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Diabetes care in institutional settings is a significant challenge that affects the whole family as well as care workers and teachers. The present study is the ideation part of a rigorous development process in the KIds with Diabetes in School (KIDS) project. We have previously conducted a thorough three-part needs assessment in which we explored the problem area from the viewpoints of (1) municipal administrative staff, (2) preschool and school staff and (3) families. Based on the identified needs and to a great extent on the contents and shortcomings of existing guidelines, the objective of the present study is to explore and develop possible solutions and recommendations for addressing the challenges and problems. To meet this objective, we held comprehensive multistakeholder participatory workshops in each of the five Danish regions. Five main themes with multiple subthemes were identified as areas to be addressed: (1) training and knowledge, (2) communication and collaboration, (3) the designated contact/support person, (4) national guidelines, and (5) the Diabetes Coordinator. Our findings demonstrate that communicative structures and dynamics are at the very heart of the identified problems and challenges and that the possible solutions should revolve around improving existing structures and highlighting the importance of constantly working on understanding and developing communication strategies. We propose a set of recommendations for practice based on these communicative needs. [ABSTRACT FROM AUTHOR]

Students' attitudes and anxieties about science were measured by responses to two self-report questionnaires. The cohorts were Danish and American students at the upper secondary- and university-levels. Relationships between and among science attitudes, science anxiety, gender, and nationality were examined. Particular attention was paid to constructivist attitudes about science. These fell into at least three broad conceptual categories: Negativity of Science Toward the Individual, Subjective Construction of Knowledge, and Inherent Bias Against Women. Multigroup confirmatory factor analyses revealed that these dimensions of constructivist attitudes were equally applicable and had the same meaning in both cultures. Gender differences in mean levels of constructivist attitudes were found; these varied across the two cultures. Constructivist beliefs were associated with science anxiety, but in different ways for females and males, and for Danes and Americans. In agreement with earlier studies, females in both the US and Danish cohorts were significantly more science anxious than males, and the gender differences for the Americans were larger than those for the Danes. Findings are discussed in terms of their implications for reducing science anxiety by changing constructivist beliefs.

Background: A predominant side effect of radiotherapy for head and neck cancer is salivary gland hypofunction and xerostomia leading to debilitating oral disorders and impaired quality of life (QoL). Intraglandular mesenchymal stem cell therapy has shown promising results as a treatment for xerostomia. Methods: This is a randomised, double-blinded, placebo-controlled, parallel-group, prospective, single-centre trial investigating the safety, tolerability, and effectiveness of allogeneic stem cells as a treatment for radiation-induced hyposalivation and xerostomia for previous head and neck cancer patients. We will include a total of 120 patients who previously have been treated with radiotherapy for a head and neck cancer in Denmark. Participants will be randomly assigned using block randomisation to one of two parallel groups in a 1:1 ratio to receive ultrasound-guided injection of allogeneic adipose-derived mesenchymal stem cell (ASC) (n = 60) or placebo (n = 60) into the submandibular glands. Placebo will consist of CryoStor10 (BiolifeSolutions), the freeze media for ASCs containing 10% dimethyl sulfoxide (DMSO). The primary endpoint is change in unstimulated whole saliva flow rate. The secondary endpoints are change in stimulated whole saliva flow rate, QoL, and composition of saliva. Further secondary endpoints are safety and immune response (human leukocyte antigen (HLA) response) to the stem cells will be assessed. Patients are evaluated at baseline (before treatment), after 4 months, and after 12 months. All study personnel, except study personnel thawing and preparing the treatment for injection, and participants will be blinded to group assignment. Unblinded study personnel will not participate in the outcome assessment. Discussion: The trials will investigate the efficacy and safety of ASC injection to the submandibular gland as a potential new treatment for post-radiation xerostomia. We hope the results will pave the way for a clinically relevant treatment to ameliorate patients with xerostomia, a severely hampering condition. Trial registration: The study is approved by the Danish Data Protection Agency (protocol number P-2020-1164), the National Ethics Committee protocol number: (Protocol number: 1802872), and the Danish Medical Agency (2018-000348-24). The protocol was registered at the ClinicalTrials.gov database (NCT04776538). [ABSTRACT FROM AUTHOR]

We conducted interviews with eleven groups of Danish and American students. The interview topics included gender and national components of science education, science anxiety, and attitudes toward science. The groups were science and nonscience students at the upper secondary and university levels, and one group of American science teachers who were students in a science enrichment program. The interviews revealed a variety of relationships between and among science attitudes, science anxiety, nationality, gender, and course of study. We also probed student attitudes toward constructivist versus traditional views of science.

Managing diabetes is complicated for many children. It often requires support from an adult during the school day. In Denmark, most children spend 30–35 h a week at school. Nevertheless, diabetes management in schools remains largely uninvestigated. This study aimed to examine the characteristics and organization of diabetes management in Danish primary schools from the personnel's perspective. All primary schools in Denmark were invited to participate in the study (n = 2129), and 525 schools were included. A questionnaire was constructed and sent by email. Questionnaire data are presented in the descriptive statistics and compared with the ISPAD guidelines. According to 77.2% of respondents, school personnel had received training in diabetes management, and 78.5% of the schools had at least one person available for diabetes support every day. Respondents felt prepared to help the students with counting carbohydrates (38.9%), dosing insulin (39.1%), and helping the students during high (52.1%) or low (60.3%) blood sugar levels, insulin chock (35.2%), or during activities (36.3%). Yet, diabetes management was a challenging task. Only 61.7% had an action plan for diabetes management, 37.4% had face-to-face information meetings with the parents, and 55.1% of respondents reported having sufficient time to cooperate with the parents. [ABSTRACT FROM AUTHOR]

Simple Summary: For a diagnostic tool to be important, there must be a high level of agreement between different observers. If not, the reliability of the measurement can not be considered valid. Previous studies have evaluated the reproducibility of tissue stiffness measurements of rectal tumors, but only on previously obtained images. Therefore, we aimed to investigate the issue in a clinical setting and found a high level of agreement between observers. Background: Endorectal ultrasound (ERUS) is an important tool when evaluating complex rectal adenomas and rectal cancer, and the accuracy is improved by adding elastography measurements. A high interobserver agreement is imperative in clinical practice. Therefore, the aim of this study was to evaluate interobserver agreement assessed on real-time images. Additionally, we investigated the intra- and interobserver agreement between experienced and inexperienced observers. Materials and methods: We prospectively included patients referred to an ERUS at the Department of Radiology with a complex rectal polyp or suspected rectal malignancy. Two operators independently scanned each patient in turn. Furthermore, four observers assessed previously obtained images using three different methods for placing the region of interest (ROI). Three months later, the four observers reassessed the images to assess intraobserver variability. Results: A total of 19 patients were included for live assessment. Agreement of tumor classification was substantial for T stage (kappa: 0.86) and fair for N stage (kappa: 0.73), with an absolute agreement for T and N stages of 84% and 89%, respectively. Agreement of SWE was good for Emean (ICC 0.94, 95% CI 0.86–0.98) and fair for Emax (ICC 0.85, 95% CI 0.66–0.94). Intra- and interobserver agreement between inexperienced and experienced observers showed good to excellent agreement with all ROI methods. Conclusion: Interobserver agreement is high in SWE when performed in a clinical setting. We found the best agreement using the mean value of several ROIs. Intra- and interobserver agreement was high regardless of operator experience. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore patients' experiences of situational awareness in the outpatient encounter when they are informed about the diagnosis of breast cancer or malignant melanoma. Background: Patients enter a stressful situation when receiving a diagnosis of breast cancer or malignant melanoma, and research indicates that needs are most prominent at this time. However, healthcare professionals often fail to address these needs adequately. It is unclear how patients experience situational awareness practised to meet their fundamental needs in the encounter when they are informed about the diagnosis of cancer. Design: This study used a phenomenological hermeneutical approach. Methods: Nine semi‐structured interviews with patients being diagnosed with breast cancer or malignant melanoma were performed. The interpretation theory of Paul Ricoeur guided the analysis. The study is presented in line with the COREQ checklist. Results: The analysis resulted in three themes: 1) "Being accompanied" refers to how patients need information to be targeted to them as individuals. 2) "Being seen" points to HCPs' exploration of the patients' perspectives to get an understanding of their preferences. 3) "Being taken care of" indicates that patients feel supported if situational awareness is practised by the healthcare professionals. Conclusion: Practicing situational awareness in the outpatient encounter is essential to patients' experience of feeling accommodated or rejected. Patients feel rejected when their fundamental needs are not met while experiencing situational awareness seems to accommodate fundamental needs and pre‐empt an inappropriate patient outcome. Relevance to clinical practice: HCPs need to acknowledge the importance of using a structured approach to meeting patients' fundamental needs in a stressful situation. Each patient is different and may experience different needs in encounters where they are receiving the diagnosis of breast cancer or malignant melanoma. Therefore, treatment and care must be tailored to the individual patient based on a caring relationship. [ABSTRACT FROM AUTHOR]

Determining the optimal insulation thickness is useful for designing zero-emission buildings (ZEB) to minimize the environmental impacts. The energy required to heat buildings in cold climates is relatively high. Substantial reductions in the total energy usage of a building can be achieved by reducing the U-value of the external surfaces. Increasing the insulation thickness reduces the operational CO 2 emissions, although simultaneously increases the embodied CO 2 emissions from materials. To mitigate climate change, Norway and Denmark are trending towards stricter regulations to limit energy use in buildings. However, these countries have no current regulations in the building codes for limit embodied CO 2 emissions from materials. This study analyzes the influence of the energy emission factor and future climate change (scenarios?) on the optimal insulation thickness. We used three independent models for case studies in Greenland and Norway. The differences between the case studies highlight the influence of model parameter choices, such as indoor climate, energy emission factor and material emissions, whereas the similarities may be used to analyze the problem from a broader perspective. The results show that optimal insulation thickness calculations are most valuable for case studies in which the energy emission factor is low. Considering energy emission factors above 25–30 g CO 2 eq/kWh, operational emissions dominated the calculation results in all case studies. • Optimal insulation thickness is highly dependent on the energy emission factor. • Such calculations are most valuable for cases with low energy emission factor. • Careful result analysis is necessary due to uncertainties in multiple parameters. [ABSTRACT FROM AUTHOR]

The gut microbiota has been implicated in obesity and its progression towards metabolic disease. Dietary interventions that target the gut microbiota have been suggested to improve metabolic health. The aim of the present study was to investigate the effect of interventions with Lactobacillus paracasei F19 or flaxseed mucilage on the gut microbiota and metabolic risk markers in obesity. A total of fifty-eight obese postmenopausal women were randomised to a single-blinded, parallel-group intervention of 6-week duration, with a daily intake of either L. paracasei F19 (9·4 × 1010 colony-forming units), flaxseed mucilage (10 g) or placebo. Quantitative metagenomic analysis of faecal DNA was performed to identify the changes in the gut microbiota. Diet-induced changes in metabolic markers were explored using adjusted linear regression models. The intake of flaxseed mucilage over 6 weeks led to a reduction in serum C-peptide and insulin release during an oral glucose tolerance test (P< 0·05) and improved insulin sensitivity measured by Matsuda index (P< 0·05). Comparison of gut microbiota composition at baseline and after 6 weeks of intervention with flaxseed mucilage showed alterations in abundance of thirty-three metagenomic species (P< 0·01), including decreased relative abundance of eight Faecalibacterium species. These changes in the microbiota could not explain the effect of flaxseed mucilage on insulin sensitivity. The intake of L. paracasei F19 did not modulate metabolic markers compared with placebo. In conclusion, flaxseed mucilage improves insulin sensitivity and alters the gut microbiota; however, the improvement in insulin sensitivity was not mediated by the observed changes in relative abundance of bacterial species. [ABSTRACT FROM PUBLISHER]

This article discusses major themes in recent transcultural psychiatric research in the Nordic countries from 2008 to 2011: (a) epidemiological studies of migration, (b) indigenous populations, and (c) quality of psychiatric care for migrants. Over the past several decades, the populations of the Nordic countries, Denmark, Finland, Norway, and Sweden, which were relatively homogeneous, have become increasingly culturally diverse. Many migrants to Nordic countries have been exposed to extreme stress, such as threats of death and/or torture and other severe social adversities before, during, and after migration, with potential effects on their physical, mental, social, and spiritual health. Growing interest in transcultural issues is reflected in the level of scientific research and clinical activity in the field by Nordic physicians, psychologists, social scientists, demographers, medical anthropologists, as well as other clinicians and policy planners. Research includes work with migrants and indigenous minorities in the Nordic countries, as well as comparisons with mental health in postconflict countries. We conclude by suggesting future directions for transcultural psychiatry research and providing guidelines for the education and training of future clinicians in the Nordic countries. [ABSTRACT FROM AUTHOR]

Introduction: Researchers in Denmark have unique possibilities of register-based research in relation to migration, ethnicity, and health. This review article outlines how these opportunities have been used, so far, by presenting a series of examples. Research topics: We selected six registers to highlight the process of how migrant study populations have been established and studied in relation to different registers: The Danish Cancer Registry, the Danish Central Psychiatric Research Register, the Danish National Patient Register, the Danish National Health Service Register, the Danish Injury Register, and the Danish Medical Birth Register. Conclusion: Our paper documents the unique opportunities to study migration, ethnicity, and health through Danish national registers. Our examples show that in Denmark ‘‘country of birth’’ is the most commonly used measure. It renders information on whether the person is an immigrant or not, and on ethnic background. Data on migration background (i.e. refugee status vs. family reunification, etc.) is more difficult to obtain and therefore less used. It has been debated if ethnicity should be registered upon using health services; however, some consider it discriminatory. Although, we do not register ethnicity in relation to use of health care in Denmark, our possibilities of linkage between population registers and registers on diseases and healthcare utilisation appear to render the same potentials. [ABSTRACT FROM PUBLISHER]

Background/Aims: Diagnostic evaluation of dementia for ethnic minority patients may be challenging. This study aimed to evaluate the quality of diagnostic evaluation of dementia for patients from ethnic minorities in Denmark. Methods: The Danish national hospital registers were used to identify patients from the main ethnic minority groups in Denmark, who were diagnosed with dementia in the period 2005-2007. Three raters independently reviewed the patients' medical records. Data were compared to data from a previous similar study in the general Danish population. Results: Fifty-seven medical records were reviewed. An acceptable diagnostic workup was documented in only 23% of the patients. Dementia diagnosis was confirmed in 35%. Significant differences in the quality of the diagnostic evaluation were found between patients from ethnic minorities and the general population. Conclusion: There are significant ethnic disparities in the quality of diagnostic evaluations and outcome of dementia in the secondary healthcare sector. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A nationwide cohort of first-time admitted patients aged 65 years or more to Danish psychiatric institutions was followed over a 10-year period in the Danish psychiatric register. The annual incidence rate was 3·4 males and 3·9 females per 1000. Females were more likely to get an age-related diagnosis, had more admissions and longer stays than males. 62·6% of the males and 53·9% of the females died as patients or were discharged within one year and not readmitted. More frequently this short-term group had a non-psychotic disorder. 21·9% of the males and 27·2% of the females became long-stay patients and were characterized by organic disorders. 1·9% of the males and 3·2% of the females became revolving-door patients and were characterized by manic depressive psychoses and organic disorders. In total the annual incidence tale of ‘heavy users’ was estimated to be 0·81 males and 1·14 females per 1000. [ABSTRACT FROM AUTHOR]

A three-month long study was undertaken of the utilization of the local psychiatric out-patient clinic by the geographically delimited population of Århus, Denmark. Of the 307 males and 580 females contacting the clinics, 107 males and 148 females were new referrals, corresponding to 1.25 males and 1.48 females per 1,000 inhabitants 15 years or more, respectively. The ratio of treated females to males increased from 0.87 in the 15-24--year age group to 2.22 for patients 55 years or above. Manic-depressive psychosis accounted for 43 per cent, followed by schizophrenia and other functional psychoses in males, and neuroses and other functional psychoses in females. The clinics collaborated closely with the in-patient facilities. Thus about 75 per cent were referrals from the in-patient clinics and 70 per cent of the discharged out-patients admitted. [ABSTRACT FROM AUTHOR]

This paper describes approaches taken at the International Rehabilitation and Research Centre in Copenhagen to helping torture victims and their families cope with the exposure to and aftermath of torture. [ABSTRACT FROM AUTHOR]

The article focuses on the developments in the field of psychiatry in Denmark. It mentions about the shortage of trained psychiatrists in the country. It states that a report by a committee of the Danish Psychiatric Society stressed on the need of relevant exposure to medical students in the field of psychiatry and informs about .