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International teaching experiences, even if short-termed, are great opportunities for student teachers to challenge their assumptions and scrutinise their beliefs, to discover different ways of approaching teaching and learning, and to better understand their own education system through a global education lens. They offer student teachers the context to develop their teaching competencies and serve as the milieu to crystallise their teacher identity and build a more global mental schema of teaching. This exploratory study examines how the National Institute of Education, Singapore, strived to broaden student teachers' perspective by providing them with the opportunity to do their teaching assistantship overseas. Specifically, the inquiry question of the study was to find out what student teachers learned during their international teaching assistantship. To answer the inquiry question, reflective journals of 13 student teachers who participated in 5-week international teaching assistantship in Denmark (n = 5), Sweden (n = 4) and the United States of America (US) (n = 4) were analysed. Thematic analysis was used to identify, analyse, and report themes that emerged from the qualitative data. The themes were coded as "connection to a wider world (sub-themes: culture awareness, alternative viewpoints, global education lens)", "observations of the school (sub-themes: class size and composition, learning assessment, technology integration)", "professional growth (sub-themes: teacher as facilitator, understanding class profile, classroom management practices)", and "personal growth (sub-themes: overcoming personal limitations, greater flexibility and willingness to change)". Despite the student teachers in Denmark and Sweden facing language barrier challenges, the results indicate that all the student teachers benefited immensely from the experience. They developed broader perspectives of societies and education, made important observations of the schools, and grew professionally and personally. They noted that although there were differences in the different education systems, there were similarities in the role of teacher as facilitator, as well as curriculum goals and pedagogical approaches. They had greater appreciation of their roles as teachers and the importance of knowing their students. They overcame personal limitations and became more flexible and open to changes. The article concludes with suggestions on how to improve such experiences to enhance the growth and cross-cultural competency of student teachers. [ABSTRACT FROM AUTHOR]

Infections with Shiga toxin-producing Escherichia coli (STEC) are increasing in Denmark and elsewhere. STEC is also the most frequent cause of haemolytic uraemic syndrome (HUS) in Danish children. Most cases are considered sporadic, while approximately one-third can be attributed to a known source of infection. Hence, we examined sources of sporadic STEC infection in Denmark. From January 2018 to December 2020, we conducted a prospective nationwide case–control study among Danish adults and children. Cases with confirmed positive STEC infection were notified infections within the national laboratory surveillance system. Control persons were randomly selected from the Danish Civil Registration System, individually matched in age in 5-year bands and sex. Participants were invited by an electronic letter to complete either an adult or child questionnaire online. Univariate and adjusted matched odds ratios were computed for adults and children using conditional logistic regression. The study recruited 1583 STEC cases and 6228 controls. A total of 658 cases (42%) and 2155 controls (35%) were included in the analysis. Depending on age, univariate analysis adjusted for socio-demographic determinants showed that the consumption of boiled beef (mOR = 2.2, 95% confidence interval (CI): 1.6–3.1) and fried minced beef (mOR = 1.6, CI: 1.2–2.1), drinking raw (unpasteurized) milk (mOR = 11, CI 1.1–110), eating grilled food (mOR = 9.8, CI: 5.6–17) and having a household member using diapers (mOR = 2.1, CI: 1.4–3.2) were determinants of sporadic STEC infection. Further multivariate adjusted analysis resulted in the same determinants. This study confirms that beef is an overall important risk factor for STEC infection in Denmark. We also present evidence that a proportion of sporadic STEC infections in Denmark are determined by age-specific eating habits, environmental exposures and household structure, rather than being exclusively food-related. These findings are relevant for targeted public health actions and guidelines. [ABSTRACT FROM AUTHOR]

This article analyses Aftenlandet (Evening Land), a film made for the Danish Film Institute in 1976 by Peter Watkins, one of the world's most politically radical directors and a pioneer of docudrama. The aim is to provide a detailed historical account of the life cycle of a key but hitherto critically neglected film in the director's career: his last to be professionally funded for nearly 25 years and one that saw Watkins working within the very particular milieu of Denmark, investigating, often controversially, the perceived political fault lines of Danish society during the 1970s. The article traces how this English-born filmmaker came to be working in Scandinavia, details the production of Evening Land1 and provides a close critical reading of the film's various themes and techniques as well as considering its reception and aftermath. Correspondence and production files from Watkins' own personal archive reveal the difficulties the filmmaker clearly experienced as something of 'an Englishman abroad' attempting to find a place for himself within Scandinavian film culture of the period. The article asserts that this experience eventually contributed to Watkins' decision to quit Scandinavia altogether following the completion of Evening Land, a decision that would inadvertently propel Watkins out of the world of professional filmmaking for nearly a quarter century. The article argues, however, that Evening Land, a film long obscure and critically neglected, still has cultural resonance and applicability to our own times in the twenty-first century. [ABSTRACT FROM AUTHOR]

Within a timespan of a few years, regulatory sandboxes, a novel initiative for testing fintech innovations, have spread to financial conduct authorities across the world. We study the discursive diffusion of this regulatory innovation as evidence of a broader reconfiguration of relations between the financial sector and its regulators. To do so, we analyse media articles, policy documents, and political speeches, identifying the logics and arguments used to diffuse rhetorical sandboxes. Based on the initial mapping, we detail the anatomy of three national arguments, showing how the underlying rationales for establishing sandboxes are variously reproduced across the contexts of the UK, Singapore, and Denmark. In each case, we find, innovation is posited as a driver of competition, which, in turn, leads to economic growth. Through regulatory sandboxes, financial regulators are becoming actively involved in the promotion of innovation and, hence, continue to rely on and reproduce the exhausted promissory legitimacy of neoliberalism. Whilst appearing to depoliticize the field of finance, the assumption that regulators should be 'open for business' is in itself political; as such, we argue, it needs to be approached more critically, which becomes possible by shifting the analytical focus from discursive diffusion to rhetorical struggle. [ABSTRACT FROM AUTHOR]

Forest School in England is the practice of young children playing outside, rooted in the outdoor kindergartens of Scandinavia and more especially Denmark. Using observation and semi-structured interviews with children and adults in two settings, this case study approach allowed an in-depth look at where, how and what children played in a Forest School in England compared with a Forest Kindergarten in Denmark. This study found that even though each case had contextual differences, with different conceptualisations of pedagogy and play, children were active in the process of their play. Choosing to play in familiar places, which resources they needed, on their own or with peers, but away from adults, a common theme to the play was play stories or narratives. Bounded by the two cases, and explored through play pedagogy, this study offers practitioners and pedagogues a unique insight into how children experience and operate in two similar yet different forest environments. [ABSTRACT FROM AUTHOR]

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One of the core principles of providing care in general practice is giving more to those who need it most. We investigate some of the complexities of this ambition in the context of cancer care for patients defined as socially disadvantaged by their general practitioner (GP). We do this by exploring how care is sought, how it is offered, and what expectations patients and GPs carry with them when receiving and providing cancer care in the Danish welfare state. We carried out semi-structured interviews with eight GPs and seven socially disadvantaged cancer patients living with different types and stages of cancer. The interviews focused on needs and challenges in cancer follow-up in general practice and were thematically coded. Drawing on theoretical concepts of morality and Nordic individualism, we point to how one of the main challenges in cancer care and follow-up is to figure out how the doctor-patient relationship should be established, practiced, and maintained. Both GPs and patients stressed the importance of the relationship, but how it should be practiced amidst social norms about being a patient, a citizen and how care-seeking should unfold seems less clear. In conclusion we argue that giving more to those who need it the most is a difficult and ill-defined task that is shaped by the cultural, social, and political expectations of both GPs and patients. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson's disease (PD) in Denmark and Norway. Methods: A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark (n = 9) and Norway (n = 5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed verbatim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. Results: The main themes were 'negotiating systems of support' and 'balancing being both a partner and a family carer'. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. Discussion: A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the collaboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family. [ABSTRACT FROM AUTHOR]

Chronological frameworks based on artefact typologies are essential for interpreting the archaeological record, but they inadvertently treat transitions between phases as abrupt events and disregard the temporality of transformation processes within and between individual phases. This study presents an absolute chronological investigation of a dynamic material culture from Early Iron Age urnfields in Denmark. The chronological framework of Early Iron Age in Southern Scandinavia is largely unconstrained by absolute dating, primarily due to it coinciding with the so-called 'Hallstatt calibration plateau' (c.750 to 400 cal BC), and it is difficult to correlate it with Central European chronologies due to a lack of imported artefacts. This study applies recent methodological advances in radiocarbon dating and Bayesian chronological modelling, specifically a statistical model for wood-age offsets in cremated bone and presents the first large-scale radiocarbon investigation of regional material culture from Early Iron Age in Southern Jutland, Denmark. Dated material is primarily cremated bone from 111 cremation burials from three urnfields. The study presents absolute date ranges for 16 types of pottery and 15 types of metalwork, which include most of the recognised metalwork types from the period. This provides new insights into gradual change in material culture, when certain artefact types were in production and primary use, how quickly types were taken up and later abandoned, and distinguishing periods of faster and slower change. The study also provides the first absolute chronology for the period, enabling correlation with chronologies from other regions. Urnfields were introduced at the Bronze-Iron Age transformation, which is often assumed to have occurred c.530-500 BC. We demonstrate that this transformation took place in the 7th century BC, however, which revives the discussion of whether the final Bronze Age period VI should be interpreted as a transitional phase to the Iron Age. [ABSTRACT FROM AUTHOR]

Background: Care home residents aged 65 + years frequently experience acute health issues, leading to emergency department visits. Falls and associated injuries are a common cause of these visits and falls in a geriatric population can be a symptom of an incipient acute illness such as infection. Conversely, the traumatic event can cause illnesses to arise due to consequences of the fall, e.g. delirium or constipation due to opioid use. We hypothesised that a traumatic event treat-and-release emergency department visit serves as an indicator for an upcoming acute hospital admission due to non-trauma-related conditions. Methods: We studied emergency department visits for traumatic events among all care home residents aged 65+ (n = 2601) living in Southern Jutland, Denmark, from 2018 to 2019. Data from highly valid national registers were used to evaluate diagnoses, mortality, and admissions. Cox Regression was used to analyse the hazard of acute hospital admission following an emergency department treat-and-release visit. Results: Most visits occurred on weekdays and during day shifts, and 72.0% were treated and released within 6 h. Contusions, open wounds, and femur fractures were the most common discharge diagnoses, accounting for 53.3% of all cases (n = 703). In-hospital mortality was 2.3%, and 30-day mortality was 10.4%. Among treat-and-release visits (n = 506), 25% resulted in a new hospital referral within 30 days, hereof 13% treat-and-release revisits (duration ≤ 6 h), and 12% hospital admissions (duration > 6 h). Over half (56%) of new hospital referrals were initiated within the first seven days of discharge. Almost three-fourths of subsequent admissions were caused by various diseases. The hazard ratio of acute hospital admissions was 2.20 (95% CI: 1.52–3.17) among residents with a recent traumatic event treat-and-release visit compared to residents with no recent traumatic event treat-and-release visit. Conclusion: Traumatic event treat-and-release visits among care home residents serve as an indicator for subsequent hospitalisations, highlighting the need for a more comprehensive evaluation, even for minor injuries. These findings have implications for improving care, continuity, and resource utilisation. Trial registration: Not relevant. [ABSTRACT FROM AUTHOR]

Background: Person-centred medicine is recommended in the care of older patients. Yet, involvement of care home residents and relatives in medication processes remains limited in routine care. Therefore, we aimed to develop a complex intervention focusing on resident and relative involvement and interprofessional communication to support person-centred medicine in the care home setting. Methods: The development took place from October 2021 to March 2022 in the Municipality of Aarhus, Denmark. The study followed the Medical Research Council guidance on complex intervention development using a combination of theoretical, evidence-based, and partnership approaches. The patient involvement tool, the PREparation of Patients for Active Involvement in medication Review (PREPAIR), was included in a preliminary intervention model. Study activities included developing programme theory, engaging stakeholders, and exploring key uncertainties through interviews, co-producing workshops, and testing with end-users to develop the intervention and an implementation strategy. The Consolidated Framework for Implementation Research and the Interprofessional Shared Decision Making Model were used. Data were analysed using a rapid analysis approach. Results: Before the workshops, six residents and four relatives were interviewed. Based on their feedback, PREPAIR was modified to the PREPAIR care home to fit the care home population. In total, ten persons participated in the co-producing workshops, including health care professionals and municipal managerial and quality improvement staff. The developed intervention prototype was tested for three residents and subsequently refined to the final intervention, including two fixed components (PREPAIR care home and an interprofessional medication communication template) delivered in a flexible three-stage workflow. Additionally, a multi-component implementation strategy was formed. In line with the developed programme theory, the intervention supported health care professionals´ awareness about resident and relative involvement. It provided a structure for involvement, empowered the residents to speak, and brought new insights through dialogue, thereby supporting involvement in medication-related decisions. The final intervention was perceived to be relevant, acceptable, and feasible in the care home setting. Conclusion: Our results indicate that the final intervention may be a viable approach to facilitate person-centred medicine through resident and relative involvement. This will be further explored in a planned feasibility study. [ABSTRACT FROM AUTHOR]

In Denmark and Sweden, statutory retirement age is indexed to life expectancy to account for mortality improvements in their populations. However, mortality improvements have not been uniform across different sub-populations. Notably, in both countries, individuals of lower socioeconomic status (SES) have experienced slower mortality improvements. As a result, a uniform rise in the statutory retirement age could disproportionally affect these low-SES groups and may unintentionally lead to a reverse redistribution effect, shifting benefits from short-lived low-SES individuals to long-lived high-SES individuals. The aim of this study is twofold: to quantify and contextualise mortality inequalities by SES in Denmark and Sweden, and to assess how indexing retirement age will affect future survival to retirement age by SES in these countries. We used Danish and Swedish registry data (1988–2019), to aggregate individuals aged 50 + based on their demographic characteristics and SES. We computed period life tables by year, sex, and SES to estimate the difference in survival across different SES groups. We then forecast mortality across SES groups to assess how indexing retirement age will affect survival inequalities to retirement age, using two forecasting models—the Mode model and the Li-Lee model. Mortality inequalities are comparable in Denmark and Sweden, even though the latter generally has higher survival. We also find that indexing retirement age to life expectancy will have two main consequences: it will reduce the probability of reaching retirement for all SES groups, particularly those of low SES, and time spent in retirement will be reduced, particularly for those of high SES. [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]

Background: Smoking is a critical risk factor responsible for over eight million annual deaths worldwide. It is essential to obtain information on smoking habits to advance research and implement preventive measures such as screening of high-risk individuals. In most countries, including Denmark, smoking habits are not systematically recorded and at best documented within unstructured free-text segments of electronic health records (EHRs). This would require researchers and clinicians to manually navigate through extensive amounts of unstructured data, which is one of the main reasons that smoking habits are rarely integrated into larger studies. Our aim is to develop machine learning models to classify patients' smoking status from their EHRs. Methods: This study proposes an efficient natural language processing (NLP) pipeline capable of classifying patients' smoking status and providing explanations for the decisions. The proposed NLP pipeline comprises four distinct components, which are; (1) considering preprocessing techniques to address abbreviations, punctuation, and other textual irregularities, (2) four cutting-edge feature extraction techniques, i.e. Embedding, BERT, Word2Vec, and Count Vectorizer, employed to extract the optimal features, (3) utilization of a Stacking-based Ensemble (SE) model and a Convolutional Long Short-Term Memory Neural Network (CNN-LSTM) for the identification of smoking status, and (4) application of a local interpretable model-agnostic explanation to explain the decisions rendered by the detection models. The EHRs of 23,132 patients with suspected lung cancer were collected from the Region of Southern Denmark during the period 1/1/2009-31/12/2018. A medical professional annotated the data into 'Smoker' and 'Non-Smoker' with further classifications as 'Active-Smoker', 'Former-Smoker', and 'Never-Smoker'. Subsequently, the annotated dataset was used for the development of binary and multiclass classification models. An extensive comparison was conducted of the detection performance across various model architectures. Results: The results of experimental validation confirm the consistency among the models. However, for binary classification, BERT method with CNN-LSTM architecture outperformed other models by achieving precision, recall, and F1-scores between 97% and 99% for both Never-Smokers and Active-Smokers. In multiclass classification, the Embedding technique with CNN-LSTM architecture yielded the most favorable results in class-specific evaluations, with equal performance measures of 97% for Never-Smoker and measures in the range of 86 to 89% for Active-Smoker and 91–92% for Never-Smoker. Conclusion: Our proposed NLP pipeline achieved a high level of classification performance. In addition, we presented the explanation of the decision made by the best performing detection model. Future work will expand the model's capabilities to analyze longer notes and a broader range of categories to maximize its utility in further research and screening applications. [ABSTRACT FROM AUTHOR]

Background: Family psychosocial challenges during the early years of a child's life are associated with later mental and physical health problems for the child. An increased psychosocial focus on parents in routine child developmental assessments may therefore be justified. Methods: Participants in this qualitative study included 11 mothers and one parental couple (mother and father) with children aged 9–23 months. Participants were recruited to Project Family Wellbeing through their general practice in Denmark. Twelve interviews were conducted, transcribed and analysed with a deductive approach. The topic guide drew on the core components of the Health Belief Model, which also served as a framework for the coding that was conducted using thematic analysis. Results: Results are presented in four themes and 11 subthemes in total. Parents welcome discussion of their psychosocial circumstances during their child's developmental assessments. Clinicians' initiatives to address psychosocial challenges and alignment of parents' and clinicians' expectations may be required to allow this discussion. A flowing conversation, an open communication style and a trustful relationship facilitate psychosocial discussion. Barriers included short consultation time, concerns about how information was used and when parents found specific psychosocial aspects stigmatising or irrelevant to discuss. Conclusion: Enquiry about the family's psychosocial circumstances in routine developmental assessments is acceptable among parents. Alignment of clinical and parental expectations of developmental assessments could facilitate the process. Future research should examine the predictive validity of the various components of developmental assessments. Trial registration: This is a qualitative study. The study participants are part of the cohort from Project Family Wellbeing (FamilieTrivsel). The project's trial registry number: NCT04129359. Registered October 16th 2019. [ABSTRACT FROM AUTHOR]

Introduction: This article addresses digital and social inclusion of adults with potential low digital skills. The article presents a case study of how digital learning activities (DLAs) as a service to refugees, immigrants, senior citizens, and young adults neither in education, employment, or training (NEETs), are delivered outside the formal educational system by two libraries and one civic organization in Norway, Denmark, and Belgium. Through the theoretical lenses of social capital building, co-creation and co-producing, the article analyzes how the DLA's were organized and tailored for the participant's needs, with an emphasis on cooperation efforts with local sub-partners and representatives from the target groups. Methods: A multiple case-design was applied using a process tracing method combining qualitative and quantitative techniques. To measure the partner organizations' experiences from the project, we conducted participant observation, personal and focus group interviews, in addition to self-reporting schemas about how they organized the DLA's. Surveys were conducted to measure the participants' experiences. Results: By combining literature and theoretical approaches from several fields; digital inclusion, public and civil organization research--with a particular focus on libraries, and their role in educating refugees and other vulnerable groups, the article provides new insights on how public and non-public organizations in local communities can work together to tailor-make DLAs and contribute to the promotion of digital inclusion. Discussion: Libraries and civic organizations have potential to reach out to vulnerable people in local communities, to provide innovative DLA's and to connect both people and organizations. Vital for recruitment of participants and to find the right level of digital/technical ambition is to closely co-create and co-produce with representatives from other local organizations in both civil and public sector during the whole process. Co-creating activities with actors representing the target group in the planning phase as well as co-producing them in the implementation phase, are important prerequisites. The article discusses the challenges of trust-building, of finding the right level of digital ambition as well as developing long-term digital activities as important factors for the promotion of digital inclusion. [ABSTRACT FROM AUTHOR]

Research in psychology and medicine has linked mental health disorders, and particularly bipolar disorder (BD), to employment in creative professions. Little is known, however, about the mechanisms for this link, which could be due to biology (primarily through a person's genes) or environmental (through socioeconomic status). Using administrative data on mental health diagnoses and occupations for the population of Denmark, we find that people with BD are more likely to be musicians than the population, but less likely to hold other creative jobs. Yet, we also show that healthy siblings of people with BD are significantly more likely to work in creative professions. Notably, people from wealthy families are consistently more likely to work in creative professions, and access to family wealth amplifies the likelihood that siblings of people with BD pursue creative occupations. Nevertheless, family wealth explains only a small share of the correlation between BD and creative employment. [ABSTRACT FROM AUTHOR]

Objectives: Older people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys. Design and measurements: Digital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable. Setting and participants: We pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE). Results: We included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84–4.28, ELSA (1.92 [1.70–2.18]), HRS(2.48[2.28–2.71), MHAS (1.92 [1.74–2.12]), and SHARE (2.60 [2.34–2.88]). Conclusion: Our research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults. [ABSTRACT FROM AUTHOR]

Aim: To achieve an in‐depth understanding of the challenges associated with diabetes management when having both schizophrenia and type 2 diabetes, while also identifying the needs for improved diabetes self‐care. Design: The study employed a qualitative explorative design utilizing a phenomenological‐hermeneutic inspired approach, involving field observations and individual semistructured interviews. Methods: Data were collected during 2020–2021 through 17 field observations of outpatient consultations and 13 individual semistructured interviews. Data, including field notes and verbatim transcribed interviews, underwent analysis following Ricoeur's interpretive philosophy, encompassing three levels: naïve reading, structural analysis and critical interpretation and discussion. This study adheres to the COREQ guidelines for qualitative research. Results: Three key themes emerged: 'Diabetes when life is noisy', 'Sacrifices and compromises in life' and 'The double silence'. Everyday life is significantly affected when having both schizophrenia and T2D. The mental health state dominates in relation to diabetes self‐care and individuals experience challenges balancing between the two conditions. However, there exists a general acknowledgement for diabetes and its long‐term complications as a serious medical condition demanding careful attention and treatment. Conclusion: Self‐managing two such complex conditions can be overwhelming and make it difficult for the individual to differentiate symptoms and prioritize diabetes care. Moreover, the existing fragmentation within healthcare systems poses communication challenges, resulting in disjointed patient pathways. Implications for patient care: The study emphasizes the need for a holistic re that addresses the physical, emotional and social challenges. There is also a need for increased awareness and education among informal caregivers and healthcare professionals to foster better understanding and support. [ABSTRACT FROM AUTHOR]

The Danish National School Test Program is a set of nationwide tests performed annually since 2010 in all public schools in Denmark. To assess the utility of this data resource for health research purposes, we examined the association of school test performance with demographic and socioeconomic characteristics as well as correlations with ninth-grade exams and higher educational attainment. This nationwide descriptive register-based study includes children born between 1994 and 2010 who lived in Denmark at the age of six years. Norm-based test scores (range 1–100, higher scores indicate better performance) in reading (Danish) and mathematics from the Danish National School Test Program were obtained for children aged 6–16 attending public schools in Denmark from 2010 to 2019. Population registers were used to identify relevant demographic and socioeconomic variables. Mean test scores by demographic and socioeconomic variables were estimated using linear regression models. Among the full Danish population of 1,137,290 children (51.3% male), 960,450 (84.5%) children attended public schools. There were 885,360 children who completed one or more tests in reading or mathematics (test participation was 77.8% for the entire population, and 92.1% for children in public schools). Mean test scores varied by demographic and socioeconomic characteristics, most notably with education and labour market affiliation of parents. For every 1-point decrease in the test scores, there was a 0.95% (95% CI: 0.93%; 0.97%) lower probability of scoring B or higher in the ninth-grade exam and a 1.03% (95% CI: 1.00%; 1.05%) lower probability of completing high school within five years after graduating from lower secondary school. In this study of schoolchildren in Denmark, demographic and socioeconomic characteristics were associated with test scores from the Danish National School Test Program. Performance in school tests correlated closely with later educational attainment, suggesting that these early measures of school performance are good markers of subsequent academic potential. [ABSTRACT FROM AUTHOR]

Background: The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. Aim: The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. Methods: A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. Results: The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. Conclusions: The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern. [ABSTRACT FROM AUTHOR]

Landforms left behind by the last Scandinavian Ice Sheet (SIS) offer an opportunity to investigate controls governing ice sheet dynamics. Terrestrial sectors of the ice sheet have received considerable attention from landform and stratigraphic investigations. In contrast, despite its geographical importance, the Baltic Sea remains poorly constrained due to limitations in bathymetric data. Both ice-sheet-scale investigations and regional studies at the southern periphery of the SIS have considered the Baltic depression to be a preferential route for ice flux towards the southern ice margin throughout the last glaciation. During the deglaciation the Baltic depression hosted the extensive Baltic Ice Lake, which likely exerted a considerable control on ice dynamics. Here we investigate the Baltic depression using newly available bathymetric data and peripheral topographic data. These data reveal an extensive landform suite stretching from Denmark in the west to Estonia in the east and from the southern European coast to the Åland Sea, comprising an area of 0.3 million km 2. We use these landforms to reconstruct aspects of the ice dynamic history of the Baltic sector of the ice sheet. Landform evidence indicates a complex retreat pattern that changes from lobate ice margins with splaying lineations to parallel mega-scale glacial lineations (MSGLs) in the deeper depressions of the Baltic Basin. Ice margin still-stands on underlying geological structures indicate the likely importance of pinning points during deglaciation, resulting in a stepped retreat signal. Over the span of the study area we identify broad changes in the ice flow direction, ranging from SE–NW to N–S and then to NW–SE. MSGLs reveal distinct corridors of fast ice flow (ice streams) with widths of 30 km and up to 95 km in places, rather than the often-interpreted Baltic-wide (300 km) accelerated ice flow zone. These smaller ice streams are interpreted as having operated close behind the ice margin during late stages of deglaciation. Where previous ice-sheet-scale investigations inferred a single ice source, our mapping identifies flow and ice margin geometries from both Swedish and northern Bothnian sources. We anticipate that our landform mapping and interpretations may be used as a framework for more detailed empirical studies by identifying targets to acquire high-resolution bathymetry and sediment cores and also for comparison with numerical ice sheet modelling. [ABSTRACT FROM AUTHOR]

Anthropogenic eutrophication of ecosystems is an important driver of biodiversity loss. Even protected areas (PAs) may be impacted by anthropogenic nutrients, for example, from atmospheric deposition or the provision of supplementary feeding. However, the resultant nutrient patterns, and the role of local wildlife in shaping them, remain poorly understood. We investigated anthropogenic influences on the role that red deer (Cervus elaphus) play in the nutrient balance of a PA in Denmark. We used habitat selection modeling and theoretical scenarios where we varied the proportion of energy the deer obtained from supplementary versus natural forage and compared it with the nutrients removed due to hunting. We show that the movement and distribution of the red deer population within the PA are very heterogeneous and likely influenced by the need for shelter. Moreover, depending on their reliance on supplementary feeding, deer can potentially import large amounts of nutrients to the PA, and concentrate them in localized hotspots. However, we also explore the potential for nutrient loss due to hunting activities. Such indirect anthropogenic impacts on nutrient landscapes may counteract restoration and conservation efforts. We therefore recommend incorporating anthropogenic influences on zoogeochemistry and the animal‐mediated connectivity between PAs and anthropogenically dominated landscapes into future management plans. [ABSTRACT FROM AUTHOR]

The construction sector is the largest contributor to waste in Europe. Approximately one-third of all waste originates from construction and demolition. In Europe, most construction and demolition waste (CDW) is recycled as backfilling and only limited amounts of construction materials are reused for their original purpose. There is a current policy push by the European Commission (EC), as well as several EU member states, focused on lifting waste up the European waste hierarchy from recycling to reuse to help preserve resources and reduce the environmental impacts of CDW, which is considered a priority waste stream. This article explores the potential and the barriers to the increased reuse of CDW and describes several business models for reuse based around the intersection between public authorities, waste companies and private companies involved in the construction and demolition sector. The article is empirically based on a study of various reuse schemes operated by waste companies, municipalities and private waste operators in Denmark. Using a mixed-methods approach, in which survey methods are combined with company visits and qualitative interviews, the article analyzes the potential and the barriers to the creation of direct reuse schemes for CDW. Based on the findings from these, four generic business models for the direct reuse and recycling of CDW are synthesized specifically targeting the CDW fractions that are waste managed at public recycling stations. Finally, the article discusses how market conditions, environmental issues and quality can influence emerging reuse schemes. [ABSTRACT FROM AUTHOR]

Ministers may be powerful policy initiators, but they are not equally powerful. Cabinet control mechanisms have become a crucial part of cabinet governance, which can serve to contain agency loss and consequently constrain ministers in the policymaking process. However, empirical studies have not focused on the impact of such control mechanisms on individual ministers' political outcomes. I turn attention to certain cabinet committees as intra-cabinet control mechanisms and argue that members of these enjoy a policymaking advantage compared to nonmembers. Analyzing ministers' number of laws proposed to parliament in Denmark from 1975 to 2022, I look beyond parties as unitary actors and provide evidence for this causal relationship. Membership of the Economic Committee increases ministers' legislative activity. Thus, even within parties in cabinet, ministers have unequal possibilities to act as policy-seeking. These findings offer new insights into political parties in governments, cabinet governance, policymaking, and legislative processes. [ABSTRACT FROM AUTHOR]

Introduction. Little is known about how shifting hospital visitor restrictions issued by national health authorities were communicated, managed, and adapted by hospital charge nurses during the COVID-19 pandemic. Aims. To describe the shifting visitor restrictions and the passing on of restrictions from the national authority level to charge nurses and secondly describe charge nurses' management of the restrictions and their challenges when enforcing them. Methods. The study consisted of a document analysis and a cross-sectional survey including open-ended questions. Descriptive statistics and qualitative content analysis were used. The survey was distributed online to 88 charge nurses in somatic units in a Danish university hospital from March 2020 to April 2021. Results. Restrictions were communicated from national authority level in an effective administrative cascade. The charge nurses led their enforcement in each unit. In total, 71 charge nurses (81%) responded to the survey. For 70%, the wording of the restrictions was clear, while 31% found them challenging to handle. On a weekly or daily basis, 68% of the charge nurses deviated from the restrictions. They identified both upsides and downsides to the absence of relatives. Communication, collaboration, and leadership were experienced as key tools in the ongoing processes of adapting to shifting restrictions. Conclusion. During this severe health crisis, essential information was passed on through well-defined management levels in an effective communication pathway. Charge nurses and their professional values were challenged when balancing shifting national restrictions against individual needs of patients and relatives. Implications for Nursing Management. Charge nurses serve as vital intermediaries between national authorities and frontline nursing practice in managing shifting visitor restrictions during a pandemic. Their experiences can contribute to further qualifying nurse managers' considerations when designing family-centred hospital visitor policies for the future. Also, they may strengthen the handling of future sudden major organizational changes. [ABSTRACT FROM AUTHOR]

Simple Summary: Cascade genetic testing is crucial for families with hereditary cancer syndromes like Lynch syndrome, where clinically established surveillance programs reduce illness and death. However, communicating genetic information within families faces barriers, with only a small uptake of genetic testing in family members informed through family-mediated contact. Provider-mediated interventions via letter or phone call increase testing uptake but raise legal and ethical concerns. We describe 30 years of national experience with cascade testing using unsolicited letters, covering administration, legislation, public attitudes, and testing rates. Our approach resulted in an average of 7.3 additional tests per family. Overall uptake of genetic testing was 54.4% after family-mediated and 64.9% after provider-mediated contact by letter. The uptake of genetic testing was highest in the first year after diagnosis of Lynch syndrome in the family, with 72.5% tested after provider-mediated contact. We propose a model for cascade genetic testing combining family- and provider-mediated contact. Cascade genetic testing and surveillance reduce morbidity and mortality in Lynch syndrome. However, barriers to conveying information about genetic disorders within families result in low uptake of genetic testing. Provider-mediated interventions may increase uptake but raise legal and ethical concerns. We describe 30 years of national experience with cascade genetic testing combining family- and provider-mediated contact in Lynch syndrome families in the Danish Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Register. We aimed to estimate the added value of information letters to family members in Lynch syndrome families (provider-mediated contact) compared to family members not receiving such letters and thus relying on family-mediated contact. National clinical practice for cascade genetic testing, encompassing infrastructure, legislation, acceptance, and management of the information letters, is also discussed. Cascade genetic testing resulted in 7.3 additional tests per family. Uptake of genetic testing was 54.4% after family-mediated and 64.9% after provider-mediated contact, corresponding to an odds ratio of 1.8 (p < 0.001). The uptake of genetic testing was highest in the first year after diagnosis of Lynch syndrome in the family, with 72.5% tested after provider-mediated contact. In conclusion, the Danish model combining family- and provider-mediated contact can increase the effect of cascade genetic testing. [ABSTRACT FROM AUTHOR]

Most Western countries have increasing number of new cancer cases per year. Cancer incidence is primarily influenced by basically avoidable risk factors and an aging population. Through hypothetical elimination scenarios of multiple major risk factors for cancer, we estimated the number of new cancer cases that are non-preventable in 2050. We compare numbers of new postmenopausal breast, prostate, lung, and colorectal cancer cases in 2021 to projected numbers of new cases in 2050 under prevention scenarios regarding smoking, overweight and obesity, and alcohol consumption: no intervention, 50%, and 100% instant reduction. Cancer incidence data were derived from NORDCAN, and risk factor prevalence data from the Danish National Health Survey. Cancer projections were calculated with the Prevent program. Hypothetical 100% instant elimination of major risk factors for cancer in Denmark in 2022 will result in unchanged numbers of new breast and colorectal cancers in 2050. The number of new prostate cancers will increase by 25% compared to 2021. Unchanged risk factor levels will result in noticeable increase in cancer burden. Increase in life expectancy and age will entail an increase in cancer incidence, despite maximum effect of preventive actions in the population. Our results are important when planning future health care. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) has long been considered as a degenerative disease of cartilage tissue resulting from bodily wear and tear. However, there is accumulating evidence that inflammation plays a key role in the pathogenesis of OA. In knee OA, the most common form of OA, exercise therapy as an effective component of early treatment addresses functional deficits, pain and inflammation. Since inflammation is critical for the development and progress of OA, anti-inflammatory therapies must be combined strategically. In the course of the NUMOQUA project, an anti-inflammatory therapeutic diet named 'Austrian Osteoarthritis Cuisine' was developed. It is based on the framework of the New Nordic Diet combined with the food-based dietary guidelines of Austria, the guidelines for OA, the Austrian food culture and the principles of a sustainable diet. The present study examines the implementation of the 'Austrian OA Cuisine' combined with the evidence-based training programme GLA:D® (Good Life with osteoArthritis in Denmark) in Austrian patients with knee OA and the effects on quality of life, nutritional and inflammatory status, as well as oxidative stress parameters. Methods: A total of 60 participants aged 50 to 75 with knee OA will be included and randomly assigned either to the intervention group or the control group. All participants will undergo the GLA:D® programme in the first 6 weeks. Additionally, the intervention group will receive nutritional group training and individual nutritional counselling on the 'Austrian OA Cuisine' over 9 months. The control group will receive general information about a healthy lifestyle. Measurements at baseline and at 4 follow-up dates include nutritional, inflammatory and oxidative stress markers. Furthermore, anthropometric, behavioural and clinical data will be obtained. The recruitment process lasted from autumn 2022 to January 2024, followed by the intervention until October 2024. Discussion: The prevalence of OA is expected to increase in the future due to ongoing demographic changes and rising obesity rates. The expected results will provide important evidence on whether this interdisciplinary therapeutic approach could be a new, cost-effective and sustainable strategy to address the disease process of OA without negative side effects. Trial registration: ClinicalTrials.gov NCT05955300. Date of registration: 23rd of October 2023. [ABSTRACT FROM AUTHOR]

Background: Patients with non-specific symptoms or signs of cancer (NSSC) present a challenge as they are a heterogeneous population who are not candidates for fast-track work-up in an organ-specific cancer pre-planned pathway (CPP). Denmark has a cancer pre-planned pathway for this population (NSSC-CPP), but several issues remain unclarified, for example, distribution and significance of symptoms and findings, and choice of imaging. Aim: To investigate symptoms, cancer diagnoses, and diagnostic yield of computed tomography (CT) and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients on NSSC-CPP to improve the overall diagnostic process. Design & setting: A retrospective medical chart review in a 1-year consecutive cohort (2020). Method: A total of 802 referrals were reviewed for diagnostic imaging in patients with NSSP from general practices, specialist practices, or the local hospital diagnostic centre responsible for NSSC-CPP. Results: The study included 248 patients; 21% had cancer, most frequently gastrointestinal cancer (27%). The most frequent symptom was weight loss (56%). CT had a sensitivity of 85%, specificity of 87%, positive predictive value (PPV) of 65%, and negative predictive value (NPV) of 96%. For 18F-FDG-PET/CT, the numbers were sensitivity 82%, specificity 62%, PPV 33%, and NPV 94%. Patients frequently underwent subsequent examinations following initial imaging. Conclusion: The findings were in accordance with the literature. Patients with NSSC had a cancer prevalence of 21%, most frequently gastrointestinal. The most frequent symptom was weight loss and, even as the only symptom, it is a potential marker for cancer. CT and 18F-FDG-PET/CT were sensitive with high NPV, whereas PPV was superior in CT. Better stratification by symptoms or findings is an obvious focus point for future studies to further optimise the NSSC-CPP work-up strategy. [ABSTRACT FROM AUTHOR]

Background: Spiritual care can improve patients' physical and emotional well-being, but patients at the end of life often experience that their spiritual needs are not sufficiently met by healthcare professionals. Object: This study evaluates the effect and experiences of a training course in spiritual care for 30 nurses at a Danish hospice. Methods: Before-and-after questionnaire and focus-group interviews were applied. Results: The course focused primarily on the nurses and their personal and collegial reflections on spiritual care, whereas increased spiritual care for patients seemed to be a secondary outcome of the course. There was a significant statistical correlation between the nurses' values and spirituality, and their confidence in being able to exercise spiritual care for patients. Conclusion: The training course facilitated spiritual empowerment, collegial spiritual care, and spiritual language among the nurses, which led to increased spiritual care for patients. [ABSTRACT FROM AUTHOR]

The year 2023 marked 130 years since the first Polish seasonal workers, the so-called beet girls (roepiger), arrived on the islands of Lolland-Falster, as the first group of Polish immigrants in Denmark. In 1940, a monument called "Roepiger" was erected in the market square of Sakskøbing and became part of human memory. But who this Danish sculpture depicts, and why, continues to be variously interpreted to this day. Social memory supports distances between the two cultures, differences in memory policies and attitudes in public diplomacy. Certain meanings were attached to the sculpture by the local Danish community, others by Poles living in Denmark, and still others by Polish and Danish officials. Finally, the personal memory of the sculpture's author, Gottfried Eickhoff, about its genesis should be taken into account. The article argues that the plaque, which was funded by Polish diplomacy and affixed to the monument's pedestal during interstate ceremonies in 2015, constitutes an appropriation. The market in Sakskøbing was given the status of a Polish memorial, passing over the coexistence of different forms of memory in cultural circuits, as characterized in Aleida Asmann's theory of memory. [ABSTRACT FROM AUTHOR]

This article combines two neglected elements within the history of online news: public service news sites and weather reporting, and it does so by utilising web archives, which – surprisingly – do not figure very prominently in journalism history. The two elements have – in isolation and in combination – at least in Denmark, become increasingly important as the online news sections of the two public service institutions Denmark's Radio (DR) and TV2 consistently are among the most visited news sites and since reporting on the weather has gained in prominence and more recently, at least on DR TV, has become increasingly educational in its linking to issues of climate change. This article focusses on online news and conducts a historical analysis of the weather reporting on DR.dk from 2005 to 2022. The analysis seeks to balance the coding of journalistic texts with considerations of the online form of journalism, which here broadly means reading the webpage as a text. A key focus in the analysis is how meteorological data have been woven into cultural and social narratives, some of which are linked to climate change. [ABSTRACT FROM AUTHOR]

Background: Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries. Methods: We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month). Results: The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019-22. Conclusions: The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats. [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]

To evaluate the validity of diagnosis codes for Major Osteoporotic Fracture (MOF) in the Danish National Patient Registry (NPR) and secondly to evaluate whether the fracture was incident/acute using register-based definitions including date criteria and procedural codes. Methods: We identified a random sample of 2400 records with a diagnosis code for a MOF in the NPR with dates in the year of 2018. Diagnoses were coded with the 10th revision of the International Classification of Diseases (ICD-10). The sample included 2375 unique fracture patients from the Region of Southern Denmark. Medical records were retrieved for the study population and reviewed by an algorithmic search function and medical doctors to verify the MOF diagnoses. Register-based definitions of incident/acute MOF was evaluated in NPR data by applying date criteria and procedural codes. Results: The PPV for MOF diagnoses overall was 0.99 (95% CI: 0.98;0.99) and PPV=0.99 for the four individual fracture sites, respectively. Further, analyses of incident/acute fractures applying date criteria, procedural codes and using patients' first contact in the NPR resulted in PPV=0.88 (95% CI: 0.84;0.91) for hip fractures, PPV=0.78 (95% CI: 0.74;0.83) for humerus fractures, PPV=0.78 (95% CI: 0.73;0.83) for clinical vertebral fractures and PPV=0.87 (95% CI: 0.83;0.90) for wrist fractures. Conclusion: ICD-10 coded MOF diagnoses are valid in the NPR. Furthermore, a set of register-based criteria can be applied to qualify if the MOF fracture was incident/acute. Thus, the NPR is a valuable and reliable data source for epidemiological research on osteoporotic fractures. [ABSTRACT FROM AUTHOR]

Purpose: A surge in the use of semaglutide injection (Ozempic®) approved to treat type 2 diabetes (T2D) has led to a global supply shortage. We investigated contemporary user rates and clinical characteristics of semaglutide (Ozempic®) users in Denmark, and the extent of "off-label" prescribing for weight loss. Patients and Methods: Nationwide population-based cross-sectional study based on linked health registries January 2018 through December 2023. All adults who received a first prescription of semaglutide once weekly (Ozempic®) were included. We examined quarterly rates of new users and total user prevalences, using other glucagon-like peptide-1 receptor agonists and weight loss medications as comparison. We also investigated user characteristics including T2D, glucose control, comedications, and cardiorenal disease. Results: The new user rate of semaglutide (Ozempic®) remained stable at approximately 4 per 1000 adult person-years between 2019 and 2021 and then accelerated, peaking at 10 per 1000 in the first quarter of 2023 after which it declined sharply. User prevalence increased to 91,626 users in Denmark in 2023. The proportion of semaglutide (Ozempic®) new users who had a record of T2D declined from 99% in 2018 to only 67% in 2022, increasing again to 87% in 2023. Among people with T2D who initiated semaglutide (Ozempic®) in 2023, 52% received antidiabetic polytherapy before initiation, 39% monotherapy, and 8% no antidiabetic therapy. Most T2D initiators had suboptimal glucose control, with 83% having an HbA1c ≥ 48 mmol/mol and 68% ≥ 53 mmol/mol despite use of antidiabetic medication, and 29% had established atherosclerotic cardiovascular disease or kidney disease. Conclusion: The use of semaglutide (Ozempic®) in Denmark has increased dramatically. Although not approved for weight loss without T2D, one-third of new users in 2022 did not have T2D. Conversely, most initiators with T2D had a clear medical indication for treatment intensification, and "off-label" use can only explain a minor part of the supply shortage. [ABSTRACT FROM AUTHOR]

Purpose: The investigation goal is the analysis of the relation between healthcare expenditures and other resources, and COVID-19 fatality rates among European countries to design effective health policies for crisis management. Design/methodology/approach: Research methodology is based on descriptive statistics and various parametric methods, also including a linear model of regression to analyze basic relationships of variables under study. Findings: Results show that a lower COVID-19 fatality rate is associated with higher levels of health expenditure (% GDP), of healthcare expenditure per capita, health expenditure in preventive care (% GDP), hospitals per million inhabitants, physicians, nurses, hospital beds and curative acute care beds per 1,000 inhabitants. Regression analysis shows that a 1% increase in healthcare expenditures per capita of countries, it reduces the level of COVID-19 fatality rate by 0.74%. In fact, many countries in Eastern Europe with low healthcare expenditures per capita in 2019 (e.g., Bulgaria, Romania, Hungary, Poland, Latvia, Slovakia, Lithuania, etc.), they have experienced high COVID-19 fatality rates. Instead, a lot of countries in Western Europe, with high healthcare expenditures per capita, such as Germany, Denmark, Austria, and the Netherlands, they had resilient health systems to face pandemic crisis and lower COVID-19 fatality rates. Practical implications: These findings suggest strategies of systematic and continuous investments in healthcare, medical technologies, and ICT infrastructures to support effective health policy of crisis management in countries to face future pandemic crisis and other emergencies in society. Originality/value: The explanation of critical role of high health expenditure (% GDP) and healthcare expenditure per capita to support robust health systems that bolster the resilience in nations to face health emergencies and worldwide crises. [ABSTRACT FROM AUTHOR]

Purpose: Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present. Design/methodology/approach: Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants' native language. Data were analyzed using an inductive thematic approach. Findings: Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services. Research limitations/implications: Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees. Practical implications: Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care. Originality/value: To the best of the authors' knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap. [ABSTRACT FROM AUTHOR]

The paper presents research from a Danish large-scale and collaborative initiative for systematically developing teacher education 'Teacher education as a laboratory for developing excellent teaching and education' (LULAB). Framed by this initiative, local teacher educators and student teachers are, in collaboration with teachers and students from partner-schools, experimenting with developing, analyzing, and sharing teaching approaches in teacher education. Hence, LULAB is an institutional strategic top-down initiative aimed to support the development of professional skills among student teachers and teacher educators, with supportive leadership for bottom-up changes from the microlevel projects. Inspired by design-based research, the findings are used iteratively to inform the organization of LULAB. Data are collected following a sequential mixed methods strategy, with questionnaires and multiple qualitative data. Findings from the first year of the LULAB initiative indicate a growing awareness among teacher educators about the co-developing role of student teachers being something distinctive for LULAB. Both teacher educators and student teachers emphasize their perceived professional outcomes. The student teachers refer in particular to insights from being invited into the machine room of teacher education and inspiration for their future work as teachers. However, there are also challenges involved in developing a culture of inquiry, and possibilities for support from the leadership looking forward are discussed.

Higher education (HE) institutions in Europe are ascribing greater importance to internationalisation as adding value to the entire institution, whereby the most important benefit identified is improved quality of teaching and learning. Notwithstanding, students' perceptions of the extent to which quality of education is associated with internationalisation is under-explored. This paper addresses this gap and employs a digital ethno-methodological approach, drawing on 126 h of teaching and learning observation, and 38 semi-structured interviews with Danish and international students enrolled in 8 Masters of Science (MSc) programmes in Denmark. Nuanced aspects of perceptions of quality, relevance and learning were mostly related to two instruments of internationalisation: international staff and an international student body. Results show that "diversity" is a keyword in students' discourses, whereby quality often equals internationalisation. However, there is a disconnect between discourses and actual practices of internationalisation, with implications for policies and practices in internationalised HE contexts.

Due to heat losses of preferential areas of packed-bed energy storage systems, transverse temperature variations may occur during the charging, discharging and standby processes. Furthermore, the heat losses of preferential areas of the storage tank cause a lower pressure drop in these areas resulting in an increased mass flow rate and further cooling, and thereby an enhanced transverse temperature variation, in a positive feedback loop – a phenomenon called instability. The transverse temperature variations may deteriorate the performance and thereby the economic feasibility of packed-bed energy storage systems. In this paper, numerical and experimental investigations of an air-based packed-bed rock thermal energy storage system for large-scale high temperature applications are presented. The objective of the study is to predict the instability and to analyze the effect of different standby durations and storage size on the instability of the air-based packed-bed system. Transient axisymmetric computational fluid dynamics models were developed for the standby and discharging processes of the packed-bed thermal energy storage systems. In addition, experimental investigations were carried out at a test facility located at Stiesdal Storage, Denmark, using magnetite rocks as heat storage material and air as heat transfer fluid. The results suggest that the numerical predictions are in good agreement with the test data. The instability phenomenon is found to increase with the standby duration, resulting in a maximum difference of 161 K between the maximum rock temperature and the outlet air temperature for a standby period of 10 h followed by a discharging process. Moreover, the results indicate that the maximum difference between the rock temperature and outlet temperature is 73 K and 56 K for a reduced-scale and a full-scale system (no standby period), respectively. • Experiments were conducted on an air-based packed-bed thermal energy storage system. • CFD models were developed and validated for both static and dynamic operation. • Instability in packed-bed systems is predicted during the discharging process. • Increase in instability is observed with the increase in standby duration. • Comparison of reduced-scale and full-scale packed-bed systems is presented. [ABSTRACT FROM AUTHOR]

Fishery and tourism coexist in many harbors. Active fishing vessels may attract tourists, which may also provide income to hotels and restaurants. This paper analyzes whether fisheries affect tourism by investigating the effect of the presence of active vessels on overnight stays in coastal areas of Denmark. The analysis is based on monthly panel data from 2016 to 2021 divided into postal code areas. Estimating a double logarithmic model accounting for fixed effects, it is found that when the number of fishing vessels belonging to a harbor in a postal code area increases by 1%, overnight stays in the same area increase by 0.11%, and when the number of fishing vessels landing in an area increases by 1%, overnight stays increase by 0.08%. Our results suggest that tourism is significantly positively affected by having active fishing vessels landing in local harbors. This implies that by considering the interactive effects of fisheries and tourism when designing fisheries policy, society might attain economic gains, potentially resulting in a larger fleet than what would be optimal solely from a fisheries perspective. [ABSTRACT FROM AUTHOR]

• The Taliban opium ban of 2000–2001 disrupted European heroin supplies. • Effects differed across the seven Nordic and Baltic countries in systematic ways. • Some heroin markets bounced back, although perhaps with less vibrancy. • Other markets substituted to another opioid, either more or less harmful. • Market responses to the 2000–2001 ban may be informative for the new, current ban. The 2000–2001 and the 2022–2023 Taliban opium bans were and could be two of the largest ever disruptions to a major illegal drug market. To help understand potential implications of the current ban for Europe, this paper analyzes how opioid markets in seven Baltic and Nordic countries responded to the earlier ban, using literature review, key informant interviews, and secondary data analysis. The seven nations' markets responded in diverse ways, including rebounding with the same drug (heroin in Norway), substitution to a more potent opioid (fentanyl replacing heroin in Estonia), and substitution to one with lower risk of overdose (buprenorphine replacing heroin in Finland). The responses were not instantaneous, but rather evolved, sometimes over several years. This variety suggests that it can be hard to predict how drug markets will respond to disruptions, but two extreme views can be challenged. It would be naive to imagine that drug markets will not adapt to shocks, but also unduly nihilistic to presume that they will always just bounce back with no lasting effects. Substitution to another way of meeting demand is possible, but that does not always negate fully the benefits of disrupting the original market. Nonetheless, there is historical precedent for a European country's opioid market switching to synthetic opioids when heroin supplies were disrupted. Given how much that switch has increased overdose rates in Canada and the United States, that is a serious concern for Europe at present. A period of reduced opioid supply may be a particularly propitious time to expand treatment services (as Norway did in the early 2000s). [ABSTRACT FROM AUTHOR]

Following the Paris Agreement's climate targets and the modelling community's scenarios of how to reach them, carbon dioxide removal is gaining increasing importance in national climate policies. This is also the case in Denmark – considered by itself and others a climate frontrunner – where biochar is envisioned to cover 10% of the 2030 reduction goal. However, apart from research experiments and test sites, biochar is at the time of research not employed in Denmark, raising the question how it came to constitute a large part of the national goal. This paper explores how biochar, as a method for carbon removal, comes into being as a relevant solution in Danish climate policy, and what this means for emission reduction efforts. Through document analysis, participatory observation, field visits and semi-structured interviews, I employ the framework of the dramaturgical regime and analyse how biochar is enacted as a climate solution through policy documents, conferences, media and network meetings. Here the concept of enactment indicates that different people's actions are not overtly coordinated, and the effects of such actions are not necessarily fully intentional, but they are nevertheless political. I argue that through different scientific, administrative, political, and media practices, biochar is enacted as a viable climate solution that enables the continuation of current forms of production and consumption. As biochar likely substitutes for emission reductions and is in risk of failing to deliver the anticipated amount of carbon removals, the enactment of biochar as a climate solution in Danish climate policy possibly constitutes a case of mitigation deterrence. • Biochar is enacted as a relevant solution in Danish climate policy. • This occurs in policy documents, conferences, media and network meetings. • Enactments enable a continuation of current forms of production and consumption. • Including biochar in Danish climate policy is possibly a case of mitigation deterrence. • Enactments can show how mitigation deterrence can come about as an emergent effect. [ABSTRACT FROM AUTHOR]

Previous research identifies stark socioeconomic disparities in child injuries, yet research on the repercussions hereof on other aspects of children's lives remains sparse. This paper tests whether social gradients in minor traumatic brain injuries (mTBIs or concussions) contribute to corresponding inequalities in children's academic performance. Previous research on this topic is mostly based on small samples and confounded by non-random selection into experiencing mTBIs. We improve on prior research by using high quality, large N, administrative registry data. Further, we control for selection into having an mTBI via comparing the test score progression of children having an mTBI with children who experience an mTBI in later years (staggered difference-in-differences). Based on Danish ER/hospital records and national test score data, we find that children from families with lower earnings and less education are more likely to experience an mTBI and that having an mTBI negatively correlates with reading test scores. However, comparing present with future mTBI cases, we show that having an mTBI within a year before a test does not negatively affect children's reading scores. Our findings suggest that negative correlations between mTBIs and academic performance more likely reflect socioeconomic gradients in mTBI incidents rather than a direct causal effect. Further, socioeconomic gradients in mTBI incidents do not significantly contribute to corresponding disparities in academic performance. • Child concussion rates are higher among families with lower earnings and education. • Concussion incidence and reading test scores are negatively correlated. • Difference-in-differences model controls for selection and identifies a causal effect. • The negative correlation is driven by selection and does not reflect a causal effect. • Social gradients in concussions do not lead to inequality in academic performance. [ABSTRACT FROM AUTHOR]

Background: Opioid agonist treatment (OAT) for patients with opioid use disorder (OUD) has a convincing evidence base, although variable retention rates suggest that it may not be beneficial for all. One of the options to include more patients is the introduction of heroin-assisted treatment (HAT), which involves the prescribing of pharmaceutical heroin in a clinical supervised setting. Clinical trials suggest that HAT positively affects illicit drug use, criminal behavior, quality of life, and health. The results are less clear for longer-term outcomes such as mortality, level of function and social integration. This protocol describes a longitudinal evaluation of the introduction of HAT into the OAT services in Norway over a 5-year period. The main aim of the project is to study the individual, organizational and societal effects of implementing HAT in the specialized healthcare services for OUD. Methods: The project adopts a multidisciplinary approach, where the primary cohort for analysis will consist of approximately 250 patients in Norway, observed during the period of 2022–2026. Cohorts for comparative analysis will include all HAT-patients in Denmark from 2010 to 2022 (N = 500) and all Norwegian patients in conventional OAT (N = 8300). Data comes from individual in-depth and semi-structured interviews, self-report questionnaires, clinical records, and national registries, collected at several time points throughout patients' courses of treatment. Qualitative analyses will use a flexible inductive thematic approach. Quantitative analyses will employ a wide array of methods including bi-variate parametric and non-parametric tests, and various forms of multivariate modeling. Discussion: The project's primary strength lies in its comprehensive and longitudinal approach. It has the potential to reveal new insights on whether pharmaceutical heroin should be an integral part of integrated conventional OAT services to individually tailor treatments for patients with OUD. This could affect considerations about drug treatment even beyond HAT-specific topics, where an expanded understanding of why some do not succeed with conventional OAT will strengthen the knowledge base for drug treatment in general. Results will be disseminated to the scientific community, clinicians, and policy makers. Trial registration: The study was approved by the Norwegian Regional Committee for Medical and Health Research Ethics (REK), ref.nr.:195733. [ABSTRACT FROM AUTHOR]