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Research has demonstrated the economic effectiveness of welfare state reforms that follow the Danish flexicurity model, broadly specifying the combination of highly flexible labor market policies and generous protection schemes. Notwithstanding, it has also been argued that large and generous welfare states may erode civic attitudes, defined here as people's willingness to cheat on taxes and claim transfers to which they are not entitled. Combining data from all available waves of the World Values Survey and the European Values Study with a self-constructed flexicurity index, this paper finds that welfare state reforms involving a combination of higher benefits, lower labor market regulations, and active labor market policies are not significantly associated with an erosion of civic attitudes. [ABSTRACT FROM AUTHOR]

Old‐age state pension is central to European welfare states. Despite the growing number of migrants in Europe, little is known about their attitudes towards state pension. Pension systems are designed for a ‘sedentary’ population, as they require many years of contribution or residency in the country. This often affects first‐generation migrants, who arrive in the residence country only at a later point in their lives. In this paper, we draw on self‐interest theory, which is commonly used to explain individuals' support towards welfare institutions and theorize on how the migration experience adds to the standard model of self‐interest in relation to support for government spending on old‐age state pensions. Hence, we move beyond traditional indicators of self‐interest such as education and employment status and we test hypotheses on how migrant‐specific characteristics like length of stay and settlement intention in the residence country are related to migrants' support for government spending on old‐age state pensions. We use data from the Migrants' Welfare State Attitudes (MIFARE) survey (2016), the first cross‐national survey that focuses on migrants' attitudes towards the welfare state that was collected in Denmark, Germany, and the Netherlands among nine different migrant groups from within and outside the EU. We find that migrants living in the country for over 5 years and those with longer settlement intentions have a higher support for government spending on pensions. We conclude that it is crucial to take migrants' unique migration experiences into account when assessing their attitudes towards state pension. [ABSTRACT FROM AUTHOR]

Introduction: In the worldwide COVID-19 pandemic, healthcare workers (HCWs) caring for people with intellectual disabilities (ID) face a unique risk above the already heightened occupational risk all HCWs are exposed to, but literature on this specific group is lacking. Understanding why individuals are hesitant to be vaccinated for COVID-19 is essential in order to provide the right measures in improving vaccination numbers. This article reviews the influencing factors of COVID-19 vaccine willingness and hesitancy in HCWs who work with people with ID. Methods: CINAHL, APA PsycArticles, APA PsycInfo, Web of Science, Semantic Scolar, Prospero, Outbreak Science, Cochrane and Scopus were searched for papers including the attitudes on COVID-vaccination of HCWs in the field of ID-care. Only two papers were found on HCWs working with people with ID, therefore the search was broadened to HCWs in general. Twenty-six papers were identified containing quantitative and qualitative data on 43,199 HCWs spread over 16 countries worldwide. Socio-demographical predictors of vaccine willingness were extracted and analysed, as well as attitudes of vaccine willingness and hesitancy. Results: Medical doctors, people of older age, men, and those previously vaccinated with the influenza vaccine were most willing to take the COVID-vaccine. Health factors and ethics were drivers of vaccine willingness; characterised by perceived COVID-threat and wanting to protect family members and others. Distrust and lack of information were the most common drivers of vaccine hesitancy; characterised by concerns on side effects, vaccine safety, vaccine efficacy, and speed of vaccine development. Limiting to the two papers investigating HCWs in the care of people with ID, some similarities were found: (1) only older age was a predictor for vaccine willingness and (2) concerns about possible side effects and the fast development of the vaccine were the main drivers for vaccine hesitancy. Additionally, vaccine willingness and hesitancy in HCWs are not stable over time and are affected by information sources and contextual factors. Conclusions: To achieve the highest COVID-vaccination degree worldwide amongst HCWs, recommendations are made for interventions on distrust-topics to nursing staff, people of younger age, women, and those not previously vaccinated within the HCW-population. Implications: Additional research is needed to specify more precisely the attitudes of HCWs caring for people with ID in general and in more countries worldwide. [ABSTRACT FROM AUTHOR]

This paper explores the social relations between inpatients in psychiatric wards. Combining Barker's (2002) concept of 'collective illness identity' with Nelson's (1993) concept of 'epistemological communities', I draw attention to the inpatients' collective identification and experiential knowledge. Through the analysis, three aspects of the inpatients' relationships are unfolded. First, how the inpatients, through bodily expressions and narrative accounts, construct a collective illness identity based on shared experiences of symptoms and suffering. Second, the ways in which the inpatients use their shared experiential knowledge to support one another and challenge the mental health professionals. Third, how the inpatients' reflections on the long‐term potential of their relationships reveal a number of concerns related to their continuation. Centrally, the paper points to the potential and challenges that arise from the inpatients' relations to one another and their embeddedness in a specific time and space. Empirically, the paper draws on five months of participant observation conducted in two psychiatric wards in Denmark and interviews with 14 psychiatric patients. [ABSTRACT FROM AUTHOR]

Access to learning facilities is essential for young people with intellectual disabilities (ID) in their transition to adulthood. Participation in education can enhance social participation and belonging and contribute to the formation and negotiation of identities and competencies. This paper examines how special needs youth education contributes to bringing young people with ID into a position as learning social participants and how their identities are formed and negotiated through belonging to the school's community of practice. The study was informed by a social theory of learning and designed as a single case study carried out at a specially planned youth education school (SPYES) in Denmark. The study shows how social participation and forming identity can be developed through a trustful and recognising teacher-student relationship, an inclusive classroom setting where individual considerations are taken, shared practice regarding leisure activities with peers, and access to an individually adapted internship at workplaces outside the school. [ABSTRACT FROM AUTHOR]

Medicalisation of hospice care has been discussed simultaneously with the development of palliative care into a medical speciality. However empirical knowledge of the role of medicalisation in hospice practice is underexplored. This paper considers hospice managers' perspectives on hospice care in the complex between values related to hospice philosophy and a specialised medical approach to hospice care. Focus groups and small group interviews were conducted with hospice managers from 16 out of the 19 Danish hospices. Drawing on hope as a theoretical framework, the study contributes to further understanding of the complexity of navigating hospice care in the impasse between an existential hope focused on meaning at the end of life and a medical hope for control of the dying body. Hospice care appeared as pulled between these dimensions of hope. The hospice managers took a pragmatic approach to medicalisation but their emphasis on dying as an existential event also points to a role for hospices as a critical voice against over-medicalisation of dying. [ABSTRACT FROM AUTHOR]

Background: This paper is embedded in a randomised controlled trial (Alcohol and Employment) that investigated whether welfare-to-work schemes combined with alcohol treatment were more effective than welfare-to-work schemes alone for helping unemployed welfare recipients with alcohol problems get back to employment and reduce their alcohol problems. The implementation of Alcohol and Employment turned out to be challenging, and fewer welfare recipients than expected were enrolled. The aim of this paper was to identify and investigate obstacles to the implementation of Alcohol and Employment. Our main objective was to study the job consultants' role in the implementation process as they were key personnel in conducting the trial. Methods: The process evaluation was conducted in four Danish municipalities in 2011-2012. Data for identifying factors important for the implementation were collected through observations and focus group interviews with job consultants. Data were analysed thematically and thoroughly discussed among members of the project team; emerging themes were then grouped and read again repeatedly until the themes were consistent. Results: Three themes emerged as the main factors influencing the degree of implementation of Alcohol and Employment: (1) The job consultants' personal attitudes toward alcohol were an important factor. The job consultants generally did not consider a high alcohol intake to be an impediment to employment, or they thought that alcohol problems were only symptoms of more profound problems. (2) The job consultants' perception of their own roles and responsibilities in relation to the welfare recipients was a barrier: they felt that addressing alcohol problems and at the same time sustaining trust with the welfare recipient was difficult. Also, they did not consider alcohol problems to be their responsibility. (3) Shortage of time and resources among the job consultants was determined to be an influential factor. Conclusions: We identified important factors at the individual level among the job consultants who threatened the implementation of Alcohol and Employment. Future studies in similar settings can take advantage of these findings when preparing interventions that are implemented by job consultants or similar professionals. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Electroconvulsive therapy (ECT) has existed worldwide for nearly 80 years. ECT is a fast‐working and potentially life‐saving treatment, but it is considered controversial. Although frequently mentioned, stigmatization in relation to ECT has not been systematically explored so far. What this paper adds to existing knowledge?: This paper provides new insight into both recipient and expert perspectives on ECT. It identifies several issues of stigmatization related to ECT and suggests that full recovery following ECT might be jeopardized due to both stigmatization and self‐stigmatization. The study suggests that most of the stigmatizing behaviors can be ascribed to (a lack of) available knowledge of and experience with ECT. What are the implications for practice?: Being aware of and listening to the needs of former ECT‐recipients seems essential to increase their treatment options and support care as well as a will to prioritize this patient group. For example, by addressing the potential stigma issues in follow‐up groups and helping to distribute sober, factual information about ECT in society. Providing written information and psychoeducation for patients and relatives before, during, and after ECT, in addition to supporting active use of diaries, might be valuable remedies for helping patients feel adequately informed and able to accept the pros and cons of ECT during and after treatment period. Abstract: Introduction: Electroconvulsive therapy (ECT) has existed worldwide for nearly 80 years. Although fast‐working and potentially life‐saving treatment, ECT is regarded as a strongly controversial treatment and stigmatization is frequently mentioned in relation to it. However, no systematic research in this area has taken place so far. Aim: The aim of this qualitative study was to explore the experiences and attitudes of former recipients of ECT and of experts professionally involved with ECT to identify potential stigmatization. Method: Two focus groups, one comprising four recipients of ECT and the other seven professional experts, were conducted. Data from each focus group were analyzed separately using a framework‐analysis. Results: The analysis yielded three major themes for the first focus group interview: ambivalent attitudes, discrediting and exclusion, and survival strategies and three major themes for the second focus group interview: dramatic depictions of ECT, an overlooked and rare treatment, and anti‐stigmatization strategies. Discussion and implications for practice: Stigmatizing attitudes and behaviors in relation to ECT are closely related to one's personal and factual knowledge, and there is a great need for multi‐facetted approaches if social acceptance and recognition are to be achieved. This study provides new knowledge on a scarcely examined area while also introducing suitable methods for anti‐stigmatization and empowerment. [ABSTRACT FROM AUTHOR]

This paper explores the intersection of gender and class concerning welfare clients with medically unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists of individuals that are defined by their lack of a bio-medical diagnosis. Their 'lack' of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women are described by the welfare officers as tired and exhausted or truly stressed after a long working life. [ABSTRACT FROM AUTHOR]

Diagnosis constitutes a major categorisation tool in medicine. This paper adds to the paucity of knowledge about part of the work such a tool performs. It examines the ways in which diabetes epidemiology translates into attempts to prevent diabetes from occurring through screening and diagnosing, and then managing those categorised as ‘at high risk’. Using a qualitative design in the context of a small-scale Danish intervention study, the findings suggest that health professionals overinterpreted relative risk reductions and exaggerated treatment effects; simultaneously, prediabetics called into question the scientifically set thresholds. Nonetheless, arguments concerning changed behaviour’s benefits were sought to be incorporated into self-care routines. The data highlight how, by identifying a normatively set threshold, a diagnosis can determine health promotion messages’ impact in ‘high-risk’ prevention strategies. [ABSTRACT FROM PUBLISHER]

Accessible Summary: What is known on this subject?: There is a need to shed light on healthcare professionals' reactions to the use of the Guided Self‐Determination method in a mental health hospital to better understand and adjust the implementation process of evidence‐based practice.Healthcare professionals´ values and beliefs play an important role when implementing evidence‐based practice in real‐world healthcare settings. What this paper adds to existing knowledge?: The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence‐based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention.In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self‐Determination method in a mental health context. What are the implications for practice?: When preparing implementation of an evidence‐based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals' acceptability, support from management and participation in supervision.In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence‐based intervention, however not using it in clinical practice, to understand barriers towards evidence‐based practice. Introduction: Evidence‐based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals' reactions to the use of evidence‐based interventions to better understand and adjust the implementation process. Aim: To explore mental healthcare professionals´ reactions to using the evidence‐based intervention Guided Self‐Determination method in the care of inpatients with severe mental illness. Method: A qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention. Results: Four themes emerged from a thematic analysis: "The expert becomes novice," "Theory used as a looking glass," "Guided Self‐Determination perceived as an interruption" and "Becoming an informer of the impact of GSD." Discussion: Using the themes may help leaders or researchers predict or discover the support needed by individual professionals. Implications for practice: When preparing implementation of an evidence‐based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence‐based practise. [ABSTRACT FROM AUTHOR]

Background: Vocational rehabilitation programs (VRP) developing and improving work ability are used in Denmark to assist long-term unemployed citizens with complex problems. The aims of this study were to (1) describe VRP-participants in relation to general health, well-being, work ability and self-efficacy at baseline and one-year follow-up, (2) obtain an understanding of VRP-participants' personal development towards improving work ability, and (3) explore VRP-participants' hopes and thoughts about their future.Methods: In a mixed methods approach, data from a longitudinal survey and semi-structured interviews were collected. In the quantitative longitudinal survey, all participants completed paper questionnaires at baseline and one-year follow-up. For the qualitative semi-structured interviews, VRP participants were recruited with a maximum variation sampling strategy through VRP coordinators and personal contact. Data were analysed by descriptive statistics and systematic text condensation. Following analysis, data were merged and presented in combination according to identified themes.Results: At baseline and one-year follow-up 146 (response rate 34%) and 74 participants (response rate 52%) respectively, responded to the questionnaire. Seven participants were interviewed. The analysis revealed four themes: 1) Individual explanations of life situation and health; 2) Finding the path; 3) Work as giving meaning to life; 4) Hope for the future. Despite self-reported scores indicating poor general health, lack of well-being, low work ability and low self-efficacy, VRP-activities seemed to have assisted participants in finding meaning in life. VRP-components that may be drivers of successful recovery processes were identified.Conclusions: VRP-participants experienced life situations that include multifactorial burdens, and low levels of general health, well-being, work ability, and self-efficacy at baseline and 1 year later. From the outset, most did not have a clear goal of employment, but over time, new goals were set as realistic opportunities for re-developing their work ability were explored. Successful core components of VRP were individually tailored programs and support, development of new relationships, and accommodated flexible internships and jobs.Trial Registration: ClinicalTrials.gov Identifier: NCT02641704 , date of registration December 29, 2015. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The Recovery Record smartphone app is a self‐monitoring tool for individuals recovering from eating disorders. Oppositely to traditional pen‐and‐paper meal diaries, the app allows for in‐app patient–clinician linkage enabling clinicians to access patient app data anytime. The aim of our study was to explore the interdisciplinary clinical perspective on Recovery Record and its impact on treatment. Method: Thirty‐one clinicians from a Danish eating disorder treatment facility participated in field studies and 23 of these in interviews. Data were generated and analyzed concurrently applying the inductive methodology of Interpretive Description. Results: We found two overarching themes: “Access to app data between treatment sessions”, and “The patient–clinician relationship”. Sub‐themes associated with the former were “Online obligations” in relation to the added workload of continuously monitoring patient app data, and “Prepared or prejudiced” relating to advantages and disadvantages of using patient app data as preparation for treatment sessions. Sub‐themes pertaining to the latter were “Expectation discrepancy” in relation to patients' and clinicians' divergent expectations for app usage, and “Pacified patients” regarding the clinicians' experience that the app potentially compromised the patient initiative in treatment sessions. Discussion: Recovery Record induced new and affected pre‐existing treatment and work conditions for clinicians. Clinicians were preoccupied with challenges associated with the app, for example, an added work load and potential harm to the patient–clinician collaboration. Thus, prior to adopting the app, we encourage clinicians and managements to discuss the objectives, advantages and disadvantages of adopting the app, and outline specific guidelines for patient and clinician app usage. [ABSTRACT FROM AUTHOR]

Hunters in the Western world today do not need to hunt to obtain food and other animal products. So why do they hunt? This paper examines the motives of hunters, the motives ascribed to hunters by members of the general public, and the role motives play for the moral acceptability of hunting among members of the general public. It draws on a nationally representative survey of the general public (n = 1,001) and hunters (n = 1,130) in Denmark. People with a negative attitude to hunting are more likely to take motives into account when they consider the acceptability of hunting. Three clusters of motives defining distinctive hunting motivational orientations were identified:action/harvest, management/care,andnatural and social encounters. The general public ascribedaction/harvestmotives to hunters more than hunters did. In a policy perspective, if hunters’ motives are misperceived, improved dialog may be needed to protect the legitimacy of recreational hunting. [ABSTRACT FROM PUBLISHER]

Purpose - The purpose of this paper is to present a study that compares ownership and usage of new media among young "tween" consumers in Denmark and Hong Kong. Further, it shows the ways of finding new interesting web sites. Design/methodology/approach - In 2004-2005 a survey was conducted in Denmark and Hong Kong of 434 fourth, fifth and sixth class students. Questionnaires were distributed in six elementary schools. Hypotheses about new media ownership and usage in the two societies are formulated based on the economic development and individualistic/collective cultural dimensions of the societies. Findings - Household ownership of new media, ownership of mobile phone and heavy use of the internet were found to be more prevalent among Danish tweens than among Hong Kong tweens. Danish tweens were more likely to use mobile phones and the internet for interpersonal communication and for enjoyment than Hong Kong tweens. Hong Kong tweens used the internet more for educational purposes than Danish tweens. The results seem to support that adoption and consumption of new media are motivated differently in cultures of individualism and collectivism, and consequently that the tween consumer segment is not as globally homogeneous as it is claimed to be. Research limitations/implications - The study was based on a convenience sample, thus it may be problematic to generalize from the findings. Practical implications - The study can serve as a guideline for marketing communication targeting tweens. The emphasis on the hedonic use and social function of new media may be suitable for a highly developed, individualistic society. In collective societies, marketers may need to put emphasis on the instrumental values of new media, such as improving academic performance. Originality/value - This paper offers insights into designing communication strategies for Danish and Hong Kong tweens, particularly when incorporating new media. Findings are compared with existing preconceptions of the tween segment in the marketing literature. [ABSTRACT FROM AUTHOR]

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

Background: Failing to comprehend risk communication might contribute to poor treatment adherence. Using hypertension as a case, we investigated how a risk communication tool for patients with an elevated risk of cardiovascular disease was perceived. Methods: As part of a large project featuring a randomised controlled trial in a general practice setting in the Region of Southern Denmark, we conducted a semi-structured individual interview study. The study included patients with hypertension who had used an intervention comprising a visual and dynamic cardiovascular risk communication tool, along with receiving recurring emails providing advice on a healthy lifestyle. The analyses were based on Malterud's Systematic Text Condensation. Results: This article focuses solely on the results of the interview study, which comprised a total of 9 conducted and analysed interviews. The IT setup had a major impact on adherence to the intervention. A positive impact was found when the IT setup was perceived as easy to use and accessible, while a negative impact was noted when it malfunctioned. The intervention increased patients' self-reported insight into risk of cardiovascular disease. Patients reported the intervention and their risk of cardiovascular disease to become less important to them when they had more severe comorbidities. The involved health professional was very important for treatment adherence when communicating risk visually. Patients expressed trust in their general practitioners, and the general practitioners' attitudes toward the intervention affected patients' perceptions of its usefulness. While the informants reported an increased awareness of their risk of cardiovascular disease, none of them felt more concerned. Conclusions: Patients reported an increase in their perceived insight into the risk of cardiovascular disease but not an increased concern. Our findings align with previous studies emphasizing the importance of patients' motivation as well as risk perception for adherence. General practitioners have an important role when implementing new tools for patients. [ABSTRACT FROM AUTHOR]

Career research has focused on the changing structures of careers, mainly in the private sector. Recent literature on employment patterns in the public sector suggests that career structures are evolving, gradually moving away from their signature traditional structures to contemporary ones. However, empirical evidence of this change is scarce and inconclusive. This qualitative study examines the changes currently unfolding in the career structure of the civil service by eliciting the experiences and views of senior Foreign Offices (FOs) staff in four countries: 198 state ambassadors from the United States, the United Kingdom, Israel, and Denmark were interviewed about their career trajectories. The data were analyzed using a thematic analysis framework. The findings revealed a gradual breakdown of the structures and policies that support traditional careers, and the emergence of new principles and practices that characterize contemporary careers. However, as they were captured midway through the process of change, all FOs display a combination of traditional and contemporary career structures at this point. The findings offer unique insights into the drivers of this evolution and highlight some of the consequences. [ABSTRACT FROM AUTHOR]

Background: During the 90 s and especially in the beginning of the 00 s research in youth, drug and alcohol consumption increased markedly in Denmark. Much of this research was applied and placed in a dilemma between reproducing existing social problem characterizations of youthful behaviors or providing genuine contribution to the sociological analysis and understanding of youth cultures. From the mid-00 s and forward however, a range of analytical tools were developed at Centre for Alcohol and Drug Research (CRF) in order to understand the relationship between youth, drug and alcohol use and to move beyond the applied perspective into a more social science analytical approach. Aim: The article investigates the relationship developments between drug and alcohol research and youth research in Denmark in general, with a special focus on research conducted at CRF. Specifically, we will focus on how analytical concepts like, e.g., cultural capital, identity, risk, recreational use, problematic use, and social integration have been developed in a Danish context, and how these concepts are informed by existing international research. Conclusion: Besides recounting the story of Danish research on youth, drug and alcohol from the perspective of CRF, this paper will conclude by providing a series of tentative conclusions on how research on youth cultures and drug and alcohol consumption can develop in the future. [ABSTRACT FROM AUTHOR]

In recent years obesity has emerged as a potential public health crisis. This article examines how being overweight is framed as a social problem in two public Danish organizations. Using recorded interactions between health consultants and overweight people, this article explores how overweight people develop a sense of self in weight loss programmes. This article uses an interactionist approach in exploring the dual nature of identities involving both the self and social structure. Drawing on sociological literature concerning the relationship between the body, health, risk and society, this paper shows how overweight people in western society are currently perceived as being morally inferior. This societal context frames the participating organizations that offer weight loss programmes to overweight people, and hence results in organizational identities that equate being overweight with having psychological problems. The analysis in this article shows the importance of situating identity processes in the organizational framework in which they occur and situating organizations in a broader societal framework that casts some people as morally inferior and others as 'normal'. [ABSTRACT FROM AUTHOR]

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This paper approaches institutionalized dementia care as a site of societal disposal, valuation, and care for human life. Drawing upon six weeks of ethnographic fieldwork and ten qualitative interviews carried out in a Danish dementia nursing home in 2014, we analyze how nursing home staff, through everyday care, uphold the value of life for residents in severe mental and physical decline. We argue that life's worth is established when residents gain qualities of personhood and agency through substitution processes carried out by staff. Yet the persistent absence of conventional personhood and autonomous agency in residents (i.e. capacities for memory, consciousness, language, and mobility) evokes experiences of ambiguity in staff and relatives of residents. We close the article with a discussion of this ambiguity and the significance of the nursing home as care institution in the welfare state. Dementia care, we propose, is not only about preserving the lives of people with dementia. At stake in the daily care practices around severely disabled residents in the nursing home is the very continuance of the main principles of the welfare society. [ABSTRACT FROM AUTHOR]

Simple Summary: Owners of dogs, cats, and other companion animals increasingly make use of the internet to find out how to best care for their animals. This may affect owners' relations with veterinarians in both positive and negative ways. A positive consequence could be that owners are better informed when they approach a veterinarian. However, there can also be challenging situations in which the owners may question veterinarians' professional advice based on online information. Using a questionnaire, we found that a majority of Austrian, Danish, and UK veterinarians (n = 641) surveyed were occasionally confronted with clients who question their medical advice based on information obtained from the internet. In addition, the veterinarians were concerned about the potential for clients to misunderstand information found on the internet, or to develop unrealistic expectations of what is possible in small animal practices. As internet use becomes ever more widespread, we suggest that the types of resources that are available and used by animal owners should be further explored. Veterinary medicine is increasingly affected by animal owners having the opportunity to become better informed on pet health issues by using various internet resources. Using an online questionnaire including a section on clients' use of internet resources to obtain medical information, this study aimed to investigate veterinarians' estimates of the percentage of clients using internet resources, how often clients question veterinarians' professional medical advice based on online information, and veterinarians' attitudes towards clients' use of internet resources, across Austrian, Danish, and UK veterinarians (n = 641). The results show that 48.8% of respondents estimated that 40–79% of their clients use internet resources to find medical information. Further, 70–80% of respondents stated that they are occasionally challenged by clients questioning their advice based on online information. Although veterinarians recognized the potential advantages related to clients' use of internet resources, such as an increased acceptance of advanced diagnostics and treatments, they also highlighted clients' increased expectations or false impressions of small animal practices as potentially negative aspects in this context. As internet use increases, it seems likely that these issues will become increasingly important in the future. [ABSTRACT FROM AUTHOR]

Developing acceptable medicines for children is a complicated task. Several factors must be considered, including age, physiology, texture preference, formulation, and legal framework among others. In the development of new paediatric medicines, these factors are assessed. However, for older medicines, e.g., prednisolone, acceptability is still a challenge. This study was an open-label randomised three-arm cross-over study investigating different formulations of prednisolone (crushed tablets, whole tablets, and oral solution) in paediatric patients with asthma and asthma-like symptoms. Participants were randomised into two different formulations on two consecutive days. For each formulation, the child or caregiver was asked to evaluate acceptability using a modified five-point Wong Baker Face scale. An analysis of variance (ANOVA) model was used to test for significance. For the 41 children, included mean age was 4.7 years (SD ± 3.6), and mean weight was 21 kg (SD ± 10.8). Sixty-one percent were boys. The participants were divided accordingly into three age groups: 6 to 23 months (N = 11), 2 to 5 years (N = 14), and 6–11 years (N = 16). The overall acceptability was low, with only 23 out of 71 scores rating the treatment either 1 or 2 (32%). The ANOVA test showed a significant difference in acceptability score between crushed tablets and whole tablets (p < 0.003). The mean acceptability score for the crushed tablet was the least favourable at 3.9 compared to oral solution (3.1), oro-dispersible tablet (2.8), and whole tablets (2.4). This is problematic in long-term treatment and for the youngest children who cannot swallow tablets. The improvement of age-appropriate and acceptable formulations is necessary. [ABSTRACT FROM AUTHOR]

Many measures have been taken to counter recidivism into gang criminality, amongst other the efforts to prevent arrested gang members to return to their gangs after imprisonment. Whereas the conditions for successful intervention may be hard to unravel, this article will claim that some efforts may be destined to failure by default, because they do not adequately address issues of social identity as a central part of the problem, e.g. replacing one identity with another when leaving one community to establish a meaningful life in another. This article presents some views on social identity from the standpoint of pragmatism and demonstrates how their application on recidivism into gang-related crime reveals problematic issues for social work. To that end, this article takes departure in outlaw-biker communities as illustrative example and make use of two interviews with former presidents of a well-known club. [ABSTRACT FROM AUTHOR]

Background: As advancements in intensive care treatment have resulted in decreased mortality rates, more attention has been given to the experience of life after critical illness. Despite an increase in literature describing the physical, psychological, and cognitive health problems arising after critical illness, there is a shortage of research exploring the lifeworld of patients and relatives, including its internal and external interplay in everyday life. Addressing this is essential for gaining insights into the experience of everyday life and recovery after critical illness. Aims and objectives: To explore patients' and relatives' experiences of everyday life after critical illness. Design: Data were collected using semi‐structured interviews with 7 relatives and 12 patients. Interviews were audiotaped and transcribed verbatim. Methods: Drawing on the phenomenological‐hermeneutic tradition, data were analysed using Ricoeur's theory of interpretation, as described by Dreyer and Pedersen. Findings: The lifeworld of everyday life was disclosed in the theme "Finding oneself after critical illness," described as an overall comprehensive understanding. This theme was divided into the subthemes (a) redefining the self, (b) reintegrating with family, and (c) resuming everyday life, which followed the trajectory of the three phases: the known past, the uncertain present, and the unknown future. Conclusion: Critical illness and physical, psychological, and cognitive health problems create new and emerging difficulties in patients' and relatives' experiences of everyday life after intensive care. These experiences affect their understanding of themselves, their families, and their ability to resume pre‐intensive care unit everyday life. Implications for practice: The study underlines the need to supplement the affirmed domains in post‐intensive care syndrome with a social domain to enhance family‐centred care within the intensive care unit and across sectoral borders. Additionally, it highlights the need to develop rehabilitation strategies aimed at patients' and relatives' multifactorial health problems. [ABSTRACT FROM AUTHOR]

Most previous studies about fertility knowledge and attitudes among men have been based on quantitative methods using questionnaires with fixed-choice response options. The aims of this qualitative study were to explore childless young men's reflections on fertility and infertility through semi-structured interviews. Danish (n = 17) and Swedish (n = 12) young childless men aged between 20 and 30 years in their last year of education were interviewed. Data were analysed using qualitative content analysis. Few informants had considered their own fertility, and most were positive towards fertility treatment. The young men had inadequate knowledge about factors that can potentially impair male and female fertility. On average, the young men each mentioned three different factors they believed influence male and female fertility: (i) health behaviour; (ii) factors beyond personal control; and (iii) age. None mentioned sexual transmitted infections (STIs) but most appeared aware of the effect of increasing age on fertility. The results of this study highlight the need for educational strategies to improve young men's knowledge about fertility and the factors that influence it, particularly about the potential adverse effect of STIs on fertility. [ABSTRACT FROM AUTHOR]

As global warming increases the temperature of the planet, so does the likelihood that European countries will be faced with climate migrants. Since climate migrants cannot apply for asylum, they would need public and political support to gain residency in the countries to which they migrate. In this article, I show how likely Danes are to grant residency to climate migrants compared to other types of migrants and explore what individual‐level factors explain variations in this. I answer the two questions by combining the results of a conjoint survey experiment with an election survey. The results show that climate migrants are perceived to be less deserving of permanent residency than migrants who typically could qualify for asylum, but more likely to be deemed deserving than those who could broadly be called economic migrants. The results also show that three factors explain variations in this – attitudes to climate change, attitudes to migration and ideology. [ABSTRACT FROM AUTHOR]

The growing rates of childhood obesity constitute a public health challenge worldwide. Therefore it is important to identify effective and widely applicable interventions to prevent it. This study aims to explore children's experience of using a newly developed smartphone application (app) designed to promote healthy eating and evaluate its efficacy on encouraging healthy eating. First, two focus groups were conducted to explore children's experience of using the app. Then, a quasi-experimental design was used to evaluate the app's efficacy. The children were asked to use the app for three months. Afterwards, the effect of the intervention was evaluated. 118 children aged 9 to 13 years (M=10.9, Sd=1.1) participated in the study. The children's experience of using the app was relatively positive, and they found the app easy to use. A significant increase in fruit (η2=.10) and vegetable preferences (η2=.37) and fruit intake (η2=.06) was found in the experimental group. No effects were found for vegetable intake, selfefficacy for healthy eating, or peer norms for healthy and unhealthy eating (p>0.05). The smartphone app-based intervention could potentially serve as an attractive and low-cost intervention to reach a wide population of children for the promotion of healthy eating and prevention of childhood obesity. [ABSTRACT FROM AUTHOR]

Purpose: Life expectancy is 15–20 years shorter for individuals with than for people without mental illness. Assuming that undiagnosed and undertreated somatic conditions are significant causes, the Central Denmark Region set out to implement joint psychiatric and somatic emergency departments (EDs) to support integrated psychiatric/somatic care as an effort to prolong the lifetime of individuals with mental illness. Through the lens of Normalization Process Theory, the authors examine healthcare frontline staff's perceptions of and work with the implementation of integrated psychiatric/somatic care in the first joint-specialty ED in Denmark. Design/methodology/approach: A single-case mixed-methods study using Normalization Process Theory (NPT) as an analytic framework to evaluate implementation of psychiatric/somatic integrated care (IC) in a joint-specialty emergency department. Data were generated from observations, qualitative interviews and questionnaires distributed to the frontline staff. Findings: Implementation was characterized by a diffuse normalization leading to an adaption of the IC in a fuzzy alignment with existing practice. Especially, confusion among the staff regarding how somatic examination in the ED would ensure prolonged lifetime for people with mental illness was a barrier to sense-making and development of coherence among the staff. The staff questioned the accuracy of IC in the ED even though they recognized the need for better somatic care for individuals with mental illness. Practical implications: This study highlights that a focus on outcomes (prolonging lifetime for people with mental illness and reducing stigmatization) can be counterproductive. Replacing the outcome focus with an output focus, in terms of how to develop and implement psychiatric/somatic IC with the patient perspective at the center, would probably be more productive. Originality/value: In 2020, the Danish Health Authorities published new whole-system recommendations for emergency medicine (EM) highlighting the need for intensifying integrated intra and interorganizational care including psychiatric/somatic IC (ref). Even though this study is not conclusive, it points to subjects that can help to identify resources needed to implement psychiatric/somatic IC and to pitfalls. The authors argue that the outcome focus, prolonging the lifetime for individuals with mental illness by identifying somatic illness, was counterproductive. In accordance with the recommendations of contemporary implementation studies, the authors recommend a shift in focus from outcome to output focus; how to develop and implement psychiatric/somatic IC. [ABSTRACT FROM AUTHOR]

Background: Cancer treatment is often given on an outpatient basis. An oncological emergency telephone line has been established to improve access to cancer care and prevent life-threatening side effects. However, healthcare professionals need to make clinical decisions without being able to assess patients face-to-face, which may be problematic. This study explores how healthcare professionals experience clinical decision-making in oncological emergency telephone consultations. Methods: An exploratory qualitative approach applying three focus groups with healthcare professionals from a Danish university hospital were undertaken. Data were analysed using inductive content analysis. Results: An overall theme elucidated how healthcare professionals ended up deciding during each call whether the problem could be solved on the phone or the patient had to come for a face-to-face consultation or to wait and see whether the condition changed. Some decisions were easy to make, while others were moderate or diffi- cult. The decision was influenced by several factors that could be structured into three themes: reliance on one's own knowledge and experience, consideration of different perspectives and the influence of context. Conclusion: This study demonstrated that clinical decisionmaking in oncological emergency telephone consultations includes three types of decisions that are intertwined with intra-personal, inter-professional and contextual factors such as personal knowledge, collaboration and workload. These factors are essential for the timely referral of patients to the right level of service. [ABSTRACT FROM AUTHOR]

Objectives: In the current study, we aimed to explore the experiences and attitudes among healthcare professionals as they transitioned from their familiar disciplines to respiratory medicine, intensive care or other departments during the first wave of the COVID‐19 pandemic. Background: In preparation for the increasing number of patients suspected of having or who would be severely ill from COVID‐19, a major reconstruction of the Danish Healthcare System was initiated. The capacity of the healthcare system to respond to the unprecedented situation was dependent on healthcare professionals' willingness and ability to engage in these new circumstances. For some, this may have resulted in uncertainty, anxiety and fear. Design: The study was a descriptive study using semi‐structured focus group interviews. Healthcare professionals (n = 62) from seven departments were included, and 11 focus group interviews were conducted. The focus group interviews took place during June 2020. Analyses was conducted using thematic analysis. The current study was reported using the consolidated criteria for reporting Qualitative research (COREQ). Results: Healthcare professionals experiences was described by five themes: 1) Voluntary involvement, 2) Changes within the organisation, 3) Risks, 4) Professional identity and 5) Personal investment. Common to all five themes was the feeling of being on a pendulum from a meaningful experience to an experience of mental overload, when situations and decisions no longer seemed to be worthwhile. Conclusions: Healthcare professionals experienced a pendulum between a meaningful experience and one of mental overload during the COVID‐19 pandemic. The swinging was conditioned by the prevailing context and was unavoidable. Relevance to clinical practice. To balance the continuous pendulum swing, leaders must consider involvement, and to be supportive and appreciative in their leader style. This is consistent with a person‐centred leadership that facilitates a well‐adjusted work‐life balance and may help prevent mental overload developing into burnout. [ABSTRACT FROM AUTHOR]

The study reports the results of a qualitative study on the views and experiences of non-peer mental health providers on working together with peer colleagues in mental health. Semi-structured interviews were conducted with 20 providers in different mental health settings. Data were systematic analyzed using thematic analysis and resulted in three overall themes: (1) The relationship and collaboration between the mental health providers and their peer colleagues, (2) The benefits of working with peers, and (3) The challenges of working with peers. In analyzing the data material, the theme of the relationship and collaboration between the non-peer mental health providers and their peer colleagues could be organized into two subthemes on the differences that the providers perceived between themselves and their peer colleagues. One subtheme was on differences when the providers perceived the differences as positive and meaningful. The other subtheme was on differences between themselves and their peer colleagues when the providers perceived the differences as concerning. This study's findings show that the attitudes and experiences of peer support in mental health providers are in general positive, but also that mental health providers in the early phases of peer support implementation could have many concerns and may find the perceived and mainly valued differences between themselves and their peer support colleagues also distressing. The implications for practice include a need to address possible barriers to peer support, including frustration or feelings of injustice among mental health providers, especially as such issues are not easy to pinpoint or address by formal guidelines on peer support. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Drawing upon data collected within 20 focus groups with consumers from five European countries, in this article we investigate how perceptions of human health risk and current anxieties regarding agricultural food production affect citizens' acceptance of the use of an emerging biotechnology, synthetic biology, in the development of vaccines for animals bred for food production. In focus group discussions in Austria, the UK, Poland and Denmark, participants tended to value the positive potential of synthetic vaccines if they could solve existing problems. Participants argued that the technology could be beneficial for animal welfare and was a potential solution to the problem of risks to human health posed by the use of antibiotics on livestock. The perceived drawbacks of antibiotic use affected the discussions towards acceptance of synthetic biology and the use of vaccines in meat production despite concerns over the potential risks. The participants from Spain stood out in that their acceptance of the synthetic vaccine appeared to be disconnected from concerns about risks related to the use of antibiotics. Participants from all countries found the vaccine to have potential uses, but also expressed concerns about health risks for consumers. In general consumers were perceived as those bearing the heaviest burden of risk, while pharmaceutical companies were perceived as likely to benefit most from production of the vaccine. We found that institutional trust and national contexts of (dis)engagement with science influenced the participants' understandings of the degree to which the synthetic livestock vaccine had a fair risk-benefit balance. [ABSTRACT FROM AUTHOR]

Assistive technologies in care work are expected to alleviate the challenges related to population aging, namely the pressure on public budgets and a shortage of care professionals. This study examines how various stakeholders view the potentials of assistive technology in an institutionalized care setting in Denmark. Using ethnographic field observations, interviews, and document analysis, we explore the residents', the staff's, and the municipality's perspectives on the technologies and analyze whether they live up to the stated expectations. We identify three parallel narratives representing each of the stakeholder's perspectives. The municipality's triple-win narrative emphasizes expected gains in terms of efficiency, improved working conditions, and better quality of care. The staff's ambiguity narrative contains both negative views regarding the motive for using technologies to save resources and positive accounts of how technologies have reduced work-related pain. The residents' limited agency narrative reflects an internalization of the staff's perspectives. We conclude that, despite both the staff and the municipality highlighting the residents' well-being and comfort as important outcomes of assistive technologies, the residents' wishes have limited influence on whether and, if so, how assistive technologies are used. Different stakeholders' views on assistive technology vary and are closely connected to their respective institutional interests and roles. These perspectives are important for a successful implementation of assistive technologies. Understanding the positions of staff and older care recipients, and differentiating between their respective perspectives can help both scholars and product developers understand the potentials and risks of AT in a more nuanced way. [ABSTRACT FROM AUTHOR]

This study explored the implementation of multidimensional preventive home visits targeted to older adults living in a disadvantaged community in Denmark. The intervention was adapted to include the following key components: involvement of community members in recruitment processes; a combination of individual and group‐based dissemination; adaptation of materials to overcome language barriers; and diversity‐sensitivity training for professionals. The study took place over 12 months between August 2016 and August 2017 and used various data sources: registry‐based data, participant observations, combined with individual and focus group interviews with the target population (n = 22) and relevant health care professionals (n = 8). Here, we report on findings pertaining to implementation barriers and facilitators as seen from the perspective of professionals. Socioeconomic vulnerability was prominent, and uptake of health care services was low, indicating under‐utilisation. Implementation facilitators and barriers were identified including potentials in nurturing local partnerships and proximity during recruitment; overcoming language barriers; offering diversity‐sensitivity training for professionals; and a need for a more multidisciplinary, comprehensive scope of preventive visits for diverse older adults in disadvantaged communities. Thus, more focus on participatory, comprehensive and community‐based health promotion are needed to ensure healthy ageing in the context of social inequality and ethnic diversity. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Strengthening primary healthcare with highly qualified nurses in acute care units or teams is a new Danish initiative intended to detect acute diseases and the deterioration of chronic diseases and to develop treatment for outpatients. This study explores healthcare professionals' experiences with this initiative. Qualitative semi-structured interviews conducted in 2019–2020. Analysis was conducted with a systematic text condensation. This study is based on an acute care team in one Danish municipality called Acute Team Odense (ATO). ATO delivers acute nursing in patients' own homes (including nursing homes) in collaboration with different healthcare professionals. Individual interviews with general practitioners (GPs) (n = 15), five focus-group interviews with nurses and nursing assistants from the municipality (n = 19) and one focus-group interview with staff from the emergency department (ED) (n = 10). Experiences of different healthcare professionals' experiences with ATO. In general, all of the participants were very satisfied with the new acute care team and the cross-sectorial possibilities. The GPs usually referred ATO to assessments in which paraclinical equipment, competencies, accessibility, response time and communication were important. The municipal nurses and nursing assistants tended to use ATO if they needed second opinions or acute nurse assistance. The ED most often used ATO to assist with intravenous therapy after an ED visit. All participants reported that ATO increased what could be assessed and treated in patients' homes, which is central to preventing unnecessary hospitalisations. ATO created new possibilities in patient's homes which potentially might prevent unnecessary hospitalisations. Acute care units or teams are mandatory in Danish health care, but limited knowledge in the area is found. Healthcare professionals found that the acute care teams provided new possibilities to assess and treat patients in their own homes. Healthcare professionals experienced that the acute care team potentially prevented hospitalisations by fast clinical nurse assessments with paraclinical tests. [ABSTRACT FROM AUTHOR]

Aims: To explore the existential significance of living with the risk of being infected with coronavirus in patients with COPD. Background: Distancing measures aim to break the coronavirus transmission chains. Physical separation from social networks and social isolation are correlated with anxiety and depression. People with a chronic obstructive lung disease are particularly vulnerable due to the increased risk of a serious course of illness, so therefore many of them choose self‐isolation to protect themselves from COVID‐19. Design: A qualitative exploratory study using individual semi‐structured interviews. Methods: From June–September 2020, 13 participants were recruited through advertisements on Facebook as a convenience sample for semi‐structured individual interviews. The interviews took place through virtual platforms or in physical meetings. Data were analysed using Ricoeur's phenomenological approach, involving naïve reading, a structural analysis and a critical interpretation strategy. The study has been reported in line with COREQ guidelines. Findings: Living with the threat of being infected with coronavirus has greatly affected everyday life for patients with COPD. The nagging fear of coronavirus as a death threat was a dominant feeling, together with anxiety, loneliness and hope. With self‐isolation, followed concerns of being forgotten and thoughts of the future, balancing between fearing the worst, and hoping the best. Conclusions: Patients with moderate to severe COPD feel compelled to self‐isolate, as they fear dying from COVID‐19. The study revealed a need for proactive contact with health professionals to calm the patients' feelings of deprivation, loneliness, hopelessness and anxiety. Relevance to clinical practice: Information about the patient's perspective may be used to develop targeted interventions aimed at giving adequate information, supporting hope, implementing digital or virtual solutions to keep in contact and avoid the feeling of being alone and forgotten during a pandemic crisis. [ABSTRACT FROM AUTHOR]

Background: Telephone consultations are common in supporting patients and caregivers in managing symptoms from cancer diseases and side effects from cancer treatment. In connection with telephone consultations, it may be a challenge that healthcare professionals have to rely on their auditory sense alone when they assess whether the problem can be solved over the telephone, or whether patients need an examination face to face. Objective: To explore how healthcare professionals identify patients' essential concerns and assess serious conditions in calls to an oncological emergency telephone without face‐to‐face contact. Methods: From a phenomenological‐hermeneutical frame of reference, the analysis of three focus groups with a total of 16 healthcare professionals was guided by content analysis. Ethics: The study follows the ethical guidelines for research. Results: Two themes emerged. To identify patients in serious conditions, healthcare professionals kept focus on: (1) 'Reaching a mutual understanding without the clinical eye'. Before making a decision regarding a face‐to‐face examination, the healthcare providers were as follows: (2) 'Listening to an inner voice – attention on clues and signs'. Limitations: The transferability of the findings is limited to healthcare professionals who perform telephone‐mediated care in a team of nurses and physicians. Conclusion: Staying open for diverse perspectives and integrating nonanalytical as well as analytical illness scripts, healthcare professionals were able to identify patients that needed further examination face to face. [ABSTRACT FROM AUTHOR]

Contemporary practice has started to rethink use of outdoor and community environments for advancing comprehensive rehabilitation outcomes. The aim is to examine health professionals' experiences and perceptions of providing rehabilitation in outdoor community settings. The purpose is to use these experiences to generate practice-based knowledge in using the outdoors as a means to guide community-based rehabilitation. The Interpretive Description methodology was accompanied by social practice theory. Fieldwork was conducted utilizing participant observation, photovoice, and focus-group interviews. Included were 27 health professionals. The analysis revealed how "naturalistic learning opportunities" offered health professionals strategies to empower activity and participation levels and yet invoked "rehabilitation setting tensions." A continuum was engaged in the theme "navigating a middle ground," representing an integrated environment approach; rehabilitation in conventional indoor and outdoor community settings. Development of a sustainable concept for outdoor community-based rehabilitation involves strengthening health professionals' competencies and skills for providing outdoor and community work. [ABSTRACT FROM AUTHOR]

Background: In Denmark and internationally, there has been an increased focus on strengthening palliative care by enhancing spiritual care. Dying patients, however, do not experience their spiritual needs being adequately met. Methods: Through an action research study design with four consecutive stages, namely, observation in practice, reflection-on-praxis, action-in-praxis, and evaluation of the action research process involving patients and hospice staff from two hospices in Denmark, two research questions were explored: (1) How do patients and staff perceive, feel, live, practice, and understand spiritual care at hospice? and (2) How can spiritual care be improved in hospice practice? The data material presented comprised 12 individual interviews with patients and nine focus group interviews with the staff. Results: We found four aspects of spiritual care through which patients and staff seemed to perceive, feel, live, practice, and understand spiritual care at hospice, and from where spiritual care may be improved in hospice practice. These aspects constituted four themes: (1) relational, (2) individualistic, (3) embodied, and (4) verbal aspects of spiritual care. Conclusion: Staff realized immanent limitations of individual aspects of spiritual care but learned to trust that their relational abilities could improve spiritual care. Embodied aspects seemed to open for verbal aspects of spiritual care, but staff were reluctant to initiative verbal dialogue. They would bodily sense values about preserving patients' boundaries in ways that seemed to hinder verbal aspects of spiritual care. During action-in-praxis, however, staff realized that they might have to initiate spiritual conversation in order to care for patients' spiritual needs. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate the relationship between diabetes stigma as experienced by adults with type 1 diabetes and diabetes outcomes using the novel, validated measure of the Type 1 Diabetes Stigma Assessment Scale. Methods: A total of 1594 adults with type 1 diabetes completed a questionnaire on socio-economic factors, psychosocial health, and diabetes stigma and these self-reported data were linked with data from electronic clinical records on glycaemic control, diabetes duration, age, and diabetes-related complications. Bivariate analyses and multivariate linear regressions were performed to assess the relationship between diabetes stigma as measured by three subscales, Identity concern, Blame and judgement, and Treated differently on the one hand, and patient characteristics and diabetes outcomes on the other. Results: Endorsement of the stigma statements ranged from 3.6–78.3% of respondents. Higher stigma scores in relation to Identity concern and Blame and judgement were significantly associated with being female, of lower age, lower diabetes duration, and having at least one complication. Those who reported higher levels of perceived stigma reported significantly higher levels of diabetes distress (β = 0.37 (95% CI: 0.33–0.40), 0.35 (95% CI: 0.30–0.39), 0.41 (95% CI: 0.35–0.46)), and HbA1c levels (β = 0.11 (95% CI: 0.02–0.21), 0.28 (95% CI: 0.16–0.40), 0.26 (95% CI: 0.14–0.42) for Identity concern, Blame and judgement, and Treated differently, respectively). Conclusions: The findings demonstrated that diabetes stigma is negatively associated with both diabetes distress and glycaemic control and should be considered part of the psychosocial burden of adults with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Frailty is associated with several negative health outcomes, such as readmissions to hospital. Physical exercise, including strength training and nutritional optimisation are essential parts of documented interventions for frail older people in preventing or minimising frailty. Further knowledge is necessary to ensure feasible and successful interventions encompassing both physical exercise and nutritional optimisation. The aim of this qualitative study was to investigate the perspectives of health professionals on which factors may affect interventions, including physical exercise and nutrition, for frail older people in relation to discharge after acute admission to hospital. Data were gathered in two semi‐structured focus groups, totalling 11 health professionals working with frail older people in a Danish university hospital and a municipality. The sampling of participants was purposive and the interviews were facilitated by a semi‐structured interview guide. Data were analysed applying a six‐step data‐driven thematic analysis. Findings showed that health professionals experienced working with nutritional optimisation and physical exercise within a frail older population as challenging, and they mostly used extrinsic motivation, such as incentives, deals or intensified messages, as external factors in their approaches as to affect specific behaviours. A discourse on the importance of activity‐ and functional training was prevalent, while diverging perspectives were present in relation to strength training, which was considered less feasible or meaningful in a community‐dwelling setting. Organisational barriers such as communication between sectors and time limitations affected negatively the work of health professionals, as they hindered co‐ordinated and adequate interventions from the health professionals. Findings and theory‐based knowledge indicate that health professionals should work towards a person‐centred approach, which includes goal‐setting, to improve physical training and nutritional interventions for frail older people. Furthermore, health professionals may need more support in order to incorporate strength training in interventions. In addition to this, improved co‐ordination between sectors is warranted. [ABSTRACT FROM AUTHOR]

The growing secularism generates considerable interest in the manifestations of religious unbelief. In this study, conducted in Finland, Denmark, and the Netherland (N = 4404), we asked participants which of the following terms best describes their religious/spiritual identity: religious believer, spiritual but not religious, spiritual seeker, atheist, anti-religious, agnostic, nonbeliever, secular, or other. We also examined the participants' God beliefs and their attitudes toward religion. While connotations of identity terms varied considerably across individuals and countries, the nonreligious identification groups consistently differed in the strength and certainty of God belief, and by the valence, ambivalence, importance, and reflection of the attitudes toward religion. The anti-religious had the most negative and unequivocal attitudes, and the agnostics, seculars, and spiritual seekers had the most uncertain God beliefs. By associating distinct attitude profiles with non-religious self-identification labels, the findings improve our understanding of why people choose a specific label in surveys on non-religiosity. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered, but surveys have demonstrated inconsistent monitoring practices. Using qualitative methods, we aimed to explore barriers and aids to routine neuromuscular monitoring and consistent reversal practice.Methods: Focus group interviews were conducted to obtain insights into the thoughts and attitudes of individual anaesthetists, as well as the influence of colleagues and department culture. Interviews were conducted at five Danish and one US hospital. Data were analysed using template analysis.Results: Danish anaesthetists used objective neuromuscular monitoring when administering a non-depolarizing relaxant, but had challenges with calibrating the monitor and sometimes interpreting measurements. Residents from the US institution used subjective neuromuscular monitoring, objective neuromuscular monitoring was generally not available and most had not used it. Danish anaesthetists used neuromuscular monitoring to assess readiness for extubation, whereas US residents used subjective neuromuscular monitoring, clinical tests like 5-second head lift and ventilatory parameters. The residents described a lack of consensus between senior anaesthesiologists in reversal practice and monitoring use. Barriers to consistent and correct neuromuscular monitoring identified included unreliable equipment, time pressure, need for training, misconceptions about pharmacokinetics of neuromuscular blocking agents and residual block, lack of standards and guidelines and departmental culture.Conclusion: Using qualitative methods, we found that though Danish anaesthetists generally apply objective neuromuscular monitoring routinely and residents at the US institution often apply subjective neuromuscular monitoring, barriers to consistent and correct use still exist. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study is (a) to explore and compare the beliefs and values of the stakeholders working in different national dual career environments, and (b) to enhance the understanding of the relationship between athletes' dual career trajectories and the respective environments. Twelve semi-structured interviews with key informants involved in dual career from Switzerland, Denmark, and Poland were used to discussing benefits, obstacles and best practices of their national dual career settings. Interviews were content analysed in a deductive-inductive way using (Schein, E. H. (2010). Organizational culture and leadership (4th ed.). San Francisco, CA: John Wiley & Sons) cultural framework. Besides the differences in support for elite athletes in higher education across the national contexts, the key informants expressed divergent values and attitudes, which were due to their opinions on how dual careers should be organised. These values were found to be linked to the ideologies of the welfare regimes in the given country. Since dual career practices and programmes are based on different underlying basic assumptions in the three contexts studied, divergent dual career trajectories are proposed to athletes as the typical way to combine elite sport and education. Based on the results of our cross-cultural comparison, we assert that culture is not only an influential but also a constituting factor in the development of dual career environments. Thus, we propose a culturally sensitive approach towards the dual career of athletes and invite professionals (e.g. coaches, career advisors, and educational programme leaders) to critically reflect on their contextualised values about how to support dual career athletes. [ABSTRACT FROM AUTHOR]

Introduction: At Odense University Hospital (OUH) alternating-air mattresses (AAM) are used in the prevention of pressure ulcers (PU); however, static overlays might be more effective and have lower costs. To investigate the properties and consequences of using static overlays for prevention of PU at OUH, a hospital-based health technology assessment (HTA) was conducted. Methods: Two types of static overlays were tested in an observational study and compared with AAM for patients with a medium–high risk of PU in geriatric and orthopaedic wards at OUH. Incidence of PU was investigated 7 months before (n=720) and 6 months after implementation (n=837). Staff attitudes were examined in a questionnaire survey (n=55) and focus group interviews (n=13). Patients who had tried one of the overlays and the AAM were interviewed (n=12). Results: No statistical difference in PU incidence was found before and after the implementation of overlays (2.5% before, 2.7% after, P=0.874, n=1557) and no patients lying on overlays developed PU (n=123). Staff had mixed attitudes, but the majority preferred having overlays as an option for their patients. Interviewed patients preferred overlays due to less noise and improved mobility. Conclusion: Both types of overlay are effective in PU prevention. However, overlays introduce challenges for staff and clear guidelines for the selection of support surfaces are needed. Overall, it is recommended that static overlays are considered as an alternative to AAM for PU prevention. [ABSTRACT FROM AUTHOR]

This essay tells the story of how Denmark transformed from a very welcoming and tolerant country to one whose prime ministers reassure its residents, "We have the strictest Alien Act possible." The approach is genealogical, following Michel Foucault, and the empirical focal point is Danish immigration policies as they evolved from the late 1960s until today. This development culminates in the emergence of the "restrictionist policy paradigm," which associates immigrants with risks like economic burdens, high unemployment levels, crimes, undemocratic attitudes, and the development of ghettos. From the perspective of the welfare project, the immigrants became "risky" as they were profiled in terms of their higher probability of developing suboptimal or dysfunctional behaviors that endanger the welfare state. The Danish experience is analyzed from a broader thesis on the welfare state as caught up between welfarist universality, industrial-capitalist expansion, and sovereign territoriality. Drawing on Foucault's work, these different logics of statehood are analyzed as evolving constellations of law, discipline, and security. Danish immigration policy mutates over time so that policies of security premised on free circulation gradually give way to discipline and legal sovereignty that block, filter, and segregate immigrants. Alongside this movement toward territorial enclosure, the discursive construction of the immigrant changes fundamentally. [ABSTRACT FROM AUTHOR]