, behavioural and academic components of school. Compared with medication and other non-pharmacological treatment, there is less evidence relating to school-based interventions to support children with ADHD. There is additionally an absence of any research focused on the experiences and practices of educators in the UK around how they work with children who are inattentive, impulsive and hyperactive. Forty-two educational practitioners from primary, secondary and alternate provision schools in the UK participated in focus groups or individual interviews that explored (1) their experiences of managing students with ADHD in the classroom and (2) factors that helped and hindered them in this endeavour. Transcripts were analysed using thematic analysis. Analysis identified six themes: broad strategies, student-centred, inclusive strategies, labelling, medication and relationships. Participants' experiences of managing students with ADHD drew upon a wide range of strategies that typically involved responding to individual needs in an inclusive manner, so individuals with ADHD could access the classroom with their peers. Participants spoke about three factors that helped and hindered managing students with ADHD. Labelling of students with ADHD was reported, with the negative aspects of labelling, such as stigmatization, affecting the classroom. Educators reported mixed experiences regarding the helpfulness of medication; where helpful, it allowed the use of strategies in the classroom. Although students with ADHD were described as having rollercoaster relationships, positive relationships were considered key to the support of children with these difficulties. This study suggests that factors such as attitudes towards ADHD, relationships experienced by students with ADHD and other treatments being delivered need to be carefully considered before strategies are put

Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study.

PubMed

Hansen, Camilla Plambeck; Overvad, Kim; Tetens, Inge; Tjønneland, Anne; Parner, Erik Thorlund; Jakobsen, Marianne Uhre; Dahm, Christina Catherine

2018-05-01

A direct way to evaluate food-based dietary guidelines is to assess if adherence is associated with development of non-communicable diseases. Thus, the objective was to develop an index to assess adherence to the 2013 Danish food-based dietary guidelines and to investigate the association between adherence to the index and risk of myocardial infarction (MI). Population-based cohort study with recruitment of participants in 1993-1997. Information on dietary intake was collected at baseline using an FFQ and an index ranging from 0 to 6 points was created to assess adherence to the 2013 Danish food-based dietary guidelines. MI cases were identified by record linkage to the Danish National Patient Register and the Causes of Death Register. Cox proportional hazards models were used to estimate hazard ratios (HR) of MI. Greater areas of Aarhus and Copenhagen, Denmark. Men and women aged 50-64 years (n 55 021) from the Diet, Cancer and Health study. A total of 3046 participants were diagnosed with first-time MI during a median follow-up of 16·9 years. A higher Danish Dietary Guidelines Index score was associated with a lower risk of MI. After adjustment for potential confounders, the hazard of MI was 13 % lower among men with a score of 3-<4 (HR=0·87; 95 % CI 0·78, 0·96) compared with men with a score of <3. The corresponding HR among women was 0·76 (95 % CI 0·63, 0·93). Adherence to the 2013 Danish food-based dietary guidelines was inversely associated with risk of MI.

Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database

PubMed Central

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert; Bjerrum, Lars

2017-01-01

Objective To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Design Retrospective cohort register-based study including the Danish National Prescription Register. Setting Population-based study of routine electronic antibiotic prescriptions from Danish general practice. Subjects All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Main outcome measures Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions. Results A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n = 506.634), respiratory tract infections (n = 456.354) and unspecified infections (n = 416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon. Conclusion Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable. PMID:28585886

Neurophysiological localisation of ulnar neuropathy at the elbow: Validation of diagnostic criteria developed by a taskforce of the Danish Society of clinical neurophysiology.

PubMed

Pugdahl, K; Beniczky, S; Wanscher, B; Johnsen, B; Qerama, E; Ballegaard, M; Benedek, K; Juhl, A; Ööpik, M; Selmar, P; Sønderborg, J; Terney, D; Fuglsang-Frederiksen, A

2017-11-01

This study validates consensus criteria for localisation of ulnar neuropathy at elbow (UNE) developed by a taskforce of the Danish Society of Clinical Neurophysiology and compares them to the existing criteria from the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM). The Danish criteria are based on combinations of conduction slowing in the segments of the elbow and forearm expressed in Z-scores, and difference between the segments in m/s. Examining fibres to several muscles and sensory fibres can increase the certainty of the localisation. Diagnostic accuracy for UNE was evaluated on 181 neurophysiological studies of the ulnar nerve from 171 peer-reviewed patients from a mixed patient-group. The diagnostic reference standard was the consensus diagnosis based on all available clinical, laboratory, and electrodiagnostic information reached by a group of experienced Danish neurophysiologists. The Danish criteria had high specificity (98.4%) and positive predictive value (PPV) (95.2%) and fair sensitivity (76.9%). Compared to the AANEM criteria, the Danish criteria had higher specificity (p<0.001) and lower sensitivity (p=0.02). The Danish consensus criteria for UNE are very specific and have high PPV. The Danish criteria for UNE are reliable and well suited for use in different centres as they are based on Z-scores. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Private Management of Public Schools: Early Experiences in Four School Districts. Report to Congressional Committees.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

School districts nationwide are experimenting with a range of reform options, one of which is private management of public schools. This General Accounting Office (GAO) report describes the early experiences of four school districts that contracted with private companies for management of their public schools. Specifically, the report describes:…

A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries. The Danish national return-to-work programme.

PubMed

Nielsen, Maj Britt D; Vinsløv Hansen, Jørgen; Aust, Birgit; Tverborgvik, Torill; Thomsen, Birthe L; Bue Bjorner, Jakob; Steen Mortensen, Ole; Rugulies, Reiner; Winzor, Glen; Ørbæk, Palle; Helverskov, Trine; Kristensen, Nicolai; Melchior Poulsen, Otto

2015-02-01

In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support. Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We randomly assigned beneficiaries to CTM (M1: n = 598; M2: n = 459; M3: n = 331) or to ordinary sickness absence management (OSM) (M1: n = 393; M2: n = 324; M3: n = 95). We used the Cox proportional hazards model to estimate hazard ratios (HR) comparing rates of becoming self-supporting between beneficiaries receiving CTM and OSM. In M2, beneficiaries from employment receiving CTM became self-supporting faster compared with beneficiaries receiving OSM (HR = 1.32, 95% CI: 1.08-1.61). In M3, beneficiaries receiving CTM became self-supporting slower than beneficiaries receiving OSM (HR = 0.72, 95% CI: 0.54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17). The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities is not warranted. ISRCTN43004323. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Assessment of exposure to EMF in a Danish case-control study of childhood cancer.

PubMed

Jensen, J K; Olsen, J H; Folkersen, E

1994-01-01

In Denmark it is permitted to draw overhead lines across residential areas. In connection with a Danish case-control study we developed a method for estimating the historical values of magnetic fields at residences. The study included 1,707 cases with childhood cancer and 4,788 matched population controls. A total of 16,082 different addresses had been occupied by the families from the time of conception until the date of diagnosis. The values of the extreme, maximum, middle and minimum 50 Hz magnetic field strengths originating from a 50-400 kV high-voltage installation were estimated for each of the dwellings included in a potential exposure area. 30 children were exposed to an average level of magnetic fields of 0.1 microT or more. The evaluated Danish method of exposure assessment was compared with the method for residential wiring codes developed by Wertheimer and Leeper /1/. We concluded that the US wiring codes are inappropriate for use in connection with the Danish electricity transmission system.

Recent changes in Danish law on drugs and drug offences.

PubMed

Jepsen, J; Laursen, L

1998-09-01

The article recounts changes in Danish Drug Law and Enforcement since the beginning of the 1990s and relates them to general trends in Danish criminal policy during the period. In addition to the implementation of EU directives, e.g. on money laundering and growth hormones, legislation has been passed to curb conspicuous dealing of drugs in the streets of Copenhagen. This part of the legislation is seen as a reaction to public fears and reactions to visible aliens dealing in drugs in a conspicuous way, albeit in minor quantities. The legal changes imply a considerable rise in penalties for repeated dealings in minor quantities and easier access to deportation of aliens. The latter has been criticized as potential violation of the human rights of aliens. This and other recent changes in criminal law and related legislation is seen as an indication of politicians' concerns with voters' anxieties, possibly at the edge of moral panics.

Managing for Desired Experiences and Site Preferences: The Case of Fee-Fishing Anglers

NASA Astrophysics Data System (ADS)

Schuett, Michael A.; Pierskalla, Chad D.

2007-02-01

Fee-fishing involves paying a fee for the privilege of fishing a body of water where fish populations are enhanced by stocking fish. Past literature on this activity has focused more on the operation of the enterprise and management of the fish than the people and site characteristics. The objectives of the study were to profile anglers and describe their site/management preferences. This study utilized an on-site interview and mail-back questionnaire at fee-fishing establishments in West Virginia ( n = 212). Factor analysis of desired recreation experiences yielded five factors: Experience nature & adventure, Stress release & relaxation, Trophy fishing, Escape, and Family time. Cluster analysis showed that these anglers can be segmented into two distinct clusters, differing by sociodemographic characteristics, fishing behavior, and site/management preferences. The findings from this study provide baseline data to aid public resource managers and fee-fishing business owners in determining how to provide satisfying outdoor experiences and deliver desired services on-site. Future research will be needed from additional fee-fishing sites to obtain more detail about this outdoor recreation cohort and be able to generalize to a larger population of participants.

Managing for desired experiences and site preferences: the case of fee-fishing anglers.

PubMed

Schuett, Michael A; Pierskalla, Chad D

2007-02-01

Fee-fishing involves paying a fee for the privilege of fishing a body of water where fish populations are enhanced by stocking fish. Past literature on this activity has focused more on the operation of the enterprise and management of the fish than the people and site characteristics. The objectives of the study were to profile anglers and describe their site/management preferences. This study utilized an on-site interview and mail-back questionnaire at fee-fishing establishments in West Virginia (n = 212). Factor analysis of desired recreation experiences yielded five factors: Experience nature & adventure, Stress release & relaxation, Trophy fishing, Escape, and Family time. Cluster analysis showed that these anglers can be segmented into two distinct clusters, differing by sociodemographic characteristics, fishing behavior, and site/management preferences. The findings from this study provide baseline data to aid public resource managers and fee-fishing business owners in determining how to provide satisfying outdoor experiences and deliver desired services on-site. Future research will be needed from additional fee-fishing sites to obtain more detail about this outdoor recreation cohort and be able to generalize to a larger population of participants.

Parents' experiences managing their child's complicated postoperative recovery.

PubMed

Purcell, Mary; Longard, Julie; Chorney, Jill; Hong, Paul

2018-03-01

Tonsillectomy is commonly performed as same-day surgery and parents are heavily relied upon for management of children's postoperative recovery. The objective of this study was to provide an in-depth description of the experiences parents face when managing their child's complicated postoperative recoveries at home. An exploratory qualitative study at an academic pediatric hospital in Eastern Canada was performed. Participants included 12 parents of children aged 3-6 years who underwent adeno/tonsillectomy and experienced unexpected outcomes or complications during the postoperative recovery period. Parents participated in semi-structured interviews within 6 months of their child's surgery. Interviews were transcribed verbatim and thematic analysis was used to identify themes in the parents' experiences. Parents described struggling to make the decision to come back to hospital, that adequate information does not prevent emotional difficulties, and feeling somewhat responsible for the unexpected outcome or complicated course of recovery. Communication with healthcare providers was considered very important in helping with the recovery process. This research helps to inform healthcare professionals about how they might better support families during complicated recovery processes. Areas of action may include clear communication, setting expectations, and psychosocial support. Copyright © 2018 Elsevier B.V. All rights reserved.

The importance of long‐term experiments in agriculture: their management to ensure continued crop production and soil fertility; the Rothamsted experience

PubMed Central

Johnston, A. E.

2018-01-01

Summary Long‐term field experiments that test a range of treatments and are intended to assess the sustainability of crop production, and thus food security, must be managed actively to identify any treatment that is failing to maintain or increase yields. Once identified, carefully considered changes can be made to the treatment or management, and if they are successful yields will change. If suitable changes cannot be made to an experiment to ensure its continued relevance to sustainable crop production, then it should be stopped. Long‐term experiments have many other uses. They provide a field resource and samples for research on plant and soil processes and properties, especially those properties where change occurs slowly and affects soil fertility. Archived samples of all inputs and outputs are an invaluable source of material for future research, and data from current and archived samples can be used to develop models to describe soil and plant processes. Such changes and uses in the Rothamsted experiments are described, and demonstrate that with the appropriate crop, soil and management, acceptable yields can be maintained for many years, with either organic manure or inorganic fertilizers. Highlights Long‐term experiments demonstrate sustainability and increases in crop yield when managed to optimize soil fertility.Shifting individual response curves into coincidence increases understanding of the factors involved.Changes in inorganic and organic pollutants in archived crop and soil samples are related to inputs over time.Models describing soil processes are developed from current and archived soil data. PMID:29527119

Attitudes to and implementation of video interpretation in a Danish hospital: A cross-sectional study.

PubMed

Mottelson, Ida Nygaard; Sodemann, Morten; Nielsen, Dorthe Susanne

2018-03-01

Immigrants, refugees, and their descendants comprise 12% of Denmark's population. Some of these people do not speak or understand Danish well enough to communicate with the staff in a healthcare setting and therefore need interpreter services. Interpretation through video conferencing equipment (video interpretation) is frequently used and creates a forum where the interpreter is not physically present in the medical consultation. The aim of this study was to investigate the attitudes to and experiences with video interpretation among charge nurses in a Danish university hospital. An electronic questionnaire was sent to 99 charge nurses. The questionnaire comprised both closed and open-ended questions. The answers were analysed using descriptive statistics and thematic text condensation. Of the 99 charge nurses, 78 (79%) completed the questionnaire. Most charge nurses, 21 (91%) of the daily/monthly users, and 21 (72%) of the monthly/yearly users, said that video interpretation increased the quality of their conversations with patients. A total of 19 (24%) departments had not used video interpretation within the last 12 months. The more the charge nurses used video interpretation, the more satisfied they were. Most of the charge nurses using video interpretation expressed satisfaction with the technology and found it easy to use. Some charge nurses are still content to allow family or friends to interpret. To reach its full potential, video interpretation technology has to be reliable and easily accessible for any consultation, including at the bedside.

Psychotherapy and Cognitive Behavioral Therapy Supervision in Danish Psychiatry: Training the Next Generation of Psychiatrists.

PubMed

Schmidt, Lasse M; Foli-Andersen, Nina J

2017-02-01

Psychotherapy training is mandatory for physicians to qualify as psychiatrists in Denmark. Evidence for the effectiveness of psychotherapy has increased, and psychotherapy is increasingly included in international treatment guidelines. The authors investigated how psychiatrists in training in Denmark evaluate the opportunities to practice psychotherapy in their training and the quality of the supervision they receive in psychotherapy training, particularly for cognitive behavioral therapy (CBT). The authors conducted a survey regarding psychotherapy training and CBT supervision among psychiatrists in training at Danish psychiatric specialist training courses. They investigated respondents' interest and experience in psychotherapy and respondents' views on the relevance and feasibility of performing psychotherapy and receiving supervision in their psychiatry training. Eighty-eight percent of the psychiatrists in training found psychotherapy to be a relevant part of their training; however, 77 % found it difficult to find time to practice psychotherapy and 44 % felt that practicing psychotherapy was a strain on their employer. Thirty-six percent and 53 %, respectively, had difficulties securing psychodynamic and CBT supervision. In CBT supervision, more than 60 % reported supervision that appeared to be below the expected CBT supervision standard and often so much below it might not qualify as CBT supervision. There is a need to focus on how to better integrate psychotherapy and supervision in the Danish psychiatric training program. Good CBT supervision may be lacking, and a way to ensure high-quality supervision is required.

The Danish health care system: it ain't broke... so don't fix it.

PubMed

Mooney, Gavin

2002-02-01

The organisation and financing of the Danish health care system was evaluated within a framework of analysis of strengths, weaknesses, opportunities and threats (a SWOT analysis) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system, and a 1 week-visit to health care authorities, providers and key persons. This paper includes the main findings by one of the panel members. The international competition 'wave' passed by Denmark, and the Danish might rightly say 'thank goodness'. Funding is very largely public and there is a single dominant authority, i.e. the county, which makes planning easier. Low levels of patient payments and the smaller size of the private sector reflect Danish 'solidarity' and promote equity. Planning is good. Exceptions to this are the over-concern with hospital waiting lists and the flirting with DRG based funding. Greater investment in planning approaches would make the system yet better. The GP blended remuneration system with capitation and fee for service is a major strength. The fact that the system has such potential for technical and allocative efficiency and also equity but is not fully exploited suggests the need for more investment in health services research. While there is scope for improving the health care system in Denmark, the rest of the world has as much to learn from the Danes as the Danes have from the rest of the world.

Cross-Cultural Translation, Adaptation and Reliability of the Danish M. D. Andeson Dysphagia Inventory (MDADI) in Patients with Head and Neck Cancer.

PubMed

Hajdú, Sara Fredslund; Plaschke, Christina Caroline; Johansen, Christoffer; Dalton, Susanne Oksbjerg; Wessel, Irene

2017-08-01

The objectives were to translate and culturally adapt the M.D. Anderson Dysphagia Inventory (MDADI) into Danish and subsequently test the reliability of the Danish version. The MDADI was translated into Danish and cross culturally adapted through cognitive interviews. The final version was test-retest evaluated in a group of head and neck cancer (HNC) patients who responded to the questionnaire twice with a mean of eight days apart. Interclass correlation coefficient, Cronbach's alpha, floor and ceiling effects, standard error of measurement and minimal detectable change were investigated. Fourteen patients were interviewed on the comprehensibility of the Danish MDADI, and all found the questionnaire meaningful, easy to understand, non-offensive and to include relevant aspects of dysphagia related to HNC. Sixty-four patients were included in the test-retest study. Especially, one item in the emotional scale (E7) appeared to be often misinterpreted, and ceiling effects were found in all four subdomains (global, emotional, functional and physical). The four subdomains and the composite score showed acceptable test-retest reliability and internal consistency in a Danish population of HNC patients. The Danish MDADI is reliable in terms of internal consistency and test-retest reproducibility and can be used in assessing the health-related quality of life in head and neck cancer patients with dysphagia.

Time to dismiss the idea of a structural fix within government? An analysis of intersectoral action for health in Danish municipalities.

PubMed

Holt, Ditte H; Carey, Gemma; Rod, Morten H

2018-06-01

This paper examines the role of organizational structure within government(s) in attempts to implement intersectoral action for health in Danish municipalities. We discuss the implications of structural reorganization and the governance structures that are established in order to ensure coordination and integration between policy sectors. The paper is based on 49 interviews with civil servants from health and non-health sectors of 10 municipalities. Based on participants' experiences, cases have been described and analyzed in an iterative process consulting the literature on Health in All Policies and joined-up government. Continuous and frequent processes of reorganizing were widespread in the municipalities. However, they appeared to have little effect on policy change. The two most common governance structures established to transcend organizational boundaries were the central unit and the intersectoral committee. According to the experiences of participants, paradoxically both of these organizational solutions tend to reproduce the organizational problems they are intended to overcome. Even if structural reorganization may succeed in dissolving some sector boundaries, it will inevitably create new ones. It is time to dismiss the idea that intersectoral action for health can be achieved by means of a structural fix. Rather than rearranging organizational boundaries it may be more useful to seek to manage the silos which exist in any organization, e.g. by promoting awareness of their implications for public health action and by enhancing the boundary spanning skills of public health officers.

Loss of Financial Management Independence After Brain Injury: Survivors' Experiences.

PubMed

Koller, Kathryn; Woods, Lindsay; Engel, Lisa; Bottari, Carolina; Dawson, Deirdre R; Nalder, Emily

2016-01-01

This pilot study explored the experiences of brain injury survivors after a change in financial management (FM) independence. Using a qualitative descriptive design, 6 participants with acquired brain injury were recruited from a community brain injury organization and participated in semistructured interviews. Data were analyzed using thematic analysis. Three themes emerged from the interviews: (1) trajectory of FM change, involving family members as key change agents; (2) current FM situation, involving FM strategies such as automatic deposits and restricted budgets; and (3) the struggle for control, in which survivors desired control while also accepting supports for FM. This study identifies some of the challenges brain injury survivors face in managing their finances and the adjustment associated with a loss of FM independence. Occupational therapists should be aware of clients' experiences when supporting them through a change in independence. Copyright © 2016 by the American Occupational Therapy Association, Inc.

The Value of Open Geographical Data - The Danish Case

NASA Astrophysics Data System (ADS)

Colding, T. S.; Folner, M.; Krarup, S.; Kongsbak, J.

2013-12-01

Good basic data for everyone is part of the common public-sector digitization strategy for 2011 to 2015. The vision is that basic data is to be the high-quality common foundation for public sector administration; efficiently updated at one place, and used by everyone - including the private sector. Open basic data will benefit public-sector efficiency as well as innovation and value creation by Danish society in general. With basic data as a new digital raw material, commercial products can be developed and public information and services can be improved, providing for greater insight and stronger democracy. On the first of January 2013 Denmark released this digital raw material. As a general rule, all basic data is to be made freely available to all public authorities, private businesses and individuals. This makes basic data a common digital resource, which can be exploited freely for commercial as well as non-commercial purposes. A positive business case contributed in convincing Danish politicians to approve the basic data program. Once the initiatives have been fully implemented, the revenues for society are expected to be approx. DKK 800 million annually. Private-sector revenues will be up to DKK half a billion annually, and it is expected that e.g. the real estate, insurance, financial, and telecom sectors, as well as GPS (sat-nav) manufacturers, public companies and entrepreneurs will be among those to benefit hugely from the initiatives. The financial gain for the private sector of open geographical data alone is expected to be approx. 100 million DKK annually. As part of the Basic data program The Danish Geodata Agency (Ministry of the Environment) gave free access to all topographic data, cadastral maps and Digital Elevation Model on Jan. 1st, 2013. The Danish Geodata Agency has decided to measure the effect of the open geographic data in the public sector (efficiency) and in the private sector (growth). The effect will be measured by using reference

Hospital management training and improvement in managerial skills: Serbian experience.

PubMed

Supic, Zorica Terzic; Bjegovic, Vesna; Marinkovic, Jelena; Milicevic, Milena Santric; Vasic, Vladimir

2010-06-01

The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Engineering and management experience at Texas A&M Transportation Institute

NASA Astrophysics Data System (ADS)

Chowdhury, Arif Tahjibul

This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the

Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S

2015-01-01

To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit

Managers' views on and experiences with moral case deliberation in nursing teams.

PubMed

Weidema, Froukje C; Molewijk, A C Bert; Kamsteeg, Frans; Widdershoven, Guy A M

2015-11-01

Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied. As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised. Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate. MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team. MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team. © 2015 John Wiley & Sons Ltd.

[Interpretation in the Danish health-care system].

PubMed

Lund Hansen, Marianne Taulo; Nielsen, Signe Smith

2013-03-04

Communication between health professional and patient is central for treatment and patient safety in the health-care system. This systematic review examines the last ten years of specialist literature concerning interpretation in the Danish health-care system. Structural search in two databases, screening of references and recommended literature from two scientists led to identification of seven relevant articles. The review showed that professional interpreters were not used consistently when needed. Family members were also used as interpreters. These results were supported by international investigations.

Danish Rural Eye Study: the association of preschool vision screening with the prevalence of amblyopia.

PubMed

Høeg, Tracy B; Moldow, Birgitte; Ellervik, Christina; Klemp, Kristian; Erngaard, Ditte; la Cour, Morten; Buch, Helena

2015-06-01

To determine the prevalence of amblyopia in Denmark before and after the initiation of the Danish national preschool vision screening programme. In a population-based cross-sectional study, 3826 participants of the Danish General Suburban Population Study (GESUS) aged 20 years and older from a Danish rural municipality received a complete general health examination and an ophthalmological interview and examination. This study included a comprehensive ophthalmologic interview, measurement of best corrected visual acuity (BCVA) in each eye, Hirschberg's test for strabismus and two 45-degree retinal fundus photographs of each eye. A complete ophthalmologic examination was performed when indicated. The prevalence of monocular visual impairment (MVI) was 4.26% (95% CI, 3.66-4.95, n = 163). Amblyopia was the most common cause, accounting for 33%. The prevalence of amblyopia was 1.44% (95% CI, 1.01-1.81, n = 55), being higher among non-preschool vision screened persons compared to those who were offered (estimated 95% attendance) preschool vision screening (1.78%, n = 41, 95% CI 1.24-2.33 versus 0.44%, n = 2, 95% CI, 0.12-1.60, p = 0.024). The leading cause of amblyopia was anisometropia (45.5%, 25/55). Amblyopia was the most common cause of MVI. Following the initiation of the Danish national preschool vision screening programme, which has an approximate attendance rate of 95%, the prevalence of amblyopia decreased by fourfold. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Compliance with national recommendations for exercise during early pregnancy in a Danish cohort.

PubMed

Broberg, Lotte; Ersbøll, Anne S; Backhausen, Mette G; Damm, Peter; Tabor, Ann; Hegaard, Hanne K

2015-11-27

Exercise during pregnancy is associated with health benefits for both the mother and the fetus, and is therefore recommended in several national guidelines. Only few studies investigate whether these guideline recommendations are met. The aims of this study were 1. To assess the prevalence of pregnant women meeting the Danish recommendations for exercise during early pregnancy, 2. To identify pre-pregnancy factors associated with a lower probability for meeting the recommendations, and 3. To describe which types of exercise pregnant women prefer before and during pregnancy. We conducted a cross-sectional study based on a questionnaire during the first trimester among 7,915 women participating in the prospective Copenhagen Pregnancy Cohort. Associations were estimated by multivariate regression analyses. In early pregnancy, 38 % of the study population met the recommendation for exercise from the Danish Health and Medicines Authority (≥3.5 hours a week). Multiparity, previous miscarriage use of assisted reproductive technology, no engagement in exercise before pregnancy, smoking, pregnancy following assisted reproductive technology, overweight, not understanding Danish language and a low educational level were all factors associated a lower probability for meeting the recommendations. The preferred types of exercise before and during pregnancy were bicycling, brisk walking, running and strength training. The proportion of women engaged in any type of exercise decreased in early pregnancy with the exception of swimming and aquatic exercise. In this cohort, more than one-third met the Danish recommendation for exercise during early pregnancy. Exercise in pregnancy is still an issue to address because the most vulnerable groups of pregnant women do not exercise. This is a cause of concern because it may reflect social inequalities in health and highlights the need for a structural and systematic approach to preconception care and early antenatal counselling.

Genetic and Environmental Regulation on Longitudinal Change of Metabolic Phenotypes in Danish and Chinese Adult Twins

PubMed Central

Li, Shuxia; Kyvik, Kirsten Ohm; Pang, Zengchang; Zhang, Dongfeng; Duan, Haiping; Tan, Qihua; Hjelmborg, Jacob; Kruse, Torben; Dalgård, Christine

2016-01-01

Objective The rate of change in metabolic phenotypes can be highly indicative of metabolic disorders and disorder-related modifications. We analyzed data from longitudinal twin studies on multiple metabolic phenotypes in Danish and Chinese twins representing two populations of distinct ethnic, cultural, social-economic backgrounds and geographical environments. Materials and Methods The study covered a relatively large sample of 502 pairs of Danish adult twins followed up for a long period of 12 years with a mean age at intake of 38 years (range: 18–65) and a total of 181 Chinese adult twin pairs traced for about 7 years with a mean baseline age of 39.5 years (range: 23–64). The classical twin models were fitted to the longitudinal change in each phenotype (Δphenotype) to estimate the genetic and environmental contributions to the variation in Δphenotype. Results Moderate to high contributions by the unique environment were estimated for all phenotypes in both Danish (from 0.51 for low density lipoprotein cholesterol up to 0.72 for triglycerides) and Chinese (from 0.41 for triglycerides up to 0.73 for diastolic blood pressure) twins; low to moderate genetic components were estimated for long-term change in most of the phenotypes in Danish twins except for triglycerides and hip circumference. Compared with Danish twins, the Chinese twins tended to have higher genetic control over the longitudinal changes in lipids (except high density lipoprotein cholesterol) and glucose, higher unique environmental contribution to blood pressure but no genetic contribution to longitudinal change in body mass traits. Conclusion Our results emphasize the major contribution of unique environment to the observed intra-individual variation in all metabolic phenotypes in both samples, and meanwhile reveal differential patterns of genetic and common environmental regulation on changes over time in metabolic phenotypes across the two samples. PMID:26862898

Production Experiences with the Cray-Enabled TORQUE Resource Manager

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ezell, Matthew A; Maxwell, Don E; Beer, David

High performance computing resources utilize batch systems to manage the user workload. Cray systems are uniquely different from typical clusters due to Cray s Application Level Placement Scheduler (ALPS). ALPS manages binary transfer, job launch and monitoring, and error handling. Batch systems require special support to integrate with ALPS using an XML protocol called BASIL. Previous versions of Adaptive Computing s TORQUE and Moab batch suite integrated with ALPS from within Moab, using PERL scripts to interface with BASIL. This would occasionally lead to problems when all the components would become unsynchronized. Version 4.1 of the TORQUE Resource Manager introducedmore » new features that allow it to directly integrate with ALPS using BASIL. This paper describes production experiences at Oak Ridge National Laboratory using the new TORQUE software versions, as well as ongoing and future work to improve TORQUE.« less

Factors associated with inter-municipality differences in dental caries experience among Danish adolescents. An ecological study.

PubMed

Ekstrand, K R; Christiansen, M E C; Qvist, V; Ismail, A

2010-02-01

Caries on children and adolescents in Denmark has declined significantly over the last 30 years. Our first analysis in 1999, however, disclosed huge inter-municipality disparities in mean DMFS values as well as in prevalence of caries on Danish children; that fluoride in the water supply and the length of the education of the mothers could explain up to 45% of the above-mentioned disparity and that very few municipalities were positive outliers, i.e. were providing significant better caries results than expected from the background variables. Three of the aims of this second analysis were to repeat the analyses done on the 1999 sample, but now on a 2004 sample and then compare it with the results from 1999. A fourth aim was by means of an interview of CDOs to determine their interpretation of relevant conditions in the public dental health service in relation dental health outcome. A total of 204 (99%) and 191 (93%) municipalities were involved in 1999 and 2004, respectively. Unit of analysis were the municipalities. Mean DMFS of 15-year-olds was used as outcome variable. Eight background variables were accounted for during the analysis: For the fourth aim, a sample of CDOs representing municipalities with positive (n = 10), with no change (n = 10), or with negative change (n = 10) in mean DMFS, relative to all municipalities, between 1999 and 2004 was selected. The inter-municipality variation in mean DMFS 1999 was 0.88 to 8.73 and in 2004 was 0.56 to 6.19. The analyses found that fluoride level of the drinking water and mothers' length of education were significant variables explaining about 44% of the variations in mean DMFS in both years. Only one municipality was characterized as a positive outlier in 1999 as well as in 2004. The dose-response relations between increasing fluoride concentrations in the water supply and DMF-S values diminished in both years at a level above 0.35 ppm. The structured interview disclosed that municipalities with significant

Managing the negatives of experience in physician teams.

PubMed

Hoff, Timothy

2010-01-01

Experience is a key shaper of thought and action in the health care workplace and a fundamental component of management and professional policies dealing with improving quality of care. Physicians rely on experience to structure social interaction, to determine authority relations, and to resist organizational encroachments on their work and autonomy. However, an overreliance on experience within physician teams may paradoxically undermine learning, participation, and entrepreneurship, affecting organizational performance. Approximately 100 hours of direct observation of normal workdays for physician teams (n = 17 physicians) in two different work settings in a single academic medical center located in the Northeastern part of the United States. Qualitative data were collected from physician teams in the medical intensive care unit and trauma/general surgery settings. Data were transcribed and computer analyzed through an interactive process of open coding, theoretical sampling, and pattern recognition that proceeded longitudinally. Three particular experience-based schemas were identified that physician teams used to structure social relations and perform work. These schemas involved using experience as a commodity, trump card, and liberator. Each of these schemas consisted of strongly held norms, beliefs, and values that produced team dynamics with the potential for undermining learning, participation, and entrepreneurship in the group. Organizations may move to mitigate the negative impact of an overreliance on experience among physicians by promoting bureaucratic forms of control that enable physicians to engage learning, participation, and entrepreneurship in their work while not usurping existing and difficult-to-change cultural drivers of team behavior.

A Necessary Evil: The Experiences of Managers Implementing Downsizing Programmes

ERIC Educational Resources Information Center

Noronha, Ernesto; D'Cruz, Premilla

2006-01-01

This paper presents the findings of a phenomenological study, which describes the experiences of human resource (HR) managers implementing a downsizing program in a steel manufacturing organization in India. Data were collected through conversational interviews. Following van Manens sententious analytic approach, the core theme of a necessary…

The journey toward shared governance: the lived experience of nurse managers and staff nurses.

PubMed

Ott, Joyce; Ross, Carl

2014-09-01

The purpose of the study was to explore the lived experience of nurse managers and staff nurses in shared governance. Shared governance refers to systems and services aligned in partnership. The information gained by studying the lived experience of nurse managers and staff nurses in shared governance is valuable for providing knowledge of empowerment. A qualitative design was used. Data were collected through a semi-structured interview using five questions with 11 Registered Nurses. Data were analysed through thematic analysis. Four themes emerged from data analysis. Nurse managers identified the journey of patient satisfaction; journey of empowerment; journey of self-management and journey of wellness. Staff nurses identified the journey of development and implementation of best practice; journey to provide quality patient care, journey to a new culture of nursing; and journey of a variety of challenges. This study supports the idea that collaboration between nurse managers and staff nurses develops a journey toward shared governance. Nursing management can use findings to empower nurses to collaborate with nurse managers toward best practice. This adds to current knowledge that partnership of nurse managers and staff nurses, supports and encourages ownership in shared governance. © 2013 John Wiley & Sons Ltd.

The principle of respect for autonomy--concordant with the experience of oncology physicians and molecular biologists in their daily work?

PubMed

Ebbesen, Mette; Pedersen, Birthe D

2008-03-26

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. We found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation. In this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the theories can be developed further to be

Leadership and management skills of general practice nurses: experience or education?

PubMed

Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

2014-12-01

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

Integrating theory into disturbance interaction experiments to better inform ecosystem management.

PubMed

Foster, Claire N; Sato, Chloe F; Lindenmayer, David B; Barton, Philip S

2016-04-01

Managing multiple, interacting disturbances is a key challenge to biodiversity conservation, and one that will only increase as global change drivers continue to alter disturbance regimes. Theoretical studies have highlighted the importance of a mechanistic understanding of stressor interactions for improving the prediction and management of interactive effects. However, many conservation studies are not designed or interpreted in the context of theory and instead focus on case-specific management questions. This is a problem as it means that few studies test the relationships highlighted in theoretical models as being important for ecological management. We explore the extent of this problem among studies of interacting disturbances by reviewing recent experimental studies of the interaction between fire and grazing in terrestrial ecosystems. Interactions between fire and grazing can occur via a number of pathways; one disturbance can modify the other's likelihood, intensity or spatial distribution, or one disturbance can alter the other's impacts on individual organisms. The strength of such interactions will vary depending on disturbance attributes (e.g. size or intensity), and this variation is likely to be nonlinear. We show that few experiments testing fire-grazing interactions are able to identify the mechanistic pathway driving an observed interaction, and most are unable to detect nonlinear effects. We demonstrate how these limitations compromise the ability of experimental studies to effectively inform ecological management. We propose a series of adjustments to the design of disturbance interaction experiments that would enable tests of key theoretical pathways and provide the deeper ecological understanding necessary for effective management. Such considerations are relevant to studies of a broad range of ecological interactions and are critical to informing the management of disturbance regimes in the context of accelerating global change. © 2015 John

Effect of diuretics on fetal growth: A drug effect or confounding by indication? Pooled Danish and Scottish cohort data

PubMed Central

Olesen, Charlotte; de Vries, Corinne S; Thrane, Nana; MacDonald, Tom M; Larsen, Helle; Sørensen, Henrik Toft

2001-01-01

Aims The diabetogenic effect of diuretics, as well as the indication for prescribing them, may impact on fetal growth. We analysed whether the purchase of prescription drugs for diuretics during pregnancy was associated with measures of fetal growth. Methods During 1991–98 all women who purchased prescription drugs for diuretics during pregnancy were identified in the Northern Jutland Prescription Database (NJDP), Denmark, and in the Medicines Monitoring Unit's Database (MEMO), Scotland. Information on birth weight and gestational age was obtained from the Danish Birth Registry, the Danish Hospital Discharge Registry and the Scottish Tayside Neonatal Database. Information on diabetes, hypertension and prepregnancy weight were obtained by hospital record review in a sample of women in the Danish cohort. Women who did not purchase prescription diuretics during pregnancy were used as a reference group in both cohorts. Results Danish women who purchased prescription loop diuretics during pregnancy gave birth to infants with higher birth weights than women who did not use diuretics; mean difference 104.7 g (95% CI; 2.6, 206.9). However, the high prevalence of diabetes (10.3%) among Danish women who purchased prescription loop diuretics during pregnancy might explain this result. Both the Danish and the Scottish women who purchased prescription diuretics during their pregnancy were at increased risk of preterm delivery (< 37 completed weeks); ORs: 1.8 (CI; 1.2, 2.7)NJDP, 1.9 (CI; 0.9, 4.3)MEMO. The proportion of hypertension among women who purchased prescription thiazides was 15.8%, and the risk of having an infant with a birth weight (BW) < 2500 g was increased; ORs: 2.6 (CI; 1.4, 5.0)NJDP, 2.4 (CI; 0.8, 7.8)MEMO. Conclusions Prescribing diuretics during pregnancy was associated with differences in birth weight and incidence of preterm delivery. Confounding by indication may explain the findings. PMID:11259987

Evaluation of test-strategies for estimating probability of low prevalence of paratuberculosis in Danish dairy herds.

PubMed

Sergeant, E S G; Nielsen, S S; Toft, N

2008-06-15

Paratuberculosis is a chronic infection affecting cattle and other ruminants. In the dairy industry, losses due to paratuberculosis can be substantial in infected herds and several countries have implemented national programmes based on herd-classification to manage the disease. The aim of this study was to develop a method to estimate the probability of low within-herd prevalence of paratuberculosis for Danish dairy herds. A stochastic simulation model was developed using the R programming environment. Features of this model included: use of age-specific estimates of test-sensitivity and specificity; use of a distribution of observed values (rather than a fixed, low value) for design prevalence; and estimates of the probability of low prevalence (PrLow) based on a specific number of test-positive animals, rather than for a result less than or equal to a specified cut-point number of reactors. Using this model, five herd-testing strategies were evaluated: (1) milk-ELISA on all lactating cows; (2) milk-ELISA on lactating cows4 years old; (4) faecal culture on all lactating cows; and (5) milk-ELISA plus faecal culture in series on all lactating cows. The five testing strategies were evaluated using observed milk-ELISA results from 19 Danish dairy herds as well as for simulated results from the same herds assuming that they were uninfected. Whole-herd milk-ELISA was the preferred strategy, and considered the most cost-effective strategy of the five alternatives. The five strategies were all efficient in detecting infection, i.e. estimating a low PrLow in infected herds, however, PrLow estimates for milk-ELISA on age-cohorts were too low in simulated uninfected herds and the strategies involving faecal culture were too expensive to be of practical interest. For simulated uninfected herds, whole-herd milk-ELISA resulted in median PrLow values>0.9 for most herds, depending on herd size and age-structure. None of the

Change Management Model for Implementing an Effective First-Year Experience Program in the Community College Setting

ERIC Educational Resources Information Center

Tucker, Joy C.

2015-01-01

This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…

Developing International Managers: The Contribution of Cultural Experience to Learning

ERIC Educational Resources Information Center

Townsend, Peter; Regan, Padraic; Li, Liang Liang

2015-01-01

Purpose: The purpose of this paper is to evaluate cultural experience as a learning strategy for developing international managers. Design/methodology/approach: Using an integrated framework, two quantitative studies, based on empirical methodology, are conducted. Study 1, with an undergraduate sample situated in the Asia Pacific, aimed to examine…

Care coordination experiences of people with disabilities enrolled in medicaid managed care.

PubMed

Bowers, Anne; Owen, Randall; Heller, Tamar

2017-10-01

To understand the impact of experience and contacts with care coordinators on Medicaid Managed Care (MMC) enrollees with disabilities. Primary data was collected from a random sample of 6000 out of the 100,000 people with disabilities enrolled in one state's mandatory MMC program. Surveys were conducted through the mail, telephone, and Internet; 1041 surveys were completed. The sample used for analysis included 442 MMC enrollees who received care coordination. Regression analyses were conducted with the outcomes of number of unmet health care needs and enrollee appraisal of the health services they received. Race, age, gender, and disability variables controlled for demographic differences, and the independent variables included enrollee experience with a care coordinator (coordinator knowledge of enrollee medical history and whether the coordinator took into account enrollee wishes and input) and frequency of contact with a care coordinator. Positive enrollee experiences with care coordinators significantly related to more positive enrollee health service appraisals and fewer unmet health care needs; frequency of contact did not have any significant impacts. People with mental health disabilities and intellectual/developmental disabilities had significantly lower health service appraisals. People with mental health disabilities had significantly more unmet needs. Quality of care coordination, but not frequency of contact alone, is associated with better health outcomes for MMC enrollees. Implications for rehabilitation Care coordination is a core component of managed care and facilitates effective healthcare management for people with complex chronic conditions and disabilities. Better experiences with care coordinators is related to fewer unmet healthcare needs and more positive health care service appraisals for Medicaid managed care enrollees. The continuous development of person-centered care coordination strategies and training programs emphasizing quality

Translation and validation of the Danish version of the brief family assessment measure III in a sample of acutely admitted elderly medical patients.

PubMed

Shamali, Mahdi; Konradsen, Hanne; Lauridsen, Jørgen T; Østergaard, Birte

2017-11-13

Family functioning plays a pivotal role in the adaptation to illness of both individuals and families, especially among elderly patients. The Brief Family Assessment Measure Third Edition (Brief FAM-III) is among the most frequently used self-report instruments that measures family functioning. However, no Danish translation or measure of its psychometric properties in a Danish population is available. The purpose of this study was to translate the Brief FAM-III into Danish and then evaluate its psychometric properties in elderly patients. The Brief FAM-III was translated into Danish using the forward-backward translation procedure and examined its psychometric properties in 60 elderly patients (aged over 65) consecutively admitted to an acute medical ward. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and confirmatory factor analysis was used to examine the construct validity of the Brief FAM-III. Evaluation of the Danish version of the Brief FAM-III confirmed the three-factor structure (General Scale, Self-Rating Scale and Dyadic Relationships Scale) identified in the original instrument. However, goodness-of-fit indicators showed a relatively poor model fit. Cronbach's alpha for the total scales of Brief FAM-III was 0.94 suggesting good internal consistency. The Danish version of the Brief FAM-III demonstrated satisfactory validity and reliability to assess family functioning among acutely admitted elderly Danish patients. We suggest that it may also be useful for monitoring family functioning over time or determining the effects of therapeutic interventions in elderly medical patients; however, further testing is recommended. © 2017 Nordic College of Caring Science.

Theorising EIA effectiveness: A contribution based on the Danish system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyhne, Ivar, E-mail: lyhne@plan.aau.dk; Laerhoven, Frank van; Cashmore, Matthew

Considerable attention has been given to the effectiveness of environmental impact assessment (EIA) since the 1970s. Relatively few research studies, however, have approached EIA as an instrument of environmental governance, and have explored the mechanisms through which EIA influences the behaviour of actors involved in planning processes. Consequently, theory in this area is underspecified. In this paper we contribute to theory-building by analysing the effectiveness of a unique EIA system: the Danish system. In this system the competent authority, instead of the project proponent, undertakes EIA reporting. Additionally, the public, rather than experts, play a central role in quality controlmore » and the Danish EIA community is relatively small which influences community dynamics in particular ways. A nation-wide survey and expert interviews were undertaken in order to examine the views of actors involved in EIA on the effectiveness of this anomalous system. The empirical data are compared with similar studies on governance mechanisms in other countries, especially the United Kingdom and the Netherlands, as well as with earlier evaluations of EIA effectiveness in Denmark. The results indicate that the more extensive role attributed to the competent authority may lead to higher EIA effectiveness when this aligns with their interests; the influence of the public is amplified by a powerful complaints system; and, the size of the EIA community appears to have no substantial influence on EIA effectiveness. We discuss how the research findings might enhance our theoretical understanding of the operation and effectiveness of governance mechanisms in EIA. - Highlights: • The effectiveness of the unique Danish EIA system is explored. • Results are compared with similar studies in the Netherlands and the UK. • Findings lead to hypotheses that contribute to theorising EIA effectiveness.« less

Building a First-Class Faculty Based on the Management Experience of the University of Pennsylvania

ERIC Educational Resources Information Center

Luo, Zhongshu

2014-01-01

The article analyzes the practice and experience of faculty management at the University of Pennsylvania and its implications for Chinese universities from the perspective of management systems and operation mechanisms. Recent reforms and innovation of faculty management at Sichuan University are described.

The principle of respect for autonomy – Concordant with the experience of oncology physicians and molecular biologists in their daily work?

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2008-01-01

Background This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. Methods This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results We found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation. Conclusion In this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the

The influence of feed and herd on fatty acid composition in 3 dairy breeds (Danish Holstein, Danish Jersey, and Swedish Red).

PubMed

Poulsen, N A; Gustavsson, F; Glantz, M; Paulsson, M; Larsen, L B; Larsen, M K

2012-11-01

The composition of milk fat from dairy cows is related to both genetic and environmental factors. Here, the effect of feed and herd was examined in 3 Scandinavian breeds, namely Danish Holstein-Friesian (DH), Danish Jersey (DJ), and Swedish Red (SR). In total, milk samples from 1,298 cows kept in indoor housing systems were collected from 61 conventional dairy herds in Denmark and Sweden. The fatty acid (FA) composition of milk was determined by gas chromatography and the content of α-tocopherol by HPLC. Based on the 17 individual FA determined, distinct FA profiles were observed for all breeds using univariate and multivariate statistics. The DJ cows were characterized by higher levels of saturated short-chain FA; in contrast, DH cows had higher content of unsaturated C18 FA, whereas higher levels of primarily C14:0, C14:1, C18:1 cis-9, and C18:3n-3 were evident in SR cows. This variation in milk fat composition across breeds was further reflected in different desaturase indices, which were generally higher in SR cows. In addition, α-tocopherol differed significantly among breeds, with DJ cows having the highest content. Herd-specific feeding plans were collected, and different feed items were separated into 4 broad feed categories, including grass products, maize silage, grain, and concentrate. The pronounced differences in overall feed composition among breeds were, to a large extent, due to regional differences between countries, with SR receiving higher levels of grain and grass silage compared with the Danish breeds. Within breeds, differences in feeding regimens among herds were furthermore higher in SR. Significant correlations between feed category and individual FA were observed in all breeds. Furthermore, variance components were estimated and used to determine the proportion of phenotypic variation that could be explained by herd. The herd effect for individual FA was generally lower for DH compared with the 2 other breeds. In addition, very low herd

The NASA Integrated Vehicle Health Management Technology Experiment for X-37

NASA Technical Reports Server (NTRS)

Schwabacher, Mark; Samuels, Jeff; Brownston, Lee; Clancy, Daniel (Technical Monitor)

2002-01-01

The NASA Integrated Vehicle Health Management (IVHM) Technology Experiment for X-37 was intended to run IVHM software on-board the X-37 spacecraft. The X-37 is intended to be an unpiloted vehicle that would orbit the Earth for up to 21 days before landing on a runway. The objectives of the experiment were to demonstrate the benefits of in-flight IVHM to the operation of a Reusable Launch Vehicle, to advance the Technology Readiness Level of this IVHM technology within a flight environment, and to demonstrate that the IVHM software could operate on the Vehicle Management Computer. The scope of the experiment was to perform real-time fault detection and isolation for X-37's electrical power system and electro-mechanical actuators. The experiment used Livingstone, a software system that performs diagnosis using a qualitative, model-based reasoning approach that searches system-wide interactions to detect and isolate failures. Two of the challenges we faced were to make this research software more efficient so that it would fit within the limited computational resources that were available to us on the X-37 spacecraft, and to modify it so that it satisfied the X-37's software safety requirements. Although the experiment is currently unfunded, the development effort had value in that it resulted in major improvements in Livingstone's efficiency and safety. This paper reviews some of the details of the modeling and integration efforts, and some of the lessons that were learned.

Literary Analyses of the Danish, the Greenlandic, and the Turkish Stories Used in the "Folktale Project." Folktale: A Cross-Cultural, Interdisciplinary Study of the Experience of Literature. Paper 12.

ERIC Educational Resources Information Center

Dollerup, Cay; And Others

As part of the Folktale project, which explores similarities and dissimilarities in the response to literature from and in different cultures, advanced undergraduate students in classes on literary interpretation or literary history analyzed a Danish, a Greenlandic, and a Turkish folk tale. Two male and two female students in classes on literary…

Noticeable Variations in the Educational Exposure During Residency in Danish Orthopedic Departments.

PubMed

Brand, Eske; Fridberg, Marie; Knudsen, Ulrik Kragegaard; Barfod, Kristoffer Weisskirchner

The objective of the study was to examine the educational exposure during residency in Danish orthopedic departments. Questionnaire-based cross-sectional study. Data were gathered from January 1, 2014 to April 30, 2014 through a nationwide web-based questionnaire containing 15 questions within the areas of workload, surgical procedures, outpatient clinic, and research activities. The residents targeted worked at small-to-large hospitals and in tertiary care centers. Every resident in Denmark (n = 163) with at least 3 active months at a department was included. Questionnaires with less than 80% completion were excluded. In total, 152 entries were registered. Among those, 27 did not meet the inclusion criteria and 29 were excluded, leaving 96 participants, representing 22 of 26 departments, for further analysis. The average number of operative procedures as primary surgeon was 16 (range: 8-35) per month. In all, 18 of 22 (81%) departments offered the possibility to participate in research facilitated by the department and 38 of 96 (40%) worked for free (an average of 10h a month [range: 3-60]) to increase the amount of surgical procedures. A large variation in the educational exposure was found among the Danish orthopedic departments. Numbers indicate that Danish residents, compared with their US counterparts, operate considerably less during residency. Most residents work overtime and many of them work for free to participate in more surgical procedures. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Experiences and own management regarding residual symptoms among people with coeliac disease.

PubMed

Jacobsson, Lisa Ring; Milberg, Anna; Hjelm, Katarina; Friedrichsen, Maria

2017-06-01

Between 7% and 30% of people with treated coeliac disease suffer from residual symptoms, and there is a knowledge gap about their own management of these symptoms. To explore experiences and management concerning residual symptoms despite a gluten-free diet in people with coeliac disease. A qualitative explorative design with semi-structured interviews with 22 adults with coeliac disease in Sweden. Data were analysed using qualitative content analysis. The informants had, at diagnosis, thought that their symptoms would disappear if they followed a gluten-free diet, but the disease was continuing to have a substantial impact on their lives, despite several years of treatment. They experienced cognitive, somatic as well as mental symptoms, including impact on personality (e.g. having a "shorter fuse", being more miserable or tired). However, only a few informants had sought medical care for persistent symptoms. Instead they tried to manage these by themselves, e.g. abstaining from food during periods of more intense symptom, or using distraction. The management of persistent symptoms resembled thorough detective work. To prevent problems related to residual symptoms the informants used withdrawal of social contact as well as acceptance of their situation. People with treated coeliac disease may experience residual symptoms of both a physical and psychological nature, causing major negative impacts on their lives in different ways. In the light of this, healthcare staff should change their practices regarding the follow-up of these people, and in addition to medical care should provide guidance on management strategies to facilitate the daily life. Furthermore, information to newly diagnosed persons should make them aware of the possibility to experience continued symptoms, despite treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

The Nordic maintenance care program: what is maintenance care? Interview based survey of Danish chiropractors

PubMed Central

2013-01-01

Objective To describe and interpret Danish Chiropractors’ perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics. Methods Semi-structured interviews were conducted with 10 chiropractors identified using a stratified, theoretical sampling framework. Interviews covered four domains relating to MC, namely: purpose, patient characteristics, content, and course and development. Data was analysed thematically. Results Practitioners regard MC primarily as a means of providing secondary or tertiary care and they primarily recommend it to patients with a history of recurrence. Initiating MC is often a shared decision between clinician and patient. The core elements of MC are examination and manipulation, but exercise and general lifestyle advice are often included. Typically, treatment intervals lie between 2 and 4 months. Clinician MC practices seem to evolve over time and are informed by individual practice experiences. Chiropractors are more likely to offer MC to patients whose complaints include a significant muscular component. Furthermore, a successful transition to MC appears dependent on correctly matching complaint with management. A positive relationship between chiropractor and patient facilitates the initiation of MC. Finally; MC appears grounded in a patient-oriented approach to care rather than a market-oriented one. Conclusion MC is perceived as both a secondary and tertiary preventative measure and its practice appears grounded in the tenet of patient-oriented care. A positive personal relationship between chiropractor and patient facilitates the initiation of MC. The results from this and previous studies should be considered in the design of studies of efficacy. PMID:23962318

Prevalence of sunburn and sun-related behaviour in the Danish population: a cross-sectional study.

PubMed

Køster, Brian; Thorgaard, Camilla; Philip, Anja; Clemmensen, Inge H

2010-07-01

In Denmark, the incidence of melanoma has been increasing since the 1960s. Intermittent exposure to ultraviolet radiation and a history of sunburn and sunbed use are known risk factors. We describe the association between use of protective measures, sun-related behaviour and experience of sunburn in the Danish population three months after the start of the campaign. A population-based sample of 3,499 persons aged 15-59 years completed a questionnaire that included items on exposure to ultraviolet radiation. We examined the relations between sunburn and sun-related behaviour by logistic regression analysis. Within the previous 12 months, 35% of the study population had experienced sunburn. Sunburn became less frequent with age (odds ratio (OR) 4.44; 15-19 vs. 50-59) and skin type (OR 2.57; I vs. III). Sunburn was negatively associated with shade and clothing and positively with use of sunscreens. We found no significant difference in sunscreen use between intentional tanners who experienced sunburn and those who did not. A larger fraction of unintentional tanners with sunburn than those who were not sunburnt had used sunscreen. Sunscreen was used to prolong the time spent in the sun by 66% of sunburnt people; however, we found no association between duration of sun exposure and sunscreen use. Future campaigns to reduce the prevalence of sunburn in the Danish population must especially target young persons and intentional tanning, and they should emphasize that sunscreen cannot be used to extend the time spent in the sun and that shade and clothing provide the best protection against sunburn.

Managing the Student Experience in a Shifting Higher Education Landscape

ERIC Educational Resources Information Center

Temple, Paul; Callender, Claire; Grove, Lyn; Kersh, Natasha

2014-01-01

This research report, prepared between January 2014 and July 2014, assesses how the management of the undergraduate student experience in English higher education (HE) is changing as a result of a more competitive environment, and in particular the impact of the new tuition fee regime introduced in 2012. Summary of respondent categories by…

Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.

PubMed

Allen, Lilian A

2018-02-12

The purpose of this study was to explore the experiences of internationally educated nurses in management positions in United States health care organisations to understand the obstacles and support these individuals' experience when pursuing and working in managerial roles. Although internationally educated nurses are an integral part of the US health care industry, few work in managerial roles. Little is known about the experiences of internationally educated nurses who do obtain management positions. In this qualitative, phenomenological study, seven internationally educated nurses who were managers in Chicago, Illinois, responded to open-ended interview questions. Supervisors contributed to the participants' acceptance of management positions. The participants experienced challenges such as cultural differences, language, and communication. Despite these challenges, the participants had positive working relationships with staff and supervisors. Further, the participants had opportunities for education and professional growth. Internationally educated nurses benefit from participating in organisational committees. They face challenges related to work responsibilities, cultural differences and communication but can succeed in management roles through developing strategies to overcome the challenges and through receiving support from staff, colleagues and supervisors. More internationally educated nurses may obtain managerial positions if supervisors provide encouragement and support. © 2018 John Wiley & Sons Ltd.

Clinical experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results.

PubMed

Tos, M; Charabi, S; Thomsen, J

1998-01-01

The Danish model for vestibular schwannoma (VS) surgery has been influenced by some historical otological events, taking its origin in the fact that the first attempt to remove CPA tumors was performed by an otologist in 1916. In approximately 50 years VS surgery was performed by neurosurgeons in a decentralized model. Highly specialized neuro- and otosurgeons have been included in our team since the early beginning of the centralized Danish model of VS surgery in 1976. Our surgical practice has always been performed on the basis of known and proven knowledge, but we spared no effort to search for innovative procedures. The present paper reflects the experience we have gained in two decades of VS surgery. Our studies on the incidence, symptomatology, diagnosis, expectancy and surgical results are presented.

Evaluation of the Danish Leave Schemes. Summary of a Report.

ERIC Educational Resources Information Center

Andersen, Dines; Appeldorn, Alice; Weise, Hanne

An evaluation examined how the Danish leave schemes, an offer to employed and unemployed persons who qualify for unemployment benefits, were functioning and to what extent the objectives have been achieved. It was found that 60 percent of those taking leave had previously been unemployed; women accounted for two-thirds of those joining the scheme;…

Potential roles of research in enhancing the performance of management in securing high quality visitor experiences in wilderness

Treesearch

Stephen F. McCool

2012-01-01

Does research help managers provide opportunities for visitors to have high quality experiences in wilderness? Difficulties in applying visitor experience research result from several factors: the nature of wilderness itself, the character of the wilderness visitor experience challenge as a research and management topic, and the paradigm of research applications...

26 CFR 521.115 - Credit against United States tax liability for Danish tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who... liability for Danish tax. For the purpose of avoidance of double taxation, Article XV provides that, on the...

26 CFR 521.115 - Credit against United States tax liability for Danish tax.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who... liability for Danish tax. For the purpose of avoidance of double taxation, Article XV provides that, on the...

Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals.

PubMed

Rasmussen, Thomas Bøjer; Ulrichsen, Sinna Pilgaard; Nørgaard, Mette

2018-01-01

Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM) chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes. The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses. We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations. Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals' estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54). In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease. The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most Danish hospitals. Together with descriptive analyses, it was possible to use an alarm from a risk-adjusted CUSUM chart to identify potential performance problems.

[Management of isolated iliac aneurysms: A Tunisian center experience].

PubMed

Jmal, H; Ben Jmaà, H; Masmoudi, S; Cherif, T; Cheikhrouhou, H; Maalej, A; Elleuch, N; Jemel, A; Frikha, I

2017-12-01

Isolated aneurysms of the iliac arteries are rare. The diagnoses of these aneurysms become easier with non-invasive radiologic investigations. The development of endovascular treatment is a recent alternative to surgical treatment. We report our experience in the management of 8 cases of isolated iliac aneurysms in the department of cardiovascular and thoracic surgery of the Habib Bourguiba Hospital of Sfax. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The Internet and Services Marketing--The Case of Danish Retail Banking.

ERIC Educational Resources Information Center

Mols, Niels Peter

2000-01-01

Examines various aspects of the motives, perceptions, and expectations connected with the introduction of Internet banking in Danish retail banking. Responses from questionnaires and results from a factor analysis and a hierarchical cluster analysis indicate a belief that Internet banking will become more important in the future. (Author/LRW)

Study of airborne science experiment management concepts for application to space shuttle. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.

1973-01-01

The management concepts and operating procedures are documented as they apply to the planning of shuttle spacelab operations. Areas discussed include: airborne missions; formulation of missions; management procedures; experimenter involvement; experiment development and performance; data handling; safety procedures; and applications to shuttle spacelab planning. Characteristics of the airborne science experience are listed, and references and figures are included.

Helmet-induced headache among Danish military personnel.

PubMed

Rahmani, Zakia; Kochanek, Aneta; Astrup, Jesper Johnsen; Poulsen, Jeppe Nørgaard; Gazerani, Parisa

2017-12-01

External compression headache is defined as a headache caused by an external physical compression applied on the head. It affects about 4% of the general population; however, certain populations (e.g. construction workers and military personnel) with particular needs of headwear or helmet are at higher risk of developing this type of headache. External compression headache is poorly studied in relation to specific populations. This study aimed to investigate the prevalence and pattern of helmet-induced external compression headache among Danish military personnel of the Northern Jutland region in Denmark. Data acquisition was based on a custom-made questionnaire delivered to volunteers who used helmets in the Danish military service and who agreed to participate in this study. The military of the Northern Jutland region of Denmark facilitated recruitment of the participants. The questionnaires were delivered on paper and the collected (anonymous) answers (total 279) were used for further analysis. About 30% of the study participants reported headache in relation to wearing a military helmet. Headache was defined as a pressing pain predominantly in the front of the head with an average intensity of 4 on a visual analogue scale of 0 (no pain) to 10 (worst pain imaginable). It was also found that helmets with different designs influenced both the occurrence of headache and its characteristics. This study is the first to demonstrate the prevalence and pattern of compression headache among military personnel in North Jutland, Denmark. The findings of this study call for further attention to helmet-induced external compression headache and strategies to minimize the burden.

Ethics and Retail Management Professionals: An Examination of Age, Education, and Experience Variables

ERIC Educational Resources Information Center

Mujtaba, Bahaudin G.; Cavico, Frank J.; McCartney, Timothy O.; DiPaolo, Peter T.

2009-01-01

Ethical maturity and behavior are of great concern to all educators, firms, and investors, and even more so in a recession. This research surveyed managers and employees in the retail environment to measure their Personal Business Ethics Scores (PBES) to see if age, education, and management experience makes a difference in making more ethical…

The clinical database and implementation of treatment guidelines by the Danish Breast Cancer Cooperative Group in 2007-2016.

PubMed

Jensen, Maj-Britt; Laenkholm, Anne-Vibeke; Offersen, Birgitte V; Christiansen, Peer; Kroman, Niels; Mouridsen, Henning T; Ejlertsen, Bent

2018-01-01

Since 40 years, Danish Breast Cancer Cooperative Group (DBCG) has provided comprehensive guidelines for diagnosis and treatment of breast cancer. This population-based analysis aimed to describe the plurality of modifications introduced over the past 10 years in the national Danish guidelines for the management of early breast cancer. By use of the clinical DBCG database we analyze the effectiveness of the implementation of guideline revisions in Denmark. From the DBCG guidelines we extracted modifications introduced in 2007-2016 and selected examples regarding surgery, radiotherapy (RT) and systemic treatment. We assessed introduction of modifications from release on the DBCG webpage to change in clinical practice using the DBCG clinical database. Over a 10-year period data from 48,772 patients newly diagnosed with malignant breast tumors were entered into DBCG's clinical database and 42,197 of these patients were diagnosed with an invasive carcinoma following breast conserving surgery (BCS) or mastectomy. More than twenty modifications were introduced in the guidelines. Implementations, based on prospectively collected data, varied widely; exemplified with around one quarter of the patients not treated according to a specific guideline within one year from the introduction, to an almost immediate full implantation. Modifications of the DBCG guidelines were generally well implemented, but the time to full implementation varied from less than one year up to around five years. Our data is registry based and does not allow a closer analysis of the causes for delay in implementation of guideline modifications.

The effectiveness and experience of self-management following acute coronary syndrome: A review of the literature.

PubMed

Guo, Ping; Harris, Ruth

2016-09-01

To evaluate the effectiveness of interventions used to support self-management, and to explore patients' experiences after acute coronary syndrome in relation to self-management. Scoping review. Keyword search of CINAHL Plus, Medline, the Cochrane Library, and PsycINFO databases for studies conducted with adult population and published in English between 1993 and 2014. From title and abstract review, duplicated articles and obviously irrelevant studies were removed. The full texts of the remaining articles were assessed against the selection criteria. Studies were included if they were original research on: (1) effectiveness of self-management interventions among individuals following acute coronary syndrome; or (2) patients' experience of self-managing recovery from acute coronary syndrome. 44 articles (19 quantitative and 25 qualitative) were included. Most studies were conducted in western countries and quantitative studies were UK centric. Self-management interventions tended to be complex and include several components, including education and counselling, goal setting and problem solving skills which were mainly professional-led rather than patient-led. The review demonstrated variation in the effectiveness of self-management interventions in main outcomes assessed - anxiety and depression, quality of life and health behavioural outcomes. For most participants in the qualitative studies, acute coronary syndrome was unexpected and the recovery trajectory was a complex process. Experiences of making adjustment and adopting lifestyle changes following acute coronary syndrome were influenced by subjective life experiences and individual, sociocultural and environmental contexts. Participants' misunderstandings, misconceptions and confusion about disease processes and management were another influential factor. They emphasised a need for ongoing input and continued support from health professionals in their self-management of rehabilitation and recovery

Leading processes of patient care and treatment in hierarchical healthcare organizations in Sweden--process managers' experiences.

PubMed

Nilsson, Kerstin; Sandoff, Mette

2015-01-01

The purpose of this study is to gain better understanding of the roles and functions of process managers by describing Swedish process managers' experiences of leading processes involving patient care and treatment when working in a hierarchical health-care organization. This study is based on an explorative design. The data were gathered from interviews with 12 process managers at three Swedish hospitals. These data underwent qualitative and interpretative analysis with a modified editing style. The process managers' experiences of leading processes in a hierarchical health-care organization are described under three themes: having or not having a mandate, exposure to conflict situations and leading process development. The results indicate a need for clarity regarding process manager's responsibility and work content, which need to be communicated to all managers and staff involved in the patient care and treatment process, irrespective of department. There also needs to be an emphasis on realistic expectations and orientation of the goals that are an intrinsic part of the task of being a process manager. Generalizations from the results of the qualitative interview studies are limited, but a deeper understanding of the phenomenon was reached, which, in turn, can be transferred to similar settings. This study contributes qualitative descriptions of leading care and treatment processes in a functional, hierarchical health-care organization from process managers' experiences, a subject that has not been investigated earlier.

Intimacy in Phone Conversations: Anxiety Reduction for Danish Seniors with Hugvie

PubMed Central

Yamazaki, Ryuji; Christensen, Louise; Skov, Kate; Chang, Chi-Chih; Damholdt, Malene F.; Sumioka, Hidenobu; Nishio, Shuichi; Ishiguro, Hiroshi

2016-01-01

There is a lack of physical contact in current telecommunications such as text messaging and Internet access. To challenge the limitation and re-embody telecommunication, researchers have attempted to introduce tactile stimulation to media and developed huggable devices. Previous experiments in Japan showed that a huggable communication technology, i.e., Hugvie decreased stress level of its female users. In the present experiment in Denmark, we aim to investigate (i) whether Hugvie can decrease stress cross-culturally, i.e., Japanese vs. Danish participants (ii), investigate whether gender plays a role in this psychological effect (stress reduction) and (iii) if there is a preference of this type of communication technology (Hugvie vs. a regular telephone). Twenty-nine healthy elderly participated (15 female and 14 male, M = 64.52 years, SD = 5.67) in Jutland, Denmark. The participants filled out questionnaires including State-Trait Anxiety Inventory, NEO Five Factor Inventory (NEO-FFI), and Becks Depression Inventory, had a 15 min conversation via phone or Hugvie and were interviewed afterward. They spoke with an unknown person of opposite gender during the conversation; the same two conversation partners were used during the experiment and the Phone and Hugvie groups were equally balanced. There was no baseline difference between the Hugvie and Phone groups on age or anxiety or depression scores. In the Hugvie group, there was a statistically significant reduction on state anxiety after meeting Hugvie (p = 0.013). The change in state anxiety for the Hugvie group was positively correlated with openness (r = 0.532, p = 0.041) as measured by the NEO-FFI. This indicates that openness to experiences may increase the chances of having an anxiety reduction from being with Hugvie. Based on the results, we see that personality may affect the participants’ engagement and benefits from Hugvie. We discuss the implications of the results and further elaborations. PMID

Possible Causes of a Harbour Porpoise Mass Stranding in Danish Waters in 2005

PubMed Central

Wright, Andrew J.; Maar, Marie; Mohn, Christian; Nabe-Nielsen, Jacob; Siebert, Ursula; Jensen, Lasse Fast; Baagøe, Hans J.; Teilmann, Jonas

2013-01-01

An unprecedented 85 harbour porpoises stranded freshly dead along approximately 100 km of Danish coastline from 7–15 April, 2005. This total is considerably above the mean weekly stranding rate for the whole of Denmark, both for any time of year, 1.23 animals/week (ranging from 0 to 20 during 2003–2008, excluding April 2005), and specifically in April, 0.65 animals/week (0 to 4, same period). Bycatch was established as the cause of death for most of the individuals through typical indications of fisheries interactions, including net markings in the skin and around the flippers, and loss of tail flukes. Local fishermen confirmed unusually large porpoise bycatch in nets set for lumpfish (Cyclopterus lumpus) and the strandings were attributed to an early lumpfish season. However, lumpfish catches for 2005 were not unusual in terms of season onset, peak or total catch, when compared to 2003–2008. Consequently, human activity was combined with environmental factors and the variation in Danish fisheries landings (determined through a principal component analysis) in a two-part statistical model to assess the correlation of these factors with both the presence of fresh strandings and the numbers of strandings on the Danish west coast. The final statistical model (which was forward selected using Akaike information criterion; AIC) indicated that naval presence is correlated with higher rates of porpoise strandings, particularly in combination with certain fisheries, although it is not correlated with the actual presence of strandings. Military vessels from various countries were confirmed in the area from the 7th April, en route to the largest naval exercise in Danish waters to date (Loyal Mariner 2005, 11–28 April). Although sonar usage cannot be confirmed, it is likely that ships were testing various equipment prior to the main exercise. Thus naval activity cannot be ruled out as a possible contributing factor. PMID:23460787

Prevalence and risk factors of Coxiella burnetii seropositivity in Danish beef and dairy cattle at slaughter adjusted for test uncertainty.

PubMed

Paul, Suman; Agger, Jens F; Agerholm, Jørgen S; Markussen, Bo

2014-03-01

Antibodies to Coxiella burnetii have been found in the Danish dairy cattle population with high levels of herd and within herd seroprevalences. However, the prevalence of antibodies to C. burnetii in Danish beef cattle remains unknown. The objectives of this study were to (1) estimate the prevalence and (2) identify risk factors associated with C. burnetii seropositivity in Danish beef and dairy cattle based on sampling at slaughter. Eight hundred blood samples from slaughtered cattle were collected from six Danish slaughter houses from August to October 2012 following a random sampling procedure. Blood samples were tested by a commercially available C. burnetii antibody ELISA kit. A sample was defined positive if the sample-to-positive ratio was greater than or equal to 40. Animal and herd information were extracted from the Danish Cattle Database. Apparent (AP) and true prevalences (TPs) specific for breed, breed groups, gender and herd type; and breed-specific true prevalences with a random effect of breed was estimated in a Bayesian framework. A Bayesian logistic regression model was used to identify risk factors of C. burnetii seropositivity. Test sensitivity and specificity estimates from a previous study involving Danish dairy cattle were used to generate prior information. The prevalence was significantly higher in dairy breeds (AP=9.11%; TP=9.45%) than in beef breeds (AP=4.32%; TP=3.54%), in females (AP=9.10%; TP=9.40%) than in males (AP=3.62%; TP=2.61%) and in dairy herds (AP=15.10%; TP=16.67%) compared to beef herds (AP=4.54%; TP=3.66%). The Bayesian logistic regression model identified breed group along with age, and number of movements as contributors for C. burnetii seropositivity. The risk of seropositivity increased with age and increasing number of movements between herds. Results indicate that seroprevalence of C. burnetii is lower in cattle sent for slaughter than in Danish dairy cows in production units. A greater proportion of this prevalence

Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort.

PubMed

Jørgensen, Jeanette Therming; Andersen, John Sahl; Tjønneland, Anne; Andersen, Zorana Jovanovic

2016-09-01

This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50-65 years. Cohort-based cross-sectional study. Danish general practice. Totally, 54,849 participants of the Danish Diet, Cancer and Health cohort (50-65 years). The sum of cohort members' face-to-face consultations with general practitioner (GP) at the cohort baseline year (1993-1997). We obtained data on GP visits from the Danish National Health Service Register at the cohort baseline (1993-1997), when information on lifestyle (smoking, body mass index (BMI), alcohol use, physical activity), medical conditions (somatic and mental), employment, education, gravidity, and hormone therapy (HT) use was collected by questionnaire. Women had on average 4.1 and men 2.8 consultations per year. In a crude model, women had 47% higher rate of GP visits than men (incidence rate ratio: 1.47; 95% Confidence Interval: 1.45-1.50), which remained unchanged after adjustment for lifestyle, socio-demographic and medical factors, but attenuated to 18% (1.18; 1.13-1.24) after adjustment for female factors (gravidity and post-menopausal HT. In a fully adjusted model, subjects with hypertension (1.63; 1.59-1.67), mental illness (1.63; 1.61-1.66), diabetes (1.56; 1.47-1.65), angina pectoris (1.28; 1.21-1.34), and unemployed persons (1.19; 1.18-1.21) had highest rates of GP visits. Gravidity and HT use explain a large proportion, but not all of the gender difference in GP utilization. Medical conditions (somatic and mental) and unemployment are the main determinants of GP utilization in men and women, while lifestyle has minor effect. Key points Female gender remained a dominant determinant of GP utilization, after adjustment for lifestyle, socio-demography, medical and gender specific factors, with females consulting their GP 18% more often than males. Female reproductive factors (use of postmenopausal hormone therapy and gravidity) explained a large proportion of

Children's moral experiences of crisis management in a child mental health setting.

PubMed

Montreuil, Marjorie; Thibeault, Catherine; McHarg, Linda; Carnevale, Franco A

2018-02-15

The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies. © 2018 Australian College of Mental Health Nurses Inc.

The Relevance and Consequences of PISA Science in a Danish Context

ERIC Educational Resources Information Center

Dolin, Jens; Krogh, Lars Brian

2010-01-01

This article reports a case study that described and analyzed the changes in the Danish school culture induced and encouraged by the Programme for International Student Assessment (PISA) results. The educational policy and reforms that were temporally connected with the publication of the PISA 2000 results are outlined and the related…

Nurses' perceptions and experiences regarding Morphine usage in burn pain management.

PubMed

Bayuo, J; Agbenorku, P

2015-06-01

Morphine, a classical example of opioid has been described as one of the analgesics of choice for burn pain management but there have been reports of under utilization of the medication and subsequent poor pain management. Nurses have a pivotal role in successful burn pain management and should therefore possess positive perception as well as strong knowledge base of pain care. In light of this realization, this study sought to investigate the perception and experiences of nurses working in the burns unit possess towards the medication. Purposive sampling approach was used to select twenty (20) nurses. Descriptive and themed content analysis approaches were used to analyze data. Mean years in general nursing practice and practice in the burns unit were obtained as 7.4 and 3.4 years respectively. Results indicate that nurses have a clear understanding of the intensity of burn pain but perception towards morphine was mixed and some respondents were unsure about some of the pertinent facts of morphine and thus, would prefer other medications such as paracetamol, diclofenac and pethidine. Addiction to the medication and morphine causing death were major themes identified. The resultant effect of these perception and experiences imply and confirm the under usage of morphine. It is therefore recommended that nurses within the burn unit be taken through training modules on the suitability of morphine in burn pain management. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

A biomedical and feminist perspective on women's experiences with weight management.

PubMed

Allan, J D

1994-10-01

Weight concerns and dieting have become so normative for U.S. women that weight is the lens through which experience is viewed. The obsession with weight and dieting among women is considered by feminists to be one result of the oppression by women resulting from questionable weight standards and weight control programs that foster a view of overweight as a sign of addiction and lack of control. Feminist critique is used to deconstruct both the literature related to weight standards and health and the research on weight loss/weight management. Feminist and ethnographic methods are used to describe successful and unsuccessful experiences with weight management of 20 Euro-American women who had participated in a 1985 weight study and agreed to be reinterviewed. Success at weight management was examined from a biomedical perspective using Body Mass Index (BMI) norms and from a feminist perspective using participants' subjective definitions of success. Based upon BMI, only 8 members of the study group were defined as successful, whereas based upon the women's perspectives, 11 members were successful. Participants' definitions of successful weight management were divergent from biomedical definitions and could be categorized into three perspectives: biomedical, reframed normal weight, and holistic. Women who ascribed to the biomedical definition of success embodied the cultural ideal of thinness by adhering to an underweight weight norm. Participants using the reframed normal weight definition of success rejected biomedical weight norms and created their own weight norms. The holistic perspective on success involved the use of a broader, health-focused definition of successful weight management and offers some directions for revising current health promotion care relative to weight.

Fertility management experiences of women with polycystic ovary syndrome in Australia.

PubMed

Holton, Sara; Papanikolaou, Vicki; Hammarberg, Karin; Rowe, Heather; Kirkman, Maggie; Jordan, Lynne; McNamee, Kathy; Bayly, Chris; McBain, John; Sinnott, Vikki; Fisher, Jane

2018-06-25

Women with polycystic ovary syndrome (PCOS) are usually told that the condition is associated with fertility difficulties. However, little is known about their fertility management including contraceptive use, childbearing desires, and pregnancy outcomes. To compare the fertility management experiences and outcomes of Australian women with and without PCOS. The 2013 Australian electoral roll was used to identify a random sample of 18- to 50-year-old women who were sent the Understanding Fertility Management in Australia survey to be completed anonymously. Factors associated with fertility management and outcomes were identified in multivariable analyses. Among the 1543 women who completed and returned the survey, 113 (7.3%) reported having PCOS. Women with PCOS reported a similar rate of current contraceptive use as women without PCOS (50.4% vs. 52.6%, p = .66). However, they were significantly younger at first pregnancy (24.9 vs. 26.8 years, p = .015), more likely to have consulted a health professional about fertility management (OR: 3.86, 95% CI: 2.50-5.96, p < .001), and perceive that it would be difficult to conceive (OR: 2.31, 95% CI: 1.41-3.79, p = .001) than women without PCOS. There were no significant differences in the number of desired children, unintended pregnancies, live births, abortions or miscarriages between women with and without PCOS. These findings indicate that women with PCOS need more nuanced information about their fertility potential. While they may experience fertility difficulties because of their condition, they should also be informed that they can conceive spontaneously and need reliable contraception to avoid pregnancy when it is not wanted.

Health hazards to waste management workers in Denmark.

PubMed

Sigsgaard, T

1999-01-01

This paper deals with the Danish investigations of garbage recycling workers (GRW) in the beginning of the 90ties. The studies are summarized here showing a wide range of symptoms and diseases, from occupational asthma to gastrointestinal and skin symptoms. From the Danish experiences it seems that under normal circumstances with a good hygiene and use of the proper protective equipment by an educated work force, garbage handling induces a small but significant risk of occupational asthma. The majority of the asthma cases we have experienced in Denmark have been due to a poor perception of the risks related to organic dust exposure. However, there is still an increased prevalence of respiratory symptoms such as chest tightness and toxic alveolitis. Furthermore gastrointestinal and skin symptoms are more frequent among GRW compared to other blue-collar workers.

Managing chronic orofacial pain: A qualitative study of patients', doctors', and dentists' experiences.

PubMed

Peters, Sarah; Goldthorpe, Joanna; McElroy, Cheryl; King, Elizabeth; Javidi, Hanieh; Tickle, Martin; Aggarwal, Vishal R

2015-11-01

Persistent pain in the face, mouth, and jaws is a common presentation to dental and medical services. The aetiology remains unclear, but a growing evidence base recognizes the effectiveness of psychological rather than biomedical interventions. To understand how this approach might be implemented into clinical practice, knowledge is needed of patients' and clinicians' experience of chronic orofacial pain (COFP). The aim of this study was to explore the experience and understanding of COFP by patients and primary and secondary care medical and dental practitioners. Qualitative interview study. Audio-recorded semi-structured interviews with a purposive sample of 12 dentists, 11 general practitioners, and seven patients were thematically analysed. Clinicians and patients recognized the role that psychological factors could play in the development and maintenance of COFP, yet management and self-management strategies were largely limited to biomedical interventions. Achieving a diagnosis proved problematic but largely functional for both parties. GPs and dentists viewed COFP as a non-dental problem and felt inadequately equipped to manage the condition. GPs, unlike dentists, felt obligated to support patients using techniques for managing patients with other long-term conditions. Frustration at the current inadequacy of COFP management often led to conflict with (or disengagement from) the clinician-patient relationship. Current management of COFP is ineffective and unsatisfactory for patients and practitioners, which impacts on their relationship. Fundamental barriers to accessing and implementing psychological interventions for COFP arise from ineffective communication between physicians and patients, and between medical and dental practitioners. Statement of contribution What is already known on this subject? COFP is characterized by persistent pain in the face, mouth, or jaws that are not the result of organic disease or physical trauma. Patients with COFP present

Developing an Environmental Decision Support System for Stream Management: the STREAMES Experience

NASA Astrophysics Data System (ADS)

Riera, J.; Argerich, A.; Comas, J.; Llorens, E.; Martí, E.; Godé, L.; Pargament, D.; Puig, M.; Sabater, F.

2005-05-01

Transferring research knowledge to stream managers is crucial for scientifically sound management. Environmental decision support systems are advocated as an effective means to accomplish this. STREAMES (STream REAach Management: an Expert System) is a decision tree based EDSS prototype developed within the context of an European project as a tool to assist water managers in the diagnosis of problems, detection of causes, and selection of management strategies for coping with stream degradation issues related mostly to excess nutrient availability. STREAMES was developed by a team of scientists, water managers, and experts in knowledge engineering. Although the tool focuses on management at the stream reach scale, it also incorporates a mass-balance catchment nutrient emission model and a simple GIS module. We will briefly present the prototype and share our experience in its development. Emphasis will be placed on the process of knowledge acquisition, the design process, the pitfalls and benefits of the communication between scientists and managers, and the potential for future development of STREAMES, particularly in the context of the EU Water Framework Directive.

Diabetes Self-Management Education; Experience of People with Diabetes.

PubMed

Mardanian Dehkordi, Leila; Abdoli, Samereh

2017-06-01

Introduction: Diabetes self-management education (DSME) is a major factor which can affects quality of life of people with diabetes (PWD). Understanding the experience of PWD participating in DSME programs is an undeniable necessity in providing effective DSME to this population. The Aim of the study was to explore the experiences of PWD from a local DSME program in Iran. Methods: This study applied a descriptive phenomenological approach. The participants were PWD attending a well-established local DSME program in an endocrinology and diabetes center in Isfahan, Iran. Fifteen participants willing to share their experience about DSME were selected through purposive sampling from September 2011 to June 2012. Data were collected via unstructured interviews and analyzed using Colaizzi's approach. Results: The experience of participants were categorized under three main themes including content of diabetes education (useful versus repetitive, intensive and volatile), teaching methods (traditional, technology ignorant) and learning environment (friendly atmosphere, cramped and dark). Conclusion: It seems the current approach for DSME cannot meet the needs and expectations of PWD attending the program. Needs assessment, interactive teaching methods, multidisciplinary approach, technology as well as appropriate physical space need to be considered to improve DSME.

[Follow-up examination of Danish stainless steel welders previously examined in 1987].

PubMed

Knudsen, Lisbeth Ehlert; Burr, Herman

2003-07-14

A Danish cohort from 1987 consisting of 226 stainless steel welders and reference persons is part of the European Study Group on Cytogenetic Biomarkers and Health (ESCH). In ESCH increased cancer morbidity and mortality was significantly associated with high levels of chromosomal aberrations, measured in blood samples several years prior to cancer registration. The positive association was found in two cohorts from the Nordic countries and from Italy. ESCH followed all registered cancer cases and control persons by questionnaires and interviews to obtain information about exposures in the period from the time of blood sampling for chromosomal aberration analysis to the time of cancer diagnosis. In Denmark the total cohort was included in the inquiry and the ESCH questions were supplemented with questions from the Danish National Work Environment Cohort Study 1990-95. Responses from one hundred and forty-four persons showed that seventy-four were employed at the same workplace place as in 1987. Differences in occupational exposures, such as more noise, heat and insufficient lighting and no differences in the self-rated health were found in comparison with the Danish National Work Environment Cohort Study as such and with the sample of metal workers. Only very few of the study persons knew the threshold limit value of welding fumes but a majority found that the working environment had improved during the past ten years. This study confirms hazardous exposures in stainless steel welding. The threshold limit value, however, has been lowered since 1987 suggesting there is less cancer risk today from stainless steel welding.

A Lexical Comparison of Signs from Icelandic and Danish Sign Languages

ERIC Educational Resources Information Center

Aldersson, Russell R.; McEntee-Atalianis, Lisa J.

2008-01-01

This article reports on a comparison of lexical items in the vocabulary of Icelandic and Danish sign languages prompted by anecdotal reports of similarity and historical records detailing close contact between the two communities. Drawing on previous studies, including Bickford (2005), McKee and Kennedy (1998, 2000a, 2000b) and Parkhurst and…

Patient-Reported Experience of Diagnosis, Management, and Burden of Neuroendocrine Tumors

PubMed Central

Wolin, Edward M.; Leyden, John; Goldstein, Grace; Kolarova, Teodora; Hollander, Ron; Warner, Richard R.P.

2017-01-01

Objectives The aim of this survey was to examine the experience of patients with neuroendocrine tumors (NETs) to raise awareness of the NET-related burden and identify unmet needs. Here, we report data from patients in the United States. Methods Patients with NETs participated in a 25-minute anonymous survey, conducted primarily online from February to May 2014. Survey questions captured information on sociodemographics, clinical characteristics, NET diagnostic experience, disease impact/management, interaction with medical teams, and NETs knowledge/awareness. Results Of 1928 patients who participated globally, the largest percentage was from the United States (39%). Approximately 50% of US patients reported being diagnosed with other conditions before receiving their NET diagnosis, which for 34% took 5 years or more. Patients experienced many symptoms on a daily basis as a result of NETs, which had a substantial negative impact on their work and daily lives. Numerous improvements were suggested by patients, including better access to NET-specific treatments and medical teams/centers and better education for the management of disease-related and treatment-related symptoms. Conclusions This survey demonstrated the significant burden of NETs on patients' lives and identified key areas for improvement in diagnosis and long-term management, including better access to NET-specific treatments and specialist medical teams/centers. PMID:28328615

Development of an online nursing management course: successful experience between Brazil and Portugal.

PubMed

Tronchin, Daisy Maria Rizatto; Peres, Heloisa Helena Ciqueto; Lima, Antônio Fernandes Costa; Alavarce, Débora Cristina; Prata, Ana Paula; Santos, Margarida Reis; Aroldi, Juscilynne Barros da Costa

2015-12-01

Objective To describe the experience of planning and developing online refresher courses in nursing management for nurses in the contexts of Brazil and Portugal. Method The instructional design was based on meaningful learning theory, andragogy, and dialectical methodology, so it valued interaction between the actors, emphasizing the scenarios of practice and applying the concepts covered. The course structure is divided into nine theoretical units, four case studies, and an essay exam. Results The course was positively evaluated by the participants, who reported opportunities for acquisition of new knowledge, interaction and exchange of experiences, motivation to study the topics, and self-learning. Conclusion It is expected that description of this experience will stimulate proposals for new courses and programs in distance education modalities, improving the processes of teaching and learning so as to give support to future analyses of their impact on the development and enhancement of management skills in nursing.

The Normative and the Personal Life: Individual Differences in Life Scripts and Life Story Events among U.S.A. and Danish Undergraduates

PubMed Central

Rubin, David C.; Berntsen, Dorthe; Hutson, Michael

2011-01-01

Life scripts are culturally shared expectations about the order and timing of life events in a prototypical life course. American and Danish undergraduates produced life story events and life scripts by listing the seven most important events in their own lives and in the lives of hypothetical people living ordinary lives. They also rated their events on several scales and completed measures of depression, PTSD symptoms, and centrality of a negative event to their lives. The Danish life script replicated earlier work; the American life script showed minor differences from the Danish life script, apparently reflecting genuine differences in shared events as well as less homogeneity in the American sample. Both consisted of mostly positive events that came disproportionately from ages 15 to 30. Valence of life story events correlated with life script valence, depression, PTSD symptoms, and identity. In the Danish undergraduates, measures of life story deviation from the life script correlated with measures of depression and PTSD symptoms. PMID:19105087

Student Participation: A Democratic Education Perspective--Experience from the Health-Promoting Schools in Macedonia

ERIC Educational Resources Information Center

Simovska, V.

2004-01-01

The paper addresses the issue of student participation from the perspective of the health-promoting schools initiative. It draws on experience from the Macedonian Network of Health-Promoting Schools and its collaboration with the Danish as well as other country networks within the European Network of Health-Promoting Schools. Student participation…

Occupations at risk of developing contact allergy to isothiazolinones in Danish contact dermatitis patients: results from a Danish multicentre study (2009-2012).

PubMed

Schwensen, Jakob F; Menné, Torkil; Andersen, Klaus E; Sommerlund, Mette; Johansen, Jeanne D

2014-11-01

In recent years, the prevalence of contact allergy to isothiazolinones has reached epidemic levels. Few studies have presented data on occupations at risk of developing contact allergy to isothiazolinones. To present demographics and examine risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone (MCI) in combination with MI and benzisothiazolinone (BIT) in Danish dermatitis patients. A retrospective epidemiological analysis of data from three Danish hospitals departments was conducted. All patients consecutively patch tested with MI, MCI/MI and BIT between 2009 and 2013 were included. MI contact allergy showed a significantly increased trend in prevalence from 1.8% in 2009 to 4.2% in 2012 (p < 0.001). Females with facial dermatitis mainly drove the increase in 2012. Adjusted logistic regression analysis showed that MI sensitization was significantly associated with occupational exposures, hand and facial dermatitis, age > 40 years, and the occupational groups of tile setters/terrazzo workers, machine operators, and painters. MCI/MI contact allergy was significantly associated with the following high-risk occupations: painting, welding (blacksmiths), machine operating, and cosmetology. The occupational group of painting was frequent in the group of patients with BIT contact allergy. Several high-risk occupations for sensitization to isothiazolinones exist. Regulation on the allowed concentration of isothiazolinones, and especially MI, in both consumer products and industrial products is needed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Parents' views and experiences of childhood obesity management in primary care: a qualitative study.

PubMed

Turner, Katrina M; Salisbury, Chris; Shield, Julian P H

2012-08-01

Primary care has been viewed as an appropriate setting for childhood obesity management. Little is known about parents' views and experiences of obesity management within this clinical setting. These views and experiences need to be explored, as they could affect treatment success. To explore parents' views and experiences of primary care as a treatment setting for childhood obesity. In-depth interviews were held with 15 parents of obese children aged 5-10 years, to explore their views and experiences of primary care childhood obesity management. Parents were contacted via a hospital-based childhood obesity clinic, general practices and Mind, Exercise, Nutrition … Do it! (MEND) groups based in Bristol, England. The interviews were audio-taped transcribed verbatim and analysed thematically. Parents viewed primary care as an appropriate setting in which to treat childhood obesity but were reluctant to consult due to a fear of being blamed for their child's weight and a concern about their child's mental well-being. They also questioned whether practitioners had the knowledge, time and resources to effectively manage childhood obesity. Parents varied in the extent to which they had found consulting a practitioner helpful, and their accounts suggested that GPs and school nurses offer different types of support. Parents need to be reassured that practitioners will address their child's weight in a non-judgemental sensitive manner and are able to treat childhood obesity effectively. A multidisciplinary team approach might benefit a child, as different practitioners may vary in the type of care they provide.

Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

PubMed

Bilardi, Jade; Walker, Sandra; McNair, Ruth; Mooney-Somers, Julie; Temple-Smith, Meredith; Bellhouse, Clare; Fairley, Christopher; Chen, Marcus; Bradshaw, Catriona

2016-01-01

Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.

Personal past experience with opioid consumption affects attitudes and knowledge related to pain management.

PubMed

Pud, Dorit

2004-12-01

The personal past experience with opioid consumption by hospital health care providers was examined for its influence on their attitudes toward and knowledge of pain management. Data were collected through a questionnaire that elicited demographic information, attitudes toward pain management, barriers to pain relief, and self-assessment of pain management knowledge. The sample ( N = 163) was divided into two groups according to past experience with opioids: 52% of participants had used opioids (UO) for pain relief in the past, and the rest had never done so (NO). UO participants noted that pain control treatment was not sufficient for pain relief, in contrast to NO participants ( p = .013). Pain management was considered a low priority relative to overall treatment by the UO group compared with the NO group ( p = .016). The former group also attributed major responsibility for inappropriate pain relief to the clinical staff (12% of the UO group vs. 1.4% of the NO group; p = .048) rather than to the patients (22.9% of the UO group vs. 32.9% of the NO group; p = .019). UO participants felt extremely competent in their ability to manage several aspects of pain therapy ( p < .05). These aspects included assessing cause of the pain (42.9% of the UO group vs. 29.3% of the NO group), selecting a starting dose for opioid therapy (26.9% of the UO group vs. 13.3% of the NO group), and using opioids intravenously (20.5% of the UO group vs. 8.3% of the NO group). Personal past experience regarding analgesic use is an important factor in evaluating attitudes toward pain and achieving optimal pain management outcomes.

The Zero Boil-Off Tank Experiment Contributions to the Development of Cryogenic Fluid Management

NASA Technical Reports Server (NTRS)

Chato, David J.; Kassemi, Mohammad

2015-01-01

The Zero Boil-Off Technology (ZBOT) Experiment involves performing a small scale ISS experiment to study tank pressurization and pressure control in microgravity. The ZBOT experiment consists of a vacuum jacketed test tank filled with an inert fluorocarbon simulant liquid. Heaters and thermo-electric coolers are used in conjunction with an axial jet mixer flow loop to study a range of thermal conditions within the tank. The objective is to provide a high quality database of low gravity fluid motions and thermal transients which will be used to validate Computational Fluid Dynamic (CFD) modeling. This CFD can then be used in turn to predict behavior in larger systems with cryogens. This paper will discuss the current status of the ZBOT experiment as it approaches its flight to installation on the International Space Station, how its findings can be scaled to larger and more ambitious cryogenic fluid management experiments, as well as ideas for follow-on investigations using ZBOT like hardware to study other aspects of cryogenic fluid management.

Physiotherapists' experiences of the management of anterior cruciate ligament injuries.

PubMed

von Aesch, Arlene V; Perry, Meredith; Sole, Gisela

2016-05-01

While extensive research has been reported for management of anterior cruciate ligament (ACL) injuries, variation in treatment by physiotherapists is evident. To explore physiotherapists' experiences regarding ACL injury rehabilitation and factors that influenced physiotherapists' decision making for ACL rehabilitation, and to elicit what research physiotherapists perceived would support their management of these patients. Qualitative study. Fifteen physiotherapists from six private clinics in New Zealand participated in semi-structured interviews. The interviews were recorded, transcribed verbatim and the general inductive approach was used to develop key themes. Participant's management strengths were evident by their intent and commitment to provide expert rehabilitation, using a biopsychosocial approach and evidence-informed practice. The lengthy management process (including prolonged rehabilitation and referral processes) and interprofessional disconnect concerned participants. Translational research was needed for clear directions for exercise prescription and milestones for return to sports and occupation following ACL injury. Participants provided a biopsychosocial and evidence-based approach to ACL injury management. Potential areas of improvement include simplifying the referral process and enhancing communication between physiotherapists and other health professionals. Future research should focus on clarifying areas of ACL rehabilitation uncertainty, or collating results in an accessible and usable format for clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Occupational exposures and sick leave during pregnancy: results from a Danish cohort study.

PubMed

Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette; Kristensen, Jette Kolding; Ramlau-Hansen, Cecilia Høst

2015-07-01

This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10-29 completed pregnancy weeks in a large cohort of Danish pregnant women. Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996-2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome. We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HRrange 1.55-2.79), cumulative lifting HRtrend 1.29, 95% CI 1.26-1.31, shift work (HRevening 1.90, 95% CI 1.73-2.09, HRnight 1.52, 95% CI 1.15-2.01), monthly night shifts HRtrend 1.12, 95% CI 1.11-1.14, increasing weekly work hours HRtrend 0.93, 95% CI 0.91-0.95 and high job strain HR 1.52, 95% CI 1.42-1.63. Some exposures influenced HR in either a positive or negative time-dependent way. Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

Effects of breed and casein genetic variants on protein profile in milk from Swedish Red, Danish Holstein, and Danish Jersey cows.

PubMed

Gustavsson, F; Buitenhuis, A J; Johansson, M; Bertelsen, H P; Glantz, M; Poulsen, N A; Lindmark Månsson, H; Stålhammar, H; Larsen, L B; Bendixen, C; Paulsson, M; Andrén, A

2014-01-01

In selecting cows for higher milk yields and milk quality, it is important to understand how these traits are affected by the bovine genome. The major milk proteins exhibit genetic polymorphism and these genetic variants can serve as markers for milk composition, milk production traits, and technological properties of milk. The aim of this study was to investigate the relationships between casein (CN) genetic variants and detailed protein composition in Swedish and Danish dairy milk. Milk and DNA samples were collected from approximately 400 individual cows each of 3 Scandinavian dairy breeds: Swedish Red (SR), Danish Holstein (DH), and Danish Jersey (DJ). The protein profile with relative concentrations of α-lactalbumin, β-lactoglobulin, and α(S1)-, α(S2)-, κ-, and β-CN was determined for each milk sample using capillary zone electrophoresis. The genetic variants of the α(S1)- (CSN1S1), β- (CSN2), and κ-CN (CSN3) genes for each cow were determined using TaqMan SNP genotyping assays (Applied Biosystems, Foster City, CA). Univariate statistical models were used to evaluate the effects of composite genetic variants, α(S1)-β-κ-CN, on the protein profile. The 3 studied Scandinavian breeds differed from each other regarding CN genotypes, with DH and SR having similar genotype frequencies, whereas the genotype frequencies in DJ differed from the other 2 breeds. The similarities in genotype frequencies of SR and DH and differences compared with DJ were also seen in milk production traits, gross milk composition, and protein profile. Frequencies of the most common composite α(S1)-β-κ-CN genotype BB/A(2)A(2)/AA were 30% in DH and 15% in SR, and cows that had this genotype gave milk with lower relative concentrations of κ- and β-CN and higher relative concentrations of αS-CN, than the majority of the other composite genotypes in SR and DH. The effect of composite genotypes on relative concentrations of the milk proteins was not as pronounced in DJ. The

Public participation in wilderness and backcountry litter control: a review of research and management experience.

Treesearch

Robert M. Muth; Roger N. Clark

1978-01-01

This paper describes the application of the Incentive System for Litter Control to wilderness and backcountry environments. Based on research, observation, and management experience, a set of procedures was developed and is presented here. Additional management considerations are discussed.

Occupational position and its relation to mental distress in a random sample of Danish residents.

PubMed

Rugulies, Reiner; Madsen, Ida E H; Nielsen, Maj Britt D; Olsen, Lis R; Mortensen, Erik L; Bech, Per

2010-08-01

To analyze the distribution of depressive, anxiety, and somatization symptoms across different occupational positions in a random sample of Danish residents. The study sample consisted of 591 Danish residents (50% women), aged 20-65, drawn from an age- and gender-stratified random sample of the Danish population. Participants filled out a survey that included the 92 item version of the Hopkins Symptom Checklist (SCL-92). We categorized occupational position into seven groups: high- and low-grade non-manual workers, skilled and unskilled manual workers, high- and low-grade self-employed, and unemployed. Compared to the reference group of high-grade non-manual workers, the depressive symptom score was statistically significantly elevated among unskilled manual workers (P = 0.043) and the unemployed (P < 0.001), after adjustment for age, gender, cohabitation, life events, and low household income. The anxiety symptom score was elevated only among the unemployed (P = 0.004). The somatization symptom score was elevated among unskilled manual workers (P = 0.002), the low-grade self-employed (P = 0.023), and the unemployed (P = 0.001). When we analyzed caseness of severe symptoms, we found that unskilled manual workers (OR = 3.27, 95% CI = 1.06-10.04) and the unemployed (OR = 6.20, 95% CI = 1.98-19.42) had a higher prevalence of severe depressive symptoms, compared to the reference group of high-grade non-manual workers. The unemployed also had a higher prevalence of severe somatization symptoms (OR = 6.28, 95% CI = 1.39-28.46). Unskilled manual workers, the unemployed, and, to a lesser extent, the low-grade self-employed showed an increased level of mental distress. Activities to promote mental health in the Danish population should be directed toward these groups.

Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management

NASA Technical Reports Server (NTRS)

Cooper, Lynne P.

2009-01-01

This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.

The Courage to Be: The Impact of Lebensphilosophie on Danish RE

ERIC Educational Resources Information Center

Bowadt, Pia Rose

2009-01-01

The article deals with the impact of Lebensphilosophie on Danish RE in the elementary and lower secondary school--an impact which is subjected to a critical analysis with special attention given to anti-intellectualism, criticism of reason and criticism of modernity as well as the romantic view of the child. The thesis of this article is that…

Patients’ experience of identifying and managing exacerbations in COPD: a qualitative study

PubMed Central

Williams, Veronika; Hardinge, Maxine; Ryan, Sara; Farmer, Andrew

2014-01-01

Background: Effective self-management in chronic obstructive pulmonary disease (COPD) is crucial to reduce hospital admissions and improve outcomes for patients. This includes early detection and treatment of exacerbations by patients themselves. Aims: To explore patients’ current understanding and experience of managing and identifying COPD exacerbations at home. Methods: A qualitative, interview-based study was carried out in patients’ homes. Interviews were audio-recorded, transcribed and analysed using a grounded theory approach. Forty-four patients (17 women, 27 men; age range 55–85 years), with moderate-to-very-severe COPD, were recruited to the interview study from primary and secondary care settings in Oxford, UK, during 2012–2013. Results: Patients identified exacerbations on the basis of measurable, ‘visible’ symptoms, such as cough and sputum and ‘invisible’ symptoms, such as chest sensations and bodily knowledge. Most patients seemed to use a combination of these approaches when identifying exacerbations, according to the symptoms that had the most impact on their well-being. Patients used additional self-management strategies during an exacerbation, such as self-medication (antibiotics and steroids) and monitored their recovery. Contact with health-care professionals usually occurred when patients felt no longer able to manage themselves. Conclusions: Patients use both assessment of objective biomarkers, which are aligned with medical knowledge, and subjective symptoms based on their experience, to identify and manage exacerbations of COPD. Health-care professionals and clinicians should acknowledge this ‘expert patient’ knowledge and integrate this into patients’ care plans to facilitate early recognition and treatment of exacerbations. PMID:25372181

UNIX-based data management system for the Mobile Satellite Propagation Experiment (PiFEx)

NASA Technical Reports Server (NTRS)

Kantak, Anil V.

1987-01-01

A new method is presented for handling data resulting from Mobile Satellite propagation experiments such as the Pilot Field Experiment (PiFEx) conducted by JPL. This method uses the UNIX operating system and C programming language. The data management system is implemented on a VAX minicomputer. The system automatically divides the large data file housing data from various experiments under a predetermined format into various individual files containing data from each experiment. The system also has a number of programs written in C and FORTRAN languages to allow the researcher to obtain meaningful quantities from the data at hand.

Autonomy and Control: Danish University Reform in the Context of Modern Governance

ERIC Educational Resources Information Center

Wright, Susan; Orberg, Jakob Williams

2008-01-01

In 2003 the Danish government reformed universities to "set them free" from the state. Yet ministers are actively trying to shape universities and even set research agendas. How does the government's notion of "freedom" reconcile independence with control? We identify three discourses of freedom: freedom to use academic…

Cross-cultural adaptation of the Work Role Functioning Questionnaire 2.0 to Norwegian and Danish.

PubMed

Johansen, Thomas; Lund, Thomas; Jensen, Chris; Momsen, Anne-Mette Hedeager; Eftedal, Monica; Øyeflaten, Irene; Braathen, Tore N; Stapelfeldt, Christina M; Amick, Ben; Labriola, Merete

2018-01-01

A healthy and productive working life has attracted attention owing to future employment and demographic challenges. The aim was to translate and adapt the Work Role Functioning Questionnaire (WRFQ) 2.0 to Norwegian and Danish. The WRFQ is a self-administered tool developed to identify health-related work limitations. Standardised cross-cultural adaptation procedures were followed in both countries' translation processes. Direct translation, synthesis, back translation and consolidation were carried out successfully. A pre-test among 78 employees who had returned to work after sickness absence found idiomatic issues requiring reformulation in the instructions, four items in the Norwegian version, and three items in the Danish version, respectively. In the final versions, seven items were adjusted in each country. Psychometric properties were analysed for the Norwegian sample (n = 40) and preliminary Cronbach's alpha coefficients were satisfactory. A final consensus process was performed to achieve similar titles and introductions. The WRFQ 2.0 cross-cultural adaptation to Norwegian and Danish was performed and consensus was obtained. Future validation studies will examine validity, reliability, responsiveness and differential item response. The WRFQ can be used to elucidate both individual and work environmental factors leading to a more holistic approach in work rehabilitation.

Synthesis of active traffic management experiences in Europe and the United States

DOT National Transportation Integrated Search

2010-03-01

This synthesis report describes both US and European techniques in Active Traffic Management (ATM). The primary focus of this synthesis is on European experience, which in some cases dates back a number of years. This report provides a compilation of...

Danish translation and linguistic validation of the BODY-Q: a description of the process.

PubMed

Poulsen, Lotte; Rose, Michael; Klassen, Anne; Roessler, Kirsten K; Sørensen, Jens Ahm

2017-01-01

Patient-reported outcome (PRO) instruments are increasingly being included in research and clinical practice to assess the patient point of view. Bariatric and body contouring surgery has the potential to improve or restore a patient's body image and health-related quality of life (HR-QOL). A new PRO instrument, called the BODY-Q, has recently been developed specifically for this patient group. The aim of the current study was to translate and perform a linguistic validation of the BODY-Q for use in Danish bariatric and body contouring patients. The translation was performed in accordance with the International Society For Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organization (WHO) recommendations. Main steps taken included forward and backward translations, an expert panel meeting, and cognitive patient interviews. All translators aimed to conduct a conceptual translation rather than a literal translation and used a simple and clear formulation to create a translation understandable for all patients. The linguistic translation process led to a conceptually equivalent Danish version of the BODY-Q. The comparison between the back translation of the first Danish version and the original English version of the BODY-Q identified 18 items or instructions requiring re-translation. The expert panel helped to identify and resolve inadequate expressions and concepts of the translation. The panel identified 31 items or instructions that needed to be changed, while the cognitive interviews led to seven major revisions. The impact of weight loss methods such as bariatric surgery and body contouring surgery on patients' HR-QOL would benefit from input from the patient perspective. A thorough translation and linguistic validation must be considered an essential step when implementing a PRO instrument to another language and/or culture. A combination of the ISPOR and WHO guidelines contributed to a straightforward and thorough translation methodology

ALS and the Military: A Population-Based Study in the Danish Registries

PubMed Central

Seals, Ryan M.; Kioumourtzoglou, Marianthi-Anna; Gredal, Ole; Hansen, Johnni; Weisskopf, Marc G.

2016-01-01

Background Prior studies have suggested that military service may be associated with the development of amyotrophic lateral sclerosis. We conducted a population-based case-control study in Denmark to assess whether occupation in the Danish military is associated with an increased risk of developing amyotrophic lateral sclerosis. Methods There were 3,650 incident cases of amyotrophic lateral sclerosis recorded in the Danish National Patient Registry between 1982 and 2009. Each case was matched to 100 age- and sex-matched population controls alive and free of amyotrophic lateral sclerosis on the date of the case diagnosis. Comprehensive occupational history was obtained from the Danish Pension Fund database, which began in 1964. Results 2.4% (n=8,922) of controls had a history of employment in the military prior to the index date. Military employees overall had an elevated rate of ALS (OR=1.3; 95% CI: 1.1-1.6). A ten-year increase in years employed by the military was associated with an odds ratio of 1.2 (95% CI: 1.0-1.4), and all quartiles of time employed were elevated. There was little suggestion of a pattern across calendar year of first employment, but there was some evidence that increasing age at first employment was associated with increased ALS rates. Rates were highest in the decade immediately following the end of employment (OR=1.6; 95% CI: 1.2-2.2). Conclusions In this large population-based case-control study, employment by the military is associated with increased rates of ALS. These findings are consistent with earlier findings that military service or employment may entail exposure to risk factors for ALS. PMID:26583610

Fatal occupational accidents in Danish fishing vessels 1989-2005.

PubMed

Laursen, Lise H; Hansen, Henrik L; Jensen, Olaf C

2008-06-01

The purpose of the study was to study the circumstances and incidence rates of fatal accidents in inspection obligated and non-inspection obligated Danish fishing vessels to identify areas for prevention. Information about the fatalities came from maritime authority reports, including vessel disaster reports, post mortem reports, maritime inquiries and police reports. The person- and vessel years at risk came from the Danish Directorate of Fisheries. During the period 1989-2005, 114 fatalities occurred. Sixty-one of the fatalities occurred in 36 vessel disasters mainly caused by foundering/capsizing due to stability changes in rough weather and collisions; 39 fatal occupational accidents mainly occurred on the larger inspection obligated trawlers during fishing. In the remaining 14 other fatal accidents, the main causal factors were difficult embarking/disembarking conditions by darkness in foreign ports and alcohol intoxication. In the period 1995-2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety training for all fishermen and improved safety measures are needed, especially in the underscored areas of sea disasters concerning small vessels and occupational accidents on big vessels. Better registration of time at risk for fishermen is needed to validate the effect of the safety measures.

Implementation of health impact assessment in Danish municipal context.

PubMed

Kraemer, Stella Rebecca Johnsdatter; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

2014-12-01

Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

Cryogenic Fluid Management Experiment (CFME) trunnion verification testing

NASA Technical Reports Server (NTRS)

Bailey, W. J.; Fester, D. A.

1983-01-01

The Cryogenic Fluid Management Experiment (CFME) was designed to characterize subcritical liquid hydrogen storage and expulsion in the low-g space environment. The CFME has now become the storage and supply tank for the Cryogenic Fluid Management Facility, which includes transfer line and receiver tanks, as well. The liquid hydrogen storage and supply vessel is supported within a vacuum jacket to two fiberglass/epoxy composite trunnions which were analyzed and designed. Analysis using the limited available data indicated the trunnion was the most fatigue critical component in the storage vessel. Before committing the complete storage tank assembly to environmental testing, an experimental assessment was performed to verify the capability of the trunnion design to withstand expected vibration and loading conditions. Three tasks were conducted to evaluate trunnion integrity. The first determined the fatigue properties of the trunnion composite laminate materials. Tests at both ambient and liquid hydrogen temperatures showed composite material fatigue properties far in excess of those expected. Next, an assessment of the adequacy of the trunnion designs was performed (based on the tested material properties).

Team approach to manage difficult-to-treat TB cases: Experiences in Europe and beyond.

PubMed

D'Ambrosio, L; Bothamley, G; Caminero Luna, J A; Duarte, R; Guglielmetti, L; Muñoz Torrico, M; Payen, M C; Saavedra Herrera, N; Salazar Lezama, M A; Skrahina, A; Tadolini, M; Tiberi, S; Veziris, N; Migliori, G B

As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes. At present, several high MDR-TB burden countries in the different WHO regions (and beyond) have introduced TB Consilium-like bodies at the national or subnational level to reach consensus on the best treatment approach for their patients affected by TB. In addition, in countries/settings where a formal system of consultation does not exist, specialized staff from MDR-TB reference centres or international organizations usually spend a considerable amount of their working time responding to phone or e-mail clinical queries on how to manage M/XDR-TB cases. The aim of this manuscript is to describe the different experiences with the TB Consilia both at the international level (European Respiratory Society - ERS/WHO TB Consilium) and in some of the countries where this experience operates successfully in Europe and beyond. The Consilium experiences are described around the following topics: (1) history, aims and focus; (2) management and funding; (3) technical functioning and structure; (4) results achieved. In addition a comparative analysis of the TB Consilia in the different countries has been performed. Copyright © 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Transfusion-free management of gastrointestinal bleeding: the experience of a bloodless institute.

PubMed

Sharma, Prabin; Barajas, Francisco J; Krishnamoorthy, Parasuram; Campo, Lyna M; Blumenthal, Ezra; Spinnell, Mitchell

2015-03-01

The Institute for Patient Blood Management and Bloodless Medicine at the Englewood Hospital has considerable experience in managing patients with gastrointestinal bleeding who do not accept blood-derived products. We present our data and experience over the last 8 years in managing such patients. There is paucity of data on management and outcomes of gastrointestinal bleeding in patients who do not accept blood-derived products. We performed a retrospective study of patients from 2003 to 2011 presenting with gastrointestinal bleeding who do not accept blood-derived products. Inclusion criteria were either overt bleeding with a presenting hemoglobin (Hb) of <12 g/dL or a decrease in Hb of >1.5 g/dL. Ninety-six patients who met the inclusion criteria were included. Forty-one upper and 48 lower gastrointestinal bleeding sources were identified. Mean Hb was 8.8 g/dL and mean nadir was 6.9 g/dL. Among 37 patients (80.5%) with Hb ≤6.0 g/dL, 30 (81%) survived. Four of 7 patients (57%) with a Hb <3 g/dL survived. The overall mortality rate was 10.4%. In unadjusted logistic regression models, age [1.06 (1.01-1.12 y)], admission to ICU [6.37(1.27-31.9)], and anticoagulation use [6.95 (1.57-30.6)] were associated with increased mortality. Initial Hb [0.68 (0.51-0.92)] and nadir Hb [0.48 (0.29-0.78)] inversely predicted mortality. These results suggest that transfusion-free management of gastrointestinal hemorrhage can be effective with mortality comparable with the general population accepting medically indicated transfusion. Management of these patients is challenging and requires a dedicated multidisciplinary team approach knowledgeable in techniques of blood conservation.

Integrated management of childhood illness: a summary of first experiences.

PubMed Central

Lambrechts, T.; Bryce, J.; Orinda, V.

1999-01-01

The strategy of Integrated Management of Childhood Illness (IMCI) aims to reduce child mortality and morbidity in developing countries by combining improved management of common childhood illnesses with proper nutrition and immunization. The strategy includes interventions to improve the skills of health workers, the health system, and family and community practices. This article describes the experience of the first countries to adopt and implement the IMCI interventions, the clinical guidelines dealing with the major causes of morbidity and mortality in children, and the training package on these guidelines for health workers in first-level health facilities. The most relevant lessons learned and how these lessons have served as a basis for developing a broader IMCI strategy are described. PMID:10444882

Association between sexually transmitted disease and church membership. A retrospective cohort study of two Danish religious minorities

PubMed Central

Kørup, Alex Kappel; Thygesen, Lau Caspar; Christensen, René dePont; Johansen, Christoffer; Søndergaard, Jens; Hvidt, Niels Christian

2016-01-01

Objectives Studies comprising Danish Seventh-day Adventists (SDAs) and Danish Baptists found that members have a lower risk of chronic diseases including cancer. Explanations have pointed to differences in lifestyle, but detailed aetiology has only been sparsely examined. Our objective was to investigate the incidence of sexually transmitted diseases (STDs) among Danish SDAs and Baptists as a proxy for cancers related to sexual behaviour. Methods We followed the Danish Cohort of Religious Societies from 1977 to 2009, and linked it with national registers of all inpatient and outpatient care contacts using the National Patient Register. We compared the incidence of syphilis, gonorrhoea and chlamydia among members of the cohort with the general population. Results The cohort comprised 3119 SDA females, 1856 SDA males, 2056 Baptist females and 1467 Baptist males. For the entire cohort, we expected a total of 32.4 events of STD, and observed only 9. Female SDAs and Baptists aged 20–39 years had significant lower incidence of chlamydia (both p<0.001). Male SDAs and Baptists aged 20–39 years also had significant lower incidence of chlamydia (p<0.01 and p<0.05, respectively). No SDA members were diagnosed with gonorrhoea, when 3.4 events were expected, which, according to Hanley's ‘rule of three’, is a significant difference. No SDA or Baptist was diagnosed with syphilis. Conclusions The cohort shows significant lower incidence of STD, most likely including human papillomavirus, which may partly explain the lower incidence of cancers of the cervix, rectum, anus, head and neck. PMID:27016243

Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study.

PubMed

Gottschau, Mathilde; Kjaer, Susanne Krüger; Jensen, Allan; Munk, Christian; Mellemkjaer, Lene

2015-01-01

To assess the association between polycystic ovary syndrome (PCOS) and cancer, especially of the endometrium, breast and ovary. The Danish National Patient Register was used to identify 12,070 in- and outpatients in whom PCOS was diagnosed when they were aged 9-49 years during 1977-2012. Using the Danish Cancer Registry, we followed the cohort through 2012 and compared the women's cancer incidence with that of the general Danish female population by means of standardized incidence ratios (SIRs). Cancer was diagnosed in 279 women with PCOS (SIR = 1.19; 95% CI = 1.06-1.34). We found an almost fourfold increased risk for endometrial cancer (numbers observed (N) = 16, SIR = 3.9; 95% CI = 2.2-6.3), the large majority of cases being type 1 (N = 14, SIR = 4.7; 95% CI = 2.6-7.9). We found no association between PCOS and breast (N = 59, SIR = 1.1; 95% CI = 0.8-1.4) or ovarian cancer (N = 10, SIR = 1.8; 95% CI = 0.8-3.2); however, significantly increased risks were found for kidney, colon and brain cancers. The results of this large cohort study support those of case-control studies showing that women with PCOS are at increased risk for endometrial cancer, whereas their risks for breast and ovarian cancer are similar to those of women in the general population. Our finding that women with PCOS also are at increased risk for cancers of the kidney, colon and brain requires further study. Copyright © 2014 Elsevier Inc. All rights reserved.

Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse.

PubMed

Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

2017-07-01

The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.

Continuity and change?: Exploring reactions to a guided self-management intervention in a randomised controlled trial for IBS with reference to prior experience of managing a long term condition

PubMed Central

Rogers, Anne; Lee, Victoria; Kennedy, Anne

2007-01-01

Self-care interventions are promoted as effective strategies for improving the quality of life and health outcomes for individuals with long-term health conditions. Outcome measures used in evaluations using Randomised Controlled Trials (RCTs) are not designed to consider patients' prior management strategies and experience of illness. Yet the experience of illness literature suggests that adjusting to living with chronic illness, together with broader contextual influences, are likely to be relevant to understanding responses to self-management initiatives. Using group and individual interview data we attempt to illuminate the transposition of IBS from a condition unsatisfactorily managed by medicine to one successfully managed within the life worlds of individuals. If routine embedding of complex interventions depends on the accomplishment of integration and workability in patients' everyday lives then the design and evaluation of such interventions should view participation as part of a process of continuity as well as change. Responses to formal self-management can be extended beyond psychological and other quantitatively measured outcomes. A useful addendum to trial outcomes for self-management education is an understanding of change as being inextricably linked to people's previous attempts to, and experience of, managing long-term conditions. We suggest that the benefits of understanding the prior experience of managing illness and contact with health services include the acceptability and workability of complex interventions in patients' everyday lives. PMID:17316438

Experience use history and its relationship to management actions and satisfaction

Treesearch

Jordan W. Smith; Roger L. Moore; Steven W. Burr

2010-01-01

Th is paper analyzes the relationship between recreationists' patterns of prior experience and their preferences for and satisfaction with specific management actions. A mail-back survey was administered to a random sample of 1,500 off-highway vehicle (OHV) owners in Utah, and data for this study come from the 600 owners who completed the questionnaire. The sample...

Children with Type 1 Diabetes Mellitus: Self-Management Experiences in School

ERIC Educational Resources Information Center

de Cássia Sparapani, Valéria; Liberatore, Raphael D. R., Jr.; Damião, Elaine B. C.; de Oliveira Dantas, Isa R.; de Camargo, Rosangela A. A.; Nascimento, Lucila C.

2017-01-01

Background: Children with type 1 diabetes mellitus (T1DM) need to perform self-management activities at school and in other environments. Learning about their experiences at school is crucial to assist them in this challenging task. Methods: Qualitative interviews were conducted with children with T1DM, aged between 7 and 12. A scenario was…

The Success of a Planned Bereavement Response--A Survey on Teacher Use of Bereavement Response Plans When Supporting Grieving Children in Danish Schools

ERIC Educational Resources Information Center

Lytje, Martin

2017-01-01

This article investigates the strengths and weaknesses of the Danish Bereavement response plans. These are used by teachers to support grieving students and have been implemented in 96% of all Danish schools. The study is based on an Internet survey conducted with 967 teachers. Issues investigated are: "generalisation of grief",…

University Academics at a Crossroads? Continuity and Transformation in Danish University Reform

ERIC Educational Resources Information Center

Krejsler, John B.; Carney, Stephen

2009-01-01

Within an overall policy script aimed at creating fewer "world-class" institutions, Danish universities are currently being remade to better serve the world of work and employment, the demands of high-technology industry, and the needs of society, which are increasingly described and defined in terms of appeals to "relevance to the…

Social Origin and Graduation Age: A Cohort Comparison of Danish University Students

ERIC Educational Resources Information Center

Klausen, Trond Beldo

2016-01-01

This paper investigates whether social origin has an impact on graduation age among university students. A large number of social background factors are applied on a large data set of 4 successive cohorts of Danish university graduates born 1960-1975. These are cohorts for whom university attendance increased steeply. Contrary to recent findings…

Europeanisation and Policy Change in the Danish Vocational Education and Training System

ERIC Educational Resources Information Center

Cort, Pia

2010-01-01

This article aims to analyse the interrelationship between the Copenhagen Process, EU vocational education and training policy, and Danish initial vocational education and training policies in order to shed light on the role of EU policies in policy and institutional change. The article points to the complexity of policy-making and the…

MicroGen: a MIAME compliant web system for microarray experiment information and workflow management.

PubMed

Burgarella, Sarah; Cattaneo, Dario; Pinciroli, Francesco; Masseroli, Marco

2005-12-01

Improvements of bio-nano-technologies and biomolecular techniques have led to increasing production of high-throughput experimental data. Spotted cDNA microarray is one of the most diffuse technologies, used in single research laboratories and in biotechnology service facilities. Although they are routinely performed, spotted microarray experiments are complex procedures entailing several experimental steps and actors with different technical skills and roles. During an experiment, involved actors, who can also be located in a distance, need to access and share specific experiment information according to their roles. Furthermore, complete information describing all experimental steps must be orderly collected to allow subsequent correct interpretation of experimental results. We developed MicroGen, a web system for managing information and workflow in the production pipeline of spotted microarray experiments. It is constituted of a core multi-database system able to store all data completely characterizing different spotted microarray experiments according to the Minimum Information About Microarray Experiments (MIAME) standard, and of an intuitive and user-friendly web interface able to support the collaborative work required among multidisciplinary actors and roles involved in spotted microarray experiment production. MicroGen supports six types of user roles: the researcher who designs and requests the experiment, the spotting operator, the hybridisation operator, the image processing operator, the system administrator, and the generic public user who can access the unrestricted part of the system to get information about MicroGen services. MicroGen represents a MIAME compliant information system that enables managing workflow and supporting collaborative work in spotted microarray experiment production.

Estimation of genetic parameters and detection of quantitative trait loci for minerals in Danish Holstein and Danish Jersey milk.

PubMed

Buitenhuis, Bart; Poulsen, Nina A; Larsen, Lotte B; Sehested, Jakob

2015-05-21

Bovine milk provides important minerals, essential for human nutrition and dairy product quality. For changing the mineral composition of the milk to improve dietary needs in human nutrition and technological properties of milk, a thorough understanding of the genetics underlying milk mineral contents is important. Therefore the aim of this study was to 1) estimate the genetic parameters for individual minerals in Danish Holstein (DH) (n=371) and Danish Jersey (DJ) (n=321) milk, and 2) detect genomic regions associated with mineral content in the milk using a genome-wide association study (GWAS) approach. For DH, high heritabilities were found for Ca (0.72), Zn (0.49), and P (0.46), while for DJ, high heritabilities were found for Ca (0.63), Zn (0.57), and Mg (0.57). Furthermore, intermediate heritabilities were found for Cu in DH, and for K, Na, P and Se in the DJ. The GWAS revealed a total of 649 significant SNP markers detected for Ca (24), Cu (90), Fe (111), Mn (3), Na (1), P (4), Se (12) and Zn (404) in DH, while for DJ, a total of 787 significant SNP markers were detected for Ca (44), Fe (43), K (498), Na (4), Mg (1), P (94) and Zn (3). Comparing the list of significant markers between DH and DJ revealed that the SNP ARS-BFGL-NGS-4939 was common in both breeds for Zn. This SNP marker is closely linked to the DGAT1 gene. Even though we found significant SNP markers on BTA14 in both DH and DJ for Ca, and Fe these significant SNPs did not overlap. The results show that Ca, Zn, P and Mg show high heritabilities. In combination with the GWAS results this opens up possibilities to select for specific minerals in bovine milk.

[Nazi Terror against the Danish Medical Profession. The February 20, 1945 Murders in Odense].

PubMed

Jeune, Bernard; Hess, Søren; Skytthe, Axel; Stræde, Therkel

2015-01-01

On February 20, 1945, during the German occupation of Denmark, members of a notorious Nazi terror organization named the Petergroup murdered four young medical doctors at the city and regional hospital of Odense. On the 70th anniversary of the crime, a symposium was organized at the Odense University Hospital, and a monument revealed close to the site of the murders in commemoration of the four victims of the crime. The young physicians were not known to be connected with the Danish resistance, and they were shot without their murderers even knowing their identities in an attempt to revenge the growing resistance in Denmark's central, third largest city, and as a reprisal for several cases where the hospital had treated wounded resistance fighters, and prevented their being handed over to the German police. The article describes the terror action of February 20, 1945 and its perpetrators, as well as other Nazi attacks on members of the Danish medical profession. It lines out the strong protest voiced by the Danish central administration against the Odense hospital killings which were on the very same day seconded by further killings and a German campaign of blowing up important Odense buildings including two newspaper printing houses. Conclusively, the authors - by way of obituaries and material from relatives of the murdered - portray the four victims of the atrocity Christian Fabricius Møller, Jørgen Hvalkof, Henning Magnus Adelsteen Dalsgaard, and Henning Ørsberg.

Should I stay or should I go? Motivational profiles of Danish seafaring officers and non-officers.

PubMed

Haka, Miia; Borch, Daniel F; Jensen, Chris; Leppin, Anja

2011-01-01

Other studies have shed light on specific types of seafarers' job stressors and job satisfaction. However, so far there have not been any systematic attempts to capture the motivational profile of seafarers when it comes to both work demands and work resources. The purpose of this study is to explore the motivational profiles of seafarers in the Danish merchant fleet by identifying factors which motivate or demotivate seafarers to stay in their specific profession. Furthermore, we examine if there is a difference in work motivators and demotivators between Danish seafaring officers and non-officers. Material and methods. A questionnaire was sent out to 560 Danish-speaking seafarers with a Danish postal address; 346 seafarers returned the questionnaire, equalling a 61% response rate. The work motivators which were identified were: duration of home leave, level of responsibility, and level of challenge. The main demotivating factors that were identified were: being away from home, shipping company´s HRM, and regulatory requirements. The results contribute to a deeper understanding of how seafarers perceive their occupation, and help to identify areas and aspects which might need change if employers want to retain their workforce in the long run. Overall, the results show that most of the job demands and job resources that seafarers perceive are psychosocial. When it comes to the best aspects of seafaring, over 70% of the answers were related to psychosocial factors rather than organizational or structural factors. In relation to the perceived worst aspects in seafaring, about 85% of the responses fell into psychosocial categories. The differences in the motivational profiles of officers and non-officers showed the importance of not only looking at the seafaring profession as a whole but also considering the different characteristics of various jobs onboard.

Vowel bias in Danish word-learning: processing biases are language-specific.

PubMed

Højen, Anders; Nazzi, Thierry

2016-01-01

The present study explored whether the phonological bias favoring consonants found in French-learning infants and children when learning new words (Havy & Nazzi, 2009; Nazzi, 2005) is language-general, as proposed by Nespor, Peña and Mehler (2003), or varies across languages, perhaps as a function of the phonological or lexical properties of the language in acquisition. To do so, we used the interactive word-learning task set up by Havy and Nazzi (2009), teaching Danish-learning 20-month-olds pairs of phonetically similar words that contrasted either on one of their consonants or one of their vowels, by either one or two phonological features. Danish was chosen because it has more vowels than consonants, and is characterized by extensive consonant lenition. Both phenomena could disfavor a consonant bias. Evidence of word-learning was found only for vocalic information, irrespective of whether one or two phonological features were changed. The implication of these findings is that the phonological biases found in early lexical processing are not language-general but develop during language acquisition, depending on the phonological or lexical properties of the native language. © 2015 John Wiley & Sons Ltd.

Developments in greenhouse gas emissions and net energy use in Danish agriculture - how to achieve substantial CO(2) reductions?

PubMed

Dalgaard, T; Olesen, J E; Petersen, S O; Petersen, B M; Jørgensen, U; Kristensen, T; Hutchings, N J; Gyldenkærne, S; Hermansen, J E

2011-11-01

Greenhouse gas (GHG) emissions from agriculture are a significant contributor to total Danish emissions. Consequently, much effort is currently given to the exploration of potential strategies to reduce agricultural emissions. This paper presents results from a study estimating agricultural GHG emissions in the form of methane, nitrous oxide and carbon dioxide (including carbon sources and sinks, and the impact of energy consumption/bioenergy production) from Danish agriculture in the years 1990-2010. An analysis of possible measures to reduce the GHG emissions indicated that a 50-70% reduction of agricultural emissions by 2050 relative to 1990 is achievable, including mitigation measures in relation to the handling of manure and fertilisers, optimization of animal feeding, cropping practices, and land use changes with more organic farming, afforestation and energy crops. In addition, the bioenergy production may be increased significantly without reducing the food production, whereby Danish agriculture could achieve a positive energy balance. Copyright © 2011 Elsevier Ltd. All rights reserved.

Work Experiences, Occupational Commitment, and Intent to Enter the Sport Management Profession

ERIC Educational Resources Information Center

Cunningham, George B.; Sagas, Michael

2004-01-01

Building from Mever, Allen, & Smith's (1993) work in organizational psychology, the purpose of this study was to examine the relationships among work experiences, affective occupational commitment, and intent to enter the sport management profession among college seniors completing their internship requirements. Results indicate that intent to…

Using Theory of Planned Behavior to Predict Healthy Eating among Danish Adolescents

ERIC Educational Resources Information Center

Gronhoj, Alice; Bech-Larsen, Tino; Chan, Kara; Tsang, Lennon

2013-01-01

Purpose: The purpose of the study was to apply the theory of planned behavior to predict Danish adolescents' behavioral intention for healthy eating. Design/methodology/approach: A cluster sample survey of 410 students aged 11 to 16 years studying in Grade 6 to Grade 10 was conducted in Denmark. Findings: Perceived behavioral control followed by…

Situating beyond the social: understanding the role of materiality in Danish nursing education.

PubMed

Soffer, Ann Katrine B

2016-10-01

Situated learning serves as an analytical framework for learning in a community of practice and has been widely used to understand the learning process that is entailed in becoming a nurse. Yet in this paper, the difficulties encountered with the original notion of situated learning once it is applied to contemporary Danish nursing education are introduced. One issue that has arisen is the analytical requirement for an educational program to be a homogeneous, singular, and social phenomenon thereby discounting the varied and different sites and materialities found within nursing education. By using the materiality of the hospital bed as an empirical example of the way materiality also shapes practices, an alternative understanding of situated participation can emerge. This approach allows different sites and materialities to be conceptualized as equally genuine parts of the situated leaning framework. I suggest the notion of multi-configured learning, which captures the heterogeneity and materiality encountered during ethnographic fieldwork at a Danish nursing school.

Motivational factors for consuming omega-3 PUFAs: an exploratory study with Danish consumers.

PubMed

Krutulyte, Rasa; Grunert, Klaus G; Scholderer, Joachim; Hagemann, Kit Skov; Elgaard, Peter; Nielsen, Brian; Graverholt, Jens Peter

2008-07-01

Growing consumer awareness of functional foods and understanding of their positive nutritional effects have led to the need of specific studies and have captured more attention than ever before. In Europe, Danish consumers have been found to be relatively negative towards the concept of functional foods. This paper presents the results of a qualitative pilot study that aimed to explore Danish consumers' motives for choosing omega-3/fish oil enriched products. The Health Action Process Approach (HAPA) was applied as a theoretical framework to understand the process by which people choose healthy foods. By conducting qualitative in-depth interviews the study mostly focused on the role of behavioural intention predictors such as risk perception, outcome expectations and self-efficacy. The results of the study suggest that consumers' understanding of healthy eating as such does not relate to the choice of omega-3/fish oil, whereas perception of omega-3 as an ingredient in selected foods does indeed influence consumers' choice of carrier-ingredient combinations.

Wellbeing at work among kitchen workers during organic food conversion in Danish public kitchens: a longitudinal survey.

PubMed

Sørensen, Nina N; Løje, Hanne; Tetens, Inge; Wu, Jason H Y; Neal, Bruce; Lassen, Anne D

2016-04-01

In 2011, the Danish Ministry of Food, Agriculture and Fisheries launched the Danish Organic Action Plan 2020 intending to double the organic agricultural area in Denmark. This study aims to measure experienced physical and psychological wellbeing at work along with beliefs and attitudes among kitchen workers before and after participating in educational training programmes in organic food conversion. This longitudinal study applied an online self-administered questionnaire among kitchen workers before and after the implementation of an organic food conversion programme with 1-year follow-up. The study targeted all staff members in the participating public kitchens taking part in the organic food conversion process funded by the Danish Organic Action Plan 2020. Of the 448 eligible kitchen workers, 235 completed the questionnaire at baseline (52%) and 149 at follow-up (63% of those surveyed at baseline). No substantive differences between baseline and follow-up measurements of organic food conversion were detected on physical or psychological wellbeing at work. Kitchen workers reported a significant improvement in the perceived food quality, motivation to work and application of nutritional guidelines. Reported organic food percentages for the kitchens also increased significantly (P< 0.001) and a shift from using ready-made food products to producing more food from base was indicated. Within 1 year, a significant increase in motivation to work among kitchen staff was observed with no substantive changes in physical or psychological wellbeing at work identified. The results support the Danish Organic Action Plan 2020 and initiatives of similar kind. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Nurse practitioner integration: Qualitative experiences of the change management process.

PubMed

Lowe, Grainne; Plummer, Virginia; Boyd, Leanne

2018-04-30

The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies. A change management theory is used to reveal the complexity involved. Qualitative interviews were undertaken using a purposive sampling strategy of key stakeholders. Thematic analysis was undertaken and key themes were correlated to the theoretical framework. The results confirm the benefits of nurse practitioner roles, but suggest organisational structures and embedded professional cultures present barriers to full role optimization. Complicated policy processes are creating barriers to the integration of nurse practitioner roles. The findings increase understanding of the links between strategic planning, human resource management, professional and organisational cultures, governance and politics in change management. Effective leadership drives the change process through the ability to align key components necessary for success. Sustainability of nurse practitioners relies on recognition of their full potential in the health care team. The results of this study highlight the importance of management and leadership in the promotion of advanced nursing skills and experience to better meet patient outcomes. The findings reinforce the potential of nurse practitioners to deliver patient centred, timely and efficient health care. © 2018 John Wiley & Sons Ltd.

Danish children born to parents with lower levels of education are more likely to become overweight.

PubMed

Matthiessen, Jeppe; Stockmarr, Anders; Fagt, Sisse; Knudsen, Vibeke Kildegaard; Biltoft-Jensen, Anja

2014-10-01

Little is known about whether the socio-economic status of parents is linked to their children becoming overweight. This study examined the association between parents' educational level and overweight Danish children in a nationally representative sample. Body mass index was calculated for a random sample of 512 children aged from four to 14 from the Danish National Survey of Diet and Physical Activity 2005-2008. Their parents provided weight and height data during an interview, together with details of their own educational level. Children were classified as overweight/obese in accordance with the International Obesity Task Force. Frequency estimates of prevalence and logistic regression models were used to correlate childhood overweight/obesity with the mothers' and fathers' educational levels as the main outcome measures. Danish mothers tended to be more highly educated than fathers and their educational level was inversely associated with their child being overweight, especially if it was a boy. However, the highest educational level of the parents was the only significant educational variable, suggesting that education was associated with overweight children irrespective of the gender of the parent. Public health initiatives should target parents with low educational levels to prevent, and reduce, social inequality in overweight children. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Whole Genome-Sequencing and Phylogenetic Analysis of a Historical Collection of Bacillus anthracis Strains from Danish Cattle

PubMed Central

Derzelle, Sylviane; Girault, Guillaume; Kokotovic, Branko; Angen, Øystein

2015-01-01

Bacillus anthracis, the causative agent of anthrax, is known as one of the most genetically monomorphic species. Canonical single-nucleotide polymorphism (SNP) typing and whole-genome sequencing were used to investigate the molecular diversity of eleven B. anthracis strains isolated from cattle in Denmark between 1935 and 1988. Danish strains were assigned into five canSNP groups or lineages, i.e. A.Br.001/002 (n = 4), A.Br.Ames (n = 2), A.Br.008/011 (n = 2), A.Br.005/006 (n = 2) and A.Br.Aust94 (n = 1). The match with the A.Br.Ames lineage is of particular interest as the occurrence of such lineage in Europe is demonstrated for the first time, filling an historical gap within the phylogeography of the lineage. Comparative genome analyses of these strains with 41 isolates from other parts of the world revealed that the two Danish A.Br.008/011 strains were related to the heroin-associated strains responsible for outbreaks of injection anthrax in drug users in Europe. Eight novel diagnostic SNPs that specifically discriminate the different sub-groups of Danish strains were identified and developed into PCR-based genotyping assays. PMID:26317972

Improving agricultural knowledge management: The AgTrials experience

PubMed Central

Hyman, Glenn; Espinosa, Herlin; Camargo, Paola; Abreu, David; Devare, Medha; Arnaud, Elizabeth; Porter, Cheryl; Mwanzia, Leroy; Sonder, Kai; Traore, Sibiry

2017-01-01

Background: Opportunities to use data and information to address challenges in international agricultural research and development are expanding rapidly. The use of agricultural trial and evaluation data has enormous potential to improve crops and management practices. However, for a number of reasons, this potential has yet to be realized. This paper reports on the experience of the AgTrials initiative, an effort to build an online database of agricultural trials applying principles of interoperability and open access. Methods: Our analysis evaluates what worked and what did not work in the development of the AgTrials information resource. We analyzed data on our users and their interaction with the platform. We also surveyed our users to gauge their perceptions of the utility of the online database. Results: The study revealed barriers to participation and impediments to interaction, opportunities for improving agricultural knowledge management and a large potential for the use of trial and evaluation data.  Conclusions: Technical and logistical mechanisms for developing interoperable online databases are well advanced.  More effort will be needed to advance organizational and institutional work for these types of databases to realize their potential. PMID:28580127

Digital questionnaire platform in the Danish Blood Donor Study.

PubMed

Burgdorf, K S; Felsted, N; Mikkelsen, S; Nielsen, M H; Thørner, L W; Pedersen, O B; Sørensen, E; Nielsen, K R; Bruun, M T; Werge, T; Erikstrup, C; Hansen, T; Ullum, H

2016-10-01

The Danish Blood Donor Study (DBDS) is a prospective, population-based study and biobank. Since 2010, 100,000 Danish blood donors have been included in the study. Prior to July 2015 all participating donors had to complete a paper-based questionnaire. Here we describe the establishment of a digital tablet-based questionnaire platform implemented in blood bank sites across Denmark. The digital questionnaire was developed using the open source survey software tool LimeSurvey. The participants accesses the questionnaire online with a standard SSL encrypted HTTP connection using their personal civil registration numbers. The questionnaire is placed at a front-end web server and a collection server retrieves the completed questionnaires. Data from blood samples, register data, genetic data and verification of signed informed consent are then transferred to and merged with the questionnaire data in the DBDS database. The digital platform enables personalized questionnaires, presenting only questions relevant to the specific donor by hiding unneeded follow-up questions on screening question results. New versions of questionnaires are immediately available at all blood collection facilities when new projects are initiated. The digital platform is a faster, cost-effective and more flexible solution to collect valid data from participating donors compared to paper-based questionnaires. The overall system can be used around the world by the use of Internet connection, but the level of security depends on the sensitivity of the data to be collected. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Using Facebook as a Learning Management System: Experiences of Pre-Service Teachers

ERIC Educational Resources Information Center

Kalelioglu, Filiz

2017-01-01

The purpose of this study was to examine students' experiences using Facebook as a learning management system during a course. The study participants were 18 junior education faculty students attending a compulsory distance education undergraduate course delivered by the Computer Education and Instructional Technology Department at a university in…

Budgetary Expertise and Experience: A Significant Link to Effective Management and Leadership.

ERIC Educational Resources Information Center

Hogges, Ralph

The importance of expertise and experience in university budgetary management is discussed. A short survey of higher education institutions indicated that program administrations were not knowledgeable about budgetary processes and procedures and were not interested in developing such expertise. It is suggested that there is a need for…

A Web-Based Multi-Database System Supporting Distributed Collaborative Management and Sharing of Microarray Experiment Information

PubMed Central

Burgarella, Sarah; Cattaneo, Dario; Masseroli, Marco

2006-01-01

We developed MicroGen, a multi-database Web based system for managing all the information characterizing spotted microarray experiments. It supports information gathering and storing according to the Minimum Information About Microarray Experiments (MIAME) standard. It also allows easy sharing of information and data among all multidisciplinary actors involved in spotted microarray experiments. PMID:17238488

26 CFR 521.106 - Control of a domestic enterprise by a Danish enterprise.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Control of a domestic enterprise by a Danish enterprise. 521.106 Section 521.106 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who...

26 CFR 521.106 - Control of a domestic enterprise by a Danish enterprise.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Control of a domestic enterprise by a Danish enterprise. 521.106 Section 521.106 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who...

Air-Ground Integration: Preliminary Results from the Coalition Attack Guidance Experiment (The International C2 Journal Volume 5, Number 3, 2011)

DTIC Science & Technology

2011-01-01

Mitchell (DNK), Royal Danish Defence College Sandeep Mulgund (USA), The MITRE Corporation Mark Nissen (USA), Naval Postgraduate School Mink Spaans (NLD...Research Management 25(1): 28-33. Cash, J.I., Jr., F.W. McFarlan, J.L. McKenney, and M.R. Vitale. 1988. Corporate Information Systems Management 2nd...Between Structure and Technology. In Handbook of Organizational Design vol. 2: 3-38, eds. P. C. Nystrom and W. H. Starbuck . New York, NY: Oxford

Pharmacy benefit management contracting: an assessment from a recent public sector procurement experience.

PubMed

Bae, Jay P; Justice, Paul G

2002-01-01

In order to contain the cost of pharmaceuticals while preserving access to medically necessary drugs, Georgia state government competitively selected a single vendor in May of 2000 to manage combined pharmacy benefits under all of the state's health programs. By initiating this procedure, it intended to maximize the state's purchasing power and improve efficiency while streamlining the administrative structure. Synthesizing information from the request for proposal (RFP) and technical proposals submitted by 11 pharmacy benefit managers (PBMs) in response, we describe a model of public sector PBM contracting approach and present an assessment of the industry's service capability and performance statistics. Payers who have been using PBM services may find it interesting to compare their experience with the recent Georgia experience. Those who are considering contracting with a PBM will find the assessment of the PBM industry timely and informative.

Increased use of inhaled corticosteroids among young Danish adult asthmatics: an observational study.

PubMed

Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper; Siersted, Hans Christian; Lykkegaard, Jesper; Andersen, Morten

2010-12-01

This population-based longitudinal study aimed to investigate trends in use of inhaled corticosteroids (ICS) and determinants of ICS use in young Danish adults with asthma. 106 757 users, aged 18-44 years, of anti-asthmatic drugs were identified in the Danish Register of Medical Product Statistics during 1997-2006. One year prevalences of ICS use were calculated in categories of gender, age, and annual consumption of inhaled beta-2-agonists (IBA) in defined daily doses (DDD) per year. Determinants of ICS use were estimated by logistic regression models. The one year prevalence of ICS use was constant, approximately 64%, during 1997-2000. An annual increase was observed from 67% in 2001 to 77% in 2006. This trend also existed when stratifying on gender, age and IBA use. Using 1997 as baseline, the adjusted odds ratios (ORs) of ICS use in 2000 was 0.98 (95% CI 0.96-1.01) compared to 1.12 (95% CI 1.09-1.15) in 2001, and 1.81 (95% CI 1.75-1.87) in 2006. Other determinants of high ICS use were female gender, young age, and high annual IBA consumption. Among those using at least 400 DDD of IBA per year (corresponding to 4.4 powder inhalations daily), nearly 20% had no ICS prescriptions in 2006. Treatment with ICS among young Danish adult asthmatics has increased since 2001. This apparent improvement was associated with the introduction of fixed dose combination inhalers with ICS and inhaled long-acting beta-2-agonists. However, there is still room for improvement. Copyright © 2010 Elsevier Ltd. All rights reserved.

Danish translation and validation of Kessler's 10-item psychological distress scale - K10.

PubMed

Thelin, Camilla; Mikkelsen, Benjamin; Laier, Gunnar; Turgut, Louise; Henriksen, Bente; Olsen, Lis Raabaek; Larsen, Jens Knud; Arnfred, Sidse

2017-08-01

Psychological distress is a trans-diagnostic feature of mental suffering closely associated with mental disorders. Kessler's 10-item Psychological Distress Scale (K10), a scale with sound psychometric properties, is widely used in epidemiological studies. To translate and investigate whether K10 is a reliable and valid rating scale for the measurement of psychological distress in a Danish population. The translation was carried out according to official WHO translation guidelines. A sample of 100 subjects was included, 54 patients from the regional Mental Health Service (MHS) and 46 subjects with no psychiatric history. All participants were assessed with a psychiatric diagnostic interview (MINI) and handed out K10. Concurrent validity was assessed by WHO Well-being Index (WHO-5). Correlation matrix analysis was conducted for the full sample and receiver operating characteristic (ROC) curves for discriminating mental health service affiliation. Mean K10 scores differed, with decreasing levels, between inpatients and outpatient in MHS and the subjects with no psychiatric history. Factor analysis confirmed a unidimensional structure, and Cronbach's alpha and Omega showed excellent internal reliability. AUC for the K10 ROC curves showed excellent sensitivity (0.947 [0.900-0.995]), accurately differentiating mental health from non-mental health patients. The Danish K10 has the same strong internal reliability as the original English version, and scores differ between psychiatric patients in outpatient and emergency ward settings. The Danish K10 translation is authorized and freely available for download at https://www.hcp.med.harvard.edu/ncs/k6_scales.php . The utility as an instrument for clinical screening in a mental healthcare setting is supported.

Five Years Experience with the CLINFO Data Base Management and Analysis System

PubMed Central

Johnston, Howard B.; Higgins, Stanley B.; Harris, Thomas R.; Lacy, William W.

1982-01-01

The CLINFO data base management and analysis system is the result of a project sponsored by the National Institutes of Health (NIH) to identify data management and data analysis activities that are critical to clinical investigation. In February of 1977, one of the three prototype CLINFO systems developed by the RAND Corporation was installed in the Clinical Research Center (CRC) at Vanderbilt University Medical Center. The Vanderbilt experience with this CLINFO system over the past five years is described. Its impact on the way clinical research data has been managed and analyzed is discussed in terms of utilization by more than 100 clinical investigators and their staff. The Vanderbilt evaluation of the system and additional information on its usage since the original evaluation is presented. Factors in the design philosophy of CLINFO which create an environment that enhances the clinical investigator's capabilities to perform computer data management and analysis of his data are discussed.

Management of testicular seminoma. Our experience.

PubMed

Sperlongano, P; Pisaniello, D; Di Mauro, U; Pone, D; Casoli, E

2000-01-01

The authors report their experience in the management of seminomas. They examine 12 cases of seminoma among a series of 19 patients with testicular germ cell tumours observed at the Second Surgical Department of the Second University of Naples. Their results showed a better prognosis for patients in early stage of the disease who underwent surgery and adjuvant prophylactic radiotherapy; good survival rates for patients in advanced stages of the disease were achieved by the combined use of surgery, adjuvant radiotherapy and chemotherapy. The authors discuss risk factors, clinical and diagnostic features of seminomas, relating their prognosis with the combined use of both surgery and adjuvant therapies. They consider total orchiectomy, followed by prophylactic radiotherapy, the treatment of choice, especially in stages IA and IIA. They don't perform the routine retroperitoneal lymphadenectomy, differently from American authors, who always achieve it to stage the disease. The authors stress the improvement in the prognosis of seminoma, which has actually reached the 98% of five-year survival rate, for stages I and II.

Ambulance personnel's experience of pain management for patients with a suspected hip fracture: A qualitative study.

PubMed

Jakopovic, D; Falk, A-C; Lindström, V

2015-07-01

Pain management is described to be insufficient for patients suffering from a hip fracture, and the management for this vulnerable group of patients may be challenging due to their medical history (multiple comorbidities) and polypharmacy. Previous research has mainly focused on fast tracks aiming to reduce time to surgery. But the research on how pain management is handled for these patients in the prehospital context has been sparse. Therefore, the purpose of this study was to describe the ambulance personnel's experience of managing the pain of patients with a suspected hip fracture. A descriptive and qualitative design with Critical Incident Technique was used for collecting data. Moreover, a qualitative content analysis was used for analysing the collected data. Twenty-two participants communicated their experiences and 51 incidents were analysed. The main finding in the study was that the ambulance personnel, by using their clinical knowledge and by empowering the patients to participate in their own care, managed to individualize the pain relief for patients with a suspected hip fracture through a variety of interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of calving interval and parity on milk yield per feeding day in Danish commercial dairy herds.

PubMed

Lehmann, J O; Fadel, J G; Mogensen, L; Kristensen, T; Gaillard, C; Kebreab, E

2016-01-01

The idea of managing cows for extended lactations rather than lactations of the traditional length of 1 yr primarily arose from observations of increasing problems with infertility and cows being dried off with high milk yields. However, it is vital for the success of extended lactation practices that cows are able to maintain milk yield per feeding day when the length of the calving interval (CInt) is increased. Milk yield per feeding day is defined as the cumulated lactation milk yield divided by the sum of days between 2 consecutive calvings. The main objective of this study was to investigate the milk production of cows managed for lactations of different lengths, and the primary aim was to investigate the relationship between CInt, parity, and milk yield. Five measurements of milk yield were used: energy-corrected milk (ECM) yield per feeding day, ECM yield per lactating day, cumulative ECM yield during the first 305 d of lactation, as well as ECM yield per day during early and late lactation. The analyses were based on a total of 1,379 completed lactations from cows calving between January 2007 and May 2013 in 4 Danish commercial dairy herds managed for extended lactation for several years. Herd-average CInt length ranged from 414 to 521 d. The herds had Holstein, Jersey, or crosses between Holstein, Jersey, and Red Danish cows with average milk yields ranging from 7,644 to 11,286 kg of ECM per cow per year. A significant effect of the CInt was noted on all 5 measurements of milk yield, and this effect interacted with parity for ECM per feeding day, ECM per lactating day and ECM per day during late lactation. The results showed that cows were at least able to produce equivalent ECM per feeding day with increasing CInt, and that first- and second-parity cows maintained ECM per lactating day. Cows with a CInt between 17 and 19 mo produced 476 kg of ECM more during the first 305 d compared with cows with a CInt of less than 13 mo. Furthermore, early

Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study.

PubMed

Van den Heuvel, S C G H; Goossens, P J J; Terlouw, C; Van Achterberg, T; Schoonhoven, L

2015-12-01

Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face

Charge Management in LISA Pathfinder: The Continuous Discharging Experiment

NASA Astrophysics Data System (ADS)

Ewing, Becca Elizabeth

2018-01-01

Test mass charging is a significant source of excess force and force noise in LISA Pathfinder (LPF). The planned design scheme for mitigation of charge induced force noise in LISA is a continuous discharge by UV light illumination. We report on analysis of a charge management experiment on-board LPF conducted during December 2016. We discuss the measurement of test mass charging noise with and without continuous UV illumination, in addition to the dynamic response in the continuous discharge scheme. Results of the continuous discharge system will be discussed for their application to operating LISA with lower test mass charge.

Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

PubMed

Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

2018-04-11

Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy

Danish Citizens and General Practitioners' Use of ICT for their Mutual Communication.

PubMed

Bertelsen, Pernille; Stub Petersen, Lone

2015-01-01

This paper reports on selected findings from a Danish national survey of citizens' perception and use of information and communication technology (ICT) for their health care [1]. Focus is on citizens' use of ICT and on communication with their General Practitioner (GP). It also focuses on citizens' experience of their GPs' ICT use and no use during medical consultations. The responsibility for medical service in Denmark is to a large extent handed over to the primary sector where the GP is the gatekeeper. Our data display that 65% of the adult citizens or their relatives have been using ICT to communicate with their GP. Twenty-two percent have experienced their GP use a computer screen to actively show them something while they have a consultation. Further, our data supports the assumption that the higher the education people have, the more likely they are to use ICT for their health care. The understanding of the use of ICT in communication with the GP is central to monitoring and developing an ICT that supports all citizens and considers new ways in which to enhance quality of care.

Conservative management of neuromuscular scoliosis: personal experience and review of literature.

PubMed

Kotwicki, Tomasz; Jozwiak, Marek

2008-01-01

The principles of conservative management of neuromuscular scoliosis in childhood and adolescence are presented. Analysis of personal experience and literature review. The topic is discussed separately for patients with flaccid or spastic paresis. These demonstrate that conservative management might be proposed for patients with neuromuscular scoliosis in many clinical situations. In spastic disorders, it maintains the symmetry around the hip joints. Bracing is technically difficult and often is not tolerated well by cerebral palsy children. In patients with flaccid paresis, the fitting and the use of brace is easier than in spastic patients. The flexibility of the spinal curvature is more important. Functional benefits of conservative management of neuromuscular scoliosis comprise stable sitting, easier use of upper limbs, discharge of the abdomen from the collapsing trunk, increased diaphragm excursion, and, not always, prevention of curve progression. Specific natural history and multiple medical problems associated with the disease make the treatment of children with neuromuscular scoliosis an extremely complex issue, best addressed when a team approach is applied. Continuously improving techniques of conservative management, comprising bracing and physiotherapy, together with correctly timed surgery incorporated in the process of rehabilitation, provide the optimal care for patients.

Cross-sectional survey on the use and impact of the Danish national antibiotic use guidelines for companion animal practice.

PubMed

Jessen, Lisbeth Rem; Sørensen, Tina Møller; Lilja, Zenia Littau; Kristensen, Maja; Hald, Tine; Damborg, Peter

2017-12-11

The Danish antibiotic use guidelines for companion animal practice were published by the Danish Veterinary Association in 2012. Since then, national surveillance data indicate a 10% reduction in the total use of antibiotics for companion animals, particularly a marked reduction in the use of third generation cephalosporins. The aim of the study was to assess if and how the guidelines have impacted diagnostic and antibiotic prescription habits of the users, and to identify user perceived barriers to implementation. An online questionnaire was sent to all 882 members of the Danish Small Animal Veterinary Association in October 2015. The survey was completed by 151 veterinarians. Respondents most frequently consulted the recommendations on skin and urinary tract infections (UTI), and users generally reported a high degree of adherence to the recommendations. Sixty-five per cent indicated that the guidelines had influenced their habits in one or more of the areas being investigated, i.e. perioperative use of antibiotics, use of first line antibiotics for the treatment of pyoderma or UTI, and/or use of microbiological diagnostics. Perioperative use of antibiotics for clean surgeries was uncommon, irrespective of whether respondents had consulted the relevant recommendations or not. On the contrary, significant differences in the prescribing habits between guideline users and non-users were observed for pyoderma and UTI, suggesting an impact of the guidelines towards more prudent antimicrobial use. The diagnostic habits were examined in a subgroup of 63 guideline users. Of those, 19 and 39% reported frequent use of culture and susceptibility (C&S) testing prior to treating pyoderma and UTI respectively, whereas 68-84% reported C&S testing in the event of poor response to treatment or recurrence of infections. The main barriers for implementation of therapeutic recommendations were confidence in old prescribing practices and unavailability of recommended drugs. The main

Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted

NASA Technical Reports Server (NTRS)

Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

2004-01-01

The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.

The Experience of Persons With Multiple Sclerosis Using MS INFoRm: An Interactive Fatigue Management Resource.

PubMed

Pétrin, Julie; Akbar, Nadine; Turpin, Karen; Smyth, Penelope; Finlayson, Marcia

2018-04-01

We aimed to understand participants' experiences with a self-guided fatigue management resource, Multiple Sclerosis: An Interactive Fatigue Management Resource ( MS INFoRm), and the extent to which they found its contents relevant and useful to their daily lives. We recruited 35 persons with MS experiencing mild to moderate fatigue, provided them with MS INFoRm, and then conducted semistructured interviews 3 weeks and 3 months after they received the resource. Interpretive description guided the analysis process. Findings indicate that participants' experience of using MS INFoRm could be understood as a process of change, influenced by their initial reactions to the resource. They reported experiencing a shift in knowledge, expectations, and behaviors with respect to fatigue self-management. These shifts led to multiple positive outcomes, including increased levels of self-confidence and improved quality of life. These findings suggest that MS INFoRm may have a place in the continuum of fatigue management interventions for people with MS.

The role of practical wisdom in nurse manager practice: why experience matters.

PubMed

Cathcart, Eloise Balasco; Greenspan, Miriam

2013-10-01

To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

"We Got Incredibly Drunk...It Was Damned Fun": Drinking Stories among Danish Youth

ERIC Educational Resources Information Center

Tutenges, Sebastien; Rod, Morten Hulvej

2009-01-01

Drinking stories are immensely popular among contemporary Danish youth. The stories are shared with much enthusiasm in school, at parties, over the telephone and via the Internet. But why are the young so compelled by these seemingly vulgar stories? Applying the theories of, most importantly, Bakhtin (1968), Ricoeur (1991), and Jackson (2002),…

Danish first aid books compliance with the new evidence-based non-resuscitative first aid guidelines.

PubMed

Jensen, Theo Walther; Møller, Thea Palsgaard; Viereck, Søren; Roland, Jens; Pedersen, Thomas Egesborg; Lippert, Freddy K

2018-01-10

The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. We identified first aid books from all the first aid courses offered by major Danish suppliers. Based on the new ERC first aid guidelines, we developed a checklist of 26 items within 16 different categories to assess the content; this checklist was adapted following the principle of mutually exclusive and collectively exhaustive questioning. To assess the agreement between four raters, Fleiss' kappa test was used. Items that did not reach an acceptable kappa score were excluded. We evaluated 10 first aid books used for first aid courses and published between 2009 and 2015. The content of the books complied with the new in 38% of the answers. In 12 of the 26 items, there was less than 50% consistency. These items include proximal pressure points and elevation of extremities for the control of bleeding, use of cervical collars, treatment for an open chest wound, burn dressing, dental avulsion, passive leg raising, administration of bronchodilators, adrenaline, and aspirin. Danish course material showed significant inconsistencies with the new evidence-based first aid guidelines. The new knowledge from the evidence-based guidelines should be incorporated into revised and updated first aid course material.

[Early achievements of the Danish pharmaceutical industry--2. The minor and almost forgotten pharmaceutical companies].

PubMed

Grevsen, Jørgen V; Kirkegaard, Hanne; Kruse, Edith; Kruse, Poul R

2009-01-01

The article series provides an account in words and pictures of the Danish pharmaceutical industry's products from the earliest times until about 1950. Part 2 deals with products from 16 minor pharmaceutical companies, founded in the last decades of the 19th century and the first decades of the 20th century. Mentioned in chronological order, according to year of foundation, the companies are: C.R. Evers & Co., Jensen & Langebek-Petersens chemisk-techniske Fabrik, Leerbeck & Holms kemiske Fabriker, A/S Skelskør Frugtplantage, Fabriken Ferrin, Chr. F. Petri, Erslevs kemiske Laboratorium, A/S Edward Jacobsen, Th. Fallesen-Schmidt, Fabriken Ferraton, Chemia, Fabriken Kemisan, Central-Laboratoriet, F.F. Gonget & Co., A/S Ejco, and M. Schultz chemiske Fabrik. None of these minor pharmaceutical companies exist today as independent firms. All of them are either closed down or merged into other firms after a number of years. The bigger pharmaceutical companies ensured their continued existence by research and development of new products. The minor companies were not innovative to the same extent, but they played a role at an early stage in the production of Danish copy medicine and in that way a role in the establishment of a Danish generic pharmaceutical industry. The earliest products included dietetic preparations as malt products and albumin maltose products, and iron preparations, often with an admixture of medicine substances. Real medicines such as sleeping, analgesic and antipyretic medicines as well as anesthetics followed later.

[Trends concerning medical articles 1989-1998. A study of Danish articles compared to other members of the European Union].

PubMed

Jørgensen, H L; Praetorius, L; Ingwersen, P

1999-11-15

The paper analyses the development of the total number of journal articles indexed in the Medline database published by authors affiliated to Denmark 1989-1998 in medicine compared to the development in the European Union during the same period. The publication analysis is then compared to the citation impact of articles published in the central journals indexed in Science Citation Index (ISI) 1987-1996 through use of the National Science Indicators (NIS, ISI) database. The total number of Danish journal articles has remained relatively constant compared to a 50% increase in the EU as a whole. The number of Danish articles published in central journals, however, has increased by 20% (compared to 27% for the EU) and the number of citations obtained by these articles by 58% (compared to 66% for the EU) in the 1987-1996 period. By population, Denmark ranked third in total number of articles in 1998. In conclusion, Denmark is very active in medical research but neither the quantity nor the quality of Danish medical research has increased at the same rate as the EU average.

Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.

PubMed

Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

2017-01-01

The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs. Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation. The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others. The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.

Cultural competence in medical education: A questionnaire study of Danish medical teachers' perceptions of and preparedness to teach cultural competence.

PubMed

Sorensen, Janne; Jervelund, Signe Smith; Norredam, Marie; Kristiansen, Maria; Krasnik, Allan

2017-03-01

The cultural competence training of healthcare professionals is a key element in ensuring the quality of both the access and delivery of healthcare to increasingly ethnically diverse populations. The aim of this study is to investigate Danish medical teachers' opinions about cultural competence, their willingness to receive training and preparedness to teach cultural competence topics. The survey was sent to medical teachers, clinical teachers and external lecturers who teach in the medical programme at the University of Copenhagen. A total of 1400 medical teachers received the survey, and 199 responded. The response rate is 14%. Data were analysed through descriptive calculations, and answers to open-ended questions were coded using content analysis. Results showed that 82.4% of the informants agreed or strongly agreed that the medical education programme should include training on cultural issues, and 60.3% agreed or strongly agreed that students should be assessed on their cultural competence skills. Regarding preparedness to teach a diverse classroom, 88.4% felt somewhat or very prepared to engage and motivate all students. About 70% were interested in receiving training on cultural competence. Generally, there is interest in and acknowledgement of the importance of cultural competence in Danish medical education among teachers at the University of Copenhagen. This creates an opportunity to implement cultural competence in the medical curriculum, training of teachers and strengthening the diversity sensitivity of the organisation. However, support for this programme by management and the allocation of an appropriate level of resources is a prerequisite to the success of the programme.

Continuous professional development for GPs: experience from Denmark.

PubMed

Kjaer, N K; Steenstrup, A P; Pedersen, L B; Halling, A

2014-07-01

Continuous professional development (CPD) for Danish general practitioners (GPs) is voluntary and based on funded accredited activities. There is an ongoing discussion on how to improve this current system by introducing mandatory elements. To inform this debate, we set out to identify GPs' current use of CPD and to explore the motives behind their choices. A mixed-methods study with a combined qualitative and quantitative approach was used. In 2012, two focus group interviews were conducted, followed up the same year by an online questionnaire sent to 1079 randomly chosen Danish GPs. Focus groups: CPD activities are chosen based on personal needs analysis, and in order to be professionally updated, to meet engaged colleagues and to prevent burnout. GPs also attend CPD to assess their own pre-existing level of competence. CPD activities need to be experienced as being both meaningful and relevant in order to have an impact. Questionnaire: The response rate was 686/1079 (63%). GPs spend on average 10.5 days per year on accredited, voluntary CPD activities. Workplace-related CPD activities and practice-based small group learning played a significant role. The main motivation for choice of CPD activities included academic interest, experience of patient-related problems in their own surgeries and medical topics where the GPs felt insufficiently confident. Danish GPs are frequent users of voluntary accredited CPD. Their CPD choices are motivated by topics strengthening their professional capacity and preventing burnout. There would seem to be no need for a mandatory system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

PubMed

Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

2016-01-01

Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

PubMed

Kakyo, T A; Xiao, L D

2018-04-19

The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

Analysis of patient diaries in Danish ICUs: a narrative approach.

PubMed

Egerod, Ingrid; Christensen, Doris

2009-10-01

The objective was to describe the structure and content of patient diaries written for critically ill patients in Danish intensive care units (ICUs). Critical illness is associated with physical and psychological aftermath including cognitive impairment and post-traumatic stress. Patient diaries written in the intensive care unit are used to help ICU-survivors come to terms with their illness. The study had a qualitative, descriptive and explorative design, using a narrative approach of analysis. Data were analysed on several levels: extra-case level, case level, diary-entry level, and sub-entry level. The sample consisted of 25 patient diaries written by critical care nurses in 2007 for patients at a general ICU in Denmark. The base narrative describes three stages: crisis, turning point, and normalisation. Each case includes parallel plots of nurse, patient and family, which converge during normalisation. Each diary is structured by: summary, daily entries and end note. Each diary entry is structured by: greeting, narrator status, patient status, family status/contextual cues and sign-off note. Patient diaries acknowledge the patient experience and provide new insights into nursing performance. This study offers a framework for understanding ICU patient diaries, which may facilitate cross-unit comparisons and support future guideline development. The dual perspectives of patient diaries and the ambiguous ownership of the narratives may pave the way for insights to improve critical care nursing and ICU rehabilitation.

Mental health nurses' experiences of managing work-related emotions through supervision.

PubMed

MacLaren, Jessica; Stenhouse, Rosie; Ritchie, Deborah

2016-10-01

The aim of this study was to explore emotion cultures constructed in supervision and consider how supervision functions as an emotionally safe space promoting critical reflection. Research published between 1995-2015 suggests supervision has a positive impact on nurses' emotional well-being, but there is little understanding of the processes involved in this and how styles of emotion interaction are established in supervision. A narrative approach was used to investigate mental health nurses' understandings and experiences of supervision. Eight semi-structured interviews were conducted with community mental health nurses in the UK during 2011. Analysis of audio data used features of speech to identify narrative discourse and illuminate meanings. A topic-centred analysis of interview narratives explored discourses shared between the participants. This supported the identification of feeling rules in participants' narratives and the exploration of the emotion context of supervision. Effective supervision was associated with three feeling rules: safety and reflexivity; staying professional; managing feelings. These feeling rules allowed the expression and exploration of emotions, promoting critical reflection. A contrast was identified between the emotion culture of supervision and the nurses' experience of their workplace cultures as requiring the suppression of difficult emotions. Despite this, contrast supervision functioned as an emotion micro-culture with its own distinctive feeling rules. The analytical construct of feeling rules allows us to connect individual emotional experiences to shared normative discourses, highlighting how these shape emotional processes taking place in supervision. This understanding supports an explanation of how supervision may positively influence nurses' emotion management and perhaps reduce burnout. © 2016 John Wiley & Sons Ltd.

Similarly Torn, Differentially Shorn? The Experience and Management of Conflict between Multiple Roles, Relationships, and Social Categories

PubMed Central

Jones, Janelle M.; Hynie, Michaela

2017-01-01

In three studies we examined the experience and management of conflict between different types of multiple identities. Participants described a conflict between pairs of role, relational, or social identities before rating the experience (i.e., magnitude, stress, and growth) and management of conflict on a newly developed scale assessing four strategies: reconciliation, where identities are integrated, realignment, where one identity is chosen over another, retreat, where both identities are avoided, and reflection, where fit (with others, situation) determines identity selection. In general, the types of identities mattered for conflict management but not its experience: Magnitude and growth did not differ, however, stress was greater for role identity conflicts (Study 3 only) and participants endorsed the use of more realignment for role conflicts (Study 2) and more retreat for relational conflicts (Study 3) relative to other types of identity conflicts. Furthermore, findings suggested that the perceived flexibility of identities, not their importance or valence, were associated with realignment and retreat for roles and with retreat for relationships. Experiencing conflicts between multiple identities leaves people similarly torn, but multiple roles and relationships may be differentially shorn to manage conflict. PMID:29051744

Similarly Torn, Differentially Shorn? The Experience and Management of Conflict between Multiple Roles, Relationships, and Social Categories.

PubMed

Jones, Janelle M; Hynie, Michaela

2017-01-01

In three studies we examined the experience and management of conflict between different types of multiple identities. Participants described a conflict between pairs of role, relational, or social identities before rating the experience (i.e., magnitude, stress, and growth) and management of conflict on a newly developed scale assessing four strategies: reconciliation , where identities are integrated, realignment , where one identity is chosen over another, retreat , where both identities are avoided, and reflection , where fit (with others, situation) determines identity selection. In general, the types of identities mattered for conflict management but not its experience: Magnitude and growth did not differ, however, stress was greater for role identity conflicts ( Study 3 only ) and participants endorsed the use of more realignment for role conflicts ( Study 2 ) and more retreat for relational conflicts ( Study 3 ) relative to other types of identity conflicts. Furthermore, findings suggested that the perceived flexibility of identities, not their importance or valence, were associated with realignment and retreat for roles and with retreat for relationships. Experiencing conflicts between multiple identities leaves people similarly torn, but multiple roles and relationships may be differentially shorn to manage conflict.

Ten-year experience in managing a capitated ophthalmology carve-out by an academic eye center.

PubMed

Olson, R J

1997-01-01

A 10-year experience of managing a capitated opthalmology carve-out by an academic health unit is presented. Lessons learned regarding pricing, utilization, and managing this contract are discussed. Handling the cost of education and remaining competitive is presented as a not-insurmountable hurdle. Academic health units can compete in today's environment; however, the learning curve is steep and the problems many.

Breastfeeding and introduction of complementary food in Danish infants.

PubMed

Kronborg, Hanne; Foverskov, Else; Væth, Michael

2015-03-01

The purpose of the present study was to describe early feeding patterns in Danish infants. A self-administered questionnaire was sent to 7113 mothers of newborns in the western part of Denmark approximately 6 months postpartum. A total of 5127 mothers (72%) returned the questionnaire and 4526 (88%) of the responding mothers provided valid answers to questions on infant nutrition. Breastfeeding was initiated after birth by 97%. At the ages of 2, 4 and 6 months, 68%, 55% and 7% of the infants, respectively, were fully breastfed, i.e. they received mother's milk only. Full breastfeeding at 4 months was for infants significantly associated with higher birth weight, longer gestational age and singleton birth; for mothers it was associated with older ages, higher educational level, lower BMI and multiparity. During the first weeks, 14% of the infants were introduced to formula and this proportion increased to 32%, 43% and 74% at 2, 4 and 6 months, respectively. Only 20% of the infants never received formula during the first 6 months of life. Time for introduction of solid food was associated with breastfeeding status. At 4 months, 3% of the previously fully breastfed infants were introduced to solid food, 12% of the partially breastfed and 17% of the non-breastfed. At 6 months, 87% of the infants had been introduced to solid food. The majority of Danish mothers introduced infants to solid food between 4 and six months, and did not exclusively breastfeed until 6 months, as recommended by WHO. © 2015 the Nordic Societies of Public Health.

Seasonal Variation of Dystocia in a Large Danish Cohort

PubMed Central

Rohr Thomsen, Christine; Uldbjerg, Niels; Hvidman, Lone; Atladóttir, Hjördís Ósk; Henriksen, Tine Brink; Milidou, Ioanna

2014-01-01

Background Dystocia is one of the most frequent causes of cesarean delivery in nulliparous women. Despite this, its causes are largely unknown. Vitamin D receptor (VDR) has been found in the myometrium. Thus, it is possible that vitamin D affects the contractility of the myometrium and may be involved in the pathogenesis of dystocia. Seasonal variation of dystocia in areas with distinct seasonal variation in sunlight exposure, like Denmark, could imply that vitamin D may play a role. This study examined whether there was seasonal variation in the incidence of dystocia in a Danish population. Method We used information from a cohort of 34,261 nulliparous women with singleton pregnancies, spontaneous onset of labor between 37 and 42 completed gestational weeks, and vertex fetal presentation. All women gave birth between 1992 and 2010 at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby. Logistic regression combined with cubic spline was used to estimate the seasonal variation for each outcome after adjusting for calendar time. Results No evidence for seasonal variation was found for any of the outcomes: acute cesarean delivery due to dystocia (p = 0.44); instrumental vaginal delivery due to dystocia (p = 0.69); oxytocin augmentation due to dystocia (p = 0.46); and overall dystocia (p = 0.91). Conclusion No seasonal variation in the incidence of dystocia was observed in a large cohort of Danish women. This may reflect no association between vitamin D and dystocia, or alternatively that other factors with seasonal variation and influence on the occurrence of dystocia attenuate such an association. PMID:24736600

Seasonal variation of dystocia in a large Danish cohort.

PubMed

Rohr Thomsen, Christine; Uldbjerg, Niels; Hvidman, Lone; Atladóttir, Hjördís Ósk; Henriksen, Tine Brink; Milidou, Ioanna

2014-01-01

Dystocia is one of the most frequent causes of cesarean delivery in nulliparous women. Despite this, its causes are largely unknown. Vitamin D receptor (VDR) has been found in the myometrium. Thus, it is possible that vitamin D affects the contractility of the myometrium and may be involved in the pathogenesis of dystocia. Seasonal variation of dystocia in areas with distinct seasonal variation in sunlight exposure, like Denmark, could imply that vitamin D may play a role. This study examined whether there was seasonal variation in the incidence of dystocia in a Danish population. We used information from a cohort of 34,261 nulliparous women with singleton pregnancies, spontaneous onset of labor between 37 and 42 completed gestational weeks, and vertex fetal presentation. All women gave birth between 1992 and 2010 at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby. Logistic regression combined with cubic spline was used to estimate the seasonal variation for each outcome after adjusting for calendar time. No evidence for seasonal variation was found for any of the outcomes: acute cesarean delivery due to dystocia (p = 0.44); instrumental vaginal delivery due to dystocia (p = 0.69); oxytocin augmentation due to dystocia (p = 0.46); and overall dystocia (p = 0.91). No seasonal variation in the incidence of dystocia was observed in a large cohort of Danish women. This may reflect no association between vitamin D and dystocia, or alternatively that other factors with seasonal variation and influence on the occurrence of dystocia attenuate such an association.