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Author(s): V B Gunge [sup.1] , I Andersen [sup.2] , C Kyrø [sup.1] , C P Hansen [sup.3] , C C Dahm [sup.3] , J Christensen [sup.4] , A Tjønneland [...], Background/objectives: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. Subjects/methods: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. Results: In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). Conclusions: A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.

The notion of intervention is gaining traction among Western environmental journalists. While existing research has predominantly focused on countries outside the Nordic region, in our study we investigate the self-perceptions of professional journalists in the Nordic countries of Finland, Iceland, Norway, and Sweden. Through semi-structured interviews, we examine the roles that Nordic journalists construct when reflecting on covering the environmental beat, paying particular attention to how they make sense of the idea of intervening – that is, their involvement in interpreting, making sense of, and engaging the public in environmental issues. Using thematic qualitative analysis to analyse the interviews, we have identified four journalistic roles: 1) objective news provider, 2) critical watchdog, 3) sense-maker and educator, and 4) environmental advocate. Our findings suggest that Nordic journalists intervene byadhering to professional norms and practices and renegotiating them. While the role of objective news provider remains prominent among Nordic journalists, it is intertwined with various forms of intervention across all identified roles.

Objectives: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large‐scale cohort of patients referred to coronary computed tomography angiography (CTA). Methods: This was a cross‐sectional study with follow‐up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross‐sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow‐up, the primary outcome was a composite endpoint of cardiovascular events and all‐cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. Results: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients. Conclusions: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors. [ABSTRACT FROM AUTHOR]

Aims: To determine the risk of dementia in patients with type 1 or type 2 diabetes and in individuals with glycosylated haemoglobin, type A1C (HbA1c) of ⩾48 mmol/mol, which is the diagnostic limit for diabetes. Methods: We included the following cohorts: all incident diabetes cases aged 15 or above registered in the National Diabetes Registry (NDR) from January 2000 through December 2012 (n = 148 036) and a reference population, adult participants from the Glostrup cohort (n = 16 801), the ADDITION Study (n = 26 586) and Copenhagen Aging and Midlife Biobank (CAMB) (n = 5408). Using these cohorts, we analysed if a diagnosis of type 1 or type 2 diabetes in the NDR or HbA1c level of ⩾ 6.5% (48 mmol/mol) in the cohorts increased risk of dementia in the Danish National Patient Registry or cognitive performance assessed by the Intelligenz-Struktur-Test 2000R (IST2000R). Results: A diagnosis of type 1 or type 2 diabetes in the NDR was associated with increased risk of dementia diagnosed both before or after age 65 as well as across different subtypes of dementia. Self-reported diabetes or high HbA1c levels were associated with lower cognitive performance (p = 0.004), while high HbA1c was associated with increased risk of dementia (HR 1.94 (1.10–3.44) in the Glostrup cohort but not in the ADDITION Study (HR 0.96 (0.57–1.61)). Conclusions: Both type 1 and type 2 diabetes are associated with an increased risk of dementia, while the importance of screening-detected elevated HbA1c remains less clear. [ABSTRACT FROM AUTHOR]

Objective: To examine the incidence of suicidal and violent behaviour following initiation of antidepressant medication. Method: Cohorts of 997 911 conscripts and 95 794 patients with a first‐time affective disorder were followed for purchase of antidepressant medication, suicide, suicide attempts and conviction for violent crime in Danish registries between 1997 through 2015. Incidence of outcomes was estimated for the first 28 days, 28–365 days or later after initiation of antidepressants or study entry. Results: Of 16.5% of conscripts and 73.7% of patients with affective disorders initiated antidepressant medication. Incidence of suicide was 3–4 times higher during the first 28 days after initiation compared to the rates in the following year in both cohorts. A similar trend was seen among the untreated patients with affective disorders, whereas suicide incidence was stable at a low level among conscripts not treated with antidepressants. Incidence of attempted suicide was highest during the 28 days before and after initiation of antidepressants, while rates of violent crime were similar before and after initiation. These trends in incidence were independent of class of antidepressant. Conclusion: Higher rates of suicidal behaviour in the weeks following initiation of antidepressant medication probably reflect disease severity and a delay in mood response. [ABSTRACT FROM AUTHOR]

Objective: Individuals with mood disorders have increased risk of cardiovascular disease. The aims of this study were to evaluate if the risk of cardiovascular disease in individuals with mood disorder could be explained by shared genetic and early environmental factors. Methods: We included 6714 Danish middle and old aged twins from two large population‐based studies. Cox proportional hazards regression was used to perform individual‐level and intra‐pair analyses of the association between self‐reported depression symptomatology scores and register‐based diagnoses of ischemic heart disease. Results: Higher depression symptomatology scores (both total, affective, and somatic) were associated with higher incidence of ischemic heart disease after multivariable adjustment in individual‐level analyses. In intra‐pair analyses, this association was similar but with slightly larger confidence intervals. There was no interaction with gender and no major differences between mono‐ or dizygotic twins. Within twin pairs, the twin scoring highest on depressive symptoms developed ischemic heart disease more often or earlier than the lower scoring twin. A sensitivity analysis including a 2‐year time lag of depression symptomatology to limit the risk of reverse causality showed similar results. Conclusion: Genetic factors and early life environment do not seem to explain the association between depressive mood and ischemic heart disease. [ABSTRACT FROM AUTHOR]

Erik Bülow,1,2 Ute Hahn,3,4 Ina Trolle Andersen,3 Ola Rolfson,1,2 Alma B Pedersen,3,5 Nils P Hailer6 1The Swedish Arthroplasty Register, Centre of Registers Västra Götaland, Gothenburg, Sweden; 2Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Mathematics, Aarhus University, Aarhus, Denmark; 5Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 6Department of Surgical Sciences/Orthopaedics, Uppsala University Hospital, Uppsala, SwedenCorrespondence: Erik Bülow, The Swedish Arthroplasty Register, Centre of Registers Västra Götaland, Gothenburg, SE-413 45, Sweden, Tel +46 70 08 234 28, Email erik.bulow@gu.sePurpose: To develop a parsimonious risk prediction model for periprosthetic joint infection (PJI) within 90 days after total hip arthroplasty (THA).Patients and Methods: We used logistic LASSO regression with bootstrap ranking to develop a risk prediction model for PJI within 90 days based on a Swedish cohort of 88,830 patients with elective THA 2008– 2015. The model was externally validated on a Danish cohort with 18,854 patients.Results: Incidence of PJI was 2.45% in Sweden and 2.17% in Denmark. A model with the underlying diagnosis for THA, body mass index (BMI), American Society for Anesthesiologists (ASA) class, sex, age, and the presence of five defined comorbidities had an area under the curve (AUC) of 0.68 (95% CI: 0.66 to 0.69) in Sweden and 0.66 (95% CI: 0.64 to 0.69) in Denmark. This was superior to traditional models based on ASA class, Charlson, Elixhauser, or the Rx Risk V comorbidity indices. Internal calibration was good for predicted probabilities up to 10%.Conclusion: A new PJI prediction model based on easily accessible data available before THA was developed and externally validated. The model had superior discriminatory ability compared to ASA class alone or more complex comorbidity indices and had good calibration. We provide a web-based calculator (https://erikbulow.shinyapps.io/thamortpred/) to facilitate shared decision making by patients and surgeons.Keywords: prediction model, total hip arthroplasty, orthopaedics, clinical decision-making tool, web calculator, external validation

This study investigates frost susceptibility of sub-base gravel determined by the ASTM D5918-13 standard as a conservative estimate of the frost heave risk of fill in overfilled arch bridges, particularly in Pearl-Chain Bridges. Frost heave of granular materials has been of great research interest from the end of the 1920s until the present day. Most new literature relates to empirical results that are several decades old. This is also the case for Danish tender specifications according to which the frost susceptibility of a sub-base gravel is solely assessed from its fines content. However, no actual frost tests have been carried out to verify this assumption. In the present study, the frost susceptibility of four different Danish gravel materials is categorised from their heave rate. We test two Danish sub-base gravel materials, with particle size distributions of 0-8 mm and 0-31.5 mm, respectively, and also two modified sub-base gravel materials with increased and reduced fines contents. The fines content of the gravel materials is analysed by laser diffraction, and compared with two common frost susceptibility criteria, Casagrande’s and Schaible’s, and with Danish tender specifications. Even though the two sub-base gravel materials are expected to be frost safe, 0-31.5 mm sub-base gravel shows medium frost susceptibility, whereas 0-8 mm sub-base gravel shows negligible frost susceptibility. The gravel materials with increased and reduced fines content are categorised as having low to medium frost susceptibility and low frost susceptibility, respectively. The permeability of the gravel materials is determined, and the permeability coefficient of 0-31.5 mm sub-base gravel is five times greater than that of 0-8 mm sub-base gravel. The results suggest that the criterion used to classify the frost susceptibility of Danish sub-base gravel materials based solely on their fines content is insufficient, and that the permeability coefficient should also be considered. [ABSTRACT FROM AUTHOR]