Search

Background Unemployment and work disability are common among individuals with non-affective psychotic disorders (NAPDs) but it is unknown whether rates differ among migrants and native-born individuals. The present study aimed to compare the risk of these outcomes during the first 5 years of illness in non-refugee migrants, refugees and native-born individuals with NAPDs in Sweden and Denmark—two countries with different immigration policies and models of early psychosis care. Methods Using national registers, we identified all individuals aged 18–35 years in Sweden and Denmark who received an incident NAPD diagnosis between 2006 and 2013 (N  = 6750 and 8320, respectively). Cohorts were followed for 5 years to determine the days of unemployment and sickness absence (analyzed using zero-inflated negative binomial models) and the time to receipt of disability pension (analyzed using complementary log-log models). Results Relative to their native-born peers, refugees and non-refugee migrants in Sweden and non-refugee migrants in Denmark were significantly less likely to have zero unemployment days (OR range: 0.54–0.72) and all migrant groups experienced more unemployment days (IRR range: 1.26–1.37). Results were largely unchanged after adjustment for sociodemographic and clinical factors. In the adjusted model, both Swedish migrant groups and refugees in Denmark were more likely to experience zero sickness absence days than native-born individuals (OR range: 1.48–1.56). Only refugees in Denmark were at greater risk of disability pension. Conclusions Non-refugee migrants and refugees with NAPDs in both Sweden and Denmark are particularly vulnerable to experiencing unemployment. Targeted interventions may help to reduce these disparities and promote long-term work ability among migrant groups. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effectiveness of a 7-weeks peer-to-peer program for young people aged 15 to 25 years with depression or anxiety symptoms in Denmark., Methods: A total of 483 participants (72% women) participated in the program and the evaluation. The participants completed questionnaires at baseline, postintervention, and at 5-month follow-up to assess changes in depression symptoms (using Beck's Depression Inventory-II), anxiety symptoms (using Spielbergers State-Trait Anxiety Inventory for Adults) and self-efficacy in controlling or managing the illness (using the personal control subscale from the Illness Perception Questionnaire-Revised). Analyses were done using repeated measures mixed linear regression models. Moreover, a register-based matched comparison group was derived as a comparison to assess changes in being in education and employment at 8-month follow-up., Results: Within the intervention group, both depression and anxiety scores declined across the 5-month follow-up compared to baseline ( b  = -9.6, 95% CI: -11.2, -8.1 for depression symptoms). The self-efficacy score increased from baseline to post-intervention ( b  = 1.4, 95% CI: 1.0, 1.8) and this level was maintained at follow-up. More than half of the participants were in education at baseline while 24% received social transfer payments. Compared with matched comparison group, a lower proportion of the intervention group remaining in education (71% vs. 80%). Among participants who were employed at baseline, a higher proportion of the intervention group were enrolled in education (27% vs. 19%) and were unemployed (14% vs. 4%) compared to the matched comparison group., Conclusion: This study supports the effectiveness of a peer-to-peer intervention for depression and anxiety symptoms, and self-efficacy in symptom control. However, mixed effects on education and employment were observed, indicating a negative impact on education among those initially enrolled and a higher proportion of employed participants starting education., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Andersen, Thygesen, Jensen, Lauridsen, Folker and Nielsen.)

The Danish Reproducibility Network (DKRN) is a grassroots initiative for establishing a peer-supportive reproducibility-focused academic network in Denmark. We modelled our approach on already existing national Reproducibility Networks. We consulted with researchers and research support professionals to identify the needs of the research community. Three themes emerged around policy implementation, training and the appropriate application of reproducible practices. The network aims to address these three themes in a strategic plan, which harnesses the benefits of grassroots initiatives. The mission of the DKRN is therefore to facilitate communication, peer-support, and the exchange of ideas through a network of topic and geographical nodes. The network is open to researchers and research support professionals from all career stages and disciplines. It aligns with broader international initiatives, and national institutions, positioning itself as a contributor to the Danish research ecosystem., (© 2024. The Author(s).)

Purpose: The aim of this study was to gain insight into experiences and reflections of persons with amyotrophic lateral sclerosis and relatives concerning the peer group rehabilitation programme "More Life – Less Illness". Methods: This qualitative study used the Interpretive Description methodology with Symbolic Interactionism as the analytical framework. Eighteen programme participants representing persons with amyotrophic lateral sclerosis (n = 8) and relatives (n = 10) were included. Data consisted of individual interviews and participant observation. Results: The analysis revealed two categorical themes, "Sense of Community Building" and "Understanding my ALS", which represented the participants' experiences and reflections on peer group rehabilitation. Through the analysis, it became apparent that "Sense of Community Building" gave rise to an increased and personalised understanding of amyotrophic lateral sclerosis among the participants. As a part of the continuous processing of the knowledge gained, "Facing Facts" and "Retaining Normality" appeared as subthemes regarding the participants' ability to live a less dependent and more meaningful life. Conclusions: This study of peer group rehabilitation for persons with amyotrophic lateral sclerosis and relatives indicates that programme participation leads to positive experiences in terms of living a shared meaningful life despite severe disability. The findings may guide practice to develop longitudinal peer group rehabilitation programmes with joint inclusion of persons with amyotrophic lateral sclerosis and relatives. Peer group rehabilitation may facilitate an increased and personalised understanding of what it means to live with amyotrophic lateral sclerosis. A programme design with six months of sequential sessions enables a continuous processing of shared experiences and gained knowledge. Joint participation of persons with amyotrophic lateral sclerosis and their relatives supports both their internal relationship and social networking. Peer group rehabilitation in amyotrophic lateral sclerosis should help overcome obstacles concerning the needs of participants, accessibility, and geographical distance. [ABSTRACT FROM AUTHOR]

The general goal of Danish residential care institutions with a therapeutic objective is to change children's behaviour and redirect their identity formation. This goal is pursued through an individualized focus on development. Dynamics of the resident group is rarely targeted directly in the pedagogical work. This article challenges the implicit understanding that social work is the primary source of identity transformation and that peer group interaction is mainly an obstacle to overcome. On the contrary, this article argues that learning about the social dynamics of the children's group is a precondition for understanding how social work influences individual children. [ABSTRACT FROM AUTHOR]

This article, based on an ethnographic study, examines the role of food in the social interaction of 11- to 17-year-old youths in sports centres in Denmark. The sports centres serve as a free space where young people receive no adult supervision. This is underlined by their understanding and use of food in this environment. Food serves as a medium that introduces occasions for getting together. The article analyses the social significance and symbolic meaning of food in children's and adolescents' peer culture. As everywhere in social life, rules of food choice and eating signal the meaning of social relations and social contexts. [ABSTRACT FROM AUTHOR]

Objective: Childhood cancer patients experience a challenging reentry to social activities after diagnosis. This study aims to generate knowledge about the challenges experienced by childhood cancer patients with peers during and after treatment., Design: This study is a qualitative mixed study., Participants: The study included 70 children - 34 boys and 36 girls - aged 3 to 17 years who are affiliated with a pediatric oncology unit in Denmark., Findings: Childhood cancer patients experience two types of exclusion: (1) unavoidable diagnosis-related exclusion and (2) person-based exclusion from teachers, peers, and peers' parents. Person-based exclusion is manifested through the perceived insecurity of peers, misconceptions, and bullying. The impact and degree of these interactions partly depend on the patients' social affiliation prior to cancer., Implication for Psychosocial Providers: There is a need to understand the exclusion experiences of childhood cancer patients and identify particularly vulnerable children to reduce the self-reported impact of person-based exclusion.

Background: The prevalence of low well-being, perceived stress and unhealthy behaviours is high among high school students, but few interventions have addressed these problems. The aim of this paper is to present a study protocol of a cluster randomised controlled trial evaluating the Healthy High School (HHS) intervention programme. The intervention programme is designed to improve well-being (primary outcome) by preventing 1) stress and promoting 2) sleep, 3) sense of community, 4) physical activity (PA) and 5) regular and healthy meals among high school students in Denmark., Methods: The development of the HHS study was guided by the Intervention Mapping protocol. The intervention comprises four components: 1) a teaching material, 2) a smartphone app, 3) a catalogue focusing on environmental changes, and 4) a peer-led innovation workshop aiming at inspiring students to initiate and participate in various movement activities. The HHS study employs a cluster-randomised controlled trial design. Thirty-one high schools across Denmark were randomly allocated to intervention (16 schools) or control (15 schools) groups. The study included all first-year students (~ 16 years of age) (n = 5976 students). Timeline: Intervention: August 2016 - June 2017. Collection of questionnaire data: Baseline (August 2016), 1st follow-up (May 2017) and 2nd follow-up (April 2018). All students were invited to participate in a monthly sub-study about perceived stress using text messages for data collection (September 2016 - June 2017). PA was objectively assessed among a sub-sample of students using accelerometers (Axivity, AX3) in August 2016 and May 2017., Primary Outcome Measures: Student well-being measured by the Cantril Ladder and the five item World Health Organisation Well-being Index (individual level outcomes)., Secondary Outcome Measures: Stress (10-item Perceived Stress Scale), sleep (quantity and quality), PA (hours of moderate-to-vigorous PA per week, hours of daily sedentary time and average daily PA), meal habits (daily intake of breakfast, lunch, snacks and water), and strong sense of community in class and at school, respectively (individual level outcomes). The study encompasses process and effect evaluation as well as health economic analyses., Trial Registration: ISRCTN ISRCTN43284296, 28 April 2017, retrospectively registered.

Study Design: A feasibility study, supplemented by a noncontrolled pretest/posttest., Objectives: To examine if a nationwide volunteer peer-mentoring program for in-patients with acute/subacute spinal cord injury is feasible and achievable., Setting: The Spinal Cord Injury Center of Western Denmark and Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark., Methods: Volunteer mentor groups were formed similarly in two highly specialized SCI centers covering Denmark. Hospital staff was responsible for referral to the mentoring project and for the interdisciplinary evaluation of patient eligibility. At each of the two centers, a person living with the consequences of SCI coordinated the intervention in collaboration with healthcare personnel. Designated project personnel introduced eligible participants to the project. Staff at the SCI centers arranged to fit in the supplementary mentoring with ongoing treatment. A self-report questionnaire was completed prior to and after peer intervention., Outcome: patient reports regarding mentoring sessions, change in quality of life (QoL), depression items from the Short Form Health Survey (SF-36), pain frequency and intensity (11-point Numerical Rating Scale)., Results: A nationwide mentor corps was established. Fifty-two eligible in-patients completed the study. Significant improvement in QoL was found after mentoring. Frequency and intensity of pain did not change, although five out of nine depression items improved significantly. A majority (94%) of the participants recommended others to meet with a peer mentor., Conclusions: Establishing a nationwide volunteer mentor system at a highly specialized neuro-rehabilitation units for SCI in-patients is both feasible and acceptable.

Aims: To investigate associations between health literacy (HL) and diet and physical activity, and motivation and diet and physical activity in Danish people with type 2 diabetes., Methods: We used a cross-sectional design including 194 individuals with type 2 diabetes participating in peer-led support groups provided by the Danish Diabetes Association between January-December 2015. The participants completed a questionnaire at the first meeting including; The Summary of Diabetes Self-Care Activities (SDSCA) measure, The Treatment Self-Regulation Questionnaire (TSRQ) (Self-Determination Theory) measuring type of motivation, and two HL scales: The HLS-EU-Q16, and the Diabetes Health Literacy scale (Ishikawa, H). Data were analyzed using linear regression models adjusting for age, gender, educational level, diabetes duration, motivation and HL., Results: The adjusted β (95%CI) showed that autonomous motivation and functional HL were associated with following recommended diet: autonomous motivation; 0.43 (0.06; 0.80) and functional HL; 0.52 (0.02; 1.00). Autonomous motivation was related to following physical activity recommendations; β (95%CI) 0.56 (0.16; 0.96)., Conclusions: This study indicates that, for people with type 2 diabetes, functional HL and autonomous motivation may be important drivers for following diet recommendations, and autonomous motivation may be the most important factor for following recommendations regarding physical activity. These concepts may therefore be highly relevant to address in interventions to people with type 2 diabetes. Different interventions are suggested., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

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.)

Aims: To present and discuss implementation experiences regarding the involvement of community pharmacists with ethnic minority backgrounds in a medication review intervention for ethnic minority poly-pharmacy patients in Denmark., Methods: Data sources include 1) reflection notes from an introductory seminar with pharmacists and the cross-disciplinary research team and 2) five individual interviews and one focus group interview with pharmacists. Data were thematically coded and synthesised to identify underlying rationales and challenges encountered when involving professionals with ethnic minority backgrounds in interventions for ethnic minorities., Results: Informants perceived the need for interventions targeted at ethnic minority poly-pharmacy patients, and highlighted the potential of involving professionals with diverse ethnic backgrounds in such interventions. However, implementation created challenges, because the professional identity of the pharmacists reduced their options for serving as peers with the same ethnic background. Furthermore, issues related to organisational difficulties and overcoming language barriers in the intervention impacted on the potential of involving professionals with ethnic minority backgrounds., Conclusions: Involving healthcare professionals with ethnic minority backgrounds in encounters with ethnic minorities holds potential for the adaptation of services to ethnically diverse populations, thus improving access to and quality of care. However, it is important to ensure sufficient personal and organisational support and to acknowledge the delicate balance between simultaneously serving as a peer and as a professional.

Background: It is currently unknown if school-based social norms interventions are effective in preventing harmful alcohol consumption and other drug use among adolescents in Denmark. This paper describes the social norms-based programme The GOOD life and the design of a cluster-randomized controlled trial to test its effectiveness., Methods/design: The intervention The GOOD life is composed of three social norms components representing three different communication channels, namely face-to-face communication (normative feedback session), print communication (posters) and interactive media (web application). The intervention period of 8 weeks is preceded and followed by data collection, with the follow-up taking place 3 months after baseline. Public schools in the Region of Southern Denmark with grades 8 and 9 are invited to participate in the study and participating schools are randomly allocated to either intervention or control schools. The aim is to recruit a total of 39 schools and a sample of 1.400 pupils for the trial. An online questionnaire is conducted to examine the use of alcohol, tobacco and marijuana as well as the perceived frequency of use among peers of their own grade, which is measured before and after the intervention. Baseline data is used to develop social norms messages which are included in the three intervention components. Primary outcomes are binge drinking (more than 5 units at one occasion) and perceived frequency of binge drinking among peers, while smoking, marijuana use and alcohol-related harm will be assessed as secondary outcomes., Discussion: The GOOD life study will provide necessary insights on descriptive and injunctive norms regarding alcohol and other drug use among Danish adolescents. In addition, it will provide new knowledge and insight on the feasibility, implementation context and effectiveness of a newly developed social norms intervention in the Danish school context., Trial Registration: Date of registration: 17 February 2016 (retrospectively registered) at Current Controlled Trials with study ID ISRCTN27491960.

Loneliness is a public health concern that increases the risk for several health, behavioral and academic problems among adolescents. Some studies have suggested that adolescents with an ethnic minority background have a higher risk for loneliness than adolescents from the majority population. The increasing numbers of migrant youth around the world mean growing numbers of heterogeneous school environments in many countries. Even though adolescents spend a substantial amount of time at school, there is currently very little non-U.S. research that has examined the importance of the ethnic composition of school classes for loneliness in adolescence. The present research aimed to address this gap by exploring the association between loneliness and three dimensions of the ethnic composition in the school class: (1) membership of ethnic majority in the school class, (2) the size of own ethnic group in the school class, and (3) the ethnic diversity of the school class. We used data from the Danish 2014 Health Behaviour in School-aged Children survey: a nationally representative sample of 4383 (51.2 % girls) 11-15-year-olds. Multilevel logistic regression analyses revealed that adolescents who did not belong to the ethnic majority in the school class had increased odds for loneliness compared to adolescents that belonged to the ethnic majority. Furthermore, having more same-ethnic classmates lowered the odds for loneliness. We did not find any statistically significant association between the ethnic diversity of the school classes and loneliness. The study adds novel and important findings to how ethnicity in a school class context, as opposed to ethnicity per se, influences adolescents' loneliness.

This article analyses how young people enrolled in drug addiction treatment in Copenhagen, Denmark, explain their cannabis careers and how they view their possibilities for quitting drug use again. Inspired by Mead and narrative studies of health and illness, the article identifies four different drug use 'aetiologies' drawn upon by the interviewees. These cover childhood experiences, self-medication, the influence of friends and cannabis use as a specific lifestyle. A central argument of the article is that these explanations not only concern the past but also point towards the future by assigning the interviewee a more or less agential position in relation to drugs. Further, the drug narratives are viewed as interactional achievements, related to the social context in which they were produced, namely, the institutional setting of the treatment centres. The article is based on 30 qualitative interviews with young people in drug addiction treatment., (© 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.)

Background: Teaching basic clinical skills to student peers and residents by medical students has previously been shown effective. This study examines if medical students can facilitate laparoscopic procedural tasks to residents using a virtual reality simulator., Methods: This was a retrospective study comparing 2 groups of gynecology residents. One group was instructed by 2 student facilitators, and a resident facilitator instructed the other group. Facilitators in both the groups were experienced in laparoscopic simulator training. The outcome measures were time and repetitions to complete a laparoscopic simulator training program., Results: A total of 51 residents participated: 15 in the student-facilitated group and 36 in the resident-facilitated group after 18 and 7 residents dropped out, respectively. The student-facilitated group averaged 230 minutes, while the resident-facilitated group averaged 200 minutes (p = 0.724). To complete the final examination module, the student-facilitated group required 19.5 repetitions vs 39.2 in the resident-facilitated group (p = 0.007)., Conclusion: Our findings suggest that students can be used as facilitators as an alternative to residents when practicing on a laparoscopic virtual reality simulator., (Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Four new, healthy snack products, consisting of fruit, vegetables, bread, dip and topping, were tested with 600 Danish adolescents aged 9-16. Participants could view, handle, and test the products in a school setting. Acceptance was measured by overall buying intention, as well as buying intention contingent on specific substitutes and on the social situation. Price consciousness, health consciousness, snack neophobia, peer influence, social activities and word-of-mouth were measured as potential determinants of acceptance of the novel products. An exploratory analysis in TETRAD suggested that the measured constructs form three layers, with overall buying intention as the terminal causal effect, health consciousness, word of mouth, snack neophobia and peer influence as endogenous determinants, and social activities and the contingent buying intentions as mediators. Estimation of the causal relationships was conducted in LISREL. Findings show a predominance of social factors as determinants of novel snack acceptance, whereas health consciousness had only a weak and indirect effect on buying intentions and the effect of snack neophobia was partly mediated by social factors., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: Previous research has indicated that health behaviours tend to cluster in social networks, but few have studied the cluster effect in workgroups. We examined the effect of workgroups on current state and change in three indicators of health behaviours (smoking, body mass index (BMI) and physical activity). Further, we examined whether health behaviours of the respondents at group level predicted lifestyle changes., Methods: In a prospective cohort (n=4730), employees from 250 workgroups in the Danish eldercare sector answered questionnaires at baseline (2005) and follow-up (2006). Multilevel regression models were used to examine the effect of workgroups., Results: Workgroups accounted for 6.49% of the variation in smoking status, 6.56% of amount smoked and 2.62% of the variation in current BMI. We found no significant workgroup clustering in physical activity or lifestyle changes. Furthermore, changes in smoking status (cessation) and weight gain were seen in workgroups with high percentage of smokers and high levels of BMI., Conclusion: We found modest evidence for clustering of some health behaviours within workgroups, which could be due to social learning or selection into and out of workgroups. Future health promotion programmes at worksites should recognize the potential clustering of lifestyle behaviours within workgroups., (Copyright © 2014. Published by Elsevier Inc.)

Background and Aims: The fast development of e-learning and social forums demands us to update our understanding of e-learning and peer learning. We aimed to investigate if higher, pre-defined levels of e-learning or social interaction in web forums improved students' learning ability., Methods: One hundred and twenty Danish medical students were randomized to six groups all with 20 students (eCases level 1, eCases level 2, eCases level 2+, eTextbook level 1, eTextbook level 2, and eTextbook level 2+). All students participated in a pre-test, Group 1 participated in an interactive case-based e-learning program, while Group 2 was presented with textbook material electronically. The 2+ groups were able to discuss the material between themselves in a web forum. The subject was head injury and associated treatment and observation guidelines in the emergency room. Following the e-learning, all students completed a post-test. Pre- and post-tests both consisted of 25 questions randomly chosen from a pool of 50 different questions., Results: All students concluded the study with comparable pre-test results. Students at Level 2 (in both groups) improved statistically significant compared to students at level 1 (p>0.05). There was no statistically significant difference between level 2 and level 2+. However, level 2+ was associated with statistically significant greater student's satisfaction than the rest of the students (p>0.05)., Conclusions: This study applies a new way of comparing different types of e-learning using a pre-defined level division and the possibility of peer learning. Our findings show that higher levels of e-learning does in fact provide better results when compared with the same type of e-learning at lower levels. While social interaction in web forums increase student satisfaction, learning ability does not seem to change. Both findings are relevant when designing new e-learning materials.

Aims: To study the characteristics, contexts and implications of drinking stories among young drinkers., Methods: Ethnographic fieldwork was conducted among Danish youth at a beach resort in Bulgaria. The fieldwork included three months of participant observation and 45 semi-structured interviews with a total of 104 tourists and 11 guides. The participants in the study were aged between 16 and 26 years., Results: The participants often shared drinking stories with each other. The stories they told involved alcohol consumption followed by one or several acts of transgression such as stripping, fighting or vomiting. They generally told the stories with amusement or pride. However, some stories were told in a critical tone and focused on negative experiences. The data suggest that for many participants, part of their reason for engaging in heavy drinking and drunken transgressions was that they wanted to build a repertoire of personal drinking stories. Their drinking behaviour was subtly motivated, inspired and guided by the drinking stories that they heard from others, as well as by the drinking stories that they themselves wanted to create., Conclusion: There is an intimate interactional relationship between drinking behaviour and drinking stories. Drinking behaviours can generate stories, but the stories, in turn, influence behaviours and attitudes related to alcohol. Drinking stories are therefore key to understanding drinking among youth., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The present study modeled the direct relationship between child sexual abuse (CSA) and adolescent peer-to-peer sexual victimization (APSV) and the mediated effect via variables representing the number of sexual partners, sexual risk behavior, and signaling sexual boundaries. A cross-sectional study on the effect of CSA on APSV was conducted, utilizing a multiple mediator model. Mediated and direct effects in the model were estimated employing Mplus using bootstrapped percentile based confidence intervals to test for significance of mediated effects. The study employed 327 Danish female adolescents with a mean age of 14.9 years (SD = 0.5). The estimates from the mediational model indicated full mediation of the effect of CSA on APSV via number of sexual partners and sexual risk behavior. The current study suggests that the link between CSA and APSV was mediated by sexual behaviors specifically pertaining to situations of social peer interaction, rather than directly on prior experiences of sexual victimization. The present study identifies a modifiable target area for intervention to reduce adolescent sexual revictimization., (© 2013 American Orthopsychiatric Association.)

The present study set out to investigate predictors of first time adolescent peer-on-peer sexual victimization (APSV) among 238 female Grade 9 students from 30 schools in Denmark. A prospective research design was utilized to examine the relationship among five potential predictors as measured at baseline and first time APSV during a 6-month period. Data analysis was a binary logistic regression analysis. Number of sexual partners and displaying sexual risk behaviors significantly predicted subsequent first time peer-on-peer sexual victimization, whereas a history of child sexual abuse, early sexual onset and failing to signal sexual boundaries did not. The present study identifies specific risk factors for first time sexual victimization that are potentially changeable. Thus, the results may inform prevention initiatives targeting initial experiences of APSV.

Background: Although patient-centred communication has provided a focus point in health care for many years, patient surveys continuously reveal serious communication problems as experienced by patients, due to poor communication. Likewise, poor inter-collegial communication can cause problems for both health care staff and patients. So, knowing that patient-centred communication and good inter-collegial communication is for the benefit of both health professionals and patients, the relevance of improving health care professionals' communication skills and investigating the effect on both professionals and patients is beyond doubt., Aim: The aim of this study was to investigate whether a training course in communication skills for health care professionals could improve: 1) Health care professionals' self-efficacy in communication with patients and colleagues 2) Health care professionals' evaluation of inter-collegial communication 3) Patients' experience of quality of care, and to investigate health care professionals' experience of: a) participation in a communication skills training course b) the influence of the course on their ability to communicate with patients and colleagues., Methods: The study was carried out in the Department of Orthopaedic Surgery, Kolding Hospital, a part of Lillebaelt Hospital, as an intervention study with baseline measurements and measurements after the intervention. The intervention was an in-house communication skills training course for all health care professionals at the department. The effect was measured partly on the health care professionals' self-efficacy and evaluation of inter-collegial communication, partly on patients' evaluation of quality of information, continuity and care. Data were collected by means of questionnaires and further explored by focus group interviews with health care professionals., Results: A total of 181 health care professionals were included in the study. The questionnaire was completed by 177 (97.8%) before; 165/169 (97.6%) immediately after and 150/153 (98%) six months after the course. The health care professionals' self-efficacy was significantly increased, both for communication with patients and colleagues. The effect was still present six months after the training course. Also the health care professionals' evaluation of inter-collegial communication showed significant improvements after the course; the effect was more pronounced for inter-professional than for intra-professional communication and more pronounced six months after than immediately after the course. A total of 32 health care professionals participated in the focus group interviews, which showed that, in general, nurses, nursing assistants, medical secretaries and managers principally experienced better control over the patient interview, increased confidence in communication, improved inter-collegial understanding and increased focus on patient-centred communication after the training course. The doctors had an overall negative experience of their participation in the training course, but nevertheless experienced positive changes in their communication after the course. In the patient survey a total of 3660 patients answered the questionnaire from the 1st of May 2007 untill the 31st of May 2010. The eligible response rates were 67.75% for the baseline measurement and 77.63% for the after measurement. There was a significant increase in patients responding "To a considerable extent" for 15/19 questions; a non-significant increase for 3/19 questions, and a statistically significant decrease for 1/19 question after the training course., Conclusion: The study has shown that a communication skills training course can improve health care professionals' self-efficacy in communication with both patients and colleagues and also improve inter-collegial communication. The focus group interviews showed that the most essential experiences of change were more confident communication with patients and colleagues and an increased patient-centredness. Furthermore, the study has shown a significant increase in patient satisfaction concerning information, continuity and care after the training course for health care professionals.

Background: Area-level socio-economic factors are significantly related to a population's health. This study investigates how school district-level factors affect the initiation of alcohol drinking of Danish adolescents., Methods: A survey sample of 11,223 female and male pupils in the 7th grade from 447 schools across Denmark was analysed for the outcome variable drinking initiation and a number of individual level predictors. Aggregated variables on school district level were created from national registry data for education, occupational level and household savings of residents, type of housing and land use characteristics., Results: About 40% of all respondents (45.8% males and 35.2% females) had ever drunk more than one glass of alcoholic beverage. Mixed-effects logistic regression showed that significant individual level predictors for drinking initiation were male gender, a lower performance at school, perceived peer group drinking and the perceived daily drinking of the father. On school district level, adolescents were more likely to initiate alcohol consumption in school districts with higher farming land use and less likely in those with higher proportion of private apartment buildings. Other school district factors were not associated with drinking initiation when controlled for individual level factors., Conclusions: The impact of socio-economic variables at school district level seems to be smaller in the welfare state of Denmark than known for other countries. However, residence in rural areas may be a direct disadvantage for youth, indicating a need for region-specific prevention programmes.

Social-cognitive models have often been used in research on prevention in adolescent populations, even though the models were designed to describe adult behavior. The aim of the study reported here was to examine critically and constructively the five social-cognitive factors in the 'attitude, social influence, self-efficacy' (ASE) model. Methods. The examination draws on the results of a qualitative follow-up study of smoking initiation based on semi-structured interviews and observations of 12 adolescents in two Danish school classes, grades 7 and 8. The qualitative study was conducted in connection with and sampled from a large quantitative study and the results of both studies are discussed. In the analyses, we explored the ASE constructs according to how they are described in the ASE theory. Furthermore, we examined contradictions and aspects which are not explained in the model and if relevant discussed these aspects using other theoretical frameworks. Results. The results showed that aspects other than those in the ASE model are also important. Smoking initiation was often situational and unplanned and was sometimes used in negotiating social relationships and identity. Furthermore, the social-cognitive models are based on the assumption that adolescents talk about smoking norms and have a high degree of individual reflexivity, which is not always characteristic of adolescent behavior. Conclusion. Applying theoretical models in health research should be a continuous process of both applying the model and discussing the theoretical assumptions of the model when applied to a specific sample. The results of the qualitative study provide some support for use of the ASE model, but the results also suggest that further studies are needed to explore how social-cognitive models can be expanded to be more comprehensive behavioral models.

Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students.

Aims: The aim of the present study was to examine the association between social-cognitive factors, school factors, and smoking initiation among adolescents who had never smoked., Methods: The study was based on longitudinal data on Danish adolescents attending randomly selected public schools. Adolescents enrolled in grade 7 (mean age, 13 years) who had never smoked (n = 912) were followed up for 6 months after baseline. Those who had still never smoked were followed up again 18 months after baseline, in grade 8 (n = 442). Social-cognitive factors were examined with five measures: self-efficacy, social influence (norms), social influence (behavior), social influence (pressure), and attitude. We used multilevel analyses to estimate the associations between social-cognitive factors at baseline and smoking initiation as well as the random effects of school, school class, and gender group in the school class., Results: At the first follow-up, we found significant associations between attitude, father's smoking, best friend's smoking, and smoking initiation. At the second follow-up, we found a significant association with pressure to smoke from friends. Of the school factors, gender group in the school class showed an effect at both first and second follow-up., Conclusion: Our results suggest that father's smoking, best friend's smoking, attitude, and pressure to smoke from friends affect smoking initiation. The results for school factors suggest an effect of classmates of the same gender, which has not previously been examined longitudinally.

Background: Smoking is a serious health threat and identifying risk factors for smoking is thus of great importance. The aim of the study was to examine the effects of social-cognitive factors and school factors on lifetime smoking status among adolescents., Methods: The study was based on cross-sectional data on 2,913 Danish adolescents in grade 7 attending 118 randomly selected public schools. Social-cognitive factors were examined with five measures: self-efficacy to resist pressure to smoke, social influence (norms), social influence (behavior), social influence (pressure), and attitude. We used multilevel analyses to estimate the associations between social-cognitive factors and lifetime smoking status as well as the group-level effects of school, school class, and gender group in the school class., Results: Each social-cognitive factor was significantly associated with lifetime smoking status, even when several potential confounders and the effects of school, school class, and gender group were taken into account. Of the three group-level school factors, gender group in the school class had the strongest effect on smoking status., Conclusion: We conclude that self-efficacy to resist pressure to smoke, attitude, and the three types of social influence are significantly associated with lifetime smoking status, even when the effects of group-level school factors are taken into account. The strong effect of gender group in school class on lifetime smoking status indicates that prevention actions should address the social context of adolescents.

This study examined the relation between risk-taking behaviour while driving, the psychosocial function of driving, leisure time activities, car oriented peer group interaction and educational attainment. Two thousand four hundred seventeen drivers aged 18-25, randomly selected from the Danish Driving Licence Register, participated in the study. Data was collected through a mail survey. The response rate was 60.4%. A positive significant effect on risk-taking behaviour based on the score on the psychosocial function of driving was found (p<0.001). A positive significant effect on risk-taking behaviour was also found based on driving related interaction with friends. Low structure/high impulsivity leisure time activities such as playing PC-games, doing body building and partying with friends were found to be related to increased risk-taking behaviour (p<0.01). Although risk-taking behaviour is generally condemned by society results show that risk-taking behaviour while driving can also be functional in the lives of the young drivers. Consequently, other motives than safety motives are at stake when engaging in risk-taking behaviour. Implications for preventive efforts are discussed.

Aim: To examine strategies of harm minimization employed by teenage drinkers., Design, Setting and Participants: Two periods of ethnographic fieldwork were conducted in a rural Danish community of approximately 2000 inhabitants. The fieldwork included 50 days of participant observation among 13-16-year-olds (n = 93) as well as 26 semistructured interviews with small self-selected friendship groups of 15-16-year-olds (n = 32)., Findings: The teenagers participating in the present study were more concerned about social than health risks. The informants monitored their own level of intoxication, but in order to reduce alcohol consumption they depended upon support from their peers. The informants preferred drinking in the company of well-known and trusted peers, and during drinking episodes they supervised and intervened in each others' drinking to the extent that they deemed it necessary and possible. In regulating the social context of drinking they relied on their personal experiences more than on formalized knowledge about alcohol and harm, which they had learned from prevention campaigns and educational programmes., Conclusions: In this study we found that teenagers may help each other to minimize alcohol-related harm, and teenage peer groups should thus be considered a resource for health promotion.

Context: Offspring of psychiatric inpatients are at higher risk of death from all causes, but their cause-specific risks have not been quantified., Objective: To investigate cause-specific deaths at 1 to 25 years in offspring of parents previously admitted as psychiatric inpatients., Design: Population-based cohort study., Setting: The entire Danish population., Participants: All singleton births (N = 1.38 million) from January 1, 1973, to December 31, 1997, with follow-up to January 1, 1999. Linkage to the national psychiatric register identified all previous parental admissions., Main Outcome Measures: Deaths from all natural causes and all unnatural causes, specifically, accidents, homicides, suicides, and undetermined causes., Results: The highest observed relative risk (RR) was for homicide in young and older children with affected mothers or fathers. Homicides were between 5 and 10 times more likely to occur in this group, according to child's age and whether the mother or father had been admitted. There was previous parental admission in approximately one third of all child homicides. We found no evidence of increased risk of homicide in exposed young adults, but this group had a 2-fold to 3-fold higher risk of suicide. In almost one fourth of the suicides, there was a history of parental admission. Young adults with 2 previously admitted parents were 6 times more likely to kill themselves than were their peers in the general population. Relative risk of suicide or open-verdict deaths by poisoning were higher than for such deaths occurring by other means., Conclusions: Almost 99% of children studied survived to their mid-20s. However, they were more vulnerable to death from unnatural causes, notably, homicide during childhood and suicide in early adulthood. Further research is needed to establish how parental psychopathology contributes to increased risk of premature death in these offspring.

The impact of group identity on adolescent tobacco, alcohol, and marijuana use was examined through a postal survey. The study included adolescents who identified with 1 subgroup (n = 1425) as well as adolescents who identified with 2 (n = 895) or 3 (n = 339) subgroups. The results showed that identification with the pop, skate/hip-hop, techno, and hippie subgroups was associated with higher risks of substance use, whereas identification with the sporty, quiet, computer nerd, and religious subgroups was associated with lower risks. Perceived group norm mediated the group identity-substance use relationship. Furthermore, identification with multiple groups with corresponding norm increased norm-consistent substance use, whereas identification with multiple groups with opposing norms reduced normative behavior. Implications for health promotion are discussed., ((c) 2007 APA, all rights reserved.)

This article shows the possible effects of an integrated intensive introduction to medical school using older students as tutors for first-year students. Our project resulted in a significant decrease in the average time to completion of the first five semesters of the medical bachelor' degree.

Background: To analyse the cross-sectional association between coping responses with infertility and occupational social class. Infertility is evenly distributed across social classes in Denmark, and there is free access to high-quality assisted reproduction technology., Methods: Data were based on a questionnaire in a consecutive sample of 1169 women and 1081 Danish men who were about to begin assisted reproduction treatment. The coping measure was developed from an adaptation of Lazarus and Folkman's Ways of Coping Questionnaire and based on results from interviews with infertile people. The measure was developed in four categories: active-avoidance coping; active-confronting coping; passive-avoidance coping; meaning-based coping. These subscales were later confirmed by factor analysis. Occupational social class was measured in a standardized way., Results: Contrary to expectations, the logistic regression analyses showed that women from lower social classes V + VI and men from social classes III + IV used significantly more active-confronting coping. Women from lower social classes V + VI used significantly more meaning-based coping. Both men and women from social classes III - VI used significantly more passive-avoidance coping and significantly less active-avoidance coping., Conclusion: Due to the significant social differences in coping with infertility, the study suggested that elements of coping may be learned from one's social network and reference group.

Objective: To determine whether adolescent smoking behaviour is associated with their perceived exposure to teachers or other pupils smoking at school, after adjustment for exposure to smoking at home, in school, and best friends smoking., Design: Logistic regression analysis of cross sectional data from students in Denmark., Subjects: 1515 grade 9 students (mean age 15.8) from 90 classes in 48 Danish schools., Outcome Measure: Self reported smoking behaviour; daily smoking and heavy smoking, defined as those smoking more than 20 cigarettes per week., Results: Of the students in this study, 62% of boys and 60% of girls reported being exposed to teachers smoking outdoors on the school premises. The proportion of boys and girls reporting to have been exposed to teachers smoking inside the school building were 86% and 88%, respectively. Furthermore, 91% of boys and 92% of girls reported that they had seen other students smoking outdoors on the school premises. Adolescents' perceived exposure to teachers smoking outdoors on the school premises was significantly associated with daily smoking, having adjusted for sex, exposure to teachers smoking indoors at school and pupils smoking outdoors at school, as well as the smoking behaviour of mother, father, and best friend (odds ratio (OR) 1.8, 95% confidence interval 1.2 to 2.8). Adolescents' perceived exposure to teachers smoking inside the school building was not associated with daily smoking (OR 0.9, 95% CI 0.5 to 1.6) and perceived exposure to pupils smoking outdoors was not associated with daily smoking (adjusted OR 1.5, 95% CI 0.5 to 4.4). There were similar findings with heavy smoking as the outcome variable., Conclusions: Teachers smoking during school hours is associated with adolescent smoking. This finding has implications for future tobacco prevention strategies in schools in many countries with liberal smoking policies where it might provide support for those working to establish smokefree schools.

Long-term psychosocial effects of malocclusion should be studied longitudinally from childhood to adulthood in orthodontically untreated populations. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who had no access to organized orthodontic care. In a follow-up study 15 years later, a questionnaire was mailed to the subjects; this contained general questions about body image and specific inquiries concerning self-perception and social implications of dental appearance. The response rate was 86%. Ten percent had received orthodontic treatment. In the remaining individuals, only one entry among thirteen items of body image--the teeth--was rated significantly less satisfactory by subjects with malocclusion at adolescence than by subjects without malocclusion at adolescence. The lowest ratings were observed in subjects with extreme maxillary overjet, extreme deep bite, and crowding. Highly significant differences were found between the two groups (subjects with and without malocclusion) in recalling adolescent awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavorable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred seven times more often in the presence of malocclusion. Differences were less marked in the perceptions of the same individuals in adulthood. However, in both adolescence and adulthood unfavorable perceptions of the teeth were expressed significantly more often by subjects with extreme maxillary overjet, extreme deep bite, and crowding. No association was found between malocclusion and present occupational status. It was concluded that certain malocclusions, especially conspicuous occlusal and space anomalies, may adversely affect body image and self-concept, not only at adolescence but also in adulthood.