Odense Pharmacoepidemiological Database: A Review of Use and Content.

PubMed

Hallas, Jesper; Hellfritzsch, Maja; Rix, Morten; Olesen, Morten; Reilev, Mette; Pottegård, Anton

2017-05-01

The Odense University Pharmacoepidemiological Database (OPED) is a prescription database established in 1990 by the University of Southern Denmark, covering reimbursed prescriptions from the county of Funen in Denmark and the region of Southern Denmark (1.2 million inhabitants). It is still active and thereby has more than 25 years of continuous coverage. In this MiniReview, we review its history, content, quality, coverage, governance and some of its uses. OPED's data include the Danish Civil Registration Number (CPR), which enables unambiguous linkage with virtually all other health-related registers in Denmark. Among its research uses, we review record linkage studies of drug effects, advanced drug utilization studies, some examples of method development and use of OPED as sampling frame to recruit patients for field studies or clinical trials. With the advent of other, more comprehensive sources of prescription data in Denmark, OPED may still play a role as in certain data-intensive regional studies. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Regionalization Lessons from Denmark.

PubMed

Vrangbaek, Karsten

2016-01-01

Denmark is a small Northern European country with an extensive welfare state and a strong commitment to maintaining a universal healthcare system. Like the other countries in the Nordic region, Denmark has a long tradition of democratically governed local and regional governments with extensive responsibilities in organizing welfare state services. The Danish healthcare system has demonstrated an ability to increase productivity, while at the same time maintaining a high level of patient satisfaction. Ongoing reforms have contributed to these results, as well as a firm commitment to innovation and coordination. Regions and municipalities in Denmark are governed by directly elected democratic councils. The Danish case is thus an example of democratic decentralization, but within a framework of national coordination and fiscal control. In spite of the difference in size and historical traditions there are also many similarities between Canada and Denmark, particularly in terms of health and social policy goals and aspirations, and in terms of the commitment to a comprehensive, universal healthcare system. These similarities provide interesting opportunities for comparison.

Teaching Power Electronics with a Design-Oriented, Project-Based Learning Method at the Technical University of Denmark

ERIC Educational Resources Information Center

Zhang, Zhe; Hansen, Claus Thorp; Andersen, Michael A. E.

2016-01-01

Power electronics is a fast-developing technology within the electrical engineering field. This paper presents the results and experiences gained from applying design-oriented project-based learning to switch-mode power supply design in a power electronics course at the Technical University of Denmark (DTU). Project-based learning (PBL) is known…

Using English as a Medium of Instruction at University Level in Denmark: The Lecturer's Perspective

ERIC Educational Resources Information Center

Werther, Charlotte; Denver, Louise; Jensen, Christian; Mees, Inger M.

2014-01-01

More than 25% of the master's degrees in Denmark are taught using English as a medium of instruction (EMI), but not all university lecturers feel they have the appropriate academic English proficiency to meet the standard required. Based on interviews conducted at the Copenhagen Business School (CBS), this article sheds light on the challenges…

The Family Startup Program: study protocol for a randomized controlled trial of a universal group-based parenting support program.

PubMed

Trillingsgaard, Tea; Maimburg, Rikke Damkjær; Simonsen, Marianne

2015-04-21

Inadequate parenting is an important public health problem with possible severe and long-term consequences related to child development. We have solid theoretical and political arguments in favor of efforts enhancing the quality of the early family environment in the population at large. However, little is known about effect of universal approaches to parenting support during the transition to parenthood. This protocol describes an experimental evaluation of group based parenting support, the Family Startup Program (FSP), currently implemented large scale in Denmark. Participants will be approximately 2500 pregnant women and partners. Inclusion criteria are parental age above 18 and the mother expecting first child. Families are recruited when attending routine pregnancy scans provided as a part of the publicly available prenatal care program at Aarhus University Hospital, Skejby. Families are randomized within four geographically defined strata to one of two conditions a) participation in FSP or b) Treatment As Usual (TAU). FSP aims to prepare new families for their roles as parents and enhance parental access to informal sources of support, i.e. social network and community resources. The program consists of twelve group sessions, with nine families in each group, continuing from pregnancy until the child is 15 months old. TAU is the publicly available pre- and postnatal care available to families in both conditions. Analyses will employ survey data, administrative data from health visitors, and administrative register based data from Statistics Denmark. All data sources will be linked via the unique Danish Civil Registration Register (CPR) identifier. Data will be obtained at four time points, during pregnancy, when the child is nine months, 18 months and seven years. The primary study outcome is measured by the Parenting Sense of Competence scale (PSOC) J Clin Child Psychol 18:167-75, 1989. Other outcomes include parenting and couple relationship quality, utility of primary sector service and child physical health, socio-emotional and cognitive development. The protocol describes an ambitious experimental evaluation of a universal group-based parenting support program; an evaluation that has not yet been made either in Denmark or internationally. ClinicalTrials.gov ID: NCT02294968. Registered November 14 2014.

Explanations of sleep paralysis among Egyptian college students and the general population in Egypt and Denmark.

PubMed

Jalal, Baland; Simons-Rudolph, Joseph; Jalal, Bamo; Hinton, Devon E

2014-04-01

This cross-cultural study compared explanations of sleep paralysis (SP) in two countries and two groups with different levels of education in one country. Comparisons were made between individuals having experienced SP at least once in a lifetime from Cairo, Egypt (n = 89), Copenhagen, Denmark (n = 59), and the American University in Cairo, Egypt (n = 44). As hypothesized, participants from the general Egyptian population were more likely to endorse supernatural causal explanation of their SP compared to participants from Denmark; participants from the American University in Cairo were less likely to endorse supernatural causes of their SP compared to participants from the general Egyptian population. Moreover, participants from the American University in Cairo were marginally significantly more likely to endorse supernatural causes of their SP compared to participants from Denmark. Additionally, we explored which culturally bound explanations and beliefs about SP existed in Egypt and Denmark. We found that nearly half (48%) of the participants from the general Egyptian population believed their SP to be caused by the Jinn, a spirit-like creature with roots in Islamic tradition, which constitutes a culturally bound interpretation of the phenomenology of SP in this region of the world. Case studies are presented to illustrate these findings.

[Assessment of the prognosis in patients who remain comatose after resuscitation from cardiac arrest].

PubMed

Ramberg, Emilie; Fedder, Anette Marianne; Dyrskog, Stig Eric; Degn, Niels Sanderhoff; Hassager, Christian; Jensen, Reinhold; Kirkegaard, Hans; Weber, Sven; Hoffmann-Petersen, Joachim Torp; Larsen, Niels Heden; Strange, Ditte Gry; Sonne, Morten; Lippert, Freddy K

2014-06-30

In Denmark there are around 3,500 unexpected cardiac arrests (CA) out of hospital each year. There is an unknown number of CA in hospitals. The survival rate after CA outside a hospital in Denmark is 10% after 30 days. There are varying data for the neurological outcome in this group of patients. The purpose of this work is to disseminate new knowledge and to help standardizing the treatment in the group of patients who remain comatose after being resuscitated from CA. Assessment of the prognosis for a patient in this group can be made after 72 hours and a multi-modal approach to the patient is required.

'Angels in nursing': images of nursing sisters in a Lutheran context in the nineteenth and twentieth centuries.

PubMed

Malchau, Susanne

2007-12-01

This article examines Catholic nursing orders in Denmark. In 1849, 300 years after the Reformation, freedom of worship was introduced in Lutheran Denmark. In 1856 the first Catholic nursing order in modern times settled in the country. Others followed, and in 1940 the nursing orders owned 17 general hospitals and had a share of 10% of the hospital beds in Denmark. The purpose of this article is to identify images in the public media text of these Catholic nursing orders in Denmark from 1856 to the present, and to deconstruct the existing angel image the nuns and sisters in nursing have obtained. The assumption is that the public image is an important indicator of how a profession is valued in society. Six images - three positive and three negative - are identified, and it is demonstrated that these images were closely connected to the nursing sisters' professional activities and confessional affiliation. Until the 1950s the image of nursing sisters as representing a counterculture in Lutheran Denmark persisted. This image was succeeded by one of professional nurses of high standards. The shift was caused by increased secularisation and the renewal of religious life, as a result of the Second Vatican Council in the 1960s.

Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden

PubMed Central

Westman, J; Wahlbeck, K; Laursen, T M; Gissler, M; Nordentoft, M; Hällgren, J; Arffman, M; Ösby, U

2015-01-01

Objective To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. Method A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden. Results Life expectancy was 24–28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (−0.8 years) and Sweden (−1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0–5.2), all diseases and medical conditions (2.3–4.8), and suicide (9.3–35.9). Conclusion People hospitalized with alcohol use disorder have an average life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population. PMID:25243359

Asymptomatic Carriers Contribute to Nosocomial Clostridium difficile Infection: A Cohort Study of 4508 Patients.

PubMed

Blixt, Thomas; Gradel, Kim Oren; Homann, Christian; Seidelin, Jakob Benedict; Schønning, Kristian; Lester, Anne; Houlind, Jette; Stangerup, Marie; Gottlieb, Magnus; Knudsen, Jenny Dahl

2017-04-01

Nosocomial infections with Clostridium difficile present a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile can spread their infection to other patients. We investigated the effects of asymptomatic carriers on nosocomial C difficile infections. We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. C difficile infection was detected in 2.6% of patients not exposed to carriers and in 4.6% of patients exposed to asymptomatic carriers at the ward level (odds ratio for infection if exposed to carrier, 1.79; 95% confidence interval, 1.16-2.76). Amount of exposure correlated with risk of C difficile infection, from 2.2% in the lowest quartile to 4.2% in the highest quartile of exposed patients (P = .026). Combining the load of exposure to carriers and length of stay seemed to have an additive effect on the risk of contracting C difficile. In a population-based prospective cohort study in Denmark, we found that asymptomatic carriers of toxigenic C difficile in hospitals increase risk of infection in other patients. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Magnetostriction and Magnetic Heterogeneities in Iron-Gallium

DTIC Science & Technology

2010-07-08

instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send...2Materials Research Division, Risø DTU , Technical University of Denmark, DK-4000 Roskilde, Denmark 3Nano-Science Center, Niels Bohr Institute, University...gauges monitored the strain. Comparing Eqs. (1) and the dependencies of the data at high magnetic fields [Fig. 1(d)], we see ðRÞ ¼ 0 everywhere, i.e

Unannounced versus announced hospital surveys: a nationwide cluster-randomized controlled trial.

PubMed

Ehlers, Lars Holger; Simonsen, Katherina Beltoft; Jensen, Morten Berg; Rasmussen, Gitte Sand; Olesen, Anne Vingaard

2017-06-01

To evaluate the effectiveness of unannounced versus announced surveys in detecting non-compliance with accreditation standards in public hospitals. A nationwide cluster-randomized controlled trial. All public hospitals in Denmark were invited. Twenty-three hospitals (77%) (3 university hospitals, 5 psychiatric hospitals and 15 general hospitals) agreed to participate. Twelve hospitals were randomized to receive unannounced surveys (intervention group) and eleven hospitals to receive announced surveys (control group). We hypothesized that the hospitals receiving the unannounced surveys would reveal a higher degree of non-compliance with accreditation standards than the hospitals receiving announced surveys. Nine surveyors trained and employed by the Danish Institute for Quality and Accreditation in Healthcare (IKAS) were randomized into teams and conducted all surveys. The outcome was the surveyors' assessment of the hospitals' level of compliance with 113 performance indicators-an abbreviated set of the Danish Healthcare Quality Programme (DDKM) version 2, covering organizational standards, patient pathway standards and patient safety standards. Compliance with performance indicators was analyzed using binomial regression analysis with bootstrapped robust standard errors. In all, 16 202 measurements were acceptable for data analysis. The risk of observing non-compliance with performance indicators for the intervention group compared with the control group was statistically insignificant (risk difference (RD) = -0.6 percentage points [-2.51-1.31], P = 0.54). A converged analysis of the six patient safety critical standards, requiring 100% compliance to gain accreditation status revealed no statistically significant difference (RD = -0.78 percentage points [-4.01-2.44], P = 0.99). Unannounced hospital surveys were not more effective than announced surveys in detecting quality problems in Danish hospitals. ClinicalTrials.gov NCT02348567, https://clinicaltrials.gov/ct2/show/NCT02348567?term=NCT02348567. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark.

PubMed

Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

2015-02-24

A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Yearly incidence of meniscal procedures per 100,000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. 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.

Use of complementary and alternative medicine at Norwegian and Danish hospitals

PubMed Central

2011-01-01

Background Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM). However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001. Methods A one-page questionnaire was sent to all included hospitals in both countries. The questionnaire was sent to the person responsible for the clinical activity, typically the medical director. 99 hospitals in the authority (85%) in Norway and 126 in Denmark (97%) responded. Given contact persons were interviewed. Results CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one) responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially. Conclusions The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional health care system. PMID:21244655

Commentary on: "Enzalutamide monotherapy in hormone-naive prostate cancer: primary analysis of an open-label, single-arm, phase 2 study." Tombal B, Borre M, Rathenborg P, Werbrouck P, Van Poppel H, Heidenreich A, Iversen P, Braeckman J, Heracek J, Baskin-Bey E, Ouatas T, Perabo F, Phung D, Hirmand M, Smith MR. Institut de Recherche Clinique, Université Catholique de Louvain, Brussels, Belgium. Electronic address: bertrand.tombal@uclouvain.be. Aarhus University Hospital, Aarhus, Denmark. Herlev Hospital, Herlev, Denmark. AZ Groeninge Kortrijk, Kortrijk, Belgium. UZ Leuven, Leuven, Belgium. Klinik und Poliklinik für Urologie, RWTH University Aachen, Aachen, Germany. Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. UZ Brussel, Brussels, Belgium. Univerzita Karlova v Praze, Prague, Czech Republic. Astellas Pharma Global Development, Leiden, Netherlands. Astellas Pharma Global Development, Northbrook, IL, USA. Medivation Inc, San Francisco, CA, USA. Massachusetts General Hospital Cancer Center, Boston, MA, USA: Lancet Oncol. 2014 May;15(6):592-600; doi: 10.1016/S1470-2045(14)70129-9. [Epub 2014 Apr 14].

PubMed

Trump, Donald

2016-05-01

The androgen receptor inhibitor enzalutamide is approved for the treatment of metastatic castration-resistant prostate cancer that has progressed on docetaxel. Our aim was to assess the activity and safety of enzalutamide monotherapy in men with hormone-naive prostate cancer. This trial is an ongoing open-label, single-arm, phase 2 study, done across 12 European sites. Men aged over 18 years with hormone-naive prostate cancer for whom hormone therapy was indicated, and who had noncastration levels of testosterone and prostate-specific antigen (PSA) of 2ng/mL or greater at screening, and an Eastern Cooperative Oncology Group score of 0, received oral enzalutamide 160mg/day. The primary outcome was the proportion of patients with an 80% or greater decline in PSA at week 25. All analyses included all patients who had received at least one dose of the study drug. This study is registered with ClinicalTrials.gov, number NCT01302041. 67 men were enrolled into the study. 62 patients (92.5%, 95% CI: 86.2-98.8) had a decline in PSA of 80% or greater at week 25. The most commonly reported treatment-emergent adverse events up to week 25 were gynaecomastia (n = 24), fatigue (n = 23), nipple pain (n = 13), and hot flush (n = 12), all of which were of mild to moderate severity. Overall, 9 patients had a treatment-emergent adverse event of grade 3 or higher, most of which were reported in one patient each, except for pneumonia (grade 3, two patients) and hypertension (grade 3, four patients). Five patients reported serious adverse events, none of which were deemed to be treatment related. Our findings suggest that enzalutamide monotherapy in men with hormone-naive prostate cancer of varying severity provides a level of disease suppression and was generally well tolerated. These findings provide a rationale for further investigation of clinical response and outcomes with enzalutamide in noncastrated men with prostate cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

Characteristics of children less than 2 years of age undergoing anaesthesia in Denmark 2005-2015: a national observational study.

PubMed

Strøm, C; Afshari, A; Lundstrøm, L H; Lohse, N

2018-04-19

There are few data available that describe the current anaesthetic management of children. We have analysed anaesthetic practice and peri-operative complications for children in Denmark aged less than two years. We conducted a population-based observational cohort study using the Danish Anaesthesia Database to identify children who received anaesthesia in hospital from 1 January 2005 until 31 December 2015. Data were combined with that from the Danish National Patient Registry and the Danish Civil Registration System. Age, sex, height, weight, ASA physical status, days in hospital before anaesthesia, number of anaesthetics per child, indications for anaesthesia, methods of anaesthesia, airway management and complications were all recorded. A total of 17,436 children (64% of whom were male) received 27,653 anaesthetics during the study period. In 58% of cases, the child had an ASA physical status score of 1. Thirty-seven percent had a previous anaesthetic episode. Seventy-nine percent were anaesthetised at a university hospital. The indications for anaesthesia were surgery (70%), diagnostic radiology (16%), non-surgical care (11%) and other indications (3%). General anaesthesia combining intravenous and inhalational agents was the most common approach for surgery (68%) and diagnostic radiology (47%). For non-surgical care, general anaesthesia using inhalational agents was the most common method (42%). Neuraxial blocks were used infrequently. The most common regional anaesthetic nerve block was an infraclavicular brachial plexus block (11%). Peri-operative complications occurred in 1.71% of cases. A large proportion of anaesthetics were conducted in children with comorbidities. Non-surgical indications for anaesthesia were frequent and peri-operative complications were rare. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

Are labour-intensive efforts to prevent pressure ulcers cost-effective?

PubMed

Mathiesen, Anne Sofie Mølbak; Nørgaard, Kamilla; Andersen, Marie Frederikke Bruun; Møller, Klaus Meyer; Ehlers, Lars Holger

2013-10-01

Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement. To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care. A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty. Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB. This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care. The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.

The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009-2011: a population-based study of hospitalizations.

PubMed

Ørsted, Iben; Mølvadgaard, Mette; Nielsen, Hans Linde; Nielsen, Henrik

2013-09-01

Denmark experienced three waves of the new pandemic influenza A (H1N1)pdm09 from July 2009 to February 2011. The aim of the study was to describe the epidemiology and clinical characteristics of hospitalized patients in a defined population of North Denmark Region with a mixed urban and rural community of 579,000 inhabitants. Review of medical records of all hospitalized patients with confirmed influenza A from July 2009 to February 2011. Two hundred and seventy-three patients were admitted to hospital. The age-related population incidences of hospitalization were as follows: 0-14 years: 111/100,000, 15-64 years: 39/100,000, and ≥ 65 years: 17/100,000. During the first wave (July 2009-August 2009), three patients were admitted - none received treatment in intensive care units (ICUs), during the second wave (October 2009-January 2010), 158 patients were admitted - nine received treatment in ICUs, and during the third wave (December 2010-February 2011), 112 patients were admitted - 25 received treatment in ICUs. Fourteen patients (5%) died within 30 days of diagnosis (median 55 years; range 14-76 years) and additional seven patients (2.6%) died within 365 days (median 25 years; range 1-86 years). Patients hospitalized with pandemic influenza A (H1N1)pdm09 were predominantly children and younger adults, and only a few patients were >65 years. The third wave was the most severe taking the number and percentage of patients admitted to ICUs and 30-day mortality into consideration. We observed that the incidence of hospitalizations as well as clinical severity among younger adults did not decline from the second to the third wave. © 2013 John Wiley & Sons Ltd.

Embryo quality and implantation rate in two different culture media: ISM1 versus Universal IVF Medium.

PubMed

Xella, Susanna; Marsella, Tiziana; Tagliasacchi, Daniela; Giulini, Simone; La Marca, Antonio; Tirelli, Alessandra; Volpe, Annibale

2010-04-01

To compare the outcome of two different culture media marketed by the MediCult AS Company (Jyllinge, Denmark)-Universal IVF Medium and ISM1 Medium culture-which, in addition to glucose, pyruvate, and energy-providing components, also contain amino acids, nucleotides, vitamins, and cholesterol. Laboratory and retrospective clinical study. University teaching hospital. A total of 726 patients, undergoing IVF-intracytoplasmic sperm injection procedure, comparable in mean age range, oocyte retrieval, and infertility indication, were included in the study. Laboratory quality and standard procedures were maintained unaffected. Oocyte retrieval, different embryo culture media. Embryo quality, ongoing pregnancy, and implantation rate. The frequency of good-quality embryos (79% vs. 74%) and the percentages of ongoing pregnancy (27.5% vs. 18%) and implantation rate (15% vs. 10%) were significantly higher in the group treated with ISM1 Medium rather than Universal IVF Medium. ISM1 Medium culture seems to improve the performance of embryonic growth and development, as well as increasing the percentage of pregnancy. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Commentary on: "Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): A multicentre, randomised, double-blind, phase 3 trial." Kwon ED, Drake CG, Scher HI, Fizazi K, Bossi A, van den Eertwegh AJ, Krainer M, Houede N, Santos R, Mahammedi H, Ng S, Maio M, Franke FA, Sundar S, Agarwal N, Bergman AM, Ciuleanu TE, Korbenfeld E, Sengeløv L, Hansen S, Logothetis C, Beer TM, McHenry MB, Gagnier P, Liu D, Gerritsen WR, CA184-043 Investigators. Departments of Urology and Immunology and Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, MN, USA, Electronic address: kwon.eugene@mayo.edu; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and Brady Urological Institute, Baltimore, MD, USA; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA; Institut Gustave Roussy, University of Paris-Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France; VU University Medical Centre, Amsterdam, Netherlands; Vienna General Hospital, Medical University Vienna, Vienna, Austria; Institut Bergonié, Bordeaux, France; CHU Caremeau, Nimes, France; Centro Médico Austral, Buenos Aires, Argentina; Centre Jean Perrin, Clermont-Ferrand, France; St John of God Hospital, Subiaco, WA, Australia; University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy; Hospital de Caridade de Ijuí, Ijuí, Brazil; Nottingham University Hospital, Nottingham, UK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Institute of Oncology Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Herlev Hospital, Herlev, Denmark; Odense University Hospital, Odense, Denmark; University of Texas MD Anderson Cancer Center, Houston,

PubMed

Trump, Donald

2016-05-01

Ipilimumab is a fully human monoclonal antibody that binds cytotoxic T-lymphocyte antigen 4 to enhance antitumour immunity. Our aim was to assess the use of ipilimumab after radiotherapy in patients with metastatic castration-resistant prostate cancer that progressed after docetaxel chemotherapy. We did a multicentre, randomised, double-blind, phase 3 trial in which men with at least one bone metastasis from castration-resistant prostate cancer that had progressed after docetaxel treatment were randomly assigned in a 1:1 ratio to receive bone-directed radiotherapy (8Gy in one fraction) followed by either ipilimumab 10mg/kg or placebo every 3 weeks for up to four doses. Non-progressing patients could continue to receive ipilimumab at 10mg/kg or placebo as maintenance therapy every 3 months until disease progression, unacceptable toxic effect, or death. Patients were randomly assigned to either treatment group via a minimisation algorithm, and stratified by Eastern Cooperative Oncology Group performance status, alkaline phosphatase concentration, haemoglobin concentration, and investigator site. Patients and investigators were masked to treatment allocation. The primary endpoint was overall survival, assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00861614. From May 26, 2009, to Feb 15, 2012, 799 patients were randomly assigned (399 to ipilimumab and 400 to placebo), all of whom were included in the intention-to-treat analysis. Median overall survival was 11.2 months (95% CI: 9.5-12.7) with ipilimumab and 10.0 months (8.3-11.0) with placebo (hazard ratio [HR] = 0.85, 0.72-1.00; P = 0.053). However, the assessment of the proportional hazards assumption showed that it was violated (P = 0.0031). A piecewise hazard model showed that the HR changed over time: the HR for 0-5 months was 1.46 (95% CI: 1.10-1.95), for 5-12 months was 0.65 (0.50-0.85), and beyond 12 months was 0.60 (0.43-0.86). The most common grade 3-4 adverse events were immune-related, occurring in 101 (26%) patients in the ipilimumab group and 11 (3%) of patients in the placebo group. The most frequent grade 3-4 adverse events included diarrhoea (64 [16%] of 393 patients in the ipilimumab group vs seven [2%] of 396 in the placebo group), fatigue (40 [11%] vs 35 [9%]), anaemia (40 [10%] vs 43 [11%]), and colitis (18 [5%] vs 0). Four (1%) deaths occurred because of toxic effects of the study drug, all in the ipilimumab group. Although there was no significant difference between the ipilimumab group and the placebo group in terms of overall survival in the primary analysis, there were signs of activity with the drug that warrant further investigation. Bristol-Myers Squibb. Copyright © 2016 Elsevier Inc. All rights reserved.

The work practice of medical secretaries and the implementation of electronic health records in Denmark.

PubMed

Bertelsen, Pernille; Nøhr, Christian

The introduction of electronic health records will entail substantial organisational changes to the clinical and administrative staff in hospitals. Hospital owners in Denmark have predicted that these changes will render up to half of medical secretaries redundant. The present study however shows that medical secretaries have a great variety of duties, and often act as the organisational "glue" or connecting thread between other professional groups at the hospital. The aim of this study is to obtain a detailed understanding of the pluralism of work tasks the medical secretaries perform. It is concluded that clinicians as well as nurses depend on medical secretaries, and therefore to reduce the number of secretaries because electronic health record systems are implemented needs very careful thinking, planning and discussion with the other professions involved.

First Case of NDM-1-Producing Klebsiella pneumoniae in Annaba University Hospital, Algeria.

PubMed

Abderrahim, Amel; Djahmi, Nassima; Pujol, Charlotte; Nedjai, Sabina; Bentakouk, Mohamed Cherif; Kirane-Gacemi, Djamila; Dekhil, Mazouz; Sotto, Albert; Lavigne, Jean-Philippe; Pantel, Alix

2017-10-01

The aim of this study was to characterize two carbapenem-resistant Klebsiella pneumoniae isolates recovered from urine samples in a patient hospitalized at Annaba University hospital (Algeria) in 2014. Two K. pneumoniae isolates were studied because they proved resistant to almost all antibiotics tested with a high level resistance to ertapenem (minimum inhibitory concentration = 32 mg/L). The results of modified Hodge test and combined disk test (ROSCO Diagnostica, Taastrup, Denmark) were positive. The two isolates harbored the bla NDM-1 gene and one was also positive for bla CTX-M-15 . Screening of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance contents detected aac(6')-Ib-cr, aac(3')-II, qnrB2, and oqxAB in both isolates. Multilocus sequence typing demonstrated that the two isolates belonged to sequence type 147. However, repetitive sequence-based PCR and pulsed-field gel electrophoresis showed that they were not clonally related. The bla NDM-1 gene and all other resistant genes were contained on an IncR plasmid of c.a. 85 kb. This study comprises the first identification of NDM-1-producing K. pneumoniae in Algeria. We thus confirm the concerning worldwide dissemination of this carbapenemase that involves the emergence of the IncR plasmid and the success of the ST147 clonal complex harboring it.

Overtreatment of displaced midshaft clavicle fractures

PubMed Central

Ban, Ilija; Nowak, Jan; Virtanen, Kaisa; Troelsen, Anders

2016-01-01

Background and purpose The best treatment for displaced clavicle fractures has been debated for decades. Operative treatment has become more common. However, several randomized trials comparing non-operative and operative treatment have not shown any compelling evidence in favor of surgery. We identified the preferred treatment of displaced midshaft clavicle fractures at public hospitals in 3 countries in Scandinavia. Patients and methods A purpose-made multiple-choice questionnaire in English was sent to all public hospitals in Denmark, Sweden, and Finland. This was addressed to the orthopedic surgeon responsible for treatment of clavicle fractures, and completed questionnaires were obtained from 85 of 118 hospitals. Results In the 3 countries, 69 of the 85 hospitals that responded would treat displaced clavicle fractures operatively. Clear criteria for treatment allocation were used at 58 of the hospitals, with the remaining 27 using individual assessment in collaboration with the patient. Precontoured locking plates were mostly used, placed either superiorly (64/85) or anteriorly (10/85). Interpretation Displaced midshaft clavicle fractures are mainly treated operatively in Sweden, Denmark, and Finland. This treatment is not supported by compelling evidence. PMID:27225678

Overtreatment of displaced midshaft clavicle fractures.

PubMed

Ban, Ilija; Nowak, Jan; Virtanen, Kaisa; Troelsen, Anders

2016-12-01

Background and purpose - The best treatment for displaced clavicle fractures has been debated for decades. Operative treatment has become more common. However, several randomized trials comparing non-operative and operative treatment have not shown any compelling evidence in favor of surgery. We identified the preferred treatment of displaced midshaft clavicle fractures at public hospitals in 3 countries in Scandinavia. Patients and methods - A purpose-made multiple-choice questionnaire in English was sent to all public hospitals in Denmark, Sweden, and Finland. This was addressed to the orthopedic surgeon responsible for treatment of clavicle fractures, and completed questionnaires were obtained from 85 of 118 hospitals. Results - In the 3 countries, 69 of the 85 hospitals that responded would treat displaced clavicle fractures operatively. Clear criteria for treatment allocation were used at 58 of the hospitals, with the remaining 27 using individual assessment in collaboration with the patient. Precontoured locking plates were mostly used, placed either superiorly (64/85) or anteriorly (10/85). Interpretation - Displaced midshaft clavicle fractures are mainly treated operatively in Sweden, Denmark, and Finland. This treatment is not supported by compelling evidence.

Who Cares for the Children? Denmark's Unique Public Child-Care Model.

ERIC Educational Resources Information Center

Polakow, Valerie

1997-01-01

U.S. working mothers wrestle daily with a child-care crisis characterized by unavailable infant care, high costs, and inadequate access and regulation. In Denmark, high-quality child care is a guaranteed entitlement for every child. Other benefits include paid parental leaves, single-parent allowances, housing subsidies, and universal health care.…

University Governance in Denmark: From Democracy to Accountability?

ERIC Educational Resources Information Center

Carney, Stephen

2006-01-01

This article reports the findings of a Danish research council-funded project aimed at exploring a comprehensive package of management reforms in higher education instituted in Denmark since 2003. The reforms attempt to change not only the way institutions are governed but the very notion of democracy and engagement in higher education. In short,…

Towards Universal Design Hotels in Denmark.

PubMed

Grangaard, Sidse

2016-01-01

Based on the research project 'Accessible Hotel Rooms' that studies the balance between the experience of supply and demand regarding accessibility features in Danish hotel rooms, this paper demonstrates factors having an influence on Universal Design hotels in Denmark. The research project was financed by the Danish Transport and Construction Agency. Different notions in the hotel sector of the current supply and demand for Universal Design hotel rooms are identified, as well as future demand. Despite supplying accessible rooms, some hotels do not advertise their accessibility features on their website. There exists an attitude in the hotel sector that functions as a barrier for Universal Design: if there are enough guests, for example business travellers, then why market the hotel on Universal Design? The paper points out the coherence between the understanding of the users and the view of demand. Another important factor is Corporate Social Responsibility, which can be regarded as a strategy or platform towards Universal Design hotels.

The Odense University Pharmacoepidemiological Database (OPED)

Cancer.gov

The Odense University Pharmacoepidemiological Database is one of two large prescription registries in Denmark and covers a stable population that is representative of the Danish population as a whole.

Women's experience of post-term pregnancy.

PubMed

Maimburg, Rikke Damkjaer

2016-06-01

In recent years, induction of labour has become increasingly common in many countries and has moved towards an earlier gestational age. The aim of this study was to describe how low-risk pregnant women experienced post-term pregnancy in a large university hospital in Denmark Qualitative interviews were carried out with 31 low-risk pregnant women. Pregnant women passing their estimated time of birth date experienced their last days of pregnancy as a countdown to induction, not as their last days of pregnancy. Categorisation of the women's pregnancy based on medical statistics, and a focus on medical issues caused the women to feel less involved, and contributed to them being willing to negotiate an earlier induction of labour to avoid being stigmatised as pathological patients.

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.

Caught between Internationalisation and Immigration: The Case of Nepalese Students in Denmark

ERIC Educational Resources Information Center

Valentin, Karen

2012-01-01

An explicit marketisation and national profiling of Denmark as an attractive country for foreign students has resulted in an increasing number of students from poor countries in the global South, including Nepal, being admitted to Danish colleges and universities. The influx of students from these countries has led to several accusations against…

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.

Patterns of Contact with Hospital for Children with an Autism Spectrum Disorder: A Danish Register-Based Study

ERIC Educational Resources Information Center

Atladottir, Hjordis Osk; Schendel, Diana E.; Lauritsen, Marlene B.; Henriksen, Tine Brink; Parner, Erik T.

2012-01-01

The aim of this study was to study patterns of contact with hospital for children with autism spectrum disorder (ASD) using Danish population based register data. We included all children born in Denmark from 1994 through 2002. We found that children diagnosed with ASD had an increased rate of contact with hospital, almost regardless of the cause…

Studies in the Major Modern Languages (English, German, French) at University Level in Denmark by 1980/81.

ERIC Educational Resources Information Center

Dollerup, Cay

This is a descriptive outline of the language situation in the Danish education system. The introductory material discusses the reason for foreign language study. A major reason is that Denmark is a small country with a difficult native language for speakers of other languages to learn. Therefore, the Danish population is exposed to foreign…

Neo-Liberalism and Universal State Education: The Cases of Denmark, Norway and Sweden 1980-2011

ERIC Educational Resources Information Center

Wiborg, Susanne

2013-01-01

This article investigates neo-liberal policy on education in Denmark, Norway and Sweden. Traditionally, the edifice of the education system in these Scandinavian countries has been built on egalitarian values, but over the last 20 years they have increasingly adopted market-led reforms of education. The extent of neo-liberal policy varies between…

Prevaccination epidemiology of herpes zoster in Denmark: Quantification of occurrence and risk factors.

PubMed

Schmidt, Sigrun A J; Vestergaard, Mogens; Baggesen, Lisbeth M; Pedersen, Lars; Schønheyder, Henrik C; Sørensen, Henrik T

2017-10-09

Herpes zoster (HZ) is a vaccine-preventable disease caused by reactivation of the varicella-zoster virus. Unfortunately, formulation of recommendations on routine immunization is hampered by a lack of data on disease burden, since most countries do not record cases of HZ in the general population. We developed and validated an algorithm to identify HZ based on routinely collected registry data and used it to quantify HZ occurrence and risk factors in Denmark prior to marketing of the HZ vaccine. We included patients aged ≥40years with a first-time systemic Acyclovir, Valacyclovir, or Famciclovir prescription or a hospital-based HZ diagnosis in the Danish nationwide health registries during 1997-2013. In a validation substudy (n=176), we computed the proportion of persons with HZ among patients who redeemed antiviral prescriptions. In a cohort study, we computed age-specific rates of HZ (45,297,258 person-years). In a case-control study, we then computed odds ratios (ORs) for common chronic diseases and immunosuppressive factors among HZ cases (n=189,025) vs. matched population controls (n=945,111). Medical record review confirmed HZ in 87% (95% confidence interval: 79-93%) of persons ≥40years who dispensed antivirals at doses recommended for HZ. HZ rates increased from 2.15/1000 person-years in 40-year-olds to 9.45/1000 person-years in 95-year-olds. Rates were highest in women. HZ was diagnosed during hospitalization among 3.5%. As expected, persons with severe immunosuppressive conditions had the highest ORs of HZ (between 1.82 and 4.12), but various autoimmune diseases, asthma, chronic kidney disease, and inhaled glucocorticoids were also associated with increased ORs (between 1.06 and 1.64). This algorithm is a valid tool for identifying HZ in routine healthcare data. It shows that HZ is common in Denmark, especially in patients with certain chronic conditions. Prioritized vaccination of such high-risk patients might be an option in countries considering alternatives to universal vaccination. Copyright © 2017 Elsevier Ltd. All rights reserved.

Point prevalence of wounds and cost impact in the acute and community setting in Denmark.

PubMed

Gottrup, F; Henneberg, E; Trangbæk, R; Bækmark, N; Zøllner, K; Sørensen, J

2013-08-01

To estimate the wound-care related costs in two hospitals in Denmark. A point-prevalence survey with a focus on resource consumption was carried out during a representative 1-week period in March 20 I 0, in two hospitals in Denmark: Regional Hospital Viborg, in the Viborg Municipality and Hillerod Hospital, in the Horsholm Municipality. Data were collected during a 2-day period for inpatients and outpatients in the hospitals and over a full week in the municipalities. The survey included information on the numbers, types and locations of the wounds, as well as resource consumption related to dressing changes. The estimation of costs was based on representative cost levels, including the salaries of health professionals or nurses and the cost of dressings and hospitalisation provided. In total, 33% (n=830) of inpatients had a wound. The majority of these were surgical/trauma wounds (25%), while pressure ulcers, leg ulcers and diabetic foot ulcers accounted for 3.3%, 1.7% and 1.6%, respectively. In the municipalities, there was a wound patient prevalence of 2.8 per I 000 population(I I I 000 acute wounds, 0.7/ I 000 pressure ulcers, 0.5/ I 000 leg ulcers and 0.3/ I 000 diabetic foot ulcers).The extrapolated figures for nurse time related to wound care per year was equivalent to I 0 full-time nurse positions in Hillerod Hospital, three in Viborg Hospital, 17 in Viborg Municipality and three in Horsholm Municipality. The total annual costs related to wound care was estimated as €3.6 million for Viborg Hospital, €4.1 million for Hillemd Hospital, € 1.2 million for Viborg Municipality and €232 548 for Horsholm Municipality, accounting for approximately 1.8% (Viborg), 1.6% (Hillerod), 2.4% (Viborg) and1.5% (Horsholm) of the total annual budgets. In the survey, 33% of the patients treated in the hospitals had a wound. Primary costs were defined as hospitalisation costs and nurse time related to dressing changes. Total annual costs of treatment, including hospitalisation, were estimated as approximately 1.6-1.8% for the hospitals and 1.5-2.4% for the municipalities. The level of costs support the relevance of increased efforts to secure better wound prevention and treatment to reduce the staff-time consumption and hospitalisation costs.

Testing the Capture Magnet

NASA Technical Reports Server (NTRS)

2004-01-01

This image of a model capture magnet was taken after an experiment in a Mars simulation chamber at the University of Aarhus, Denmark. It has some dust on it, but not as much as that on the Mars Exploration Rover Spirit's capture magnet. The capture and filter magnets on both Mars Exploration Rovers were delivered by the magnetic properties team at the Center for Planetary Science, Copenhagen, Denmark.

Management of cerebral palsy varies by healthcare region.

PubMed

Rackauskaite, Gija; Uldall, Peter W; Bech, Bodil H; Østergaard, John R

2015-11-01

Cerebral palsy (CP) is the most common type of motor disability in childhood. The aim of the present paper was to describe regional differences in the management of CP in school-aged children in Denmark. This was a cross-sectional study based on the Danish Cerebral Palsy Registry. The parents of 462 children answered a questionnaire about their child's treatment and the family's characteristics. Descriptive and logistic regression analyses were performed for every treatment modality, stratified by the Gross Motor Function Classification System (GMFCS) level and adjusted for family and child characteristics. Significant regional differences were found regarding the provision of occupational therapy at all GMFCS levels, speech therapy at GMFCS levels II-V and orthopaedic surgery at GMFCS levels I and III-V. No regional differences were observed in the frequency of physiotherapy. We found no regional differences in the severity of disability. Regional differences in the management of CP cannot be explained by social differences or differences in the severity of the disability. This study was funded by the Research Foundation from the Central Denmark Region and the Department of Clinical Medicine at Aarhus University Hospital, the Augustinus Foundation, the Bevica Foundation, the Dagmar Marshalls Foundation, the Ludvig and Sara Elsass Foundation, and the Civil Engineer Frode V. Nyegaard's and his Wife's Foundation. not relevant.

Agents of Internationalisation? Danish Universities' Practices for Attracting International Students

ERIC Educational Resources Information Center

Mosneaga, Ana; Agergaard, Jytte

2012-01-01

Universities are increasingly urged to take new responsibilities as agents of internationalisation as the globalisation of higher education intensifies the competition for international students and leads to transformation of national and European policy landscapes. Drawing on the case study of two leading universities in Denmark, this paper…

Is Drop-Out from University Dependent on National Culture and Policy? The Case of Denmark

ERIC Educational Resources Information Center

Troelsen, Rie; Laursen, Per F.

2014-01-01

National cultures are known to influence educational institutions and practices in many ways. It therefore seems reasonable to assume that drop-out from university is also influenced by differences in national cultures. In this article, we compare drop-out from Danish universities with drop-out from European universities. Based on Danish national…

Whole-genome Sequencing Used to Investigate a Nationwide Outbreak of Listeriosis Caused by Ready-to-eat Delicatessen Meat, Denmark, 2014.

PubMed

Kvistholm Jensen, Anne; Nielsen, Eva Møller; Björkman, Jonas Torgny; Jensen, Tenna; Müller, Luise; Persson, Søren; Bjerager, Gitte; Perge, Annette; Krause, Tyra Grove; Kiil, Kristoffer; Sørensen, Gitte; Andersen, Jens Kirk; Mølbak, Kåre; Ethelberg, Steen

2016-07-01

Listeriosis is a serious foodborne infection. Outbreaks of listeriosis occur rarely, but have often proved difficult to solve. In June 2014, we detected and investigated a listeriosis outbreak in Denmark using patient interviews and whole-genome sequencing (WGS). We performed WGS on Listeria monocytogenes isolates from patients and available isolates from ready-to-eat foods and compared them using single-nucleotide polymorphism (SNP) analysis. Case patients had L. monocytogenes with ≤3 SNPs (the outbreak strain) isolated in September 2013-December 2014. Through interviews, we established case patients' food and clinical histories. Food production facilities were inspected and sampled, and we performed trace-back/trace-forward of food delivery chains. In total, 41 cases were identified; 17 deaths occurred (41%). An isolate from a delicatessen meat (spiced meat roll) from company A was identical to the outbreak strain. Half of the patients were infected while hospitalized/institutionalized; institutions were supplied food by company A. The outbreak strain was repeatedly isolated from further samples taken within this company and within companies in its distribution chain. Products from company A were traced and recalled from >6000 food establishments, after which the outbreak ended. Ready-to-eat spiced meat roll from a single production facility caused this outbreak. The product, served sliced and cold, is popular among the elderly; serving it at hospitals probably contributed to the high case-fatality rate. WGS used for patient isolates and isolates from food control inspections, coupled with routine epidemiological follow-up, was instrumental in swiftly locating the source of infections, preventing further illnesses and deaths. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

The Lived Experiences of Persons Hospitalized for Construction of an Urgent Fecal Ostomy.

PubMed

Herlufsen, Per; Brødsgaard, Anne

The purpose of this study was to describe the lived experiences of hospital stays for patients undergoing urgent ostomy surgery. Qualitative, descriptive, phenomenological study. Six persons undergoing acute hospital admission and urgent ileostomy or colostomy surgery (either permanent or temporary) participated in the study. Participants were of Danish ethnicity and between the ages of 48 and 75 years. The research setting was the surgical department at a university hospital in the Capital Region of Denmark. Data collection and analyses were guided by a Reflective Lifeworld Research approach; this approach is based on phenomenological philosophy. Data were collected during in-depth interviews using a semistructured interview guide. Their average length was 50 minutes (range, 30-65 minutes). Interviews were digitally recorded and transcribed. Transcriptions were analyzed in 4 phases according to the principles of Reflective Lifeworld Research. The phenomenon we labeled "lived experiences of acute hospitalization with construction of an urgent unplanned fecal ostomy" comprised 4 constituents: (1) undergoing unexpected bodily changes, (2) partnership with professional caregivers, (3) experience of vulnerability, and (4) a lack of continuity. These constituents can be described as a number of challenges due to both hospitalization and ostomy creation. We found that individuals experience a number of challenges due to acute hospitalization and urgent construction of a fecal ostomy. These challenges are due to the unexpected bodily changes and interpersonal and organizational conditions. Nurses should be aware of not only the physical implications of urgent creation of a fecal ostomy but also the individual and psychological implications of this event.

Talent Development as a University Mission: The Quadruple Helix

ERIC Educational Resources Information Center

Holm-Nielsen, Lauritz B.; Thorn, Kristian; Olesen, Jeppe Dorup; Huey, Tina

2013-01-01

In this paper, the authors discuss the rationale behind making talent development at the PhD, post-doctoral and early career levels an equal fourth pillar of the university's mission, alongside the more traditional pillars of the triple helix. Using Denmark and Aarhus University as a case study, the paper describes how increased institutional…

Pilot-in-the-Loop CFD Method Development

DTIC Science & Technology

2015-04-30

Comparison of Actuator Disk and Actuator Line Wind Turbine Models and Best Practices for Their Use,” Paper AIAA 2012-0900, 50th AIAA Aerospace...Field Actuator Disc Model,” Wind Energy, Vol. 1, (2), 1998, pp. 73–88. [4] Leclerc, C., and Masson, C., “ Wind Turbine Performance Predictions Using a...6] Mikkelsen, R., “Actuator Disc Methods Applied to Wind Turbines ,” Ph.D. thesis, Technical University of Denmark, Lyngby, Denmark, 2003. [7

Patrick Davenport | NREL

Science.gov Websites

systems. In graduate school, Patrick completed his thesis research project with and was subsequently research position in the Computational Biomechanics Laboratory (FEM) at the University of Denver. Education M.S. Materials & Manufacturing Engineering, Technical University of Denmark (DTU) M.B.A

Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes.

PubMed

Aziz, Mubeena; Sidelmann, Johannes J; Faber, Jens; Wissing, Marie-Louise M; Naver, Klara V; Mikkelsen, Anne-Lis; Nilas, Lisbeth; Skouby, Sven O

2015-10-01

Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk of cardiovascular disease in women with PCOS. 149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS was diagnosed in accordance with the Rotterdam criteria and the women were classified into four phenotypes according to BMI and insulin resistance measured by the homeostasis model assessment of insulin resistance index. Body composition was determined by dual-energy X-ray absorptiometry. Main outcome measures were the biomarkers C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and von Willebrand factor antigen. Normal weight insulin-resistant PCOS women were characterized by abdominal obesity and elevated levels of plasma PAI-1. Overweight/obese insulin-resistant PCOS women had increased levels of both PAI-1 and CRP. Of the three Rotterdam criteria, only hyperandrogenemia was significantly associated with the hemostatic risk marker of long-term cardiovascular disease risk. Surrogate risk markers for cardiovascular disease are elevated in women with PCOS, especially insulin-resistant and overweight/obese women. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Where the thread of home births never broke - An interview with Susanne Houd.

PubMed

Santos, Mário J D S

2017-04-01

The option of a planned home birth defies medical and social normativity across countries. In Denmark, despite the dramatic decline in the home birth rates between 1960 and 1980, the right to choose the place of birth was preserved. Little has been produced documenting this process. To present and discuss Susanne Houd's reflection on the history and social dynamics of home birth in Denmark, based in an in-depth interview. This paper is part of wider Short Term Scientific Mission (STSM), in which this interview was framed as oral history. The whole interview transcript is presented, keeping the highest level of detail. In Susanne Houd's testimony, four factors were highlighted as contributing to the decline in the rate of home births from the 1960s to the 1970s: new maternity hospitals; the development of obstetrics as a research-based discipline; the compliance of midwives; and a shift in women's preference, favouring hospital birth. The development of the Danish home birth models was described by Susanne Houd in regard to the processes associated with the medicalisation of childbirth, the role of consumers, and the changing professional dynamics of midwifery. An untold history of home birth in Denmark was documented in this testimony. The Danish childbirth hospitalisation process was presented as the result of a complex interaction of factors. Susanne Houd's reflections reveal how the concerted action of consumers and midwives, framed as a system-challenging praxis, was the cornerstone for the sustainability of home birth models in Denmark. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Incidence of Rheumatoid Arthritis in the Southern part of Denmark from 1995 to 2001

PubMed Central

Pedersen, Jens K; Svendsen, Anders J; Hørslev-Petersen, Kim

2007-01-01

We estimated the incidence of rheumatoid arthritis in the southern part of Denmark from 1995 to 2001. At a rheumatology hospital serving a population of about 200 000 people over the age of 15, medical records were scrutinized. As case definition we used the tree and list format of 1987 American College of Rheumatology criteria for rheumatoid arthritis. The mean annual incidence rate per 100 000 person years was 40 in females, 21 in males, and 31 in females and males combined. The incidence of rheumatoid arthritis in Denmark is in accordance with recent studies from North America, the UK, and Northern European countries. The aetiology of rheumatoid arthritis is unknown but this study indicates that in these populations the exposure to non-genetic host and environmental aetiological factors is similar. PMID:19088896

Does drinking water influence hospital-admitted sialolithiasis on an epidemiological level in Denmark?

PubMed Central

Schrøder, Stine; Homøe, Preben; Wagner, Niels; Vataire, Anne-Lise; Lundager Madsen, Hans Erik; Bardow, Allan

2015-01-01

Objectives Sialolithiasis, or salivary stones, is not a rare disease of the major salivary glands. However, the aetiology and incidence remain largely unknown. Since sialoliths are comprised mainly of calcium phosphate salts, we hypothesise that drinking water calcium levels and other elements in drinking water could play a role in sialolithiasis. Owing to substantial intermunicipality differences in drinking water composition, Denmark constitutes a unique environment for testing such relations. Design An epidemiological study based on patient data extracted from the National Patient Registry and drinking water data from the Geological Survey of Denmark and Greenland retrieved as weighted data on all major drinking water constituents for each of the 3364 waterworks in Denmark. All patient cases with International Statistical Classification of Diseases 10th Revision (ICD-10) codes for sialolithiasis registered between the years 2000 and 2010 were included in the study (n=3014) and related to the drinking water composition on a municipality level (n=98). Primary and secondary outcome measures Multiple regression analysis using iterative search and testing among all demographic and drinking water variables with sialolithiasis incidence as the outcome in search of possible relations among the variables tested. Results The nationwide incidence of hospital-admitted sialolithiasis was 5.5 cases per 100 000 citizens per year in Denmark. Strong relations were found between the incidence of sialolithiasis and the drinking water concentration of calcium, magnesium and hydrogen carbonate, however, in separate models (p<0.001). Analyses also confirmed correlations between drinking water calcium and magnesium and their concentration in saliva whereas this was not the case for hydrogen carbonate. Conclusions Differences in drinking water calcium and magnesium may play a role in the incidence of sialolithiasis. These findings are of interest because many countries have started large-scale desalination programmes of drinking water. PMID:25941183

Epidemiology of forearm fractures in adults in Denmark: national age- and gender-specific incidence rates, ratio of forearm to hip fractures, and extent of surgical fracture repair in inpatients and outpatients.

PubMed

Abrahamsen, B; Jørgensen, N R; Schwarz, P

2015-01-01

National epidemiological studies of forearm fractures are scarce. We examined in- and outpatient rates in Denmark, including anatomical location, surgery, hospitalization ratio, recurrent fractures, and ratio of forearm to hip fractures. This may be useful for triangulation in countries with less detailed information. Rates were higher than previously estimated. Despite a significant contribution to the overall burden of osteoporotic, nonvertebral fractures, relatively little information is available about age- and gender-specific incidence rates for many countries including Denmark. We used national individual patient data on inpatient and outpatient treatment to calculate rates of forearm fractures, taking readmissions into account, with subtables for distal and proximal fractures. We also calculated ratios of forearm to hip fractures that may be useful when imputing forearm fracture rates from other administrative sources. In addition, we report the rates of hospital admission and the rates of surgical treatment, allowing readers to extrapolate from the number of admissions or surgical procedures to incidence rates, should their data sources be less comprehensive. Forearm fracture rates were 278 per 100,000 patient years in men aged 50+ and 1,110 per 100,000 in women aged 50+. The female to male incidence rate ratio was 4.0 for the age group 50+ but close to unity in persons aged 40 or under. Two thirds of patients were treated on an outpatient basis with little difference across age and gender strata. Four out of five fractures were treated conservatively. The rate of forearm fractures in Denmark was somewhat higher in both genders than recently imputed from hip fracture rates and were close to the rates previously reported in studies from Norway and Sweden. The rates of forearm fracture in Denmark are higher than previously estimated and very similar to the high risk reported from studies in Norway and Sweden.

[Rehabilitation of patients with acquired brain injury].

PubMed

Rasmussen, Anne Almskou; Jørgensen, Henrik Stig; Nielsen, Jørgen Feldbæk

2014-05-12

In Denmark the development of rehabilitation of patients with acquired brain injury (ABI) has differed from most parts of Europe. Denmark has no medical rehabilitation specialty. In 2000 two specialized hospital units were established to serve the population of 5.7 million inhabitants. They cover the needs of patients with the most severe ABIs. Only recently rehabilitation of patients with ABI has been anchored in the medical specialty of neurology. Since then the development has taken an up-going curve. This process has been supported by The Danish Health and Medicines Authority publishing several papers that highlights evidence-based organization and interventions. Current development aim to define: 1) skills of the medical doctor engaged in the rehabilitation of patients with ABI, 2) stratification to different levels of specialization at hospital and in the community, and 3) national guidelines that specify skills and collaboration between groups of professionals working with ABI rehabilitation.

Continued antidepressant treatment and suicide in patients with depressive disorder.

PubMed

Søndergård, Lars; Lopez, Ana Garcia; Andersen, Per Kragh; Kessing, Lars Vedel

2007-01-01

Antidepressant use in Denmark, as in many developed countries, has substantially increased during recent years, coinciding with a decreasing suicide rate. In a nationwide observational cohort study with linkage of registers of all prescribed antidepressants and recorded suicides in Denmark from 1995 to 2000, we investigated the relation between continued treatment with antidepressants and suicide in a population of all patients discharged from hospital psychiatry with a diagnosis of depressive disorder. Patients discharged from hospital psychiatry with a diagnosis of depressive disorder had a highly increased rate of suicide. Those who continued treatment with antidepressants had a decreased rate of suicide compared with those who purchased antidepressants once (rate ratio: 0.31, 95% confidence interval: 0.26-0.36). Further, the rate of suicide decreased consistently with the number of prescriptions. On individualized data from a cohort of patients with a known history of depressive disorder, continued antidepressant treatment was associated with reduced risk of suicide.

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.

Maternal deaths in Denmark 2002-2006.

PubMed

Bødker, Birgit; Hvidman, Lone; Weber, Tom; Møller, Margrethe; Aarre, Annette; Nielsen, Karen Marie; Sørensen, Jette Led

2009-01-01

To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care. Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records. Denmark 2002-2006. Women who died during a pregnancy or within 42 days after a pregnancy. Maternal deaths were identified by notification from maternity wards and data from the Danish National Board of Health. A national audit committee assessed hospital records of direct and indirect deaths. Maternal mortality ratio, causes of death and suboptimal care. In the study period, 26 women died during pregnancy or within 42 days from direct or indirect causes, leading to a maternal mortality ratio of 8.0/100,000 live births. Causes of death were cardiac disease, thromboembolism, hypertensive disorders of pregnancy, Streptococcus A infections, suicide, amniotic fluid embolism, cerebrovascular hemorrhage, asthma and diabetes. Our method proved valid and can be used for future research. Causes of death could be identified and learning points from the assessments could form the basis of focused education and guidelines. Future complementary 'near miss' studies and cooperation with other countries with comparable health systems are expected to improve the benefits of the enquiries, contributing to improved management of life-threatening conditions in pregnancy and childbirth.

[The hardest battles begin after the war].

PubMed

Sodemann, Morten; Svabo, Arndis; Jacobsen, Arne

2010-01-11

While psychic effects of war trauma are well-described, the somatic long-term consequences of war trauma have not previously been described. In three clinical cases from the Migrant Health Clinic at Odense University Hospital, we describe the complicated somatic problems which can be associated with a refugee status. The cross disciplinary team chose three cases that describe the long-term effects of war trauma. Post-traumatic stress disorder (PTSD) can appear 10-20 years after a primary war-related trauma and secondary trauma after the arrival in Denmark trigger and prolong post-traumatic stress symptoms with a range of somatic symptoms. Warning signs of an underlying PTSD disorder have often been present for many years, but overlooked or ignored. Many patients with PTSD and somatic symptoms loose previously acquired language skills, disintegrate and drop out of the labour market after 3-4 years in Denmark. Somatic symptoms along with PTSD can develop into a seriously complicated condition that requires skilled cross-disciplinary management. Experience from the Cross Disciplinary Migrant Health Clinic shows that by investing time in obtaining a full clinical and social history it is possible to increase the quality of life of these patients. Early screening and early specialized cross disciplinary and cross sectorial management are crucial to secure and maintain integration, but unfortunately the long waiting list to institutions that treat PTSD contributes to the high level of disintegration.

The “Health Benefit Basket” in Denmark

PubMed Central

Ankjaer-Jensen, Anni; Danneskiold-Samsøe, Bent

2005-01-01

Until 2007, when the new legislation on health care becomes effective, the right to receive free health care services in Denmark, or “health benefits,” are described in a comprehensive set of legislation, including laws, executive orders and legal guidelines. This contribution provides an overview of the current main legislation regulating the Danish “health benefit basket” and describes the regulatory mechanisms for the provision of curative care at Danish hospitals and primary health care offices. Although the services are both financed and planned by the counties, they differ substantially in the way that benefits are regulated. PMID:16270211

Towards a Danish LIS University.

ERIC Educational Resources Information Center

Harbo, Ole

2000-01-01

Analyzes the development of LIS (library and information science) research in Denmark since 1985, when research became one of the main activities of the Royal School of Library and Information Science. Outlines the development of the school from a professional school to a university institution, including political, economic, and professional…

Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment.

PubMed

Høybye, Mette Terp

2013-02-01

Given the growing attention to the importance of design in shaping healing hospital environments this study extends the understanding of healing environments, beyond causal links between environmental exposure and health outcome by elucidating how environments and practices interrelate. The study was conducted as an ethnographic fieldwork from March 2011 to September 2011 at the Department of Haematology at Odense University Hospital, Denmark, systematically using participant observation and interviews as research strategies. It included 20 patients, four of who were followed closely over an extended time period. Through thematic analysis five key concepts emerged about the social dynamics of hospital environments: practices of self; creating personal space; social recognition; negotiating space; and ambiguity of space and care. Through these concepts, the study demonstrates how the hospital environment is a flow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients' sense of healing changes with the experience of progression in treatment and the capacity of the hospital space to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Healing environments are complex relations between practices, space and care, where recognition of the individual patient's needs, values and experiences is key to developing the environment to support the patient quality of life. The present study holds implications for practice to inform design of future hospital environments for cancer treatment. The study points to the importance for being attentive to the need for flexible spaces in hospitals that recognize the dynamics of healing, by providing individualized care, relating to the particular and changing needs of patients supporting their potential and their challenged condition with the best care possible.

Semen Quality as a Predictor of Subsequent Morbidity: A Danish Cohort Study of 4,712 Men With Long-Term Follow-up.

PubMed

Latif, Tabassam; Kold Jensen, Tina; Mehlsen, Jesper; Holmboe, Stine Agergaard; Brinth, Louise; Pors, Kirsten; Skouby, Sven Olaf; Jørgensen, Niels; Lindahl-Jacobsen, Rune

2017-10-15

Semen quality has been suggested to be a biological marker of long-term morbidity and mortality; however, few studies have been conducted on this subject. We identified 5,370 men seen for infertility at Frederiksberg Hospital, Denmark, during 1977-2010, and 4,712 of these men were followed in the Danish National Patient Registry until first hospitalization, death, or the end of the study. We classified patients according to hospitalizations and the presence of cardiovascular disease, diabetes, testicular cancer, or prostate cancer. We found a clear association between sperm concentration below 15 million/mL and all-cause hospitalizations (hazard ratio = 1.5, 95% confidence interval: 1.4, 1.6) and cardiovascular disease (hazard ratio = 1.4, 95% confidence interval: 1.2, 1.6), compared with men with a concentration above 40 million/mL. The probabilities for hospitalizations were also higher with a low total sperm count and low motility. Men with a sperm concentration of 195-200 million/mL were, on average, hospitalized for the first time 7 years later than were men with a sperm concentration of 0-5 million/mL. Semen quality was associated with long-term morbidity, and a significantly higher risk of hospitalization was found, in particular for cardiovascular diseases and diabetes mellitus. Our study supports the suggestion that semen quality is a strong biomarker of general health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

When and Why Do University Managers Use Publication Incentive Payments?

ERIC Educational Resources Information Center

Opstrup, Niels

2017-01-01

Pay-for-performance schemes have become a widespread management strategy in the public sector. However, not much is known about the rationales that trigger the adoption of performance-related pay provisions. This article examines managerial and organisational features of university departments in Denmark that use publication incentive payments.…

1. Photocopy of measured drawing (original delineated by the Royal ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopy of measured drawing (original delineated by the Royal Danish Academy of Fine Arts (Kunstakademiets), Copenhagen, Denmark, 1961) Photographer and date of photograph unknown HOSPITALSGADE (FRONT) ELEVATION - Hospitalsgade 23 (House), 23 Hospital Street, Christiansted, St. Croix, VI

Mental Health Systems in Scandinavia.

ERIC Educational Resources Information Center

Vail, David J.

The guidebook is introduced by general observations on the Scandinavian countries concerning history, social policy, medicine, mental health, and psychiatric diagnosis. Discussed individually for Norway, Sweden, and Denmark are the following areas: mental health programs and statistics; mental illness programs, regional, hospital, aftercare,…

Feasibility of comparing core data from existing trauma registries in scandinavia. Reaching for a Scandinavian major trauma outcome study (MTOS).

PubMed

Ringdal, K G; Lossius, H M

2007-01-01

The organisation of trauma care in Scandinavia has several similarities, including trauma registries, but so far there are limited amount of research on efficiency and outcome. Data and results from trauma outcome studies like the US MTOS are not fully applicable to the Scandinavian trauma population. To reveal the feasibility of using data from existing trauma registries of major hospitals in Scandinavia, for a minimal common dataset, in a joint, prospective Scandinavian MTOS. We collected data points, data point definitions, and inclusion/exclusion criteria, from the major trauma registries of the Swedish trauma registry standard, three university hospitals in Denmark, one university hospital in Finland, and the Norwegian National Trauma Registry. The collected material was compared to reveal common data points, inclusion criteria, and the compatibility of data point definitions. The median number of data points was 147 (range 71-257; interquartile range = 90-205). Most registries lacked precise data definition catalogues. Only 16 data points could be considered as common, of which just a few were core trauma data. Four data points had the same data category options but were not considered having the same data point definitions. The inclusion criteria were not uniform. Trauma registries in Scandinavia have few common core data and data point definitions. There were data points for calculating the Trauma and Injury Severity Score (TRISS) but the inclusion criteria varied too much to ensure a valid comparison. A consensus process for a joint trauma core data set will be initiated by the Scandinavian Networking Group for Trauma and Emergency Management (SCANTEM) to increase research on trauma efficiency and outcome.

CNS infections in Greenland: A nationwide register-based cohort study

PubMed Central

Nordholm, Anne Christine; Søborg, Bolette; Andersson, Mikael; Hoffmann, Steen; Skinhøj, Peter; Koch, Anders

2017-01-01

Background Indigenous Arctic people suffer from high rates of infectious diseases. However, the burden of central nervous system (CNS) infections is poorly documented. This study aimed to estimate incidence rates and mortality of CNS infections among Inuits and non-Inuits in Greenland and in Denmark. Methods We conducted a nationwide cohort study using the populations of Greenland and Denmark 1990–2012. Information on CNS infection hospitalizations and pathogens was retrieved from national registries and laboratories. Incidence rates were estimated as cases per 100,000 person-years. Incidence rate ratios were calculated using log-linear Poisson-regression. Mortality was estimated using Kaplan-Meier curves and Log Rank test. Results The incidence rate of CNS infections was twice as high in Greenland (35.6 per 100,000 person years) as in Denmark (17.7 per 100,000 person years), but equally high among Inuits in Greenland and Denmark (38.2 and 35.4, respectively). Mortality from CNS infections was 2 fold higher among Inuits (10.5%) than among non-Inuits (4.8%) with a fivefold higher case fatality rate in Inuit toddlers. Conclusion Overall, Inuits living in Greenland and Denmark suffer from twice the rate of CNS infections compared with non-Inuits, and Inuit toddlers carried the highest risk of mortality. Further studies regarding risk factors such as genetic susceptibility, life style and socioeconomic factors are warranted. PMID:28158207

Fast track vaginal surgery.

PubMed

Ottesen, Marianne; Sørensen, Mette; Rasmussen, Yvonne; Smidt-Jensen, Steen; Kehlet, Henrik; Ottesen, Bent

2002-02-01

Our aim was to describe the need for postoperative hospitalization after vaginal surgery for utero-vaginal prolapse with well-defined charts for postoperative care. A prospective, descriptive study. Consecutive women admitted for first-time vaginal surgery for utero-vaginal prolapse at a public university hospital in Copenhagen, Denmark, underwent surgery and postoperative care in a fast track setting from September 15, 1999 to June 15 2000. A multimodal rehabilitation model with emphasis on information, standardized general anesthesia, reduced surgical distress, optimized pain-relief, early oral nutrition and ambulation, minimal use of indwelling catheter and vaginal packing. Postoperative hospital stay, complications, re-admission, success rate, patients' satisfaction and acceptability. Forty-one women with a median age of 69 years (range, 44-88 years) were included. All underwent anterior and/or posterior vaginal repair. Nineteen (46.3%) underwent vaginal hysterectomy, and eight (19.5%) underwent the Manchester procedure. Postoperative hospital stay was median 24 hr. Only three (7.3%) were discharged later than 48 hr. No re-admissions occurred. The most frequent complications were urinary retention exceeding 450 ml, and urinary tract infection (12.2%, and 9.8%, respectively). Short-term success rate was 97.6%. Patients' satisfaction rates were 85.4-95.1%. The median score of acceptability was 10 on a 0-10 points scale. The need for postoperative hospitalization was median 24 hr after vaginal surgery in a fast track setting, independently of the complexity of the procedure performed. Short-term success rate, satisfaction rates, and acceptability were all excellent. Follow up has been established to evaluate long-term success rates and recurrence.

Students' drinking behavior and perceptions towards introducing alcohol policies on university campus in Denmark: a focus group study.

PubMed

Ladekjær Larsen, Eva; Smorawski, Gitte Andsager; Kragbak, Katrine Lund; Stock, Christiane

2016-04-29

High alcohol consumption among university students is a well-researched health concern in many countries. At universities in Denmark, policies of alcohol consumption are a new phenomenon if existing at all. However, little is known of how students perceive campus alcohol policies. The aim of this study is to explore students' perceptions of alcohol policies on campus in relation to attitudes and practices of alcohol consumption. We conducted six focus group interviews with students from the University of Southern Denmark at two different campuses. The interviews discussed topics such as experiences and attitudes towards alcohol consumption among students, regulations, and norms of alcohol use on campus. The analysis followed a pre-determined codebook. Alcohol consumption is an integrated practice on campus. Most of the participants found it unnecessary to make major restrictions. Instead, regulations were socially controlled by students themselves and related to what was considered to be appropriate behavior. However students were open minded towards smaller limitations of alcohol availability. These included banning the sale of alcohol in vending machines and limiting consumption during the introduction week primarily due to avoiding social exclusion of students who do not drink. Some international students perceived the level of consumption as too high and distinguished between situations where they perceived drinking as unusual. The study showed that alcohol is a central part of students' lives. When developing and implementing alcohol policies on campus, seeking student input in the process and addressing alcohol policies in the larger community will likely improve the success of the policies.

Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015.

PubMed

Møllehave, Line Tang; Linneberg, Allan; Skaaby, Tea; Knudsen, Nils; Ehlers, Lars; Jørgensen, Torben; Thuesen, Betina Heinsbæk

2018-03-01

Iodine fortification (IF) may contribute to changes in costs of thyroid disease treatment through changes in disease patterns. From a health economic perspective, assessment of the development in costs of thyroid disease treatment in the population is pertinent. To assess the trends in annual medicine and hospital costs of thyroid disease treatment during 1995-2015 in Denmark, i.e., before and after the introduction of mandatory IF in 2000. Information on treatments for thyroid disease (antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size and age and sex distribution. The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural thyroid diseases observed in concurrent studies. The costs of total direct medicine and hospital costs for thyroid disease treatment in Denmark increased from 1995 to 2015. This is possibly due to several factors, e.g., changes in treatment practices, and the direct effect of IF alone remains to be estimated.

The impact of the Danish smoking ban on hospital admissions for acute myocardial infarction.

PubMed

Christensen, Tabita Maria; Møller, Lisbeth; Jørgensen, Torben; Pisinger, Charlotta

2014-01-01

Exposure to secondhand smoke is associated with an increased risk of acute myocardial infarction (AMI). The positive impact of a smoking ban on AMI hospitalization rates has been demonstrated both inside and outside Europe. A national smoking ban (SB) was implemented in Denmark on 15 August 2007. To evaluate the impact of the Danish SB on hospital admissions for AMI. Poisson regression models were used to analyse changes over time in AMI-admissions in Denmark. We investigated a seven year period: five years before and two years after implementation of the SB. We accounted for the variation in the population size and for seasonal trends. Potential confounders included were: gender, age and the incidence of type 2 diabetes (T2D). A significant reduction in the number of AMI-admissions was found in the last three years of the study period after adjusting for the potential confounders. The significant reductions were found one year before the SB (relative rate (RR) = 0.86, 95% confidence interval (CI) 0.79-0.94), one year after the SB (RR = 0.77, 95% CI 0.71-0.85) and two years after the SB (RR = 0.77, 95% CI 0.70-0.84). A significant reduction in the number of AMI-admissions was found already one year before the SB after adjustment for the incidence of T2D. The results differ from most results found in similar studies throughout the world and may be explained by the incremental enactment of SBs in Denmark and the implementation of a nation-wide ban on industrially produced trans-fatty acids in food in 2004.

Epidemiology of European Community-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex 80 Type IV Strains Isolated in Denmark from 1993 to 2004▿

PubMed Central

Larsen, A. R.; Böcher, S.; Stegger, M.; Goering, R.; Pallesen, L. V.; Skov, R.

2008-01-01

In Europe, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have been caused predominantly by isolates belonging to the “European CA-MRSA” clone (sequence type 80, staphylococcal cassette chromosome mec type IV). In this study, the epidemiology of European CA-MRSA was investigated on a nationwide scale, covering the period from 1993 to 2004. Denmark has been a low-prevalence country regarding MRSA since the mid-1970s but has experienced an increase in the number of new MRSA cases in recent years. Our results show that European CA-MRSA contributed to this increase. The isolates primarily caused skin and soft tissue infections (SSTIs) in patients outside hospitals, and transmission between household members was the predominant mode of spread. Although some of the isolates were found in hospitalized patients, nosocomial transmission seemed likely in only one instance, pointing to endogenous infections as an important factor. Compared to the CA-MRSA clone most common in the United States (USA300), the European CA-MRSA clone seems less well adapted to persist in hospital environments. Patients with a recent history of travel or family relation to the Mediterranean or Middle East were highly overrepresented. The epidemiological data indicated that the European CA-MRSA isolates were introduced into Denmark on multiple occasions, paralleled by an increasing level of genetic diversity of the isolates found during the study period. European CA-MRSA has previously been described as a rather uniform clone. However, we found pronounced, diverse pulsed-field gel electrophoresis subtypes, staphylococcal protein A gene (spa) types, and susceptibility patterns. PMID:17989197

Whose Parallellingualism? Overt and Covert Ideologies in Danish University Language Policies

ERIC Educational Resources Information Center

Hultgren, Anna Kristina

2014-01-01

This paper aims to contribute to the study of multilingualism in the workplace by analysing top-down language policies advocating parallellingualism at Denmark's eight universities. Parallellingualism, a key concept in Nordic language policy, has been suggested as a way to ensure an equitable balance between English and the Nordic language(s)…

Indoor Chemical Exposures: Humans' Non-respiratory Interactions with Room Air

ScienceCinema

Charles Weschler

2017-12-09

March 18, 2010 Berkeley Lab Environmental Energy Technology Division distinguished lecture: The marked difference in pollutant concentrations between an occupied and un-occupied room are only partially explained by human bio-effluents. Humans alter levels of ozone and related oxidants such as nitrate and hydroxyl radicals in the rooms they inhabit; in effect, they change the oxidative capacity of room air. Ozone-initiated reactions on exposed skin, hair and clothing generate products, including potentially irritating chemicals whose concentrations are much higher in the occupant's breathing zone than in the core of the room. Charles J. Weschler is a Professor at the School of Public Health, the Department of Environmental and Occupational Medicine and the Environmental and Occupational Health Sciences Institute (EOHSI) at the University of Medicine and Dentistry of New Jersey (UMDNJ)/Robert Wood Johnson Medical School & Rutgers University (New Jersey). He is also a Visiting Professor at the International Centre for Indoor Environment and Energy, Technical University of Denmark (DTU, Lyngby, Denmark).

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

Charles Weschler

March 18, 2010 Berkeley Lab Environmental Energy Technology Division distinguished lecture: The marked difference in pollutant concentrations between an occupied and un-occupied room are only partially explained by human bio-effluents. Humans alter levels of ozone and related oxidants such as nitrate and hydroxyl radicals in the rooms they inhabit; in effect, they change the oxidative capacity of room air. Ozone-initiated reactions on exposed skin, hair and clothing generate products, including potentially irritating chemicals whose concentrations are much higher in the occupant's breathing zone than in the core of the room. Charles J. Weschler is a Professor at the School ofmore » Public Health, the Department of Environmental and Occupational Medicine and the Environmental and Occupational Health Sciences Institute (EOHSI) at the University of Medicine and Dentistry of New Jersey (UMDNJ)/Robert Wood Johnson Medical School & Rutgers University (New Jersey). He is also a Visiting Professor at the International Centre for Indoor Environment and Energy, Technical University of Denmark (DTU, Lyngby, Denmark).« less

Earnings among Young and Mature Danish University Graduates

ERIC Educational Resources Information Center

Klausen, Trond Beldo

2016-01-01

This paper studies the association between graduation age and earnings among university graduates in Denmark, which is a country with one of the oldest student populations in the world. Exploiting a rich data-set from administrative registers, the current study is able to track labour market career for a longer period of time and to control for…

Maternal mortality in Denmark, 1985-1994.

PubMed

Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit; Weber, Tom; Møller, Margrete; Sørensen, Jette Led

2009-02-01

In Denmark, maternal mortality has been reported over the last century, both locally through hospital reports and in national registries. The purpose of this study was to analyze data from national medical registries of pregnancy-related deaths in Denmark 1985-1994 and to classify them according to the UK Confidential Enquiry into Maternal Deaths (CEMD). All deaths of women with a registered pregnancy within 12 months prior to the death were identified by comparing the Danish medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-10). All cases were classified using the UK CEMD classification. Cases of maternal death were further evaluated by an audit group. 311 cases were classified. 92 deaths (29.6%) occurred 42 days), 1 woman died from a direct obstetric cause, 46 from indirect causes, and 172 from fortuitous causes. Hypertensive disorders of pregnancy were the major cause of direct maternal deaths. The rate of maternal deaths constituted 9.8/100,000 maternities (i.e. the number of women delivering registrable live births at any gestation or stillbirths at 24 weeks of gestation or later). This is the first systematic report on deaths in Denmark based on data from national registries. The maternal mortality rate in Denmark is comparable to the rates in other developed countries. Fortunately, statistics are low, but each case represents potential learning. Obstetric care has changed and classification methods differ between countries. Prospective registration and registry linkage seem to be a way to ensure completion. This retrospective study has provided the background for a prospective study on registration and evaluation of maternal mortality in Denmark.

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

PubMed

Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

2010-12-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

Maternal Infection Requiring Hospitalization during Pregnancy and Autism Spectrum Disorders

ERIC Educational Resources Information Center

Atladottir, Hjordis O.; Thorsen, Poul; Ostergaard, Lars; Schendel, Diana E.; Lemcke, Sanne; Abdallah, Morsi; Parner, Erik T.

2010-01-01

Exposure to prenatal infection has been suggested to cause deficiencies in fetal neurodevelopment. In this study we included all children born in Denmark from 1980, through 2005. Diagnoses of autism spectrum disorders (ASDs) and maternal infection were obtained through nationwide registers. Data was analyzed using Cox proportional hazards…

Teaching Chemical Engineering Thermodynamics at Three Levels--Experience from the Technical University of Denmark (DTU)

ERIC Educational Resources Information Center

Kontogeorgis, Georgios M.; Michelsen, Michael L.; Clement, Karsten H.

2009-01-01

According to so-called "Bologna model," many technical universities in Europe have divided their educations into separate 3-year Bachelor and 2-year Master programs (followed by an optional Ph.D. study). Following the "Bologna model," DTU has recently transformed its 5-year engineering education into a 3-year Bachelor (B.Sc.)…

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study.

PubMed

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Petersen, Pelle Trier; Lindhardt, Bjarne Ørskov; von Plessen, Christian; Rohde, Gernot; Ravn, Pernille

2017-04-20

Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis. We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

Risk of neurological diseases among survivors of electric shocks: a nationwide cohort study, Denmark, 1968-2008.

PubMed

Grell, Kathrine; Meersohn, Andrea; Schüz, Joachim; Johansen, Christoffer

2012-09-01

Several studies suggest a link between electric injuries and neurological diseases, where electric shocks may explain elevated risks for neuronal degeneration and, subsequently, neurological diseases. We conducted a retrospective cohort study on the risk of neurological diseases among people in Denmark who had survived an electric accident in 1968-2008. The cohort included 3,133 people and occurrences of neurological diseases were determined by linkage to the nationwide population-based Danish National Register of Patients. The numbers of cases observed at first hospital contact in the cohort were compared with the respective rates of first hospital contacts for neurological diseases in the general population. We observed significantly increased risks for peripheral nerve diseases (standardized hospitalization ratio (SHR), 1.66; 95% confidence interval (CI), 1.22-2.22), for migraine (SHR, 1.80; 95% CI, 1.23-2.54), for vertigo (SHR, 1.60; 95% CI, 1.22-2.05), and for epilepsy (SHR, 1.45; 95% CI, 1.11-1.85). Only small numbers of cases of other neurological diseases were found, making the risk estimates unstable. These findings suggest an association between a single electric shock and increased risks for peripheral nerve diseases, migraines, vertigo, and epilepsy, but confirmation of these observations is needed. Copyright © 2012 Wiley Periodicals, Inc.

Registry-Based Surveillance of Influenza-Associated Hospitalisations during the 2009 Influenza Pandemic in Denmark: The Hidden Burden on the Young

PubMed Central

Widgren, Katarina; Nielsen, Jens; Mølbak, Kåre

2010-01-01

Background To follow the impact of the 2009 influenza pandemic in Denmark, influenza surveillance was extended with a system monitoring potentially influenza-associated hospitalisations. Methodology/Principal Findings National administrative data from 2004–2010 from the automatic reporting of all hospital visits and admissions in Denmark (population 5.5 million) were used. In-patient hospitalisations linked to ICD-10 codes for potentially influenza-associated conditions (influenza, viral and bacterial pneumonia, respiratory distress, and febrile convulsion) were aggregated by week and age groups; <5 years, 5–24 years, 25–64 years and ≥65 years. Weekly numbers of influenza-associated hospitalisations were plotted to follow the course of the pandemic. We calculated the total numbers of influenza-associated hospitalisations in each influenza season (week 30 to week 15, the following year). Risk ratios of being admitted with an influenza-associated condition in this season (2009/2010) compared to the previous five seasons (2004/2005–2008/2009) were calculated using binary regression. During the pandemic season, influenza-associated hospitalisations peaked in week 47, 2009. The total number of influenza-associated hospitalisations was 38,273 compared to the median of previous seasons of 35,662 (p = 0.28). The risk ratio of influenza-associated hospitalisations during the pandemic season compared to previous seasons was 1.63 (95%CI 1.49–1.78) for 5–24 year-olds and ranged between 0.98 and 1.08 for the other three age groups. Conclusions The 2009 pandemic influenza did not lead to an overall increase in the number of influenza-associated hospitalisations in Denmark in the 2009/2010 season and could be managed within existing hospital capacity. However, there was a disproportionally large impact on the age group 5–24 years. The influenza-associated hospitalisations during the 2009/2010 pandemic influenza season bore the signature features of historical pandemics: A skewed age-pattern and early out of season transmission. PMID:21085646

Aging, longevity and health

PubMed Central

Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M.; Bohr, Vilhelm A.

2016-01-01

The IARU Congress on Aging, Longevity and Health, held on 5–7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health. PMID:21820462

The Danish Cardiac Rehabilitation Database.

PubMed

Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole

2016-01-01

The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients.

Agricultural work and the risk of Parkinson's disease in Denmark, 1981-1993.

PubMed

Tüchsen, F; Jensen, A A

2000-08-01

This study examined the possible association between agricultural and horticultural work and the subsequent morbidity of Parkinson's disease. Fixed cohorts of 2,273,872 men and women aged 20-59 years on 1 January 1981 and identified in the Central Population Register of Denmark were followed, and all first-time hospitalizations with Parkinson's disease as the principal diagnosis during the 13 years until 31 December 1993 were recorded. Standardized hospitalization ratios (SHR) were calculated using all gainfully employed persons as the standard and by multiplying the ratio by 100. Ninety-five percent confidence intervals (95% CI) were calculated on the assumption of a Poisson distribution. A high risk of Parkinson's disease was found for the men and women in agriculture and horticulture (134 cases, SHR 132, 95% CI 111-156). Statistically significantly high risks were found for farmers (79 cases, SHR 130, 95% CI 103-163) and for all men in agriculture and horticulture (109 cases, SHR 134, 95% CI 109-162). A consistent pattern of high Parkinson's disease morbidity was found among occupational groups employed in agriculture and horticulture.

Student satisfaction and loyalty in Denmark: Application of EPSI methodology.

PubMed

Shahsavar, Tina; Sudzina, Frantisek

2017-01-01

Monitoring and managing customers' satisfaction are key features to benefit from today's competitive environment. In higher education context, only a few studies are available on satisfaction and loyalty of the main customers who are the students, which signifies the need to investigate the field more thoroughly. The aim of this research is to measure the strength of determinants of students' satisfaction and the importance of antecedents in students' satisfaction and loyalty in Denmark. Our research model is the modification of European Performance Satisfaction Index (EPSI), which takes the university's image direct effects on students' expectations into account from students' perspective. The structural equation model of student satisfaction and loyalty has been evaluated using partial least square path modelling. Our findings confirm that the EPSI framework is applicable on student satisfaction and loyalty among Danish universities. We show that all the relationships among variables of the research model are significant except the relationship between quality of software and students' loyalty. Results further verify the significance of antecedents in students' satisfaction and loyalty at Danish universities; the university image and student satisfaction are the antecedents of student loyalty with a significant direct effect, while perceived value, quality of hardware, quality of software, expectations, and university image are antecedents of student satisfaction. Eventually, our findings may be of an inspiration to maintain and improve students' experiences during their study at the university. Dedicating resources to identified important factors from students' perception enable universities to attract more students, make them highly satisfied and loyal.

Dignity as an empirical lifeworld construction-in the field of surgery in Denmark.

PubMed

Rasmussen, Tina Seidelin; Delmar, Charlotte

2014-01-01

Patient dignity is a complex yet central phenomenon. Disrespect for dignity can mean retention of sick role, loss of self-care and control, decreased participation and therefore influence healing. At the same time, nurses have an obligation to respect dignity, and patients expect it. In clinical practice, with the focus on efficiency and economy, dignity can be compromised. The surgical patient may be particularly vulnerable to loss of dignity, when focus is solely on surgical procedure, efficiency, and productivity. The aim of the article is to describe the characteristics of the importance of dignity perceived by four surgical patients at a university hospital in Denmark. The hermeneutic phenomenological approach of Van Manen is used to analyse and interpret data collected from in-depth semi-structured interviews. The interviews explored the lived experience with two women and two men who had undergone a surgical intervention in a Danish vascular surgery department. The thematic analysis led to the basic theme: "To be an important person" illustrated by the themes: "Being a co-player," "Over exposure," and "To swallow the bitter pill." The findings provide a better understanding of patient's perspective of dignity, which is characterized by a complex interaction of several factors. Nurses should be concerned with balancing expectations, values, and opinions to maintain dignity in nursing and create a common platform for collaboration. This collaboration makes it possible for patients to be involved and have a voice in relation to nursing, treatment, and administering of time even though it could be at the expense of the terms of the system.

Fluctuations in the prevalence of chromate allergy in Denmark and exposure to chrome-tanned leather.

PubMed

Carøe, Caroline; Andersen, Klaus E; Thyssen, Jacob P; Mortz, Charlotte G

2010-12-01

A recent Danish study showed a significant increase in the prevalence of chromate contact allergy after the mid-1990s, probably as a result of exposure to leather products. To reproduce the results by analysing data from the period 1992-2009 at Odense University Hospital, Denmark. The temporal development in the occurrence of chromate contact allergy and assumed causative exposures were investigated. A retrospective analysis of patch test data was performed (n = 8483), and medical charts from patients with chromate allergy (n = 231) were reviewed. Comparisons were made using the χ(2) -test. A test of the reproducibility of the TRUE Test® was also performed. Logistic regression analyses were used to test for associations. No significant changes in the prevalence or exposure sources of chromate allergy during 1992-2009 were identified. Leather shoes (24.4%) were the most frequent exposure sources in chromate allergy, and were mainly registered in women, although the difference between men and women was not significant (P = 0.07). Cement and leather glove exposure occurred significantly more often in men than in women (P = 0.002). Foot dermatitis (40.3%) was the most frequent anatomical location, apart from hand eczema (60.6%). The reproducibility of the TRUE Test® was 93.3%. Apart from hand eczema, the most frequent clinical picture of chromate allergy was foot dermatitis caused by leather shoe exposure. A tendency for an increasing prevalence of chromate contact allergy from 1997 was shown, but no significant change was detectable. © 2010 John Wiley & Sons A/S.

Work injuries among drivers in the goods-transport branch in Denmark.

PubMed

Shibuya, Hitomi; Cleal, Bryan; Mikkelsen, Kim Lyngby

2008-05-01

Goods-transport drivers in Denmark had an elevated rate of hospital contact due to injury compared with the skilled/semiskilled workforce in general in recent years. There is a need to elucidate the causes of their work injuries. We analyzed the Danish National Work Injury Register for the 10-year period 1993-2002. The vast majority (92.6%) of the work injuries among goods-transport were sustained under non-traffic activities, that is, collecting, loading, unloading, and delivering goods. They fell from height (22.3%), suffered from overexertion (14.2%), got caught between/under objects (12.6%), collided with objects (12.0%), slipped/tripped (10.6%), or got struck by falling objects (9.0%). There is a clear need for efforts to prevent work injuries under non-traffic activities among goods-transport drivers in Denmark. For this end, it is necessary to involve not only the drivers' employers for reinforcement of safety procedures, but also the employers' customers for improvement of the physical environment, in which drivers collect, load, unload, and deliver goods. (c) 2008 Wiley-Liss, Inc.

Differences in hospital attendance for anaphylaxis between immigrants and non-immigrants: a cohort study.

PubMed

Norredam, M; Sheikh, A; Dynnes Svendsen, K; Holm Petersen, J; Garvey, L H; Kristiansen, M

2016-07-01

The impact of migration on the risk of anaphylaxis remains unknown. We hypothesized that non-Western immigrants have a lower incidence of anaphylaxis compared to Danish-born. We investigated variations in hospital attendance for anaphylaxis between immigrants and Danish-born including time- and age- trends. A register-based, historical prospective cohort design. Refugees or family reunified immigrants (n = 127 250) who, between January 1, 1994 and December 31, 2010, obtained residency permits in Denmark were included and matched in a 1 : 6 ratio on age and sex with Danish-born individuals (n = 740 600). Personal identification numbers were cross-linked to the Danish National Patient Registry identifying all first-time hospital attendances for anaphylaxis from January 1, 1994 and December 31, 2010. Incidence rate ratios were estimated, stratified for sex and region of birth, adjusting for age using a Cox regression model including the influence of duration of residence and age when residence was obtained. In total 1053 hospital attendances for anaphylaxis were identified: 89 among non-Western immigrants, 9 among Western immigrants and 955 among Danish-born patients. Both male (RR = 0.65; 95%CI: 0.46;0.90) and female (RR = 0.64; 95%CI: 0.48;0.85) non-Western immigrants had a significantly lower risk ratio of hospital attendance for anaphylaxis compared to Danish-born. Compared to Danish-born, non-Western immigrants living in Denmark during the entire follow-up period also showed a decreased risk (RR = 0.65; 95%CI: 0.34;1.25). Compared to Danish-born, non-Western immigrants who obtained residence permission as children had a decreased risk of hospital attendance for anaphylaxis (RR = 0.48; 95%CI: 0.25;0.91). This Danish register-based study using nationwide data revealed fewer hospital attendances for anaphylaxis among non-Western immigrants compared to Danish-born; however this protection was lost over time. © 2016 John Wiley & Sons Ltd.

Quality assessment of patient leaflets on misoprostol-induced labour: does written information adhere to international standards for patient involvement and informed consent?

PubMed Central

Clausen, Jette Aaroe; Rydahl, Eva

2016-01-01

Objectives The need for thorough patient information is increasing as maternity care becomes more medicalised. The aim was to assess the quality of written patient information on labour induction. In most Danish hospitals, misoprostol is the first-choice drug for induction in low-risk pregnancies. Misoprostol has been associated with adverse side effects and severe outcomes for mother and child and is not registered for obstetric use in Denmark. Setting Secondary care hospitals in Denmark. Data Patient information leaflets from all hospitals that used misoprostol as an induction agent by June 2015 (N=13). Design Patient leaflets were evaluated according to a validated scoring tool (International Patient Decision Aid Standards instrument, IPDAS), core elements in the Danish Health Act, and items regarding off-label use and non-registered medication. Two of the authors scored all leaflets independently. Outcome measures Women's involvement in decision-making, information on benefits and harms associated with the treatment, other justifiable treatment options, and non-registered treatment. Results Generally, the hospitals scored low on the IPDAS checklist. No hospitals encouraged women to consider their preferences. Information on side effects and adverse outcomes was poorly covered and varied substantially between hospitals. Few hospitals informed about precautions regarding outpatient inductions, and none informed about the lack of evidence on the safety of this procedure. None informed that misoprostol is not registered for induction or explained the meaning of off-label use or use of non-registered medication. Elements such as interprofessional consensus, long-term experience, and health authorities' approval were used to add credibility to the use of misoprostol. Conclusions Central criteria for patient involvement and informed consent were not met, and the patient leaflets did not inform according to current evidence on misoprostol-induced labour. Our findings indicate that patients receive very different, sometimes contradictory, information with potential ethical implications. Concerns should be given to outpatient inductions, where precise written information is of particular importance. PMID:27235300

Lidar - DTU SpinnerLidar - Reviewed Data

DOE Data Explorer

Herges, Thomas

2017-10-23

Scaled Wind Farm Technology (SWiFT) Facility meteorological tower (MET), turbine, and Technical University of Denmark (DTU) SpinnerLidar data acquired on 20161216 UTC during a neutral atmospheric boundary layer inflow at a single focus distance of 2.5 D (D=27 m).

Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers.

PubMed

Hansen, Laura S; Sloth, Erik; Hjortdal, Vibeke E; Jakobsen, Carl-Johan

2015-08-01

Short-term (30 days) mortality frequently is used as an outcome measure after cardiac surgery, although it has been proposed that the follow-up period should be extended to 120 days to allow for more accurate benchmarking. The authors aimed to evaluate whether mortality rates 120 days after surgery were comparable to general mortality and to compare causes of death between the cohort and the general population. A multicenter descriptive cohort study using prospectively entered registry data. University hospital. The cohort was obtained from the Western Denmark Heart Registry and matched to the Danish National Hospital Register as well as the Danish Register of Causes of Death. A weighted, age-matched general population consisting of all Danish patients who died within the study period was identified through the central authority on Danish statistics. A total of 11,988 patients (>15 years) who underwent cardiac-surgery at Aarhus, Aalborg and Odense University Hospitals from April 1, 2006 to December 31, 2012 were included. Coronary artery bypass grafting, valve surgery and combinations. Mortality after cardiac surgery matches with mortality in the general population after 140 days. Mortality curves run almost parallel from this point onwards, regardless of The European system for cardiac operative risk evaluation (EuroSCORE) and intervention. The causes of death in the cohort differed statistically significantly from the background population (p<0.0001; one-sample t-test) throughout the first postoperative year. The leading cause of death in the cohort was cardiac (38%); 53% of which was categorized as heart failure. A total of 54% of these patients were assessed preoperatively as having normal or mildly impaired heart function (EuroSCORE). This study supported an extended follow-up period after cardiac surgery when benchmarking cardiac surgery centers. Regardless of preoperative heart function, heart failure was the consistent leading cause of death. Copyright © 2015 Elsevier Inc. All rights reserved.

"Actually, I 'May' Be Clever Enough to Do It". Using Identity as a Lens to Investigate Students' Trajectories towards Science and University

ERIC Educational Resources Information Center

Krogh, Lars Brian; Andersen, Hanne Moeller

2013-01-01

We have followed a group of students in the potential pipeline for science through their last years of upper secondary school and in the context of a university mentorship program. The student group is defined by their choice of Mathematics at A-level which is mandatory for admission to tertiary STEM education in Denmark. Rich data (repeated…

Aging, longevity and health.

PubMed

Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M; Bohr, Vilhelm A

2011-10-01

The IARU Congress on Aging, Longevity and Health, held on 5-7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health. Copyright © 2011. Published by Elsevier Ireland Ltd.. All rights reserved.

GPR Use and Activities in Denmark

NASA Astrophysics Data System (ADS)

Ringgaard, Jørgen; Wisén, Roger

2014-05-01

Academic work on GPR in Denmark is performed both by the Technical University of Denmark (DTU) and the University of Copenhagen (KU). The work at DTU includes development of antennas and systems, e.g. an airborne ice-sounder GPR system (POLARIS) that today is in frequent use for monitoring of ice thickness in Greenland. DTU often collaborates with ESA (European Space Agency) regarding electromagnetic development projects. At KU there is an ongoing work with GPR applied to water resources. The main objective is to study flux of water and matter across different hydrological domains. There are several recent publications from KU describing research for data analysis and modelling as well as hydro geophysical applications. Also the Geological Survey of Denmark and Greenland (GEUS) performs frequent geological mapping with GPR. There have been mainly two actors on the Danish commercial market for several years: FalkGeo and Ramboll. Falkgeo has been active for many years acquiring data for several different applications such as archeology, utilities and roads. Their equipment pool comprises both a multichannel Terravision system form GSSI and a 2D system from Mala Geoscience with a comprehensive range of antennas. Ramboll has performed GPR surveys for two decades mainly with 2D systems from GSSI. In recent years Ramboll has also obtained a system with RTA antennas from Mala Geoscience and a multichannel system from 3D-Radar. These systems have opened markets both for deeper geological mapping and for shallow mapping. The geological mapping with the Mala system has often been combined with resistivity imaging (CVES) and refraction seismic. The 3D system has been applied in airports and on road for mapping of layer thicknesses, delamination and for control of asphalt works. Other areas comprise bridge deck evaluation and utility mapping. Ramboll also acts as client advisor for BaneDanmark, a state owned company who operates and develops the Danish state railway network. For this Ramboll has written a guideline for application of GPR on BaneDanmark railways. There are no national guidelines or test sites in Denmark. The use of GPR on roads is very limited in Denmark compared to our neighboring countries. This is possibly due to conservatism in the industry and due to the fact that Denmark decided not to participate in a collaboration between some of our neighboring countries about preparation of guidelines for application of GPR on roads, the Mara Nord Project. An improvement in accuracy and more automatized routines for mapping of delamination and stripping would also widen the market for application of GPR in airports and on roads. International guidelines for application of GPR in several fields would also help to make authorities recognize it as a valid complement and alternative to other established methods. This abstract is a contribution to COST Action TU1208.

Assessing and managing multiple risks in a changing world – the Roskilde recommendations.

EPA Science Inventory

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common curre...

Collaborative Information Retrieval.

ERIC Educational Resources Information Center

Bruce, Harry; Fidel, Raya

1999-01-01

Researchers from the University of Washington, Microsoft Research, Boeing, and Risoe National Laboratory in Denmark have embarked on a project to explore the manifestations of Collaborative Information Retrieval (CIR) in work settings and to propose technological innovations and organizational changes that can support, facilitate, and improve CIR.…

Contact allergy to chlorhexidine in a tertiary dermatology clinic in Denmark.

PubMed

Opstrup, Morten S; Johansen, Jeanne D; Zachariae, Claus; Garvey, Lene H

2016-01-01

Chlorhexidine is a widely used disinfectant in the healthcare setting and in cosmetic products. A high prevalence of chlorhexidine contact allergy was reported in Denmark in the 1980s (2.0-5.4% of patients patch tested). It is unknown whether the prevalence is still high, which products cause the contact allergy, and whether accidental re-exposure occurs in some patients. To estimate the prevalence of chlorhexidine contact allergy in a tertiary dermatology clinic in Denmark; to investigate whether patch testing with both chlorhexidine diacetate and chlorhexidine digluconate is necessary; to investigate how many patients have combined immediate-type allergy and contact allergy; and to identify which products cause chlorhexidine contact allergy, and whether patients are accidentally re-exposed. This was a retrospective study including all patients patch tested with chlorhexidine during 2003-2013 at the Department of Dermato-Allergology at Copenhagen University Hospital Gentofte (n = 8497). All patients with a positive patch test reaction to chlorhexidine were sent a questionnaire comprising questions about the cause of the allergy and re-exposure. Overall, 1.0% (n = 82) of all patients patch tested with chlorhexidine were positive. A decrease in the prevalence was observed over time, most likely because of lowering of the test concentration from 1.0 to 0.5% in 2008. Of the 82 patients, 28 (0.3%) had positive test reactions to both chlorhexidine salts, 43 (0.5%) had a positive test reaction only to chlorhexidine diacetate, and 11 (0.1%) had a positive test reaction to chlorhexidine digluconate. Three patients were both patch test-positive and prick test-positive. A known cause of the allergy was reported by 19 patients (40%) in the questionnaire: the products used in the healthcare setting were mainly reported, but some reported cosmetic products. Accidental re-exposure was reported by 15 patients (32%), of whom 13 reported symptoms. The prevalence of chlorhexidine contact allergy does not seem to be higher in Denmark than in other European countries. Patch testing with both chlorhexidine diacetate and chlorhexidine digluconate may be beneficial. Testing for immediate-type allergy in patients with a positive patch test reaction to chlorhexidine is recommended. Chlorhexidine-containing products used in the healthcare setting and in cosmetics are potential causes of sensitization and allergy. Re-exposure is common, highlighting the fact that patients and healthcare personnel need to be well informed about possible sources of exposure. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia.

PubMed

Herling, Suzanne F; Palle, Connie; Møller, Ann M; Thomsen, Thordis; Sørensen, Jan

2016-03-01

The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference in Danish kroner between total abdominal hysterectomy and robotic-assisted laparoscopic hysterectomy. The average cost of consumables was 12,642 Danish kroner more expensive per patient for robotic-assisted laparoscopic hysterectomy than for total abdominal hysterectomy (2014 price level: 1€ = 7.50 Danish kroner). When including all cost-drivers, the analysis showed that the robotic-assisted laparoscopic hysterectomy procedure was 9386 Danish kroner (17%) cheaper than the total abdominal hysterectomy (p = 0.003). When the robot investment was included, the cost difference reduced to 4053 Danish kroner (robotic-assisted laparoscopic hysterectomy was 7% cheaper than total abdominal hysterectomy) (p = 0.20). Increasing age and Type 2 diabetes appeared to influence the overall costs. For women with endometrial cancer or atypical complex hyperplasia, robotic-assisted laparoscopic hysterectomy was cheaper than total abdominal hysterectomy, mostly due to fewer complications and shorter length of hospital stay. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Risk of lactic acidosis in type 2 diabetes patients using metformin: A case control study.

PubMed

Aharaz, Abdellatif; Pottegård, Anton; Henriksen, Daniel Pilsgaard; Hallas, Jesper; Beck-Nielsen, Henning; Lassen, Annmarie Touborg

2018-01-01

Metformin constitutes first-line treatment of type 2 diabetes mellitus. It is presumed to have lactic acidosis as a dangerous, but rare, side effect. To estimate the incidence rate of lactic acidosis in patients with type 2 diabetes mellitus as well as to estimate the relative risk of lactic acidosis associated with metformin treatment. This is a population-based combined cohort and case-control study among patients with type 2 diabetes mellitus who were acutely admitted with lactic acidosis at Odense University Hospital, Denmark; in the period from 1st June 2009 to 1st October 2013. The patients included as cases were all acutely hospitalized with lactic acidosis (pH <7.35 and lactate ≥2.0 mmol/l). For each case, we identified 24 age- and sex-matched controls sampled from the same cohort with type 2 diabetes mellitus. The use of metformin identified by using a prescription database. Analyses included multivariable logistic regression and adjusting for predefined confounding: renal function, HbA1c, comorbidity and diabetes duration. Our cohort included 10,652 patients with type 2 diabetes mellitus with a median age of 74 years, and 51.5% were male. During follow-up, 163 individuals were hospitalized with lactic acidosis, corresponding to an incidence rate of 391/100,000 person years. Use of metformin was not associated with lactic acidosis: adjusted odds ratio was 0.79 (95%CI 0.54-1.17). Among patients with type 2 diabetes mellitus, the incidence rate of acute hospitalization with lactic acidosis was 391/100,000 person years. Use of metformin did not increase the risk of lactic acidosis. However, comorbidity seems to be an important risk factor.

Widespread adoption of information technology in primary care physician offices in Denmark: a case study.

PubMed

Protti, Denis; Johansen, Ib

2010-03-01

Denmark is one of the world's leading countries in the use of health care technology. Virtually all primary care physicians have electronic medical records with full clinical functionality. Their systems are also connected to a national network, which allows them to electronically send and receive clinical data to and from consultant specialists, hospitals, pharmacies, and other health care providers. Under the auspices of a nonprofit organization called MedCom, over 5 million clinical messages are transferred monthly. One of the most important innovations has been the "one-letter solution," which allows one electronic form to be used for all types of letters to and from primary care physicians; it is used in over 5,000 health institutions with 50 different technology vendor systems.

Effect of European Clinical Trials Directive on academic drug trials in Denmark: retrospective study of applications to the Danish Medicines Agency 1993-2006.

PubMed

Berendt, Louise; Håkansson, Cecilia; Bach, Karin Friis; Dalhoff, Kim; Andreasen, Per Buch; Petersen, Lene Grejs; Andersen, Elin; Poulsen, Henrik Enghusen

2008-01-05

To determine the impact of the European Union's Clinical Trials Directive on the number of academic drug trials carried out in Denmark. Retrospective review of applications for drug trials to the Danish Medicines Agency, 1993-2006. Applications for drug trials for alternate years were classified as academic or commercial trials. A random subset of academic trials was reviewed for number of participants in and intended monitoring of the trials. Academic and commercial drug trials showed an identical steady decline from 1993 to 2006 and no noticeable change after 2004 when good clinical practice became mandatory for academic trials. The Clinical Trials Directive introduced in May 2004 to ensure good clinical practice for academic drug trials was not associated with a decline in research activity in Denmark; presumably because good clinical practice units had already been in place in Danish universities since 1999. With such an infrastructure academic researchers can do drug trials under the same regulations as drug companies.

Wind Turbine - SWiFT southeast - WTGa1 - Reviewed Data

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

Herges, Thomas

Scaled Wind Farm Technology (SWiFT) Facility meteorological tower (MET), turbine, and Technical University of Denmark (DTU) SpinnerLidar data acquired on 20161216 UTC during a neutral atmospheric boundary layer inflow at a single focus distance of 2.5 D (D=27 m).

Surface Meteorological Station - SWiFT southwest - METa1 - Reviewed Data

DOE Data Explorer

Herges, Thomas

2017-10-23

Scaled Wind Farm Technology (SWiFT) Facility meteorological tower (MET), turbine, and Technical University of Denmark (DTU) SpinnerLidar data acquired on 20161216 UTC during a neutral atmospheric boundary layer inflow at a single focus distance of 2.5 D (D=27 m).

Doubling Syndemics

PubMed Central

2017-01-01

Abstract This study investigates health concerns and access to health services for Roma from Romania who live in homelessness in Copenhagen, Denmark. They collect refundable bottles and call themselves “badocari,” which in Romanian refers to “people who work with bottles.” Homeless Roma in Denmark have not previously been studied through ethnographic research. The study stresses the importance of a syndemic approach towards understanding badocari health concerns. Syndemics is understood as co-occurring diseases, which unfold within contexts of social injustice. The case of the badocari is argued to be a case of “doubling syndemics” since the co-occurring diseases are further multiplied and enhanced by an ongoing mobility between dual contexts of precarious livelihoods in Romania and Denmark, respectively. The study complements the approach to syndemics with a perspective on human rights. It sheds light on the limited possibilities that exist for addressing health concerns of the badocari, both in Romania and in Denmark, and argues that the universal human right to health is not realized in the everyday lives of destitute EU migrants such as the badocari. Rather, they experience lack of access to adequate medical treatment and follow-up care, both as citizens of a member state and as co-citizens of the European Union. PMID:29302164

Burke new Tectonics editor

NASA Astrophysics Data System (ADS)

Kevin C. Burke, National Academy of Sciences/ National Research Council (NAS/NRC), assumed responsibilities as Editor in Chief of the American Geophysical Union (AGU) journal Tectonics at the beginning of 1990, taking over from Raymond A. Price, Queens University, Kingston, Ontario. Asger Berthelsen, University of Copenhagen, Denmark, continues as the European Editor, and Paul F. Hoffman, Geological Society of Canada, assumes the task of North American Editor. Tectonics is a joint publication of AGU and the European Geophysical Society.

PREFACE: Preface

NASA Astrophysics Data System (ADS)

Ye, Chaohui; Wang, Zhong Lin; Zhou, Bingkun

2011-02-01

The 3rd International Photonics and OptoElectronics Meeting (POEM 2010) was held from November 2-5, 2011, in Wuhan, China. POEM takes place annually, usually in November, with the aim of focusing on the key techniques of scientific frontiers and industry in the field of optoelectronics, understanding future trends as well as making the most of the industrial advantages of Wuhan - Optics Valley of China (OVC). POEM 2010 presented a plenary session and six parallel sessions. The latter comprised Laser Technology and Applications; Nano-enabled Energy Technologies and Materials; Optoelectronic Devices and Integration; Optoelectronic Sensing and Imaging; Solar Cells, Solid State Lighting and Information Display Technologies; and Tera-Hertz Science and Technology. 700 delegates from the field of optoelectronics - including world-famous experts, researchers, investors and entrepreneurs from more than 20 countries - attended the conference, among whom were 160 invited speakers. POEM 2010 once again received extensive praise for its intricate planning, rich contents, and the high-level and influential invited speakers which it attracted. Participants remarked that the presentations by the invited experts, the 'hot topic' discussions, students' posters, and the awards for papers were very engaging. They appreciated this valuable and beneficial opportunity for exchanging ideas with top photonics and optoelectronics experts. Our thanks are extended to the Conference Secretariat and Local Organizing Committee, who have been completely dedicated to their work, and who made the conference such a great success. We are also grateful for the financial support from 111 Project (B07038), and for the help with organization and coordination from Wuhan National Laboratory for Optoelectronics and Huazhong University of Science and Technology. Proceedings of POEM 2010234 papers were selected out of the 343 manuscripts submitted. The organizers of POEM 2010 are grateful to all the authors whose papers are being published in this volume of the Journal of Physics: Conference Series. The proceedings are divided into six sections according to different technical areas: Laser Technology and Applications (LTA) Nano-enabled Energy Technologies and Materials (NETM) Optoelectronic Devices and Integration (OEDI) Optoelectronic Sensing and Imaging (OSI) Solar Cells, Solid State Lighting and Information Display Technologies (SSID) Tera-Hertz Science and Technology (THST) Wuhan, PR ChinaDecember, 2010 Chaohui YeZhong Lin WangBingkun ZhouConference Chairs The 3rd International Photonics and OptoElectronics Meeting (POEM 2010)November 2-5, 2010Wuhan, China Supporters:Ministry of Education of China (MOE)State Administration of Foreign Experts Affairs (SAFEA)National Natural Science Foundation of China (NSFC) Sponsors:Huazhong University of Science and Technology (HUST)China Hubei Provincial Science Technology Department (HBSTD)Wuhan East Lake National Innovation Model Park Co-operating Societies:Institute of Physics (IOP)American Institute of Physics (AIP)International Biomedical Optics Society (IBOS)Laser Institute of America (LIA)Optical Society of America (OSA)IEEE Photonics Society (Singapore and Hongkong Chapters)Chinese Optical Society (COS) Organizer:Wuhan National Laboratory for Optoelectronics (WNLO) 1. LASER TECHNOLOGY AND APPLICATIONS (LTA)Editors:Peixiang Lu, Wuhan National Laboratory for Optoelectronics (China)Katsumi Midorikawa, Extreme Photonics Research Group, RIKEN (Japan)Bernd Wilhelmi, Jenoptik AG, Jena (Germany) 2. NANO-ENABLED ENERGY TECHNOLOGIES AND MATERIALS (NETM)Editors:Zhong Lin Wang, Wuhan National Laboratory for Optoelectronics (China) and Georgia Institute of Technology (USA)Guozhen Shen, Wuhan National Laboratory for Optoelectronics (China) 3. OPTOELECTRONIC DEVICES AND INTEGRATION (OEDI)Editors:Chinlon Lin, Bell Laboratory (USA)Jesper Moerk, Technical University of Denmark (Denmark)Xun Li, McMaster University (Canada)Xinliang Zhang, Wuhan National Laboratory for Optoelectronics (China)Junqiang Sun, Wuhan National Laboratory for Optoelectronics (China) 4. OPTOELECTRONIC SENSING AND IMAGING (OSI)Editors:Kecheng Yang, Wuhan National Laboratory for Optoelectronics (China)Pengcheng Li, Wuhan National Laboratory for Optoelectronics (China) 5. SOLAR CELLS, SOLID-STATE LIGHTING AND INFORMATION DISPLAY TECHNOLOGIES (SSID)Editors:Hiroshi Amano, Meijo University (Japan)Yibing Cheng, Monash University (Australia)Jinzhong Yu, Institute of Semiconductor, CAS (China)Changqing Chen, Wuhan National Laboratory for Optoelectronics (China)Hongwei Han, Wuhan National Laboratory for Optoelectronics (China)Guoli Tu, Wuhan National Laboratory for Optoelectronics (China) 6. TERA-HERTZ SCIENCE AND TECHNOLOGY (THST)Editors:Jianquan Yao, Tianjin University (China)Shenggang Liu, University of Electronic Science and Technology of China (China)X C Zhang, Rensselaer Polytechnic Institute (USA)Jinsong Liu, Wuhan National Laboratory for Optoelectronics (China) International Advisory Committee:Yibing Cheng, Monash University (Australia)Stephen Z D Cheng, University of Akron (USA)Min Gu, Swinburne University of Technology (Australia)Andrew B Holmes, the University of Melbourne (Australia)Chinlon Lin, Bell Laboratory (retired, USA)Xun Li, McMaster University (Canada)Shenggang Liu, University of Electronic Science and Technology of China (China)Jesper Moerk, Technical University of Denmark (Denmark)Dennis L Matthews, University of California, Davis (USA)Jiacong Shen, Jilin University (China)Ping Shum, Nanyang Technological University (Singapore)Chester C T Shu, Chinese University of Hong Kong (China)Valery V Tuchin, Saratov State University (Russia)Bruce Tromberg, University of California/Irvine (USA)Peiheng Wu, University of Nanjing (China)Alan Willner, University of Southern California (USA)Lihong Wang, Washington University in St. Louis (USA)C P Wong, Georgia Institute of Technology (USA)Jianquan Yao, Tianjin University (China)Xi Zhang, Tsinghua University (China)X C Zhang, Rensselaer Polytechnic Institute (USA) Program Committee:Qingming Luo, Wuhan National Laboratory for Optoelectronics (China) - ChairHiroshi Amano, Meijo University (Japan)Yibing Cheng, Monash University (Australia)Peixiang Lu, Wuhan National Laboratory for Optoelectronics (China)Ruxin Li, Shanghai Institute of Optics and Fine Mechanics (China)Chinlon Lin, Bell Laboratory (USA)Xun Li, McMaster University (Canada)Shenggang Liu, University of Electronic Science and Technology of China (China)Katsumi Midorikawa, Extreme Photonics Research Group, RIKEN (Japan)Jesper Moerk, Technical University of Denmark (Denmark)Valery V Tuchin, Saratov State University (Russia)Lihong Wang, Washington University in St. Louis (USA)Zhong Lin Wang, Georgia Institute of Technology(USA)Jinzhong Yu, Institute of Semiconductor, CAS (China)Jianquan Yao, Tianjin University (China)X C Zhang, Rensselaer Polytechnic Institute (USA) Local Organizing committee:Lin Lin, Wuhan National Laboratory for Optoelectronics (China) - ChairSheng Lu, Administration Committee of Wuhan East Lake Hi-tech Development Zone (China) - ChairChangqing Chen, Wuhan National Laboratory for Optoelectronics (China)Ling Fu, Wuhan National Laboratory for Optoelectronics (China)Hongwei Han, Wuhan National Laboratory for Optoelectronics (China)Peixiang Lu, Wuhan National Laboratory for Optoelectronics (China)Pengcheng Li, Wuhan National Laboratory for Optoelectronics (China)Jinsong Liu, Wuhan National Laboratory for Optoelectronics (China)Junqiang Sun, Wuhan National Laboratory for Optoelectronics (China)Guozhen Shen, Wuhan National Laboratory for Optoelectronics (China)Guoli Tu, Wuhan National Laboratory for Optoelectronics (China)Kecheng Yang, Wuhan National Laboratory for Optoelectronics (China)Xinliang Zhang, Wuhan National Laboratory for Optoelectronics (China)Yuandi Zhao, Wuhan National Laboratory for Optoelectronics (China) Local Secretariat:Xiaochun Xiao, Huazhong University of Science and Technology (China)Weiwei Dong, Huazhong University of Science and Technology (China)

Socioeconomic status and prognosis of COPD in Denmark.

PubMed

Lange, Peter; Marott, Jacob Louis; Vestbo, Jørgen; Ingebrigtsen, Truls Sylvan; Nordestgaard, Børge Grønne

2014-08-01

We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education < 8 years; 3,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p < 0.001), higher prevalence of respiratory symptoms (p < 0.001) and lower forced expiratory volume in the first second in percent of predicted value (FEV1%pred) (p < 0.001). Adjusting for sex, age, FEV1%pred, dyspnea, frequency of previous exacerbations and smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.

[Initial evolution research for design and process accuracy of one type of domestic computer aided design soft and computer aided manufacture].

PubMed

Song, Yang; Zhao, Yi-jiao; Sun, Yu-chun; Lü, Pei-jun; Wang, Yong

2013-09-01

To evaluate the design and manufacture accuracy of a domestic computer aided design (CAD) and computer aided manufacture (CAM) system, and to compare it with similar foreign products. Thirty models of posterior-teeth-single-crown preparations were collected, and STL data of these preparations was collected by Denmark 3Shape scanner. Three copings were made for each preparation, the one designed and manufactured using commercial CAD/CAM system (3Shape CAD software and Wieland T1 CAM equipment) was assigned into control group T0, the one designed and manufactured using domestic CAD software (developed by Peking University School and Hospital of Stomatology and Nanjing University of Aeronautics and Astronautics) and Wieland T1 CAM equipment was assigned into experimental group TCAD for design accuracy evaluation, and the one designed and manufactured using 3Shape CAD software and domestic CAM equipment (developed by Peking University School and Hospital of Stomatology, Tsinghua University and ShanDong XinHua Incorporated Company of medical apparatus and instruments) was assigned into experimental group TCAM for manufacture accuracy evaluation. Finally, the marginal fitness were compared and evaluated by using 3D & Profile measurement microscope laser. The marginal fitness of TCAD was 27.98 (19.10, 46.57) µm in buccal, 32.67 (20.65, 50.82) µm in lingual, 27.38 (22.53, 52.61) µm in mesial, 29.50 (22.68, 53.65) µm in distal; of TCAM was 21.69 (15.87, 30.21) µm in buccal, 18.51 (13.50, 22.51) µm in lingual, 19.15 (15.42, 26.89) µm in mesial, 22.77 (18.58, 32.15) µm in distal; and there were no statistical differences compared with T0 [20.16 (17.16, 48.00) µm in buccal, 21.51 (17.05, 28.31) µm in lingual, 23.54 (17.89, 30.04) µm in mesial and 23.94 (17.93, 28.19) µm in distal] except lingual data of TCAD. The design and machining precision of this domestic CAD/CAM system is at the same level of those comparable foreign products.

Exploratory research session on the quantization of the gravitational field. At the Institute for Theoretical Physics, Copenhagen, Denmark, June-July 1957

NASA Astrophysics Data System (ADS)

DeWitt, Bryce S.

2017-06-01

During the period June-July 1957 six physicists met at the Institute for Theoretical Physics of the University of Copenhagen in Denmark to work together on problems connected with the quantization of the gravitational field. A large part of the discussion was devoted to exposition of the individual work of the various participants, but a number of new results were also obtained. The topics investigated by these physicists are outlined in this report and may be grouped under the following main headings: The theory of measurement. Topographical problems in general relativity. Feynman quantization. Canonical quantization. Approximation methods. Special problems.

Different Stories, Same Dream.

ERIC Educational Resources Information Center

Walter, Vickie

1989-01-01

The Deaf Way Conference at Gallaudet University (Washington, DC) gathered over 5,000 people from 81 nations to discuss the future of deaf people worldwide. This article offers brief summaries of conditions in Pakistan, Thailand, Japan, Saudi Arabia, Peru, Venezuela, and Denmark. National history, demographics, special education, and sign language…

Student satisfaction and loyalty in Denmark: Application of EPSI methodology

PubMed Central

Shahsavar, Tina

2017-01-01

Monitoring and managing customers’ satisfaction are key features to benefit from today’s competitive environment. In higher education context, only a few studies are available on satisfaction and loyalty of the main customers who are the students, which signifies the need to investigate the field more thoroughly. The aim of this research is to measure the strength of determinants of students’ satisfaction and the importance of antecedents in students’ satisfaction and loyalty in Denmark. Our research model is the modification of European Performance Satisfaction Index (EPSI), which takes the university’s image direct effects on students’ expectations into account from students’ perspective. The structural equation model of student satisfaction and loyalty has been evaluated using partial least square path modelling. Our findings confirm that the EPSI framework is applicable on student satisfaction and loyalty among Danish universities. We show that all the relationships among variables of the research model are significant except the relationship between quality of software and students’ loyalty. Results further verify the significance of antecedents in students’ satisfaction and loyalty at Danish universities; the university image and student satisfaction are the antecedents of student loyalty with a significant direct effect, while perceived value, quality of hardware, quality of software, expectations, and university image are antecedents of student satisfaction. Eventually, our findings may be of an inspiration to maintain and improve students’ experiences during their study at the university. Dedicating resources to identified important factors from students’ perception enable universities to attract more students, make them highly satisfied and loyal. PMID:29240801

Time trends in alcohol intake in early pregnancy and official recommendations in Denmark, 1998-2013.

PubMed

Kesmodel, Ulrik S; Petersen, Gitte L; Henriksen, Tine B; Strandberg-Larsen, Katrine

2016-07-01

In 1999, Danish health authorities modified their recommendation to pregnant women, condoning some alcohol intake. In 2007, the recommendation was changed to one of alcohol abstention. We aimed to assess changes in average alcohol intake (drinks/week) and alcohol binge drinking in early pregnancy from 1998 to 2013 in relation to the changes in official recommendations in 1999 (condoning some intake) and 2007 (abstention). All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark, between September 1998 and June 2013 were invited to participate. During the study period, 68 395 pregnant women filled in a self-administered questionnaire at gestational week 11 (median). From 1998, questions on binge drinking included data on the number of binge episodes (≥5 drinks on a single occasion), and the timing (gestational week) of these episodes. Additional questions on binge drinking defined as ≥3 drinks on a single occasion were asked separately from 2000. A question assessed the average number of alcohol-containing drinks per week the woman consumed currently at the time of filling in the questionnaire. From 1998 to 2013 the proportion of women reporting no alcohol intake increased from 31.2 to 83.3% (p < 0.001), the main decline occurring between 1998 and 2007. The proportion of binge drinkers decreased (p < 0.001) but remained more stable across the period. The decline in the proportion of pregnant women consuming alcohol occurred independently of official recommendations. Increasing national and international awareness may partly explain the changes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Prognostic factors associated with mortality in patients with septic arthritis: a descriptive cohort study.

PubMed

Andreasen, R A; Andersen, N S; Just, S A; Christensen, R; Hansen, Imj

2017-01-01

To evaluate the 30-day mortality rate of septic arthritis (SA) in adults in Funen, central Denmark, and to explore whether, at the time of SA presentation, risk factors for the 30-day mortality rate could be revealed. Our secondary objective was to describe the microbiological aetiologies, systemic signs of inflammation, and co-morbidity. A descriptive study identifying patients with SA from central Denmark, during the period 2006-2013, by the use of joint fluid culture data retrieved from the electronic database at the Department of Clinical Microbiology, Odense University Hospital. Patients with a positive joint fluid culture were considered eligible and their medical records were examined. We identified 215 patients with SA, mean age 64.8 years. At presentation, mean C-reactive protein (CRP) was 204 mg/L, mean white blood cell count (WBC) 11.9 × 10 9 /L, and mean body temperature 37.6°C. A total of 101 patients (47%) had a prosthetic joint, 46 (21%) had an inflammatory joint disease, and 24 (11%) had diabetes mellitus (DM). Staphylococcus aureus was the most common pathogen (104 patients, 48.4%). The 30-day mortality rate was 9.3% and the significant risk factor for death was liver disease at time of presentation [odds ratio (OR) 40.40, 95% confidence interval (CI) 5.38-303]. The other factors tested such as age > 65 years, elevated temperature, rheumatoid arthritis (RA), prostheses, and diabetes mellitus (DM) did not reach statistical significance. In our sample of patients with SA, we found a 30-day mortality rate in almost one in 10 adults. Among possible explanations, our study indicates that liver disease is a clinically relevant risk factor.

Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease.

PubMed

Azimi, Aziza; Charlot, Mette Gitz; Torp-Pedersen, Christian; Gislason, Gunnar H; Køber, Lars; Jensen, Lisette Okkels; Thayssen, Per; Ravkilde, Jan; Tilsted, Hans-Henrik; Lassen, Jens Flensted; Thuesen, Leif

2013-05-01

Obesity is paradoxically associated with enhanced survival in patients with established cardiovascular disease. We explored this paradox further by examining the influence of obesity on survival in patients with verified atherosclerotic heart disease. This retrospective registry based cohort study included all patients from the Western Denmark Heart Registry with coronary atherosclerosis confirmed by coronary angiography from January 2000 to December 2010. Patients were divided into eight groups according to body mass index (BMI) based on WHO BMI classification. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. The study included 37 573 patients (70.7% men) with a mean age of (66.3 ± 11.1) years. During the 11 years of follow-up, 5866 (15.6%) patients died. Multivariable analysis confirmed that the risk of death was the lowest among the preobese patients (27.5 ≤ BMI<30 kg/m(2)) with adjusted HR of 0.82 (95% CI 0.71 to 0.95; p=0.008) and increased with both low (BMI<18.50 kg/m(2)) and very high (BMI ≥ 40 kg/m(2)) BMI, HR 2.04 (95% CI 1.63 to 2.57; p<0.001) and HR 1.35 (95% CI 1.05 to 1.72; p<0.01), respectively. Also the normal weight class I (18.5 ≤ BMI<23 kg/m(2)) had a significant risk of mortality HR 1.28 (95% CI 1.13 to 1.45; p<0.001). Obese classes I and II did not differ from the reference group (23 ≤ BMI<25 kg/m(2)). Overweight atherosclerotic heart disease patients have improved survival compared with normal weight patients. Underweight and severely obese patients have increased mortality. Our results lean more towards an overweight paradox than an obesity paradox.

Danish version of the Tilburg Frailty Indicator--translation, cross-cultural adaption and validity pretest by cognitive interviewing.

PubMed

Andreasen, Jane; Sørensen, Erik E; Gobbens, Robbert J J; Lund, Hans; Aadahl, Mette

2014-01-01

The Tilburg Frailty Indicator (TFI) is a self-administered questionnaire with a bio-psycho-social integrated approach that measures the degree of frailty in elderly persons. The TFI was developed in the Netherlands and tested in a population of elderly Dutch men and women. The aim of this study was to translate and culturally adapt the TFI to a Danish context, and to test face validity of the Danish version by cognitive interviewing. An internationally recognized procedure was applied as a basis for the translation process. The primary tasks were forward translation, reconciliation, back translation, harmonization and pretest. Pretest and review of the preliminary version by cognitive interviewing, were performed at a local community center and in an acute medical ward at the University Hospital in Aalborg, Denmark respectively. A large agreement regarding meaning of the items in the forward translation and reconciliation process was seen. Minor discrepancies were solved by consensus. Back translation revealed unclear wording in one matter. The harmonization committee agreed on a version for cognitive interviewing after revision of minor issues and thirty-four participants were interviewed. Two issues became evident and these were revised. The cognitive interviews and final lay-out resulted in minor adjustments as text type size, specific font, and lining for optimizing readability. In conclusion, we consider the TFI to be translated in such rigorous manner that the instrument can be further tested in clinical practice. The overall objective of the questionnaire being to identify frailty and improve the interventions relating to frail elderly persons in Denmark. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Learning to live with a permanent intestinal ostomy: impact on everyday life and educational needs.

PubMed

Danielsen, Anne Kjaergaard; Soerensen, Erik Elgaard; Burcharth, Kirsten; Rosenberg, Jacob

2013-01-01

The aim of the study was to explore the impact of a permanent stoma on patients' everyday lives and to gain further insight into their need for ostomy-related education. The sample population comprised 15 persons with permanent ostomies. Stomas were created to manage colorectal cancer or inflammatory bowel disease. The research setting was the surgical department at a hospital in the Capitol Region of Denmark associated with the University of Copenhagen. Focus group interviews were conducted using a phenomenological hermeneutic approach. Data were collected and analyzed using qualitative content analysis. Stoma creation led to feelings of stigma, worries about disclosure, a need for control and self-imposed limits. Furthermore, patients experienced difficulties identifying their new lives with their lives before surgery. Participants stated they need to be seen as a whole person, to have close contact with health care professionals, and receive trustworthy information about life with an ostomy. Respondents proposed group sessions conducted after hospital discharge. They further recommended that sessions be delivered by lay teachers who had a stoma themselves. Self-imposed isolation was often selected as a strategy for avoiding disclosing the presence of a stoma. Patient education, using health promotional methods, should take the settings into account and patients' possibility of effective knowledge transfer. Respondents recommend involvement of lay teachers, who have a stoma, and group-based learning processes are proposed, when planning and conducting patient education.

Influences on Intercultural Classroom Communication: Student Voices

ERIC Educational Resources Information Center

Tarp, Gertrud

2017-01-01

The case study is an attempt to understand how students experience intercultural classroom communication and what kind of competence they need to cope in intercultural classroom communication. The context is a supplementary course in English for university enrolment in Denmark. It is a multinational student body and all the students have finished…

Scandinavian Approaches to Gender Equality in Academia: A Comparative Study

ERIC Educational Resources Information Center

Nielsen, Mathias Wullum

2017-01-01

This study investigates how Denmark, Norway, and Sweden approach issues of gender equality in research differently. Based on a comparative document analysis of gender equality activities in six Scandinavian universities, together with an examination of the legislative and political frameworks surrounding these activities, the article provides new…

A History of Adult Education in Germany (1800-1933).

ERIC Educational Resources Information Center

Pirtle, Wayne George

German adult education before 1933 stressed group experience in the family, clan, and culture rather than knowledge and the individual. Outside trends, expecially in England, Austria, Denmark, and the United States, repeatedly influenced the German movement. While lecture institutes, university extension, and other activities were important, the…

Physical Education and Recreation in Europe.

ERIC Educational Resources Information Center

Howell, M. L.; Van Vliet, M. L.

Physical education and research programs, and recreational and athletic facilities, in Yugoslavia, Sweden, Denmark, Germany, England, and the U.S.S.R. are examined by two faculty members from the University of Alberta. This publication is an abridgement of their report on European approaches to physical education and recreation, giving their…

Popularization of Science in Denmark in Relation to Women.

ERIC Educational Resources Information Center

Olesen, Dorte

1988-01-01

Describes the diversity of channels through which the cause of science is being promoted and the special efforts being made to involve females in science and technology. Topics include the background of science popularization, tradition, innovation, television programs, science museums, the role of universities, youth activities, computers, and…

Bowel Endometriosis Syndrome: a new scoring system for pelvic organ dysfunction and quality of life.

PubMed

Riiskjær, M; Egekvist, A G; Hartwell, D; Forman, A; Seyer-Hansen, M; Kesmodel, U S

2017-09-01

Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? The BENS score can be used to identify women with BENS and to monitor the effect of medical and surgical treatment of women suffering from bowel endometriosis. Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems are mainly based on anatomical and surgical findings. The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. Patients filled in questionnaires on pelvic pain, quality of life (QoL) and urinary, sexual and bowel function. Items were selected for the final score using clinical and statistical criteria. The chosen variables were included in a multivariate analysis. Individual score values were designated items to form the BENS score, which was divided into 'no BENS', 'minor BENS' and 'major BENS.' Internal and external validations were performed. The six most important items were 'pelvic pain', 'use of analgesics', 'dyschezia', 'straining to urinate', 'fecal urgency' and 'satisfaction with sexual life'. The range of the BENS score (0-28) was divided into 0-8 (no BENS), 9-16 (minor BENS) and 17-28 (major BENS). External validation showed a significant association between BENS score and QoL (P = 0.0001). The BENS scoring system is limited by the fact that it was developed from a single endometriosis unit in Denmark, making it susceptible to social, cultural and demographic bias. It is the first endometriosis classification system to be based directly on the symptomatology of the patient. Validation in other languages will promote comparison of treatments and results across borders. No external funding was either sought or obtained for this study. A.F. is an investigator for Bayer, outside this work. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Laparoscopic Lavage for Perforated Diverticulitis With Purulent Peritonitis: A Randomized Trial.

PubMed

Thornell, Anders; Angenete, Eva; Bisgaard, Thue; Bock, David; Burcharth, Jakob; Heath, Jane; Pommergaard, Hans-Christian; Rosenberg, Jacob; Stilling, Nikolaj; Skullman, Stefan; Haglind, Eva

2016-02-02

Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. To compare laparoscopic lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287). 9 hospitals in Sweden and Denmark. Patients who have confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. Randomization between laparoscopic lavage and the Hartmann procedure. Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key secondary outcomes were number of reoperations, hospital readmissions, total length of hospital stay during 12 months, and adverse events. A total of 43 and 40 patients were randomly assigned to laparoscopic lavage and the Hartmann procedure with a median (first, third quartiles) follow-up of 372 days (336, 394) and 378 days (226, 396), respectively. Fewer patients in the laparoscopic group (12 of 43; 27.9%) than in the Hartmann group (25 of 40; 62.5%) had at least 1 reoperation within 12 months (relative risk reduction, 59%; relative risk, 0.41 [95% CI, 0.23 to 0.72]; P = 0.004). Mortality and severe adverse events did not differ between groups. Total length of hospital stay (days) within 12 months was shorter for the laparoscopic group than the Hartmann group, with a reduction of 35% (relative risk, 0.65 [CI, 0.45 to 0.94]; P = 0.047). After 12 months, 3 patients in the laparoscopic group and 11 in the Hartmann group had a stoma. Not all patients presenting with suspected diverticulitis were enrolled. Laparoscopic lavage reduced the need for reoperations, had a similar safety profile to the Hartmann procedure, and may be an appropriate treatment of choice for acute perforated diverticulitis with purulent peritonitis. ALF; Sahlgrenska University Hospital, Gothenburg.

Increased alcohol consumption as a cause of alcoholism, without similar evidence for depression: a Mendelian randomization study.

PubMed

Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Tolstrup, Janne Schurmann; Nordestgaard, Børge Grønne

2015-04-01

Increased alcohol consumption has been associated with depression and alcoholism, but whether these associations are causal remains unclear. We tested whether alcohol consumption is causally associated with depression and alcoholism. We included 78,154 men and women aged 20-100 years randomly selected in 1991-2010 from the general population of Copenhagen, Denmark, and genotyped 68,486 participants for two genetic variants in two alcohol dehydrogenase (ADH) genes, ADH-1B (rs1229984) and ADH-1C (rs698). We performed observational and causal analyses using a Mendelian randomization design with antidepressant medication use and hospitalization/death, with depression and alcoholism as outcomes. In prospective analyses, the multifactorially adjusted hazard ratio for participants reporting >6 drinks/day vs participants reporting 0.1-1 drinks/day was 1.28 (95% confidence interval, 1.00-1.65) for prescription antidepressant use, with a corresponding hazard ratio of 0.80 (0.45-1.45) for hospitalization/death with depression and of 11.7 (8.77-15.6) for hospitalization/death with alcoholism. For hospitalization/death with alcoholism, instrumental variable analysis yielded a causal odds ratio of 28.6 (95 % confidence interval 6.47-126) for an increase of 1 drink/day estimated from the combined genotype combination, whereas the corresponding multifactorially adjusted observational odds ratio was 1.28 (1.25-1.31). Corresponding odds ratios were 1.11 (0.67-1.83) causal and 1.04 (1.03-1.06) observational for prescription antidepressant use, and 4.52 (0.99-20.5) causal and 0.98 (0.94-1.03) observational for hospitalization/death with depression. These data indicate that the association between increased alcohol consumption and alcoholism is causal, without similar strong evidence for depression. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Differences in survival on chronic dialysis treatment between ethnic groups in Denmark: a population-wide, national cohort study.

PubMed

van den Beukel, Tessa O; Hommel, Kristine; Kamper, Anne-Lise; Heaf, James G; Siegert, Carl E H; Honig, Adriaan; Jager, Kitty J; Dekker, Friedo W; Norredam, Marie

2016-07-01

In Western countries, black and Asian dialysis patients experience better survival compared with white patients. The aim of this study is to compare the survival of native Danish dialysis patients with that of dialysis patients originating from other countries and to explore the association between the duration of residence in Denmark before the start of dialysis and the mortality on dialysis. We performed a population-wide national cohort study of incident chronic dialysis patients in Denmark (≥18 years old) who started dialysis between 1995 and 2010. In total, 8459 patients were native Danes, 344 originated from other Western countries, 79 from North Africa or West Asia, 173 from South or South-East Asia and 54 from sub-Saharan Africa. Native Danes were more likely to die on dialysis compared with the other groups (crude incidence rates for mortality: 234, 166, 96, 110 and 53 per 1000 person-years, respectively). Native Danes had greater hazard ratios (HRs) for mortality compared with the other groups {HRs for mortality adjusted for sociodemographic and clinical characteristics: 1.32 [95% confidence interval (CI) 1.14-1.54]; 2.22 [95% CI 1.51-3.23]; 1.79 [95% CI 1.41-2.27]; 2.00 [95% CI 1.10-3.57], respectively}. Compared with native Danes, adjusted HRs for mortality for Western immigrants living in Denmark for ≤10 years, >10 to ≤20 years and >20 years were 0.44 (95% CI 0.27-0.71), 0.56 (95% CI 0.39-0.82) and 0.86 (95% CI 0.70-1.04), respectively. For non-Western immigrants, these HRs were 0.42 (95% CI 0.27-0.67), 0.52 (95% CI 0.33-0.80) and 0.48 (95% CI 0.35-0.66), respectively. Incident chronic dialysis patients in Denmark originating from countries other than Denmark have a better survival compared with native Danes. For Western immigrants, this survival benefit declines among those who have lived in Denmark longer. For non-Western immigrants, the survival benefit largely remains over time. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

[Inpatient psychiatry in Denmark].

PubMed

Gnirss, M

1993-01-01

The paper describes organization and clinical aspects of Danish psychiatry seen from the view of a psychiatrist trained in Switzerland. Differences of the two societies, the description of the hospital, the psychiatrist's daily work as well as juridical aspects and their effects to the work on a psychiatric ward form the main themes of this article. At the end the author tries to value the two different systems.

Study protocol: Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer (RESPECT).

PubMed

Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Hasle, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis; Wehner, Peder Skov; Schmiegelow, Kjeld; Larsen, Hanne Baekgaard

2013-11-14

During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness. Clinical Trials.gov: file. NCT01772849 and NCT01772862.

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

PubMed Central

Godtfredsen, Nina Skavlan; Frølich, Anne

2016-01-01

Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals. PMID:27616948

ONR Far East Scientific Bulletin. Volume 10, Number 3, July-September 1985,

DTIC Science & Technology

1985-09-01

to alpha and beta interferon. " Vaccines Using recombinant DNA technology, researchers at Osaka University have developed a vaccine against the Chicken ... Pox virus. Using recombinant DNA technology, researchers at Kyushu University have developed a vaccine against the Herpes simplex virus. " Drugs...Germany 9 Norway 8 Holland 7 U.K. 6 France 4 Denmark 4 Austria 4 U.S.S.R. 3 Australia 2 Singapore 2 Spain 2 Poland I Egypt I Israel I Mexico I 20

Plasma YKL-40 in Inuit and Danes.

PubMed

Nøjgaard, Camilla; Johansen, Julia S; Bjerregaard, Peter; Bojesen, Stig E; Becker, Ulrik

2015-01-01

The aim of the present study was to investigate whether there are differences in plasma levels of YKL-40 between Inuit in Greenland and in Denmark and in Danes, as well as to study the relationship between alcohol intake, plasma YKL-40 and other factors in Inuit. Plasma YKL-40 levels were measured on 1645 people from The Greenland Population Study (a cross-sectional population study of Inuit from Denmark and West Greenland) and were compared with the plasma YKL-40 levels of 8899 people from The Copenhagen City Heart Study (a population-based, prospective study of the Danish general population). The plasma concentrations of YKL-40 were significantly (P = 0.001) lower in Inuit living in Greenland (median 46 µg/l, range 10-2164, n = 1164) compared with the plasma YKL-40 levels of Inuit living in Denmark (median 63 µg/l, range 20-2827, n = 481) and of Danes living in Denmark (median 55 µg/l, range 10-2909, n = 8899). In Inuit, increased alcohol intake was significantly associated with increased plasma YKL-40 levels (P < 0.001), and high plasma YKL-40 levels were associated with high values of alkaline phosphatase and low values of albumin. Smoking, gender and bilirubin were not associated with the plasma YKL-40 level. High levels of YKL-40 and alcohol were associated with where people lived. The plasma concentrations of YKL-40 are significantly lower in Inuit living in Greenland than Inuit and Danes living in Denmark. A number of factors, including different alcohol intake patterns, nutrition and genes may play a role in these findings. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Low Noise Optical Amplifiers

DTIC Science & Technology

2010-05-01

Karsten Rottwitt DTU Fotonik Department of Photonics Engineering, Technical University of Denmark - 2 - TABLE OF...at DTU Fotonik, has intensified through two new ph.d positions within parametric amplifiers, one partly funded through a research program on phase...Activities: As indicated in the above DTU Fotonik now has significant activities on using parametric processes in optical fibers. This includes

Institutional Autonomy and Academic Freedom in the Nordic Context--Similarities and Differences

ERIC Educational Resources Information Center

Nokkala, Terhi; Bladh, Agneta

2014-01-01

Owing to their common history, similarities in language and culture, long traditions in political collaboration and the shared Nordic societal model, an assumption is often made that the operational and regulatory context of universities is similar in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. In this article, we…

Challenges in Teaching "Colloid and Surface Chemistry"--A Danish Experience

ERIC Educational Resources Information Center

Kontogeorgis, Georgios M.; Vigild, Martin E.

2009-01-01

Seven years ago we were asked, as one of our first teaching duties at the Technical University of Denmark (DTU), to teach a 5 ECTS point course on "Colloid and Surface Chemistry". The topic is itself at the same time exciting and demanding, largely due to its multidisciplinary nature. Several "local" requirements posed…

L'Education populaire en Europe. 2. Scandinavie (Mass Adult Education in Europe. 2. Scandinavia).

ERIC Educational Resources Information Center

Trichaud, Lucien

Covering Denmark, Norway, Sweden, and Finland in turn, this comparative survey of mass adult education in Scandinavia provides a historical and descriptive background on each country, followed by the development and present situation of folk high schools, cooperatives, university extension, correspondence study, labor education, mass media, and…

Hannah Arendt's Fame Rests on the Wrong Foundation

ERIC Educational Resources Information Center

Jacoby, Russell

2006-01-01

A street is named after her. Back-to-back conferences celebrate her. New books champion her. Hannah Arendt has joined the small world of philosophical heroes. During her life, she received honorary degrees from Princeton, Smith, and other colleges and universities. Denmark awarded her its Sonning Prize for "commendable work that benefits European…

Does Staff Diversity Imply Openness to Diversity?

ERIC Educational Resources Information Center

Lauring, Jakob; Selmer, Jan

2013-01-01

Purpose: Post-secondary educational organizations are currently some of the most diverse settings to be found. However, few educational studies have dealt with staff diversity and hardly any has looked outside the USA. The purpose of this paper is to present a study of members of international university departments in Denmark. The authors set out…

Mentoring First Year Study Groups--Benefits from the Mentors' Perspective

ERIC Educational Resources Information Center

Dyrberg, Nadia Rahbek; Michelsen, Claus

2017-01-01

The "study group concept" at the University of Southern Denmark (SDU) was implemented to aid first year students' transitional challenges. A mentor (an older student) is affiliated each study group to facilitate productive group work, bring awareness to study habits, and share his/her own experiences with life as a student. The study…

Systematic Exploitation of Marginal Flexibility in Staff Planning.

ERIC Educational Resources Information Center

Lawaetz, Peter

1984-01-01

The Technical University of Denmark has tried to free resources in a stagnant or declining budget for development of new subject areas by planned contraction of ordinary activities, with only moderate success due to low mobility and strong specialization of the scientific staff. A more realistic planning system has been introduced, using…

Placement Supervision of Pedagogue Students in Denmark: The Role of University Colleges and Early Childhood Centres

ERIC Educational Resources Information Center

Jensen, Jytte Juul

2015-01-01

The article examines Danish pedagogue students' supervision during their placement periods in early childhood settings. Throughout the long history of Danish pedagogue education, discourses relating to the placement element have been located either within a "work" paradigm or a "scholastic" paradigm. These two understandings of…

Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial: methods of a randomized effectiveness trial

PubMed Central

2013-01-01

Background Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional hospital treatment measured according to first treatment failure, which is defined as readmission due to COPD within 30 days after discharge. Methods COPD patients with acute exacerbation who fulfilled the eligibility criteria and were from two university hospitals in Denmark were randomized (1:1) by computer-generated tables that allocated treatments in blocks of four to receive either standard treatment at the hospital or the same standard treatment at home using telemedicine technology (that is, a video conference system with a touch screen and webcam and monitoring equipment (spirometer, thermometer, and pulse oximeter)). Patients treated in the telemedicine group were backed up by an organizational setting securing 24/7/365 online access to the hospital, as well as access to oxygen, nebulizer therapy, oral medical therapy and surveillance of vital parameters from home monitoring devices. Patients in both groups were discharged when clinically stable and when fulfilling five pre-specified discharge criteria. Follow-up was performed at 1, 3 and 6 months after discharge. The primary outcome was treatment failure defined as readmission due to exacerbation in COPD within 30 days. Secondary outcomes were death from any cause, prescription of additional antibiotics or steroids, need of intubation or non-invasive ventilation, emergency room visits, visits to the general practitioner, lung function, bed days, health-related quality of life, healthcare costs and user satisfaction. Results Enrollment of patients started in June 2010 and ended in December 2011. Follow-up ended in May 2012. Results were analyzed in 2013. Conclusions The results may have implications on future hospital treatment modalities for patients with severe exacerbations in COPD where telemedicine may be used as an alternative to conventional admission. Trial registration Clinical Trials NCT01155856 PMID:24139548

Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation.

PubMed

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C; Frederiksen, Christian A; Laursen, Christian B; Sloth, Erik; Mølgaard, Ole; Knudsen, Lars; Kirkegaard, Hans

2018-03-27

Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone for structured interviews. A total of 22 facilities in Denmark were found to receive traumatized patients. All facilities used a trauma care manual and all had a multidisciplinary trauma team. The study found three different trauma team activation criteria and nine different compositions of teams who participate in trauma care. Training was heterogeneous and, beyond the major trauma centers, databases were only maintained in a few facilities. The study established an inventory of the existing Danish facilities that receive traumatized patients. The trauma team activation criteria and the trauma teams were heterogeneous in both size and composition. A national database for traumatized patients, research on nationwide trauma team activation criteria, and team composition guidelines are all called for.

Implementation of team training in medical education in Denmark

PubMed Central

Ostergaard, H; Ostergaard, D; Lippert, A

2004-01-01

In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed. PMID:15465962

Implementation of team training in medical education in Denmark.

PubMed

Østergaard, H T; Østergaard, D; Lippert, A

2004-10-01

In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed.

Implementation of team training in medical education in Denmark.

PubMed

Østergaard, H T; Østergaard, D; Lippert, A

2008-10-01

In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed.

Actinobaculum schaalii, a Common Uropathogen in Elderly Patients, Denmark

PubMed Central

Jensen, Anders; Hansen, Thomas M.; Søby, Karen M.; Prag, Jørgen

2010-01-01

Actinobaculum schaalii can cause urinary tract infections and septicemia but is difficult to identify by cultivation. To obtain a fast diagnosis and identify A. schaalii, we developed a TaqMan real-time quantitative PCR. Routine urine samples were obtained from 177 hospitalized patients and 75 outpatients in Viborg County, Denmark, in 2008–2009. The PCR detected A. schaalii in 22% of samples from patients >60 years of age. This assay showed that A. schaalii is more common than implied by routine cultivation. In 90% of PCR-positive urine samples, other common uropathogens were identified. This finding suggests that A. schaalii is a common, undetected, bacterial pathogen. Our results suggest that A. schaalii may be a more common pathogen than previously thought, especially in patients with unexplained chronic urinary tract infections, who are often treated with trimethoprim or ciprofloxacin, to which A. schaalii is resistant. PMID:20031046

Access to health care in the Scandinavian countries: ethical aspects.

PubMed

Holm, S; Liss, P E; Norheim, O F

1999-01-01

The health care systems are fairly similar in the Scandinavian countries. The exact details vary, but in all three countries the system is almost exclusively publicly funded through taxation, and most (or all) hospitals are also publicly owned and managed. The countries also have a fairly strong primary care sector (even though it varies between the countries), with family physicians to various degrees acting as gatekeepers to specialist services. In Denmark most of the GP services are free. For the patient in Norway and Sweden there are out-of-pocket co-payments for GP consultations, with upper limits, but consultations for children are free. Hospital treatment is free in Denmark while the other countries use a system with out-of-pocket co-payment. There is a very strong public commitment to access to high quality health care for all. Solidarity and equality form the ideological basis for the Scandinavian welfare state. Means testing, for instance, has been widely rejected in the Scandinavian countries on the grounds that public services should not stigmatise any particular group. Solidarity also means devoting special consideration to the needs of those who have less chance than others of making their voices heard or exercising their rights. Issues of limited access are now, however, challenging the thinking about a health care system based on solidarity.

Pre-Analytical Conditions in Non-Invasive Prenatal Testing of Cell-Free Fetal RHD

PubMed Central

Rieneck, Klaus; Krog, Grethe Risum; Nielsen, Leif Kofoed; Tabor, Ann; Dziegiel, Morten Hanefeld

2013-01-01

Background Non-invasive prenatal testing of cell-free fetal DNA (cffDNA) in maternal plasma can predict the fetal RhD type in D negative pregnant women. In Denmark, routine antenatal screening for the fetal RhD gene (RHD) directs the administration of antenatal anti-D prophylaxis only to women who carry an RhD positive fetus. Prophylaxis reduces the risk of immunization that may lead to hemolytic disease of the fetus and the newborn. The reliability of predicting the fetal RhD type depends on pre-analytical factors and assay sensitivity. We evaluated the testing setup in the Capital Region of Denmark, based on data from routine antenatal RHD screening. Methods Blood samples were drawn at gestational age 25 weeks. DNA extracted from 1 mL of plasma was analyzed for fetal RHD using a duplex method for exon 7/10. We investigated the effect of blood sample transportation time (n = 110) and ambient outdoor temperatures (n = 1539) on the levels of cffDNA and total DNA. We compared two different quantification methods, the delta Ct method and a universal standard curve. PCR pipetting was compared on two systems (n = 104). Results The cffDNA level was unaffected by blood sample transportation for up to 9 days and by ambient outdoor temperatures ranging from -10°C to 28°C during transport. The universal standard curve was applicable for cffDNA quantification. Identical levels of cffDNA were observed using the two automated PCR pipetting systems. We detected a mean of 100 fetal DNA copies/mL at a median gestational age of 25 weeks (range 10–39, n = 1317). Conclusion The setup for real-time PCR-based, non-invasive prenatal testing of cffDNA in the Capital Region of Denmark is very robust. Our findings regarding the transportation of blood samples demonstrate the high stability of cffDNA. The applicability of a universal standard curve facilitates easy cffDNA quantification. PMID:24204719

Pre-analytical conditions in non-invasive prenatal testing of cell-free fetal RHD.

PubMed

Clausen, Frederik Banch; Jakobsen, Tanja Roien; Rieneck, Klaus; Krog, Grethe Risum; Nielsen, Leif Kofoed; Tabor, Ann; Dziegiel, Morten Hanefeld

2013-01-01

Non-invasive prenatal testing of cell-free fetal DNA (cffDNA) in maternal plasma can predict the fetal RhD type in D negative pregnant women. In Denmark, routine antenatal screening for the fetal RhD gene (RHD) directs the administration of antenatal anti-D prophylaxis only to women who carry an RhD positive fetus. Prophylaxis reduces the risk of immunization that may lead to hemolytic disease of the fetus and the newborn. The reliability of predicting the fetal RhD type depends on pre-analytical factors and assay sensitivity. We evaluated the testing setup in the Capital Region of Denmark, based on data from routine antenatal RHD screening. Blood samples were drawn at gestational age 25 weeks. DNA extracted from 1 mL of plasma was analyzed for fetal RHD using a duplex method for exon 7/10. We investigated the effect of blood sample transportation time (n = 110) and ambient outdoor temperatures (n = 1539) on the levels of cffDNA and total DNA. We compared two different quantification methods, the delta Ct method and a universal standard curve. PCR pipetting was compared on two systems (n = 104). The cffDNA level was unaffected by blood sample transportation for up to 9 days and by ambient outdoor temperatures ranging from -10 °C to 28 °C during transport. The universal standard curve was applicable for cffDNA quantification. Identical levels of cffDNA were observed using the two automated PCR pipetting systems. We detected a mean of 100 fetal DNA copies/mL at a median gestational age of 25 weeks (range 10-39, n = 1317). The setup for real-time PCR-based, non-invasive prenatal testing of cffDNA in the Capital Region of Denmark is very robust. Our findings regarding the transportation of blood samples demonstrate the high stability of cffDNA. The applicability of a universal standard curve facilitates easy cffDNA quantification.

Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs.

PubMed Central

Poulsen, K. B.; Bremmelgaard, A.; Sørensen, A. I.; Raahave, D.; Petersen, J. V.

1994-01-01

A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system. Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0.5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures. PMID:7925666

[Emergency eye care in French university hospitals].

PubMed

Bourges, J-L

2018-03-01

The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Understanding traffic crash under-reporting: Linking police and medical records to individual and crash characteristics.

PubMed

Janstrup, Kira H; Kaplan, Sigal; Hels, Tove; Lauritsen, Jens; Prato, Carlo G

2016-08-17

This study aligns to the body of research dedicated to estimating the underreporting of road crash injuries and adds the perspective of understanding individual and crash factors contributing to the decision to report a crash to the police, the hospital, or both. This study focuses on road crash injuries that occurred in the province of Funen, Denmark, between 2003 and 2007 and were registered in the police, the hospital, or both authorities. Underreporting rates are computed with the capture-recapture method, and the probability for road crash injuries in police records to appear in hospital records (and vice versa) is estimated with joint binary logit models. The capture-recapture analysis shows high underreporting rates of road crash injuries in Denmark and the growth of underreporting not only with the decrease in injury severity but also with the involvement of cyclists (reporting rates of about 14% for serious injuries and 7% for slight injuries) and motorcyclists (reporting rates of about 35% for serious injuries and 10% for slight injuries). Model estimates show that the likelihood of appearing in both data sets is positively related to helmet and seat belt use, number of motor vehicles involved, alcohol involvement, higher speed limit, and females being injured. This study adds significantly to the literature about underreporting by recognizing that understanding the heterogeneity in the reporting rate of road crashes may lead to devising policy measures aimed at increasing the reporting rate by targeting specific road user groups (e.g., males, young road users) or specific situational factors (e.g., slight injuries, arm injuries, leg injuries, weekend).

A qualitative assessment of implementing a cross-cultural survey on cancer wards in Denmark--a description of barriers.

PubMed

Kristiansen, Maria; Hassani, Amani; Krasnik, Allan

2010-01-12

Research into migration and health is often confronted with methodological challenges related to the identification of migrants in various settings. Furthermore, it is often difficult to reach an acceptable level of participation among migrant groups in quantitative research. The aim of this study is to conduct a qualitative assessment of the barriers encountered during the implementation of a cross-cultural survey on cancer wards in Copenhagen, Denmark. Participant observation at the involved wards was combined with qualitative interviews with selected nurses and informal talks with a wider group of nurses at the wards involved in the survey. One possible way to increase the participation of migrant patients in research is through the involvement of the hospital staff in contact with patients. Involvement of nurses on cancer wards in the delivery of questionnaires to patients was challenging, despite a general willingness to participate in psychosocial research. The main difficulties were found to be both external (policy changes, general strike among nurses) and internal on the wards (heavy workload, lack of time, focus on medical aspects of cancer rather than psychosocial aspects). These factors interacted and resulted in a lower priority being given to psychosocial research. Further, nurses expressed a feeling that researchers in general did not recognize their contribution in research, making it more difficult to engage fully in studies. Involving hospital staff in research is feasible but not straightforward. Awareness of the influence of possible external and internal factors and efforts to deal with these factors are fundamental to the successful implementation of psychosocial cancer research in a hospital setting.

[Subjective Workload, Job Satisfaction, and Work-Life-Balance of Physicians and Nurses in a Municipal Hospital in a Rural Area Compared to an Urban University Hospital].

PubMed

Körber, Michael; Schmid, Klaus; Drexler, Hans; Kiesel, Johannes

2018-05-01

Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, p<0.01). Nurses of both hospitals had sufficient opportunity to reconcile work and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective workload and stress factors reported by physicians at the University Hospital were significantly higher than those by doctors at the municipal hospital. © Georg Thieme Verlag KG Stuttgart · New York.

Remembering John M. Olson (1929-2017).

PubMed

Blankenship, Robert E; Brune, Daniel C; Olson, Jon C

2018-02-19

Here we provide reflections of and a tribute to John M. Olson, a pioneering researcher in photosynthesis. We trace his career, which began at Wesleyan University and the University of Pennsylvania, and continued at Utrech in The Netherlands, Brookhaven National Laboratory, and Odense University in Denmark. He was the world expert on pigment organization in the green photosynthetic bacteria, and discovered and characterized the first chlorophyll-containing protein, which has come to be known as the Fenna-Matthews-Olson (FMO) protein. He also thought and wrote extensively on the origin and early evolution of photosynthesis. We include personal comments from Brian Matthews, Raymond Cox, Paolo Gerola, Beverly Pierson and Jon Olson.

From Teacher-Centered Instruction to Peer Tutoring in the Heterogeneous International Classroom: A Danish Case of Instructional Change

ERIC Educational Resources Information Center

Lueg, Klarissa; Lueg, Rainer

2014-01-01

This case study documents a seminar redesign from a teacher-centered instruction format to collaborative "reciprocal peer tutoring" (RPT) at Aarhus University, Denmark. Departing from concepts by Bourdieu and Vertovec, we argue that teaching concepts should meet the needs of students within Higher Education (HE). Our student sample is…

Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

ERIC Educational Resources Information Center

Shah, Mahsood

2012-01-01

External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

Academic Autonomy in a Rapidly Changing Higher Education Framework: Academia on the Procrustean Bed?

ERIC Educational Resources Information Center

Schmidt, Evanthia Kalpazidou; Langberg, Kamma

2008-01-01

In a number of European countries, the recognition of the university's key role in the evolution of the knowledge society--and in the identification and solving of political, socioeconomic, environmental, and cultural problems--has led to radical reforms of higher education systems. Denmark has implemented the most radical reforms of the region in…

Telling Modernization: Three Voices. Life History, Gender and the Discourse of Modernization. Roskilde University Life History Project Paper.

ERIC Educational Resources Information Center

Anderson, Linda

The relationship between life history, gender, and the discourse of modernization was examined from the perspective of a researcher with extensive experience performing evaluations about modernization within human services in Denmark. Three stories about site-based management in two human service institutionsa youth center and a boarding school…

Seven-Step Problem-Based Learning in an Interaction Design Course

ERIC Educational Resources Information Center

Schultz, Nette; Christensen, Hans Peter

2004-01-01

The objective in this paper is the implementation of the highly structured seven-step problem-based learning (PBL) procedure as part of the learning process in a human-computer interaction (HCI) design course at the Technical University of Denmark, taking into account the common learning processes in PBL and the interaction design process. These…

The Impact of Globalization on the U.S. Defense Industrial Base

DTIC Science & Technology

2013-10-01

national security and technology. 0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% U.S. Greece U.k. France Turkey Poland Denmark Germany Italy Netherlands Belgium...Master of Public Policy degree from the University of Maryland, College Park, in 2011, and holds a Bachelor of Arts degree in anthropology from the

[Issues related to national university medical schools: focusing on the low wages of university hospital physicians].

PubMed

Takamuku, Masatoshi

2015-01-01

University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government.

The Danish National Health Survey 2010. Study design and respondent characteristics.

PubMed

Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte; Andreasen, Anne Helms; Hvidberg, Michael Falk; Kristensen, Peter Lund; Larsen, Finn Breinholt; Ortiz, Britta; Juel, Knud

2012-06-01

In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content of the questionnaire. The survey was based on five regional stratified random samples and one national random sample. The samples were mutually exclusive. A total of 298,550 individuals (16 years or older) were invited to participate. Information was collected using a mixed mode approach (paper and web questionnaires). A questionnaire with a minimum of 52 core questions was used in all six subsamples. Calibrated weights were computed in order to take account of the complex survey design and reduce non-response bias. In all, 177,639 individuals completed the questionnaire (59.5%). The response rate varied from 52.3% in the Capital Region of Denmark sample to 65.5% in the North Denmark Region sample. The response rate was particularly low among young men, unmarried people and among individuals with a different ethnic background than Danish. The survey was a result of extensive national cooperation across sectors, which makes it unique in its field of application, e.g. health surveillance, planning and prioritizing public health initiatives and research. However, the low response rate in some subgroups of the study population can pose problems in generalizing data, and efforts to increase the response rate will be important in the forthcoming surveys.

Residency hospital type and career paths in Japan: an analysis of physician registration cohorts.

PubMed

Koike, Soichi; Kodama, Tomoko; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki

2010-01-01

In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened. The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications. Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented. More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices. University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.

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.

Lymphogranuloma venereum proctitis: a differential diagnose to inflammatory bowel disease.

PubMed

Høie, Sverre; Knudsen, Lene Surland; Gerstoft, Jan

2011-04-01

Lymphogranuloma venereum (LGV) is a sexually transmitted disease, endemic in tropical and subtropical areas for many years. After 2003 there have been several outbreaks in western countries, especially among HIV-positive men who have sex with men (MSM). An important manifestation of LGV is a proctitis, with a clinical presentation and endoscopic findings resembling those of inflammatory bowel diseases (IBDs). LGV is considered new in Scandinavia. This case report focuses on difficulties in differentiating LGV and IBD. This case report used a systematic search in the literature using PubMed and clinical cases from the Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark (Cases 1-3) and the Section of Surgery, Hamar Hospital, Norway (Case 4). Clinical and endoscopic findings in LGV and IBD resemble each other. All cases were MSM. Three out of four were HIV-positive. Three out of four contacted their general practitioner (GP) due to gastrointestinal (GI) symptoms, and were referred to a gastroenterologist (GE) with suspicion of IBD. Because of non-successful IBD treatment, control of HIV status, relapses of GI-symptoms or extended information concerning sexual habits, LGV was suspected and diagnosed. All patients responded with remission of GI-symptoms and endoscopic findings after oral treatment with doxycycline. Due to similarities between LGV and IBD, LGV should be considered as a differential diagnosis in patients with proctitis or IBD-related symptoms, especially among HIV-positive men. Hence LGV patients may be spared long-lasting examination, mistreatment and surgery.

Positive predictive value of peptic ulcer diagnosis codes in the Danish National Patient Registry

PubMed Central

Viborg, Søren; Søgaard, Kirstine Kobberøe; Jepsen, Peter

2017-01-01

Background Diagnoses of peptic ulcer are registered in the Danish National Patient Registry (DNPR) for administrative as well as research purposes, but it is unknown whether the coding validity depends on the location of the ulcer. Objective To validate the International Classification of Diseases, 10th revision diagnosis codes of peptic ulcer in the DNPR by estimating positive predictive values (PPVs) for gastric and duodenal ulcer diagnoses. Methods We identified all patients registered with a hospital discharge diagnosis of peptic ulcer from Aarhus University Hospital, Denmark, in 1995–2006. Among them, we randomly selected 200 who had an outpatient gastroscopy at the time of ulcer diagnosis. We reviewed the findings from these gastroscopies to confirm the presence of peptic ulcer and its location. We calculated PPVs and corresponding 95% confidence intervals (CIs) of gastric and duodenal ulcer diagnoses, using descriptions from the gastroscopic examinations as standard reference. Results In total, 182 records (91%) were available for review. The overall PPV of peptic ulcer diagnoses in DNPR was 95.6% (95% CI 91.5–98.1), with PPVs of 90.3% (95% CI 82.4–95.5) for gastric ulcer diagnoses, and 94.4% (95% CI 87.4–98.2) for duodenal ulcer diagnoses. PPVs were constant over time. Conclusion The PPV of uncomplicated peptic ulcer diagnoses in the DNPR is high, and the location of the ulcers is registered correctly in most cases, indicating that the diagnoses are useful for research purposes. PMID:28503076

Positive predictive value of peptic ulcer diagnosis codes in the Danish National Patient Registry.

PubMed

Viborg, Søren; Søgaard, Kirstine Kobberøe; Jepsen, Peter

2017-01-01

Diagnoses of peptic ulcer are registered in the Danish National Patient Registry (DNPR) for administrative as well as research purposes, but it is unknown whether the coding validity depends on the location of the ulcer. To validate the International Classification of Diseases, 10 th revision diagnosis codes of peptic ulcer in the DNPR by estimating positive predictive values (PPVs) for gastric and duodenal ulcer diagnoses. We identified all patients registered with a hospital discharge diagnosis of peptic ulcer from Aarhus University Hospital, Denmark, in 1995-2006. Among them, we randomly selected 200 who had an outpatient gastroscopy at the time of ulcer diagnosis. We reviewed the findings from these gastroscopies to confirm the presence of peptic ulcer and its location. We calculated PPVs and corresponding 95% confidence intervals (CIs) of gastric and duodenal ulcer diagnoses, using descriptions from the gastroscopic examinations as standard reference. In total, 182 records (91%) were available for review. The overall PPV of peptic ulcer diagnoses in DNPR was 95.6% (95% CI 91.5-98.1), with PPVs of 90.3% (95% CI 82.4-95.5) for gastric ulcer diagnoses, and 94.4% (95% CI 87.4-98.2) for duodenal ulcer diagnoses. PPVs were constant over time. The PPV of uncomplicated peptic ulcer diagnoses in the DNPR is high, and the location of the ulcers is registered correctly in most cases, indicating that the diagnoses are useful for research purposes.

Pyogenic brain abscess, a 15 year survey

PubMed Central

2012-01-01

Background Brain abscess is a potentially fatal disease. This study assesses clinical aspects of brain abscess in a large hospital cohort. Methods Retrospective review of adult patients with pyogenic brain abscess at Rigshospitalet University Hospital, Denmark between 1994 and 2009. Prognostic factors associated with Glasgow Outcome Score (GOS) (death, severe disability or vegetative state) were assessed by logistic regression. Results 102 patients were included. On admission, only 20% of patients had a triad of fever, headache and nausea, 39% had no fever, 26% had normal CRP and 49% had no leucocytosis. Median delay from symptom onset to antibiotic treatment was 7 days (range 0–97 days). Source of infection was contiguous in 36%, haematogenous in 28%, surgical or traumatic in 9% and unknown in 27% of cases. Abscess location did not accurately predict the portal of entry. 67% were treated by burr hole aspiration, 20% by craniotomy and 13% by antibiotics alone. Median duration of antibiotic treatment was 62 days. No cases of recurrent abscess were observed. At discharge 23% had GOS ≤3. The 1-, 3- and 12-month mortality was 11%, 17% and 19%. Adverse outcome was associated with a low GCS at admission, presence of comorbidities and intraventricular rupture of abscess. Conclusions The clinical signs of brain abscess are unspecific, many patients presented without clear signs of infection and diagnosis and treatment were often delayed. Decreased GCS, presence of comorbidities and intraventricular rupture of brain abscess were associated with poor outcome. Brain abscess remains associated with considerable morbidity and mortality. PMID:23193986

Afternoon serum-melatonin in sleep disordered breathing.

PubMed

Ulfberg, J; Micic, S; Strøm, J

1998-08-01

To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

Positive predictive value of cardiac examination, procedure and surgery codes in the Danish National Patient Registry: a population-based validation study

PubMed Central

Adelborg, Kasper; Sundbøll, Jens; Munch, Troels; Frøslev, Trine; Sørensen, Henrik Toft; Bøtker, Hans Erik; Schmidt, Morten

2016-01-01

Objective Danish medical registries are widely used for cardiovascular research, but little is known about the data quality of cardiac interventions. We computed positive predictive values (PPVs) of codes for cardiac examinations, procedures and surgeries registered in the Danish National Patient Registry during 2010–2012. Design Population-based validation study. Setting We randomly sampled patients from 1 university hospital and 2 regional hospitals in the Central Denmark Region. Participants 1239 patients undergoing different cardiac interventions. Main outcome measure PPVs with medical record review as reference standard. Results A total of 1233 medical records (99% of the total sample) were available for review. PPVs ranged from 83% to 100%. For examinations, the PPV was overall 98%, reflecting PPVs of 97% for echocardiography, 97% for right heart catheterisation and 100% for coronary angiogram. For procedures, the PPV was 98% overall, with PPVs of 98% for thrombolysis, 92% for cardioversion, 100% for radiofrequency ablation, 98% for percutaneous coronary intervention, and 100% for both cardiac pacemakers and implantable cardiac defibrillators. For cardiac surgery, the overall PPVs was 99%, encompassing PPVs of 100% for mitral valve surgery, 99% for aortic valve surgery, 98% for coronary artery bypass graft surgery, and 100% for heart transplantation. The accuracy of coding was consistent within age, sex, and calendar year categories, and the agreement between independent reviewers was high (99%). Conclusions Cardiac examinations, procedures and surgeries have high PPVs in the Danish National Patient Registry. PMID:27940630

Acquisition of Oceanographic Measurements from Baleen Whales and Acquisition of Oceanographic Measurements from Baleen Whales: Field Deployments of Tags Developed Under Grant ONR (N00014-13-1-0854)

DTIC Science & Technology

2015-09-30

Jonas Teilmann Department of Bioscience Aarhus University Fredriksborgvej 399 DK-4000 Roskilde Denmark phone: +45 21424291 fax: +45 87 16 87 51...Mammal Research Unit (SMRU, www.smru.st-andrews.ac.uk), University of St. Andrews, Scotland. WORK COMPLETED The project developed a prototype CTD...temperature and depth components from that work along with the tag controller/transmitter etc, are all still valid. • The risk for building a new tag fall

Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors.

PubMed

Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther; Thorne, Sally; Lomborg, Kirsten

The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may be compromised by HCP attitudes and conduct. These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.

University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians

PubMed Central

2014-01-01

Background German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Methods Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Results Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1–2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3–4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Conclusion Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success. PMID:24755299

University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

PubMed

Degen, Christiane; Kuntz, Ludwig

2014-04-23

German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.

Predictors of international students' psychological and sociocultural adjustment to the context of reception while studying at Aarhus University, Denmark.

PubMed

Ozer, Simon

2015-12-01

The number of international students engaging in intercultural education and thereby adjusting to cross-cultural transition has risen conspicuously as a consequence of globalization and increased mobility. This process of acculturation has been associated with increased creativity as well as adaptation challenges. This paper investigates international students' psychological and sociocultural adjustment to studying at Aarhus University in Denmark. Both international students (n = 129) and domestic students (n = 111) participated in the study. The international students did not report impaired psychological conditions as compared to the control group of domestic students. However, the international students reported a significantly lower level of social support. Social support and perceived discrimination were significant predictors of both psychological and sociocultural adjustment. Additionally, the level of English proficiency alone predicted sociocultural adjustment. Values of vertical individualism and horizontal collectivism predicted psychological adjustment. Finally, integration was found to be a significantly more adaptive acculturation orientation than separation in regard to sociocultural adjustment. These findings were discussed in relation to relevant international research and it was concluded that international students comprise a resourceful student sample and that the international academic environment at Aarhus University appears to be an adequately cultural and value-oriented good fit as a context of reception for the multicultural engagement of international students. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Assessing the role of GPs in Nordic health care systems.

PubMed

Quaye, Randolph K

2016-05-03

Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the "gate keeping" role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.

The Basic Courses for the Study of Religions at the University of Southern Denmark

ERIC Educational Resources Information Center

Jensen, Tim

2015-01-01

This essay is part of a collection of short essays solicited from authors around the globe who teach religion courses at the college level (not for professional religious training). They are published together with an introduction in "Teaching Theology and Religion" 18:3 (July 2015). The authors were asked to provide a brief overview of…

Social and Spatial Disparities in Emotional Responses to Education: Feelings of "Guilt" among Student-Parents

ERIC Educational Resources Information Center

Brooks, Rachel

2015-01-01

This article explores the emotional responses to higher education of students with dependent children, and draws on 68 in-depth interviews conducted with student-parents in universities in the UK and Denmark. By focussing on one specific emotion--guilt--it contends that emotions are important in helping to understand the way in which particular…

The Influence of Strategy and External Quality Audit on University Performance: An Australian Perspective

ERIC Educational Resources Information Center

Shah, Mahsood; Nair, Sid

2011-01-01

External quality audits have been introduced in many parts of the world including Asia Pacific, Asia, Africa, Europe, and the Middle East. While external quality audits have been introduced for more than a decade in some countries like New Zealand, the United Kingdom (UK), Denmark, and Sweden, there is limited research on the extent to which such…

Aerospace Medicine and Biology: A Continuing Bibliography with Indexes

DTIC Science & Technology

1987-09-01

drug against motion sickness more closely than any other medication. Author A87-35422 THE USE OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IN AVIATORS A87...diagnosis and treatment Denmark) Aviation, Space, and Environmental Medicine (ISSN Extracorporeal shock wave lithotripsy (ESWL) has recently become 0095...and M. J. GRIFFIN ( Southampton , University, functional mechanisms are insufficient. Solutions are discussed England) Aviation, Space, and Environmental

The outcome of antenatal ultrasound diagnosed anomalies of the kidney and urinary tract in a large Danish birth cohort.

PubMed

Andrés-Jensen, Liv; Jørgensen, Finn Stener; Thorup, Jorgen; Flachs, Julie; Madsen, Jan Lysgaard; Maroun, Lisa Leth; Nørgaard, Pernille; Vinicoff, Pablo Gustavo; Olsen, Beth Härstedt; Cortes, Dina

2016-09-01

Antenatal ultrasound diagnosed anomalies of the kidney and urinary tract (AUDAKUT) are reported in 0.3%-5% on prenatal ultrasound (US) and 0.3%-4.5% on postnatal US. The anterior-posterior diameter of the renal pelvis (APD) is an essential measurement. Series with low threshold values of APD prenatally and postnatally will include healthy infants. It is important to avoid follow-up of such infants. In 2006, new Danish guidelines for AUDAKUT were introduced. Investigations of incidences and type of AUDAKUT based on Danish guidelines, including long-term follow-up. Cohort study. Copenhagen University Hospital Hvidovre and Copenhagen University Hospital Rigshospitalet, Denmark. Consecutive cases with AUDAKUT in the second and third trimesters, which were either terminated before 22 completed weeks of gestation or born in the 8-year period January 2006-December 2013. Patients were followed until June 2014. 50 193 live born children and 24 terminated fetuses (0.05%) were included. The prevalence of AUDAKUT was only 0.39% prenatally, 0.29% at first postnatal US and 0.22% at the end of follow-up, including terminated cases. The greater the prenatal and postnatal APD, the higher risk of febrile urinary tract infection (fUTI) and surgical intervention, and lower probability of resolution. 25% of the identified patients had fUTI and/or surgery. We recommend threshold values of APD at least 10 mm in the third trimester and in general at least 12 mm at first postnatal US for intensive follow-up. In this largest to date unselected birth cohort of AUDAKUT, the incidences of clinically significant AUDAKUT were in the lowest range of those previously published. 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/

Heritability and familial aggregation of diverticular disease: a population-based study of twins and siblings.

PubMed

Strate, Lisa L; Erichsen, Rune; Baron, John A; Mortensen, Jakob; Pedersen, Jacob Krabbe; Riis, Anders H; Christensen, Kaare; Sørensen, Henrik Toft

2013-04-01

Little is known about the role of heritable factors in diverticular disease. We evaluated the contribution of heritable factors to the development of diverticular disease diagnosed at a hospitalization or outpatient visit. Using nationwide patient registries, we identified 142,123 incident cases of diverticular disease diagnosed at a hospitalization (1977-2011) or an outpatient hospital visit (1995-2011) in Denmark, including cases in 10,420 index siblings and 923 twins. We calculated standardized incidence ratios for siblings versus the general population and concordance rates for monozygotic versus dizygotic twin pairs as measures of relative risk (RR). The RR for diverticular disease in siblings of index cases was 2.92 (95% confidence interval [CI], 2.50-3.39) compared with the general population. The RRs were similar irrespective of the sex of the sibling or index case and were particularly strong in siblings of hospitalized cases and cases that underwent surgery. The proband-wise concordance rate for monozygotic twins was double that of dizygotic twins (0.16 [95% CI, 0.11-0.22] vs 0.07 [95% CI, 0.05-0.11], respectively). The RR of diverticular disease in one twin when the other had diverticular disease was 14.5 (95% CI, 8.9-23) for monozygotic twins compared with 5.5 (95% CI, 3.3-8.6) for dizygotic twins. Associations were stronger in female monozygotic twins compared with male twins (tetrachoric correlation, 0.60 [95% CI, 0.49-0.70] vs 0.33 [95% CI, 0.13-0.51]; P = .03 in an analysis stratified by sex and zygosity). We estimate that 53% (95% CI, 45%-61%) of susceptibility to diverticular disease results from genetic factors. Based on a population-based study in Denmark, genetic factors appear to contribute to development of diverticular disease. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis? A nation-wide study from the Danish Palliative Care Database (DPD).

PubMed

Adsersen, Mathilde; Thygesen, Lau Caspar; Jensen, Anders Bonde; Neergaard, Mette Asbjoern; Sjøgren, Per; Groenvold, Mogens

2017-03-23

Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were to investigate whether cancer patients' admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both). This was a register-based study of adult patients living in Denmark who died from cancer in 2010-2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression. In the study population (N = 44,548) the overall admittance proportion to SPC was 37%. Higher odds of overall admittance to SPC were found for women (OR = 1.23; 1.17-1.28), younger patients (<40 compared with 80+ years old) (OR = 6.44; 5.19-7.99) and patients with sarcoma, pancreatic and stomach cancers, whereas the lowest were for patients with haematological malignancies. The higher admission found for women was most pronounced for hospices compared to hospital-based palliative care teams/units, whereas higher admission of younger patients was more pronounced for hospital-based palliative care teams/units. Patients with brain cancer were more often admitted to hospices, whereas patients with prostate cancer were more often admitted to hospital-based palliative care teams/units. It is unlikely that the variations in relation to sex, age and cancer diagnoses can be fully explained by differences in need. Future research should investigate whether the groups having the lowest admittance to SPC receive sufficient palliative care elsewhere.

[Physician shortage in Japan: the new postgraduate medical education program and physicians as a human medical resource].

PubMed

Nomura, Kyoko

2011-01-01

Japan now faces a serious physician shortage. After introducing the new postgraduate medical education (PGME) system and doctor-to-facility matching system, residents shifted their teaching hospitals from university hospitals to non-university hospitals. Because university hospitals had played a central role in allocating physicians to communities, the decrease in the number of physicians at university hospitals has driven this physician shortage. Japanese policymakers blame the new PGME for exacerbating this physician shortage and have tentatively agreed to reform the PGME to encourage residents to return to university hospitals. However, the PGME system should not be reformed only for political reasons; such a change requires a scientific basis. First, after the introduction of the new PGME, residents showed an improved clinical competence; therefore, it has accomplished its ultimate goal. Second, the residents' satisfaction level in terms of the residency system and clinical skills training was significantly higher at non-university hospitals than at university hospitals. This implies that training conditions at university hospitals are not as good as at non-university hospitals, which explains the decrease in the number of physicians at university hospitals. Third, in 2009, the Japanese government increased the maximum medical school enrollment to mitigate the physician shortage. However, a simple increase does not solve the problem of physician shortage unless it also addresses the problem of physician maldistribution. Fourth, the number of females entering medicine is increasing, and women constituted 30% of newly certified physicians in 2010. In this era of physician shortage, female physicians are highly recommended as a human medical resource.

HLA DQB1*06:02 Negative Narcolepsy with Hypocretin/Orexin Deficiency

PubMed Central

Han, Fang; Lin, Ling; Schormair, Barbara; Pizza, Fabio; Plazzi, Giuseppe; Ollila, Hanna M.; Nevsimalova, Sona; Jennum, Poul; Knudsen, Stine; Winkelmann, Juliane; Coquillard, Cristin; Babrzadeh, Farbod; Strom, Tim M.; Wang, Chunlin; Mindrinos, Michael; Vina, Marcelo Fernandez; Mignot, Emmanuel

2014-01-01

Study Objectives: To identify rare allelic variants and HLA alleles in narcolepsy patients with hypocretin (orexin, HCRT) deficiency but lacking DQB1*06:02. Settings: China (Peking University People's Hospital), Czech Republic (Charles University), Denmark (Golstrup Hospital), Italy (University of Bologna), Korea (Catholic University), and USA (Stanford University). Design: CSF hypocretin-1, DQB1*06:02, clinical and polysomnographic data were collected in narcolepsy patients (552 with and 144 without cataplexy) from 6 sites. Numbers of cases with and without DQB1*06:02 and low CSF hypocretin-1 were compiled. HLA class I (A, B, C), class II (DRBs, DQA1, DQB1, DPA1, and DPB1), and whole exome sequencing were conducted in 9 DQB1*06:02 negative cases with low CSF hypocretin-1. Sanger sequencing of selected exons in DNMT1, HCRT, and MOG was performed to exclude mutations in known narcolepsy-associated genes. Measurements and Results: Classic narcolepsy markers DQB1*06:02 and low CSF hypocretin-1 were found in 87.4% of cases with cataplexy, and in 20.0% without cataplexy. Nine cases (all with cataplexy) were DQB1*06:02 negative with low CSF hypocretin-1, constituting 1.7% [0.8%-3.4%] of all cases with cataplexy and 1.8% [0.8%-3.4%] of cases with low CSF hypocretin independent of cataplexy across sites. Five HLA negative subjects had severe cataplexy, often occurring without clear triggers. Subjects had diverse ethnic backgrounds and HLA alleles at all loci, suggesting no single secondary HLA association. The rare subtype DPB1*0901, and homologous DPB1*10:01 subtype, were present in 5 subjects, suggesting a secondary association with HLA-DP. Preprohypocretin sequencing revealed no mutations beyond one previously reported in a very early onset case. No new MOG or DNMT1 mutations were found, nor were suspicious or private variants in novel genes identified through exome sequencing. Conclusions: Hypocretin, MOG, or DNMT1 mutations are exceptional findings in DQB1*06:02 negative cases with hypocretin deficiency. A secondary HLA-DP association may be present in these cases. These represent particularly difficult diagnostic challenges. Citation: Han F, Lin L, Schormair B, Pizza F, Plazzi G, Ollila HM, Nevsimalova S, Jennum P, Knudsen S, Winkelmann J, Coquillard C, Babrzadeh F, Strom TM, Wang C, Mindrinos M, Vina MF, Mignot E. HLA DQB1*06:02 negative narcolepsy with hypocretin/orexin deficiency. SLEEP 2014;37(10):1601-1608. PMID:25197808

First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder.

PubMed

Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Ojvind; Mortensen, Preben Bo

2012-02-01

Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth. Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007. Denmark. All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth. Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group. Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.

A qualitative assessment of implementing a cross-cultural survey on cancer wards in Denmark - a description of barriers

PubMed Central

2010-01-01

Background Research into migration and health is often confronted with methodological challenges related to the identification of migrants in various settings. Furthermore, it is often difficult to reach an acceptable level of participation among migrant groups in quantitative research. The aim of this study is to conduct a qualitative assessment of the barriers encountered during the implementation of a cross-cultural survey on cancer wards in Copenhagen, Denmark. Methods Participant observation at the involved wards was combined with qualitative interviews with selected nurses and informal talks with a wider group of nurses at the wards involved in the survey. Results One possible way to increase the participation of migrant patients in research is through the involvement of the hospital staff in contact with patients. Involvement of nurses on cancer wards in the delivery of questionnaires to patients was challenging, despite a general willingness to participate in psychosocial research. The main difficulties were found to be both external (policy changes, general strike among nurses) and internal on the wards (heavy workload, lack of time, focus on medical aspects of cancer rather than psychosocial aspects). These factors interacted and resulted in a lower priority being given to psychosocial research. Further, nurses expressed a feeling that researchers in general did not recognize their contribution in research, making it more difficult to engage fully in studies. Conclusions Involving hospital staff in research is feasible but not straightforward. Awareness of the influence of possible external and internal factors and efforts to deal with these factors are fundamental to the successful implementation of psychosocial cancer research in a hospital setting. PMID:20067615

Empirical investigation of the ethical reasoning of physicians and molecular biologists - the importance of the four principles of biomedical ethics.

PubMed

Ebbesen, Mette; Pedersen, Birthe D

2007-10-25

This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. 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. In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice. This study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress - respect for autonomy, beneficence, nonmaleficence and justice - are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting.

Empirical investigation of the ethical reasoning of physicians and molecular biologists – the importance of the four principles of biomedical ethics

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2007-01-01

Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method 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 In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice. Conclusion This study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. PMID:17961251

Noninvasive Retinal Markers in Diabetic Retinopathy: Advancing from Bench towards Bedside

PubMed Central

Blindbæk, Søren Leer; Torp, Thomas Lee; Lundberg, Kristian; Soelberg, Kerstin; Vergmann, Anna Stage; Poulsen, Christina Døfler; Frydkjaer-Olsen, Ulrik; Broe, Rebecca; Rasmussen, Malin Lundberg; Wied, Jimmi; Lind, Majbrit; Vestergaard, Anders Højslet; Peto, Tunde

2017-01-01

The retinal vascular system is the only part of the human body available for direct, in vivo inspection. Noninvasive retinal markers are important to identity patients in risk of sight-threatening diabetic retinopathy. Studies have correlated structural features like retinal vascular caliber and fractals with micro- and macrovascular dysfunction in diabetes. Likewise, the retinal metabolism can be evaluated by retinal oximetry, and higher retinal venular oxygen saturation has been demonstrated in patients with diabetic retinopathy. So far, most studies have been cross-sectional, but these can only disclose associations and are not able to separate cause from effect or to establish the predictive value of retinal vascular dysfunction with respect to long-term complications. Likewise, retinal markers have not been investigated as markers of treatment outcome in patients with proliferative diabetic retinopathy and diabetic macular edema. The Department of Ophthalmology at Odense University Hospital, Denmark, has a strong tradition of studying the retinal microvasculature in diabetic retinopathy. In the present paper, we demonstrate the importance of the retinal vasculature not only as predictors of long-term microvasculopathy but also as markers of treatment outcome in sight-threatening diabetic retinopathy in well-established population-based cohorts of patients with diabetes. PMID:28491870

Antenatal group consultations: Facilitating patient-patient education.

PubMed

Nisbeth Jensen, Matilde; Fage-Butler, Antoinette Mary

2016-12-01

This article investigates the perspectives of pregnant women attending antenatal group consultations to gain their understandings of whether and how peer learning is facilitated in this setting. We conducted semi-structured individual interviews with 16 women who had participated in group consultations at Aarhus University Hospital, Denmark, and analysed the data using qualitative content analysis. Our research design also included observations and patient guest book data. Women who were pregnant for the first time greatly appreciated the experiential knowledge of multiparous women in the group. Group consultations provided new learning opportunities, as individuals' questions prompted learning within the groups, as well as questions and answers. There was more time for reflection in group consultations than in dyadic communication. Midwives played a key role in facilitating peer learning. Some topics were not deemed appropriate for discussion. Antenatal group consultations can support learning, as individuals participate positively both in their own knowledge acquisition and that of others. We call such peer learning patient-patient education. Our study indicates the strengths of group consultations for learning from the perspective of the group members. It highlights how learning may be facilitated in group consultations, and thus has broad practical relevance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Validation of a Screening Questionnaire for Chronic Leg Ulcers.

PubMed

Zarchi, Kian; Theut Riis, Peter; Graversgaard, Christine; Miller, Iben M; Heidenheim, Michael; Jemec, Gregor B E

2016-12-01

The use of a validated screening questionnaire to identify individuals with chronic leg ulcers allows large-scale population-based studies to be conducted that measure and monitor the prevalence of the disease. The aim of this study was to design and validate such a screening questionnaire to identify patients with chronic leg ulcers. A simple 3-item questionnaire was developed at the Department of Dermatology, University Hospital of Zealand, Denmark. In total, 90 patients attending the department's outpatient clinic for dermatological diseases and chronic wounds were included in this study. All included participants completed the questionnaire and were subsequently examined by dermatologists. We found that the constructed 3-item questionnaire in this study had a sensitivity and specificity of 95% and 93% and a positive predictive value and negative predictive value of 78% and 95%, respectively. Moreover, we found that the use of the 3-item questionnaire, as compared with a single question, in which the participants were asked whether they currently have a leg ulcer, resulted in significantly higher positive predictive value (+11.6%, P = .035) and specificity (+5.6%, P = .046) of the diagnostic test. Future studies are merited to investigate the diagnostic accuracy of the questionnaire in other populations and settings.

Use of a national hospitalization register to identify industrial sectors carrying high risk of severe injuries: a three-year cohort study of more than 900,000 Danish men.

PubMed

Baarts, C; Mikkelsen, K L; Hannerz, H; Tüchsen, F

2000-12-01

Data indicates that Denmark has relatively high risks of occupational injuries. We evaluated all injuries resulting in hospitalization by occupation. All gainfully employed men younger than 60 in 1990 were divided into 47 industrial groups and followed using the National Inpatient Registry, for hospitalized injuries 1991-1993. Following ICD-8, injuries were grouped into six categories: head, upper extremities, back, trunk, lower extremities and ruptures, sprains and strains. Standardized industrial hospitalization ratios (SHRs) were calculated and Pearson's independence test was performed for each category. Industrial differences were ascertained for each injury category. The highest associated injury category was upper extremity injuries ranging from SHR = 43 (fire services and salvage corps) to SHR = 209 (slaughterhouse industry). Carpentry, joinery, bricklaying and construction work had significantly high SHRs for all injury categories, whereas administrative work was significantly low throughout. Occupational surveillance systems based on hospitalized injuries can be used to identify high-risk industries, and thereby suggest where to direct prevention efforts. Copyright 2000 Wiley-Liss, Inc.

Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees.

PubMed

Török, Eszter; Clark, Alice Jessie; Jensen, Johan Høy; Lange, Theis; Bonde, Jens Peter; Bjorner, Jakob Bue; Rugulies, Reiner; Hvidtfeldt, Ulla Arthur; Hansen, Åse Marie; Ersbøll, Annette Kjær; Rod, Naja Hulvej

2018-06-06

There is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social capital predicts a lower risk of individual long-term sickness absence among Danish hospital employees followed prospectively for 1 year. This study is based on the Well-being in HospitAL Employees cohort. The study sample consisted of 32 053 individuals nested within 2182 work-units in the Capital Region of Denmark. Work-unit social capital was measured with an eight-item scale covering elements of trust, justice and collaboration between employees and leaders. Social capital at the work-unit level was computed as the aggregated mean of individual-level social capital within each work-unit. Data on long-term sickness absence were retrieved from the employers' payroll system and were operationalised as ≥29 consecutive days of sickness absence. We used a 12-point difference in social capital as the metric in our analyses and conducted two-level hierarchical logistic regression analysis. Adjustments were made for sex, age, seniority, occupational group and part-time work at the individual level, and work-unit size, the proportion of female employees and the proportion of part-time work at the work-unit level. The OR for long-term sickness absence associated with a 12-point higher work-unit social capital was 0.73 (95% CI 0.68 to 0.78). Further, we found an association between higher work-unit social capital and lower long-term sickness absence across quartiles of social capital: compared with the lowest quartile, the OR for long-term sickness absence in the highest quartile was 0.51 (95% CI 0.44 to 0.60). Our study provides support for work-unit social capital being a protective factor for individual long-term sickness absence among hospital employees in the Capital Region of Denmark. © 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.

Improvement of clinical quality indicators through reorganization of the acute care by establishing an emergency department-a register study based on data from national indicators.

PubMed

Mattsson, Maria Søe; Mattsson, Nick; Jørsboe, Hanne B

2014-11-05

The Emergency Departments (EDs) reorganization process in Denmark began in 2007 and includes creating a single entrance for all emergency patients, establishing triage, having a specialist in the front and introducing the use of electronic overview boards and electronic patient files. The aim of this study was to investigate the quality of acute care in a re-organized ED based on national indicator project data in a pre and post reorganizational setting. Quasi experimental design was used to examine the effect of the health care quality in relation to the reorganization of an ED. Patients admitted at Nykøbing Falster Hospital in 2008 or 2012 were included in the study and data reports from the national databases (RKKP) regarding stroke, COPD, heart failure, bleeding and perforated ulcer or hip fracture were analysed. Holbæk Hospital works as a control hospital. Chi-square test was used for analysing significant differences from pre-and post intervention and Z-test to compare the experimental groups to the control group (HOL). P < 0.05 was considered statistically significant. We assessed 4584 patient cases from RKKP. A significant positive change was seen in all of the additional eight indicators related to stroke at NFS (P < 0.001); however, COPD indicators were unchanged in both hospitals. In NFS two of eight heart failure indicators were significantly improved after the reorganization (p < 0.01). In patients admitted with a bleeding ulcer 2 of 5 indicators were significantly improved after the reorganization in NFS and HOL (p < 0.01). Both compared hospitals showed significant improvements in the two indicators concerning hip fracture (p < 0.001). Significant reductions in the 30 day-mortality in patients admitted with stroke were seen when the pre- and the post-intervention data were compared for both NFS and HOL (p = 0.024). During the organisation of the new EDs, several of the indicators improved and the overall 30 days mortality decreased in the five diseases. The development of a common set of indicators for monitoring acute treatment at EDs in Denmark is recommended.

Effect of a Computerized Provider Order Entry (CPOE) System on Medication Orders at a Community Hospital and University Hospital

PubMed Central

Wess, Mark L.; Embi, Peter J.; Besier, James L.; Lowry, Chad H.; Anderson, Paul F.; Besier, James C.; Thelen, Geriann; Hegner, Catherine

2007-01-01

Computerized Provider Order Entry (CPOE) has been demonstrated to improve the medication ordering process, but most published studies have been performed at academic hospitals. Little is known about the effects of CPOE at community hospitals. With a pre-post study design, we assessed the effects of a CPOE system on the medication ordering process at both a community and university hospital. The time from provider ordering to pharmacist verification decreased by two hours with CPOE at the community hospital (p<0.0001) and by one hour at the university hospital (p<0.0001). The rate of medication clarifications requiring signature was 2.80 percent pre-CPOE and 0.40 percent with CPOE (p<0.0001) at the community hospital. The university hospital was 2.76 percent pre-CPOE and 0.46 percent with CPOE (p<0.0001). CPOE improved medication order processing at both community and university hospitals. These findings add to the limited literature on CPOE in community hospitals. PMID:18693946

State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

Assessing advertising content in a hospital advertising campaign: An application of Puto and Wells (1984) measure of informational and transformational advertising content.

PubMed

Menon, Mohan K; Goodnight, Janelle M; Wayne, Robin J

2006-01-01

The following is a report of a study designed to measure advertising content based on the cognitive and affective elements of informational (i.e., information processing) and transformational (i.e., experiential) content using the measure of advertising informational and transformational content developed by Puto and Wells (1984). A university hospital advertising campaign designed to be high in transformational content did not appear to affect perceived quality of local university hospitals relative to private hospitals or increase the likelihood of choosing a university hospital in the future. Further, experiences with university hospitals that seemed to be in direct contrast to the content of the advertisements based on subject perceptions affected how university hospital advertisements were perceived in terms of content. Conclusions and implications for hospital advertising campaigns are discussed.

Testing alternative factor models of PTSD and the robustness of the dysphoria factor.

PubMed

Elklit, Ask; Armour, Cherie; Shevlin, Mark

2010-01-01

This study first aimed to examine the structure of self-reported posttraumatic stress disorder (PTSD) symptoms using three different samples. The second aim of the paper was to test the robustness of the factor analytic model when depression scores were controlled for. Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The best fitting model was subsequently re-fitted to the data after including a depression variable. The analyses were based on responses from 973 participants across three samples. Sample 1 consisted of 633 parents who were members of 'The National Association of Infant Death' and who had lost a child. Sample 2 consisted of 227 victims of rape, who completed a questionnaire within 4 weeks of the rape. Each respondent had been in contact with the Centre for Rape Victims (CRV) at the Aarhus University Hospital, Denmark. Sample 3 consisted of 113 refugees resident in Denmark. All participants had been referred to a treatment centre which focused on rehabilitating refugees through treatment for psychosocial integration problems (RRCF: Rehabliterings og Revliderings Centre for Flygtninge). In total 500 participants received a diagnosis of PTSD/sub-clinical PTSD (Sample 1, N=214; 2, N=176; 3, N=110). A correlated four-factor model with re-experiencing, avoidance, dysphoria, and arousal factors provided the best fit to the sample data. The average attenuation in the factor loadings was highest for the dysphoria factor (M=-.26, SD=.11) compared to the re-experiencing (M=-.14, SD=.18), avoidance (M=-.10, SD=.21), and arousal (M=-.09, SD=.13) factors. With regards to the best fitting factor model these results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings. The attenuation of dysphoria factor loadings suggests that dysphoria is a non-specific component of PTSD.

Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study

PubMed Central

Michaëlis, Camilla; Kristiansen, Maria; Norredam, Marie

2015-01-01

Objective To examine quality of life and coping strategies among immigrant women living with chronic pain. Design Qualitative content analysis based on in-depth semistructured interviews. Setting A clinic specifically targeting immigrants at a larger university hospital in Copenhagen, Denmark. Participants Non-western female immigrant patients suffering from chronic pain (n=13). Main outcome measures Experiences of the impact of chronic pain on quality of life. Results Chronic pain was perceived to have an extensive, adverse effect on all aspects of quality of life, including physical health, mental well-being and social relations. This included the ability to maintain activities of daily living and the ability to work. Chronic pain was further experienced as a cause of emotional distress, depression and altered personalities, which all had great consequences on women's social interactions, causing change and loss of social relations. A variety of coping strategies were used to cope with the pain, manage its consequences, and restore a level of health that would enable women to function and fulfil social roles. Many participants coped with the pain by altering everyday life, keeping daily activities to a minimum and taking pain-killing drugs, offering temporary relief. Seeking healthcare was another coping strategy used as an active means to assert agency and as a temporary distraction from pain. However, accessing healthcare also involved a risk of disagreement and disappointments. Conclusions Chronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain. PMID:26163036

Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study.

PubMed

Michaëlis, Camilla; Kristiansen, Maria; Norredam, Marie

2015-07-10

To examine quality of life and coping strategies among immigrant women living with chronic pain. Qualitative content analysis based on in-depth semistructured interviews. A clinic specifically targeting immigrants at a larger university hospital in Copenhagen, Denmark. Non-western female immigrant patients suffering from chronic pain (n=13). Experiences of the impact of chronic pain on quality of life. Chronic pain was perceived to have an extensive, adverse effect on all aspects of quality of life, including physical health, mental well-being and social relations. This included the ability to maintain activities of daily living and the ability to work. Chronic pain was further experienced as a cause of emotional distress, depression and altered personalities, which all had great consequences on women's social interactions, causing change and loss of social relations. A variety of coping strategies were used to cope with the pain, manage its consequences, and restore a level of health that would enable women to function and fulfil social roles. Many participants coped with the pain by altering everyday life, keeping daily activities to a minimum and taking pain-killing drugs, offering temporary relief. Seeking healthcare was another coping strategy used as an active means to assert agency and as a temporary distraction from pain. However, accessing healthcare also involved a risk of disagreement and disappointments. Chronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain. 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.

Financial Analysis of National University Hospitals in Korea.

PubMed

Lee, Munjae

2015-10-01

This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

Financial Analysis of National University Hospitals in Korea

PubMed Central

Lee, Munjae

2015-01-01

Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

Association Between Pandemic Influenza A(H1N1) Vaccination in Pregnancy and Early Childhood Morbidity in Offspring.

PubMed

Hviid, Anders; Svanström, Henrik; Mølgaard-Nielsen, Ditte; Lambach, Philipp

2017-03-01

Several studies investigating potential adverse effects of the pandemic A(H1N1) vaccine have supported that influenza A(H1N1) vaccination does not increase the risk for major pregnancy and birth adverse outcomes, but little is known about possible adverse effects in offspring of A(H1N1)-vaccinated mothers beyond the perinatal period and into early childhood. To evaluate whether pandemic influenza A(H1N1) vaccination in pregnancy increases the risk for early childhood morbidity in offspring. Register-based cohort study comprising all live-born singleton children in Denmark from pregnancies overlapping the A(H1N1) influenza vaccination campaign in Denmark, from November 2, 2009, to March 31, 2010. From a cohort of 61 359 pregnancies, offspring exposed and unexposed to the influenza A(H1N1) vaccine during pregnancy were matched 1:4 on propensity scores. Vaccination in pregnancy with a monovalent inactivated AS03-adjuvanted split virion influenza A(H1N1)pdm09 vaccine (Pandemrix; GlaxoSmithKline Biologicals). Rate ratios of hospitalization in early childhood until 5 years of age. Hospitalization was defined as (1) first inpatient hospital admission, (2) all inpatient hospital admissions, and (3) first hospital contact for selected diseases, which included individual infectious diseases and individual neurologic, autoimmune, and behavioral conditions. The mean (SD) age at end of follow-up was 4.6 (0.40) years for the 61 359 children included in the study. In the cohort, the mothers of 55 048 children were unvaccinated, 349 mothers were vaccinated in the first trimester, and 5962 mothers were vaccinated in the second or third trimesters. Children exposed in the first trimester were not more likely to be hospitalized in early childhood than unexposed children (hospitalization rates per 1000 person-years, 300.6 for exposed vs 257.5 for unexposed; rate ratio, 1.17; 95% CI, 0.94-1.45). Similarly, children exposed in the second or third trimester were not more likely to be hospitalized in early childhood than unexposed children (hospitalization rates per 1000 person-years, 203.6 for exposed vs 219.3 for unexposed; rate ratio, 0.93; 95% CI, 0.87-0.99). This 7% decreased risk was primarily a result of reduced risks for infectious disease-related hospitalizations. To our knowledge, this is the most comprehensive study to date of potential adverse effects manifesting after the perinatal period. We detected no increased risk for early childhood morbidity. These results support the safety profile of the influenza A(H1N1) vaccine used in pregnancy.

Reactive Swarm Formation Control Using Realistic Surface Vessel Dynamics and Environmental Effects

DTIC Science & Technology

2012-05-10

hour per response, including the time for reviewing instructions. searching existing data sources. gathering and maintaining the data needed, and...1997, 2001, 2003, % % %(#) Department fo Automation % Danish Technical University, DTU . % DK 2800 Kgs. Lyngby, Denmark...tristan.perez@ntnu.no % Date: 2005-05-04 % Comments: %Adapted from the files reference (*) to match the data of the vessel %design of ADI-Limited

Learning Problems of Junior Level Children: A Nordic Joint Research Project (No. 2108).

ERIC Educational Resources Information Center

Jansson, Karin, Ed.

1981-01-01

Four cities in Norway, Sweden, and Denmark have been engaged since 1977 in a joint study of the junior level of elementary school. (More than 5,000 pupils are involved in the study.) The Department of Education at the University of Turku joined the project in the autumn term of 1979. The purpose of the Swedish project, reported here, was to…

[Treatment of gamma-hydroxybutyrate withdrawal].

PubMed

Strand, Niels August Willer; Petersen, Tonny Studsgaard; Nielsen, Lars Martin; Boegevig, Soren

2017-12-11

Gamma-hydroxybutyrate (GHB) is a drug of abuse, for which physical addiction develops quickly. GHB withdrawal can develop into a life-threatening condition and has previously been treated mainly with benzodiazepines. These have not always proven effective, leading to long hospitalizations in intensive care units. Based on successful Dutch treatment results for using GHB to treat GHB withdrawal symptoms, we propose to implement a similar method in Denmark. The method requires an interdisciplinary effort for which The Danish Poison Information Centre should be consulted for expertise.

Smart information system for gachon university gil hospital.

PubMed

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Smart Information System for Gachon University Gil Hospital

PubMed Central

Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-01-01

Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

Comittees

NASA Astrophysics Data System (ADS)

2004-10-01

Fritz Caspers (CERN, Switzerland), Michel Chanel (CERN, Switzerland), Håkan Danared (MSL, Sweden), Bernhard Franzke (GSI, Germany), Manfred Grieser (MPI für Kernphysik, Germany), Dieter Habs (LMU München, Germany), Jeffrey Hangst (University of Aarhus, Denmark), Takeshi Katayama (RIKEN/Univ. Tokyo, Japan), H.-Jürgen Kluge (GSI, Germany), Shyh-Yuan Lee (Indiana University, USA), Rudolf Maier (FZ Jülich, Germany), John Marriner (FNAL, USA), Igor Meshkov (JINR, Russia), Dieter Möhl (CERN, Switzerland), Vasily Parkhomchuk (BINP, Russia), Robert Pollock (Indiana University), Dieter Prasuhn (FZ Jülich, Germany), Dag Reistad (TSL, Sweden), John Schiffer (ANL, USA), Andrew Sessler (LBNL, USA), Alexander Skrinsky (BINP, Russia), Markus Steck (GSI, Germany), Jie Wei (BNL, USA), Andreas Wolf (MPI für Kernphysik, Germany), Hongwei Zhao (IMP, People's Rep. of China).

Design-based research in designing the model for educating simulation facilitators.

PubMed

Koivisto, Jaana-Maija; Hannula, Leena; Bøje, Rikke Buus; Prescott, Stephen; Bland, Andrew; Rekola, Leena; Haho, Päivi

2018-03-01

The purpose of this article is to introduce the concept of design-based research, its appropriateness in creating education-based models, and to describe the process of developing such a model. The model was designed as part of the Nurse Educator Simulation based learning project, funded by the EU's Lifelong Learning program (2013-1-DK1-LEO05-07053). The project partners were VIA University College, Denmark, the University of Huddersfield, UK and Metropolia University of Applied Sciences, Finland. As an outcome of the development process, "the NESTLED model for educating simulation facilitators" (NESTLED model) was generated. This article also illustrates five design principles that could be applied to other pedagogies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study.

PubMed

Primdahl, Stine C; Todsen, Tobias; Clemmesen, Louise; Knudsen, Lars; Weile, Jesper

2016-09-21

Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed. We aimed to develop a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4 on the Likert scale. Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second Delphi round, the experts excluded one element from the scale. In the third Delphi round, consensus was obtained on the eight elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure. We developed an RS for assessment of UGVA competence based on opinions of ultrasound experts through a modified Delphi consensus study.

Occupational therapists' job satisfaction in a changing hospital organisation--a time-geography-based study.

PubMed

Bendixen, Hans Jørgen; Ellegård, Kajsa

2014-01-01

To investigate occupational therapists' job satisfaction under a changing regime by using a time-geographic approach focusing on the therapists' everyday working lives. Nine occupational therapists at the Copenhagen University Hospital, Gentofte, Denmark. A mixed-method design was employed. Occupational therapists kept time-geographic diaries, and the results from them were grounded for individual, semi-structured in-depth interviews. Individual reflections on everyday working life were recorded. Transcribed statements from the interviews were analysed to determine factors influencing job satisfaction. The nine therapists kept diaries for one day a month for a total of 70 preselected days over a period of nine months; six participated in individual interviews. Four factors constraining OT job satisfaction were revealed. Economic concerns, new professional paradigms and methods in combination with a new organisational structure for the occupational therapy service caused uncertainty. In addition, decreasing possibilities for supervision by colleagues influenced job satisfaction. Opportunities for experiencing autonomy in everyday working life were described as facilitators for job satisfaction. The time-geographic and interview methods were useful in focusing on the job satisfaction of occupational therapists, who provided individual interpretations of the balance between autonomy and three types of constraints in everyday working life. The constraints related to organisation, power relations and - not least - how the organisational project of the department fitted in with OTs' individual projects. Matching of organisational and individual projects is of crucial importance, not only for OTs but for most workplaces where individuals are employed to serve patients in the healthcare sector.

Marine n-3 polyunsaturated fatty acids in patients with end-stage renal failure and in subjects without kidney disease: a comparative study.

PubMed

Madsen, Trine; Christensen, Jeppe H; Svensson, My; Witt, Petra M; Toft, Egon; Schmidt, Erik B

2011-03-01

Patients with end-stage renal disease treated with chronic hemodialysis (HD) are reported to have low levels of marine n-3 polyunsaturated fatty acids (PUFA) in plasma and cell membranes compared with healthy subjects. The aim of this study was to investigate whether n-3 PUFA levels in plasma and cells are lower in HD patients as compared with subjects without kidney disease. A comparative study was carried out. This study was carried out at the Departments of Nephrology and Cardiology, Aalborg Hospital, Aarhus University Hospital, Denmark. This study consisted of 2 study populations comprising HD patients and 5 study populations comprising subjects without kidney disease. The fatty acid distribution in plasma phospholipids and platelet phospholipids was measured using gas chromatography. Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA) levels in plasma or serum phospholipids and platelet phospholipids in HD patients were compared with n-3 PUFA levels in subjects without kidney disease. EPA and DHA were lower and AA/EPA was higher in plasma/serum phospholipids in HD patients than in subjects without kidney disease. Similarly, higher AA and AA/EPA and lower EPA and DHA levels were found in platelet phospholipids of HD patients. Adjustment for gender, age, and habitual intake of fish and fish oil supplements did not change these results. HD patients have lower n-3 PUFA levels in plasma and cells compared with subjects without kidney disease. Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Respiratory acidosis prolongs, while alkalosis shortens, the duration and recovery time of vecuronium in humans.

PubMed

Yamauchi, Masanori; Takahashi, Hiromi; Iwasaki, Hiroshi; Namiki, Akiyoshi

2002-03-01

To determine the effects of respiratory acidosis and alkalosis by mechanical ventilation on the onset, duration, and recovery times of vecuronium. Randomized, prospective study. Operating rooms in the Sapporo Medical University Hospital and Kitami Red Cross Hospital. 90 ASA physical status I and II patients undergoing lower abdominal surgery. Patients were randomly allocated to one of three groups by arterial carbon dioxide tension level (PaCO2; mmHg) after induction: hyperventilation group (PaCO2 = 25-35), normoventilation group (PaCO2 = 35-45), and hypoventilation group (PaCO2 = 45-55). Anesthesia was maintained by spinal block with inhalation of 50% to 66% nitrous oxide in oxygen and intermittent intravenous administration of fentanyl and midazolam with tracheal intubation. After vecuronium 0.08 mg/kg was given, onset, duration, and recovery time were measured by mechanomyography (Biometer Myograph 2,000, Odense, Denmark). There were significant differences in the duration and recovery time of vecuronium among the normoventilation group (12.7 +/- 3.3 min and 11.8 +/- 2.8 min, respectively), the hyperventilation group (10.6 +/- 3.5 min and 9.2 +/- 2.7 min, respectively; p < 0.01), and the hypoventilation group (14.4 +/- 3.1 min and 15.0 +/- 3.7 min, respectively; p < 0.01) (mean SD). The closest significant correlation in this study was observed between recovery time and arterial blood pH (r = 0.57; p < 0.05). In humans, duration and recovery times of vecuronium are prolonged in respiratory acidosis and shortened in respiratory alkalosis.

Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

PubMed

Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

2011-12-01

This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

PhD Students' Work Conditions and Study Environment in University- and Industry-Based PhD Programmes

ERIC Educational Resources Information Center

Kolmos, A.; Kofoed, L. B.; Du, X. Y.

2008-01-01

During the last 10 years, new models of funding and training PhD students have been established in Denmark in order to integrate industry into the entire PhD education. Several programmes have been conducted where it is possible to co-finance PhD scholarships or to become an employee as an industrial PhD in a company. An important question is what…

Hepatitis B vaccination coverage and risk factors associated with incomplete vaccination of children born to hepatitis B surface antigen-positive mothers, Denmark, 2006 to 2010.

PubMed

Kunoee, Asja; Nielsen, Jens; Cowan, Susan

2016-01-01

In Denmark, universal screening of pregnant women for hepatitis B has been in place since November 2005, with the first two years as a trial period with enhanced surveillance. It is unknown what the change to universal screening without enhanced surveillance has meant for vaccination coverage among children born to hepatitis B surface antigen (HBsAg)-positive mothers and what risk factors exist for incomplete vaccination. This retrospective cohort study included 699 children of mothers positive for HBsAg. Information on vaccination and risk factors was collected from central registers. In total, 93% (651/699) of the children were vaccinated within 48 hours of birth, with considerable variation between birthplaces. Only 64% (306/475) of the children had received all four vaccinations through their general practitioner (GP) at the age of two years, and 10% (47/475) of the children had received no hepatitis B vaccinations at all. Enhanced surveillance was correlated positively with coverage of birth vaccination but not with coverage at the GP. No or few prenatal examinations were a risk factor for incomplete vaccination at the GP. Maternity wards and GPs are encouraged to revise their vaccination procedures and routines for pregnant women, mothers with chronic HBV infection and their children.

Prevalence of hip osteoarthritis in chiropractic practice in Denmark: a descriptive cross-sectional and prospective study.

PubMed

Poulsen, Erik; Christensen, Henrik W; Overgaard, Søren; Hartvigsen, Jan

2012-05-01

The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered by the chiropractic practitioner. A total of 2000 patient records and 1000 radiographs were reviewed retrospectively in 20 chiropractic clinics throughout Denmark. Information obtained included patients' primary complaint, physical examination and radiographic findings of hip OA, and treatment. Subsequently, the 20 clinics participated in a prospective survey where they collected equivalent information over a 2-week period. Retrospective review of records revealed that 1.4% of patients in Danish chiropractic practice had signs of clinical hip OA. Of these, 59% demonstrated radiographic signs of hip OA. Prospective data collection revealed that 3.4% of new patients had signs of clinical hip OA. Fifty-four percent of these demonstrated radiographic signs of hip OA, and of these 70% were diagnosed as having OA of the hip for the first time. Initial treatment involved manual treatment and advice on over-the-counter pain medication and/or supplements. Of all 1000 retrospectively reviewed radiographs in patients 40 years or older, 19.2% demonstrated radiographic signs of hip OA. Osteoarthritis of the hip is diagnosed and managed in primary care chiropractic practice in Denmark; however, it is likely underdiagnosed. In those newly presenting to chiropractic practitioners, first-time diagnosis with clinical and radiographic signs of hip OA appears to be common. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Energy drink consumption and the relation to socio-demographic factors and health behaviour among young adults in Denmark. A population-based study.

PubMed

Friis, Karina; Lyng, Jeppe I; Lasgaard, Mathias; Larsen, Finn B

2014-10-01

The objective of this study is to estimate the prevalence of energy drink consumption and examine the associations of socio-demographic factors and health behaviour with energy drink consumption among young adults in Denmark. The study is based on a public health survey from 2010 (n = 3923). Multiple logistic regression analyses were used to analyse the association between weekly consumption of energy drink and the potential explanatory factors of interest. In total, 15.8 % of the young adults drink energy drinks on a weekly basis. Men have higher odds of weekly energy drink consumption than women. The study also shows that young age, being employed and having a low educational level are associated with weekly energy drink consumption. According to health behaviour, daily smoking, high amounts of alcohol consumption, alcoholic binge drinking and being overweight are associated with weekly energy drink consumption. Compared with other European countries the prevalence of energy drink consumption is relatively low in Denmark. In Denmark energy drink consumption is typically a male phenomenon and there is a clear social gradient in the prevalence of energy drink consumption where the intake is far more common among people with low levels of education than among people with higher levels of education. This study also shows that there is some kind of 'add on' effect of energy drinks, meaning that people who also use other stimulants-such as alcohol and cigarettes-are more inclined to consume energy drinks. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

National survey of emergency departments in Denmark.

PubMed

Wen, Leana S; Anderson, Philip D; Stagelund, Søren; Sullivan, Ashley F; Camargo, Carlos A

2013-06-01

Emergency departments (EDs) are the basic unit of emergency medicine, but often differ in fundamental features. We sought to describe and characterize EDs in Denmark. All EDs open 24/7 to the general public were surveyed using the National ED Inventories survey instrument (http://www.emnet-nedi.org). ED staff were asked about ED characteristics with reference to the calendar year 2008. Twenty-eight EDs participated (82% response). All were located in hospitals. Less than half [43%, 95% confidence interval (CI) 24-63%] were independent departments. Thirty-nine percent (95% CI 22-59%) had a contiguous layout, with medical and surgical care provided in one area. The vast majority of EDs saw both adults and children; only 10% saw adults only and none saw children only. The median number of annual visits was 32 000 (interquartile range, 14 700-47 000). The majority (68%, 95% CI 47-89%) believed that their ED was at good balance or capacity, with 22% responding that they were under capacity and 9% reporting overcapacity. Technological resources were generally available, with the exception of dedicated computed tomography scanners and negative-pressure rooms. Almost all common emergencies were identified as being treatable 24/7 in the EDs. Although there is some variation in their layout and characteristics, most Danish EDs have a high degree of resource availability and are able to treat common emergencies. As Denmark seeks to reform emergency care through ED consolidation, this national survey helps to establish a benchmark for future comparisons.

Incidence and prevalence rates of personality disorders in Denmark-A register study.

PubMed

Pedersen, Liselotte; Simonsen, Erik

2014-11-01

Personality disorders (PDs) are prevalent in about one in every 10 adults. Prior to the introduction of the ICD-10 in Denmark, the incidence rate for PD (including schizotypal) among psychiatric patients was approximately 12% and the prevalence rate 14%. The aim of the present clinical epidemiology study is to investigate the use of ICD-10 PD as primary and secondary diagnoses in years 1995, 2000 and 2006, comorbid disorders and their relation to age and gender. The study includes all adult patients admitted to any psychiatric hospital (inpatients and outpatients) in Denmark. Both incidence and prevalence rates of PD diagnoses decrease over the study period. It is evident that all specific diagnoses significantly decrease or remain stable whereas the unspecified and mixed type significantly increases constituting up to 50% of diagnoses. Emotionally unstable PD stands out as the single most prevalent covering around one third of PD diagnoses. A decrease is found in the prevalence of patients receiving a PD diagnosis as a primary diagnosis, but an increase as a secondary diagnosis (most often as comorbid to depression or anxiety disorder). Differences are found in relation to gender and age. PDs are among the most prevalent disorders; however, rates are decreasing in psychiatric settings. There seem to be a rather huge gap between clinical evaluation and research data on prevalence of PDs. Clinicians need more education and sufficient time for in-depth personality assessment of PDs in all patient groups.

Mental disorders in childhood and young adulthood among children born to women with fertility problems.

PubMed

Svahn, M F; Hargreave, M; Nielsen, T S S; Plessen, K J; Jensen, S M; Kjaer, S K; Jensen, A

2015-09-01

Is the risk of hospital admission or outpatient contact for mental disorders increased in children born to women with fertility problems compared with children born to women without fertility problems? We found an increased risk of hospital admission or outpatient contact for mental disorders in children born to women with fertility problems. Few studies have investigated the risk of mental disorders in children born after fertility treatment and although some studies have pointed to an increased risk, others found no association. The inconsistent results may be due to methodological constraints in many previous studies, including small sample size and short follow-up, resulting in imprecise risk estimates and lack of information on risk patterns of mental disorders in adulthood. This nationwide retrospective register-based cohort study included all 2 412 721 children born in Denmark between 1969 and 2006. All children were followed from date of birth until date of hospital contact for a mental disorder, date of emigration, date of death or 31 December 2009, whichever occurred first. Information concerning maternal fertility status for all children in the cohort was obtained by linkage to the Danish Infertility Cohort, which contains data on nearly all women with fertility problems in Denmark since 1963. A total of 124 269 (5%) children were born to women with fertility problems and 2 288 452 (95%) to women without fertility problems. To identify children hospitalized for a mental disorder, the cohort was linked to the Danish Psychiatric Central Research Registry. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between maternal fertility status and the risk of hospital admission or outpatient contact for various groups of mental disorders, including any mental disorder and all 11 main discharge diagnostic groups, classified according to the International Classification of Diseases, version 10. During a mean follow-up period of 21 years (range, 0-40 years), 168 686 (7%) children were admitted to hospital or had an outpatient contact for a mental disorder. Children born to women with fertility problems had a significantly higher risk of any mental disorder (HR 1.23; 95% CI 1.20-1.26) and for most of the 11 main discharge groups, including schizophrenia (HR 1.16; 95% CI 1.07-1.27), mood (affective) disorders (HR 1.21; 95% CI 1.15-1.28) and disorders of psychological development (HR 1.15; 95% CI 1.09-1.21) as well as the subgroup of attention-deficit/hyperactivity disorders (HR 1.36; 95% CI 1.29-1.45) compared with children born to women without fertility problems. The risk estimates did not change markedly when analyses were performed separately for mental disorders diagnosed during childhood (0-19 years) and in young adulthood (20-40 years). The true risk of mental disorders may be somewhat underestimated, as only severe disorders requiring hospital admission or outpatient contact were considered as events. Furthermore, we could not determine whether the increased risks observed were due to factors related to the underlying infertility or to fertility treatment procedures. This is the first report on mental disorders in adulthood among children born to women with fertility problems. Furthermore, we have assessed the risk of several severe mental disorders not previously studied (e.g. neurotic, stress-related and somatoform disorders and disorders of adult personality and behaviour). These important findings should be investigated further in large epidemiological studies designed to differentiate between factors related to fertility treatment and to the underlying infertility. The study was supported by internal funding from the Unit of Virus, Lifestyle and Genes at the Danish Cancer Society Research Center. All authors report no conflicts of interest. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

National Surveillance of Central Diabetes Insipidus (CDI) in Denmark: results from 5 years registration of 9309 prescriptions of desmopressin to 1285 CDI patients.

PubMed

Juul, K V; Schroeder, M; Rittig, S; Nørgaard, J P

2014-06-01

Epidemiological data for central diabetes insipidus (CDI) are sparse. The purpose of this study was to provide accurate epidemiological data on CDI on a national level. This was a drug utilization and patient registry study during a 5-year period from 2007 to 2011. We used the Danish National Prescription Registry data linked with the Danish National Patient Registry to study the epidemiology of CDI using waiting time distribution and other pharmacoepidemiological methods. A total of 1285 patients with CDI were recorded in the observation period and given 9309 prescriptions for desmopressin in the nasal formulation, orodispersible tablet, or conventional tablet. The period prevalence rate of CDI in Denmark over the 5-year period investigated was 23 CDI patients per 100 000 inhabitants, with a higher prevalence in children and older adults (>80 years of age). The 1-year period prevalence rate of CDI decreased in Denmark over the 5 years from approximately 10 to 7 CDI patients per 100 000 inhabitants. The yearly incidence rate of new cases of CDI was found to be 3 to 4 patients per 100 000. The incidence of (presumable) congenital CDI was found to be 2 infants per 100 000 infants. Half of the patients with CDI prescribed as oral treatment were provided dosing instructions to only administer the drug before bedtime, and one third of the CDI patients either had no specific instructions or were instructed to use the drug as needed. Hospital admissions due to severe hyponatremia occurred in 0.9% of patients over a 5-year period, predominantly in females with an incidence ratio of women to men of 1.8:1. Half of the cases of CDI are acquired later in life. At least half of the patients with CDI are instructed to prevent nocturnal polyuria, but it is not clear whether their CDI remains uncontrolled during the daytime or, alternatively, whether they use desmopressin only as needed. Female patients with CDI had approximately twice the number of hospital admissions due to severe hyponatremia than male patients with CDI.

Constructive eHealth evaluation: lessons from evaluation of EHR development in 4 Danish hospitals.

PubMed

Høstgaard, Anna Marie Balling; Bertelsen, Pernille; Nøhr, Christian

2017-04-20

Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented. A case study evaluation of the EHR development process in the North Denmark Region was conducted from 2004 to 2010. The population consisted of clinicians, IT professionals, administrators, and vendors. The study involved 4 hospitals in the region. Data were collected using questionnaires, observations, interviews, and insight gathered from relevant documents. The evaluation showed a need for a) Early involvement of clinicians, b) The best possible representation of clinicians, and c) Workload reduction for those involved. The consequences of not providing this were a lack of ownership of decisions and negative attitudes towards the clinical benefits related to these decisions. Further, the result disclosed that by following the above recommendations, and by providing feedback to the 4 actor groups, the physicians' involvement was improved. As a result they took ownership of decisions and gained a positive attitude to the clinical benefits. The CeHEM has proven successful in formative evaluation of EHR development and can point at important issues that need to be taken care of by management. The method provides a framework that takes care of feedback and learning during eHealth development. It can thus support successful eHealth development in a broader context while building on a well-known success factor: end-user involvement in eHealth development.

Lumbar spinal stenosis: comparison of surgical practice variation and clinical outcome in three national spine registries.

PubMed

Lønne, Greger; Fritzell, Peter; Hägg, Olle; Nordvall, Dennis; Gerdhem, Paul; Lagerbäck, Tobias; Andersen, Mikkel; Eiskjaer, Søren; Gehrchen, Martin; Jacobs, Wilco; van Hooff, Miranda L; Solberg, Tore K

2018-05-21

Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains controversial, resulting in practice-based variation. The present study aimed to evaluate in a pragmatic study if surgical selection criteria and variation in use of arthrodesis in three Scandinavian countries can be linked to variation in treatment effectiveness. This is an observational study based on a combined cohort from the national spine registries of Norway, Sweden, and Denmark. Patients aged 50 and older operated during 2011-2013 for LSS were included. Patient-Reported Outcome Measures (PROMs): Oswestry Disability Index (ODI) (primary outcome), Numeric Rating Scale (NRS) for leg pain and back pain, and health-related quality of life (Euro-Qol-5D) were reported. Analysis included case-mix adjustment. In addition, we report differences in hospital stay. Analyses of baseline data were done by analysis of variance (ANOVA), chi-square, or logistic regression tests. The comparisons of the mean changes of PROMs at 1-year follow-up between the countries were done by ANOVA (crude) and analysis of covariance (case-mix adjustment). Out of 14,223 included patients, 10,890 (77%) responded at 1-year follow-up. Apart from fewer smokers in Sweden and higher comorbidity rate in Norway, baseline characteristics were similar. The rate of additional fusion surgery (patients without or with spondylolisthesis) was 11% (4%, 47%) in Norway, 21% (9%, 56%) in Sweden, and 28% (15%, 88%) in Denmark. At 1-year follow-up, the mean improvement for ODI (95% confidence interval) was 18 (17-18) in Norway, 17 (17-18) in Sweden, and 18 (17-19) in Denmark. Patients operated with arthrodesis had prolonged hospital stay. Real-life data from three national spine registers showed similar indications for decompression surgery but significant differences in the use of concomitant arthrodesis in Scandinavia. Additional arthrodesis was not associated with better treatment effectiveness. Copyright © 2018 Elsevier Inc. All rights reserved.

Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark: 4-year register-based follow-up.

PubMed

Hastrup, Lene Halling; Aagaard, Jørgen

2015-02-01

Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. The study was based on a quasi-experimental design with a control group from the neighbouring region. Costs and retention in mental health services were analysed by using register data 1 year before and 4 years after inclusion in the study. Data on the use of supportive housing were available for the year before baseline and the subsequent 2 years only. Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P < 0.17). Days in supportive housing were lower for the ACT group before baseline and remained so (dropping to zero) for the subsequent 2 years. Over 4 years, the mean total costs per patient in the group receiving ACT were DDK 493,442 (SE = 34,292). Excluding costs of supportive housing, the mean total costs per patient of the control group were DDK 537,218 (SE = 59,371), P < 0.53. If these costs are included, however, the mean total costs for the ACT group are unchanged, whereas costs for the control group rise to DDK 671,500 (SE = 73,671), P < 0.03. While ACT appears to have resulted in a significant reduction in costs for psychiatric hospitalizations, baseline differences in use of supportive housing make the effects of ACT on overall costs more ambiguous. At worst, however, overall costs did not increase. Given the generally acknowledged clinical benefits of ACT over standard outpatient care, the results support further dissemination of ACT in Denmark.

Potential gains from hospital mergers in Denmark.

PubMed

Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller

2010-12-01

The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.

Howard University Hospital finds partner in helping children succeed.

PubMed

Botvin, Judith D

2005-01-01

Howard University Hospital, Washington, D.C., becomes the site for the launch of a national ad campaign by the nonprofit youth education organization, Communities in Schools. The hospital and university share the organization's mission of supporting young people in the community.

Health literacy among Danish university students enrolled in health-related study programmes.

PubMed

Elsborg, Lea; Krossdal, Fie; Kayser, Lars

2017-12-01

It is important to address people's health literacy when providing health care. Health professionals should be aware of, and have insight into, people's health literacy when they provide health services. Health professionals need to be health literate themselves. We examined the level of health literacy in students in Denmark attending one of four full university programmes related to health and investigated how their health literacy was associated with their sociodemographic background. The health literacy level of the students was measured using the multi-dimensional Health Literacy Questionnaire (HLQ) supplemented with sociodemographic questions. The questionnaire was administrated through the students' Facebook groups. The students were enrolled in courses on health informatics, medicine, molecular biomedicine or public health. Out of a total of 7663 students, 630 responded to the questionnaire. No sex difference was found although female students scored higher than male students in domain 4 (social support for health). Students attending the public health programme tended to score higher and those attending molecular biomedicine tended to score lower in the HLQ. There was a positive correlation between HLQ scores and the educational level of the students' parents. If one of their parents was employed in the health care sector, the HLQ score tended to be higher in domains 1 and 4. Students who had been hospitalized also tended to score higher in domains 1, 5 and 6. Students' health literacy relates to their personal background and educational path. This may be of importance when planning curricula and educational activities, including cross-disciplinary courses.

[The Great European Georg Friedrich Nicolai: physician and pacifist. Berlin, Germany, 1874 - Santiago, Chile, 1964].

PubMed

Cabello C, Felipe

2013-04-01

Georg Friedrich Nicolai (1874-1964) was a German physician and physiologist whose pacifism during the First World War led him in 1914 to cosign with W. J. Foerster, A. Einstein and O. Bueck a "Manifesto to the Europeans" against the entry of Germany into the war and the invasion of Belgium. As a result of this appeal and his strong pacifism, Nicolai lost his positions as cardiologist to the German royal family, professor at the University of Berlin and chief of laboratory at the Charite hospital also in Berlin, and was sent as a garrison physician in Graundenz, in today's Poland. There he began to write his book, The Biology of War. It managed to avoid censorship and was published in Leipzig in 1916. He was court-martialed in Danzig in 1916 but escaped to Denmark. Nicolai was reinstated to his faculty positions by the Weimar Republic after the war but was subsequently forced to emigrate from Germany to South America by the pressure of right wing student groups who accused him of being a deserter and a traitor. From 1922 to 1932 Nicolai lived in Argentina, and from 1932 until his death in 1964, in Chile. In this later country Nicolai was professor in the University of Chile and interacted with members of the Chilean intelligentsia, including the poets Vicente Huidobro, Gonzalo Rojas and Pablo Neruda. Through his friendship with Chilean psychiatrist Agustin Tellez, Nicolai influenced the development of phenomenological psychiatric school in Chile. The Chilean novelist Fernando Alegria compared him favorably with Robert J. Oppenheimer and Linus Pauling.

Swiss (German) Version of the Actinic Keratosis Quality of Life questionnaire.

PubMed

Meier, Larissa S; Schubert, Maria; Göksu, Yasemin; Esmann, Solveig; Vinding, Gabrielle R; Jemec, Gregor B E; Hofbauer, Günther F L

2018-04-18

Actinic keratosis (AK) is a sun-induced skin lesion that may progress to invasive squamous cell carcinoma of the skin. Recently, the Actinic Keratosis Quality of Life questionnaire (AKQoL) was designed for patients with AK in Denmark as a specific quality of life instrument for AK patients. The objective of this study was to adapt the AKQoL for the German language region of Switzerland and to evaluate its psychometric properties (validity, reliability). Translation and cultural adaptation of the questionnaire were assessed by using the technique of cognitive interviewing. During the translation process, 34 patients with AK from the Department of Dermatology, University Hospital Zurich, were interviewed in 3 sessions of cognitive interviewing. The translated questionnaire was then distributed together with the Dermatology Life Quality Index (DLQI) to a second group of 113 patients for validation and reliability testing. Within this group, we measured the internal consistency by the Cronbach coefficient α and Spearman correlation coefficient between the AKQoL and the DLQI. The problems encountered during the translation process led to changes in 5 categories as described by Epstein: stylistic changes, change in breadth, change in actual meaning, change in frequency and time frame, change in intensity. We found a Cronbach α of 0.82, an acceptable internal consistency. The Spearman correlation coefficient between total scores of AKQoL and DLQI was 0.57. We culturally adapted and validated a Swiss (German) version of the AKQoL questionnaire applicable for the population of a university center in Switzerland to measure and monitor the quality of life in patients with AK. © 2018 S. Karger AG, Basel.

International perspectives on emergency department crowding.

PubMed

Pines, Jesse M; Hilton, Joshua A; Weber, Ellen J; Alkemade, Annechien J; Al Shabanah, Hasan; Anderson, Philip D; Bernhard, Michael; Bertini, Alessio; Gries, André; Ferrandiz, Santiago; Kumar, Vijaya Arun; Harjola, Veli-Pekka; Hogan, Barbara; Madsen, Bo; Mason, Suzanne; Ohlén, Gunnar; Rainer, Timothy; Rathlev, Niels; Revue, Eric; Richardson, Drew; Sattarian, Mehdi; Schull, Michael J

2011-12-01

The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes. © 2011 by the Society for Academic Emergency Medicine.

A genetic basis for infectious mononucleosis: evidence from a family study of hospitalized cases in Denmark.

PubMed

Rostgaard, Klaus; Wohlfahrt, Jan; Hjalgrim, Henrik

2014-06-01

Circumstantial evidence from genome-wide association and family studies of various Epstein-Barr virus-associated diseases suggests a substantial genetic component in infectious mononucleosis (IM) etiology. However, familial aggregation of IM has scarcely been studied. We used data from the Danish Civil Registration System and the Danish National Hospital Discharge Register to study rate ratios of IM in a cohort of 2 823 583 Danish children born between 1971 and 2011. Specifically, we investigated the risk of IM in twins and in first-, second-, and third-degree relatives of patients with IM. In the analyses, IM was defined as a diagnosis of IM in a hospital contact. Effects of contagion between family members were dealt with by excluding follow-up time the first year after the occurrence of IM in a relative. A total of 16 870 cases of IM were observed during 40.4 million person-years of follow-up from 1977 to 2011. The rate ratios and the associated 95% confidence intervals were 9.3 (3.0-29) in same-sex twins, 3.0 (2.6-3.5) in siblings, 1.9 (1.6-2.2) in children, 1.4 (1.3-1.6) in second-degree relatives, and 1.0 (0.9-1.2) in third-degree relatives of IM patients. The rate ratios were very similar for IM in children (aged 0-6 years) and older children/adolescents (aged 7-19 years). We found evidence of familial aggregation of IM that warrants genome-wide association studies on IM disease etiology, especially to examine commonalities with causal pathways in other Epstein-Barr virus-related diseases. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Accuracy and Coverage of Diagnosis and Procedural Coding of Severely Injured Patients in the Finnish Hospital Discharge Register: Comparison to Patient Files and the Helsinki Trauma Registry.

PubMed

Heinänen, M; Brinck, T; Handolin, L; Mattila, V M; Söderlund, T

2017-09-01

The Finnish Hospital Discharge Register data are frequently used for research purposes. The Finnish Hospital Discharge Register has shown excellent validity in single injuries or disease groups, but no studies have assessed patients with multiple trauma diagnoses. We aimed to evaluate the accuracy and coverage of the Finnish Hospital Discharge Register but at the same time validate the data of the trauma registry of the Helsinki University Hospital's Trauma Unit. We assessed the accuracy and coverage of the Finnish Hospital Discharge Register data by comparing them to the original patient files and trauma registry files from the trauma registry of the Helsinki University Hospital's Trauma Unit. We identified a baseline cohort of patients with severe thorax injury from the trauma registry of the Helsinki University Hospital's Trauma Unit of 2013 (sample of 107 patients). We hypothesized that the Finnish Hospital Discharge Register would lack valuable information about these patients. Using patient files, we identified 965 trauma diagnoses in these 107 patients. From the Finnish Hospital Discharge Register, we identified 632 (65.5%) diagnoses and from the trauma registry of the Helsinki University Hospital's Trauma Unit, 924 (95.8%) diagnoses. A total of 170 (17.6%) trauma diagnoses were missing from the Finnish Hospital Discharge Register data and 41 (4.2%) from the trauma registry of the Helsinki University Hospital's Trauma Unit data. The coverage and accuracy of diagnoses in the Finnish Hospital Discharge Register were 65.5% (95% confidence interval: 62.5%-68.5%) and 73.8% (95% confidence interval: 70.4%-77.2%), respectively, and for the trauma registry of the Helsinki University Hospital's Trauma Unit, 95.8% (95% confidence interval: 94.5%-97.0%) and 97.6% (95% confidence interval: 96.7%-98.6%), respectively. According to patient records, these patients were subjects in 249 operations. We identified 40 (16.1%) missing operation codes from the Finnish Hospital Discharge Register and 19 (7.6%) from the trauma registry of the Helsinki University Hospital's Trauma Unit. The validity of the Finnish Hospital Discharge Register data is unsatisfactory in terms of the accuracy and coverage of diagnoses in patients with multiple trauma diagnoses. Procedural codes provide greater accuracy. We found the coverage and accuracy of the trauma registry of the Helsinki University Hospital's Trauma Unit to be excellent. Therefore, a special trauma registry, such as the trauma registry of the Helsinki University Hospital's Trauma Unit, provides much more accurate data and should be the preferred registry when extracting data for research or for administrative use, such as resource prioritizing.

Spatial analysis and temporal trends of porcine reproductive and respiratory syndrome in Denmark from 2007 to 2010 based on laboratory submission data.

PubMed

Antunes, Ana Carolina Lopes; Halasa, Tariq; Lauritsen, Klara Tølbøl; Kristensen, Charlotte Sonne; Larsen, Lars Erik; Toft, Nils

2015-12-21

Porcine reproductive and respiratory syndrome (PRRS) has been a cause for great concern to the Danish pig industry since it was first diagnosed in 1992. The causative agent of PRRS is an RNA virus which is divided into different genotypes. The clinical signs, as well as its morbidity and mortality, is highly variable between herds and regions. Two different genotypes of PRRS virus (PRRSV) are found in Denmark: type 1 and type 2. Approximately 40% of Danish swine herds are seropositive for one or both PRRSV types. The objective of this study was to describe the temporal trend and spatial distribution of PRRSV in Danish swine herds from 2007 to 2010, based on type-specific serological tests from the PRRS surveillance and control program in Denmark using the results stored in the information management system at the National Veterinary Institute, Technical University of Denmark (DTU Vet). The average monthly seroprevalence of PRRSV type 1 was 9% (minimum of 5%; maximum of 13%) in breeding herds, and 20% (minimum of 14%; maximum of 26%) in production herds; PRRSV type 2 had an average seroprevalence of 3% (minimum of 1%; maximum of 9%) in breeding herds and of 9% (minimum of 5%; maximum of 13%) within production herds. The seroconversion rate followed a similar and consistent pattern, being higher for type 1 than for type 2 for both PRRSV types. Regarding the spatiotemporal results, the relative risk distribution maps changed over time as a consequence of the changes in PRRSV seroprevalence, suggesting a general decline in the extent of areas with higher relative risk for both type 1 and 2. Local spatial analysis results demonstrated the existence of statistically significant clusters in areas where the relative risk was higher for both herds. PRRSV type 1 seroprevalence was constantly higher than for PRRSV type 2 in both herd types. Significant spatial clusters were consistently found in Denmark, suggesting that PRRSV is endemic in these areas. Furthermore, relative risk distribution maps revealed different patterns over time as a consequence of the changes in seroprevalence.

Recent health policy initiatives in Nordic countries

PubMed Central

Saltman, Richard B.

1992-01-01

Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003

Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark.

PubMed

Raffing, Rie; Jensen, Thor Bern; Tønnesen, Hanne

2017-10-23

Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors' self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. The Scientific Ethical Committee for the Capital Region of Denmark. Number: H-3-2010-101, date: 2010.09.29.

A substantial number of scientific publications originate from non-university hospitals.

PubMed

Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J; Rasmussen, Claus; Lauszus, Finn F; Frost, Lars; Hornung, Nete; Lederballe, Ole; Andersen, Jens Peter

2011-11-01

As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities. We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus. In 878 of 1,252 papers, the first and/or last author was affiliated to a non-university hospital. Original papers made up 69% of these publications versus 86% of publications with university affiliation on first or last place. Case reports and reviews most frequently had authors from regional hospitals as first and/or last authors. The total number of publications from regional hospitals increased by 48% over the 10-year period. Publications were cited more often if the first or last author was from a university hospital and even more so if they were affiliated to foreign institutions. Cardiology, gynaecology and obstetrics, and environmental medicine were the three specialities with the largest number of regional hospital publications. A substantial number of scientific publications originate from non-university hospitals. Almost two thirds of the publications were original research published in international journals. Variations between specialities may reflect local conditions. not relevant. not relevant.

Somatic hospital contacts, invasive cardiac procedures, and mortality from heart disease in patients with severe mental disorder.

PubMed

Laursen, Thomas Munk; Munk-Olsen, Trine; Agerbo, Esben; Gasse, Christiane; Mortensen, Preben Bo

2009-07-01

Excess mortality from heart disease is observed in patients with severe mental disorder. This excess mortality may be rooted in adverse effects of pharmacological or psychotropic treatment, lifestyle factors, or inadequate somatic care. To examine whether persons with severe mental disorder, defined as persons admitted to a psychiatric hospital with bipolar affective disorder, schizoaffective disorder, or schizophrenia, are in contact with hospitals and undergoing invasive procedures for heart disease to the same degree as the nonpsychiatric general population, and to determine whether they have higher mortality rates of heart disease. A population-based cohort of 4.6 million persons born in Denmark was followed up from 1994 to 2007. Rates of mortality, somatic contacts, and invasive procedures were estimated by survival analysis. Incidence rate ratios of heart disease admissions and heart disease mortality as well as probability of invasive cardiac procedures. The incidence rate ratio of heart disease contacts in persons with severe mental disorder compared with the rate for the nonpsychiatric general population was only slightly increased, at 1.11 (95% confidence interval, 1.08-1.14). In contrast, their excess mortality rate ratio from heart disease was 2.90 (95% confidence interval, 2.71-3.10). Five years after the first contact for somatic heart disease, the risk of dying of heart disease was 8.26% for persons with severe mental disorder (aged <70 years) but only 2.86% in patients with heart disease who had never been admitted to a psychiatric hospital. The fraction undergoing invasive procedures within 5 years was reduced among patients with severe mental disorder as compared with the nonpsychiatric general population (7.04% vs 12.27%, respectively). Individuals with severe mental disorder had only negligible excess rates of contact for heart disease. Given their excess mortality from heart disease and lower rates of invasive procedures after first contact, it would seem that the treatment for heart disease offered to these individuals in Denmark is neither sufficiently efficient nor sufficiently intensive. This undertreatment may explain part of their excess mortality.

Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain: What are the Clinical Implications of Pain During Testing?

PubMed

Rafn, Bolette S; Tang, Lars; Nielsen, Martin P; Branci, Sonia; Hölmich, Per; Thorborg, Kristian

2016-05-01

To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. Cross-sectional study. Clinical assessments at Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. Twenty-four male soccer players with unilateral long-standing hip and groin pain. The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion, adduction, abduction, isometric hip flexion-modified Thomas test, and eccentric hip adduction). Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). In 4 tests (isometric hip adduction, abduction, flexion, and eccentric adduction), no significant correlations were found between pain during testing and hip muscle strength (Spearman rho = -0.28 to 0.06, P = 0.09-0.39). Isometric hip flexion (modified Thomas test position) showed a moderate negative correlation between pain and hip muscle strength (Spearman rho = -0.44, P = 0.016). Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain.

Making a web based ulcer record work by aligning architecture, legislation and users - a formative evaluation study.

PubMed

Ekeland, Anne G; Skipenes, Eva; Nyheim, Beate; Christiansen, Ellen K

2011-01-01

The University Hospital of North Norway selected a web-based ulcer record used in Denmark, available from mobile phones. Data was stored in a common database and easily accessible. According to Norwegian legislation, only employees of the organization that owns an IT system can access the system, and use of mobile units requires strong security solutions. The system had to be changed. The paper addresses interactions in order to make the system legal, and assesses regulations that followed. By addressing conflicting scripts and the contingent nature of knowledge, we conducted a formative evaluation aiming at improving the object being studied. Participatory observation in a one year process, minutes from meetings and information from participants, constitute the data material. In the technological domain, one database was replaced by four. In the health care delivery domain, easy access was replaced by a more complicated log on procedure, and in the domain of law and security, a clarification of risk levels was obtained, thereby allowing for access by mobile phones with today's authentication mechanisms. Flexibility concerning predefined scripts was important in all domains. Changes were made that improved the platform for further development of legitimate communication of patient data via mobile units. The study also shows the value of formative evaluations in innovations.

Determining the best catheter for sonohysterography.

PubMed

Dessole, S; Farina, M; Capobianco, G; Nardelli, G B; Ambrosini, G; Meloni, G B

2001-09-01

To compare the characteristics of six different catheters for performing sonohysterography (SHG) to identify those that offer the best compromise between reliability, tolerability, and cost. Prospective study. University hospital. Six hundred ten women undergoing SHG. We performed SHG with six different types of catheters: Foleycath (Wembley Rubber Products, Sepang, Malaysia), Hysca Hysterosalpingography Catheter (GTA International Medical Devices S.A., La Caleta D.N., Dominican Republic), H/S Catheter Set (Ackrad Laboratories, Cranford, NJ), PBN Balloon Hystero-Salpingography Catheter (PBN Medicals, Stenloese, Denmark), ZUI-2.0 Catheter (Zinnanti Uterine Injection; BEI Medical System International, Gembloux, Belgium), and Goldstein Catheter (Cook, Spencer, IN). We assessed the reliability, the physician's ease of use, the time requested for the insertion of the catheter, the volume of contrast medium used, the tolerability for the patients, and the cost of the catheters. In 568 (93%) correctly performed procedures, no statistically significant differences were found among the catheters. The Foleycath was the most difficult for the physician to use and required significantly more time to position correctly. The Goldstein catheter was the best tolerated by the patients. The Foleycath was the cheapest whereas the PBN Balloon was the most expensive. The choice of the catheter must be targeted to achieving a good balance between tolerability for the patients, efficacy, cost, and the personal preference of the operator.

Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study.

PubMed

Hegaard, H K; Petersson, K; Hedegaard, M; Ottesen, B; Dykes, A K; Henriksen, T B; Damm, P

2010-02-01

We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hospital, Denmark, from August 1989 to September 1991 were invited to participate in the study. A total of 4458 healthy women who delivered after 37 completed gestational weeks participated in this study. The associations between sports (0, 1-2, 3+ h/week) or leisure-time physical activity (sedentary, light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (<2500 g) or a high birth weight (>/=4500 g) was also unchanged. In conclusion, in this large population-based study, we found no association between sports and leisure-time physical activity and low-birth weight, high-birth weight, or average-birth weight.

Public health benefits of hair-mercury analysis and dietary advice in lowering methylmercury exposure in pregnant women.

PubMed

Kirk, Line E; Jørgensen, Jan S; Nielsen, Flemming; Grandjean, Philippe

2017-06-01

To evaluate whether a public health intervention using focused dietary advice combined with a hair-mercury analysis can lower neurotoxic methylmercury exposure among pregnant women without decreasing their overall intake of seafood. A total of 146 pregnant women were consecutively recruited from the antenatal clinic at a Danish university hospital at their initial ultrasound scan. Dietary advice was provided on avoiding methylmercury exposure from large predatory fish and a hair sample from each participant was analysed for mercury, with the results being communicated shortly thereafter to the women. A dietary questionnaire was filled in. Follow-up three months later included a dietary questionnaire and a repeat hair-mercury analysis. In the follow-up group, 22% of the women had hair-mercury concentrations above a safe limit of 0.58 µg/g at enrolment, decreasing to 8% three months later. Average hair-mercury concentrations decreased by 21%. However, the total seafood intake remained at the same level after three months. Increased exposure to methylmercury among pregnant women is an important public health concern in Denmark. The observed lowering of hair-mercury concentrations associated with dietary advice corresponds to a substantial public health benefit that probably makes such an intervention highly profitable.

Improved sperm kinematics in semen samples collected after 2 h versus 4-7 days of ejaculation abstinence.

PubMed

Alipour, H; Van Der Horst, G; Christiansen, O B; Dardmeh, F; Jørgensen, N; Nielsen, H I; Hnida, C

2017-07-01

Does a short abstinence period of only 2 h yield spermatozoa with better motility characteristics than samples collected after 4-7 days? Despite lower semen volume, sperm concentration, total sperm counts and total motile counts, higher percentages of motile spermatozoa with higher velocity and progressiveness were detected in samples obtained after 2 h. Most studies that have assessed the effect of abstinence periods on sperm motility parameters in men with a sperm concentration below 15 million/ml have detected a higher percentage of motile spermatozoa in samples obtained after short abstinence periods. Studies of men with sperm concentrations above 15 million/ml have reported significantly decreased motile sperm counts after 24 h of abstinence compared with longer abstinence periods. This study had a controlled repeated-measures design based on semen samples from 43 male partners, in couples attending for IVF treatment, who had a sperm concentration above 15 million/ml. Data were collected between June 2014 and December 2015 in the Fertility Unit of Aalborg University Hospital (Aalborg, Denmark). Participants provided a semen sample after 4-7 days of abstinence followed by another sample after only 2 h. For both ejaculates, sperm concentration, total sperm counts, motility groups and detailed kinematic parameters were assessed and compared by using the Sperm Class Analyzer (SCA) computer-aided sperm analysis system before and after density gradient selection. The laboratory's local manual method (Makler chamber) was used for comparison. The second raw ejaculate demonstrated lower semen volume (P < 0.0001), sperm concentration (P = 0.003) and sperm counts in all motility sub-groups (P < 0.001) but higher percentages of spermatozoa with higher velocity (P < 0.01), progressiveness (P < 0.001) and hyperactivation (P < 0.001), compared with the first raw ejaculate. The first ejaculate in this study was also used for the IVF/ICSI treatments and therefore only patients with a semen volume ≥2 ml and concentration ≥15 million/ml were included. Further validation in large prospective randomized controlled trials, more purposely directed at normozoospermic males with partners having problems conceiving when there appears to be no female factor, is needed to confirm the potential advantage of using a second semen sample in improving fertilization and pregnancy rates in assisted reproduction. Despite the significantly lower semen volume, sperm concentration and total sperm counts in all motility sub-groups, the significantly higher percentage of spermatozoa with better motility characteristics (velocity, progressiveness and hyperactivation) in the second ejaculate, may provide and allow for a simpler and more effective selection of higher quality spermatozoa. This could prove to be an advantage for ART procedures such as intracytoplasmic sperm injection where a large number of spermatozoa is not needed. It can also be speculated that pooling two consecutive ejaculates obtained after 4-7 days and after 2 h, could be an advantage for intrauterine insemination where a large number of motile spermatozoa are needed. This study was supported by internal grants from the Department of Health Science and Technology, Faculty of Medicine, Aalborg University (Aalborg, Denmark). The SCA® was provided by a grant from 'Ferring Pharmaceuticals' to Aalborg University Hospital (H.I.N). G.V.D.H. is an external senior scientific consultant to Microptic S/L (Barcelona, Spain). H.A. has provided scientific input and presentations for Microptic S/L (Barcelona, Spain) on several occasions. All other authors declare no conflict of interest. N/A. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Low Birth Weight in Children Born to Mothers with Hyperthyroidism and High Birth Weight in Hypothyroidism, whereas Preterm Birth Is Common in Both Conditions: A Danish National Hospital Register Study

PubMed Central

Andersen, Stine Linding; Olsen, Jørn; Wu, Chun Sen; Laurberg, Peter

2013-01-01

Objectives Maternal hyper- and hypothyroidism have been associated with increased risk of adverse pregnancy outcomes, but studies have led to inconsistent results. We aimed to identify children born to mothers with a hospital-recorded diagnosis of thyroid dysfunction in Denmark and to study the association with gestational age at delivery and birth weight of the child. Study Design Population-based cohort study using Danish nationwide registers. All singleton live births in Denmark between January 1, 1978 and December 31, 2006 were identified and stratified by maternal diagnosis of hyper- or hypothyroidism registered in the Danish National Hospital Register before January 1, 2007. Results Maternal first-time diagnosis of thyroid dysfunction before, during or after pregnancy was registered in 32,809 (2.0%) of the singleton live births (n = 1,638,338). Maternal diagnosis of hyperthyroidism (adjusted OR 1.22, 95% CI 1.15-1.30) and hypothyroidism (adjusted OR 1.17, 95% CI 1.08-1.27) were associated with increased risk of preterm birth. Moreover, birth weight in children born to mothers with a diagnosis of hyperthyroidism was lower (adjusted difference −51 g, 95% CI −58 to −43 g) and higher in relation to maternal hypothyroidism (adjusted difference 20 g, 95% CI 10-30 g). Hyperthyroidism was associated with small-for-gestational-age (adjusted OR 1.15, 95% CI 1.10-1.20) and hypothyroidism with large-for-gestational-age children (adjusted OR 1.24, 95% CI 1.17-1.31). Conclusions Based on Danish nationwide registers, both maternal hyper- and hypothyroidism were associated with increased risk of preterm birth. Actual birth weight of the child and birth weight for gestational age were low if the mother had a diagnosis of hyperthyroidism and high if the diagnosis was hypothyroidism. PMID:24783052

Risk of stillbirth and infant deaths after assisted reproductive technology: a Nordic study from the CoNARTaS group.

PubMed

Henningsen, A A; Wennerholm, U B; Gissler, M; Romundstad, L B; Nygren, K G; Tiitinen, A; Skjaerven, R; Nyboe Andersen, A; Lidegaard, Ø; Forman, J L; Pinborg, A

2014-05-01

Is the risk of stillbirth and perinatal deaths increased after assisted reproductive technology (ART) compared with pregnancies established by spontaneous conception (SC)? A significantly increased risk of stillbirth in ART singletons was only observed before 28 + 0 gestational weeks. The current literature indicates that children born after ART have an increased risk of perinatal death. The knowledge on stillbirth in ART pregnancies is limited. A population based case-control study. A total of 62 485 singletons and 29 793 twins born after ART in Denmark, Finland, Norway and Sweden, from 1982 to 2007, were compared with 362 798 spontaneously conceived (SC) singletons and 132 181 twins. The adjusted rate ratio for stillbirth at gestational weeks 22 + 0 to 27 + 6 was 2.08 [95% confidence interval (CI) 1.55-2.78] for ART versus SC singletons. After 28 + 0 gestational weeks there was no significant difference in the risk of stillbirth between ART and SC singletons. ART twins had a lower risk of stillbirth compared with SC twins, but when restricting the analysis to opposite-sex twins and excluding all monozygotic twins, there was no significant difference between the groups. Singletons conceived by ART had an overall increased risk of early neonatal death (adjusted odds ratio 1.54, 95% CI 1.28-1.85) and death within the first year after birth (1.45, 1.26-1.68). No difference regarding these two parameters was found when further adjusting for the gestational age [(0.97, 0.80-1.18) and (0.99, 0.85-1.16), respectively]. ART twins had a lower risk of early neonatal and infant deaths than SC twins, but no difference was found when restricting the analyses to opposite-sex twins. We were not able to adjust for potential confounders, such as a prior history of stillbirth, induction of labour, body mass index or smoking. The risk of stillbirth in ART versus SC singletons was only increased for very early gestational ages (before 28 weeks). This might indicate that the current clinical management of ART pregnancies is sufficient regarding prevention of stillbirth during the third trimester. No conflict of interest was reported. The European Society for Human Reproduction and Embryology (ESHRE), the University of Copenhagen, Denmark, the Danish Agency for Science, Technology and Innovation and Sahlgrenska University Hospital, Gothenburg, Sweden supported the project. The CoNARTaS group has received travel and meeting funding from the Nordic Society of Obstetrics and Gynecology (NFOG).

Danish Palliative Care Database.

PubMed

Groenvold, Mogens; Adsersen, Mathilde; Hansen, Maiken Bang

2016-01-01

The aim of the Danish Palliative Care Database (DPD) is to monitor, evaluate, and improve the clinical quality of specialized palliative care (SPC) (ie, the activity of hospital-based palliative care teams/departments and hospices) in Denmark. The study population is all patients in Denmark referred to and/or in contact with SPC after January 1, 2010. The main variables in DPD are data about referral for patients admitted and not admitted to SPC, type of the first SPC contact, clinical and sociodemographic factors, multidisciplinary conference, and the patient-reported European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care questionnaire, assessing health-related quality of life. The data support the estimation of currently five quality of care indicators, ie, the proportions of 1) referred and eligible patients who were actually admitted to SPC, 2) patients who waited <10 days before admission to SPC, 3) patients who died from cancer and who obtained contact with SPC, 4) patients who were screened with European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care at admission to SPC, and 5) patients who were discussed at a multidisciplinary conference. In 2014, all 43 SPC units in Denmark reported their data to DPD, and all 9,434 cancer patients (100%) referred to SPC were registered in DPD. In total, 41,104 unique cancer patients were registered in DPD during the 5 years 2010-2014. Of those registered, 96% had cancer. DPD is a national clinical quality database for SPC having clinically relevant variables and high data and patient completeness.

Trends in colorectal cancer survival in northern Denmark: 1985-2004.

PubMed

Iversen, L H; Nørgaard, M; Jepsen, P; Jacobsen, J; Christensen, M M; Gandrup, P; Madsen, M R; Laurberg, S; Wogelius, P; Sørensen, H T

2007-03-01

The prognosis for colorectal cancer (CRC) is less favourable in Denmark than in neighbouring countries. To improve cancer treatment in Denmark, a National Cancer Plan was proposed in 2000. We conducted this population-based study to monitor recent trends in CRC survival and mortality in four Danish counties. We used hospital discharge registry data for the period January 1985-March 2004 in the counties of north Jutland, Ringkjøbing, Viborg and Aarhus. We computed crude survival and used Cox proportional hazards regression analysis to compare mortality over time, adjusted for age and gender. A total of 19,515 CRC patients were identified and linked with the Central Office of Civil Registration to ascertain survival through January 2005. From 1985 to 2004, 1-year and 5-year survival improved both for patients with colon and rectal cancer. From 1995-1999 to 2000-2004, overall 1-year survival of 65% for colon cancer did not improve, and some age groups experienced a decreasing 1-year survival probability. For rectal cancer, overall 1-year survival increased from 71% in 1995-1999 to 74% in 2000-2004. Using 1985-1989 as reference period, 30-day mortality did not decrease after implementation of the National Cancer Plan in 2000, neither for patients with colon nor rectal cancer. However, 1-year mortality for patients with rectal cancer did decline after its implementation. Survival and mortality from colon and rectal cancer improved before the National Cancer Plan was proposed; after its implementation, however, improvement has been observed for rectal cancer only.

[Relief of upper urinary tract obstruction in patients with cancer of the prostate].

PubMed

Kraemer, Pia Charlotte; Borre, Michael

2009-03-09

Hydronephrosis in patients with prostate cancer can be relieved by nephrostomia or internal urinary diversion by a double-J ureteral stent. The latter can be placed either retrograde or antegrade by means of an already established nephrostomy. The purpose of the present study was to summarize the use of the different kinds of catheters and to explore differences in use and functional durability. Furthermore, the number of days of hospitalization was recorded. We retrospectively reviewed 51 journals from prostate cancer patients who had undergone external and/or internal relief during the 10-year period from 1997-2007. All patients were admitted to Aarhus University Hospital, Skejby, Denmark. A total of 237 procedures were performed. In the acute situation, the patient typically underwent external catheter relief with either one-sided or - more frequently - two-sided nephrostomy. At the time of death three out of four patients had nephrostomies as well. Most patients underwent internal stent relief in the period from first relief by nephrostomy to the time of death (median: seven months). The number of catheter-related infections was lower than expected. Double-J urethral stents lasted longer than nephrostomies, but half of those relieved by internal stents only survived one or two catheter replacements before dying. Malignant extrinsic ureteral obstruction in prostate cancer patients is frequent and both types of relief are safe and efficient. Nephrostomies should be preferred in patients who are in bad health or infected while double-J stents - especially antegrade - should be offered to healthier or stronger patients. Successful placement and positive effect of a double-J stent is furthermore dependent on well-functioning kidneys and bladder.

Perioperative pain after robot-assisted versus laparoscopic rectal resection.

PubMed

Tolstrup, Rikke; Funder, Jonas Amstrup; Lundbech, Liselotte; Thomassen, Niels; Iversen, Lene Hjerrild

2018-03-01

In order to improve the surgical treatment of rectal cancer, robot-assisted laparoscopy has been introduced. The robot has gained widespread use; however, the scientific basis for treatment of rectal cancer is still unclear. The aim of this study was to investigate whether robot-assisted laparoscopic rectal resection cause less perioperative pain than standard laparoscopic resection measured by the numerical rating scale (NRS score) as well as morphine consumption. Fifty-one patients were randomized to either laparoscopic or robot-assisted rectal resection at the Department of Surgery at Aarhus University Hospital in Denmark. The intra-operative analgetic consumption was recorded prospectively and registered in patient records. Likewise all postoperative medicine administration including analgesia was recorded prospectively at the hospital medical charts. All morphine analogues were converted into equivalent oral morphine by a converter. Postoperative pain where measured by numeric rating scale (NRS) every hour at the postoperative care unit and three times a day at the ward. Opioid consumption during operation was significantly lower during robotic-assisted surgery than during laparoscopic surgery (p=0.0001). However, there were no differences in opioid consumption or NRS in the period of recovery. We found no differences in length of surgery between the two groups; however, ten patients from the laparoscopic group underwent conversion to open surgery compared to one from the robotic group (p=0.005). No significant difference between groups with respect to complications where found. In the present study, we found that patients who underwent rectal cancer resection by robotic technique needed less analgetics during surgery than patients operated laparoscopically. We did, however, not find any difference in postoperative pain score or morphine consumption postoperatively between the robotic and laparoscopic group.

Caught between a rock and a hard place: An intrinsic single case study of nurse researchers' experiences of the presence of a nursing research culture in clinical practice.

PubMed

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2018-04-01

To explore how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice. Higher demands in the hospitals for increasing the quality of patient care engender a higher demand for the skills of health professionals and evidence-based practice. However, the utilisation of nursing research in clinical practice is still limited. Intrinsic single case study design underlined by a constructivist perspective. Data were produced through a focus group interview with seven nurse researchers employed in clinical practice in two university hospitals in Zealand, Denmark, to capture the intrinsic aspects of the concept of nursing research culture in the context of clinical practice. A thematic analysis was conducted based on Braun and Clarke's theoretical guideline. "Caught between a rock and a hard place" was constructed as the main theme describing how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice. The main theme was supported by three subthemes: Minimal academic tradition affects nursing research; Minimal recognition from physicians affects nursing research; and Moving towards a research culture. The nurse researchers in this study did not experience the presence of a nursing research culture in clinical practice, however; they called for more attention on removing barriers against research utilisation, promotion of applied research and interdisciplinary research collaboration, and passionate management support. The results of this case study show the pressure which nurse researchers employed in clinical practice are exposed to, and give examples on how to accommodate the further development of a nursing research culture in clinical practice. © 2017 John Wiley & Sons Ltd.

Unpacking Educational Environments: Visions from Reggio Emilia, Australia, Sweden, Denmark and the United States. A Selection of Papers Presented at the Conference (Institute of Early Childhood, Macquarie University, North Ryde, New South Wales, Australia, May 16, 1998).

ERIC Educational Resources Information Center

Fleet, Alma, Ed.; Robertson, Janet, Ed.

These four early childhood education conference papers discuss ideas and themes to create healthy educational environments inspired by preschool sites in Reggio Emilia, Italy. The first paper, "Environmental Visions: Daisies and the Possible" (Alma Fleet and Janet Robertson), discusses the influences of Reggio Emilia. The paper notes how…

Postgraduate education on electro-active polymers at Southern Denmark University

NASA Astrophysics Data System (ADS)

Jones, Richard W.

2009-03-01

A recently introduced elective to the Master's of Science in Mechatronics program at Southern Denmark University, entitled 'Mechatronics: Design and Build' concentrates on some of the interdisciplinary aspects of Mechatronics Engineering. The 'Motion Control of Mechatronic Devices' is the main theme of this elective. Within this 'theme' the modelling, identification and compensation of nonlinear effects such as friction, stiction and hysteresis are considered. One of the most important components of the elective considers 'Smart Materials' and their use for actuation purposes. The theory, modelling and properties of piezoceramics. magneto- and electro- rheological fluids and dielectric electro active polymers (DEAP) are introduced in the 'Smart Materials' component. This paper initially reviews the laboratory experiments that have been developed for the dielectric electro active polymer section of the 'Mechatronics: Design and Build' elective. In lectures the students are introduced to the basic theory and fabrication of tubular actuators, that use DEAP material based on smart compliant electrode technology. In the laboratory the students to (a) carry out a series of experiments to characterise the tubular actuators, and (b) design a closed-loop position controller and test the performance of the controlled actuator for both step changes in desired position and periodic input reference signals. The last part of this contribution reviews some of the DEAP-based demonstration devices that been developed by Danfoss PolyPower A/S using their PolyPowerTM material which utilizes smart compliant electrode technology.

Conference scene: DGVS spring conference 2009.

PubMed

Kolligs, Frank Thomas

2009-10-01

The 3rd annual DGVS Spring Conference of the German Society for Gastroenterology (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten) was held at the Seminaris Campus Hotel in Berlin, Germany, on 8-9 May, 2009. The conference was organized by Roland Schmid and Matthias Ebert from the Technical University of Munich, Germany. The central theme of the meeting was 'translational gastrointestinal oncology: towards personalized medicine and individualized therapy'. The conference covered talks on markers for diagnosis, screening and surveillance of colorectal cancer, targets for molecular therapy, response prediction in clinical oncology, development and integration of molecular imaging in gastrointestinal oncology and translational research in clinical trial design. Owing to the broad array of topics and limitations of space, this article will focus on biomarkers, response prediction and the integration of biomarkers into clinical trials. Presentations mentioned in this summary were given by Matthias Ebert (Technical University of Munich, Germany), Esmeralda Heiden (Epigenomics, Berlin, Germany), Frank Kolligs (University of Munich, Germany), Florian Lordick (University of Heidelberg, Germany), Hans Jorgen Nielsen (University of Copenhagen, Denmark), Anke Reinacher-Schick (University of Bochum, Germany), Christoph Röcken (University of Berlin, Germany), Wolff Schmiegel (University of Bochum, Germany) and Thomas Seufferlein (University of Halle, Germany).

Isolation of Escherichia coli Strains with AcrAB–TolC Efflux Pump-Associated Intermediate Interpretation or Resistance to Fluoroquinolone, Chloramphenicol and Aminopenicillin from Dogs Admitted to a University Veterinary Hospital

PubMed Central

SATO, Toyotaka; YOKOTA, Shin-ichi; ICHIHASHI, Risa; MIYAUCHI, Tomoka; OKUBO, Torahiko; USUI, Masaru; FUJII, Nobuhiro; TAMURA, Yutaka

2014-01-01

ABSTRACT Understanding the prevalence of antimicrobial-resistance and the relationship between emergence of resistant bacteria and clinical treatment can facilitate design of effective treatment strategies. We here examined antimicrobial susceptibilities of Escherichia coli isolated from dogs admitted to a university hospital (University hospital) and companion animal clinics (Community clinics) in the same city and investigated underlying multidrug-resistance mechanisms. The prevalence of E. coli with intermediate and resistant interpretations to ampicillin (AMP), enrofloxacin (ENR) and chloramphenicol (CHL) was higher in the University hospital than in the Community clinics cases. Use of antimicrobials, including fluoroquinolone, was also significantly higher in the University hospital than in the Community clinics cases. Upon isolation using ENR-supplemented agar plates, all ENR-resistant isolates had 3–4 nucleotide mutations that accompanied by amino acid substitutions in the quinolone-resistance-determining regions of gyrA, parC and parE, and 94.7% of all isolates derived from the University hospital showed AMP and/or CHL resistance and possessed blaTEM and/or catA1. The average mRNA expression levels of acrA, acrB and tolC and the prevalence of organic solvent tolerance, in isolates derived from ENR-supplemented agar plates were significantly higher in the University hospital than in the Community clinics isolates. Thus, E. coli derived from the University hospital cases more often showed concomitant decreased susceptibilities to aminopenicillins, fluoroquinolones and CHL than did those derived from the Community clinics; this was related to an active AcrAB–TolC efflux pump, in addition to acquisition of specific resistance genes and genetic mutations. PMID:24646457

26 CFR 521.103 - Scope of the convention.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of... alien who is a resident of Denmark, or by a Danish corporation, from the operation of ships or aircraft registered in Denmark (Article V); (3) Interest and royalties (including motion picture film rentals) derived...

26 CFR 521.103 - Scope of the convention.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of... alien who is a resident of Denmark, or by a Danish corporation, from the operation of ships or aircraft registered in Denmark (Article V); (3) Interest and royalties (including motion picture film rentals) derived...

26 CFR 521.103 - Scope of the convention.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of... alien who is a resident of Denmark, or by a Danish corporation, from the operation of ships or aircraft registered in Denmark (Article V); (3) Interest and royalties (including motion picture film rentals) derived...

26 CFR 521.103 - Scope of the convention.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of... alien who is a resident of Denmark, or by a Danish corporation, from the operation of ships or aircraft registered in Denmark (Article V); (3) Interest and royalties (including motion picture film rentals) derived...

Vocational Education and Training in Denmark. First Edition.

ERIC Educational Resources Information Center

Nielsen, Soren P.

This monograph examines vocational education and training (VT) in Denmark. Section 1 presents background information/framework data on the following: Denmark's political and administrative structure; population, employment, and unemployment; and the Danish economy. In section 2, the history of VT in Denmark is traced from before 1870 to the…

[Postgraduate training program in neurology at the regional hospitals in Hokkaido area].

PubMed

Matsumoto, Akihisa

2007-11-01

In the new post graduate training system, the 55% of interns in the Hokkaido area choosed the post graduate training at the general hospitals and 45% of them choosed the medical universities (Hokkaido university, Asahikawa medical university, Sapporo medical university). Furthermore, 23% of interns in Hokkaido area choosed the general hospitals and medical universities in Sapporo city. As to the post graduate training system in neurology, 5 hospitals included the neurology for at least 1 month to 3 months. On the other hand, in one general hospital in Sapporo city, the clinical training of neurology was not included in the post graduate training system. During 2 years of the new post graduate training system, only 25% of the interns could rotate the neurological department. Since the neurology training course is necessary for the post graduate training system, it is suggested to need to support the opportunity to rotate the neurology for the interns.

Cancer patients and positive sensory impressions in the hospital environment--a qualitative interview study.

PubMed

Timmermann, C; Uhrenfeldt, L; Birkelund, R

2013-01-01

This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis process was guided by the hermeneutical-phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital environment had a significant impact on their mood, generating positive thoughts and feelings. A view to nature also helped them to forget their negative thoughts for a while. The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive sensory impressions and the opportunity for recreation through environmental facilities strengthen the patient's positive thoughts and feelings. © 2012 Blackwell Publishing Ltd.

O Brincar como uma Acao Mediadora no Trabalho Desenvolvido com Criancas Hospitalizadas (Play as a Mediating Activity in Work Developed with Hospitalized Children).

ERIC Educational Resources Information Center

Goulart, Aurea Maria Paes Leme; de Moraes, Silvia Pereira Gonzaga

2000-01-01

Describes experiences with hospitalized children through the extension project "Writing and Reading at the University Hospital", State University of Maringa Hospital (Brazil). States the initial project proposal provided educational assistance to the children separated from school due to being in the hospital. Used play and games as an…

Long-term inpatient disease burden in the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: A cohort study of 21,297 childhood cancer survivors.

PubMed

de Fine Licht, Sofie; Rugbjerg, Kathrine; Gudmundsdottir, Thorgerdur; Bonnesen, Trine G; Asdahl, Peter Haubjerg; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Tryggvadottir, Laufey; Wesenberg, Finn; Hasle, Henrik; Winther, Jeanette F; Olsen, Jørgen H

2017-05-01

Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943-2008 in Denmark, 1971-2008 in Finland, 1955-2008 in Iceland, and 1958-2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977-2010; Finland, 1975-2012; Iceland, 1999-2008; and Sweden, 1968-2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors' standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0-42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91-1.97). The AER was 3,068 (2,980-3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess hospitalisations were for diseases of the nervous system (19.1% of all excess hospitalisations), endocrine system (11.1%), digestive organs (10.5%), and respiratory system (10.0%). Survivors of all types of childhood cancer were at increased, persistent risk for subsequent hospitalisation, the highest risks being those of survivors of neuroblastoma (RR: 2.6 [2.4-2.8]; n = 876), hepatic tumours (RR: 2.5 [2.0-3.1]; n = 92), central nervous system tumours (RR: 2.4 [2.3-2.5]; n = 6,175), and Hodgkin lymphoma (RR: 2.4 [2.3-2.5]; n = 2,027). Survivors spent on average five times as many days in hospital as comparison individuals (SBDR: 4.96 [4.94-4.98]; n = 422,218). The analyses of bed days in hospital included new primary cancers and recurrences. Of the total 422,218 days survivors spent in hospital, 47% (197,596 bed days) were for new primary cancers and recurrences. Our study is likely to underestimate the absolute overall disease burden experienced by survivors, as less severe late effects are missed if they are treated sufficiently in the outpatient setting or in the primary health care system. Childhood cancer survivors were at increased long-term risk for diseases requiring inpatient treatment even decades after their initial cancer. Health care providers who do not work in the area of late effects, especially those in primary health care, should be aware of this highly challenged group of patients in order to avoid or postpone hospitalisations by prevention, early detection, and appropriate treatments.

Which Implant Is Best After Failed Treatment for Pathologic Femur Fractures?

DTIC Science & Technology

2012-01-01

performed at the Karolinska University Hospital, Stockholm, Sweden. J. A. Forsberg (&) Regenerative Medicine, Naval Medical Research Center, Silver...Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden 123 Clin Orthop Relat Res DOI 10.1007/s11999-012-2558-2...NAME(S) AND ADDRESS(ES) Karolinska Institute, Karolinska University Hospital,Section of Orthopaedics and Sports Medicine, Department,of Molecular

A significant and consistent reduction in rotavirus gastroenteritis hospitalization of children under 5 years of age, following the introduction of universal rotavirus immunization in Israel.

PubMed

Muhsen, Khitam; Rubenstein, Uri; Kassem, Eias; Goren, Sophy; Schachter, Yaakov; Kremer, Adi; Shulman, Lester M; Ephros, Moshe; Cohen, Dani

2015-01-01

Universal rotavirus vaccination with RotaTeq was introduced in Israel in December 2010. We examined hospitalization rates of children under 5 years of age due to all-cause and rotavirus gastroenteritis, both before and 3 years after universal introduction of the vaccination. An ongoing hospital-based surveillance network that was established in November 2007, accessed information regarding hospitalization of children due to gastroenteritis (n = 6205) in 3 hospitals in northern Israel, with an annual average of about 60,000 children under 5 years of age living in the catchment area of these hospitals. Stool samples were tested for rotavirus by immunochromatography. Compared to the period preceding implementation of the universal rotavirus vaccination (2008-2010), hospitalizations due to rotavirus gastroenteritis in children <5 years of age decreased significantly, by 55% (95% CI 43%-67%) during the period of universal vaccination (2011-2013), a decrease that was sustained throughout the 3 year period. This reduction was greater in children aged 0-23 months (60-61%) than in toddlers aged 24-59 months (36%). A 32% (95% CI 21%-45%) decrease in the incidence of all-cause gastroenteritis was also observed. During the period preceding universal vaccination, rotavirus diarrhea showed typical winter seasonality, with highest incidence in December. However, the winter peak was substantially blunted during the period of universal immunization. Surveillance of rotavirus gastroenteritis should continue to assess the long-term impact of such a program. Our findings are of relevance to high and middle-income countries considering the introduction of a universal rotavirus immunization program.

Comparison of sick leave patterns between Norway and Denmark in the health and care sector: a register study.

PubMed

Krane, Line; Fleten, Nils; Stapelfeldt, Christina M; Nielsen, Claus Vinther; Jensen, Chris; Johnsen, Roar; Braaten, Tonje

2013-11-01

Sickness absence is of considerable concern in both Norway and Denmark. Labour Force Surveys indicate that absence in Norway is about twice that in Denmark and twice that of the mean reported by the Organisation for Economic Co-operation and Development. This study compares absence patterns according to age, percentage of employment, and occupation between municipal employees in the health and care sectors in two municipalities in Norway and Denmark. Data recorded in the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark were extracted for the years 2004 and 2008, revealing 3498 and 7751 employee-years, respectively. We calculated absence rates together with number of sick leave episodes, and their association with the above-mentioned covariates. Gender-specific comparative descriptive statistics and negative binomial regression analysis were performed. The sickness absence rate in women was 11.3% in Norway (95% confidence interval [CI] 11.2-11.4) and 7.0% in Denmark (95% CI 7.0-7.1) whereas mean number of sick leave episodes among women was 2.4 in Denmark, compared to 2.3 in Norway (p = 0.02). Young employees in Denmark had more sick leave episodes than in Norway. Proportion of absentees was higher in Denmark compared to Norway (p < 0.0001). The finding of that more employees in Denmark have more frequent, but shorter sick leave episodes compared to Norway, for whatever reasons, may indicate that more frequent sick leaves episodes prevent higher sick leaves rates.

Head circumference growth among extremely preterm infants in Denmark has improved during the past two decades.

PubMed

Zachariassen, Gitte; Hansen, Bo Mølholm

2015-07-01

Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. This was an observational study with comparison of head circumference (HC), weight and length growth in two Danish cohorts of extremely preterm (gestational age (GA) < 28 weeks) and extremely low birth weight (ELBW with a BW < 1,000 g) infants (A: 1994-1995 and B: 2004-2008). Infants in cohort A (n = 198) and B (n = 64) had a median GA and BW of 27 + 2 weeks and 948 g in A, and 27 + 3 weeks and 934 g in B. At discharge, infants in B compared with A had increased more in HC (p = 0.000), length (p = 0.008) and weight (p = 0.000). At two years CA, HC was still significantly larger in cohort B than A (p = 0.03), while no significant difference was recorded for length or weight. Growth during hospitalisation seems to have improved among extremely preterm and low birth weight infants from 1994-1995 to 2004-2008. This may be a result of improved nutrition in combination with improved intensive care during hospitalisation. Collection of data in the 2004-2008 cohort was supported by the Institute of Regional Health Services Research, the Egmont Foundation and the University of Southern Denmark. Collection of data from birth to two years of age in the 1994-1995 cohort was without financial support. For the 1994-1995 study, all eight regional Research Ethics Committees in Denmark at that time approved the study. The 2004-2008 study was approved by the Danish National Committee on Biomedical Research Ethics, and handling of data and registrations were approved by the Danish Data Protection Agency.

Awareness of sunburn in childhood, use of sunbeds and change of moles in Denmark, Northern Ireland, Norway and Sweden.

PubMed

Hajdarevic, Senada; Hvidberg, Line; Lin, Yulan; Donnelly, Conan; Gavin, Anna; Lagerlund, Magdalena; Pedersen, Anette F; Rasmussen, Birgit H; Runesdotter, Sara; Vedsted, Peter; Tishelman, Carol

2016-02-01

Malignant melanoma (MM) is increasing rapidly in Northern Europe. To reduce incidence and mortality through earlier diagnosis, public awareness of MM is important. Thus, we aim to examine awareness of risk factors and a symptom of MM, and how awareness varies by country and socio-demographic factors in Denmark, Northern Ireland (NI), Norway and Sweden. Population-based telephone interviews using the 'Awareness and Beliefs about Cancer' measure were conducted in 2011 among 8355 adults ≥50 years as part of the International Cancer Benchmarking Partnership Module 2. Prevalence ratios (PRs) with 95% confidence intervals were calculated. In these four countries, lowest awareness was found for 'sunburn in childhood' (63%), whereas awareness was high for 'use of sunbeds' (91%) and 'mole change' (97%). Lack of awareness of 'sunburn in childhood' was more prevalent among respondents from Norway [PR = 1.38 (1.28-1.48)] but less prevalent among respondents from Northern Ireland (NI) [PR = 0.78 (0.72-0.85)] and Sweden [PR = 0.86 (0.79-0.93)] compared with respondents from Denmark. Lack of awareness of 'use of sunbeds' was more prevalent among respondents from Norway [PR = 2.99 (2.39-3.74)], Sweden [PR = 1.57 (1.22-2.00)], and NI [PR = 1.65 (1.30-2.10)] compared with respondents form Denmark. Being a man, age ≥70, living alone, and having lower education, were each independently associated with lack of MM-awareness. The results indicate relatively low awareness of 'sunburn in childhood' as a risk factor for MM, and important disparities in MM-awareness across countries and socio-demographic groups. Improved and more directed initiatives to enhance public MM-awareness, particularly about 'sunburn in childhood', are needed. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Making collaboration work.

PubMed

Sims, Alison

2016-10-07

The Children's Hospitals Network (CHN) was formed in 2012 following a review of national specialist services. Oxford University Hospitals NHS Foundation Trust (OUH) and the University Hospital Southampton NHS Foundation Trust (UHS) collaborated in its formation, with the CHN hosting clinical and operational networks across more than 20 district general hospitals in the Thames Valley and Wessex regions.

[Efforts of gender equality at Kinki University School of Medicine].

PubMed

Miyamoto, Katsuichi

2013-01-01

In recent years, medical doctors are in short supply in many university hospitals. Retirement of female doctor after delivery is one of the reasons. Although they want to return to work after giving birth, they quit unavoidable because the working conditions do not match. Then, Kinki university hospital established the "provisions for special work arrangements". This work arrangement is the wage less, but the working hours is less than the regular. This work arrangement increased returner to the university hospital after delivery.

Digital gamma-gamma coincidence HPGe system for environmental analysis.

PubMed

Marković, Nikola; Roos, Per; Nielsen, Sven Poul

2017-08-01

The performance of a new gamma-gamma coincidence spectrometer system for environmental samples analysis at the Center for Nuclear Technologies of the Technical University of Denmark (DTU) is reported. Nutech Coincidence Low Energy Germanium Sandwich (NUCLeGeS) system consists of two HPGe detectors in a surface laboratory with a digital acquisition system used to collect the data in time-stamped list mode with 10ns time resolution. The spectrometer is used in both anticoincidence and coincidence modes. Copyright © 2017 Elsevier Ltd. All rights reserved.

NuSTAR on-ground calibration: II. Effective area

NASA Astrophysics Data System (ADS)

Brejnholt, Nicolai F.; Christensen, Finn E.; Westergaard, Niels J.; Hailey, Charles J.; Koglin, Jason E.; Craig, William W.

2012-09-01

The Nuclear Spectroscopic Telescope ARray (NuSTAR) was launched in June 2012 carrying the first focusing hard X-ray (5-80keV) optics to orbit. The multilayer coating was carried out at the Technical University of Denmark (DTU Space). In this article we introduce the NuSTAR multilayer reference database and its implementation in the NuSTAR optic response model. The database and its implementation is validated using on-ground effective area calibration data and used to estimate in-orbit performance.

Real time wind farm emulation using SimWindFarm toolbox

NASA Astrophysics Data System (ADS)

Topor, Marcel

2016-06-01

This paper presents a wind farm emulation solution using an open source Matlab/Simulink toolbox and the National Instruments cRIO platform. This work is based on the Aeolus SimWindFarm (SWF) toolbox models developed at Aalborg university, Denmark. Using the Matlab Simulink models developed in SWF, the modeling code can be exported to a real time model using the NI Veristand model framework and the resulting code is integrated as a hardware in the loop control on the NI 9068 platform.

[Evaluation of the management of soft tissue sarcomas in Franche-Comté since the establishment of a multidisciplinary meeting at University Hospital. About 47 cases].

PubMed

Haddad, J; Kalbacher, E; Piccard, M; Aubry, S; Chaigneau, L; Pauchot, J

2017-02-01

A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The Role of the Company in Generating Skills. The Learning Effects of Work Organization. Denmark.

ERIC Educational Resources Information Center

Kristensen, Peer Hull; Petersen, James Hopner

The impact of developments in work organizations on the skilling process in Denmark was studied through a macro analysis of available statistical information about the development of workplace training in Denmark and case studies of three Danish firms. The macro analysis focused on the following: Denmark's vocational training system; the Danish…

[Patient information prior to sterilization].

PubMed

Rasmussen, O V; Henriksen, L O; Baldur, B; Hansen, T

1992-09-14

The law in Denmark prescribes that the patient and the general practitioner to whom the patient directs his or her request for sterilization are obliged to confirm by their signatures that the patient has received information about sterilization, its risk and consequences. We asked 97 men and 96 women, if they had received this information prior to their sterilization. They were also asked about their knowledge about sterilization. 54% of the women and 35% of the men indicated that they had not received information. Only few of these wished further information by the hospital doctor. Knowledge about sterilization was good. It is concluded that the information to the patient prior to sterilization is far from optimal. The patients' signature confirming verbal information is not a sufficient safeguard. We recommend, among other things, that the patient should receive written information and that both the general practitioner and the hospital responsible for the operation should ensure that optimal information is received by the patient.

Drugs in injured drivers in Denmark.

PubMed

Bernhoft, I M; Steentoft, A; Johansen, S S; Klitgaard, N A; Larsen, L B; Hansen, L B

2005-06-10

As part of the project Impaired Motorists, Methods of Roadside Testing and Assessment for Licensing (IMMORTAL) under the European Commission's Transport RTD Programme of the 5th Framework Programme [I.M. Bernhoft, Drugs in accidents involved drivers in Denmark, D-R4.3 of the project Impaired Motorists, Methods Of Roadside Testing and Assessment for Licensing (IMMORTAL), , 2005], a study regarding drugs in accident-involved drivers was carried out in Denmark. The main objectives of this study were: (1) to collect and analyse samples from injured drivers for the presence of drugs; (2) to give an indication whether drugs may have contributed to traffic accidents; and (3) to get information on the drug-positive drivers and their drug use. This paper focuses on objective 1. Injured drivers who were treated in hospital were asked to give a saliva sample, a blood sample or both. The samples were screened for the following substances: opiates, amphetamines, methamphetamines, incl. MDMA (ecstasy), cannabinoids and metabolites, cocaine and metabolites and benzodiazepines. Screenings were carried out by means of Cozart Microplate EIA kit. Positive screenings were confirmation analysed by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography/tandem mass spectrometry (LC/MS/MS). In total, 26 out of 330 patients were confirmed positive for one or more of the six drug groups. However, three patients were excluded from the survey for various reasons. Of the remaining 23 drug-positive patients 15 were found positive for one drug group, and in five of these cases alcohol was present in a concentration over the legal limit in Denmark (0.05%). The other eight patients were found positive for two drug groups, and in four of these cases, alcohol was also present in a concentration over the legal limit. Alcohol was found both in combinations with medicinal drugs, with illegal drugs and with both. Based on the saliva or blood concentrations, we estimate that there is a strong suspicion of impairment in 9 out of 23 cases, and in another six cases it was likely that the drivers were impaired.

[A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

PubMed

Maisch, Bernhard

2005-03-01

1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state government, may be unrealistic, when the 4th biggest university hospital in Germany will be created by the merger. University hospitals recrute the patients for high end medicine beyond their region because of the specialized academic competence and advanced technical possibilities. Additional recruitment of patients for routine hospital can hardly be expected.d) A private management will have to consider primarily the "shareholder value", even when investing in infrastructure and buildings, as it can be expected for one partner. On the longterm this will not be possible without a substantial reduction of employees in both institutions. There are, however, also substantial efforts of some private hospital chains in clinical research, e. g. by Helios in Berlin and Rhön Gmbh at the Leipzig Heart Center.e) There is a yet underestimated but very substantial risk because of the taxation for the private owner when academic staff is transferred from the university to hospital care in their dual function as academic teachers and doctors. This risk also applies for the university if the transfer should come from hospital to the university. These costs would add to the financial burden, which has to be carried in addition to the DRGs.

Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark.

PubMed Central

Møller, L; Kristensen, T S; Hollnagel, H

1996-01-01

STUDY OBJECTIVE: To analyse the association between self rated health and the incidence of fatal and non-fatal coronary heart disease (CHD) in a Danish cohort followed up over 16 years. DESIGN: This was a prospective epidemiological follow up study. SETTING: A cohort from the County of Copenhagen, Denmark. PARTICIPANTS: The study included 1052 men and women born in 1936. During the 16 years' follow up 50 cases of CHD were registered in either the Danish register of deaths or the register of hospital admissions. MAIN RESULTS: Univariate analysis showed the following relative risks of CHD in the four self rated health groups: 'extremely good': 1.0, 'good': 4.0, 'poor': 5.8, 'miserable': 12.1 (p = 0.02). After control for the conventional CHD risk factors and a substantial number of other potential confounders the relative risks were: 1.0, 4.2, 6.5, and 18.6 (p = 0.02) respectively. CONCLUSIONS: Self rated health was an independent predictor of CHD in the present cohort. If confirmed, the association between self rated health and CHD may lead to new insight into psychosocial processes leading to this disease. Images PMID:8882226

Malnutrition related deaths.

PubMed

Sparre-Sørensen, Maja; Kristensen, Gustav N

2016-10-01

Studies have shown that malnutrition increases the risk of morbidity, mortality, the length of hospital stay, and costs in the elderly population. Approximately one third of all patients admitted to geriatric wards in Denmark are malnourished according to the Danish Geriatric database. The aim of this study is to describe and examine the sudden increase in deaths due to malnutrition in the elderly population in Denmark from 1999 and, similarly, the sudden decline in malnutrition related deaths in 2007. A descriptive epidemiologic study was performed. All Danes listed in the national death registry who died from malnutrition in the period from 1994 to 2012 are included. The number of deaths from malnutrition increased significantly during the period from 1999 to 2007, especially in the age group 70 years and over. Additionally, we document a surprising similarity between the development in excess mortality from malnutrition in the five Danish regions during the same period. During the period 1999-2007 malnutrition was the direct cause of 340 extra deaths, and probably ten times more registered under other diseases. This development in excess mortality runs parallel in all five Danish regions over time. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Hospitality Major Vocational High School Students' Expectations on University Education

ERIC Educational Resources Information Center

Chung, Ya-Ting; Yang, Cheng-Cheng

2013-01-01

Hospitality is not a new industry in Asia, but high quality hospitality industry has become more and more important in the trend of questing service-based economy and the increasing number of tourists in Asia. Thus there are more universities opened hospitality degree programs in Asia, Taiwan is no exception. In this context, why high school…

Hospital Coding Practice, Data Quality, and DRG-Based Reimbursement under the Thai Universal Coverage Scheme

ERIC Educational Resources Information Center

Pongpirul, Krit

2011-01-01

In the Thai Universal Coverage scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group (DRG) reimbursement. Questionable quality of the submitted DRG codes has been of concern whereas knowledge about hospital coding practice has been lacking. The objectives of this thesis are (1) To explore hospital coding…

Two Billion Years of Magmatism in One Place on Mars

NASA Astrophysics Data System (ADS)

Taylor, G. J.

2017-05-01

Thomas Lapen and Minako Righter (University of Houston), and colleagues at Aarhus University (Denmark), the Universities of Washington (Seattle), Wisconsin (Madison), California (Berkeley), and Arizona (Tucson), and Purdue University (Indiana) show that a geochemically-related group of Martian meteorites formed over a much longer time span than thought previously. So-called depleted shergottites formed during the time interval 325 to 600 million years ago, but now age dating on a recently discovered Martian meteorite, Northwest Africa (NWA) 7635, extends that interval by 1800 million years to 2400 million years. NWA 7635 and almost all other depleted shergottites were ejected from Mars in the same impact event, as defined by their same cosmic-ray exposure age of 1 million years, so all resided in one small area on Mars. This long time span of volcanic activity in the same place on the planet indicates that magma production was continuous, consistent with geophysical calculations of magma generation in plumes of hot mantle rising from the core-mantle boundary deep inside Mars.

Phoenix Telltale Movie with Clouds, Sol 103

NASA Technical Reports Server (NTRS)

2008-01-01

NASA's Phoenix Mars Lander's telltale catches a breeze as clouds move over the landing site on Sol 103 (Sept. 7, 2008), the 103rd Martian day since landing.

Phoenix's Surface Stereo Imager took this series of images during daily telltale monitoring around 3 p.m. local solar time and captured the clouds moving over the landing site.

Phoenix can measure wind speed and direction by imaging the telltale, which is about about 10 centimeters (4 inches) tall. The telltale was built by the University of Aarhus, Denmark.

The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

Vithanage Receives 2009 Natural Hazards Focus Group Award for Graduate Research

NASA Astrophysics Data System (ADS)

2010-04-01

Meththika Vithanage has been awarded the Natural Hazards Focus Group Award for Graduate Research, given annually to recent Ph.D. recipients for outstanding contributions to natural hazards research. Vithanage’s thesis is entitled “Effect of tsunami on coastal aquifers: Field studies and tank experiments.” She was formally presented with the award at the Natural Hazards Focus Group reception during the 2009 AGU Fall Meeting, held 14-18 December in San Francisco, Calif. Vithanage received her B.S. in natural resources from Sabaragamuwa University of Sri Lanka in 2002 and an M.S. in environmental science from the University of Peradeniya, Sri Lanka, in 2005. In 2009, she attained a Ph.D. in hydrogeology under the supervision of Karsten Jensen and Peter Engesgaard in the Department of Geology and Geography at University of Copenhagen, Denmark. Her research interests include groundwater flow modeling, density-dependent flow and solute transport modeling, and water quality analysis.

What affects local community hospitals' survival in turbulent times?

PubMed

Chiang, Hung-Che; Wang, Shiow-Ing

2015-06-01

Hospital closures became a prevalent phenomenon in Taiwan after the implementation of a national health insurance program. A wide range of causes contributes to the viability of hospitals, but little is known about the situation under universal coverage health systems. The purpose of present study is to recognize the factors that may contribute to hospital survival under the universal coverage health system. This is a retrospective case-control study. Local community hospitals that contracted with the Bureau of National Health Insurance in 1998 and remained open during the period 1998-2011 are the designated cases. Controls are local community hospitals that closed during the same period. Using longitudinal representative health claim data, 209 local community hospitals that closed during 1998-2011 were compared with 165 that remained open. Variables related to institutional characteristics, degree of competition, characteristics of patients and financial performance were analyzed by logistic regression models. Hospitals' survival was positively related to specialty hospital, the number of respiratory care beds, the physician to population ratio, the number of clinics in the same region, a highly competitive market and the occupancy rate of elderly patients in the hospital. Teaching hospitals, investor-owned hospitals, the provision of obstetrics services or home care, and the number of medical centers or other local community hospitals may jeopardize the chance of survival. Factors-enhanced local hospitals to survive under the universal coverage health system have been identified. Hospital managers could manipulate these findings and adapt strategies for subsistence. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Reducing Prescriptions of Long-Acting Benzodiazepine Drugs in Denmark: A Descriptive Analysis of Nationwide Prescriptions during a 10-Year Period.

PubMed

Eriksen, Sophie Isabel; Bjerrum, Lars

2015-06-01

Prolonged consumption of benzodiazepine drugs (BZD) and benzodiazepine receptor agonists (zolpidem, zaleplon, zopiclone; altogether Z drugs) is related to potential physiological and psychological dependence along with other adverse effects. This study aimed to analyse the prescribing of long-acting BZD (half-life >10 hr), compared to short-acting BZD in Denmark during a 10-year period. Descriptive analysis of total sales data from the Danish Register of Medicinal Product Statistics, to individuals in the primary healthcare sector, of all BZD and Z drugs in the period of 2003-2013. Prescription data derive from all community and hospital pharmacies in Denmark. The prescribing of long-acting BZD was reduced from 25.8 defined daily doses (DDD)/1000 inhabitants/day in 2003 to 8.8 DDD/1000 inhabitants/day in 2013, a relative reduction of 66%. The prescribing of short-acting BZD was reduced from 26.1 DDD/1000 inhabitants/day in 2003 to 16.4 DDD/1000 inhabitants/day in 2013, a relative reduction of 37%. Prescription data in this study did not include information about indications for initiating treatments. In addition, due to compliance problems, some of the prescribed drugs may not have been consumed according to the prescription. The observed reduction in BZD use was correlated to the introduction of new national guidelines on prescription of addictive drugs, but this study was not designed to detect a causal relationship. The prescribing of long-acting BZD decreased considerably more than the prescribing of short-acting BZD in the 10-year period. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Acute admissions to medical departments in Denmark: diagnoses and patient characteristics.

PubMed

Vest-Hansen, Betina; Riis, Anders Hammerich; Sørensen, Henrik Toft; Christiansen, Christian Fynbo

2014-09-01

Despite extensive research on individual diseases, population-based knowledge about reasons for acute medical admissions remains limited. Our aim was to examine primary diagnoses, Charlson Comorbidity Index (CCI) score, age, and gender among patients admitted acutely to medical departments in Denmark. In this population-based observational study, 264,265 acute medical patients admitted during 2010 were identified in the Danish National Registry of Patients (DNRP), covering all hospitals in Denmark. Reasons for acute admissions were assessed by primary diagnoses, grouped according to the International Classification of Diseases 10th edition. Additionally, the CCI score, age and gender were presented according to each diagnostic group. Two-thirds of the patients had one of the four following reasons for admission: cardiovascular diseases (19.3%), non-specific Z-diagnoses ("Factors influencing health status and contact with health services") (16.9%), infectious diseases (15.5%), and non-specific R-diagnoses ("Symptoms and abnormal findings, not elsewhere classified") (11.8%). In total, 45% of the patients had a CCI score of one or more and there was a considerable overlap between the patients' chronic diseases and the reason for admission. The median age of the study population was 64 years (IQR 47-77 years), ranging from 46 years (IQR 27-66) for injury and poisoning to 74 years (IQR 60-83) for hematological diseases. Gender representation varied considerably within the diagnostic groups, for example with male predominance in mental disorders (59.0%) and female predominance in diseases of the musculoskeletal system (57.8%). Our study identifies that acute medical patients often present with non-specific symptoms or complications related to their chronic diseases. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Evaluating the use and limitations of the Danish National Patient Register in register-based research using an example of multiple sclerosis.

PubMed

Mason, K; Thygesen, L C; Stenager, E; Brønnum-Hansen, H; Koch-Henriksen, N

2012-03-01

The Danish National Patient Register, Landspatientregistret (LPR), is a register of all hospital discharges and outpatient treatments in Denmark. It is increasingly used in research so it is important to understand to what extent this can be used as an accurate source of information. Virtually all patients in Denmark with multiple sclerosis (MS) are reported to the Combined MS Registry (DMSR), so this was used as the standard which the LPR was compared against. All residents of Denmark are assigned a unique Civil Register (CPR) number; this was used to compare data between registers. The LPR completeness was estimated by the proportion of cases from the DMSR that could be retrieved from the LPR. The LPR validity was estimated by the proportion of cases, listed in the LPR and DMSR, in whom the MS diagnosis could be confirmed as definite/probable/possible by the DMSR. We found that 86.9% of those who were DMSR listed with an approved MS diagnosis were also listed in the LPR with a MS diagnosis. The diagnosis was valid in 96.3% of patients listed in the LPR when compared against the DMSR. The low completeness reduces the usefulness of the LPR in epidemiological MS research, in particular incidence studies. The study also found that the completeness of the LPR could be increased to 92.8% by including LPR records from other departments in addition, but this reduced the validity of the LPR to 95.1%. However, these results cannot uncritically be applied to registration of other diseases in the LPR. © 2011 John Wiley & Sons A/S.

[Firework injuries in Denmark in the period 1995/1996 to 2006/2007].

PubMed

Foged, Thomas; Lauritsen, Jens; Ipsen, Tune; Ibsen, Tune

2007-12-03

The purpose of this study was to observe the occurrence and character of firework injuries on the two days around New Year in Denmark over the last decade. Since 1995/1996 all Accident and Emergency Departments in Denmark have registered all contacts where fireworks were the cause of injury on 31st December and 1st January. Data comprised hospital, sex, age, type of firework, diagnosis and final treatment. Follow-up and reminder by phone secured a 100% response rate. The total number of injured patients was 4,447. The number of firework injuries on the 31st of December and 1st of January was reduced by half over the 12-year period. Furthermore, the number of firework injuries caused by illegal fireworks in 2006/2007 was only 10% of the number in 1996/1997. Only 8% of injuries on last New Year's Eve were caused by illegal firewoks compared to almost 50% at the beginning of the period. A similar halving is seen in serious injuries. Roughly one quarter sustained injuries to the eyes, one quarter to the head/neck and 38% to hands. Firework injuries are now half of the level in 1996/1997. Injuries caused by illegal fireworks and serious injuries have shown a downward tendency throughout the period. The actual number of severe injuries from illegal fireworks is now only 10% of the level in the mid-1990s. This reduction can be attributed to preventive campaigns, greater knowledge of the risk of fireworks in general as well as legislation. Continued focus on preventive campaigns, control of fireworks for the general public and control of firework distribution to professionals is recommended.

Working Time Arrangements as Potential Risk Factors for Ischemic Heart Disease Among Workers in Denmark: A Study Protocol

PubMed Central

2016-01-01

Background It has long been suspected that a worker’s risk of developing an ischemic heart disease (IHD) may be influenced by his or her working time arrangements. A multitude of studies have been performed, and special attention has been given to long working hours and nighttime work. The statistical powers of the individual studies have, however, generally been too low to either dismiss or confirm an actual relationship, and meta-analyses of underpowered studies are generally associated with publication bias. Hence, uncertainty remains and whether these factors indeed are related to IHD has yet to be settled. Objective This project will test whether the incidences of IHD and usage of antihypertensive drugs among employees in Denmark are independent of weekly working hours and nighttime work. The objective of this paper is to present the intended analyses. Methods We will link individual participant data from the Danish labor force survey, 1999–2013, to data on socioeconomic status, industry, emigrations, redeemed prescriptions, hospitalizations, and deaths from registers covering the entire population of Denmark. The study will include approximately 160,000 participants, who will be followed through the registers, from the time of the interview until the end of 2014, for first occurrence of IHD and for antihypertensive drug treatment. We will use Poisson regression to analyze incidence rates as a function of nighttime work and of weekly working hours. Results We expect results to be ready in mid-2017. Conclusions To our knowledge, this will be the largest study ever of its kind. It will, moreover, be free from hindsight bias, since the hypotheses, inclusion criteria, significance levels, and statistical models will be completely defined and published before we are allowed to link the exposure data to the outcome data. PMID:27335284

Societal costs of diabetes mellitus in Denmark.

PubMed

Sortsø, C; Green, A; Jensen, P B; Emneus, M

2016-07-01

To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark. National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N = 318 729) were included in this study. Complication status was defined according to data from the Danish National Hospital Register. Diabetes-attributable costs were calculated as the difference between costs of patients with diabetes and the expected costs given the annual resource consumption of the diabetes-free population. Societal costs attributable to diabetes were estimated to be at least 4.27 billion EUR in 2011, corresponding to 14,349 EUR per patient-year. A twofold higher healthcare resource usage was found for patients with diabetes as compared with the diabetes-free population. Attributable costs, grouped according to different components, were 732 million EUR for primary and secondary care services, 153 million EUR for pharmaceutical drugs, 851 million EUR for nursing services, 1.77 billion EUR in lost productivity and 761 million EUR for additional costs. A steep increase in diabetes-attributable costs was found for patients with major complications compared with patients without complications across all cost components. For attributable healthcare costs this increase was estimated to be 6,992 EUR per person-year after controlling for potential confounders. Nearly half of the total costs of patients with diabetes can be attributed directly to their diabetes. The majority of costs are incurred among patients with major complications pointing to the importance of secondary preventive efforts among patients with diabetes. © 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Current use of nitrous oxide in public hospitals in Scandinavian countries.

PubMed

Husum, B; Stenqvist, O; Alahuhta, S; Sigurdsson, G H; Dale, O

2013-10-01

The use of nitrous oxide in modern anaesthesia has been questioned. We surveyed changes in use of nitrous oxide in Scandinavia and its justifications during the last two decades. All 191 departments of anaesthesia in the Scandinavian countries were requested by email to answer an electronic survey in SurveyMonkey. One hundred and twenty-five (64%) of the departments responded; four were excluded. The 121 departments provided 807.520 general anaesthetics annually. The usage of nitrous oxide was reported in 11.9% of cases, ranging from 0.6% in Denmark to 38.6% in Iceland while volatile anaesthetics were employed in 48.9%, lowest in Denmark (22.6%) and highest in Iceland (91.9%). Nitrous oxide was co-administered with volatile anaesthetics in 21.5% of general anaesthetics [2.4% (Denmark) -34.5% (Iceland)]. Use of nitrous oxide was unchanged in five departments (4%), decreasing in 75 (62%) and stopped in 41 (34%). Reasons for decreasing or stopping use of nitrous oxide were fairly uniform in the five countries, the most important being that other agents were 'better', whereas few put weight on its potential risk for increasing morbidity. Decision to stop using nitrous oxide was made by the departments except in four cases. Of 87 maternity wards, nitrous oxide was used in 72, whereas this was the case in 42 of 111 day-surgery units. The use of nitrous oxide has decreased in the Scandinavian countries, apparently because many now prefer other agents. Difference in practices between the five countries were unexpected and apparently not justified on anticipated evidence only. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Smallpox vaccination and all-cause infectious disease hospitalization: a Danish register-based cohort study.

PubMed

Sørup, Signe; Villumsen, Marie; Ravn, Henrik; Benn, Christine Stabell; Sørensen, Thorkild I A; Aaby, Peter; Jess, Tine; Roth, Adam

2011-08-01

There is growing evidence from observational studies and randomized trials in low-income countries that vaccinations have non-specific effects. Administration of live vaccines reduces overall child morbidity and mortality, presumably due to protection against non-targeted infections. In Denmark, the live vaccine against smallpox was phased out in the 1970s due to the eradication of smallpox. We used the phasing-out period to investigate the effect of smallpox vaccination on the risk of hospitalization for infections. From the Copenhagen School Health Records Register, a cohort of 4048 individuals was sampled, of whom 3559 had information about receiving or not receiving smallpox vaccination. Infectious disease hospitalizations were identified in the Danish National Patient Register. During 87,228 person-years of follow-up, 1440 infectious disease hospitalizations occurred. Smallpox-vaccinated individuals had a reduced risk of all-cause infectious disease hospitalization compared with smallpox-unvaccinated individuals [hazard ratio (HR) 0.84; 95% confidence interval (CI) 0.72-0.98]. The reduced risk of hospitalizations was seen for most subgroups of infectious diseases. The effect may have been most pronounced after early smallpox vaccination (vaccination age <3.5 years: HR 0.81; 95% CI 0.69-0.95; vaccination age ≥ 3.5 years: HR 0.91 95% CI 0.76-1.10). Among the smallpox-vaccinated, the risk of infectious disease hospitalization increased 6% with each 1-year increase in vaccination age (HR 1.06; 95% CI 1.02-1.10). Smallpox vaccination is associated with a reduced risk of infectious disease hospitalization in a high-income setting.

European University Students' Experiences and Attitudes toward Campus Alcohol Policy: A Qualitative Study.

PubMed

Van Hal, Guido; Tavolacci, Marie-Pierre; Stock, Christiane; Vriesacker, Bart; Orosova, Olga; Kalina, Ondrej; Salonna, Ferdinand; Lukacs, Andrea; Ladekjaer Larsen, Eva; Ladner, Joël; Jacobs, Liezille

2018-01-24

Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, this has the potential to place students at risk of overconsumption, which has adverse health consequences. Therefore, our study objectives were to explore and compare university students' experiences and attitudes toward alcohol policy on their campus using a qualitative approach. 29 focus group discussions (FGDs) were conducted among students from universities in five European countries: Belgium (4 FGDs), Denmark (6 FGDs), France (5 FGDs), Hungary (6 FGDs), and the Slovak Republic (8 FGDs), with a total number of 189 participants. Across the five European countries, students recognized that alcohol was a big problem on their campuses yet they knew very little, if any, about the rules concerning alcohol on their campus. Students will not support an on campus alcohol restriction and a policy should therefore focus on prevention initiatives.

Medicine, natural philosophy, and the influence of Melanchthon in reformation Denmark and Norway.

PubMed

Fink-Jensen, Morten

2006-01-01

In the sixteenth and early seventeenth centuries, all intellectual pursuits in Europe were colored by the religious conditions of the age. Accordingly, investigations into nature were unable to avoid issues dealing with the workings of divine power. The reestablishment of the University of Copenhagen after the Reformation of 1536 in the joint kingdom of Denmark and Norway prompted the formulation of an official Lutheran program for the study of medicine and natural philosophy (including anatomy). This program was wholly based on the ideas of the German reformer Philip Melanchthon, the aim being to apply knowledge of, for example, anatomy in support of the newly reformed Lutheran society. Thus, the crown and the church officially sanctioned Melanchthon's thoughts on natural philosophy as a means to apprehend, first, the majestic glory of divine providence; second, that man was truly created and assigned his place by God; and third, that it was demanded of all men and women that they submit themselves to the will of God and the laws of the public authorities.

TYCHO Brahe's Empiric Methods, His Instruments, His Sudden Escape from Denmark and a New Theory About His Death

NASA Astrophysics Data System (ADS)

Thykier, C.

1992-07-01

Tycho Brahe (1546-1601) was born a noble being, a son of Otto Brahe, and a member of the Royal Danish Council. Very early he developed a great interest in science and especially astronomy. In 1575 Tycho visited the learned Prince Wilhelm II in Kassel. Here he was inspired by the famous instrument maker Burgi to build new precise astronomical instruments, and on the recommendation of Wilhelm King Frederic II of Denmark was given the island Hven (which at that time belonged to Denmark) as an entailed estate. At 26 years old, Tycho became famous for his work DE NOVA STELLA on the supernova that brightened up in 1572, and since this phenomenon kept its position fixed among the stars, it immediately invalidated the Aristotelian dogma of the invariability of the fixed-star world. In 1577 Tycho observed the great comet and followed its celestial motion by means of a quadrant and a sextant. He then came to the conclusion that the comet orbit moved far out among the planets, in contradiction to the Aristotelian dogma of the crystal spheres for the planets. However, Tycho's great contribution to science was his construction of the observatory buildings Uraniborg and Stjerneborg ("Star Castle") with their equipment of ancient sighting instruments and his use of these instruments without telescopes for observations of the planets over a period of almost 20 years. Tycho's work is collected in 15 volumes, OPERA OMNIA by J. L. E. Dreyer. Tycho also mapped Hven correctly and he triangulated both sides of Oresund relative to Hven. When Tycho moved to Prague in 1599 he lived there for a couple of years and met Kepler who became his assistant and collaborator. Kepler was the one who analyzed Tycho's material and derived the Keplerian laws for the motions of the planets. On this basis Newton derived the law of gravitation. Tycho Brahe has been considered the father of modern empirical science. In 1596 he was accused of negligence of his administrative duties and several other things by the young new King Christian IV. Almost all of Tycho Brahe's privileges given to him by the late King Frederik II were taken from him. Shortly after that, he gathered his family and assistants and went to Rostock, from where he wrote a letter to Christian IV saying that he would contemplate returning to Denmark if the king would give him back his privileges. Christian very sternly answered the astronomer that if he should hope to return to Denmark he had to act like a servant. Tycho was too proud to go down to his knees for the king and never returned. So the reason for Tycho's acceptance of the invitation by Emperor Rudolf to come to Prague was that Christian IV would not continue the very considerable financial support to Tycho of about one percentage of the state income. The latest historical research has indicated that a "camarilla" of enemies stood behind Christian IV's aversion against Tycho. Tycho was not merely an astronomer, but also an astrologer and alchemist. As far as we know he never tried to make gold; his alchemic experiments were of medical character. This was not legal without permission from the Church and the University. Both the clergy and the doctors of the university envied the great scientist because princes and learned people preferred to visit Tycho at his "private university" on the island of Hven instead of visiting the University of Copenhagen. A new theory about Tycho's death has appeared. It has always been told that he died of a burst urinary bladder because he drank too much at parties. According to forensic medicine, however, this cannot be true. Tycho lived for some time after he became ill, and a bursted bladder would cause sudden death. A more plausible explanation would be that Tycho poisoned himself with his very strong medicines containing heavy metals like mercury and arsenic.

Manifestations of Gorlin-Goltz syndrome.

PubMed

Larsen, Anne Kristine; Mikkelsen, Dorthe Bisgaard; Hertz, Jens Michael; Bygum, Anette

2014-05-01

Gorlin-Goltz syndrome is an uncommon hereditary condition caused by mutations in the PTCH1 gene causing a wide range of developmental abnormalities. Multiple basal cell carcinomas, palmoplantar pits and jaw cysts are cardinal features. Many clinicians are unfamiliar with the different manifestations and the fact that patients are especially sensitive to ionizing radiation. This was a retrospective analysis of patients with Gorlin-Goltz syndrome seen at the Department of Dermatology and Allergy Centre or at Department of Plastic Surgery, Odense University Hospital, Denmark, in the period from 1994 to 2013. A total of 17 patients from eight families fulfilled the diagnostic criteria. In all, 14 patients had basal cell carcinomas, 12 patients had jaw cysts and ten patients had calcification of the falx cerebri. Other clinical features were frontal bossing, kyphoscoliosis, rib anomalies, coalitio, cleft lip/palate, eye anomalies, milia and syndactyly. In one family, medulloblastoma and astrocytoma occurred. Traditional treatment principles of basal cell carcinomas were used including radiotherapy performed in six patients. PTCH1 mutations were identified in five families and none of these mutations had previously been described. The patient cohort illustrates classic and rare disease manifestations. It is necessary to remind clinicians that radiation therapy in Gorlin-Goltz syndrome is relatively contraindicated. Today, mutation analysis can be used for confirmation of the diagnosis and for predictive genetic testing. Patients should be offered genetic counselling and life-long surveillance. not relevant. not relevant.

Occupational irritant contact dermatitis diagnosed by analysis of contact irritants and allergens in the work environment.

PubMed

Friis, Ulrik F; Menné, Torkil; Schwensen, Jakob F; Flyvholm, Mari-Ann; Bonde, Jens P E; Johansen, Jeanne D

2014-12-01

Irritant contact dermatitis (ICD) is a common diagnosis in patients with occupational contact dermatitis (OCD). Studies are lacking on the usefulness of material safety data sheets (MSDSs) in making the diagnosis of ICD. To characterize irritant exposures leading to the diagnosis of occupational ICD (OICD), and to evaluate the occurrence of concomitant exposures to contact allergens. We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010-August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing. OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens. In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association of polycystic ovary syndrome susceptibility single nucleotide polymorphism rs2479106 and PCOS in Caucasian patients with PCOS or hirsutism as referral diagnosis.

PubMed

Eriksen, Mette B; Brusgaard, Klaus; Andersen, Marianne; Tan, Qihua; Altinok, Magda L; Gaster, Michael; Glintborg, Dorte

2012-07-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disease among premenopausal women. A recent study found association between three single nucleotide polymorphisms (SNPs) and PCOS in a cohort of Han Chinese women. To investigate the association between rs13405728 (LHCGR gene), rs13429458 (THADA gene) and rs2479106 (DENND1A gene), PCOS, hirsutism and metabolic and hormonal parameters in a well characterized cohort of Caucasian patients of Danish descendant with PCOS or hirsutism. Patients underwent clinical examination, hormone analyses, oral glucose tolerance test and transvaginal ultrasound. Genetic variation was tested using allelic discrimination by real-time PCR. 268 patients referred to The Department of Endocrinology, Odense University Hospital, Denmark with PCOS or hirsutism between 1997 and 2011. Two hundred and forty-eight healthy females were included as controls. Genotype distributions and allele frequencies of rs13405728, rs13429458, and rs2479106 were comparable in patients and controls. The rs2479106 G allele was associated with a decreased PCOS susceptibility. None of the SNPs were associated with hirsutism or increased metabolic parameters. The rs2479106 G allele was associated with decreased PCOS susceptibility, thus confirming previously reported findings of association between rs2479106 and PCOS. Metabolic and hormonal parameters were comparable between genotypes of rs13405728 and rs2479106. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Geophysicists

NASA Astrophysics Data System (ADS)

William W. Fox, Jr., has been appointed director of the Cooperative Institute for Marine and Atmospheric Studies (CIMAS). He had been director of the Southeast Fisheries Center of the National Marine Fisheries Service since 1978. CIMAS was established in 1977 by the National Oceanic and Atmospheric Administration and the University of Miami.Seven of the 689 U.S. Fulbright Scholars for 1982-1983 are lecturing and conducting advanced research in geology in universities abroad. Brian Francis Farrell, a research assistant in planetary studies at Harvard University, is lecturing in oceanography at the University of Cambridge in England through June. William B. Fergusson, associate professor of civil engineering at Villanova University, will lecture in geology at the Kangwon National University in Korea until July. Ray Edward Ferrell, Jr., geology chairman at Louisiana State University in Baton Rouge, lectured and conducted research in marine geology at the University of Oslo in Norway. M. Allan Kays, professor of geology at the University of Oregon in Eugene, will conduct research in geology at the University of Copenhagen in Denmark through April. Richard Vernon McGehee, associate professor of health education at Southeastern Louisiana University (University Station campus), will be lecturing in geology at the University of Monrovia in Liberia through July. Bruce Warren Nelson, a professor of environmental studies at the University of Virginia in Charlottesville, will be lecturing in geology at the Universiti Malaya in Malaysia through April. Ronald Porter Willis, professor of geology at the University of Wisconsin—Eau Claire, will be lecturing in geology at the Seoul National University in Korea through July.

[Diagnosing gender identity].

PubMed

Kaltiala-Heino, Riittakerttu; Mattila, Aino; Kärnä, Teemu; Joutsenneimi, Kaisla

2015-01-01

Transsexualism and other variations of gender identity are based on a stable sense of identity. The aetiology of this phenomenon is not fully known. Suffering caused by gender dysphoria is alleviated with sex reassignment. The psychiatric assessment of both adolescents and adults has been centralized in Finland to two university hospitals, the Helsinki University Hospital and Tampere University Hospital. In both hospitals, multidisciplinary teams aim at differential diagnosis by using well-known psychiatric and psychological instruments. Wishes for sex reassignment that are caused by a mental health disorder are excluded. Assessment in adolescence is challenging because the identity in youth is still forming.

Towards 50% wind electricity in Denmark: Dilemmas and challenges

NASA Astrophysics Data System (ADS)

Bach, Paul-Frederik

2016-05-01

Electricity and heat supply systems are essential contributors to a fossil-free future in Denmark. The combined production of heat and power (CHP) and the production of wind energy are already well developed in Denmark. Combined heat and power covers about 40% of the demand for space heating in Denmark, and the production of wind energy is supposed to exceed 50% of the demand for electricity by 2020. The changing electricity and heat production has some consequences already now: i) Decreasing wholesale prices in Denmark and in other countries. ii) Thermal power plants are closing down. Denmark is no longer self-sufficient with electricity under all conditions. iii) The electricity production pattern does not match the demand pattern. The result is that the neighbouring countries must absorb the variations from wind and solar power. Essential challenges: i) The future of combined heat and power in Denmark is uncertain. ii) Denmark will need new backup capacity for filling the gaps in wind power and solar cell output. iii) Flexible electricity consumers are supposed to contribute to balancing the future power systems. There is still a long way to go before the Smart Grid visions are implemented in large scale. iv) The transformation of the power system will create new risks of power failures.

Radio advertising increases hospital call center volume by 48%.

PubMed

2006-01-01

Since the fall of 2005, call volume at University of Southern California University Hospital of Los Angeles' call center has increased by nearly 50%. How? The hospital embarked on a long-term radio campaign to promote its presence as a premier academic medical center and to increase patient volume.

Aggressive television ad campaign for Cooper University Hospital features hometown celebrity.

PubMed

2006-01-01

Cooper University Hospital in Camden, NJ, features an extensive ambulatory care network that includes practice sites across eight counties of Southern New Jersey. Recently, the hospital worked with Willing Strategic Advertising to produce an award-winning television advertising campaign endorsed by New Jersey-born TV personality, Kelly Ripa.

The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia.

PubMed

Melgaard, Dorte; Baandrup, Ulrik; Bøgsted, Martin; Bendtsen, Mette Dahl; Hansen, Tina

2017-06-01

Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome was mortality during hospitalization and within 30 days of discharge and rehospitalization within 30 days of discharge. A total of 154 consecutive patients (54.5% male, mean age 77.4 years (SD 11.51)) hospitalized because of CAP from September 1, 2013 to March 31, 2014 at North Denmark Regional Hospital were included in this study. The volume-viscosity swallow test was conducted for each patient. A total of 34.42% patients presented with OD. Patients with OD and CAP presented significant differences in age, CURB-65, and dementia compared with those of patients with CAP alone. The majority lived in nursing homes, had a lower body mass index, Barthel 20 score, and handgrip strength, and had poor oral health compared with patients with CAP only. Patients with OD presented an increased length of stay in hospital (P < 0.001), intra-hospital mortality (P < 0.001), and 30-day mortality rate (P < 0.001) compared with those of patients with CAP only. Their rate of rehospitalization 0-30 days after discharge was also increased (P < 0.001) compared with that of patients with CAP only. Thus, OD is related to frailty and poor outcome.

Tertiary-care facility's seniors association attracts its highest number of referrals through word-of-mouth. University Hospital, Denver, CO.

PubMed

Lewicki, G

1999-01-01

University Hospital, Denver, has started its University Seniors Assn. to promote health and wellness to people 50 and older. Within four months the organization had 500 members. Now the association is 3,500 members strong.

Denmark. A Study of the Educational System of Denmark and Guide to the Academic Placement of Students in Educational Institutions in the United States. PIER World Education Series.

ERIC Educational Resources Information Center

Woolston, Valerie A.; Dickey, Karlene N.

This volume offers a full country study of the structure and content of the educational system of Denmark, together with a formal set of placement recommendations for Danish students wishing to study in the United States. Chapter 1 introduces the volume with descriptions of Denmark and its people, government, the government's role in education,…

Increased Incidence Rate of Trauma- and Stressor-Related Disorders in Denmark After the September 11, 2001, Terrorist Attacks in the United States.

PubMed

Hansen, Bertel T; Østergaard, Søren D; Sønderskov, Kim M; Dinesen, Peter T

2016-10-01

The terrorist attacks that occurred on September 11, 2001 (hereafter referred to as 9/11) in the United States had a profound impact on the physical and mental health of Americans, but the effects beyond the United States are largely unknown. To understand the wider aftermath, we examined the consequences of the 9/11 attacks on mental disorders in the Kingdom of Denmark. Utilizing population data from the Danish Psychiatric Central Research Register from 1995 to 2012, we used a time-series intervention approach to estimate the change in the incidence rate of mental disorders after the 9/11 attacks. Based on analyses of 1,448,250 contacts with psychiatric services, we found that the attacks were followed by an immediate 16% increase in the incidence rate of trauma- and stressor-related disorders. This surge dissipated approximately a year after 9/11. In contrast, no similar increases were found for other disorders. This is consistent with the prominent role of external stressors in the etiology of trauma- and stressor-related disorders. The results indicate that the effects of 9/11 on mental disorders extended across the Atlantic Ocean to Denmark. Thus, the impact of terrorist attacks on mental health is likely not limited to inhabitants of the country under attack; it also extends to people far away and without immediate relation to it. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adverse Events in Affiliated Hospitals of Mazandaran University of Medical Sciences

PubMed Central

Saravi, Benyamin Mohseni; Siamian, Hasan; Nezhad, Ayyob Barzegar; Asghari, Zoleleykha; Kabirzadeh, Azar

2014-01-01

Due to the complexity of the hospital environment, its structure faces with multiple hazards. The risks whether by providing the care and whether by hospital environment endanger patients, relatives and care providers. Therefore, a more accurate reporting and analysis of the report by focusing on access to preventative methods is essential. In this study, hospitals' adverse event that has sent by affiliated hospitals of Mazandaran University of Medical Sciences to deputy for treatment has studied. PMID:24944536

Childhood Infections and Subsequent School Achievement Among 598,553 Danish Children.

PubMed

Köhler-Forsberg, Ole; Sørensen, Holger J; Nordentoft, Merete; McGrath, John J; Benros, Michael E; Petersen, Liselotte

2017-12-22

Hospitalizations for infections have been associated with subsequent decreased cognitive ability, but it is uncertain if childhood infections influence subsequent scholastic achievement (SA). We aimed to estimate the association between infections during childhood and SA. Nationwide prospective cohort-study including 598,553 children born in Denmark between 1987 and 1997 and their parents. Exposures were hospitalization for infections and treatment with anti-infective agents. Outcomes were completion of ninth grade and ninth grade test scores. Data were analyzed with logistic and linear regression analysis techniques and adjusted for any mental disorder, birthweight, Apgar score, malformations at birth, chronic somatic diseases, first born child, parental educational level and parental mental disorders. Hospitalization with infections was linked to lower completion of ninth grade with an odds ratio of 0.82 (95%-CI 0.79-0.85) compared with children without prior hospitalizations for infections. Dose response relationships were observed with respect to number of hospital contacts for infections and a shorter time since last hospitalization (all p<0.001). Among those who completed the ninth grade test score, we found a dose-response and time-since relationship between number of prior severe infections and subsequent lower grade scores (p<0.001). Treatment of non-severe infections with anti-infective agents did not predict lower completion of ninth grade but was associated with lower grade scores (p<0.001). Infections, particularly those requiring hospitalizations, were associated with subsequent affected cognitive ability as indicated by lower SA. These findings might also be explained by missed school days or socioeconomic factors associated with the susceptibility of acquiring infections.

Enterprise size and risk of hospital treated injuries among manual construction workers in Denmark: a study protocol.

PubMed

Pedersen, Betina H; Hannerz, Harald; Christensen, Ulla; Tüchsen, Finn

2011-04-21

In most countries throughout the world the construction industry continues to account for a disturbingly high proportion of fatal and nonfatal injuries. Research has shown that large enterprises seem to be most actively working for a safe working environment when compared to small and medium-sized enterprises. Also, statistics from Canada, Italy and South Korea suggest that the risk of injury among construction workers decreases with enterprise size, that is the smaller the enterprise the greater the risk of injury. This trend, however, is neither confirmed by the official statistics from Eurostat valid for EU-15 + Norway nor by a separate Danish study - although these findings might have missed a trend due to severe underreporting. In addition, none of the above mentioned studies controlled for the occupational distribution within the enterprises. A part of the declining injury rates observed in Canada, Italy and South Korea therefore might be explained by an increasing proportion of white-collar employees in large enterprises. To investigate the relation between enterprise size and injury rates in the Danish construction industry. All male construction workers in Denmark aged 20-59 years will be followed yearly through national registers from 1999 to 2006 for first hospital treated injury (ICD-10: S00-T98) and linked to data about employment status, occupation and enterprise size. Enterprise size-classes are based on the Danish business pattern where micro (less than 5 employees), small (5-9 employees) and medium-sized (10-19 employees) enterprises will be compared to large enterprises (at least 20 employees). The analyses will be controlled for age (five-year age groups), calendar year (as categorical variable) and occupation. A multi-level Poisson regression will be used where the enterprises will be treated as the subjects while observations within the enterprises will be treated as correlated repeated measurements. This follow-up study uses register data that include all people in the target population. Sampling bias and response bias are thereby eliminated. A disadvantage of the study is that only injuries requiring hospital treatment are covered.

Enterprise size and risk of hospital treated injuries among manual construction workers in Denmark: a study protocol

PubMed Central

2011-01-01

Background In most countries throughout the world the construction industry continues to account for a disturbingly high proportion of fatal and nonfatal injuries. Research has shown that large enterprises seem to be most actively working for a safe working environment when compared to small and medium-sized enterprises. Also, statistics from Canada, Italy and South Korea suggest that the risk of injury among construction workers decreases with enterprise size, that is the smaller the enterprise the greater the risk of injury. This trend, however, is neither confirmed by the official statistics from Eurostat valid for EU-15 + Norway nor by a separate Danish study - although these findings might have missed a trend due to severe underreporting. In addition, none of the above mentioned studies controlled for the occupational distribution within the enterprises. A part of the declining injury rates observed in Canada, Italy and South Korea therefore might be explained by an increasing proportion of white-collar employees in large enterprises. Objective To investigate the relation between enterprise size and injury rates in the Danish construction industry. Methods/Design All male construction workers in Denmark aged 20-59 years will be followed yearly through national registers from 1999 to 2006 for first hospital treated injury (ICD-10: S00-T98) and linked to data about employment status, occupation and enterprise size. Enterprise size-classes are based on the Danish business pattern where micro (less than 5 employees), small (5-9 employees) and medium-sized (10-19 employees) enterprises will be compared to large enterprises (at least 20 employees). The analyses will be controlled for age (five-year age groups), calendar year (as categorical variable) and occupation. A multi-level Poisson regression will be used where the enterprises will be treated as the subjects while observations within the enterprises will be treated as correlated repeated measurements. Discussion This follow-up study uses register data that include all people in the target population. Sampling bias and response bias are thereby eliminated. A disadvantage of the study is that only injuries requiring hospital treatment are covered. PMID:21510851

The O3-Vet project: integration of a standard nomenclature of clinical terms in a veterinary electronic medical record for veterinary hospitals.

PubMed

Zaninelli, M; Campagnoli, A; Reyes, M; Rojas, V

2012-11-01

In order to improve the hospital information system of the Chilean University Hospital, the Veterinary Medicine School of Universidad de Chile made a research cooperation with Università San Raffaele Roma to develop and test a new release of the O3-Vet software application. O3-Vet was selected by the Chilean University mainly for two reasons: (1) it uses human medicine standardized technologies such as "Health Level 7" (HL7) and "Integrating the Healthcare Enterprise" (IHE), which allow a good level of data sharing and hospital management; (2) it is open source, which means it can be adapted to specific hospital needs. In the new release, a subset of diagnostic terms was added from the "Systematized Nomenclature of Medicine Clinical Terms" (SNOMED CT), selected by the "American Animal Hospital Association" (AAHA) to standardize the filing of clinical data and its retrieval. Results from a limited survey of veterinarians of the University (n=9) show that the new release improved the management of the Chilean University Hospital and the ability to retrieve useful clinical data. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

California's county hospitals and the University of California graduate medical education system. Current issues and future directions.

PubMed

Jameson, W J; Pierce, K; Martin, D K

1998-05-01

California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating UC GME programs in county hospitals helps serve the public missions of both institutions. Such partnerships enhance the GME experience of UC residents, provide key primary care training opportunities, and ensure continued health care access for indigent and uninsured populations. Only through affiliation with university training programs have county hospitals been able to run the cost-effective, quality programs that constitute an acceptable safety net for the poor. Financial stress, however, has led county hospitals and UC's GME programs to advocate for reform in both GME financing and indigent care funding. County hospitals must participate in constructing strategies for GME reform to assure that GME funding mechanisms provide for equitable compensation of county hospitals' essential role. Joint advocacy will also be essential in achieving significant indigent care policy reform.

Assessing Governance Alternatives for University-Owned Public Teaching Hospitals.

ERIC Educational Resources Information Center

Whitley, Evangeline L.

The governance options matrix is provided to offer a way for state and university policymakers to examine the functioning environments of specific university-owned public teaching hospitals. With it, they can consider the benefits and problems involved with different options for governance. The issues related to the environmental factors affecting…

Gruppeorganiseret og selvstyret fremmedsprogstilegnelse. Et undervisningseksperiment pa RUC [and] Skolesprogene. Om fremmedsprogenes status og funktion i gymnasiet. ROLIG Papir 22 (Group Organized and Self Managed Foreign Language Acquisition. A Research Project at RUC [and] School Languages. On the Status and Function of Foreign Languages in Secondary Schools. ROLIG Paper 22).

ERIC Educational Resources Information Center

Jakobsen, Karen Sonne

Two articles highlight different issues on foreign language learning and instruction in Denmark. The first article describes a research project at Roskilde University Center that focuses on group organized and self managed foreign language acquisition. The idea for the project came about as a result of concern over problems related to foreign…

Historical development of the renal histopathology services in Malaysia.

PubMed

Looi, Lai-Meng; Cheah, Phaik-Leng

2009-06-01

Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its first renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently filtered out to the private sector as more histopathologists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, fibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

PubMed Central

Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

2010-01-01

Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

Rates and characteristics of sleep paralysis in the general population of Denmark and Egypt.

PubMed

Jalal, Baland; Hinton, Devon E

2013-09-01

In the current research we report data from two studies that examined rates and characteristics of sleep paralysis (SP) in the general population of Denmark and Egypt. In Study I, individuals from Denmark and Egypt did not differ in age whereas there were more males in the Egyptian sample (47 vs. 64 %); in Study II, individuals from Denmark and Egypt were comparable in terms of age and gender distribution. In Study I we found that significantly fewer individuals had experienced SP in Denmark [25 % (56/223)] than in Egypt [44 % (207/470)] p < .001. In Study II we found that individuals who had experienced at least one lifetime episode of SP from Denmark (n = 58) as compared to those from Egypt (n = 143) reported significantly fewer SP episodes in a lifetime relative to SP experiencers from Egypt (M = 6.0 vs. M = 19.4, p < .001). SP in the Egyptian sample was characterized by high rates of SP (as compared to in Denmark), frequent occurrences (three times that in the Denmark sample), prolonged immobility during SP, and great fear of dying from the experience. In addition, in Egypt, believing SP to be precipitated by the supernatural was associated with fear of the experience and longer SP immobility. Findings are discussed in the context of cultural elaboration and salience theories of SP.

Hospitable Gestures in the University Lecture: Analysing Derrida's Pedagogy

ERIC Educational Resources Information Center

Ruitenberg, Claudia

2014-01-01

Based on archival research, this article analyses the pedagogical gestures in Derrida's (largely unpublished) lectures on hospitality (1995/96), with particular attention to the enactment of hospitality in these gestures. The motivation for this analysis is twofold. First, since the large-group university lecture has been widely critiqued as…

The OJ287 observing campaign hots up

NASA Astrophysics Data System (ADS)

Poyner, G.

2006-12-01

In the August 2006 issue of the Journal [116(4), 163-164] I gave details of the BAAVSS observing campaign to monitor the binary black hole OJ287. The campaign is now once again in full swing for the 2006/2007 season, now that solar conjunction is finally over. During the summer break, new analysis was done on the BAAVSS & TA data by Dr Mauri Valtonen (Dept of Physics and Tuorla Observatory, University of Turku, Finland & Dept of Physics, University of the West Indies, Trinidad) and Dr Mark Kidger (Herschel Science Centre, European Space Astronomy centre, Villafranca del Castillo Satellite Tracking Station, Madrid, Spain, & INSA) and Dr Harry Lehto (NORDITA, Copenhagen, Denmark). A detailed examination of these data from the past 15 years, and especially the last 12 months, has led to some interesting conclusions.

Drug selection in French university hospitals: analysis of formularies for nine competitive pharmacological classes.

PubMed

Gallini, Adeline; Juillard-Condat, Blandine; Saux, Marie-Claude; Taboulet, Florence

2011-11-01

To give a panorama of the selectivity and agreement of French university hospitals' drug formularies (HDF) for nine competitive classes. All university hospitals were asked to send their HDF and selection criteria as of January 2009 for nine competitive pharmacological classes (proton pump inhibitors, serotonin antagonists, low molecular weight heparins, erythropoietins, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, statins, α-adrenoreceptor antagonists and selective serotonin re-uptake inhibitors). Selectivity of HDF was estimated by the percentage of drug entities selected by the hospital within the pharmacological class. Agreement between hospitals was assessed with modified kappa coefficients for multi-raters. Twenty-one out of the 29 hospitals agreed to participate. These hospitals selected between 34% and 63% of the drug entities available for the nine classes, which represented 18 to 35 agents. Regarding the nature of chosen drug entities, the overall level of agreement was 'fair' and varied with pharmacological classes. Selection criteria were sent by only 12 hospitals. The technical component was the most important element in all hospitals. The weight of the economic component varied between 20% and 40% in the tender's grade. Large variations were seen in the number and nature of drugs selected by university hospitals which can be attributable to two successive decision-making processes (evaluation by the Drug and Therapeutics Committee followed by the purchasing process). © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure.

PubMed

Rørth, Rasmus; Fosbøl, Emil L; Mogensen, Ulrik M; Kragholm, Kristian; Numé, Anna-Karin; Gislason, Gunnar H; Jhund, Pardeep S; Petrie, Mark C; McMurray, John J V; Torp-Pedersen, Christian; Køber, Lars; Kristensen, Søren L

2018-02-01

Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF. We identified all patients of working age (18-60 years) with a first HF hospitalization in the period 1997-2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission. The primary outcome was death from any cause and the secondary outcome was readmission for HF. Cumulative incidence curves, binomial regression and Cox regression models were used to assess outcomes. Of 25 571 patients with a first hospitalization for HF, 15 428 (60%) were part of the workforce at baseline. Patients in the workforce were significantly younger (53 vs. 55 years) more likely to be male (75% vs 64%) and less likely to have diabetes (13% vs 22%) and chronic obstructive pulmonary disease (5% vs 10%) (all P < 0.0001). Not being part of the workforce was associated with a significantly higher risk of death [hazard ratio (HR) 1.59; 95% confidence interval (CI) 1.50-1.68] and rehospitalization for HF (HR 1.09; 95% CI 1.05-1.14), in analyses adjusted for age, sex, co-morbidities, education level, calendar time, and duration of first HF hospitalization. Not being part of the workforce at time of first HF hospitalization was independently associated with increased mortality and recurrent HF hospitalization. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Impact of structural and economic factors on hospitalization costs, inpatient mortality, and treatment type of traumatic hip fractures in Switzerland.

PubMed

Mehra, Tarun; Moos, Rudolf M; Seifert, Burkhardt; Bopp, Matthias; Senn, Oliver; Simmen, Hans-Peter; Neuhaus, Valentin; Ciritsis, Bernhard

2017-12-01

The assessment of structural and potentially economic factors determining cost, treatment type, and inpatient mortality of traumatic hip fractures are important health policy issues. We showed that insurance status and treatment in university hospitals were significantly associated with treatment type (i.e., primary hip replacement), cost, and lower inpatient mortality respectively. The purpose of this study was to determine the influence of the structural level of hospital care and patient insurance type on treatment, hospitalization cost, and inpatient mortality in cases with traumatic hip fractures in Switzerland. The Swiss national medical statistic 2011-2012 was screened for adults with hip fracture as primary diagnosis. Gender, age, insurance type, year of discharge, hospital infrastructure level, length-of-stay, case weight, reason for discharge, and all coded diagnoses and procedures were extracted. Descriptive statistics and multivariate logistic regression with treatment by primary hip replacement as well as inpatient mortality as dependent variables were performed. We obtained 24,678 inpatient case records from the medical statistic. Hospitalization costs were calculated from a second dataset, the Swiss national cost statistic (7528 cases with hip fractures, discharged in 2012). Average inpatient costs per case were the highest for discharges from university hospitals (US$21,471, SD US$17,015) and the lowest in basic coverage hospitals (US$18,291, SD US$12,635). Controlling for other variables, higher costs for hip fracture treatment at university hospitals were significant in multivariate regression (p < 0.001). University hospitals had a lower inpatient mortality rate than full and basic care providers (2.8% vs. both 4.0%); results confirmed in our multivariate logistic regression analysis (odds ratio (OR) 1.434, 95% CI 1.127-1.824 and OR 1.459, 95% confidence interval (CI) 1.139-1.870 for full and basic coverage hospitals vs. university hospitals respectively). The proportion of privately insured varied between 16.0% in university hospitals and 38.9% in specialized hospitals. Private insurance had an OR of 1.419 (95% CI 1.306-1.542) in predicting treatment of a hip fracture with primary hip replacement. The seeming importance of insurance type on hip fracture treatment and the large inequity in the distribution of privately insured between provider types would be worth a closer look by the regulatory authorities. Better outcomes, i.e., lower mortality rates for hip fracture treatment in hospitals with a higher structural care level advocate centralization of care.

Going all digital in a university hospital: a unified large-scale PACS for multiple departments and hospitals

NASA Astrophysics Data System (ADS)

Vogl, Raimund

2001-08-01

In 1997, a large PACS was first introduced at Innsbruck University Hospital in the context of a new traumatology centre. In the subsequent years, this initial PACS setting covering only one department was expanded to most of the hospital campus, with currently some 250 viewing stations attached. Constantly connecting new modalities and viewing stations created the demand for several redesigns from the original PACS configuration to cope with the increasing data load. We give an account of these changes necessary to develop a multi hospital PACS and the considerations that lead us there. Issues of personnel for running a large scale PACS are discussed and we give an outlook to the new information systems currently under development for archiving and communication of general medical imaging data and for simple telemedicine networking between several large university hospitals.

Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

PubMed

Hsiao, Yu-Yu; Cheng, Shou-Hsia

2013-07-01

To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. A survey questionnaire was mailed to discharged patients in October 2010. This study included 183 large-scale hospitals in Taiwan. A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the patient-reported hospital quality (PRHQ), was included to characterize patient's experience of hospital stay. Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an Medical Center Hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.

Income-related and educational inequality in small-for-gestational age and preterm birth in Denmark and Finland 1987-2003.

PubMed

Mortensen, Laust H; Lauridsen, Jørgen T; Diderichsen, Finn; Kaplan, George A; Gissler, Mika; Andersen, Anne-Marie N

2010-02-01

In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs). From the national medical birth registries we gathered information on all births from 1987 to 2003. Information on highest completed maternal education and household income in the year preceding birth of the offspring was obtained for 1,012,400 births in Denmark and 499,390 in Finland. We then calculated CIXs for income- and education-related inequality in SGA and preterm birth. The mean household income-related inequality in SGA was -0.04 (95% confidence interval: -0.05, -0.04) in Denmark and -0.03 (-0.04, -0.02) in Finland. The maternal education-related inequality in SGA was -0.08 (-0.10, -0.06) in Denmark and -0.07 (-0.08, -0.06) in Finland. The income-related inequality in preterm birth was -0.03 (-0.03, -0.02) in Denmark and -0.03 (-0.04, -0.02) in Finland. The education-related inequality in preterm birth was -0.05 (-0.07, -0.04) in Denmark and -0.04 (-0.05, -0.03) in Finland. In Denmark, the income-related and education-related inequity in SGA increased over time. In Finland, the income-related inequality in SGA birth increased slightly, while education-related inequalities remained stable. Inequalities in preterm birth decreased over time in both countries. Denmark and Finland are examples of nations with free prenatal care and publicly financed obstetric care of high quality. During the period of study there were macroeconomic shocks affecting both countries. However, only small income- and education-related inequalities in SGA and preterm births during the period were observed.

Cost-of-illness of patients with contact dermatitis in Denmark.

PubMed

Saetterstrøm, Bjørn; Olsen, Jens; Johansen, Jeanne Duus

2014-09-01

Contact dermatitis is a frequent occupational and non-occupational skin disease. To investigate the effects of contact dermatitis on labour market affiliation and societal costs in terms of healthcare costs and production loss. A total of 21 441 patients patch tested either in hospital departments or at dermatological clinics in the period 2004-2009 were included in the study. The analyses were stratified by children (age 0-15 years), occupational contact dermatitis (age 16-65 years), and non-occupational dermatitis (age ≥ 16 years). Controls were selected from a 30% random sample of the population. Individual encrypted data were retrieved on healthcare utilization, socio-demographics, education, labour market affiliation and transfer payments from public registers in Denmark for cases and controls. Attributable healthcare costs for 4 years prior to patch testing (1 year for children) and the year after patch testing were €959 for children, €724 for occupational contact dermatitis, and €1794 for non-occupational dermatitis. Productivity costs for the same period were €10 722 for occupational contact dermatitis and €3074 for non-occupational contact dermatitis. The main findings of this study were that there were statistically significant attributable healthcare costs for both children and adults, and statistically significant productivity loss for adults. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Existing data sources for clinical epidemiology: The North Denmark Bacteremia Research Database

PubMed Central

Schønheyder, Henrik C; Søgaard, Mette

2010-01-01

Bacteremia is associated with high morbidity and mortality. Improving prevention and treatment requires better knowledge of the disease and its prognosis. However, in order to study the entire spectrum of bacteremia patients, we need valid sources of information, prospective data collection, and complete follow-up. In North Denmark Region, all patients diagnosed with bacteremia have been registered in a population-based database since 1981. The information has been recorded prospectively since 1992 and the main variables are: the patient’s unique civil registration number, date of sampling the first positive blood culture, date of admission, clinical department, date of notification of growth, place of acquisition, focus of infection, microbiological species, antibiogram, and empirical antimicrobial treatment. During the time from 1981 to 2008, information on 22,556 cases of bacteremia has been recorded. The civil registration number makes it possible to link the database to other medical databases and thereby build large cohorts with detailed longitudinal data that include hospital histories since 1977, comorbidity data, and complete follow-up of survival. The database is suited for epidemiological research and, presently, approximately 60 studies have been published. Other Danish departments of clinical microbiology have recently started to record the same information and a population base of 2.3 million will be available for future studies. PMID:20865114

Absence from work due to occupational and non-occupational accidents.

PubMed

Jørgensen, Kirsten; Laursen, Bjarne

2013-02-01

The aim of the present study was to investigate absence from work in Denmark due to occupational and non-occupational accidents. Since the beginning of the last decade, political focus has been placed on the population's working capacity and the scope of absence due to illness. Absence from work is estimated at between 3% and 6% of working hours in the EU and costs are estimated at approximately 2.5% of GNP. Victims of accidents treated at two emergency departments were interviewed regarding absence for the injured, the family and others. All answers were linked to the hospital information on the injury, so that it was possible to examine the relation between absence and injury type, and cause of the accident. In total, 1,479 injured persons were interviewed. 36% of these reported absence from work by themselves or others. In mean, an injury caused 3.21 days of absence. Based on this the total absence due to injuries in Denmark was estimated to 1,822,000 workdays, corresponding to approximately 6% of the total absence from work due to all types of illness. Non-occupational injuries resulted in more absence than did occupational injuries. Absence due to accidents contributed to a considerable part of the total absence from work, and non-occupational accidents caused more absence than did occupational accidents.

The Danish Schizophrenia Registry

PubMed Central

Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea; Korshøj, Lene; Voldsgaard, Inge; Nordentoft, Merete

2016-01-01

Aim of database To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients. Main variables The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning. Descriptive data The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may obtain access to the data for use in specific research projects by applying to the steering committee. Conclusion The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time devoted is necessary to maintain the integrity of the registry and the validity of the data. PMID:27843348

The Danish Schizophrenia Registry.

PubMed

Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea; Korshøj, Lene; Voldsgaard, Inge; Nordentoft, Merete

2016-01-01

To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients. The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning. The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may obtain access to the data for use in specific research projects by applying to the steering committee. The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time devoted is necessary to maintain the integrity of the registry and the validity of the data.

Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study.

PubMed

Berlin, Claudia; Panczak, Radoslaw; Hasler, Rebecca; Zwahlen, Marcel

2016-11-01

Switzerland has mountains and valleys complicating the access to a hospital and critical care in case of emergencies. Treatment success for acute myocardial infarction (AMI) or stroke depends on timely treatment. We examined the relationship between distance to different hospital types and mortality from AMI or stroke in the Swiss National Cohort (SNC) Study. The SNC is a longitudinal mortality study of the census 2000 population of Switzerland. For 4.5 million Swiss residents not living in a nursing home and older than 30 years in the year 2000, we calculated driving time and straight-line distance from their home to the nearest acute, acute with emergency room, central and university hospital (in total 173 hospitals). On the basis of quintiles, we used multivariable Cox proportional hazard models to estimate HRs of AMI and stroke mortality for driving time distance groups compared to the closest distance group. Over 8 years, 19 301 AMI and 21 931 stroke deaths occurred. Mean driving time to the nearest acute hospital was 6.5 min (29.7 min to a university hospital). For AMI mortality, driving time to a university hospital showed the strongest association among the four types of hospitals with a hazard ratio (HR) of 1.19 (95% CI 1.10 to 1.30) and 1.10 (95% CI 1.01 to 1.20) for men and women aged 65+ years when comparing the highest quintile with the lowest quintile of driving time. For stroke mortality, the association with university hospital driving time was less pronounced than for AMI mortality and did not show a clear incremental pattern with increasing driving time. There was no association with driving time to the nearest hospital. The increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway. 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/.

[The state of pediatric anesthesia in Japan: an analysis of the Japanese society of anesthesiologists survey of critical incidents in the operating room].

PubMed

Irita, Kazuo; Tsuzaki, Koichi; Sawa, Tomohiro; Sanuki, Michiyoshi; Nakatsuka, Hideki; Makita, Koshi; Morita, Kiyoshi

2007-01-01

The Japanese Society of Anesthesiologists (JSA) survey of critical incidents in the operating room and other reports have shown that pediatric patients undergoing anesthesia are at an increased risk. Purpose was to examine the state of pediatric anesthesia in Japan. This might clarify the role of children's hospitals for pediatric anesthesia, and the relationship between critical incidents and volume of pediatric anesthetic procedures. The JSA has conducted annual surveys of critical incidents in the operating room by sending to and collecting confidential questionnaires from all JSA Certified Training Hospitals. From 1999 to 2003, 342,840 pediatric (0-5 yr) anesthetic procedures were registered. During this period, only 15 cardiac arrests and 3 deaths within 7 postoperative days totally attributable to anesthetic management were reported. Therefore, we analyzed cardiac arrests and deaths due to all etiologies. The hospitals were classified as children's hospitals, university hospitals, and other hospitals, and the incidence of cardiac arrest, the recovery rate from cardiac arrest without any sequelae, and the mortality rate were compared according to types of the hospitals. The relationship between death due to intraoperative critical incidents and the volume of pediatric anesthetic procedures was examined using data from the 2003 survey, the recovery rate of which was 85.7%. In 2003, 739 JSA Certified Training Hospitals responded to the survey: 7 children's hospitals, 109 university hospitals, and 623 other hospitals. Among these hospitals, 707 and 270 hospitals conducted pediatric and newborn (<1 mo) anesthesia, respectively. In 2003, 4,630 newborn, 17,890 infant (<1 yr), and 60,524 child (1-5 yr) anesthetic procedures were registered. Odds ratios were determined to compare the risks among the hospital groups, and the 95% confidential interval (CI) was shown. The Chi square test was used to compare the background of patients with cardiac arrest. P values less than 0.05 were considered significant. In 2003, 95.7% and 36.5% of JSA Certified Training Hospitals which responded to the survey had conducted pediatric and newborn anesthesia, respectively. Children's hospitals, university hospitals, and other hospitals were responsible for 10.7%, 31.0%, and 58.3% of pediatric anesthetic procedures, respectively. Seven children's hospitals (100.0%), 54 university hospitals (50.5%), and 54 other hospitals (9.1%) conducted more than 201 annual pediatric anesthetic procedures, respectively, and these 115 hospitals conducted 62.5% of all pediatric anesthetic procedures in Japan. There was no significant difference between the overall mortality rate in hospitals with an annual pediatric anesthetic volume of less than 200 and that in hospitals with an annual pediatric anesthetic volume of more than 201 (5.46 versus 7.12/10,000 anesthetic procedures). However, the overall mortality rate was 4.87 times higher (95% confidential interval: 1.53-15.66) in hospitals with an annual pediatric anesthetic volume of more than 101 (7.91/10,000 anesthetic procedures) than in those with an annual pediatric anesthetic volume of less than 100 (1.62/10,000 anesthetic procedures). The situation was quite different when we focused on newborn anesthetic procedures : the overall mortality was 2.63 times higher (95% confidential interval : 1.19-5.84) in hospitals with an annual newborn anesthetic volume of less than 12 (126.6/ 10,000 anesthetic procedures) than those with an annual newborn anesthetic volume of more than 13 (48.5/10,000 anesthetic procedures). Between 1999 and 2003, the incidences of cardiac arrest in children's hospitals, university hospitals, and other hospitals were 9.54 (1.89 times higher than the other hospitals; CI 1.31-2.67), 10.30, and 5.11/10,000 anesthetic procedures, respectively. Among the children who developed cardiac arrest, the ratio of poor preoperative conditions with an American Society of Anesthesiologists physical status classification of more than 3 was significantly lower in the children's hospitals (68.9%) than the university hospitals (84.3%) and the other hospitals (84.0%). The recovery rate from cardiac arrest was 51.1% (2.49 times higher than the university hospitals; CI 1.23-5.06, and 3.05 times higher than the other hospitals ; CI 1.45-6.43), 29.6%, and 25.5%, respectively. The mortality rate was 9.54 (1.77 times higher than the other hospitals; CI 1.25-2.52), 8.87, and 5.38/10,000 anesthetic procedures in children's hospitals, university hospitals and other hospitals, respectively. Almost all JSA Certified Training Hospitals conducted pediatric anesthesia, although only 15.6% of them had an annual pediatric anesthetic volume of more than 200. It was suggested that general pediatric anesthesia was conduced safely in JSA Certified Training Hospitals, even if they had a low annual pediatric anesthetic volume. The exception was newborn anesthetic procedures : the mortality was high in hospitals with an annual newborn anesthetic volume of less than 12. Analysis of critical incidents in the operating room failed to show the superiority of children's hospitals in comparison with the university hospitals and other hospitals. Collecting and analyzing data including the patients without critical incidents are required for further analysis.

University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.

PubMed

Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier

2015-08-01

We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident.

Concentrating Solar Power Projects in Denmark | Concentrating Solar Power |

Science.gov Websites

;alphabetical by project name. You can browse a project profile by clicking on the project name. Aalborg CSP-Brà NREL Denmark Concentrating solar power (CSP) projects in Denmark are listed belowâ€"

[Success factors in the German healthcare market. Hospitals between cluster formation and privatisation].

PubMed

Schmidt, C; Möller, J; Hardt, F; Gabbert, T; Bauer, M

2007-12-01

The German hospital market is in a state of transition due to the introduction of diagnosis-related groups (DRGs) and a constant change of the reimbursement, demographic, economical and technical framework. To date mainly public hospitals were bought by private hospital chains, but this trend has currently reached university hospitals. During recent months a consolidation within the market of private hospitals took place, while new market players such as foreign hospital chains, US universities and private equity firms emerged on the scene. The target of the privatisation process, however, turns more and more to larger hospitals. Central key values remain the cluster formation and centralisation of key competences such as food supply, purchasing and pharmacy. Within a network of clinics the representation of different care components (basic, regular and maximum care provider) and care levels (low, normal, intermediate and intensive care) remain important elements of efficient hospital management. Today, successful hospital operation is based on the successful competition for patients and even more for qualified staff. In this aspect, university hospitals could play a decisive role, because of their combination of maximum acute care provision and educational mandate. No such network has yet been formed due to the different interests of the owners, however, given the new market situation this alternative concept could become more attractive.

KAMEDO report No. 93-the power failure at Karolinska University Hospital, Huddinge, 07 April 2007.

PubMed

Angantyr, Lars-Göran; Häggström, Eskil; Kulling, Per

2009-01-01

A sudden and extensive power failure occurred at Karolinska University Hospital in Huddinge on Easter Saturday, 07 April 2007. The power failure lasted one hour and 22 minutes, but it took a longer time for activities to return to normal. It put many patients at great risk, particularly in the intensive care unit and other departments with critically ill patients. This report details the conditions and response at Karolinska University Hospital during the power failure and provides lessons learned for future events.

Transgender Surgery in Denmark From 1994 to 2015: 20-Year Follow-Up Study.

PubMed

Aydin, Dogu; Buk, Liv Johanne; Partoft, Søren; Bonde, Christian; Thomsen, Michael Vestergaard; Tos, Tina

2016-04-01

Gender dysphoria is a mismatch between a person's biological sex and gender identity. The best treatment is believed to be hormonal therapy and gender-confirming surgery that will transition the individual toward the desired gender. Treatment in Denmark is covered by public health care, and gender-confirming surgery in Denmark is centralized at a single-center with few specialized plastic surgeons conducting top surgery (mastectomy or breast augmentation) and bottom surgery (vaginoplasty or phalloplasty and metoidioplasty). To report the first nationwide single-center review on transsexual patients in Denmark undergoing gender-confirming surgery performed by a single surgical team and to assess whether age at time of gender-confirming surgery decreased during a 20-year period. Electronic patient databases were used to identify patients diagnosed with gender identity disorders from January 1994 through March 2015. Patients were excluded from the study if they were pseudohermaphrodites or if their gender was not reported. Gender distribution, age trends, and surgeries performed for Danish patients who underwent gender-confirming surgery. One hundred fifty-eight patients referred for gender-confirming surgery were included. Fifty-five cases (35%) were male-to-female (MtF) and 103 (65%) were female-to-male (FtM). In total, 126 gender-confirming surgeries were performed. For FtM cases, top surgery (mastectomy) was conducted in 62 patients and bottom surgery (phalloplasty and metoidioplasty) was conducted in 17 patients. For MtF cases, 45 underwent bottom surgery (vaginoplasty), 2 of whom received breast augmentation. The FtM:MtF ratio of the referred patients was 1.9:1. The median age at the time of surgery decreased from 40 to 27 years during the 20-year period. Gender-confirming surgery was performed on 65 FtM and 40 MtF cases at our hospital, and 21 transsexuals underwent surgery abroad. Mastectomy was performed in 62 FtM and bottom surgery in 17 FtM cases. Vaginoplasty was performed in 45 MtF and breast augmentation in 2 MtF cases. There was a significant decrease in age at the time of gender-confirming surgery during the course of the study period. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of antimicrobial resistant Escherichia coli from patients with suspected urinary tract infection in primary care, Denmark.

PubMed

Córdoba, Gloria; Holm, Anne; Hansen, Frank; Hammerum, Anette M; Bjerrum, Lars

2017-10-10

Escherichia coli is the most common pathogen causing Urinary Tract Infections (UTI). Data from the current National Surveillance program in Denmark (DANMAP) may not accurately represent the prevalence of resistant E. coli in primary care, because only urine samples from complicated cases may be forwarded to the microbiological departments at hospitals for diagnostic examination. The aim of this study was to assess the prevalence of resistant E. coli to the most commonly used antimicrobial agents in primary care in a consecutive sample of patients from general practice. Observational study carried out from December 2014 to December 2015. Thirty-nine general practices from The Capital Region of Denmark included adult patients with urinary tract symptoms and suspected UTI. All urine samples were sent to the central laboratory Statens Serum Institut (SSI). Significant bacteriuria was interpreted according to the European Urinalysis Standards. Susceptibility testing was performed and interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards. From the 39 general practices 505 patients were recruited. Completed data were obtained from 485 (96%) patients. According to the European Urinalysis Standards, 261 (54%) patients had positive bacteriuria. The most common uropathogen in patients with uncomplicated (uUTI) and complicated (cUTI) urinary tract infection was E. coli 105 (69%) and 76 (70%), respectively. Eighty-two (45%) of 181 E. coli isolates were resistant to at least one of the tested antibiotics and 50 out of 82 isolates were resistant to two or more antimicrobial agents. The highest resistance-rate was found against ampicillin 34% (95% CI 24;42) in uUTI and 36% (24;46) in cUTI. There were no differences in the distribution of resistance between uncomplicated and complicated cases. The prevalence of resistance was similar to the one reported in DANMAP 2014. In E. coli from uUTI there is high resistance rates to antimicrobial agents commonly used in primary care. There was no difference in the distribution of resistant E. coli in suspected uUTI vs cUTI. In Denmark, data from the National Surveillance program DANMAP can guide the decision for choice of antibiotic in patients with suspected UTI seeking care in primary care. ClinicalTrials.gov NCT02249273 .

Activity-based costing and its application in a Turkish university hospital.

PubMed

Yereli, Ayşe Necef

2009-03-01

Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

Evaluation of an open-rota system in a Danish psychiatric hospital: a mechanism for improving job satisfaction and work-life balance.

PubMed

Pryce, Joanna; Albertsen, Karen; Nielsen, Karina

2006-05-01

To evaluate the impact of an open-rota scheduling system on the health, work-life balance and job satisfaction of nurses working in a psychiatric ward in Denmark. The effects of shift rotation and scheduling are well known; however, little is known about the wider benefits of open-rota systems. Method A structured questionnaire was distributed to control and intervention groups preintervention and postintervention (20 months). Nurses within the intervention group trialed an open-rota system in which nurses designed their own work-rest schedules. Nurses in the intervention group reported that they were more satisfied with their work hours, less likely to swap their shift when working within the open-rota system and reported significant increases in work-life balance, job satisfaction, social support and community spirit when compared with nurses in the control groups. The ownership and choice over work-rest schedules has benefits for nurses, and potentially the hospital.

Educational and Vocational Guidance in Denmark. Education in Denmark.

ERIC Educational Resources Information Center

Ministry of Education, Copenhagen (Denmark).

This report sketches educational and vocational guidance in Denmark. It begins with a historical account of developments in the areas of career and school counseling. Outlined next are guidance programs at the following levels: folkeskole, gymnasium and studenterkursus (upper secondary education), higher preparatory examination, vocational school,…

The Financing of Vocational Education and Training in Denmark. Financing Portrait. CEDEFOP Panorama.

ERIC Educational Resources Information Center

Hansen, Martin Eggert

The financing of vocational education and training (VET) in Denmark was evaluated through consultations with various bodies, including the following: Denmark's Ministry of Labor and Ministry of Education, Danish Employer's Confederation, Confederation of Danish Industry, Danish Confederation of Trade Unions, Association of County Councils, and…

76 FR 13890 - Importation of Bromeliad Plants in Growing Media From Belgium, Denmark, and the Netherlands

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... in Growing Media From Belgium, Denmark, and the Netherlands AGENCY: Animal and Plant Health..., Cryptanthus, Guzmania, Hohenbergia, Neoregelia, Tillandsia, and Vriesea from Belgium, Denmark, and the... regulations in ``Subpart--Nursery Stock, Plants, Roots, Bulbs, Seeds, and Other Plant Products,'' Sec. Sec...

26 CFR 521.101 - Introductory.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of Danish... representative; and in the case of Denmark, the Chief of the Taxation Department of the Ministry of Finance... III (1) An enterprise of one of the contracting States shall not be subject to taxation in the other...

Polycystic kidney disease at Howard University Hospital.

PubMed

Hosten, A O; Cummings, Y

1977-08-01

Adult polycystic kidney disease treatment at Howard University Hospital is summarized. The cases are taken from autopsies performed between January 1955 and November 1975 and from the Hospital's dialysis population. Polycystic kidney disease was identified in six adults and four infants. Only two dialysis patients were clinically thought to have the disease. A review of the major clinical features of the disease is presented.

Annual Trauma Anesthesia and Critical Care Symposium (4th) Held in Baltimore, Maryland on May 2 - 5, 1991

DTIC Science & Technology

1991-07-01

Chairman for the Clinic of Anaesthesiology University Hospital Mainz, Germany Vice-President, European Academy of Anaesthesiology Medical Director...Consultant Anesthetist Department of Anaesthesiology Frenchay Hospital President, Association of Anaesthetists of Great Britain and Ireland President...of the Institute for Anaesthesiology University Hospital-Nijmegen Member of the National Health Council (Gezondheidsraad) Vice-President, National

Screening, testing, and reporting for drug and alcohol use on labor and delivery: a survey of Maryland birthing hospitals.

PubMed

Miller, Catherine; Lanham, Amy; Welsh, Christopher; Ramanadhan, Shaalini; Terplan, Mishka

2014-01-01

Recent amendments to the Child Abuse Prevention and Treatment Act tie the receipt of federal block grants to mandatory reporting of substance-exposed newborns. To determine rates of screening, testing, and reporting of drug and alcohol use at the time of delivery, we administered a telephone survey of nursing managers and perinatal social workers at Maryland birthing hospitals. Of the 34 hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported universal screening, only 6% used a validated instrument. Testing was reported by 94% with 45% reporting universal maternal testing and 7% universal newborn testing. Only 32% reported obtaining maternal consent prior to testing. There is significant heterogeneity in screening and testing for substance use in birthing hospitals. Given federal reporting mandates, state-level practices need to be standardized.

The impact of varicella vaccination on varicella-related hospitalization rates: global data review

PubMed Central

Hirose, Maki; Gilio, Alfredo Elias; Ferronato, Angela Esposito; Ragazzi, Selma Lopes Betta

2016-01-01

Abstract Objective: To describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. Data source: We identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or) "hospitalization". Publications in English published between January 1995 and May 2015 were included. Data synthesis: 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4%–99.2% reduction in hospitalization rates in children younger than four years, 6–14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1–4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1–4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1–4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1–4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7%–73.8% decrease (general population), coverage of 60%–95%. Conclusions: The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data. PMID:26965075

The impact of varicella vaccination on varicella-related hospitalization rates: global data review.

PubMed

Hirose, Maki; Gilio, Alfredo Elias; Ferronato, Angela Esposito; Ragazzi, Selma Lopes Betta

2016-09-01

to describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. we identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or) "hospitalization". Publications in English published between January 1995 and May 2015 were included. 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4% -99.2% reduction in hospitalization rates in children younger than four years after 6-14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1-4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1-4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1-4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1-4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7% -73.8% decrease (general population), coverage of 60%-95%. The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Long-term sick leave and its risk factors during pregnancy among Danish hospital employees.

PubMed

Kaerlev, Linda; Jacobsen, Lene B; Olsen, Jørn; Bonde, Jens Peter

2004-01-01

The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. A register-based study was undertaken of 4,852 female hospital employees aged 20-45 years from the second largest hospital in Denmark during 1995-99 based on job titles, working time, sick leave, and births combined with a survey among a total of 773 women who had been pregnant during their employment (response rate 85%). Altogether 236 (31%) were on sick leave for at least 10% of their scheduled work time during their latest pregnancy and 169 (22%) had been absent at least 20% of the time. The pregnant women had an average sickness absence of 6.1 days per month, non-pregnant women 0.95 days per month. Sick leave was more frequent in late than in early gestation. Women employed as nursing aides or hospital orderlies, launderers, and nurses had more sick leave days than other hospital employees. Part-time work, previous sickness absence not related to pregnancy, and previous chronic back pain were risk factors for long-term sick leave as were much walking or standing, long working days, high work level, little practical support from supervisors and colleagues, low job control, much lifting and night or shift work. Sick leave was unrelated to family size, support from the family and number of working years. Long-term sick leave during pregnancy was frequent and to some extent predictable. Efforts should be made to organize work for pregnant women in a manner that optimizes their health and well-being.

Measuring distributed leadership agency in a hospital context.

PubMed

Jønsson, Thomas; Unterrainer, Christine; Jeppesen, Hans-Jeppe; Jain, Ajay Kumar

2016-09-19

Purpose The purpose of this paper is to develop and validate an instrument that can measure distributed leadership (DL) as employees' active participation in DL tasks. The authors designate this as the distributed leadership agency (DLA). Design/methodology/approach Data were collected throughout all departments and occupational groups at a merged centralized hospital setting in Denmark. A total of 1,774 employees from 24 hospital departments and 16 occupational groups completed our survey. Structural equation model and confirmatory factor analyses were applied to identify appropriate items and a test for measurement invariance, predictive, discriminant and convergent validity, and ANOVAs were applied to analyse group differences in DLA. Findings The identified unidimensional questionnaire consists of seven items, as it is different from, but associated with, empowering leadership, organizational influence, attitude to participation and trust in management. As theoretically predicted, DLA is positively related to self-efficacy, job satisfaction and innovative behaviour. Chief physicians, permanent employees and employee representatives scored higher on the scale than the rest of their respective counterparts. Practical implications The survey offers a method to assess a distribution of leadership agency in hospital organizations. Such assessment may provide a basis for organizational and leadership development. Originality/value The present study provides a reliable and valid quantitative instrument that measures how much employees at all hierarchical levels are involved in concrete leadership activities in the hospital context. Taking a normative perspective the authors could show that DL - measured with the DLA-questionnaire - has positive effects on employees' behaviour.

Review of thromboembolic prophylaxis in patients attending Cork University Hospital.

PubMed

Byrne, Stephen; Weaver, Daniel Timothy

2013-06-01

Although preventable, venous thromboembolism remains a common cause of hospital acquired morbidity and mortality. Guidelines, such as the one produced by the American College of Chest Physicians (ACCP), are aimed at reducing hospital associated venous thromboemboli. Unfortunately the majority of studies have revealed inadequate adherence to these guidelines. The objective of this study was to evaluate the use of venous thromboembolism prophylaxis at Cork University Hospital. Cork University Hospital, Wilton, Cork, Ireland. Data from the patient's chart, drug kardex and laboratory results were recorded during April 2010. A Caprini score, a venous thromboembolism risk factor assessment tool, was subsequently calculated for each patient based on data collected. Appropriate prophylaxis was determined after examining data collected, Caprini score and prophylactic regime according to the ACCP 8th edition guidelines. Primary outcome was to analyse adherence to VTE prophylaxis guidelines. A total of 394 patients met the inclusion criteria and were reviewed, of which, 60% (n = 236) were medical and 37% (n = 146) were surgical patients. In total 63% of patients received some form of venous thromboembolism prophylaxis. Furthermore, 54% of medical and 76% of surgical patients received prophylaxis. However only 37% of the patients studied received appropriate thromboprophylaxis according to the ACCP 8th edition guidelines (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). Additionally 51% of surgical and 27% of medical patients received appropriate prophylaxis. Data collected from Cork University Hospital revealed poor adherence to international venous thromboembolism prophylaxis guidelines. As stated in the ACCP 8th edition guidelines, every hospital should develop a formal strategy for venous thromboembolism prevention (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). In order to improve adherence to guidelines, Cork University Hospital should develop, implement and re-evaluate a specific protocol for venous thromboembolism prophylaxis.

Impacts of 21st century climate changes on flora and vegetation in Denmark

NASA Astrophysics Data System (ADS)

Skov, Flemming; Nygaard, Bettina; Wind, Peter; Borchsenius, Finn; Normand, Signe; Balslev, Henrik; Fløjgaard, Camilla; Svenning, Jens-Christian

2009-11-01

In this paper we examined the potential impacts of predicted climatic changes on the flora and vegetation in Denmark using data from a digital database on the natural vegetation of Europe. Climate scenarios A2 and B2 were used to find regions with present climatic conditions similar to Denmark's climate in the year 2100. The potential natural vegetation of Denmark today is predominantly deciduous forest that would cover more than 90% of the landscape. Swamps, bogs, and wet forest would be found under moist or wet conditions. Dwarf shrub heaths would be naturally occurring on poor soils along the coast together with dune systems and salt-marsh vegetation. When comparing the natural vegetation of Denmark to the vegetation of five future-climate analogue areas, the most obvious trend is a shift from deciduous to thermophilous broadleaved forest currently found in Southern and Eastern Europe. A total of 983 taxa were recorded for this study of which 539 were found in Denmark. The Sørensen index was used to measure the floristic similarity between Denmark and the five subregions. Deciduous forest, dwarf shrub heath, and coastal vegetation were treated in more detail, focusing on potential new immigrant species to Denmark. Finally, implications for management were discussed. The floristic similarity between Denmark and regions in Europe with a climate similar to what is expected for Denmark in year 2100 was found to vary between 48-78%, decreasing from North to South. Hence, it seems inevitable that climate changes of the magnitudes foreseen will alter the distribution of individual species and the composition of natural vegetation units. Changes, however, will not be immediate. Historic evidence shows a considerable lag in response to climatic change under natural conditions, but little is known about the effects of human land-use and pollution on this process. Facing such uncertainties we suggested that a dynamic strategy based on modeling, monitoring and adaptive management is adopted. Modeling techniques can be constantly improved, but will never be perfect and should therefore be linked to a fine-masked network of observatories to check model predictions and feed empirical data back into the models for calibration and further development.

Implementation of Venous Thromboembolism Prophylaxis Guidelines in Clinical Practice: A Retrospective Study in Two Croatian Hospitals.

PubMed

Marušić, Srećko; Knežević, Aleksandar; Bačić Vrca, Vesna; Marinović, Ivana; Bačić, Julija; Obreli Neto, Paulo Roque; Amidžić Klarić, Daniela; Diklić, Dijaneta

2017-12-01

The aim of this study was to evaluate the implementation of the 9th edition of the American College of Chest Physicians (ACCP9) guidelines for prevention of venous thromboembolism in nonsurgical patients in clinical practice in one university and one general Croatian hospital. A retrospective study was conducted at Zadar General Hospital from Zadar and Dubrava University Hospital from Zagreb. Medical charts of all patients admitted to Medical Departments in two periods, before and after implementation of the ACCP9 guidelines, were analyzed. The ACCP9 guidelines were made available to all physicians through the hospital electronic information system immediately after the publication. The Hospital Drug Committees promoted implementation of the guidelines during their periodical clinical visits. Overall, 850 patients were included in the study in two periods. There was no statistically significant difference in the number of high-risk patients receiving thromboprophylaxis after the guidelines implementation in either hospital. In both periods, a signifi-cantly higher number of high-risk patients received thromboprophylaxis in Dubrava University Hos-pital in comparison with Zadar General Hospital (31.7% vs. 3.8% and 40.3% vs. 7.3%, respectively; p<0.001). This study revealed insufficient implementation of evidence-based thromboprophylaxis guidelines in clinical practice in two Croatian hospitals.

Income Analysis of University-Owned Teaching Hospitals.

ERIC Educational Resources Information Center

Isaacs, Joseph C.

1979-01-01

The annual survey, undertaken by the Association of American Medical Colleges, of income, expense and general operating information for university-owned teaching hospitals is discussed. Focus is on sources of income, including state funds, Medicare, and insurance companies. (JMD)

Nordic databases to evaluate medications in pregnancy.

PubMed

Kieler, Helle

2014-01-01

The objective of this review is to describe the possibilities to assess drugs used in pregnancy by means of the Nordic health registers. The Nordic countries comprise five countries: Denmark, Finland, Iceland, Norway and Sweden and have a total population of 25 million. All five countries have in their national health registers for many years recorded information concerning all births, cancer diagnoses, hospital contacts, causes of death and dispensed drugs. The registers can be used for studying drugs dispensed during pregnancy and though most previous studies focused on risks of congenital abnormalities, other health consequences of maternal medication can also be assessed. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Leadership and capacity building in international chiropractic research: introducing the chiropractic academy for research leadership (CARL).

PubMed

Adams, Jon; Kawchuk, Greg; Breen, Alexander; De Carvalho, Diana; Eklund, Andreas; Fernandez, Matthew; Funabashi, Martha; Holmes, Michelle M; Johansson, Melker S; de Luca, Katie; Moore, Craig; Pagé, Isabelle; Pohlman, Katherine A; Swain, Michael S; Wong, Arnold Y L; Hartvigsen, Jan

2018-01-01

In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may be caused by a lack of chiropractic teaching programs in major universities. As a response to this challenge the Chiropractic Academy for Research Leadership, CARL, was created with the aim of develop a global network of successful early-career chiropractic researchers under the mentorship of three successful senior academics from Australia, Canada, and Denmark. The program centres upon an annual week-long program residential that rotates continental locations over the first three-year cycle and between residentials the CARL fellows work on self-initiated research and leadership initiatives. Through a competivite application process, the first cohort was selected and consists of 13 early career researchers from five professions in seven countries who represent diverse areas of interests of high relevance for chiropractic. The first residential was held in Odense, Denmark, with the second being planned in April 2018 in Edmonton, Canada, and the final residential to be held in Sydney, Australia in 2019.

Reintegration: public or private responsibility? Consequences of Dutch and Danish policies toward work-disabled persons.

PubMed

Høgelund, Jan

2002-01-01

The Scandinavian welfare states are known for their universal social security coverage and high labor-market participation rates for all groups in society. The institutional setup in continental European welfare states, on the other hand, is said to foster a divide between employed persons and persons outside the labor market. In the area of disability policies, The Netherlands and Denmark illustrate this distinction. In The Netherlands, strong ties exist between the employer and the sick-listed worker, both because of solid job-protection legislation and because the financing of sickness and disability benefits is closely linked to the individual employer. In contrast, employer responsibility is limited in Denmark, where an extensive responsibility rests with public authorities. The author investigates the consequences of these differences using panel data on Dutch and Danish long-term sick-listed workers. The findings show that the strong ties in The Netherlands between employers and sick-listed workers enhance labor-market reintegration of long-term sick-listed workers. A significant drawback of the Dutch policy, however, is that employers refrain from employing persons with a high risk of falling ill. As a result, Dutch disability policy leads to a bigger insider-outsider divide than Danish policy.

Denmark's Master of Public Governance Program: Assessment and Lessons Learned

ERIC Educational Resources Information Center

Greve, Carsten; Pedersen, Anne Reff

2017-01-01

This paper focuses on Denmark's Master of Public Governance and its assessments and lessons learned. Denmark is seen to have an efficient economy and public sector, a digitalized public service delivery system, and an advanced work-life balance. The Danish government invested substantial resources into developing a Master of Public Governance…

[Problems in career planning for novice medical technologists in Japanese national hospitals].

PubMed

Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

2012-12-01

Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs.

Building new university hospital--what citizens know and policy makers should be aware of.

PubMed

Oresković, S; Letica, S; Mastilica, M; Babić-Bosanac, S; Civljak, M; Bozicević, I; Borovecki, A

2002-12-01

Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.

Sickness absence patterns and trends in the health care sector: 5-year monitoring of female municipal employees in the health and care sectors in Norway and Denmark

PubMed Central

2014-01-01

Background Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. Methods Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. Results There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20–29- (P = 0.01) and 50–59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20–29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P <0.0001 and P <0.0001, respectively) in all age groups except for the 30–39- and 60–67-year-old age groups. The proportion of employees without sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P <0.0001, respectively), while in Norway, only short-term absence increased (P = 0.09). Conclusions We found an overall increase in sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes. PMID:25005027

Long-term inpatient disease burden in the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: A cohort study of 21,297 childhood cancer survivors

PubMed Central

Rugbjerg, Kathrine; Bonnesen, Trine G.; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Wesenberg, Finn; Winther, Jeanette F.

2017-01-01

Background Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. Methods and findings From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943–2008 in Denmark, 1971–2008 in Finland, 1955–2008 in Iceland, and 1958–2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977–2010; Finland, 1975–2012; Iceland, 1999–2008; and Sweden, 1968–2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors’ standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0–42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91–1.97). The AER was 3,068 (2,980–3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess hospitalisations were for diseases of the nervous system (19.1% of all excess hospitalisations), endocrine system (11.1%), digestive organs (10.5%), and respiratory system (10.0%). Survivors of all types of childhood cancer were at increased, persistent risk for subsequent hospitalisation, the highest risks being those of survivors of neuroblastoma (RR: 2.6 [2.4–2.8]; n = 876), hepatic tumours (RR: 2.5 [2.0–3.1]; n = 92), central nervous system tumours (RR: 2.4 [2.3–2.5]; n = 6,175), and Hodgkin lymphoma (RR: 2.4 [2.3–2.5]; n = 2,027). Survivors spent on average five times as many days in hospital as comparison individuals (SBDR: 4.96 [4.94–4.98]; n = 422,218). The analyses of bed days in hospital included new primary cancers and recurrences. Of the total 422,218 days survivors spent in hospital, 47% (197,596 bed days) were for new primary cancers and recurrences. Our study is likely to underestimate the absolute overall disease burden experienced by survivors, as less severe late effects are missed if they are treated sufficiently in the outpatient setting or in the primary health care system. Conclusions Childhood cancer survivors were at increased long-term risk for diseases requiring inpatient treatment even decades after their initial cancer. Health care providers who do not work in the area of late effects, especially those in primary health care, should be aware of this highly challenged group of patients in order to avoid or postpone hospitalisations by prevention, early detection, and appropriate treatments. PMID:28486495

[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. Often the speakers are members of the society. In the future the Danish Society of Insurance Medicine will face new challenges as regards to the communication of knowledge about new diseases and new treatments in the light of with biostatistics and new insurance products.

Information technology governance domains in hospitals: a case study in Iran.

PubMed

Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam

2014-11-30

IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.

Time trends in pediatric hospitalizations for hepatitis A in Greece (1999-2013): Assessment of the impact of universal infant immunization in 2008.

PubMed

Papaevangelou, V; Alexopoulou, Z; Hadjichristodoulou, C; Kourlamba, G; Katsioulis, A; Theodoridou, K; Spoulou, V; Theodoridou, M

2016-07-02

Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999-2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999-2008) and post-vaccination (2009-2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks.

[Measures taken by a university hospital for the prevention and control of the 2009 H1N1 influenza].

PubMed

Hayashi, Jun; Murata, Masayuki; Furusyo, Norihiro; Hoshina, Takayuki; Shimono, Nobuyuki

2010-09-01

After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.

SpaceX CRS-14 What's On Board Science Briefing

NASA Image and Video Library

2018-04-01

Torsten Neubert of the National Space Institute at the Technical University of Denmark, and principal investigator for the Atmosphere-Space Interactions Monitor, discusses how this Earth observatory will study severe thunderstorms and their role in the Earth's atmosphere and climate. This is one of the scientific investigations that will be aboard a Dragon spacecraft scheduled for liftoff from Cape Canaveral Air Force Station's Space Launch Complex 40 at 4:30 p.m. EST, on April 2, 2018. The SpaceX Falcon 9 rocket will launch the company's 14th Commercial Resupply Services mission to the space station.

The Nordic concept of reactive psychosis--a multicenter reliability study.

PubMed

Hansen, H; Dahl, A A; Bertelsen, A; Birket-Smith, M; von Knorring, L; Ottosson, J O; Pakaslahti, A; Retterstøl, N; Salvesen, C; Thorsteinsson, G

1992-07-01

Reactive psychosis is a common diagnosis in the Nordic countries (Norway, Sweden, Denmark, Finland and Iceland) and in several other parts of the world. In ICD-9 and DSM-III-R, the concept is defined more narrowly than in the Nordic tradition. In this study we examined the interrater reliability of the Nordic concept by the case-summary method between clinicians from 9 university departments in the Nordic countries. The results show that Nordic psychiatrists have a reasonably reliable concept of reactive psychosis, and that this psychosis can be diagnosed as reliably as schizophrenia and affective psychosis.

Life in the Universe - Is there anybody out there?

NASA Astrophysics Data System (ADS)

2001-07-01

The Universe is indescribably huge. Can it be possible that Humanity is the only form of intelligent life which exists in all this immensity? Are we really alone ? Throughout history there have been sightings of creatures from elsewhere. Science fiction novels and films with flying saucers and bizarre looking aliens are part of our general culture. Perhaps the Earth is really only an experiment designed by mice and soon we will all be destroyed to make way for a new interstellar highway ! The possibility that there is life in the Universe has always excited the general public and scientists are equally enthusiastic. Physicists, biologists, chemists, cosmologists, astronomers are researching all over Europe to try to answer this age-old question : Is there life in the Universe ? Our current understanding What is our understanding at the beginning of the 21st century? Is there any scientific evidence for other forms of life? How can you define life? What signs are they looking for? What would the reaction be if other forms of life were discovered? The European Organisation for Nuclear Research (CERN) , the European Space Agency (ESA) and the European Southern Observatory (ESO) , in cooperation with the European Association for Astronomy Education (EAAE) have organised a competition to find out what the young people in Europe think. The European Molecular Biology Laboratory (EMBL) and the European Synchrotron Radiation Facility (ESRF) are also associated with the programme. The "Life in the Universe" programme ESO PR Video Clip 05/01 [192x144 pix MPEG-version] ESO PR Video Clip 05/01 (13300 frames/8:52 min) [MPEG Video+Audio; 192x144 pix; 12.1Mb] [RealMedia; streaming; 56kps] ESO Video Clip 05/01 is a trailer for the Europe-wide "Life in the Universe" programme. It touches upon some of the main issues and includes statements by members of the Experts' Panel. The "Life in the Universe" programme is being mounted in collaboration with the research directorate of the European Commission for the "European Week of Science and Technology" in November 2001. Competitions are already underway in 23 European countries [2] to find the best projects from school students between 14 and 18. The projects can be scientific or a piece of art, a theatrical performance, poetry or even a musical performance. The only restriction is that the final work must be based on scientific evidence. Two winning teams from each country will be invited to a final event at CERN's headquarters, in Geneva on 8-11 November, 2001 to present their projects to a panel of International Experts at a special three day event devoted to understanding the possibility of other life forms existing in our Universe. This final event will be broadcast all over the world via the Internet. The website The home base of the 'Life in the Universe" project is a vibrant web space http://www.lifeinuniverse.org where details of the programme can be found. It is still under development but already has a wealth of information and links to the national websites, where all entries are posted. Is there other life in the Universe? We do not know - but the search is on! To find out what is happening for "Life in the Universe" in each country, contact the National Steering Committees ! Notes [1] This is a joint Press Release by the European Organization for Nuclear Research (CERN) , the European Space Agency (ESA) and the European Southern Observatory (ESO). These European intergovernmental research organisations organised the highly successful Physics On Stage programme during the European Week of Science and Technology in 2000. [2] The 23 countries are Austria, Belgium, Bulgaria, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland, United Kingdom. CERN , the European Organization for Nuclear Research , has its headquarters in Geneva. At present, its Member States are Austria, Belgium, Bulgaria, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Netherlands, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland and the United Kingdom. Israel, Japan, the Russian Federation, the United States of America, Turkey, the European Commission and UNESCO have observer status. The European Space Agency (ESA) is an international/intergovernmental organisation made of 15 member states: Austria, Belgium, Denmark, Finland, France, Germany, Ireland, Italy, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom. ESA provides and promotes, for peaceful purposes only, cooperation among its member states in space research, technology and their applications. With ESA, Europe shapes and shares space for people, companies and the scientific community. The European Southern Observatory (ESO) is an intergovernmental organisation supported by Belgium, Denmark, France, Germany, Italy, the Netherlands, Portugal, Sweden and Switzerland. ESO is a major driving force in European astronomy, performing tasks that are beyond the capabilities of the individual member countries. The ESO La Silla Observatory (Chile) is one of the largest and best-equipped in the world. Of ESO's Very Large Telescope Array (VLT) at Cerro Paranal (Chile), the four 8.2-m telescopes, ANTU, KUEYEN, MELIPAL and YEPUN are already in operation; the VLT Interferometer (VLTI) follows next.

A Comparison Of The Universal TOR Guideline To The Absence Of Prehospital ROSC And Duration Of Resuscitation In Predicting Futility From Out-of-Hospital Cardiac Arrest

PubMed Central

Drennan, Ian R.; Case, Erin; Verbeek, P. Richard; Reynolds, Joshua C.; Goldberger, Zachary D.; Jasti, Jamie; Charleston, Mark; Herren, Heather; Idris, Ahamed H.; Leslie, Paul R.; Austin, Michael A.; Xiong, Yan; Schmicker, Robert H.; Morrison, Laurie J.

2017-01-01

Introduction The Universal Termination of Resuscitation (TOR) Guideline accurately identifies potential out-of-hospital cardiac arrest (OHCA) survivors. However, implementation is inconsistent with some emergency medical service (EMS) agencies using absence of return of spontaneous circulation (ROSC) as sole criterion for termination. Objective To compare the performance of the Universal TOR Guideline with the single criterion of no prehospital ROSC. Second, to determine factors associated with survival for patients transported without a ROSC. Lastly, to compare the impact of time to ROSC as a marker of futility to the Universal TOR Guideline. Design Retrospective, observational cohort study Participants Non-traumatic, adult (≥18 years) OHCA patients of presumed cardiac etiology treated by EMS providers Setting ROC-PRIMED and ROC-Epistry post ROC-PRIMED databases between 2007 and 2011. Outcomes Primary outcome was survival to hospital discharge and the secondary outcome was functional survival. We used multivariable regression to evaluate factors associated with survival in patients transported without a ROSC. Results 36,543 treated OHCAs occurred of which 9,467 (26%) were transported to hospital without a ROSC. Patients transported without a ROSC who met the Universal TOR Guideline for transport had a survival of 3.0% (95% CI 2.5%–3.4%) compared to 0.7% (95% CI 0.4%–0.9%) in patients who met the Universal TOR Guideline for termination. The Universal TOR Guideline identified 99% of survivors requiring continued resuscitation and transportation to hospital including early identification of survivors who sustained a ROSC after extended durations of CPR. Conclusion Using absence of ROSC as a sole predictor of futility misses potential survivors. The Universal TOR Guideline remains a strong predictor of survival. PMID:27923115

Cases of typhoid fever in Copenhagen region: a retrospective study of presentation and relapse.

PubMed

Barrett, Freja Cecille; Knudsen, Jenny Dahl; Johansen, Isik Somuncu

2013-08-11

Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main characteristics for travellers infected with S. Typhi considering both clinical and laboratory findings in order to provide for faster and better diagnostics in the future. The outcome of treatment, especially concerning relapse, was evaluated as well. Retrospectively collected data from 19 adult cases of typhoid fever over a 5-year period at the Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Denmark. The patients were young adults, presenting with symptoms within a month after travelling. 84% were returned from travelling in the Indian subcontinent. 17 out of 19 patients were VFR-travellers. The main symptoms were fever (100%), gastrointestinal symptoms (84%), headache (58%) and dry cough (26%). Laboratory findings showed elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH) in all cases and elevated alanine transaminase (ALAT) in 47% of cases. In primary cases 4 isolates were fully susceptible to ciprofloxacin, the remaining were intermediate susceptible. Relapse occurred in 37% of the cases and only in cases where the patient was infected by a strain with intermediate susceptibility. Better pre-travel counselling should be given to VFR-travellers. The main symptoms and laboratory findings confirm previous findings. The relapse rate was unexpected high and could be correlated to ciprofloxacin-resistance.

New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

PubMed Central

Mogensen, Stine; Treldal, Charlotte; Feldager, Erik; Pulis, Sylvia; Jacobsen, Jette; Andersen, Ove; Rasmussen, Mette

2012-01-01

Objective To evaluate the effect and acceptance of a new lidocaine lozenge compared with a lidocaine viscous oral solution as a pharyngeal anesthetic before upper gastrointestinal endoscopy (UGE), a diagnostic procedure commonly performed worldwide during which many patients experience severe discomfort mostly because of the gag reflex. Participants The single-blinded, randomized, controlled study involved 110 adult patients undergoing diagnostic UGE at the Department of Gastroenterology, Hvidovre University Hospital, Denmark. Methods The patients were randomized to receive either 100 mg lidocaine as a lozenge or 5 mL lidocaine viscous oral solution 2%. Intravenous midazolam was administered if needed. The effect of a lidocaine lozenge in reducing patient discomfort, including the gag reflex, during UGE compared with a lidocaine oral solution was assessed. Results Questionnaires from the patients showed that the gag reflex was acceptable for 64% in the lozenge group compared with 33% in the oral solution group (P = 0.0072). UGE was evaluated as acceptable by 69% in the lozenge group compared with 39% in the oral solution group (P = 0.0092). The taste was evaluated as good by 78% in the lozenge group (P < 0.0001), and 82% found the lozenge to have good texture (P < 0.0001). Conclusion The lozenge reduced the gag reflex, diminished patients’ discomfort during UGE, and was evaluated as having a good taste and texture. The lozenge improved patients’ acceptance of UGE. PMID:22915898

Effect of self-hypnosis on duration of labor and maternal and neonatal outcomes: a randomized controlled trial.

PubMed

Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Nohr, Ellen A

2013-07-01

To examine the effect of a brief course in self-hypnosis for childbirth on duration of the labor and other birth outcomes. A randomized, controlled, single-blind trial. Aarhus University Hospital Skejby, Denmark. A total of 1222 healthy nulliparous women. A hypnosis group receiving three 1-h lessons in self-hypnosis with additional audio-recordings to ease childbirth, a relaxation group receiving three 1-h lessons in various relaxation methods and mindfulness with audio-recordings for additional training, and a usual-care group receiving only the usual antenatal care were compared. Duration of labor, birth complications, lactation success, caring for the child, and preferred future mode of delivery. No differences were found across the three groups on duration from arriving at the birth department until the expulsive phase of second stage of labor, the duration of the expulsive phase, or other birth outcomes. Fewer emergency and more elective cesarean sections occurred in the hypnosis group. No difference was seen across the groups for lactation success or caring for the child but fewer women in the hypnosis group preferred a cesarean section in future pregnancies because of fear of childbirth and negative birth experiences. Learning self-hypnosis to ease childbirth taught as a brief course failed to show any effects on duration of childbirth and other birth outcomes. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Young female cancer patients' experiences with fertility counselling and fertility preservation-a qualitative small-scale study within the Danish health care setting.

PubMed

Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T

2016-07-14

Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi's phenomenological analysis. None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice.

Young female cancer patients’ experiences with fertility counselling and fertility preservation—a qualitative small-scale study within the Danish health care setting

PubMed Central

Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T.

2016-01-01

Introduction Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Methods Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi’s phenomenological analysis. Results None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Conclusion Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice. PMID:27413812

Preoperative Electrocardiogram Score for Predicting New-Onset Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

PubMed

Gu, Jiwei; Andreasen, Jan J; Melgaard, Jacob; Lundbye-Christensen, Søren; Hansen, John; Schmidt, Erik B; Thorsteinsson, Kristinn; Graff, Claus

2017-02-01

To investigate if electrocardiogram (ECG) markers from routine preoperative ECGs can be used in combination with clinical data to predict new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Retrospective observational case-control study. Single-center university hospital. One hundred consecutive adult patients (50 POAF, 50 without POAF) who underwent coronary artery bypass grafting, valve surgery, or combinations. Retrospective review of medical records and registration of POAF. Clinical data and demographics were retrieved from the Western Denmark Heart Registry and patient records. Paper tracings of preoperative ECGs were collected from patient records, and ECG measurements were read by two independent readers blinded to outcome. A subset of four clinical variables (age, gender, body mass index, and type of surgery) were selected to form a multivariate clinical prediction model for POAF and five ECG variables (QRS duration, PR interval, P-wave duration, left atrial enlargement, and left ventricular hypertrophy) were used in a multivariate ECG model. Adding ECG variables to the clinical prediction model significantly improved the area under the receiver operating characteristic curve from 0.54 to 0.67 (with cross-validation). The best predictive model for POAF was a combined clinical and ECG model with the following four variables: age, PR-interval, QRS duration, and left atrial enlargement. ECG markers obtained from a routine preoperative ECG may be helpful in predicting new-onset POAF in patients undergoing cardiac surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Anxiety in voluntary HIV-antibody testing in pregnancy and its implications for preventive strategies.

PubMed

Foldspang, A; Hedegaard, M

1991-06-01

During a three-month period in 1989, 820 pregnant women attending the antenatal clinic of the Aarhus University Hospital, Denmark, were offered a HIV-antibody test and asked to fill out an anonymous questionnaire about attitudes to HIV-antibody testing; 779 (95.0%) agreed to do so. One hundred and fifty-six women (20.0% of the participants) had been tested on a previous occasion, and 629 (80.7%) accepted the present offer to be tested. The most prevalent reasons to decline testing were indifference to the epidemic (45.3% of those declining), refusal of (further) blood testing (34.7%) and fear of being infected (16.7%). Women who consented to be tested most often expressed fear of being infected (21.8%). Fear of registration worried less than 5% of study group members; only 1% declined to be tested because of such worry. The pattern of worries expressed by the pregnant women is interpreted as one of anxiety and, in part at least, perplexity as concerns how to take rational consequences of public messages about the HIV epidemic. It is suggested that future surveillance be based primarily on voluntary testing and, whenever needed and possible, supplied with anonymous unlinked testing of existing blood samples from groups and persons declining to be tested. Such surveillance strategies should be supported in individual patient contacts and public health educational campaigns underscoring the risk of heterosexual transmission of HIV and the need for repeated HIV-antibody testing of selected groups and individuals.

[Extralegal coercive measures in psychiatric wards-- patients' perspectives].

PubMed

Jensen, Hans Mørch; Poulsen, Henrik Day

2006-02-06

A revision of the Danish Mental Health Act is planned to take place in 2005-2006. The Ministry of Health requires investigation into whether extralegal coercive measures take place in psychiatric wards. Extralegal coercion refers to restrictions and rules not included in the current Mental Health Act and considered by patients to be coercion. Twenty-two psychiatric patients participated in four group interviews directed by two physicians at four University Hospitals in Copenhagen, Denmark. The patients were asked to define what they perceived as extralegal coercion, house rules and psychiatric treatment. The majority of patients perceived lack of single rooms, restrictions on leaving the ward and shielding, i.e., being confined to one's room, to be extralegal coercion. A few also found the pressure to take medication and collection of clothes items to be extralegal coercion. Rules on smoking, clothing, day and night routines, the use of radio and TV, drugs, alcohol, visits, eating and the use of telephones were considered not extralegal coercion but necessary house rules. House rules should be clear and stated in writing. Restrictions on the use of money and locking of the front door at night were accepted in certain situations, hence not considered to be extralegal coercion. Extralegal coercion does occur in psychiatric wards but in certain situations is accepted if documented. House rules are considered to be necessary and not extralegal coercion. Increased use of compulsory protocols for documenting coercive measures was not considered to be necessary, but documentation in patients' files was useful alternative.

Children's Perspective on Learning: An International Study in Denmark, Estonia, Germany and Sweden

ERIC Educational Resources Information Center

Sandberg, Anette; Broström, Stig; Johansson, Inge; Frøkjaer, Thorleif; Kieferle, Christa; Seifert, Anja; Roth, Angela; Tuul, Maire; Ugaste, Aino; Laan, Meeli

2017-01-01

This article explores how some children in Denmark, Estonia, Germany and Sweden describe their perspective on learning. The aim of the international study is to gain knowledge of how preschool children in Sweden, Denmark, Estonia and Germany reflect and perceive their learning in preschool and other surrounding social contexts. The results are…

Forest restoration in the Nordic countries

Treesearch

Palle Madsen; Ása Arad•ttir; Emile Gardiner; Pelle Gemmel; Kåre Lund Høie; Magnus Löf; John A. Stanturf; Peter Tigerstedt; Hardi Tullus; Sauli Valkonen; Veiko Uri

2000-01-01

The Nordic countries include Iceland, Norway, Sweden, Finland, and Denmark, which range from lat. 54° in southern Denmark to lat. 72° at North Cape, Norway. This region is dominated by the boreal coniferous vegetational zone.Denmark and southern Sweden are, however, located in the deciduous (nemoral) forest zone, whereas the interior part of Iceland and the high...

Changing Patterns of Finance in Higher Education. Country Study: Denmark. OECD Educational Monographs.

ERIC Educational Resources Information Center

Enslev, Lisbeth; And Others

A country study on Denmark is presented as part of a series prepared by the Organisation for Economic Cooperation and Development (OCED) Education Committee activity on changing patterns of finance in higher education. In Denmark, postsecondary institutions are the direct responsibility of the state. Some central problems are to strike a balance…

Library Services to the Homebound Elderly in Denmark.

ERIC Educational Resources Information Center

Nielsen, Gyda Skat

The number of elderly people in Denmark continues to grow, which means there is an increasing need for special library services to those elderly who are not able to come to the library because of physical or mental limitations. This paper uses the practices of Sollerod Public Libraries (Sollerod, Denmark) to frame the discussion of the following:…

Existing data sources for clinical epidemiology: Scandinavian Cohort for osteonecrosis of the jaw – work in progress and challenges

PubMed Central

Schiodt, Morten; Larsson Wexell, Cecilia; Herlofson, Bente Brokstad; Giltvedt, Karen Marie; Norholt, Sven Erik; Ehrenstein, Vera

2015-01-01

Osteonecrosis of the jaw (ONJ) is a severe side effect associated with antiresorptive treatment. Monitoring of ONJ using routine databases in Scandinavian countries is a challenge owing to lack of valid algorithms and to heterogeneous referral practices. The aim of this paper is to describe the process of establishing a Scandinavian ONJ Cohort enrolling all ONJ cases related to antiresorptive treatment arising in Denmark, Norway, and Sweden between 2011 and 2019. The initial purpose of the cohort is to support an ongoing pharmacovigilance study of denosumab and zoledronic acid in Denmark, Norway, and Sweden. The three countries, with their 199 clinics, departments, and units of oral and maxillofacial surgery, both hospital-based and freestanding, differ somewhat in referral practices of the ONJ patients. By directly contacting all providers of care to ONJ patients in the three countries, we established a network for reporting incident cases to each country’s research database directly or through a member of the Scandinavian ONJ task force as a liaison. The task force includes a Scandinavian coordinator and three national coordinators collaborating directly with the clinics. A uniform ONJ registration form has been developed, and the relevant medical community has been informed either directly or through presentations at professional meetings. A website with study information is published in each country, and data entry is ongoing. This large-scale systematic uniform registration of ONJ cases in Denmark, Norway, and Sweden, with an underlying total population of more than 20 million people, merged into the Scandinavian ONJ Cohort, will contribute to better knowledge and understanding of this challenging group of patients, and ultimately, help improve patient care. The Scandinavian ONJ Cohort as a whole and its component national ONJ research databases may offer the potential for large-scale multinational intervention and safety studies in the future. PMID:25657594

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 of absolute risks.

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-related accidents may occur, which will limit estimation of absolute risks. PMID:27678553

Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival?

PubMed Central

Forbes, L J L; Simon, A E; Warburton, F; Boniface, D; Brain, K E; Dessaix, A; Donnelly, C; Haynes, K; Hvidberg, L; Lagerlund, M; Lockwood, G; Tishelman, C; Vedsted, P; Vigmostad, M N; Ramirez, A J; Wardle, J

2013-01-01

Background: There are wide international differences in 1-year cancer survival. The UK and Denmark perform poorly compared with other high-income countries with similar health care systems: Australia, Canada and Sweden have good cancer survival rates, Norway intermediate survival rates. The objective of this study was to examine the pattern of differences in cancer awareness and beliefs across these countries to identify where these might contribute to the pattern of survival. Methods: We carried out a population-based telephone interview survey of 19 079 men and women aged ⩾50 years in Australia, Canada, Denmark, Norway, Sweden and the UK using the Awareness and Beliefs about Cancer measure. Results: Awareness that the risk of cancer increased with age was lower in the UK (14%), Canada (13%) and Australia (16%) but was higher in Denmark (25%), Norway (29%) and Sweden (38%). Symptom awareness was no lower in the UK and Denmark than other countries. Perceived barriers to symptomatic presentation were highest in the UK, in particular being worried about wasting the doctor's time (UK 34% Canada 21% Australia 14% Denmark 12% Norway 11% Sweden 9%). Conclusion: The UK had low awareness of age-related risk and the highest perceived barriers to symptomatic presentation, but symptom awareness in the UK did not differ from other countries. Denmark had higher awareness of age-related risk and few perceived barriers to symptomatic presentation. This suggests that other factors must be involved in explaining Denmark's poor survival rates. In the UK, interventions that address barriers to prompt presentation in primary care should be developed and evaluated. PMID:23370208

Testicular cancer risk in first- and second-generation immigrants to Denmark.

PubMed

Myrup, Charlotte; Westergaard, Tine; Schnack, Tine; Oudin, Anna; Ritz, Christian; Wohlfahrt, Jan; Melbye, Mads

2008-01-02

Immigrant studies offer insights into the relative importance of environment and genes in disease etiology. There is considerable variation in testicular cancer incidence worldwide. We investigated testicular cancer risk in first- and second-generation immigrants to Denmark, a high-incidence country, to evaluate the relative influence of genes and environment and the potential timing of action of environmental factor(s). A cohort of 2.1 million men who were born since 1930 and lived in Denmark between 1968 and 2003 was established based on information in the Danish Civil Registration System, which included their immigration histories. Cancer histories were obtained from the Danish Cancer Registry. Testicular cancer risk was estimated as rate ratios (RRs) with 95% confidence intervals (CIs) based on log-linear Poisson regression. Overall, 4216 testicular cancer cases occurred during 43 million person-years of follow-up in 2.1 million men. These included 166 cases among 344,444 direct immigrants to Denmark and 13 cases among 56,189 men born in Denmark to immigrant parents. These first- and second-generation immigrants had RRs of testicular cancer of 0.37 (95% CI = 0.31 to 0.43) and 0.88 (95% CI = 0.51 to 1.53), respectively, compared with men born in Denmark of parents born in Denmark. The rate in first-generation immigrants was not modified by age at immigration or duration of stay and reflected that in the country of origin. The testicular cancer risk in first-generation immigrants was lower than that in native-born Danes and reflected that in the countries of origin, whereas the risk in second-generation immigrants was similar to that in natives of Denmark. Together these findings argue for a substantial influence of environmental factors limited to the period early in life, most probably to the period in utero.

Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center

ERIC Educational Resources Information Center

Farley, Eugene S.; Piemme, Thomas E.

1975-01-01

Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

Physician-Owned Surgical Hospitals Outperform Other Hospitals in Medicare Value-Based Purchasing Program.

PubMed

Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott

2016-10-01

The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals and creates financial incentives for quality improvement and fosters increased transparency. Limited information is available comparing hospital performance across health care business models. The 2015 Hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Of 3,089 hospitals with total performance scores, categories of representative health care business models included 104 physician-owned surgical hospitals, 111 University HealthSystem Consortium, 14 US News & World Report Honor Roll hospitals, 33 Kaiser Permanente, and 124 Pioneer accountable care organization affiliated hospitals. Estimated mean total performance scores for physician-owned surgical hospitals (64.4; 95% CI, 61.83-66.38) and Kaiser Permanente (60.79; 95% CI, 56.56-65.03) were significantly higher compared with all remaining hospitals, and University HealthSystem Consortium members (36.8; 95% CI, 34.51-39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included physician-owned surgical hospitals (mean 2.32; p < 0.0001), US News & World Report honorees (mean 2.24; p = 0.0140), and University HealthSystem Consortium members (mean 1.99; p < 0.0001), and Kaiser Permanente hospitals had lower case mix value (mean 1.54; p < 0.0001). Re-estimation of total performance scores did not change the original results after adjustment for differences in hospital case mix index. The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals can guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A simulation model of hospital management based on cost accounting analysis according to disease.

PubMed

Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

2004-12-01

Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

They use humor, off-beat images. These ads keep the consumers' minds OUT of the hospital.

PubMed

Botvin, Judith D

2003-01-01

Limited budgets make it more important for a healthcare campaign to stand out. NeathawkDubuque, Richmond, Va., showcases television commercials for Washington Hospital Center and Georgetown University Hospital, both in Washington, D.C.; and print ads for the University of Virginia Health System, Charlottesville, Va. Additionally, Coil Counts Ford and Cheney, Chicago, provide a distinctive campaign for Advocate Illinois Masonic Medical Center, Chicago.

DNA-thioguanine nucleotide concentration and relapse-free survival during maintenance therapy of childhood acute lymphoblastic leukaemia (NOPHO ALL2008): a prospective substudy of a phase 3 trial.

PubMed

Nielsen, Stine Nygaard; Grell, Kathrine; Nersting, Jacob; Abrahamsson, Jonas; Lund, Bendik; Kanerva, Jukka; Jónsson, Ólafur Gísli; Vaitkeviciene, Goda; Pruunsild, Kaie; Hjalgrim, Lisa Lyngsie; Schmiegelow, Kjeld

2017-04-01

Adjustment of mercaptopurine and methotrexate maintenance therapy of acute lymphoblastic leukaemia by leucocyte count is confounded by natural variations. Cytotoxicity is primarily mediated by DNA-incorporated thioguanine nucleotides (DNA-TGN). The aim of this study was to establish whether DNA-TGN concentrations in blood leucocytes during maintenance therapy are associated with relapse-free survival. In this substudy of the NOPHO ALL2008 phase 3 trial done in 23 hospitals in seven European countries (Denmark, Estonia, Finland, Iceland, Lithuania, Norway, and Sweden), we analysed data from centralised and blinded analyses of 6-mercaptopurine and methotrexate metabolites in blood samples from patients with non-high-risk childhood acute lymphoblastic leukaemia. Eligible patients were aged 1·0-17·9 years; had been diagnosed with non-high-risk precursor B-cell or T-cell leukaemia; had been treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol; and had reached maintenance therapy in first remission. Maintenance therapy was (mercaptopurine 75 mg/m 2 once per day and methotrexate 20 mg/m 2 once per week, targeted to a leucocyte count of 1·5-3·0 × 10 9 cells per L). We measured DNA-TGN and erythrocyte concentrations of TGN nucleotides, methylated mercaptopurine metabolites, and methotrexate polyglutamates. The primary objective was the association of DNA-TGN concentrations and 6-mercaptopurine and methotrexate metabolites with relapse-free survival. The secondary endpoint was the assessment of DNA-TGN concentration and 6-mercaptopurine and methotrexate metabolites during maintenance therapy phase 2. Between Nov 26, 2008 and June 14, 2016, 1509 patients from the NOPHO ALL2008 study were assessed for eligibility in the DNA-TGN substudy, of which 918 (89%) of 1026 eligible patients had at least one DNA-TGN measurement and were included in the analyses. Median follow-up was 4·6 years (IQR 3·1-6·1). Relapse-free survival was significantly associated with DNA-TGN concentration (adjusted hazard ratio 0·81 per 100 fmol/μg DNA increase, 95% CI 0·67-0·98; p=0·029). In patients with at least five blood samples, erythrocyte concentrations of TGN, methylated mercaptopurine metabolites, and methotrexate polyglutamates were associated with DNA-TGN concentration (all p<0·0001). Our results suggest the need for intervention trials to identify clinically applicable strategies for individualised drug dosing to increase DNA-TGN concentration, and randomised studies to investigate whether such strategies improve cure rates compared with current dose adjustments based on white blood cell counts. Danish Cancer Society, Childhood Cancer Foundation (Denmark), Childhood Cancer Foundation (Sweden), Nordic Cancer Union, Otto Christensen Foundation, University Hospital Rigshospitalet, and Novo Nordic Foundation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mapping telemedicine efforts: surveying regional initiatives in Denmark.

PubMed

Kierkegaard, Patrick

2015-05-01

The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies are being utilized? What medical disciplines are being supported using telemedicine systems? All data were surveyed from the Telemedicinsk Landkort, a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. The results of this study suggest that a growing numbers of telemedicine initiatives are currently in operation across Denmark but that considerable variations exist in terms of regional efforts as the number of operational telemedicine projects varied from region to region. The results of this study provide a timely picture of the factors that are shaping the telemedicine landscape of Denmark and suggest potential strategies to help policymakers increase and improve national telemedicine deployment.

Most Efficient Spectrograph to Shoot the Southern Skies

NASA Astrophysics Data System (ADS)

2009-05-01

ESO's Very Large Telescope -- Europe's flagship facility for ground-based astronomy -- has been equipped with the first of its second generation instruments: X-shooter. It can record the entire spectrum of a celestial object in one shot -- from the ultraviolet to the near-infrared -- with high sensitivity. This unique new instrument will be particularly useful for the study of distant exploding objects called gamma-ray bursts. ESO PR Photo 20a/09 An X-shooter spectrum ESO PR Photo 20b/09 The X-shooter instrument ESO PR Photo 20c/09 First Light of X-shooter "X-shooter offers a capability that is unique among astronomical instruments installed at large telescopes," says Sandro D'Odorico, who coordinated the Europe-wide consortium of scientists and engineers that built this remarkable instrument. "Until now, different instruments at different telescopes and multiple observations were needed to cover this kind of wavelength range, making it very difficult to compare data, which, even though from the same object, could have been taken at different times and under different sky conditions." X-shooter collects the full spectrum from the ultraviolet (300 nm) to the near-infrared (2400 nm) in parallel, capturing up to half of all the light from an object that passes through the atmosphere and the various elements of the telescope. "All in all, X-shooter can save us a factor of three or more in terms of precious telescope time and opens a new window of opportunity for the study of many, still poorly understood, celestial sources," says D'Odorico. The name of the 2.5-ton instrument was chosen to stress its capacity to capture data highly efficiently from a source whose nature and energy distribution are not known in advance of the observation. This property is particularly crucial in the study of gamma-ray bursts, the most energetic explosions known to occur in the Universe (ESO 17/09). Until now, a rough estimate of the distance of the target was needed, so as to know which instrument to use for a detailed study. Thanks to X-shooter, astronomers won't have to go through this first observing step. This is particularly relevant for gamma-ray bursts, which fade away very quickly and where being fast is the key to understanding the nature of these elusive cosmic sources. "I am very confident that X-shooter will discover the most distant gamma-ray bursts in the Universe, or in other words, the first objects that formed in the young Universe," says François Hammer, who leads the French efforts in X-shooter. X-shooter was built by a consortium of 11 institutes in Denmark, France, Italy and the Netherlands, together with ESO. In total 68 person-years of work by engineers, technicians and astronomers and a global budget of six million Euros were required. The development time was remarkably fast for a project of this complexity, which was completed in just over five years, starting from the kick-off meeting held in December 2003. "The success of X-shooter and its relatively short completion time are a tribute to the quality and dedication of the many people involved in the project," says Alan Moorwood, ESO Director of Programmes. The instrument was installed at the telescope at the end of 2008 and the first observations in its full configuration were made on 14 March 2009, demonstrating that the instrument works efficiently over the full spectral range with unprecedented resolution and quality. X-shooter has already proved its full capability by obtaining the complete spectra of low metallicity stars, of X-ray binaries, of distant quasars and galaxies, of the nebulae associated with Eta Carinae and the supernova 1987A, as well as with the observation of a distant gamma-ray burst that coincidently exploded at the time of the commissioning run. X-shooter will be offered to the astronomical community from 1 October 2009. The instrument is clearly answering a need in the scientific community as about 150 proposals were received for the first runs of X-shooter, for a total of 350 observing nights, making it the second most requested instrument at the Very Large Telescope in this period. More information ESO's Very Large Telescope (VLT) is the world's most advanced optical instrument. It is an ensemble of four 8.2-metre telescopes located at the Paranal Observatory on an isolated mountain peak in the Atacama Desert in North Chile. The four 8.2-metre telescopes have a total of 12 focal stations where different instruments for imaging and spectroscopic observations are installed and a special station where the light of the four telescopes is combined for interferometric observations. The first VLT instrument was installed in 1998 and has been followed by 12 more in the last 10 years, distributed at the different focal stations. X-shooter is the first of the second generation of VLT instruments and replaces the workhorse-instrument FORS1, which has been successfully used for more than ten years by hundreds of astronomers. X-shooter operates at the Cassegrain focus of the Kueyen telescope (UT2). In response to an ESO Call for Proposals for second generation VLT instrumentation, ESO received three proposals for an intermediate resolution, high efficiency spectrograph. These were eventually merged into a single proposal around the present concept of X-shooter, which was approved for construction in November 2003. The Final Design Review, at which the instrument design is finalised and declared ready for construction, took place in April 2006. The first observations with the instrument at the telescope in its full configuration were on 14 March 2009. X-shooter is a joint project by Denmark, France, Italy, the Netherlands and ESO. The collaborating institutes in Denmark are the Niels Bohr and the DARK Institutes of the University of Copenhagen and the National Space Institute (Technical University of Denmark); in France GEPI at the Observatoire de Paris and APC at the Université D. Diderot, with contributions from the CEA and the CNRS; in Italy the Osservatorio di Brera, Trieste, Palermo and Catania; and in the Netherlands, the University of Amsterdam, the University of Nijmegen and ASTRON. Beside the participating institutes and ESO, the project was supported by the National Agencies of Italy (INAF), the Italian Ministry for Education, University and Research (MIUR), the Netherlands (NOVA and NWO) and by the Carlsberg Foundation in Denmark. The project was also supported in Denmark and the Netherlands with funds from the EU Descartes prize, the highest European prize for science, awarded in 2002 to the European collaboration on gamma-ray burst research headed by Professor Ed van den Heuvel. ESO, the European Southern Observatory, is the foremost intergovernmental astronomy organisation in Europe. It is supported by 14 countries: Austria, Belgium, the Czech Republic, Denmark, France, Finland, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. ESO carries out an ambitious programme focused on the design, construction and operation of powerful ground-based observing facilities enabling astronomers to make important scientific discoveries. ESO also plays a leading role in promoting and organising cooperation in astronomical research. ESO operates three unique world-class observing sites in the Atacama Desert region of Chile: La Silla, Paranal and Chajnantor.

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.

Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study

PubMed Central

Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling; Andersen, Per Kragh; Giacco, Domenico; Nordentoft, Merete

2016-01-01

Introduction Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services. Design and methods We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date. Ethics and dissemination The study has been approved by The Danish Health and Medicines Authority (j.nr.: 3-3013-934/1/) and by The Danish Data Protection Agency (j.nr.: 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed (j.nr.: H-2-2014-FSP70). Findings will be disseminated through scientific publications, presentations and in a PhD thesis. PMID:27683519

[How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

PubMed

Kawano, Seiji

2014-12-01

As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).

Historical Study (1986-2014): Improvements in Nutritional Status of Dialysis Patients.

PubMed

Koefoed, Mette; Kromann, Charles Boy; Hvidtfeldt, Danni; Juliussen, Sophie Ryberg; Andersen, Jens Rikardt; Marckmann, Peter

2016-09-01

Malnutrition is common in dialysis patients and is associated with adverse clinical outcomes. Despite an increased focus on improved nutrition in dialysis patients, it is claimed that the prevalence of malnutrition in this group of patients has not changed during the last decades. Direct historical comparisons of the nutritional status of dialysis patients have never been published. To directly compare the nutritional status of past and current dialysis patients, we implemented the methodology of a study from 1986 on a population of dialysis patients in 2014. Historical study comparing results of two cross-sectional studies performed in 1986 and 2014. We compared the nutritional status of hemodialysis (HD) and peritoneal dialysis (PD) patients attending the dialysis center at Roskilde Hospital, Denmark, in February to June 2014, with that of HD and PD patients treated at the dialysis center at Fredericia Hospital, Denmark, in April 1986. Maintenance PD and HD patients (n = 64 in 2014 and n = 48 in 1986). We performed anthropometry (body weight, triceps skinfold, and midarm muscle circumferences [MAMCs]) and determined plasma transferrin. Relative body weight, triceps skinfold, MAMC, body mass index, and prevalence of protein-caloric malnutrition as defined in the original study from 1986. Average relative body weight, triceps skinfold, MAMC, and body mass index were significantly higher in 2014 compared with 1986. The prevalence of protein-caloric malnutrition was significantly lower in 2014 (18%) compared with 1986 (52%). The nutritional status of maintenance dialysis patients has improved during the last 3 decades. The reason for this improvement could not be identified in the present study, but the most likely contributors are the higher prevalence of obesity in the general population, less predialytic malnutrition, and an improved focus on nutrition in maintenance dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools? A qualitative study

PubMed Central

Malta Hansen, Carolina; Rod, Morten Hulvej; Folke, Fredrik; Torp-Pedersen, Christian; Tjørnhøj-Thomsen, Tine

2016-01-01

Objective Cardiopulmonary resuscitation (CPR) training in schools is recommended to increase bystander CPR and thereby survival of out-of-hospital cardiac arrest, but despite mandating legislation, low rates of implementation have been observed in several countries, including Denmark. The purpose of the study was to explore barriers to implementation of CPR training in Danish secondary schools. Design A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and across the interviews. Setting 8 secondary schools in Denmark. Schools were selected using strategic sampling to reach maximum variation, including schools with/without recent experience in CPR training of students, public/private schools and schools near to and far from hospitals. Participants The study population comprised 25 participants, 9 school leadership members and 16 teachers. Results School leadership and teachers considered it important for implementation and sustainability of CPR training that teachers conduct CPR training of students. However, they preferred external instructors to train students, unless teachers acquired the CPR skills which they considered were needed. They considered CPR training to differ substantially from other teaching subjects because it is a matter of life and death, and they therefore believed extraordinary skills were required for conducting the training. This was mainly rooted in their insecurity about their own CPR skills. CPR training kits seemed to lower expectations of skill requirements to conduct CPR training, but only among those who were familiar with such kits. Conclusions To facilitate implementation of CPR training in schools, it is necessary to have clear guidelines regarding the required proficiency level to train students in CPR, to provide teachers with these skills, and to underscore that extensive skills are not required to provide CPR. Further, it is important to familiarise teachers with CPR training kits. PMID:27113236

Analysis of Time-of-Day Energy Demand and Supply in University and Hospital

NASA Astrophysics Data System (ADS)

Shimazaki, Yoichi

The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.

New hypotheses regarding the Danish health puzzle.

PubMed

Bakah, May; Raphael, Dennis

2017-12-01

Nordic welfare states have achieved admirable population health profiles as a result of public policies that provide economic and social security across the life course. Denmark has been an exception to this rule, as its life expectancies and infant mortality rates since the mid-1970s have lagged behind the other Nordic nations and, in the case of life expectancy, behind most Organisation for Economic Co-operation and Development nations. In this review paper, we identify a number of new hypotheses for why this may be the case. These hypotheses concern the health effects of neo-liberal restructuring of the economy and its institutions, the institution of flexi-security in Denmark's labour market and the influence of Denmark's tobacco and alcohol industries. Also of note is that Denmark experienced higher unemployment rates during its initial period of health stagnation, as well as its treatment of non-Western immigrants and high wealth inequality and, until recently, the fact that Denmark did not systematically address the issue of health inequalities. These hypotheses may serve as covering explanations for the usually provided accounts of elevated behavioural risks and psychosocial stress as being responsible for Denmark's health profile.

Small-scale cannabis growers in Denmark and Finland.

PubMed

Hakkarainen, Pekka; Frank, Vibeke Asmussen; Perälä, Jussi; Dahl, Helle Vibeke

2011-01-01

To compare domestic cannabis cultivation in Denmark and Finland to describe national characteristics in small-scale cannabis growing. A Web survey conducted among small-scale cannabis growers in Denmark (June to November 2008) and Finland (May to June 2009). Current cannabis growers (Denmark, 401; Finland, 1,054). Comparisons in regard to social background, growing history, practices, purposes and motives of growing, and perceptions of risks. Cannabis was cultivated primarily for own use, but sharing with friends and avoiding criminal circles also were significant motives for growing. Finnish growers prioritized indoor cultivation, whereas the Danes were more in favor of open-air plantations. Risks of getting caught by the police were observed to be greater in Finland. Growing for medical purposes was twice as prevalent in Finland as in Denmark. Cannabis growing is a stronger and more novel phenomenon in Finland than in Denmark, but both countries have been influenced by international trends. Finnish and Danish small-scale cannabis cultivators can be considered to be ideologically oriented lifestyle growers. Differences in the magnitude of the phenomenon may reflect differences in the availability and quality of cannabis in national drug markets. The Internet had promoted the spreading of the trend. Copyright © 2011 S. Karger AG, Basel.

Oncological outcomes of metastatic testicular cancers under centralized management through regional medical network.

PubMed

Inai, Hiromu; Kawai, Koji; Kojima, Takahiro; Joraku, Akira; Shimazui, Toru; Yamauchi, Atsushi; Miyagawa, Tomoaki; Endo, Tsuyoshi; Fukuhara, Yoshiharu; Miyazaki, Jun; Uchida, Katsunori; Nishiyama, Hiroyuki

2013-12-01

To investigate the dose intensity of induction chemotherapy and oncological outcomes of metastatic testicular cancer under centralized management through a regional medical network. We retrospectively analyzed the outcomes of 86 metastatic testicular cancer patients who were given induction chemotherapy at Tsukuba University Hospital and four branch hospitals between January 2000 and November 2010. Principally, management of patients with poor-prognosis disease and patients having risk factors for bleomycin, etoposide and cisplatin were referred to Tsukuba University Hospital before chemotherapy. For high-risk groups, etoposide and cisplatin or etoposide, ifosfamide and cisplatin was used as an alternative to bleomycin, etoposide and cisplatin. Overall, 56 and 30 patients were treated at Tsukuba University Hospital and branch hospitals, respectively. Forty-seven, 18 and 21 patients were classified with good-, intermediate- and poor-prognosis disease, respectively, according to the International Germ Cell Cancer Collaborative Group criteria. Eighteen of the 21 patients (86%) with poor-prognosis disease were treated at Tsukuba University Hospital from the beginning of induction chemotherapy. Induction chemotherapy with a high relative dose intensity was possible in most patients. The average relative dose intensity of each drug was >0.96. Treatment procedures other than induction chemotherapy were efficiently centralized; 74% of post-chemotherapy surgery and all second-line or subsequent chemotherapies were performed at Tsukuba University Hospital. The 5-year overall survival rates of the good-, intermediate- and poor-prognosis groups were 97, 93 and 84%, respectively. Induction chemotherapy with high relative dose intensity, post-chemotherapy surgery and salvage chemotherapy was accomplished efficiently through centralization of management. Oncological outcomes were excellent, especially in patients with poor-prognosis disease, whose 5-year OS reached 84%.

Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

PubMed Central

YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

2010-01-01

Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

[Are investment activity and backlog in investments risks for university medicine in Germany?].

PubMed

Amann, I; Heyder, R; Strehl, R

2009-08-01

University medicine in Germany requires significantly higher funding and investment because its tasks not only include health care but also research and teaching. However, over recent decades less and less funding compared to the development of the turnover has been available. This trend is due to decreasing public funding. The diminishing funding has caused a major backlog of investment at German university hospitals. The first part of the article summarizes the investments policies at university hospitals and other hospitals. The second part describes the investment needs in university medicine and exposes risk factors for research, education and health care due to the process of investment planning and realization. Goal-oriented solutions are shown to facilitate investments. The third part discusses several risks caused by insufficient investments in university medicine. There are special risks for research, teaching, and the capacity for innovation in university medicine besides economical and medical risks. Some policies and financial strategies to overcome the backlog in investments are presented. After a summary, the article concludes with some practical examples of further measures to ensure sustainable funding.

Conflict management in public university hospitals in Turkey: a pilot study.

PubMed

Tengilimoglu, Dilaver; Kisa, Adnan

2005-01-01

By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

Medical school hotline: A History of the University of Hawai'i Postgraduate Medical Education Program at Okinawa Chubu Hospital, 1966-2012.

PubMed

Maeshiro, Masao; Izutsu, Satoru; Connolly, Kathleen Kihmm

2014-06-01

The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

PubMed Central

Loucif, Lotfi; Kassah-Laouar, Ahmed; Saidi, Mahdia; Messala, Amina; Chelaghma, Widad

2016-01-01

Seven nonredundant ertapenem-resistant Klebsiella pneumoniae isolates were collected between May 2014 and 19 January 2015 in the nephrology and hematology units of Batna University Hospital in Algeria. All strains coproduced the blaOXA-48, blaCTX-M-15, blaSHV-1, and blaTEM-1D genes. Six of these isolates belonged to the pandemic clone sequence type 101 (ST101). The blaOXA-48 gene was located on a conjugative IncL/M-type plasmid. This is the first known outbreak of OXA-48-producing K. pneumoniae isolates involving an ST101 clone in Batna University Hospital. PMID:27645236

Time trends in pediatric hospitalizations for hepatitis A in Greece (1999–2013): Assessment of the impact of universal infant immunization in 2008

PubMed Central

Papaevangelou, V.; Alexopoulou, Z.; Hadjichristodoulou, C.; Kourlamba, G.; Katsioulis, A.; Theodoridou, K.; Spoulou, V.; Theodoridou, M.

2016-01-01

ABSTRACT Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999–2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999–2008) and post-vaccination (2009–2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks. PMID:27141813

Haemostatic alterations in a group of canine cancer patients are associated with cancer type and disease progression

PubMed Central

2012-01-01

Background Haemostatic alterations are commonly detected in human and canine cancer patients. Previous studies have described haemostatic dysfunction in canine patients with haemangiosarcomas and carcinomas, and haemostasis has been assessed in dogs with various malignant and benign neoplasias. Few studies have addressed the effect of cancer type and progression of disease on the presence of haemostatic alterations in canine patients. The objective of the present study was to evaluate haemostatic variables of coagulation and fibrinolysis in a group of canine cancer patients, and to compare haemostatic changes to the cancer type and progression of disease. Methods The study population consisted of 71 dogs with malignant neoplasia presented to the University Hospital for Companion Animals, Faculty of Life Sciences, University of Copenhagen, Denmark. The study was designed as a prospective observational study evaluating the haemostatic function in canine cancer patients stratified according to type of cancer disease and disease progression. The coagulation response was evaluated by thromboelastrography (TEG), platelet count, activated partial thromboplastin time (aPTT), prothombin time (PT), fibrinogen and antithrombin (AT); and fibrinolysis by d-dimer and plasminogen. Results Hypercoagulability was the most common haemostatic dysfunction found. Non mammary carcinomas had increased clot strength (TEG G), aPTT and fibrinogen compared to the other groups. When stratifying the patients according to disease progression dogs with distant metastatic disease exhibited significantly increased fibrinogen, and d-dimer compared to dogs with local invasive and local non-invasive cancers. Conclusion Hypercoagulability was confirmed as the most common haemostatic abnormality in canine cancer patients and haemostatic dysfunction in canine cancer patients was found related to the cancer type and progression of disease. Increase in TEG G, aPTT and fibrinogen were observed in non-mammary carcinomas and were speculated to overall represent a proinflammatory response associated with the disease. Dogs with distant metastatic disease exhibited increased fibrinogen and d-dimer. Future studies are needed to elucidate the clinical importance of these results. PMID:22280938

Sexual dysfunction after colpectomy and vaginal reconstruction with a vertical rectus abdominis myocutaneous flap.

PubMed

Løve, Uffe S; Sjøgren, Pia; Rasmussen, Peter; Laurberg, Søren; Christensen, Henrik K

2013-02-01

The use of the vertical rectus abdominis myocutaneous flap in reconstruction after abdominoperineal resection or pelvic exenteration for neoplasia is well documented. However, functional outcomes after vaginal reconstruction, including sexual function, are poorly described. This study aimed to examine sexual function in women following extensive pelvic surgery with colpectomy and vaginal reconstruction with the use of a vertical rectus abdominis myocutaneous flap. This study is a retrospective review of medical records in combination with patient questionnaires. Nonresponders were followed up with a second contact. This study was performed at a tertiary care university medical center (Colorectal Section, Department of Surgery P, Aarhus University Hospital, Denmark) All women undergoing pelvic surgery and simultaneous vaginal reconstruction with the use of a vertical rectus abdominis myocutaneous flap between 2004 and 2010 at our department were identified from a patient database. Thirty women who were alive at the time of identification were included in the study. Sexual function before and after surgery was evaluated by the use of the Sexual function Vaginal changes Questionnaire. The main outcome end point was whether the patient was sexually active after vaginal reconstruction. Twenty-six participants (87%) answered the questionnaire. Fifty percent of patients reported an active sex life before surgery. In general, patients reported an unchanged desire for both physical and sexual contact after surgery. However, only 2 patients (14%) reported being sexually active after surgery. This was a retrospective study with a heterogeneous cohort involving several types of cancers and surgical procedures. Factors other than vertical rectus abdominis myocutaneous flap reconstruction itself may interfere with the sexual function. Extensive pelvic surgery with colpectomy leads to sexual dysfunction even when the vagina is reconstructed with a vertical rectus abdominis myocutaneous flap. This knowledge may improve the quality of information given to this group of patients before surgery.

Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

PubMed

Istl, Alexandra C; McAlister, Vivian C

2016-12-01

The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

Clinical efficacy of telemedicine in emergency radiotherapy for malignant spinal cord compression.

PubMed

Hashimoto, S; Shirato, H; Kaneko, K; Ooshio, W; Nishioka, T; Miyasaka, K

2001-09-01

The authors developed a Telecommunication-HElped Radiotherapy Planning and Information SysTem (THERAPIST), then estimated its clinical benefit in radiotherapy in district hospitals where consultation with the university hospital was required. The system consists of a personal computer with an image scanner and a digital camera, set up in district hospitals and directly connected via ISDN to an image server, and a treatment planning device set up in a university hospital. Image data and consultative reports are sent to the server. Radiation oncologists at the university hospital determine a treatment schedule and verify actual treatment fields. From 1998 to 1999, 12 patients with malignant spinal cord compression (MSCC) were treated by emergency radiotherapy with the help of this system. Image quality, transmission time, and cost benefit also were satisfactory for clinical use. The mean time between the onset of symptoms and the start of radiotherapy was reduced significantly from 7.1 days to 0.8 days (P < .05) by the introduction of the system. Five of 6 nonambulant patients became ambulant after the introduction of THERAPIST compared with 2 of 8 before the introduction of THERAPIST. The treatment outcome was significantly better after the introduction of the system (P < .05), and suggested to be beyond the international standard. The telecommunication-helped radiotherapy and information system was useful in emergency radiotherapy in district hospitals for patients with MSCC for whom consultation with experienced radiation oncologists at a university hospital was required.

Danish patients are positive towards fees for non-attendance in public hospitals. A qualitative study.

PubMed

Lou, Stina; Frumer, Michal; Olesen, Steen; Nielsen, Agnete Hedemann; Væggemose, Ulla

2016-07-01

Patients' non-attendance is a significant problem in modern healthcare. Non-attendance delays treatment, reduces efficiency and increases healthcare costs. For several years, the introduction of financial incentives such as a non-attendance fee has been discussed in Denmark. Set in the context of a tax-financed, free-for-all healthcare system, the political hesitance to introduce fees relates to concerns that additional fees may be badly received by tax-paying citizens and may undermine the political priority of patient equity. The aim of this qualitative sub-study was to investigate patients' attitudes towards a fee for non-attendance. Six semi-structured focus group interviews were conducted with a total of 44 patients who had been informed about being charged a fee for non-attendance. Data were transcribed verbatim and analysed using a qualitative content analysis. Overall, patients' attitudes towards the non-attendance fee were positive. Non-attendance was viewed as evidence of disregard for the common free-for-all healthcare, and a fee was expected to motivate non-attendees to show up. However, most patients argued that certain groups (e.g. the mentally disabled) should be exempted from the fee. Furthermore, an implementation of fees should be easy to manage administratively and should not increase bureaucracy. In general, patients' attitudes towards implementing non-attendance fees are positive. Danish Regions, Ministry of Health and Central Denmark Region. not relevant.

The Right to Development: Construction of a Non-Agriculturalist Discourse of Rurality in Denmark

ERIC Educational Resources Information Center

Svendsen, Gunnar Lind Haase

2004-01-01

The paper argues for the existence of two powerful discourses of rurality in Denmark after World War II. The first one is termed the modernist-agriculturalist discourse. Although still influential in the current public debate, in Denmark as well as in other Western European countries, this discourse of rurality had its heyday in the 1960s. It is…

Apprentice or Student? The Structures of Construction Industry Vocational Education and Training in Denmark and Sweden and Their Possible Consequences for Safety Learning

ERIC Educational Resources Information Center

Grytnes, Regine; Grill, Martin; Pousette, Anders; Törner, Marianne; Nielsen, Kent J.

2018-01-01

There is a notable difference in occupational injury rates in the two Scandinavian countries, Sweden and Denmark, with the latter having a 40% higher rate of fatal occupational injuries in the construction industry. This study explored differences in the vocational education and training (VET) systems between Sweden and Denmark that may be…

Anaesthesia care for emergency endoscopy for peptic ulcer bleeding. A nationwide population-based cohort study.

PubMed

Duch, Patricia; Haahr, Camilla; Møller, Morten Hylander; Rosenstock, Steffen J; Foss, Nicolai B; Lundstrøm, Lars Hyldborg; Lohse, Nicolai

2016-08-01

Currently, no standard approach exists to the level of monitoring or presence of staff with anaesthetic expertise required during emergency esophago-gastro-duodenoscopy (EGD) for peptic ulcer bleeding (PUB). We assess the association between anaesthesia care and mortality. We further describe the prevalence and inter-hospital variation of anaesthesia care in Denmark and identify clinical predictors for choosing anaesthesia care. This population-based cohort study included all emergency EGDs for PUB in adults during 2012-2013. About 90-day all-cause mortality after EGD was estimated by crude and adjusted logistic regression. Clinical predictors of anaesthesia care were identified in another logistic regression model. Some 3.056 EGDs performed at 21 hospitals were included; 2074 (68%) received anaesthesia care and 982 (32%) were managed under supervison of the endoscopist. Some 16.7% of the patients undergoing EGD with anaesthesia care died within 90 days after the procedure, compared to 9.8% of the patients who had no anaesthesia care, adjusted OR = 1.51 (95% CI = 1.25-1.83). Comparing the two hospitals with the most frequent (98.6% of al EGDs) and least frequent (6.9%) use of anaesthesia care, mortality was 13.7% and 11.7%, respectively, adjusted OR = 1.22 (95% CI = 0.55-2.71). The prevalence of anaesthesia care varied between the hospitals, median = 78.9% (range 6.9-98.6%). Predictors of choosing anaesthesia care were shock at admission, high ASA score, and no pre-existing comorbidity. Use of anaesthesia care for emergency EGD was associated with increased mortality, most likely because of confounding by indication. The use of anaesthesia care varied greatly between hospitals, but was unrelated to mortality at hospital level.

Cardiac Patients’ Walking Activity Determined by a Step Counter in Cardiac Telerehabilitation: Data From the Intervention Arm of a Randomized Controlled Trial

PubMed Central

Hansen, John; Grønkjær, Mette; Andreasen, Jan Jesper; Nielsen, Gitte; Sørensen, Erik Elgaard; Dinesen, Birthe Irene

2016-01-01

Background Walking represents a large part of daily physical activity. It reduces both overall and cardiovascular diseases and mortality and is suitable for cardiac patients. A step counter measures walking activity and might be a motivational tool to increase and maintain physical activity. There is a lack of knowledge about both cardiac patients’ adherence to step counter use in a cardiac telerehabilitation program and how many steps cardiac patients walk up to 1 year after a cardiac event. Objective The purpose of this substudy was to explore cardiac patients’ walking activity. The walking activity was analyzed in relation to duration of pedometer use to determine correlations between walking activity, demographics, and medical and rehabilitation data. Methods A total of 64 patients from a randomized controlled telerehabilitation trial (Teledi@log) from Aalborg University Hospital and Hjoerring Hospital, Denmark, from December 2012 to March 2014 were included in this study. Inclusion criteria were patients hospitalized with acute coronary syndrome, heart failure, and coronary artery bypass grafting or valve surgery. In Teledi@log, the patients received telerehabilitation technology and selected one of three telerehabilitation settings: a call center, a community health care center, or a hospital. Monitoring of steps continued for 12 months and a step counter (Fitbit Zip) was used to monitor daily steps. Results Cardiac patients walked a mean 5899 (SD 3274) steps per day, increasing from mean 5191 (SD 3198) steps per day in the first week to mean 7890 (SD 2629) steps per day after 1 year. Adherence to step counter use lasted for a mean 160 (SD 100) days. The patients who walked significantly more were younger (P=.01) and continued to use the pedometer for a longer period (P=.04). Furthermore, less physically active patients weighed more. There were no significant differences in mean steps per day for patients in the three rehabilitation settings or in the disease groups. Conclusions This study indicates that cardiac telerehabilitation at a call center can support walking activity just as effectively as telerehabilitation at either a hospital or a health care center. In this study, the patients tended to walk fewer steps per day than cardiac patients in comparable studies, but our study may represent a more realistic picture of walking activity due to the continuation of step counter use. Qualitative studies on patients’ behavior and motivation regarding step counter use are needed to shed light on adherence to and motivation to use step counters. Trial Registration ClinicalTrails.gov NCT01752192; https://clinicaltrials.gov/ct2/show/NCT01752192 (Archived by WebCite at http://www.webcitation.org/6fgigfUyV) PMID:27044310

Methods of Mathematical and Computational Physics for Industry, Science, and Technology

NASA Astrophysics Data System (ADS)

Melnik, Roderick V. N.; Voss, Frands

2006-11-01

Many industrial problems provide scientists with important and challenging problems that need to be solved today rather than tomorrow. The key role of mathematical physics, modelling, and computational methodologies in addressing such problems continues to increase. Science has never been exogenous to applied research. Gigantic ships and steam engines, repeating catapult of Dionysius and the Antikythera `computer' invented around 80BC are just a few examples demonstrating a profound link between theoretical and applied science in the ancient world. Nowadays, many industrial problems are typically approached by groups of researchers who are working as a team bringing their expertise to the success of the entire enterprise. Since the late 1960s several groups of European mathematicians and scientists have started organizing regular meetings, seeking new challenges from industry and contributing to the solution of important industrial problems. In particular, this often took the format of week-long workshops originally initiated by the Oxford Study Groups with Industry in 1968. Such workshops are now held in many European countries (typically under the auspices of the European Study Groups with Industry - ESGI), as well as in Australia, Canada, the United States, and other countries around the world. Problems given by industrial partners are sometimes very difficult to complete within a week. However, during a week of brainstorming activities these problems inevitably stimulate developing fruitful new ideas, new approaches, and new collaborations. At the same time, there are cases where as soon as the problem is formulated mathematically, it is relatively easy to solve. Hence, putting the industrial problem into a mathematical framework, based on physical laws, often provides a key element to the success. In addition to this important first step, the value in such cases is the real, practical applicability of the results obtained for an industrial partner who presents the problem. Under both outlined scenarios, scientists and mathematicians are provided with an opportunity to challenge themselves with real-world problems and to work together in a team on important industrial issues. This issue is a result of selected contributions by participants of the meeting that took place in the Sønderborg area of Denmark, one of the most important centers for information technology, telecommunication and electronics in the country. The meeting was hosted by the University of Southern Denmark in a picturesque area of Southern Jutland. It brought together about 65 participants, among whom were professional mathematicians, engineers, physicists, and industrial participants. The meeting was a truly international one, with delegates from four major Danish Universities, the UK, Norway, Italy, Czech Republic, Turkey, China, Germany, Latvia, Canada, the United States, and Finland. Five challenging projects were presented by leading industrial companies, including Grundfos, Danfoss Industrial Control, Unisensor, and Danfoss Flow Division (now Siemens). The meeting featured also the Mathematics for Industry Workshop with several distinguished international speakers. This volume of Journal of Physics: Conference Series on `Methods of Mathematical and Computational Physics for Industry, Science, and Technology' contains contributions from some of the participants of the workshop as well as the papers produced as a result of collaborative efforts with the above mentioned industrial companies. We would like to thank all authors and participants for their contributions and for bearing with us during the review process and preparation of this issue. We thank also all our referees for their timely and detailed reports. The publication of the proceedings of this meeting in Denmark was delayed due to problems with a previous publisher. We are very grateful that Journal of Physics: Conference Series kindly agreed to publish the proceedings rapidly at this late stage. As industrial problems become increasingly multidisciplinary, their successful solutions are often contingent on effective collaborative efforts between scientists, mathematicians, industrialists, and engineers. This volume has provided several examples of such collaborative efforts in the context of real-world industrial problems along with the analysis of important physics-based mathematical models applicable in a range of industrial contexts. Roderick V N Melnik, Professor of Mathematical Modelling, Syddansk Universitet (Denmark) and Professor and Canada Research Chair, Wilfrid Laurier University, Waterloo, Canada E-mail: rmelnik@wlu.ca Frands Voss, Director of the Mads Clausen Institute, Syddansk Universitet (Denmark)

Assessment of the Risk to Public Health due to Use of Antimicrobials in Pigs—An Example of Pleuromutilins in Denmark

PubMed Central

Alban, Lis; Ellis-Iversen, Johanne; Andreasen, Margit; Dahl, Jan; Sönksen, Ute W.

2017-01-01

Antibiotic consumption in pigs can be optimized by developing treatment guidelines, which encourage veterinarians to use effective drugs with low probability of developing resistance of importance for human health. In Denmark, treatment guidelines for use in swine production are currently under review at the Danish Veterinary and Food Administration. Use of pleuromutilins in swine has previously been associated with a very low risk for human health. However, recent international data and sporadic findings of novel resistance genes suggest a change of risk. Consequently, a reassessment was undertaken inspired by a risk assessment framework developed by the European Medicines Agency. Livestock-associated methicillin-resistant Staphylococcus aureus of clonal complex 398 (MRSA CC398) and enterococci were identified as relevant hazards. The release assessment showed that the probability of development of pleuromutilin resistance was high in MRSA CC398 (medium uncertainty) and low in enterococci (high uncertainty). A relatively small proportion of Danes has an occupational exposure to pigs, and foodborne transmission was only considered of relevance for enterococci, resulting in an altogether low exposure risk. The human consequences of infection with pleuromutilin-resistant MRSA CC398 or enterococci were assessed as low for the public in general but high for vulnerable groups such as hospitalized and immunocompromised persons. For MRSA CC398, the total risk was estimated as low (low uncertainty), among other due to the current guidelines on prevention of MRSA in place at Danish hospitals, which include screening of patients with daily contact to pigs on admittance. Moreover, MRSA CC398 has a medium human–human transmission potential. For enterococci, the total risk was estimated as low due to low prevalence of resistance, low probability of spread to humans, low virulence, but no screening of hospitalized patients, high ability of acquiring resistance genes, and a limited number of alternative antimicrobials (high uncertainty). This assessment reflects the current situation and should be repeated if pleuromutilin consumption increases substantially, resulting in increased prevalence of mobile, easily transmissible resistance mechanisms. Continuous monitoring of pleuromutilin resistance in selected human pathogens should therefore be considered. This also includes monitoring of linezolid resistance, since resistance mechanisms for pleuromutilins and oxazolidones are often coupled. PMID:28603717

Information Technology Governance Domains in Hospitals: A Case Study in Iran

PubMed Central

Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam

2015-01-01

IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization’s IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital’s IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, “the head of hospital” acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies. PMID:25948446

The future of qualitative research in psychology--a discussion with Svend Brinkmann, Günter Mey, Luca Tateo, and Anete Strand.

PubMed

Demuth, Carolin; Terkildsen, Thomas

2015-06-01

In May 2014, a workshop on "The future of qualitative research in psychology" took place at Aalborg University (Denmark), Department of Communication & Psychology organized by Carolin Demuth. Participants from Aalborg University engaged in a lively exchange with the two invited discussants Svend Brinkmann (Aalborg University) and Günter Mey (Stendal University of Applied Science). The discussion started out by addressing the specifics of qualitative research in the field of psychology, its historical development and the perils of recent trends of standardization and neo-positivistic orientations. In light of the discrepancy of what could be potentially achieved with qualitative methods for psychological research and how they are actually currently applied, an emphasis was made that we need to return to an understanding of qualitative methods as a craft skill and to take into account the subjectivity of the researcher in the process of scientific knowledge production. Finally, a re-focus on experience as the genuine object of psychological research, as well as a transdisciplinary approach to our understanding of human psychological functioning within a socially co-constructed, biological, as well as material world was discussed.

A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

ERIC Educational Resources Information Center

Young, Philip E.

1976-01-01

The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

Managing out of hours clinical photography at the University Hospitals Bristol.

PubMed

Brinkworth, Simon; Kenny, Alice; Knights, Christina

2018-04-01

In recent years, Medical Illustration at University Hospitals Bristol (UHBristol) NHS Foundation Trust has seen a steady increase in photography requests, including the need for out of hours photography provision. This paper details how Medical Illustration at UHBristol decided to manage an out of hours clinical photography service.

Brief Report: The Negev Hospital-University-Based (HUB) Autism Database

ERIC Educational Resources Information Center

Meiri, Gal; Dinstein, Ilan; Michaelowski, Analya; Flusser, Hagit; Ilan, Michal; Faroy, Michal; Bar-Sinai, Asif; Manelis, Liora; Stolowicz, Dana; Yosef, Lili Lea; Davidovitch, Nadav; Golan, Hava; Arbelle, Shosh; Menashe, Idan

2017-01-01

Elucidating the heterogeneous etiologies of autism will require investment in comprehensive longitudinal data acquisition from large community based cohorts. With this in mind, we have established a hospital-university-based (HUB) database of autism which incorporates prospective and retrospective data from a large and ethnically diverse…

Strategies for Effective Psychiatric Hospitalization of College and University Students

ERIC Educational Resources Information Center

Rockland-Miller, Harry; Eells, Gregory

2008-01-01

University and college counseling services face growing demands for services and self-reported increases in the level of presenting psychopathology, including need for psychiatric hospitalization. However, challenges in communication often occur between the systems of an inpatient psychiatric unit and an outpatient college and/or university…

Impacts of Campus Involvement on Hospitality Student Achievement and Satisfaction

ERIC Educational Resources Information Center

Yin, Dean; Lei, Simon A.

2007-01-01

Campus involvement affecting satisfaction and academic achievement (overall grade point average) of hospitality undergraduate students at a state university in the Midwest (University X) was investigated through a survey research. A four-part survey instrument was developed to facilitate this study. There were a number of academic, professional,…

Implementing Medical Teaching Policy in University Hospitals

ERIC Educational Resources Information Center

Engbers, Rik; Fluit, Cornelia Cornelia R. M. G.; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F. J. M.

2017-01-01

Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have…

[Multiresistant tuberculosis in Denmark 1993-1996].

PubMed

Viskum, K; Kok-Jensen, A

1998-05-18

Infections with multiresistant tubercle bacilli have also become a problem in the rich part of the world. The reasons are lack of compliance in patients with life style problems and ineffectiveness of the health system due to lack of fundings. During a four year period, 1993-1996 ten patients were seen in Denmark with tuberculosis due to multiresistant Mycobacterium tuberculosis. Nine were infected abroad, one developed MDR-TB during treatment in Denmark. It is possible to cure these patients, but it is expensive and takes a long time. In the future more cases created within Denmark are likely to be seen due to lack of funding for the tuberculosis programme and, depending on immigration, further cases created abroad are expected.

The Oregon Health and Science University-Oregon State Hospital Collaboration: Reflections on an Evolving Public-Academic Partnership.

PubMed

Chien, Joseph; Novosad, David; Mobbs, Karl E

2016-03-01

This column describes the conceptualization and implementation of an innovative collaboration between Oregon State Hospital and Oregon Health and Science University that was created to address understaffing and improve the quality of care. The hospital created a forensic evaluation rotation to address the growing population of forensic patients, which created a valuable recruiting tool for the hospital. One of the authors, a recent recruit, provides a first-person account of his experience working within the collaboration. The model could be emulated by other public-sector facilities facing similar challenges with psychiatrist recruitment and retention.

The tragedy of becoming tired of living: Youth and young adults' suicide in Greenland and Denmark.

PubMed

Bolliger, Larissa; Gulis, Gabriel

2018-06-01

Suicide is a tremendous public health issue and worldwide the second leading cause of death among young people. In 2015, Greenland had the highest burden of disease due to self-harm with loss of 2,952.97 disability-adjusted life years per 100,000 inhabitants, more than six times as many as Denmark. What are possible reasons for Greenland's higher youth suicide rate compared to Denmark, despite being one kingdom of Denmark? Mixed methods in the form of qualitative, semi-structured interviews, the analysis of available data for 2003-2016 and a literature review were conducted with the aim to answer this question. Several exposures cause this difference, most significantly adverse effects of the colonial past, such as social issues and experienced traumas in Greenland compared to its former coloniser Denmark. The ongoing burden of youth suicide in Greenland requires enhanced actions of all stakeholders involved in suicide prevention, intervention and postvention.

Developing marketing strategies for university teaching hospitals.

PubMed

Fink, D J

1980-07-01

University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

Changes in private alcohol importation after alcohol tax reductions and import allowance increases in Denmark

PubMed Central

Grittner, Ulrike; Bloomfield, Kim

2010-01-01

AIMS This paper examines changes in alcohol import in Denmark between 2003 and 2006, after the excise tax on spirits in Denmark was lowered by 45% on October 1, 2003 and travellers’ allowances for alcohol import were increased on January1, 2004. Additionally, the paper seeks to develop a profile of alcohol importers and analyse the relation between the distance to the German border and import behaviour, as Germany is the main alcohol import country for Denmark. DATA Cross-sectional and panel data from Denmark, from 2003 to 2006, were analyzed. Samples were collected by telephone interviews, using random digit dialing. RESULTS While the percentage of people who imported alcohol fell over time, the amount of alcohol purchased rose for those who did import. Distance to the German border was inversely related to the likelihood of importing and the level of imported amounts. Heavy drinkers and those with higher incomes were more likely to import, and heavy drinkers imported higher amounts than moderate drinkers or abstainers. CONCLUSION Distance of residence from the German border, socio-economic status and drinking behaviour are related to private alcohol import in Denmark. Policy changes resulted in a shift to fewer people importing higher amounts of alcohol so that the overall import level did not change substantially. PMID:21532978

Comparison between air pollution concentrations measured at the nearest monitoring station to the delivery hospital and those measured at stations nearest the residential postal code regions of pregnant women in Fukuoka.

PubMed

Michikawa, Takehiro; Morokuma, Seiichi; Nitta, Hiroshi; Kato, Kiyoko; Yamazaki, Shin

2017-06-13

Numerous earlier studies examining the association of air pollution with maternal and foetal health estimated maternal exposure to air pollutants based on the women's residential addresses. However, residential addresses, which are personally identifiable information, are not always obtainable. Since a majority of pregnant women reside near their delivery hospitals, the concentrations of air pollutants at the respective delivery hospitals may be surrogate markers of pollutant exposure at home. We compared air pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital with those measured at the closest monitoring stations to the respective residential postal code regions of pregnant women in Fukuoka. Aggregated postal code data for the home addresses of pregnant women who delivered at Kyushu University Hospital in 2014 was obtained from Kyushu University Hospital. For each of the study's 695 women who resided in Fukuoka Prefecture, we assigned pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital and pollutant concentrations measured at the nearest monitoring station to their respective residential postal code regions. Among the 695 women, 584 (84.0%) resided in the proximity of the nearest monitoring station to hospital or one of the four other stations (as the nearest stations to their respective residential postal code region) in Fukuoka city. Pearson's correlation for daily mean concentrations among the monitoring stations in Fukuoka city was strong for fine particulate matter (PM 2.5 ), suspended particulate matter (SPM), and photochemical oxidants (Ox) (coefficients ≥0.9), but moderate for coarse particulate matter (the result of subtracting the PM 2.5 from the SPM concentrations), nitrogen dioxide, and sulphur dioxide. Hospital-based and residence-based concentrations of PM 2.5 , SPM, and Ox were comparable. For PM 2.5 , SPM, and Ox, exposure estimation based on the delivery hospital is likely to approximate that based on the home of pregnant women.

Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines?

PubMed

Prabhu, Arpan V; Donovan, Ashley L; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; Beriwal, Sushil; Kale, Hrishikesh; Heller, Matthew

The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials. Copyright © 2018 Elsevier Inc. All rights reserved.

Percutaneous coronary intervention in Thammasat University Hospital: the first three-year experience.

PubMed

Piyayotai, Dilok; Hutayanon, Pisit

2010-12-01

To study the results of percutaneous coronary intervention (PCI) and in-hospital outcomes in cardiac catheterization laboratory, Thammasat University Hospital since May, 2006 until April, 2009. This is the prospective, single-center study. The consecutive patients who underwent PCI in Thammasat University Hospital since May 2006 to April 2009 were recruited in the study. Clinical data, angiographic data, and in-hospital outcomes were analyzed and demonstrated. Six hundred and seventeen patients undergoing 755 PCI procedures were enrolled in the study. 62.70% were male and 37.30% were female. Mean age was 65.45 +/- 11.21 years (range 33-97 years) and 20.10% were more than 75 years old. The indications for PCI were non-ST segment-elevation acute coronary syndrome (NSTEACS) (41.72%), chronic stable angina (25.32%), acute ST segment elevation myocardial infarction (STEMI) (8.87%), staged PCI (15.76%). The other indications were heart failure, cardiomyopathy, post-cardiac arrest and etc. The procedure was single vessel PCI in 73.25% and multivessel PCI in 26.75% (double vessels PCI 24.64% and triple vessels PCI 2.11%). According to lesion locations, 45.21% were left anterior descending (LAD) artery lesions, 30.09% were right coronary artery (RCA) lesions, 23.28% were left circumflex (LCX) artery lesions, 1.19% were left main (LM) lesions and 0.24% were graft lesions. The overall angiographic success rate was 95.57%. During hospital stay the major adverse events developed as death in 0.93%, periprocedural myocardial infarction in 3.17%, emergency coronary artery bypass graft in 0.53%, and stroke in 0.26%. During the first three years of PCI experience in Thammasat University Hospital, the overall success rate was high with low in-hospital adverse outcomes.

Relationship of Employees’ Achievement Motivation and Quality of Working Life with Their Self-efficacy at Selected Hospitals with a Multi-group Analysis: Moderating Role of Organizational Ownership

PubMed Central

Mahmoudi, Ghahraman; Rostami, Fahimeh Hoseinian; Mahmoudjanloo, Shaharbanoo; Jahani, Mohammad Ali

2017-01-01

Introduction: Motivational deficiencies and the low quality of working life significantly reduce employees’ work performance and consequently their efficacy (effectiveness and proper performance in doing a task or specific tasks). Aim: The aim of this study was to determine the relationship between achievement motivation and quality of working life with self-efficacy among staff working in Mazandaran hospitals, by taking organizational ownership as a mediator variable. Materials and Methods: This study was an applied descriptive-correlation. Research population consisted of all staff working in selected hospitals of Mazandaran Province, Iran. 341 employees were selected with randomly-stratified sampling as the statistical sample. Three valid questionnaires were used for data collection. Data were analysis based on structured equations and path analysis with SPSS19 and AMOS. Results: In private hospitals, there was a significant relationship between the quality of working life and self-efficacy (p<0.001). In relationship between achievement motivation and self-efficacy, there was no significant differences between university hospitals and social security hospitals, but relationship between the quality of working life and self-efficacy was significant (p <0. 05). Considering achievement motivation and self-efficacy in private hospitals and university hospitals, a significant differences was observed (p<0. 05). Conclusion: The hospital ownership has a moderating in relationship of achievement motivation and quality of working life with self-efficacy. Staff’s empowerment courses for university hospitals and improvement in the overall space of job, increase in job security, reducing salary differences is suggested for private hospitals. PMID:29284991

Relationship of Employees' Achievement Motivation and Quality of Working Life with Their Self-efficacy at Selected Hospitals with a Multi-group Analysis: Moderating Role of Organizational Ownership.

PubMed

Mahmoudi, Ghahraman; Rostami, Fahimeh Hoseinian; Mahmoudjanloo, Shaharbanoo; Jahani, Mohammad Ali

2017-12-01

Motivational deficiencies and the low quality of working life significantly reduce employees' work performance and consequently their efficacy (effectiveness and proper performance in doing a task or specific tasks). The aim of this study was to determine the relationship between achievement motivation and quality of working life with self-efficacy among staff working in Mazandaran hospitals, by taking organizational ownership as a mediator variable. This study was an applied descriptive-correlation. Research population consisted of all staff working in selected hospitals of Mazandaran Province, Iran. 341 employees were selected with randomly-stratified sampling as the statistical sample. Three valid questionnaires were used for data collection. Data were analysis based on structured equations and path analysis with SPSS19 and AMOS. In private hospitals, there was a significant relationship between the quality of working life and self-efficacy (p<0.001). In relationship between achievement motivation and self-efficacy, there was no significant differences between university hospitals and social security hospitals, but relationship between the quality of working life and self-efficacy was significant (p <0. 05). Considering achievement motivation and self-efficacy in private hospitals and university hospitals, a significant differences was observed (p<0. 05). The hospital ownership has a moderating in relationship of achievement motivation and quality of working life with self-efficacy. Staff's empowerment courses for university hospitals and improvement in the overall space of job, increase in job security, reducing salary differences is suggested for private hospitals.

[[In process].

PubMed

Eckart, Wolfgang U

2016-01-01

The 'case' of Georg Friedrich NICOLAI, a Berlin physiologist and pacifist, who vehemently stood against a chauvi- nistic academic world in Germany in August 1914, is typical for the academic situation and the role of nationalistic professors as 'mandarines' at German universities and academies at the outbreak of the Great War. NICOLAI suffered a lot from his pacifist internationalism: he was brutally excluded from scientific community, and his academic career was destroyed. Had he not successfully escaped to Denmark, his physical existence would have been endangered as well. On the other hand his dignity was never endangered while NICOLAI successfully resisted military dictatorship and a kind of submissive chauvinism of a perishing Kaiserreich.

Secret Science: Exploring Cold War Greenland

NASA Astrophysics Data System (ADS)

Harper, K.

2013-12-01

During the early Cold War - from the immediate postwar period through the 1960s - the United States military carried out extensive scientific studies and pursued technological developments in Greenland. With few exceptions, most of these were classified - sometimes because new scientific knowledge was born classified, but mostly because the reasons behind the scientific explorations were. Meteorological and climatological, ionospheric, glaciological, seismological, and geological studies were among the geophysical undertakings carried out by military and civilian scientists--some in collaboration with the Danish government, and some carried out without their knowledge. This poster will present some of the results of the Exploring Greenland Project that is coming to a conclusion at Denmark's Aarhus University.

[110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

PubMed

Zlatkov, V

2014-01-01

The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution. Currently, the hospital has nearly 400 beds and 600 employees who work at nine clinics and six laboratories, covering the entire spectrum of obstetric and gynecological activities. Its leading specialists still continue to embody the highest level of professionalism and dedication. The future development of the hospital is chiefly associated with the renovation of facilities, resources and equipment and with the enhancement of the professional competence of the staff and of the quality of hospital products to improve the health and satisfaction of the patients.

A celebration of mechanics: from nano to macro. The J. Michael T. Thompson Festschrift issue.

PubMed

Elishakoff, Isaac

2013-06-28

This Theme Issue is dedicated to the topic 'Mechanics: from nano to macro' and marks the 75th birthday of Dr J. Michael T. Thompson, Fellow of the Royal Society, whose current affiliations are as follows: (i) Honorary Fellow, Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, University of Cambridge; (ii) Emeritus Professor of Nonlinear Dynamics, Department of Civil, Environmental and Geomatic Engineering, University College London; and (iii) Professor of Theoretical and Applied Dynamics (Distinguished Sixth Century Chair, part-time), University of Aberdeen. He also serves as Chairman of the Board of Directors at ES-Consult (consulting engineers) in Copenhagen, Denmark. The pertinent question that arises from the very start is: should we first salute Michael and then describe the Theme Issue, or vice versa? Indeed, according to Blaise Pascal (1623-1662), the last thing one discovers in composing a work is what to put first. I would like to take the liberty of deviating from the tradition of the Philosophical Transactions and start with the tribute to Michael; after all he is the prime cause of this Theme Issue.

Strategic planning for future learning environments: an exploration of interpersonal, interprofessional and political factors.

PubMed

Schmidt, Cathrine

2013-09-01

This article, written from the stance of a public planner and a policy maker, explores the challenges and potential in creating future learning environments through the concept of a new learning landscape. It is based on the belief that physical planning can support the strategic goals of universities. In Denmark, a political focus on education as a mean to improve national capacity for innovation and growth are redefining the universities role in society. This is in turn changing the circumstances for the physical planning. Drawing on examples of physical initiatives in three different scales--city, building and room scale, the paper highlights how space and place matters on an interpersonal, an interprofessional and a political level. The article suggests that a wider understanding of how new learning landscapes are created--both as a material reality and a political discourse--can help frame an emerging community of practice. This involves university leaders, faculty and students, architects, designers and urban planners, citizens and policy makers with the common goal of creating future learning environments today.

Translating value-based health care: an experiment into healthcare governance and dialogical accountability.

PubMed

Bonde, Morten; Bossen, Claus; Danholt, Peter

2018-04-19

This article analyses an experiment into healthcare governance in Denmark inspired by principles of value-based health care and intended to re-orient the focus of healthcare governance from 'productivity' to 'value for the patient'. The region in charge of the experiment exempted nine hospital departments from activity-based financing and accountability based on diagnosis-related groups, which allegedly incentivised hospitals in 'perverse' and counterproductive ways. Instead, the departments were to develop new indicators from their local practices to support and account for quality and value for the patient. Drawing on the actor-network theory concept of 'translation', this article analyses how the experiment was received and put into practice in the nine departments, and how it established new kinds of accountability relations. We argue that the experiment provides fruitful inspiration for future governance schemes in healthcare to embrace the local complexities of clinical practices. In particular, we argue that the locally developed indicators facilitated what we call 'dialogical accountability', and we discuss whether this represents a feasible way forward for value-based health care. © 2018 Foundation for the Sociology of Health & Illness.

Inequalities in health and gender.

PubMed

Haavio-Mannila, E

1986-01-01

Gender inequalities in health are studied in Denmark, Finland, Norway and Sweden on the basis of survey data on morbidity and symptoms of anxiety, and of mental hospitalization statistics. Women have higher rates of illness than men in countries where, and in periods when, they have to a great extent stayed at home as full-time housewives. Participation in paid economic activity and the resulting economical independence thus seems to be beneficial to women's health on the macro-level of society. On the micro-level of individual families, inequality in morbidity by gender is smaller in families with two economical providers than in families where the wife stays at home. The anxiety rates of employed wives are, however, relatively high compared with those of men and non-employed wives. Only in Sweden is the mental health of employed wives good, perhaps because of supportive social policies favouring women's work outside the home. The strain involved in combining family and work among women thus becomes manifest in the appearance of symptoms of anxiety but not in physical morbidity nor mental hospitalization.

Antipsychotics and associated risk of out-of-hospital cardiac arrest.

PubMed

Weeke, P; Jensen, A; Folke, F; Gislason, G H; Olesen, J B; Fosbøl, E L; Wissenberg, M; Lippert, F K; Christensen, E F; Nielsen, S L; Holm, E; Kanters, J K; Poulsen, H E; Køber, L; Torp-Pedersen, C

2014-10-01

Antipsychotic drugs have been associated with sudden cardiac death, but differences in the risk of out-of-hospital cardiac arrest (OHCA) associated with different antipsychotic drug classes are not clear. We identified all OHCAs in Denmark (2001-2010). The risk of OHCA associated with antipsychotic drug use was evaluated by conditional logistic regression analysis in case-time-control models. In total, 2,205 (7.6%) of 28,947 OHCA patients received treatment with an antipsychotic drug at the time of the event. Overall, treatment with any antipsychotic drug was associated with OHCA (odds ratio (OR) = 1.53, 95% confidence interval (CI): 1.23-1.89), as was use with typical antipsychotics (OR = 1.66, CI: 1.27-2.17). By contrast, overall, atypical antipsychotic drug use was not (OR = 1.29, CI: 0.90-1.85). Two individual typical antipsychotic drugs, haloperidol (OR = 2.43, CI: 1.20-4.93) and levomepromazine (OR = 2.05, CI: 1.18-3.56), were associated with OHCA, as was one atypical antipsychotic drug, quetiapine (OR = 3.64, CI: 1.59-8.30).

[Development of advanced educational programs, including research programs, for undergraduate students in National Universities: the facts in 2010].

PubMed

Kurosaki, Yuji; Tomioka, Yoshihisa; Santa, Tomofumi; Kitamura, Yoshihisa

2012-01-01

This article summarizes detailed facts obtained from the questionnaire conducted in 2010 at about 14 National Universities on the topic of "Research programs and advanced educational programs for undergraduate students". The contents of the questionnaire included: (1) Research programs based on the coalition of university and hospital and/or community pharmacy, other Graduate Schools, such as School of Medicine etc., and the University Hospital, (2) Educational systems for the achievement of research programs and their research outcomes, (3) Research programs based on pharmacist practices, (4) Ongoing advanced educational programs for undergraduate students, taking advantage of the coalition with Graduate School, School of Medicine (and Dentistry), and University Hospital. Some of the advanced educational programs outlined in this questionnaire will be carried out by our group in the coming years and the educational benefits together with associated problems shall as well be clarified. This approach will be informative for the development of the leader-oriented pharmacist programs for the college of Pharmacy.

Histopathological diagnosis of eyelid tumors in Chiang Mai University Hospital.

PubMed

Nithithanaphat, Chanut; Ausayakhun, Sakarin; Wiwatwongwana, Damrong; Mahanupab, Pongsak

2014-10-01

To report the histopathological diagnosis ofeyelid tumors and to study the prevalence of eyelid tumors in Chiang Mai University Hospital Chiang Mai, Thailand. A retrospective review of medical and pathological records ofpatients diagnosed as eyelid tumor that underwent histopathological biopsy between January 2007 and December 2013 in Chiang Mai University Hospital was done. Three hundred sixteen cases of eyelid tumors were reviewed. The mean age at diagnosis was 54.2 +/- 19.6 years (range 1 month-99 years), women were 59.5% (n = 188) and men 40.5% (n = 128). The tumor sites were left lower eyelid (27.5%), right upper eyelid (24.4%), right lower eyelid (21.2%), and left upper eyelid (18.7%). There were 204 (64.6%) benign tumors and 112 (35.4%) malignant tumors. Nevi were the most common in benign group (16.4%) and basal cell carcinoma was the most common eyelid malignancy (18.0%). The most common histopathological diagnosis for benign eyelid tumor was nevus, while the most common malignant eyelid tumor was basal cell carcinoma at Chiang Mai University Hospital.

[Description of current hypnosis practice in French university hospitals].

PubMed

Chabridon, G; Nekrouf, N; Bioy, A

2017-10-01

Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % of the University Hospitals, 91,7 % for anxiety disorders, 66,7 % for psychotraumatic care and 25 % for mood disorders. Therefore, hypnosis seems to have found its place in the care of pain and as an anesthetic to replace standard procedures. However, the use of hypnotherapy in psychiatry is less frequent, indications for its use being variable and not very consensual. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression.

PubMed

Rasmussen, Line Ryberg; Mainz, Jan; Jørgensen, Mette; Videbech, Poul; Johnsen, Søren Paaske

2018-04-26

The relationship between inpatient volume and the quality of mental health care remains unclear. This study examined the association between inpatient volume in psychiatric hospital wards and quality of mental health care among patients with depression admitted to wards in Denmark. In a nationwide, population-based cohort study, 17,971 patients (N=21,120 admissions) admitted to psychiatric hospital wards between 2011 and 2016 were identified from the Danish Depression Database. Inpatient volume was categorized into quartiles according to the individual ward's average caseload volume per year during the study period: low volume (quartile 1, <102 inpatients per year), medium volume (quartile 2, 102-172 inpatients per year), high volume (quartile 3, 173-227 inpatients per year) and very high volume (quartile 4, >227 inpatients per year). Quality of mental health care was assessed by receipt of process performance measures reflecting national clinical guidelines for care of depression. Compared with patients admitted to low-volume psychiatric hospital wards, patients admitted to very-high-volume wards were more likely to receive a high overall quality of mental health care (≥80% of the recommended process performance measures) (adjusted relative risk [ARR]=1.78, 95% confidence interval [CI]=1.02-3.09) as well as individual processes of care, including a somatic examination (ARR=1.35, CI=1.03-1.78). Admission to very-high-volume psychiatric hospital wards was associated with a greater chance of receiving guideline-recommended process performance measures for care of depression.

Return Migrants' Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example.

PubMed

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-09-19

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants' access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

PubMed Central

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-01-01

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption. PMID:27657096

Cancer in children and young adults born after assisted reproductive technology: a Nordic cohort study from the Committee of Nordic ART and Safety (CoNARTaS).

PubMed

Sundh, Karin Jerhamre; Henningsen, Anna-Karina A; Källen, Karin; Bergh, Christina; Romundstad, Liv Bente; Gissler, Mika; Pinborg, Anja; Skjaerven, Rolv; Tiitinen, Aila; Vassard, Ditte; Lannering, Birgitta; Wennerholm, Ulla-Britt

2014-09-01

Do children and young adults born after assisted reproductive technology (ART) have an increased risk of cancer? Children born after ART showed no overall increase in the rate of cancer when compared with children born as a result of spontaneous conception. Children born after ART have more adverse perinatal outcomes, i.e. preterm births, low birthweights and birth defects. Previous studies have shown divergent results regarding the risk of cancer among children born after ART. A retrospective Nordic population-based cohort study was performed, comprising all children born after ART in Sweden, Denmark, Finland and Norway between 1982 and 2007. The mean (±standard deviation) follow-up time was 9.5 (4.8) years. Children born after ART (n = 91 796) were compared with a control group of children born after spontaneous conception. This control group was almost 4-fold the size of the ART group (n = 358 419) and matched for parity, year of birth and country. Data on perinatal outcomes and cancer were obtained from the National Medical Birth Registries, the Cancer Registries, the Patient Registries and the Cause of Death Registries. The cancer diagnoses were divided into 12 main groups. Hazard ratios (HRs) and adjusted HR were calculated. Adjustments were carried out for country, maternal age, parity, sex, gestational age and birth defects. There was no significant increase in overall cancer rates among children born after ART when compared with children born after spontaneous conception (adjusted HR 1.08; 95% CI 0.91-1.27). Cancer, of any form, was found among 181 children born after ART (2.0/1000 children, 21.0/100 000 person-years) compared with 638 children born after spontaneous conception (1.8/1000 children, 18.8/100 000 person-years). Leukaemia was the most common type of cancer (n = 278, 0.62/1000 children) but no significantly increased incidence was found among children born after ART. An increased risk was observed for 2 of 12 cancer groups. They were central nervous system tumours (adjusted HR 1.44; 95% CI 1.01-2.05) and malignant epithelial neoplasms (adjusted HR 2.03; 95% CI 1.06-3.89); the absolute risks were 0.46/1000 and 0.15/1000 children, respectively, corresponding to an absolute increased risk of 0.14/1000 and 0.08/1000 children, respectively. As this is an observational study, the main limitation is the fact that it is not possible to adjust for all potential confounders. We were not able to control for confounders such as socio-economic status and perinatal factors, such as Apgar score, which other studies have suggested affect cancer rates. The results of this large population-based cohort study are in agreement with most previously published studies. The main findings are reassuring for couples undergoing ART, children born after ART and clinicians working with ART. No conflict of interest was reported. The study was supported by grants from The European Society for Human Reproduction and Embryology (ESHRE), Sahlgrenska University Hospital, Gothenburg, Sweden, the University of Copenhagen, Denmark, the Danish Agency of Science, Technology and Innovation and the Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

University Hospitals for Sale.

ERIC Educational Resources Information Center

Culliton, Barbara J.

1984-01-01

Although faculty opposition stopped the sale of Harvard's McLean Hospital to the Hospital Corporation of America (HCA), a partnership remains a possibility. Issues related to the proposed sale as well as those affecting hospital economics are considered. Proposed terms of the sale are included. (JN)

Rotavirus genotypes in Malaysia and Universal rotavirus vaccination

PubMed Central

Lee, Way Seah; Lim, Benjamin Tze Ying; Chai, Pei Fan; Kirkwood, Carl D.; Lee, Jimmy Kok Foo

2012-01-01

Group A rotavirus (RV-A) genotypes isolated in Malaysia was studied to estimate the effectiveness of a universal RV-A vaccination in Malaysia. A simple mathematical model was used, with input from a two-year, two-center, prospective study on hospitalization of RV-A gastroenteritis (RVGE) in young children, published data on RV-A hospitalizations and genotypes, mortality on childhood GE and published genotype-specific efficacy data on two RV-A vaccines. Assuming a 95% vaccine coverage, the overall projected effectiveness was 75.7 to 88.1% for Rotateq® and 78.7 to 90.6% for Rotarix® against RVGE-related hospitalizations. The projected annual reduction in RVGE-related deaths was 27 to 32 deaths (from 34 deaths) for Rotateq® and 28 to 32 deaths annually forRotarix®. A universal RV-A vaccine is efficacious in reducing RVGE-related hospitalizations and mortality in Malaysia. PMID:23022710

Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

PubMed

Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

2016-03-01

This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

Pediatric trauma at an adult trauma center.

PubMed

Siram, Suryanarayana; Oyetunji, Tolulope A; Khoury, Amal L; Walker, Sonya R; Bolorunduro, Oluwaseyi B; Chang, David C; Greene, Wendy R; Cornwell, Edward E; Frederick, Wayne A I

2010-08-01

Accidental traumatic injury is the number 1 cause of morbidity and mortality in the pediatric population. In this study, we aim to prove that certain pediatric patients can be treated with good outcomes at an adult level 1 trauma center. Retrospective analysis using the Howard University Hospital trauma registry identified 71 patients treated at Howard University Hospital between the ages of 1 and 17 years old. Specific variables were identified and collected for each patient. The majority of pediatric traumas treated at Howard University Hospital between June 2004 and May 2005 had high survival rates (93%). The patients who did not survive (7%) included 3 patients who were dead on arrival and 2 who died shortly after arrival to the hospital. Certain pediatric populations who present with minor and/or isolated injuries can be treated in an adult level 1 trauma center with similar outcomes to treatment in a pediatric level 1 trauma center.

A haemovigilance team provides both significant financial and quality benefits in a University Hospital.

PubMed

Decadt, Ine; Costermans, Els; Van de Poel, Maai; Kesteloot, Katrien; Devos, Timothy

2017-04-01

Haemovigilance is the process of surveillance of blood transfusion procedures including unexpected hazards and reactions during the transfusion pathway in both donors and recipients. The haemovigilance team aims to increase blood transfusion safety and to decrease both morbidity and mortality in donors and recipients. The team collects data about transfusion reactions and incidents, instructs the involved health workers and assures the tracing of blood components. The haemovigilance team at the University Hospitals Leuven has played a pioneering role in the development of haemovigilance in Belgium Although the literature about safety and quality improvements by haemovigilance systems is abundant, there are no published data available measuring their financial impact in a hospital. Therefore, we studied the costs and returns of the haemovigilance team at the University Hospitals Leuven. This study has a descriptive explorative design. Research of the current costs and returns of the haemovigilance team were based upon data from the Medical Administration of the hospital. Data were analyzed descriptively. The haemovigilance team of the University Hospitals Leuven is financially viable: the direct costs are covered by the annual financial support of the National Public Health Service. The indirect returns come from two important tasks of the haemovigilance team itself: correction of the electronic registration of administered blood component and improvement of the return of conform preserved blood components to the blood bank. Besides safety and quality improvement, which are obviously their main goals, the haemovigilance team also implies a financial benefit for the hospital. Copyright © 2016 Elsevier Ltd. All rights reserved.

Renovating Charity Hospital or building a new hospital in post-Katrina New Orleans: economic rationale versus political will.

PubMed

Leleu, Hervé; Moises, James; Valdmanis, Vivian Grace

2013-02-01

Since September 2005, Charity Hospital of New Orleans has been closed due to Hurricane Katrina. A debate following the closing arose about whether this public hospital should be renovated or a new medical center affiliated with the Louisiana State University should be built. Using academic literature, government statistics, and popular press reports, we describe the economic implications that support the view that Charity Hospital should have been renovated. We also address why this policy was not pursued by demonstrating the influence politics and individual stakeholders (specifically, Louisiana State University) had on the eventual policy pursued. In this commentary we also note the political identity movement away from public-sector provision of services to private-sector interests.

The Hospital Microbiome Project: Meeting Report for the 1st Hospital Microbiome Project Workshop on sampling design and building science measurements, Chicago, USA, June 7th-8th 2012

PubMed Central

Smith, Daniel; Alverdy, John; An, Gary; Coleman, Maureen; Garcia-Houchins, Sylvia; Green, Jessica; Keegan, Kevin; Kelley, Scott T.; Kirkup, Benjamin C.; Kociolek, Larry; Levin, Hal; Landon, Emily; Olsiewski, Paula; Knight, Rob; Siegel, Jeffrey; Weber, Stephen; Gilbert, Jack

2013-01-01

This report details the outcome of the 1st Hospital Microbiome Project workshop held on June 7th-8th, 2012 at the University of Chicago, USA. The workshop was arranged to determine the most appropriate sampling strategy and approach to building science measurement to characterize the development of a microbial community within a new hospital pavilion being built at the University of Chicago Medical Center. The workshop made several recommendations and led to the development of a full proposal to the Alfred P. Sloan Foundation as well as to the creation of the Hospital Microbiome Consortium. PMID:23961316

[Analysis of HIV antibody positive cases in Peking University Hospital of Stomatology during 9 years].

PubMed

Ding, Jian-fen; Qiu, Juan; Shen, Shu-ming

2016-02-01

To investigate the prevalence and characteristics of HIV patients found in Peking University Hospital of Stomatology during 9 years, and provide management strategy for early diagnosis and control of HIV in Stomatology Hospital. A retrospective study of the HIV positive patients diagnosed by HIV antibody screening was carried out. The related information about these patients found in Peking University School of Stomatology during 2005-2013 was obtained from China Disease Control Information System. 68,562 patients accepted HIV antibody screening in Peking University Hospital of Stomatology during 2005-2013. Thirty one patients were found HIV antibody positive. The ratio of HIV antibody positive was about 0.045%, which was composed of 25 males and 6 females. 61.29% patients aged between 20-40 years, and their career was mainly commercial service with a education level of junior high school. The proportion of sexual route of transmission was about 74.91%, and 34.78% of them were male homosexuality. Most of the patients with HIV antibody positive were found in the out-patient clinic, especially in the department of oral mucosal diseases, accounting for 70.97%. HIV antibody positive rate in Peking University School of Stomatology was slightly lower than that in general hospitals. Medical staff should increase their awareness of AIDS prevention and control, for higher HIV risk departments, such as oral mucosal diseases and periodontal disease, efforts should be made to increase HIV screening, expand the scope of screening, and promote provider-initiated HIV testing and counseling.

[Information from the invoicing sector as support for decision-making: a case study at the University Hospital of the Federal University of Grande Dourados (UFGD)].

PubMed

Cintra, Renato Fabiano; Vieira, Saulo Fabiano Amâncio; Hall, Rosemar José; Fernandes, Cristiano Rodrigues

2013-10-01

The public sector is the main financing agent of hospital admissions and the information generated constitutes the input for the hospital information network of the Unified Health System (SUS). This paper seeks to design a report template to be used for decision-making in both public and university hospitals. The theoretical approach sought inspiration in discussions about the SUS, hospital institutions, hospital information systems and decision-making. The methodological procedures used are characterized as qualitative-descriptive methods and were conducted in a single case study and action research. The primary data analysis was carried out in two stages from January through December 2007 and from January through December 2008. Based on these periods, the findings were described and the elaboration of new reports was presented, with the importance and need for each being duly emphasized. Lastly, a structured report template was created for the case study that includes information discussed in the article. The conclusion reached is that the hospital information system can become a potential support tool, as the necessary adjustments are made and the report is structured to furnish the institution with an objective communication tool for decision-making.

Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012.

PubMed

Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

2015-01-01

Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved.

Web-based training in German university eye hospitals - Education 2.0?

PubMed

Handzel, Daniel M; Hesse, L

2011-01-01

To analyse web-based training in ophthalmology offered by German university eye hospitals. In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn't offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today's communication unused.

National Medical Care System May Impede Fostering of True Specialization of Radiation Oncologists: Study Based on Structure Survey in Japan

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

Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi

2012-01-01

Purpose: To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. Methods and Materials: In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient onmore » the basis of Japanese Blue Book guidelines (200 patients per RO). Results: The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). Conclusions: ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists.« less

National medical care system may impede fostering of true specialization of radiation oncologists: study based on structure survey in Japan.

PubMed

Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi; Ikeda, Hiroshi; Sekiguchi, Kenji; Kamikonya, Norihiko; Koizumi, Masahiko; Tago, Masao; Ando, Yutaka; Tsukamoto, Nobuhiro; Terahara, Atsuro; Nakamura, Katsumasa; Mitsumori, Michihide; Nishimura, Tetsuo; Hareyama, Masato; Teshima, Teruki

2012-01-01

To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists. Copyright © 2012 Elsevier Inc. All rights reserved.

Can We Improve Workflows in the OR? A Comparison of Quality Perceptions and Preoperative Efficiency across Institutions in Spine Surgery.

PubMed

Wasterlain, Amy S; Tran, Andrew A; Tang, Chad; Campbell, David R; Braun, Hillary J; Scuderi, Yasmeen A; Scuderi, Gaetano J

2015-03-01

Cost containment and surgical inefficiencies are major concerns for hospitals in this era of declining resources. The primary aim of this investigation was to understand subjective perceptions of perioperative spine surgical quality across three practice settings and to identify potential factors contributing to these perceptions. Subsequently, we objectively evaluated factors that influence the duration of time in which the patient is in the operating room (OR) prior to the surgical incision and assessed the influence of fluoroscopy technician expertise on radiation dose and imaging efficiency. One hundred and eight medical device representatives with at least 1 year of OR experience were surveyed at a national conference. Three distinct healthcare facilities were identified: university, small volume, and large volume private hospitals. Respondents rated facilities on a five-point scale for staff quality; size and consistency of surgical teams; and overall likelihood of recommending the facility. Separately, 140 posterior lumbar procedures from two institutions were retrospectively reviewed. Two time periods were quantified for each surgical case: patient arrival in the OR to induction of anesthesia (T1) and induction to surgical incision (T2). T1 and T2 were compared between university and large private hospital settings using t tests and multivariate analysis. For 44 separate lumbar spine surgical procedures, practice setting, patient BMI, number of vertebral levels requiring imaging, number of localizing fluoroscopy images taken, total fluoroscopy time, total radiation dose, fluoroscopy machine, and whether the fluoroscopist could correctly state his or her role, which was to obtain a lateral lumbar localizing image, were recorded. T-tests were used to compare cases in which the fluoroscopist could and could not correctly state the task. Survey ratings for surgeons were not significantly different across university, large private, and small private hospitals. Fewer circulating nurses were rated as excellent or good in university versus private hospitals (p < 0.001). Small volume private hospital surgical teams were more likely to have worked together before than university teams (p < 0.05), and university teams were larger (p < 0.05). Respondents were more likely to recommend a university or large private hospital for complex instrumentation cases (p < 0.001). On objective measures, university patients were older, less obese, and had higher mean ASA scores (2.5 versus 2.2, p < 0.001). Compared to the university setting, private hospital cases had significantly shorter Time 1 (8 versus 37 min, p < 0.001) and Time 2 (23 versus 30 min, p < 0.001), even after adjusting for ASA score, BMI, and age. Cases in which the fluoroscopist knew the imaging purpose were associated with significantly fewer images (mean 1.8 versus 3.4 images, p < 0.0001) and shorter total exposure times (2.3 versus 4.0 sec, p < 0.001). Operations performed in the university setting were associated with significantly more images (2.7 versus 1.8 images, p < 0.001), longer total exposure times (3.2 versus 2.3 sec, p = 0.0027), and total radiation dose (27.8 versus 53.3 rad, p < 0.001) when compared with those performed in the private setting. The university practice setting was associated with significantly more images (2.7 versus 1.8 images, p < 0.001), longer total exposure times (3.2 versus 2.3 sec, p = 0.003), and total radiation dose (27.8 versus 53.3 rad, p < 0.001) when compared with non-university settings. Large private and university hospitals had higher surgeon ratings. The university setting was associated with larger and less consistent surgical teams and lower nurse ratings. Surgical staff awareness of the procedure and attention to preoperative tasks specific to the procedure reduced pre-operative time spent in the OR as well as fluoroscopy radiation. These data suggest that nurses and support staff make substantial contributions to overall quality of care, and that leadership and interpersonal coordination are especially important within large teams at teaching hospitals.

The art of improvisation: the working process of administrators at a Federal University Hospital.

PubMed

Littike, Denilda; Sodré, Francis

2015-10-01

The scope of this article is to analyze the working process of administrators at a Federal University Hospital (HUF). It includes research with a qualitative approach conducted through interviews with twelve administrators. The work process, the work tools and the human activity per se are understood to be under scrutiny. Work is acknowledged as a category that analyzes the management methods used by professional health workers. The HUFs are responsible for two social policies, namely education and health. The aim of the administrators' work is an organizational issue, and the administration tools used are bureaucratic and out-of-date for the current political context of hospital management. The most significant feature of this hospital administration is improvisation, which reduces the potential of the administrators in such a way that, instead of introducing innovative changes into their work process, they prefer to leave their jobs. Improvisation is caused by the production of sequential obstacles in management decision-making at this teaching hospital. In short, the transfer of administration at the HUF, from direct government administration by the University to the Brazilian Company of Hospital Services (EBSERH), was analyzed on the grounds that this would establish a "new" management model.

Training rotations at hospitals as a recruitment tool for Certified Registered Nurse Anesthetists.

PubMed

Wachtel, Ruth E; Dexter, Franklin

2012-08-01

Recruiting newly graduating Certified Registered Nurse Anesthetists (CRNAs) is expensive. Recruitment into rural areas is especially challenging. We analyzed the first jobs of all 95 graduates of the University of Iowa's CRNA training program, from the initial graduating class of 1997 through the class of 2009. We compared the location of the student's first job to where the student lived at the time of application to the program. Hospitals enhanced recruitment of CRNAs by having student rotations (P = .001). Most students who joined a practice offering an outside rotation were not from the county or contiguous counties of the hospital they joined (P < .001). In years that hospitals with rotations hired more than the median number of students, significantly more students had rotated through the hospital (P = .02). Offering a CRNA training program did not facilitate the university's retention of nurses already living in its county or contiguous counties (P = 0.58). Consequently, rural hospitals can view sponsoring rotations as a recruitment tool for graduating CRNAs. The university sponsoring the training program did not retain an advantage, however, in hiring its own graduates. Because this case study provided valuable insights, other programs should consider performing similar analyses.

Hazardous medical waste generation rates of different categories of health-care facilities.

PubMed

Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

2012-07-01

Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed(-1)d(-1), using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed(-1)d(-1), for the public psychiatric hospitals, to up to 0.72 kg bed(-1)d(-1), for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed(-1)d(-1), for the psychiatric clinics, to up to 0.49 kg bed(-1)d(-1), for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Evaluation of the Oran university hospital information system].

PubMed

Chougrani, Saada; Ouhadj, Salah; Agag, Fouzia

2013-01-01

Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system. Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records. The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%. The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.

[Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

PubMed

Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

2017-04-01

On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.