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People frequently assume that attitudes towards the government's involvement in the economy differentiate left- from right-wing politics. This paper compares this idea to a version of acceptance of inequality theory, where acceptance of inequality is the principal element of left–right competition, but the specific inequality motivating individuals' left–right choice may differ. Using multilevel regression models with survey data from the World Values Survey, as well as two case studies, this paper finds that: (a) acceptance of inequality is a better context-independent predictor of left-right self-placements around the world; and (b) in the Netherlands and Denmark, the correlation between acceptance of an inequality (regarding class or immigration) and right-wing self-placement is stronger when the specific issue dimension is salient to citizens. However, the paper finds no equivalent interaction effect for attitudes towards economic statism. The evidence thus supports the view that the left–right dimension concerns acceptance of inequality, rather than economic interventionism. [ABSTRACT FROM AUTHOR]

Due to demographic changes and structural developments in the healthcare system, an increasing number of patients receive home care nursing in Denmark. Little is known about the complexity of home care. The aim of this paper was to investigate the challenges that home care nurses experience in their clinical practice by studying factors related to home care nurses' experiences of encounters with patients as burdensome. A population-based survey was undertaken involving all nurses in homecare services in one municipality in Denmark. The participating nurses registered all home care contacts by the patients during the daytime for 1 week. A registration form was used including a series of items designed to identify factors related to the perceived burden of each visit. Statistical frequency analyses were used to examine factors related to the home care nurses' experiences of encounters with patients as burdensome, and to investigate the challenges that home care nurses meet in their clinical practice. Home care nurses estimated 7.6% of 941 representative homecare visits as burdensome. Assessment of burden was associated with patients being below 60 years of age, time consumption and unexpected problems during the visit, especially of a psychosocial nature. Even though <10% of the encounters were considered burdensome, there is reason to believe that an increase can be expected due to ongoing emphasis on achieving greater efficiency in the healthcare system. [ABSTRACT FROM AUTHOR]

Unequal divisions of paid work and care among new parents contribute to increasing inequalities. One explanation for this is joint utility maximization and the benefits of partners (temporarily) specializing in paid work and care. This paper examines the (dis)advantages of specializing compared to dividing tasks more equally by studying whether differences in specialization between same-sex and different-sex couples lead to differences in household earnings after entering parenthood. Using register data from Norway, Finland, Denmark, and Sweden and examining first-time parents, we show that female couples have a more equal within-couple income development during the transition to parenthood than different-sex couples do. However, we find no differences in household income (including or excluding social transfers) between the two types of couples. Although a more equal task division may be preferred from an individual perspective, our results show no evidence of a "best strategy" when it comes to maximizing household income. [ABSTRACT FROM AUTHOR]

This paper explores the lives and agency of three generations free colored women on St. Croix, an island in the Danish-Norwegian West-Indies from the period 1760–1850. Different social strategies these women adopted in finding and defining their identities in a racially prejudiced society and how their social networks and family bonds affected their choices and lives have been studied. By applying a combination of prosopography and microhistory, new insights, and perspectives of free colored women's agency is gained. This paper suggests that free women of color were resourceful and independent and consciously employed complex social practices to climb the social ladder. [ABSTRACT FROM AUTHOR]

This paper examines the determinants of residential CO2 emissions, which are not covered by the European Union Emissions Trading System (EU ETS), in 19 European countries between 2000-2017. Using both static and dynamic panel models, we found strong relationships between CO2 emissions per capita, GDP per capita, energy prices and heating needs. We then assessed the impact of European carbon taxation and show that a €20/tonne CO2 tax lowers emissions by 1% on average. We found that this tax affects countries differently in terms of tax revenue-to-GDP ratio. Poland and the Czech Republic would have to pay the highest contribution, and Portugal and Denmark the lowest. Finally, we propose a scenario that equalizes countries' tax burdens. We show that, were Europe to redistribute all tax revenues, the main beneficiaries would be Poland and Belgium, while Denmark and Luxembourg would have to pay a surtax. [ABSTRACT FROM AUTHOR]

This paper highlights a methodological vagueness within the existing qualitative research interview literature related to reflecting where interviews takes place. The aim is to interrogate how the use of the concept of emplaced participation can account for the multisensory constitution of place within interviews as well as how the place can provide an opportunity to generate knowledge about participants' everyday practices. Casey's understanding of place as a gathering and Pink's perspectives on emplaced participation provide a sensitive epistemological approach that can be applied by researchers outside the field of ethnography. Based on empirical ethnographic material from fieldwork in Denmark, this paper makes a novel contribution to how researchers can use sensory and emplaced experience before and during an interview. We argue that, if we cease taking emplaced dimensions for granted, new methodological techniques can be developed, which, in turn, can lead to new types of knowledge of practice. [ABSTRACT FROM AUTHOR]

Email is a born-digital form of communication, which can be studied in a number of ways using a variety of methods, as with any other socially and culturally mediated phenomenon. However, despite a great number of studies, the methodologies of the studies have attracted only little attention. In this paper, we wish to extend our knowledge regarding methodological challenges in studying emails. In particular, we will consider the methodological challenges, which any scholar will encounter when email in its digital form is transformed to and preserved as an object of study. Based on a review of existing studies' archiving strategies as well as our own study on email consultations in a healthcare setting, we will examine and discuss analytical and methodological consequences of different approaches to archiving and data management of emails. We demonstrate that the archived record is shaped by its context of creation. Since collection methods and archiving tools are not neutral, we call for a greater attentiveness to this part of the research process. We conclude by outlining implications for systematic empirical research into emails as a form of communication. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. Methods: The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N =12,000) and 2019 (N =14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N =13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. Results: The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. Conclusions: The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study. [ABSTRACT FROM AUTHOR]

This paper contributes to our understanding of the social life of used computers in West Africa through analysis of the sending, distribution, recognition, and reception of recycled equipment. Based on multi-sited and longitudinal fieldwork in Denmark and Ghana, it employs George Marcus' suggestion of following things as a methodological selection device for ethnography. Theoretically, it engages the concept of affective circuits to address how transnational recycling, belonging, hometown development, and family relations are interlinked. I present a three-fold argument: first, that the actions of sending, distributing, recognizing, and receiving used equipment enable different actors to demonstrate and perform hometown belonging, development, and leadership; second, that these capacities reflect differentiated mobilities and connectivity of the people involved; and third, that the recycled furniture and information technology (IT) gear become upcycled to objects of value, being mobilized and transformed through long-term processes and negotiations of reciprocity. [ABSTRACT FROM AUTHOR]

Aim: This article aims to describe the study design, including descriptive statistics on changes in response rates, characteristics associated with response and response mode distribution, in the Danish National Health Survey (DNHS) in 2010, 2013 and 2017. Methods: Each survey was based on five regional stratified random samples and one national random sample drawn from the Danish Civil Registration System. The subsamples were mutually exclusive. Around 300,000 individuals (aged ⩾16 years) were invited to participate in each survey using a mixed-mode approach (paper/web). A questionnaire with a minimum of 52 questions was used in all subsamples. In 2010 and 2013, invitations were sent via the regular postal service, whereas a secure electronical mail service was used to invite the majority (around 90%) in 2017. Weights accounted for survey design and non-response. Results: Participation decreased from 59.5% in 2010 to 54.0% in 2013 after which it increased to 58.7% in 2017. The proportion answering the web questionnaire increased from 31.0% to 77.4% between 2013 and 2017 and varied from 73.8% to 79.7% between the subsamples in 2017. Overall, the response rate was low among young men and old women and among individuals who were unmarried, had low sociodemographic status, were from ethnic minority backgrounds or were living in the eastern part of Denmark. Conclusions: The survey mode, response mode distribution as well as response rate have changed over time. Weights to handle non-response can be applied to accommodate possible problems in generalising the results. However, efforts should continuously be made to ensure that response is missing at random. [ABSTRACT FROM AUTHOR]

Low wage growth is a challenge common to many OECD countries including countries with very different institutional systems. This paper utilises and extends Rochefort and Cobb's (1993) 'problem definition' framework to analyse how employer and union representatives in Australia and Denmark explain the causes of low wage growth. Drawing on elite interviews, which allow us to assess the nuance of actors' perceptions, we find disagreement among Australian actors about the role of the collective bargaining system in contributing to low wage growth. Despite disagreement over the extent of the low wage growth problem in Denmark, both unions and employers expressed confidence in the ability of the bargaining system to resolve it. We argue that the greater degree of consensus in Denmark compared with Australia reflects differences in national institutional systems and knowledge regimes, which have influenced the ways actors in these countries perceive low wage growth. [ABSTRACT FROM AUTHOR]

This paper reports from a study of intersubjectivity in a Danish nursery ("vuggestue") for the 0-3 year olds. The study uses psychoanalytic infant observation. The concept of intersubjectivity is introduced from developmental psychology. Intersubjective moments depend on the adults' mental participation in children's interests and reactions. We know from developmental psychology that for children intersubjectivity is developmentally important and often joyful. The study shows how moments of play, sharing new experiences, participation in creative work, as well as mundane situations are potentially rich intersubjective moments. The study also shows how competence in verbal language expands the possibilities of intersubjective sharing. [ABSTRACT FROM AUTHOR]

Aims: Preventing smoking and aiding cessation among youth and young adults carries the possibility of reducing future smoking prevalence significantly. This paper estimates the impact on future smoking prevalence of 25 year olds by increasing tobacco prices, securing indoor smoke-free homes and implementing school-based multi-tiered interventions. Methods: Utilizing a multi-state Markov model, a status quo projection of the smoking prevalence from years 2017 to 2030 were compared with projections of the smoking prevalence in 2030 considering the impact of the three prevention strategies. Results: In a status quo projection, 27.0% of Danish 25-year-old females are expected to be smokers in 2030, while 13.2% would be smokers in 2030 were all three prevention strategies in effect from 2019. By itself, increasing tobacco prices by 50% reduced the prevalence of smokers among 25-year-old females to 14.8% in 2030, a relative reduction of 47.5%. For 25-year-old males in 2030 the reductions were similar, with a prevalence of 16.6% when all three prevention strategies were in effect, a relative reduction of 51.5%. Conclusions: Implementing increasing tobacco prices, indoor smoke-free homes and school-based multi-tiered interventions in Denmark is likely to significantly decrease youth smoking prevalence in the future. However, these three strategies will not produce a smoke-free generation without other initiatives. [ABSTRACT FROM AUTHOR]

This article provides an overview of the use of artificial intelligence (AI) in Denmark and Sweden, as well as the responses of social partners to this technology. Both countries are highly digitalized, with Denmark having a higher percentage of companies using AI compared to Sweden. Social partners in both countries have responded to technological changes through tripartite, bipartite, and unilateral initiatives. The European Union's regulations on digitalization have raised concerns among Nordic social partners. In Denmark, there have been debates and initiatives regarding AI, including the introduction of machine learning in public institutions and discussions on data ethics and ownership. Trade unions and employers' associations have negotiated collective agreements addressing digital workers' rights. In Sweden, the focus has been on sectors like manufacturing and the service sector, with concerns about job loss and re-skilling needs. The Swedish government has established commissions and allocated research funding to address the consequences of AI. Both countries emphasize bipartite agreements but also engage in tripartite measures involving the government. The implementation of EU regulations on AI is also a topic of discussion in both countries. [Extracted from the article]

Denmark and Sweden are small open economies that rely on exports for economic growth. At the same time, these countries have some of the largest public sectors in the world and a high wage equality. With extensive collective bargaining and strong unions in both private and public sectors, coordination of wage setting is crucial for balancing competitiveness and real wage increases. This paper investigates how coordination between public sector and private sector wage setting in the two countries is achieved. Like other studies, we find that agreements in the manufacturing export sector set the pattern for public sector wage bargaining. However, we also find that institutional differences have significant distributive implications for public sector employees. In Denmark, wage increase disparities between the public and private sectors are automatically adjusted according to formalized procedures. In Sweden, no automatic adjustment exists, and coordination is instead based on tightly coordinated bargaining practices by unions and public sector employers. Surprisingly, we find most public sub-sector variation of wage increases in Denmark, whereas wage structures in Sweden have been very stable. We argue that timing of bargaining, level of private sector wage flexibility and politicization of public sector bargaining are key drivers for these distributional differences. [ABSTRACT FROM AUTHOR]

It is often assumed that the simple presence of international students and ubiquitous use of English as a medium of instruction (EMI) are the main agents of internationalisation of higher education (HE), whereby English equals international education and inbound student mobility equals increased internationalisation. While there are perceived benefits of these two instruments at the institutional and national levels, students' experiences of internationalisation in a Danish context are under-explored. Using a digital ethnographic enquiry, empirical evidence draws on 126 hours of observation of online teaching and 38 semi-structured interviews with domestic and international students of MSc programmes in Denmark. This article contends that the meaning of internationalisation and self-perceived gains are experienced differently between Danish and international students. The disconnect between discourses and actual experiences of internationalisation reported in this paper highlights the need for further student-centred research to inform institutional policies and practices, challenging long-held views of what 'international' means. Internationalisation practices that foster international spaces in which diverse groups of students can engage in meaningful interactions require those working in HE to realign institutional activities with humanistic values for the common good. [ABSTRACT FROM AUTHOR]

Aim: Focusing on drinking and partying among young Muslim women in Denmark, our aim was to examine how the drinking practices of young Muslim women are influenced by belonging, understood as sentiments of (national) belonging as well as the broader (politicised) discourse on Muslims in Denmark. Methods and data: Based on 32 qualitative in-depth interviews with young Muslim women, this paper explores their drinking practices as situated in a national youth culture highly influenced by alcohol intoxication. We draw on Nira Yuval-Davies' (2006) distinction between belonging (as emotional attachment) and the politics of belonging. Findings: We found that the young women attempt to avoid negative comments based on stereotypes of Muslims and their drinking, by toning down being a Muslim. In addition, we showed how the difficulties of drinking alcohol while being both Muslim and Danish leads to several of the young women experiencing an 'identity crisis'. Lastly, we found that a way for the studied women to reconcile Muslim and Danish identities is through faith, namely through actively choosing what kind of Muslim they want to be. Conclusion: Being part of a national youth culture of alcohol intoxication is inevitably dilemma-filled for the study's participants and they are challenged in their belonging. We argue that these dilemmas do not stand alone, but rather point to the broader predicaments of these women in Danish society. [ABSTRACT FROM AUTHOR]

Aim: This paper describes the design of the 'Move More' study, which aims to develop and assess the feasibility of a social-prescribing intervention to increase physical activity among physically inactive Danes. Background: Physical inactivity constitutes a public-health challenge in Denmark. Social prescribing may be a promising tool to tackle physical inactivity by linking physical activity support from general practitioners with community-based activities in sports clubs, as this may help physically inactive citizens become more physically active. Given the range of stakeholders and behaviours required for social prescribing of physical activity, an intervention that harnesses this approach may constitute a complex intervention. The methods and decisions made in the stages of developing complex interventions are seldom reported. The present study enabled us to describe how co-creation can be used in a pragmatic development process for a complex intervention that considers the needs of stakeholders and the conditions of the delivery context. Methods: The study is based on the core elements of the development and feasibility phases of the Medical Research Council Framework for Developing and Evaluating Complex Interventions. Additionally, it is informed by a framework for the co-creation and prototyping of public-health interventions, drawing from a scoping review, stakeholder consultations and co-creation workshops. Ultimately, a feasibility study will be conducted to refine the programme theory by introducing the proposed intervention in case studies. Perspectives: The study will result in a prototype intervention manual and recommendations for implementation of an adapted social-prescribing intervention targeting physical inactivity in Denmark. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments' early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events. [ABSTRACT FROM AUTHOR]

We estimate the cost-effectiveness of plug-in electric vehicle (PEV) subsidies in reducing tailpipe-CO2 emissions in China, the U.S., and nine European countries. We find that the per-tonne cost of tailpipe-CO2 avoided increases linearly with the government-subsidized percentage of the PEV price. Costs are relatively higher in the Netherlands and Denmark, which subsidized high-priced PEVs including plug-in hybrids, and lower in the U.S., where PEVs replaced higher-emissions cars. Chinese PEV subsidies have a short-run static cost of up to $1,600 per tonne, far exceeding the social cost of carbon, suggesting that subsidies are more a part of China’s industrial policy than its carbon policy. When subsidy-induced PEV sales and power generation emissions are considered, the ordering of countries based on the cost-effectiveness of subsidies changes. The long-run dynamic subsidy cost is expected to be lower, as current subsidies may drive future innovation and sales, and due to grid decarbonization. [ABSTRACT FROM AUTHOR]

The Bologna process and the 3+2-degree structure presents students with several decision points in higher education, both which bachelor's programme to choose, and whether to continue beyond bachelor. Based on a small-scale survey containing both closed and open-ended questions, this paper studies reasons the students give for entering a master's programme. We compare students in Norway and Denmark who have entered a master's programme in educational studies. In both countries, students mention multiple reasons for choosing to enter the master's level, and reasons related to career and access to interesting jobs were most frequently mentioned. Additionally, academic motives and identity motives were mentioned. There are also differences between Norwegian and Danish students, but these differences are mainly linked to aspects of the transition. In Denmark, students who change institution when entering the master's level state different reasons, while in Norway, differences are related to whether students enter a master's programme directly or delayed. Further, differences in labour market structure also affects these transitions. These differences point to historical understandings of national status differences between degrees and institutions still being important, even if the implementation of the Bologna structure in the educational system should have led to a harmonisation. [ABSTRACT FROM AUTHOR]

Background: Caring for a family member can be demanding, particularly when caregivers experience profound distress. Supportive interventions may help prevent mental and physical illness in the caregiver. General practice plays a key role by regularly engaging with patients and caregivers, thereby being able to identify their support needs, offer talk therapy and refer to care initiatives. Objective: This study aimed to develop and pilot-test the Caregiver Care Model to mitigate grief reactions among caregivers in general practice. Design: A participatory intervention development study. Methods: A prototype was developed in a workshop with healthcare professionals. The prototype was refined based on a pilot-test among 40 caregivers from 5 general practice clinics and a workshop with general practitioners. The data were obtained from workshops, feedback questionnaires completed by healthcare professionals, and interviews with caregivers and general practitioners. The analysis focused on model development and mechanisms of impact. Results: The prototype was refined by focusing the dialogue questionnaire, minimising the grief facilitation tools and expanding the target group. The prototype seemed to accommodate the needs among caregivers by acknowledging their situation. The final model includes up to seven caregiver consultations in general practice. A dialogue questionnaire filled in by the caregiver serves as a fixed starting point and preparation for the first consultation. If needed, talk therapy in general practice or referrals to other services are used. Conclusion: The model offers promising support for caregivers. Its flexible structure allows for customisation. The viability of the model should be further tested. [ABSTRACT FROM AUTHOR]

Introduction: Living with dementia can be challenging, even more so for people diagnosed before age 65. Loss of identity is one of the main subjective consequences dementia poses at this stage in life due to the loss of social relations and daily activities. While a growing body of research is reporting the experienced impact of early-onset dementia on identity for this group, studies synthesizing this knowledge are very limited. Therefore, we have conducted a meta-ethnographic review to explain how people with early-onset dementia form their sense of identity. Method: A systematic review of literature from five databases was conducted. Ten original studies published between 2004 and 2020 were included and analyzed using an interpretive approach. Findings: A conceptual interpretation emerged from the analysis, showing that social arenas and activities of daily life, as well as assumptions about dementia and natural aging made by the participants and society, influenced the participants' sense of identity. Conclusion: Being in nonjudgmental environments can support people with early-onset dementia in creating continuity and positive connections in their personal history. Providing such environments can be a viable venue for healthcare professionals to support people with early-onset dementia in maintaining a positive sense of identity. [ABSTRACT FROM AUTHOR]

Objectives: This study compares the follow-up rates of non-normal cervical screening samples between Denmark and Flanders (Belgium) to illuminate whether organizational differences between the health systems might affect the follow-up rates, e.g. sending of reminders in Denmark since 2012 compared to Flanders with no such system in place. Methods: The study population included 48,082 Danish women and 22,271 Flemish women who received abnormal or inadequate primary screening results from 2014 to 2016. The participants were followed for 24 months, and the timeliness and appropriateness of the recommended follow-up, according to national guidelines, were evaluated. Results: After 18 months over 90% of the Danish women had received some form of follow-up, while in Flanders, this level is achieved only for those who test positive for human papillomavirus. The analysis also revealed that 10–28% of follow-ups were performed too early, with Danish women showing the highest proportions. In both regions, general practitioners (GPs) exhibited better follow-up rates compared to gynaecologists, with gynaecologists displaying a tendency towards earlier re-testing than recommended. Conclusions: An important factor influencing the follow-up rate may be the sending of reminders in Denmark since 2012, as the follow-up rates in general were higher in this period. It is noteworthy that a reminder system is currently being implemented in Flanders and further studies on the potential effects should be studied. Additionally, the organization of the health system might influence the follow-up rate, as engaging the GP for screening in Denmark may have had a positive effect. [ABSTRACT FROM AUTHOR]

The naval town of Portsmouth bore a large portion of the brunt of the casualties lost at the Battle of Jutland (1916). The article will explore the precedent of naval philanthropy in Portsmouth and its historical links with naval disasters affecting the town which will lead to an analysis of how the town viewed their civic duty and mobilised local support for war widows immediately after the Battle of Jutland. It will then turn to assess the role of the local War Pensions Statutory Committee and its intersections with charitable organisations such as the Royal Patriotic Fund and Lady Beatty's Jutland Fund. The analysis will lastly explore some of the stories of the nearly 100-strong Jutland war widows who worked in Portsmouth Royal Dockyard during the war. It will highlight the agency of civic leaders in determining aspects of World War One relief and how war widows were able to navigate and survive their personal tragedies in a naval town. [ABSTRACT FROM AUTHOR]

Aim: To present the content, data quality, and research potential of the West Jutland Tele-Electrocardiogram Registry (WEJU-tECG). Methods: Danish patients reporting symptoms indicating heart disease in the prehospital setting are subjected to a 12-lead tele-electrocardiogram (ECG) in the ambulance, which is digitally sent to a local tele-centre. WEJU-tECG is a newly established Danish registry containing information from the individual tele-ECGs received at the Regional Hospital West Jutland tele-centre. Results: WEJU-tECG holds extracted information from all tele-ECGs with a valid Civil Personal Register number between 2011 and 2020. WEJU-tECG contains information on patient characteristics, tele-ECG data (including a computerised tele-ECG interpretation), vital signs, and time information. A unique Civil Personal Register number allows individual-level linkage between WEJU-tECG and other Danish registries and enables complete follow-up. WEJU-tECG contains 43,696 tele-ECGs from 29,489 different patient contacts among 20,280 different patients. WEJU-tECG contains 5566 patients with ST-segment deviations. The median age is 67 years and 45% are women. Completeness is highest for time information (100% for all variables), tele-ECG data (99% for heart rate, the specific intervals and axes, and QRS duration, and 86% for J-point deviation), and patient characteristics (100% for all variables). Completeness is lowest for vital signs (13% for systolic, diastolic, and mean arterial blood pressure, and 12% for blood oxygen saturation). The computerised tele-ECG interpretation had a negative predictive value of 80% for ST-segment elevation myocardial infarction and 94% for non-ST-segment elevation myocardial infarction and a positive predictive value of 45% for ST-segment elevation myocardial infarction and 32% for non-ST-segment elevation myocardial infarction. Conclusions: WEJU-tECG is a novel population-based tele-ECG registry with high research potential. [ABSTRACT FROM AUTHOR]

Arthritis affects many individuals and can cause pain and limit physical functioning. Exercise is an important treatment option for individuals with arthritis; however, adherence to exercise programs can be challenging. A new initiative in Denmark has introduced nature-based exercises for patients with arthritis. This qualitative study aimed to explore the experiences of the individuals who participated in those exercises. The study used a hermeneutic-phenomenological approach and conducted along-side interviews with 12 women and three men who participated in nature-based exercise programs for arthritis. Analysis of the data revealed two main themes. The first theme highlighted the positive effects of being in nature, such as increased vitality, reduced pain, and a sense of well-being. The second theme emphasized the social benefits of participating in these exercises, including a sense of connection and community with others. Overall, this study suggests that incorporating nature-based exercises in treatment programs for arthritis could have significant benefits for individuals with this condition. [ABSTRACT FROM AUTHOR]

Introduction: Holistic rehabilitation approaches addressing the numerous complex challenges in young persons with acquired brain injury are required. The purpose of this study was to describe and evaluate the holistic person-centered youth mentoring intervention program, which is based on occupational therapy. Methods: Prospectively collected data were extracted from a national clinical quality database (n = 59). Proportions of young persons receiving different aspects of support and proportions rating the intervention as meaningful were calculated. One-year changes in occupation, work ability, and social interactions were calculated. Results: The young persons most frequently received support for energy management (75%) and structuring of everyday life (61%). Seventy-three percent rated the intervention as meaningful. One year post-inclusion, occupation and work ability had increased by 35% and 58%, respectively, and it had declined by 10% and 26%, respectively. The 1-year increase and decrease in social interactions were less clear (15% and 25%, respectively). One-year changes did not differ between those who entered the program early or late after injury indicating the potential beneficial effect of the program. Conclusion: The findings could indicate that the program has a unique value in supporting young persons with acquired brain injury to create a meaningful everyday life through occupation, work ability, and social interaction. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the challenges women with neuromuscular disease face when having to urinate when away from home. The design for this study was qualitative using the interpretive description methodology and the Sense of Coherence theory. The method was three semi-structured focus group interviews with 12 women (3 ambulant and 9 non-ambulant) with neuromuscular diseases at a specialized rehabilitation hospital. We found that physical and functional barriers hampered the opportunity to urinate when away from home due to lack of accessibility and impaired physical functioning. Psychosocial impacts were related to inconvenience and dependency on relatives, fear of stigmatization and impacted dignity, and the constant social sacrifices. The challenge of access to adequate and equitable sanitation for women with neuromuscular diseases is not at always met in society, and these women consequently often must resort to repressing the fundamental need to urinate. [ABSTRACT FROM AUTHOR]

Aim: To investigate the challenges and barriers in Danish care professionals' work in relation to elderly citizens who use substances. Method: The study draws on data from a "going along" study of care professionals' encounters with citizens as well as interviews with professionals. This was conducted in two smaller, rural municipalities in Denmark. Findings: Providing adequate care for elderly citizens who use substances can be highly challenging. This is due to a multitude of factors, especially (1) the complexity of their health conditions, (2) contradictory logics of care (autonomy vs. healthy living), (3) citizens often unpredictable behaviours, (4) lack of cooperation between welfare systems and, not least, (5) lack of knowledge and education among healthcare professionals. Conclusions: There is a need for more specialised procedures locally, the appointment of local "experts", better cooperation between sectors and easier accessible training and information on the group on a national level. [ABSTRACT FROM AUTHOR]

Introduction: Chronic non-cancer pain (CNCP) is a lifelong condition with radical consequences, calling for management involving patients' families. Interventions based on the family systems nursing framework by Wright and Leahey have proved beneficial in other populations but require investigation in a CNCP population. This trial assumed that family nursing conversations (FNCs) based on the family systems nursing framework would increase patients' and family members' self-efficacy concerning CNCP management. Objective: To investigate whether an intervention with FNCs as an add-on to the usual multidisciplinary treatment of CNCP would have an effect on patients' and family members' self-efficacy. Additionally, to investigate any impact on family function, health-related quality of life, anxiety, and depression. Methods: The trial applied a prospective non-blinded quasi-experimental design with two comparable groups of patients and family members: a historical control group (HCG) and an intervention group (IG). The intervention was executed by nurses employed at a multidisciplinary pain center in the Capital Region of Denmark. HCG data were collected before the nurses' intervention training. The primary outcome was self-efficacy. Secondary outcomes were family function, health-related quality of life, anxiety, and depression. Results: In total, 58 patients and 85 family members were included. The primary outcome, self-efficacy, detected no statistically significant between-group differences in mean change for patients, p =.990, or family members, p =.765. A statistically significant effect in favor of the IG was found in between-group differences in mean change in patients' behavioral family function, p =.034, and anxiety, p =.031. No statistically significant between-group differences were detected in family members' secondary outcomes. Conclusion: The intervention had no effect on patients' or family members' self-efficacy but a positive effect on patients' behavioral family function and anxiety. The intervention was deeply affected by the COVID-19 pandemic. Hence, any results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

This article maps affective operations in artful teaching practices in Social Education at a University College in Denmark to make visible the ways affect shapes experience, behavior, and forms of social connection. The article contributes to the fields of playful learning and aesthetic learning in higher education through its application of a relational and situated approach to affectivity as a new line of inquiry illuminating the dynamics of affect in artful educational practices. We argue that bringing considerations of affectivity to the study of artful educational practices utilized as a catalyst for playful learning in Social Education has: (1) important implications for how we might leverage the affective power of bodies learning together (Harris, Jones, 2021) for designing and developing inclusive playful learning encounters; (2) important implications for how we might better understand the exclusive dynamics and micropolitical dimensions of aesthetic practices in order to better respond to the inherent power structures and nuanced nature of privilege. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

Objective: Compare the effectiveness of a problem-solving, individualised, home-based occupational therapy intervention (ABLE 2.0), to usual occupational therapy, on activities of daily living (ADL) ability in persons with chronic conditions. Design: A single-centre, double-blinded, randomised controlled trial with 10- and 26-week follow-up. Setting: A Danish municipality. Subjects: Persons with chronic conditions experiencing problems performing ADL tasks (n = 80). Interventions: ABLE 2.0 was compared with usual occupational therapy. Main measures: Coprimary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 10. Secondary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 26, and perceived satisfaction with ADL ability (ADL-Interview Satisfaction) and observed ADL process ability (Assessment of Motor and Process Skills) at Weeks 10 and 26. Results: In total, 78 persons were randomly assigned: 40 to usual occupational therapy and 38 to ABLE 2.0. No statistically significant nor clinically relevant difference between group mean changes in primary outcomes was identified from baseline to Week 10 (ADL-Interview Performance [−0.16; 95% CI: −0.38 to 0.06] and Assessment of Motor and Process Skills ADL motor ability [−0.1; 95% CI: −0.3 to 0.1]). At Week 26, a statistically significant and clinically relevant difference was found in Assessment of Motor and Process Skills ADL motor ability (LS mean change: −0.3; 95% CI: −0.5 to −0.1) between groups. Conclusion: ABLE 2.0 was effective in improving observed ADL motor ability at 26 weeks. [ABSTRACT FROM AUTHOR]

Ineffective use of the early warning score (EWS) can compromise recognition and response to patients' deteriorating condition. This study explores nurses' and physicians' ideas on initiatives for supporting the effective use of the EWS in a hospital setting. Participatory workshops were conducted, and data were analyzed using content analysis. Ideas generated for integrating new functions into the EWS protocol to facilitate effective use are described. Also recommended was that all users receive training and an update on how to use the EWS score to support acceptance and confidence using the protocol and thereby increase adherence to the EWS. Further research is needed on the efficiency of incorporating nurses' clinical judgment in the EWS protocol within different specialties and the effect on adherence to the tool. [ABSTRACT FROM AUTHOR]

Objective: To explore rehabilitees' and professionals' experiences of goal-setting in a context of (un)certainty with a progressive neurodegenerative disease and how they navigate this (un)certainty in Parkinson's disease rehabilitation. Design: A long-term multi-sited ethnographic fieldwork (2019−2020) following 20 rehabilitees and their goals over time and settings. Observation at 30 goal-setting meetings. Participants: Rehabilitees and professionals in Danish Parkinson's disease rehabilitation. Two randomly chosen groups of rehabilitees attending a Parkinson's disease course at a rehabilitation centre participated. Methods: Semi-structured interviews and participant observation. Results: Living with Parkinson's disease holds a certainty that the condition will progress yet an uncertainty regarding the pace and severity, as indicated by the notion (un)certainty. The (un)certainty challenges goal-setting. Reflecting on goal-setting, rehabilitees brought forth existential, economical, and societal considerations. Some expressed an ambivalent view, questioning the value of goal-setting with a progressive condition, yet finding own rehabilitation goals relevant. Others expressed a pragmatic view, attuning goals to fit the situation. Professionals found that the visible and invisible symptoms and the uncertain pace of Parkinson's made goal-setting challenging. They had to strike a balance between mentioning symptoms to come, yet not rendering the future too bleak. Conclusions: Rehabilitees and professionals found that setting goals in a condition that progresses is no easy task. They made use of strategies such as observation, repetition, future-proofing strategies, and attuning goals to navigate the (un)certainty. In goal-setting, to maintain functioning with progressive Parkinson's disease was a viable goal. Participants found they just do the best they can to navigate (un)certainty. [ABSTRACT FROM AUTHOR]

The genome has become a crucial component in precision medicine aimed at tailoring medical treatment to the individual. To the extent that social science studies of genomics have explored questions related to the individual, these studies have focused on how the governance regarding genomes facilitates individuals' rights, choices, and responsibilities. By contrast, we approach genomic governance by investigating how enactments of the person in precision medicine actualize practices of reciprocity and belonging in a national collective. Based on document analysis and ethnographic fieldwork in Denmark, we show that genomes are treated simultaneously as digital representations of individuals, social resources for a welfare state population, and emblems of public trust. By drawing on classical and contemporary anthropological theories of personhood, we unfold how Danish precision medicine prescribes a moral continuity between person, state, and territory. We argue that Danish precision medicine revitalizes a national politics of belonging and generates socio-spatial orientations through which the "me" of the person shares origin and place with the "we" of the welfare state. [ABSTRACT FROM AUTHOR]

Hospital clowns are widely used in pediatric settings. However, the field of pain and pain experience in children is complex and multifaceted. Therefore, the aim of this study was to expand knowledge on the impact and influence of hospital clowns on 4 to 15-year-old children's experiences of managing painful procedures and conditions. A convergent mixed method study was conducted integrating findings from three individual studies: a prospective non-blinded study and two focused ethnographic studies. The findings illuminated a child—clown interaction characterized by a close relationship evolving during a continuous, mutually focused attention, conceptualized as WE. This WE represent a responsive interaction between child and clown, which supported the child during the procedures, and generated three integrated findings: an age-differentiated approach; understanding the child's condition; and previous experiences as a part of the child's history. The WE approach strengthened the child's competences and ability to manage during painful procedures. [ABSTRACT FROM AUTHOR]

Aim: Diabetes mellitus type 1 is one of the most common serious chronic diseases in childhood and the incidence is increasing. Insight into risk factors may inform our etiologic understanding of the disease and subsequent prevention. Any socio-economic gradient in disease risk indicates a potential for prevention, since this points towards socially patterned environmental risk factors. The aim of this study was to investigate the association between measures of parental socio-economic position and the onset of type 1 diabetes in offspring based on individual data in the entire Danish population. Methods: In a study population of all children born in Denmark between 1 January 1987 and 31 December 2010, we examined the association between parental socio-economic position and the risk of type 1 diabetes up to the age of 25 years. The risk of type 1 diabetes was estimated according to maternal education, paternal education and household income using Cox proportional hazards regression, with adjustments for the a priori selected confounding variables: year of birth, maternal age at birth and parental type 1 diabetes. Results: In the study population of 1,433,584 children, a total of 4610 developed type 1 diabetes. We found no clear pattern in type 1 diabetes risk according to parental educational attainment or parental household income. Conclusions: In this large population covering study of the risk of type 1 diabetes according to individual-level parental socio-economic position, we found no strong indication of a socially patterned disease risk. [ABSTRACT FROM AUTHOR]

Although European Union legal frameworks tend to conceive of sex and gender in binary terms, a growing number of countries in Europe and around the world have been increasingly allowing for third gender markers and non-binary possibilities in identity documents, passports, and public registries, of which the X marker in the sex or gender field has become the most common. However, initiatives like the X, which may initially signal trans-friendliness, must be considered alongside heightened border surveillance. As more and more European countries begin to follow this trend of expanding possibilities for registering (non-binary) gender (e.g. Malta, Denmark, Germany, the Netherlands), we look here to some illustrative examples (e.g. Nepal, Canada, Pakistan) that have been at the forefront of non-binary legal recognition to interrogate the complications and conundrums that these developments may provoke in European contexts. [ABSTRACT FROM AUTHOR]

Aims: Detrimental effects on health and well-being were reported during the COVID-19-induced lockdown periods in several countries, but these associations have not been studied in small-scale island societies. This study aimed to examine the lockdown period's impact on general well-being, perceived stress and activity levels in the Faroe Islands. Methods: We used cross-sectional data from two extensive population-based surveys of the general health conducted in November 2019 (the pre-COVID survey; n =2906), and four to six weeks into the first national lockdown (the lockdown survey; n =1204). Results: A larger proportion of participants in the lockdown survey versus pre-COVID survey displayed excellent/very good self-rated health (68.1% vs. 62.0%; p <0.001), and the same pattern was observed for reporting good quality of life (85.7% vs. 82.7%; p <0.05). These associations remained statistically significant in a logistic regression model after adjusting for characteristics for which varying impact of the pandemic has been shown. Indicators of health behaviour showed that larger proportions of participants kept active during the lockdown survey versus pre-COVID survey, and these differences were statistically significant for physical, mental and spiritual activities (p <0.001). On the other hand, similar stress levels in the pre-COVID/lockdown periods were observed, but stratified analysis showed that participants with a high-stress level displayed better self-rated health in the lockdown period compared to the pre-COVID period (p =0.001). Conclusions: Findings indicate that self-reported health and quality of life improved during the early phase of the COVID lockdown, and individuals reported higher activity levels associated with good mental health during the COVID-19-induced lockdown period. [ABSTRACT FROM AUTHOR]

In 2018, the then right-wing government in Denmark led by Lars Løkke Rasmussen and supported by the extreme right-wing party Danish People's Party presented new legislation to end 'parallel societies' in Denmark by toughening the criminal law, enforcing Danish knowledge and nursery school assistance to toddlers, and, more importantly for this article, a series of urban interventions in 'ghetto areas' considered as such mainly when the proportion of immigrants and descendants from non-Western countries exceeded 50 per cent. Until recently research has focused on either the discursive elements of the 'ghetto politics' in Denmark or the urban interventions from an architectural or urban planning point of view. However, newfangled research deal with the entwined economic elements. In this article, I compare the different developmental plans proposed in the affected areas because of the legislation, with an aim to reach further and point at the inherent elements of urban b/ordering, that is, measures taken to attain social order and gain legitimacy by demarcating categories of people to incorporate some and exclude others through urban space. Indeed, through this comparison, I conclude that the ghetto legislation is a compelling example of the urban b/ordering inherent to the politics and dynamics of current liberal capitalist social democracies. It is a social experiment that remodels the geography of Denmark in terms that recall the eugenic and hygienic social and urban policies of the 19th century and form part of a worrying pattern that may have consequences that go beyond the stated ones. [ABSTRACT FROM AUTHOR]

For several decades, the social investment (SI) state has been heralded as the saviour of the welfare state, while at the same time being criticised for being just another instance of neoliberal downsizing of the welfare state. Recently, efforts have been made to provide clearer conceptualisations of how to assess the existence and impact of SI. However, these attempts have hitherto mainly focused on the policy functions and instruments of the SI state. This article contributes to existing research by offering a novel analytical framework on the capacity needed by street-level organisations (SLOs) to implement the central policy functions of the SI state, and by elucidating how administrative reforms influence this capacity. The article applies the framework to the implementation in Denmark of Active Labour Market Policies (ALMPs) in local job centres. This case is considered an SI 'flagship' in terms of formal policies, while also having undergone multiple administrative reforms, which makes it highly illustrative for the central argument of the article – that the success or failure of an SI approach is not only determined by politics and formal policies. The empirical analysis reveals how the capacity to implement SI policies has been enhanced by administrative reforms; this has been done by giving job centres more room for discretion and enhancing their ability to make long-term investments and to promote integrated service provision across different service areas. However, at the same time the local job centres remain closely monitored and controlled through an external accountability performance measurement system. [ABSTRACT FROM AUTHOR]

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6–10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple's everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process. [ABSTRACT FROM AUTHOR]

Aims: To examine the associations between undocumented pregnant migrant women and the risk of experiencing stillbirth or preterm birth. Methods: A retrospective case–control study based on nationwide registers from Statistics Denmark and hospital journals from the seven largest hospital wards in Denmark from 1 January 2011 to 31 December 2018. A total of 882 undocumented pregnant migrant women and 3528 matched controls (both documented migrant and non-migrant women) were included. Logistic regression models were used to estimate the risk of undocumented pregnant migrant women experiencing (a) stillbirth and (b) preterm birth compared with the control group. Results: Of the undocumented pregnant migrant women, 33.3% were EU citizens, 16.2% were applicants for residence and 50.5% had an unknown basis for residence. The mean age of the undocumented pregnant migrant women was 28.4 years, whereas the mean age of women in the control group was 30.9 years. Higher adjusted odds of experiencing stillbirth (aOR 3.50; 95% CI 1.31–9.38) and preterm birth (aOR 1.41; 95% CI 1.04–1.93) were observed among the undocumented pregnant migrant women compared with the control group. The basis of residence was not associated with higher odds of experiencing stillbirth or preterm birth. Conclusions: We found a higher risk of stillbirth and preterm birth among the undocumented pregnant migrant women than in the control group. Our findings suggest a need to increase the focus on providing access to antenatal care among those women currently excluded from this care. [ABSTRACT FROM AUTHOR]

Aims: A key issue in public health is how to approach ethnic inequities. Despite an increased focus on the health of people from ethnic minorities in the last 15 years, significant ethnic health inequities still exist in Denmark. These arise during pregnancy and are exacerbated by higher rates of exposure to health risks during the life course. This study aimed to formulate recommendations on both structural and organisational levels to reduce ethnic health inequities. Methods: Nine decision-makers – representing municipalities, regions, the private sector and voluntary organisations in Denmark – participated in the formulation of recommendations inspired by the Delphi method. The consensus process was conducted in three rounds during spring 2020, resulting in eight overall recommendations, including suggestions for action. Results: The recommendations address both structural and organisational levels. They aim to strengthen: 1) health policies and strategies related to the needs of people from ethnic minorities, including health literacy, linguistic, cultural and social differences; 2) health-promoting local initiatives developed in co-creation with people from ethnic minorities; 3) health promotion and prevention from a life course perspective with a focus on early intervention; 4) cross-sectoral and interdisciplinary collaborations that facilitate transitions and coordination; 5) competencies of professionals in terms of cultural knowledge, awareness, reflexivity and skills; 6) access to healthcare services by increasing information and resources; 7) interpreting assistance for, and linguistic accessibility to, healthcare services; 8) documentation and intervention research. Conclusions: To reduce ethnic health inequities, it is crucial that Danish welfare institutions, including their strategies, approaches and skills of employees, are adapted to serve an increasingly heterogeneous population. [ABSTRACT FROM AUTHOR]

Background: Rehabilitation is increasingly being introduced in dementia care but studies highlight extensive heterogeneity in practices, conceptual confusion and divergent perceptions of its relevance across care organizations and national contexts. As this have implications for development of dementia care as well as for people with dementia's access to care it is important to study the organizational narratives and practices in rehabilitation-oriented dementia care organizations. Methods: The study build on qualitative interviews (individual and group interviews) with health professionals (N = 26) engaged with dementia care and rehabilitation in two Danish municipalities. The interviews were conducted in 2018–2019. The empirical data was analyzed using abductive analysis and theory-based narrative analysis, using Loseke's conceptualizations of and approach to analyzing formula stories. Findings: Four dominant organizational narratives were constructed from the data. Each narrative produced a specific organizational narrative of client identity: the active participant in individualized rehabilitation, the inactive individual benefitting from enhanced social environments, the disengaging self and the vulnerable self. Conclusion: Introducing rehabilitation in dementia care may amplify the organizational polyphonic and provide a plurality of organizational identities each expressing different perceptions of personhood and agency for people with dementia. The organizational narratives were negotiated within a specific structural context where national regulation and dominant discourses on economic challenges and ageing gave precedence to some narratives more than others. In Danish elder care, the first narrative is the most influential but risks excluding people with dementia. Instead, rehabilitation in dementia care is positioned within a social and relational perspective, which may silence important discussion of agency and resistance. [ABSTRACT FROM AUTHOR]

This study tests the hypothesis that the role identity of street-level bureaucrats is related to variation in their discretionary decisions in relation to the behavior of citizen-clients. The study draws on crosssectional survey data on 465 officers from prisons in Denmark. Results from the study show a negative correlation between prison officers role identity as formalistic (state-agent) and the likelihood of differentiating in response to citizen-clients' behavior. Correspondingly, the results shows a positive relationship between informal rule identification (citizen-agent) and differential responses against citizen-client behavior. The findings indicate a causal relationship between street-level bureaucrats' role identity and their discretionary decisions. [ABSTRACT FROM AUTHOR]

The further involvement of citizens in the processing of their own cases is attracting attention as a possible strategy for improving the quality of employment services across national borders. However, employment services are characterized by detailed regulation and strong elements of conditionality. This article utilizes Bernardo Zacka's framework on morality at the street level, drawing on focus group interviews to analyze how caseworkers in Denmark experience and deal with such demands for increased client participation. (1) We map four normative considerations that are emphasized by our informants: legality, authenticity, realism, and resonance. (2) In doing so, we outline two central cross-pressures that arise as they strive to balance client participation with conditionality in practice, namely between legality and authenticity, on the one hand, and between realism and resonance, on the other hand. (3) Finally, we unfold three coping strategies pursued by caseworkers to dampen such tensions: dividing the self, dissolving contradictions, and disassembling clients' wishes. We add to the literature by studying coping strategies from a perspective that carefully highlights the normative elements of employment service work—the values frontline workers attribute particular importance to and strive to actualize in their work. [ABSTRACT FROM AUTHOR]

Background: Knowledge about the process and the results of the implementation of clinical guidelines to improve palliative care is limited. A national project aimed at improving the quality of life of advanced cancer patients admitted to specialized palliative care services in Denmark by implementing clinical guidelines for the treatment of pain, dyspnea, constipation, and depression. Aim: To investigate the degree of clinical guideline implementation by evaluating the proportion of patients treated according to guidelines among those who qualified (i.e. reported severe symptom level) before and after the 44 palliative care services implemented the guidelines, and how often different types of interventions were provided. Design: This is a national register-based study. Setting/participants: Data from the improvement project were stored in and later obtained from the Danish Palliative Care Database. Adult patients with advanced cancer admitted to palliative care between September 2017 and June 2019 who answered the EORTC QLQ-C15-PAL questionnaire were included. Results: In total 11,330 patients answered the EORTC QLQ-C15-PAL. The proportions of services that implemented the four guidelines ranged 73%–93%. Among services that had implemented guidelines, the proportion of patients receiving interventions was roughly constant over time reaching between 54% and 86% (lowest for depression). Pain and constipation were frequently treated pharmacologically (66%–72%), whereas dyspnea and depression were frequently treated non-pharmacologically (61% each). Conclusions: Implementing clinical guidelines was more successful for physical symptoms than for depression. The project generated national data on interventions provided when guidelines were followed, which may be used to understand differences in care and outcomes. [ABSTRACT FROM AUTHOR]