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PubMed1993

A comparison of nursing approaches for the promotion and management of continence in the U.K. and Denmark.

Incontinence is recognized as a health problem of sizeable proportions affecting a wide age range of the population. This paper compares the nursing approaches for the promotion and management of continence within the U.K. and Denmark. Semi-structured interview of key health professionals within Denmark was undertaken. The information collected forms the basis for a comparison of prevalence of incontinence, clinical practice, management, education and research.

Cost of Illness↗

PubMed1987

The significance of genetic factors in the etiology of schizophrenia: results from the national study of adoptees in Denmark.

The prevalence of schizophrenic illness in the biological and adoptive relatives of schizophrenic adoptees has been examined for a total sample of adoptees in Denmark. The total sample was studied in two stages, beginning with the Copenhagen sample of adoptions granted by the courts in the city and county of Copenhagen, the results of which have been reported previously. The adoptions granted by the courts in the remainder of Denmark comprised the Provincial sample the preliminary results of which appear to confirm those obtained earlier. Chronic schizophrenia and milder syndromes described as latent, borderline, or uncertain schizophrenia were found in both samples to concentrate significantly in the biological relatives of schizophrenic adoptees as compared to their controls, but not in their adoptive relatives. These milder and marginal syndromes resembling schizophrenia occurring in the families of schizophrenic patients confirm the observations of Bleuler and others who succeeded him. Their presence in the biological families of schizophrenic adoptees indicates not only their familial but also their genetic relationship to schizophrenia.

Adoption↗

PubMedDate not supplied

Models of midwifery care. Denmark, Sweden, and The Netherlands.

The organization of maternity services in Denmark, Sweden, and the Netherlands was studied under the sponsorship of the World Health Organization European Headquarters Office of Maternal and Child Health. Midwifery care is highly respected and is a central feature of obstetric care in each of these countries. In Denmark and Sweden, almost all births are in the hospital, and autonomous midwives are employed by national health services. About three-quarters of Dutch midwives are in independent practice, and 34% of Dutch women give birth at home. In each country midwives provide "the first line" of care for normal pregnant women and are viewed as essential to the excellent perinatal outcomes these three countries enjoy.

Birth Rate↗

PubMed1994

Differential T-cell expression of LFA-1 in residents from Africa and Denmark. Description of the phenomenon and its possible basis.

All circulating T cells constitutively express the adhesion molecule leukocyte function-associated antigen 1 (LFA-1; CD11a/CD18) at either low or high surface density. In the present paper we have compared the expression of the LFA-1 alpha-chain CD11a on peripheral T cells obtained from indigenous Africans with permanent residence in Africa to T cells from indigenous Danes with permanent residence in Denmark. The Africans had a higher percentage of T cells with high CD11a expression than did Danish donors. The difference was evident in both the CD3-, CD4+, and CD8+ subsets. The difference did not appear to reflect a higher degree of peripheral T-cell activation in the African donors, as T-cell expression of the activation marker IL-2 receptor (CD25) was similar in the two groups. Furthermore, we observed no apparent correlation between CD3+ CD11a(hi) and CD3+ CD25+ values in individual donors. LFA-1 expression on T cells obtained from expatriate Africans with long-term residence in Denmark resembled that of Danish permanent residents more than that of Africans with permanent residence in Africa. In addition, T cells obtained from two expatriate Danes with long-term residence in rural Africa were phenotypically similar to those from African permanent residents. The data suggest that the observed difference is environmental rather than ethnic and may reflect the degree of exposure to infectious agents.

Africa↗

PubMed1993

Minimally invasive therapy in Denmark.

Minimally invasive therapy (MIT) is beginning to have impacts on health care in Denmark, although diffusion has been delayed compared to diffusion in other European countries. Now policy makers are beginning to appreciate the potential advantages in terms of closing hospitals and shifting treatment to the out-patient setting, and diffusion will probably go faster in the future. Denmark does not have a system for technology assessment, neither central nor regional, and there is no early warning mechanism to survey international developments. This implies lack of possibilities for the planning of diffusion, training, and criteria for treatment.

Denmark↗

PubMed1991

Evolution of Staphylococcus aureus resistance to erythromycin in Denmark, 1959 to 1988: comparison with erythromycin-susceptible strains.

Between 1959 and 1988, all Staphylococcus aureus strains (15 168 patients) isolated from blood in Denmark have been collected, investigated and stored, and clinical data has been obtained. Erythromycin resistance was found in 4.9% of these strains. The frequency of erythromycin resistance peaked at 25% in 1966, due to the spread in hospitals of multiresistant strains of the 83A complex. When these strains dominated, an increased mortality rate was seen in patients infected with erythromycin-resistant S. aureus. In contrast to most countries, erythromycin resistance in S. aureus declined to less than 5% in 1971, continued to fall to 1.3% in 1983, and has increased slowly to 2.4% in 1988. The decline was only due to a decrease of multiresistant strains. Erythromycin-resistant strains isolated in recent years are predominantly resistant only to penicillin and erythromycin and belong to many different phage type patterns. In Denmark, inducible resistance has occurred at a stable high frequency of approximately 90% of the erythromycin-resistant strains during the last 30 years. Erythromycin-resistant strains isolated today, however, have higher minimum inhibitory concentrations, and are rarely resistant to spectinomycin, in contrast to the strains isolated in the first half of the observation period.

Denmark↗

PubMed1992

Spread of Staphylococcus aureus strains of phage-type 95 in Denmark 1968-1989.

The spread of Staphylococcus aureus strains of phage-type 95 was traced retrospectively in Denmark by the review of more than 15,000 S. aureus bacteraemia isolates (1957-88) and from data collected by phage-typing of c. 260,000 isolates from all body sites (1977-89). The first two type 95 strains had been isolated from blood in 1968, and after an interval of 3 years there was a steady increase of bacteraemia strains all over Denmark. From 1977 to 1989 the incidence of type 95 strains among isolates from all body sites increased from 3.8 to 18.8%. Different patterns of increase were recorded in 13 major hospitals and in various clinical departments of two hospitals and these were further analysed. Conjunctival swabs gave the highest percentage of type 95 strains and those from abscesses gave the lowest percentage. Of the type 95 bacteraemia strains 90.4% were resistant to penicillin, but neither methicillin nor gentamicin resistance was recorded.

Bacteremia↗

PubMedDate not supplied

Firearms fatalities in Denmark 1970-1979.

In the 10-year period from 1970 to 1979 933 firearm fatalities occurred in Denmark which represent an increase of 45% during a little more than 10 years. Eighty-eight per cent were suicides, 8% homicides, and 4% accidents. Accidental shootings have decreased from 8% to 4% and the fall seems to be a result of fewer accidents in connection with hunting, probably due to a more restrictive legislation about hunting. An increasing share of the total number of deaths, now responsible for 57% of the fatalities, are by shotgun. There has been a remarkable increase in the use of sawn-off long barreled weapons. Still considering the marked increase of firearm fatalities, fatal shootings are of very limited importance in Denmark, especially homicidal shootings of which there are 2-3 per year. Shotguns are at the present time the only procurable dangerous weapons which have led to an increased share of the total firearm fatalities. Restrictions in the use of shotguns during hunting seem to have had positive effects on the reduction of hunting accidents. As mentioned above, the most valuable method of bringing the firearm fatalities under further control seems to be increased control over the procurement and possession of shotguns.

Accidents↗

PubMed1994

Deaths among drug addicts in Denmark in 1987-1991.

In the period 1987-1991 a total of 739 fatalities among drug addicts was investigated at the three University Institutes of Forensic Medicine in Denmark. The annual number rose from 130-140 in the first 4 years to 192 in 1991, and 80% were males. The mean and median age for both males and females increased by 1 year in the period. The main drug of abuse was heroin, in most cases supplemented by various other drugs, and in almost all cases taken intravenously. In about one-third of the cases each year there was information of abuse of alcohol in addition. In the poisoning cases, the main drug of poisoning was morphine/heroin, constituting 35-55% of the cases each year. As regards methadone-poisoning cases, the number increased significantly in 1991 compared to the first 4 years. Furthermore, the number and proportion of addicts dying while in methadone treatment increased during the 5-year period. In about half of the methadone poisoning cases, there was information of methadone treatment at the time of death. The other half obviously obtained the methadone completely illegally. Ketobemidone was the third most frequent drug of poisoning, while propoxyphene and barbituric acid only were found in a very few cases each. The results are compared to those from an earlier investigation concerning drug deaths in Denmark in 1968-1986. The importance of registering drug deaths is emphasized.

Adolescent↗

PubMed1996

Dietary risk factors for renal cell carcinoma in Denmark.

The role of diet in the aetiology of renal cell carcinoma was investigated in a population-based case-control study in Denmark. Cases were 20-79 years old, with a histologically verified diagnosis of renal cell carcinoma. Controls were sampled from the general population and were frequency-matched on age and sex. A total of 351 cases (73% of the eligible) and 340 controls (68% of the eligible) were included in the study. Dietary information was obtained in a self-administered food frequency questionnaire and the information was confirmed in a subsequent interview performed by trained interviewers who also elicited information on other suspected risk factors such as smoking, occupation, medical history, education and reproductive history. Logistic regression models were used to calculate the odds ratios, and, both frequency of consumption of various food stuffs and computed nutrients were examined. A positive association was observed between risk of renal cell carcinoma and total energy intake (odds ratio, OR, for highest quartile compared to lowest: 1.7 (95% confidence interval, CI, 1.0-3.0) for men, and 3.5 (95% CI 1.6-6.5) for women), fat intake (OR for highest quartile compared to lowest: 1.9 (95% CI 1.1-3.5) for men, and 3.3 (95% CI 1.6-6.9) for women). For women, an effect was also seen for intake of carbohydrates (OR for highest quartile compared to lowest: 3.2 (95% CI 1.5-6.8), while no protective effect was seen for vegetables or fruit. Dairy products may be associated with risk of renal cell cancer (OR for women using thickly spread butter compared to thinly spread: 11.4 (95% CI 2.8-45), OR for women who drank more than one glass of milk with 3.5% fat content compared to never drink milk: 3.7 (95% CI 1.2-11). As expected, total energy intake, intake of fat, protein and carbohydrates were closely correlated making it difficult to identify one of the energy sources as more closely associated with risk of renal cell cancer than the other. Several energy sources have been identified as possible risk factors for renal cell carcinoma. It is possible that a high energy intake as such rather than the individual sources are responsible for the increased risk. Furthermore, dairy fats may be associated with renal cell carcinoma risk. The observed associations appeared stronger in women, and did not explain the association with obesity and low socio-economic status previously found in Denmark.

Adult↗

PubMed2005

Wet deposition of pesticides and nitrophenols at two sites in Denmark: measurements and contributions from regional sources.

The concentrations of selected pesticides, of some of their degradation products and nitrophenols in rain were measured at two stations in Denmark in the period January 2000-July 2001. Forty compounds were quantified at least at one station during at least one sampling period. Additionally 17 compounds could be detected but not quantified, and 22 compounds could not be detected at all. The highest depositions of pesticides were observed for pendimethalin and desethylterbuthylazine, which is a degradation product of terbuthylazine. The deposition of the nitrophenols 2,4-dinitrophenol, DNOC, 3-methyl-4-nitrophenol was much higher than that of pesticides. The deposition of 2,4-dinitrophenol was e.g. up to a factor of 40 higher than that of pendimethalin. Atrazine, chloridazon, 2,4-D, dieldrin, disulfoton, fenitrothion, isoproturon, lenacil, metazachlor and propachlor were found in precipitation, although these pesticides are not allowed in Denmark. It can therefore be concluded that they came from abroad and have been transported over at least 60-80 km. For some of these compounds the transport distance is much longer.

Chromatography, Liquid↗

PubMed2005

A critical review of available data on sexual abuse of children in Denmark.

OBJECTIVE: To describe different data sources that may illuminate the incidence and character of child sexual abuse (CSA) in Denmark in the late 1990s. METHOD: Data concerning alleged sexual abuse of children below 15 years of age in the 1990s were retrieved from the Danish National Patient Register and the Danish National Criminal Register. In addition, all police files concerning reported CSA in 1 year (1998), were reviewed. RESULTS: The average annual incidence of CSA was .06 per 1,000 children, based on data in the National Patient Register; however, it was .5 per 1,000 based on data in the Criminal Register. In the Criminal Register, significant annual differences were found in cases of sexual offence against children below 12 years. The police reports comprised very comprehensive information about the victims and the character of CSA. Based on this information the incidence of police reported CSA in 1998 was 1.0 per 1,000 children, and .6 per 1,000 excluding reported cases of indecent exposure. Half of intra-familial CSA resulted in a conviction compared to 40% of extra-familial CSA and 16% of indecent exposure. CONCLUSIONS: In Denmark, criminal statistics contain the most systematic collection of data on CSA. However, data reflect the reporting behavior by parents or other closely related adults, which may be influenced by changes in public awareness of the problem. Consequently, register data should be supplemented by data obtained from self-reported surveys on CSA.

Adolescent↗

PubMed2005

Modelling and implementing electronic health records in Denmark.

The Danish Health IT strategy [Danish Ministry of Interior and Health, National Strategy for IT in the Health Sector 2003-2007, Copenhagen, 2003 (in Danish). http://www.im.dk/publikationer/itstrategi/itstrategi.pdf. notes that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, and its adoption is now being promoted through pilot projects. At the same time, several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, has analysed the challenges of using different information models and integration platforms. This paper also maps the development in Denmark to the new paradigms in modelling techniques and integration technology.

Computer Simulation↗

PubMedDate not supplied

Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey.

OBJECTIVE: The purpose of this study is to provide an expanded description of Danish chiropractic patients and to compare characteristics seen in a survey from 1999 with those seen in 2002. METHODS: All chiropractic clinics in Denmark were asked to collect information on new patients during 1 randomly assigned week in 2002 using a survey questionnaire. All 52 weeks of the year 2002 were represented with an even dispersion of weeks (182 clinics participated). Outcome measures included age, sex, education, occupation, location and duration of chief complaint, pain intensity, limitation of activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire. As in 1999, the most frequent area of complaint was pain related to the lower back and pelvis (49%). Contrary to the 1999 survey, most of the patients (64%) had complaints of less than 4 weeks of duration. Twenty-nine percent of the patients had been off work because of their symptoms; most of these for less than 1 week. Fifty-one percent of all patients were referred to chiropractors in 2002 (doubling since 1999). Referrals from general medical practitioners rose from 11% in 1999 to 17% in 2002. Sixty percent of all patients had similar symptoms in the past, and approximately half had previously received treatment of the same or a similar problem. Thirty percent of first-time chiropractic patients were x-rayed. Compared with general population measures, Danish chiropractic patients had significantly worse physical health status measured by the SF-12. CONCLUSIONS: Most Danish chiropractic patients complain of pain related to the spine, especially the lower back, with duration of symptoms of less than 4 weeks, and many with recurrent back pain. Referrals from general medical practitioners have increased since 1999.

Absenteeism↗

PubMed2004

Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969-1993.

We investigated the cancer risk of patients hospitalized for schizophrenia in a nationwide cohort study. All 22766 adults admitted for schizophrenia, ICD-8 295, in Denmark between 1969 and 1993 were followed up for cancer through 1995. The incidence of site-specific cancers was compared with national incidence rates, adjusted for sex, age and calendar time. The risk for cancer was increased for both men and women during the first year of follow-up. When the first year of follow-up was excluded, the risk for all tobacco-associated cancers and for prostate and rectal cancers was reduced for male patients with schizophrenia. The standardized incidence ratio (SIR) of lung cancer was marginally reduced (SIR, 0.86; 95% CI: 0.65, 1.02) for male patients with schizophrenia; this was due, however, to a reduction in risk for older patients. An increased risk for breast cancer found for female patients with schizophrenia (SIR, 1.20; 95% CI: 1.05, 1.38) should be interpreted with caution, given the high proportion of nulliparous women with schizophrenia in Denmark. The data might support reduced risks for prostate and rectal cancer among male patients with schizophrenia, whereas a changing smoking pattern might explain the reduced risk for tobacco-related cancers.

Adolescent↗

PubMed2004

Work environment and somatic hospital admissions in Denmark 1994-1999.

OBJECTIVE: The aim was to elucidate the usefulness of the excess hospitalisation fraction (EHF) approach-as a practical alternative to the calculation of etiological fractions-for prioritising national preventive measures in the total environment. In this study we used the inequality in somatic hospitalisation across industrial sectors as an example. The presented EHFs may provide an estimate of the order of magnitude of the prevention potential, which may also be useful in priority setting in countries comparable to Denmark. METHODS: All economically active adults in Denmark were followed-up for 6 years after hospital discharge, and industrial specific EHFs for 58 industrial sectors were calculated for 11 main diagnostic groups. Assuming 'education and research' to be the industrial sector which is least exposed to occupational hazards, we calculated the EHFs as a practical approximation to the etiologic fraction for all other industries, using hospitalisation rates adjusted for age. In addition, we also controlled for social class since many risk factors may also be related to life style or living conditions. RESULTS: Compared to 'education and research' the EHF in all other industries was (additional control for social class in brackets): Women 11% (7%), men 15% (8%). The EHFs for some of the main diagnostic groups were as follows: Circulatory diseases: Women 18% (12%), men 16% (10%). Neoplasms: Women 3% (4%), men 8% (6%). Musculoskeletal diseases: Women 19% (12%), men 21% (10%). Diseases in the respiratory system: Women 12% (8%), men 16% (9%). Diseases in the nervous system: Women 12% (7%), men 17% (12%). Violent events (injuries and trauma): Women 6% (5%), men 17% (6%). CONCLUSIONS: The advantage of this method is that the EHF can be calculated for all diseases and for the whole population without detailed knowledge of causal risk factors and their distribution in the population. Two main methodological problems are that we cannot control for selection bias related to occupation, and that the control for social class may lead to conservative estimates. Our estimates are, however, close to estimates of etiologic fractions published in the literature. Large unexpected EHFs for diseases of the blood and blood-forming organs should be seen as challenges for future research.

Adult↗

PubMed2005

Spatial and temporal patterns of pig herds diagnosed with Postweaning Multisystemic Wasting Syndrome (PMWS) during the first two years of its occurrence in Denmark.

The clinical syndrome Postweaning Multisystemic Wasting Syndrome (PMWS) in pigs has emerged globally during the last decade. In October 2001, the first pig herd diagnosed with PMWS was reported in Denmark, and since then the number of herds diagnosed with PMWS has increased markedly. The etiology of PMWS is not well understood, but increased knowledge of the causal factors is prerequisite for applying preventive interventions. In this study we described the temporal (time of diagnosis), spatial (location of herds) and spatio-temporal pattern of Danish pig herds diagnosed with PMWS during the first two years after the first herd was diagnosed, and we tested for spatial and spatio-temporal clustering using scan statistics. The study population consisted of pig herds that during the study period (October 2001-September 2003) performed diagnostic submissions to the two major veterinary diagnostic laboratories in Denmark (6724 herds). Of these, 277 herds were diagnosed with PMWS. Two statistically significant spatial clusters of herds diagnosed with PMWS were identified. These clusters included 11% and 8% of the study herds, respectively. Within these two clusters the relative risk for a herd to be diagnosed with PMWS was twice as high as expected. One statistically significant spatio-temporal cluster was identified between February and May 2002. We discuss different hypotheses that could explain why pig herds diagnosed with PMWS were clustered both spatially and spatio-temporally, and conclude that the results support the hypothesis that PMWS is caused by introduction of a new, unidentified, pathogen into the Danish pig production.

Animals↗

PubMed2006

Helminths of red foxes (Vulpes vulpes) in Denmark.

An epidemiological study of helminths in 1040 red foxes collected from various localities in Denmark during 1997-2002, revealed 21 helminth species at autopsy, including nine nematode species: Capillaria plica (prevalence 80.5%), Capillaria aerophila (74.1%), Crenosoma vulpis (17.4%), Angiostrongylus vasorum (48.6% from Northern Zealand (endemic area)), Toxocara canis (59.4%), Toxascaris leonina (0.6%), Uncinaria stenocephala (68.6%), Ancylostoma caninum (0.6%), and Trichuris vulpis (0.5%); seven cestodes: Mesocestoides sp. (35.6%), a number of Taeniid species (Taenia pisiformis, T. hydatigena, T. taeniaeformis, T. crassiceps, and unidentified Taenia spp.) (22.8%), and Echinococcus multilocularis (0.3%); four trematodes: Alaria alata (15.4%), Cryptocotyle lingua (23.8%), Pseudamphystomum truncatum (3.6% from Northern Zealand), and Echinochasmus perfoliatus (2.4% from Northern Zealand); one acanthocephalan: Polymorphus sp. (1.2%). Significant difference in prevalence was found for T. canis and A. vasorum according to host sex, and for T. canis, U. stenocephala, Mesocestoides sp., Taenia spp., A. alata, A. vasorum, and Capillaria spp. according to age groups (adult, young or cub). Prevalence and average worm intensity for each helminth species varied considerably according to geographical locality, season, and year. Aggregated distribution was found for several helminth species. The two species E. multilocularis and E. perfoliatus are first records for Denmark.

Age Factors↗