Search

Background: Work-related violence committed by clients, patients, and customers represents a major occupational health risk for employees that needs to be reduced. Methods: We tested a comprehensive violence prevention intervention involving active participation of both employees and managers in the Prison and Probation Service (PPS) and on psychiatric wards in Denmark. We used a stepped wedge cluster randomised controlled trial design. We measured the degree of implementation of the intervention by registration of fidelity, reach, and dose and used a mixed-effects regression analysis to estimate the effects of the intervention. Results: We recruited 16 work units for the intervention, but three work units dropped out. The average implementation rate was 73%. In the psychiatric wards, the intervention led to statistically significant improvements in the primary outcome (an increase in the degree to which managers and employees continuously work on violence prevention practices based on their registration and experiences), but none statistically significant improvements in any of the secondary outcomes. In the PPS units, the intervention did not lead to a statistically significant improvement in the primary outcome, but to statistically significant improvements in three secondary outcomes. Conclusion: Most work units were able to carry out the intervention as planned. The intervention showed mixed results regarding the primary outcome. Nevertheless, the results indicate improvements also in the sector where a change in the primary outcome was not achieved. The results point at that a participatory and comprehensive approach could be a viable way of working with violence prevention in high-risk workplaces. Trial registration: ISRCTN86993466: 20/12/2017 [ABSTRACT FROM AUTHOR]

Objectives: To investigate epidemiology, demography, and genetic and clinical characteristics of patients with familial Mediterranean fever (FMF) in Denmark. Method: In this population-based, cross-sectional cohort study, we identified FMF patients from discharge diagnoses using ICD-10 codes in the Danish National Patient Register, and linked data from the Danish Civil Registration System and laboratory databases for results of MEFV gene variant screening. Results: We identified 495 FMF patients (prevalence 1:11 680) with a median age of 29 years and a female ratio of 51%. The median age at diagnosis of FMF was 13 (IQR 7-22) years, with an estimated median diagnostic delay of 3 (IQR 0.7-6.9) years. The predominant ethnicities were Turkish (41.8%), Lebanese (15.8%), Syrian (6.5%), South-West Asian (7.9%), and South-East Asian (3.0%). The MEFV genotype distribution was 18.7% homozygous, 21.2% compound heterozygous, 32.0% heterozygous, 11.0% with complex alleles or unresolved zygosity, and 17.1% with no detected variants. M694V was the most prevalent variant in the overall cohort (32.5%). Homozygous or compound heterozygous MEFV exon 10 variants were associated with younger age at diagnosis (p < 0.001) and reduced number of hospital contacts before diagnosis (p = 0.008). The Charlson Comorbidity Index was ≥ 2 in 8.1% of patients. The prevalence of amyloidosis was 1.0%. Conclusions: FMF in Denmark is rare and patients are mainly of Eastern Mediterranean ethnicity. Diagnostic delay was long but patients with exon 10 MEFV variants were diagnosed at a younger age. Prolonged diagnostic delay is probably caused by lack of FMF awareness in the Danish healthcare system. [ABSTRACT FROM AUTHOR]

Here we study genetic differentiation and changes over time in genetic variability in the rare pine marten Martes martes. Samples from three isolated geographic regions: Jutland and Sealand (Denmark) and southern Scania (southernmost Sweden), were genotyped by sequencing the hypervariable domain of the mitochondria control region. Both recent and museum samples were analysed in order to evaluate any temporal loss of genetic variability. Eight haplotypes were found. Two were main haplotypes shared by individuals from all three regions, and in all localities unique haplotypes were found. When comparing the data with previous haplotype analysis, our results suggest that at least three different haplotype groups exist in central and Northern Europe, with the samples from southern Scania being differentiated from samples previously analysed from central Sweden, and the genotypic data for Jutland and Sealand suggest a recent independent evolutionary history for the Danish pine marten. [ABSTRACT FROM AUTHOR]

Objective: The autoinflammatory disease familial Mediterranean fever (FMF), characterized by recurrent attacks of sterile fever, serosal, and/or synovial inflammation, is caused by variants in the Mediterranean fever gene, MEFV , coding for the pyrin inflammasome sensor. The diagnosis of FMF is mainly based on clinical symptoms and confirmed by detection of disease-associated MEFV variants. However, the diagnosis is challenging among patients carrying variants of uncertain clinical significance (VUS). In this study, we aimed to identify potential FMF discriminatory diagnostic markers in a cohort of clinically characterized FMF patients., Method: We established a cohort of clinically and MEFV genotype-characterized FMF patients by enrolling patients from major Danish hospitals (n = 91). The secretory profile of pyrin inflammasome-activated monocytes from healthy donors (HDs) and MEFV -characterized FMF patients (n = 28) was assessed by analysing cell supernatants for a custom-designed panel of 23 cytokines, chemokines, and soluble tumour necrosis factor receptors associated with monocyte and macrophage function., Results: MEFV genotypes in Danish FMF patients were associated with age at symptom onset (p < 0.05), FMF among relatives (p < 0.01), proportion of patients in colchicine treatment (p < 0.01), and treatment response (p < 0.05). Secretion of chemokines CCL1 and CXCL1 from pyrin-activated FMF monocytes was significantly decreased compared to HDs (p < 0.05), and could discriminate FMF patients with 'non-confirmatory' MEFV genotypes from HDs with 80.0% and 70.0% sensitivity for CCL1 and CXCL1, respectively (p < 0.05)., Conclusion: Our data suggest that a functional diagnostic assay based on CCL1 or CXCL1 levels in pyrin-activated patient monocytes may contribute to FMF diagnosis in patients with VUS.

The concept of co-production suggests a collaborative production of public welfare services, across boundaries of participant categories, for example professionals, service users, peer-workers and volunteers. While co-production has been embraced in most European countries, the way in which it is translated into everyday practice remains understudied. Drawing on ethnographic data from Danish community mental health services, we attempt to fill this gap by critically investigating how participants interact in an organisational set-up with blurred boundaries between participant categories. In particular, we clarify under what circumstances the blurred boundaries emerge as believable. Theoretically, we combine Lamont and Molnár's (2002) distinction between symbolic boundaries and social boundaries with Goffman's (1974) microanalysis of "principles of convincingness". The article presents three findings: (1) co-production is employed as a symbolic resource for blurring social boundaries; (2) the believability of blurred boundaries is worked up through participants' access to resources of validation, knowledge and authority; and (3) incongruence between symbolic and social boundaries institutionalises practices where participants merely act 'as if' boundaries are blurred. Clarification of the principles of convincingness contributes to a general discussion of how co-production frames the everyday negotiation of symbolic and social boundaries in public welfare services., (© 2018 Foundation for the Sociology of Health & Illness.)

Addiction research has demonstrated how recovering individuals need narratives that make sense of past drug use and enable constructions of future, non-addict identities. However, there has not been much investigation into how these recovery narratives actually develop moment-to-moment in drug treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both 'the whats' (story content) and 'the hows' (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged. The demonstration of how local narrative environments shape stories contributes to the general understanding of interactive storytelling in encounters between professionals and clients in treatment settings., (© 2015 The Author. Sociology of Health & Illness published by John Wiley & Sons Ltd. on behalf of Foundation for Sociology of Health & Illness.)

Introduction: This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients., Methods: This was a prospective, controlled, observational study, involving seven local hospitals and one level I trauma centre using a before and after design. All patients treated by a trauma team within a 5-month period (1 December 2009-30 April 2010) prior to and a 12-month period (1 May 2010-30 April 2011) after implementing a PS-HEMS were included. We compared time from dispatch of the first ground ambulance to arrival in the trauma centre for patients with Injury Severity Score (ISS) > 15. Secondary end points were the proportion of secondary transfers and 30-day mortality., Results: We included 1788 patients, of which 204 had an ISS > 15. The PS-HEMS transported 44 severely injured directly to the trauma centre resulting in a reduction of secondary transfers from 50% before to 34% after implementation (P = 0.04). Median delay for definitive care for severely injured patients was 218 min before and 90 min after implementation (P < 0.01). The 30-day mortality was reduced from 29% (16/56) before to 14% (21/147) after PS-HEMS (P = 0.02). Logistic regression showed PS-HEMS had an odds ratio (OR) for survival of 6.9 compared with ground transport., Conclusions: Implementation of a PS-HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30-day mortality., (© 2013 The Acta Anaesthesiologica Scandinavica Foundation.)

Inspired by social problems theory, this article analyzes the "formula story" of harm reduction in a Danish addiction-treatment context. In Denmark, very few opiate addicts are in drug-free therapeutic treatment. Instead, they are offered methadone (often on a permanent basis) accompanied by practical help in tackling the negative social, economic, and health-related consequences of their drug use. The aim of this article is to show how the formula story of harm reduction-and first and foremost the idea that opiate addiction is an incurable condition-tends to work as a self-fulfilling prophesy. Opiate addicts entering the treatment system risk being "made up" as chronic addicts regardless of how they themselves look upon their own addiction problem and notwithstanding that many of them have not given up their hope of becoming drug-free. The article is based on two types of data: (1) file records (gathered in 2007) describing the addiction problems and treatment careers of clients enrolled at outpatient treatment centers in Copenhagen, and (2) qualitative interviews (conducted in 2006) with 30 methadone-program participants at the centers. The analysis is qualitative and the empirical results cannot necessarily be generalized to other methadone-maintenance programs. Yet the theoretical message of the article is applicable to all treatment institutions and social problems work in general. Definitions and categorizations of clients are not innocent, and naming people and their problems is the same as changing them.

In 1992, The Danish Medical Research Council established a national committee on scientific dishonesty with the twofold task of handling cases of scientific misconduct and taking preventive initiatives. Scientific dishonesty was proven in only five cases, but in another nine cases lesser degrees of deviations from good scientific practice were found. The experiences from a total of 24 treated cases indicated that three key areas were at the basis of most of the accusations and the deviations from good practice: uncertainty about 1) authorship, about 2) rights and duties to use scientific data and about 3) agreements at the initiation of joint studies. As a consequence guidelines on good practice have been issued on these key subjects.

Analyses of the occupational activity of the 45-59-year-old Danes in the 10-year period 1984-1994 show that the decrease in occupational activity status is marked for women at the age of 50 and for men about 5 years later. Moreover, it is not possible to detect an increase in the occupational activity, as far as the employment rate is concerned, of the 45-59-year-olds during the same 10-year period.

The Danish Committee on Scientific Dishonesty (DCSD) has existed for five years. As a preventive measure two sets of guidelines for the presentation of experimental reports and data documentation have been issued. Experiences from 24 cases of suspected scientific dishonesty have proven a need for further guidelines covering a wider range of scientific practice. Three key areas susceptible to conflicts between researchers and often resulting in subsequent accusations of scientific misconduct have been localized. Guidelines have, therefore, been prepared for these three areas: 1) Agreements at the start of cooperative research projects. 2) Rights and duties in storing and using research data. 3) Authorship. It is hoped that they will be helpful in prevention of conflicts and deviations from good scientific practice, and that they will be useful in the education of young researchers. The Danish Committee on Scientific Dishonesty. The Ministry of Research and Information Technology, Copenhagen.

Scientific dishonesty has been the subject of much public interest in recent years. Although the problem has had a low profile in Denmark, there is no reason to believe that it is non-existent. Several preconditions known to be important prevail here as well as in other countries, such as pressure to publish and severe competition for research grants and senior academic positions. The Danish Medical Research Council (DMRC) decided to respond to this problem by preparing a report on scientific dishonesty with suggestions to the research institutions on rules for good scientific practice and procedures for investigation of suspected dishonesty. To this end, an investigatory system was suggested. The system should consist of two regional committees and one national committee. They should be headed by high court judges and experienced health sciences researchers as members. The committees will investigate cases reported to them and conclude on whether dishonesty has been established and on whether the scientific work should be retracted. Sanctions shall remain the task of the institutions. Preventive measures comprise open access to and a long storage period for scientific data.

The term scientific dishonesty covers the wide scope from consciously fraudulent actions to gross negligence and refers both to character trait and to actions. Scientific dishonesty may occur in any country, but reactions in Europe have been slow to emerge. On the basis of a thorough review, the Danish Medical Research Council therefore has made recommendations on how to handle and how to prevent scientific dishonesty. Suspected cases must be referred directly to a national committee chaired by a High Court judge. An ad hoc investigatory committee may be appointed in each case. If dishonesty is established, the institution then is asked to implement appropriate sanctions and to report on the actions taken to the national committee. Prevention of scientific dishonesty forms an essential part of good scientific practice and must have an impact on research training, requirements for data storage, guidelines for scientific publication, and criteria for evaluating grant proposals and promotions.