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1.
Animal ; 18(9): 101289, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39241328

RESUMO

Specialty (niche) pork products may provide societal benefits in terms of e.g. higher animal welfare, reduced use of antibiotics, and lower environmental impact. At the same time, they offer a business opportunity for farmers, slaughterhouses, meat processers, and retailers, who can capitalise on consumer segments willing to pay a price premium. However, the added cost of delivering niche products and a limited willingness among consumers to pay the higher prices may negate the benefits of this approach, particularly as niche products typically have high substitutability with standard pork. One way to ensure the success of the niche pork products is to drive down costs across all parts of the value chain. Inspired by data from the Danish pork market, the present study seeks to identify cost drivers in the value chain. We found two promising approaches to reduce the costs associated with niche products. First, the pricing strategy can be altered so that mainstream pork is replaced entirely by specialty pork products in the chiller section, thereby making niche the new standard. Second, with improved carcass balance, the price premium paid to farmers can be assigned to a larger proportion of the pig, thus enabling the retail price to be lowered. For example, we found that improved carcass balance had the potential to halve the necessary retail price increase, regardless of the pricing strategy employed. The conclusion is that it is possible to drive down costs across all parts of the value chain to enable further production and profitable sale of welfare pork.


Assuntos
Bem-Estar do Animal , Animais , Bem-Estar do Animal/economia , Suínos , Dinamarca , Custos e Análise de Custo , Comércio/economia , Carne de Porco/economia
2.
Europace ; 26(9)2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39230873

RESUMO

AIMS: Atrial fibrillation (AF) is a common arrhythmia associated with reduced quality of life that can lead to serious complications such as stroke and heart failure. Ablation is a safe and effective treatment for AF but is not offered equally to all patients. The aim of this study is to identify demographic groups more or less likely to undergo AF ablation. METHODS AND RESULTS: All patients with newly diagnosed AF between 2010 and 2018 were identified in the Danish nationwide registries. The association between gender, age, level of education and attachment to the job market, and the likelihood of receiving AF ablation was investigated using multivariable Cox proportional hazard analysis. Cumulative incidence was calculated using the Aalen-Johansen estimator. A total of 176 248 patients were included. Men were more likely to receive ablation than women (7% vs. 3%). Patients aged 25-44 and 45-64 were most likely to receive ablation, while only 0.7% of patients aged 80 or above received ablation. The rate of ablation significantly decreased with decreasing level of education. Full-time employed patients were most likely to receive ablation, followed by self-employed, unemployed, on sick leave, undergoing education, and early retired patients. Retired patients were the least likely to receive ablation (3%). CONCLUSION: This study found that women, older patients, patients with lower levels of education, and patients on social benefits are less likely to receive AF ablation. These findings suggest that there are significant social and economic disparities in AF ablation treatment in Denmark.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Escolaridade , Disparidades em Assistência à Saúde , Sistema de Registros , Humanos , Fibrilação Atrial/cirurgia , Fibrilação Atrial/epidemiologia , Dinamarca/epidemiologia , Masculino , Feminino , Ablação por Cateter/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Idoso , Idoso de 80 Anos ou mais , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Emprego/estatística & dados numéricos , Fatores Etários , Fatores Sexuais , Fatores de Risco , Desemprego/estatística & dados numéricos
3.
Atherosclerosis ; 397: 118574, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39244851

RESUMO

BACKGROUND AND AIMS: We tested the association of polygenic risk scores (PRS) for low-density lipoprotein cholesterol (LDL-C) and coronary artery disease (CAD) with LDL-C and risk of ischemic heart disease (IHD) in the Danish general population. METHODS: We included a total of 21,485 individuals from the Copenhagen General Population Study and Copenhagen City Heart Study. For everyone, LDL-PRS and CAD-PRS were calculated, each based on >400,000 variants. We also genotyped four rare variants in LDLR or APOB known to cause familial hypercholesterolemia (FH). RESULTS: Heterozygous carriers of FH-causing variants in APOB or LDLR had a mean LDL-C of 5.40 and 6.09 mmol/L, respectively, and an odds ratio for IHD of 2.27 (95 % CI 1.43-3.51) when compared to non-carriers. The LDL-PRS explained 13.8 % of the total variation in LDL-C in the cohort. Individuals in the lowest and highest 1 % of LDL-PRS had a mean LDL-C of 2.49 and 4.75 mmol/L, respectively. Compared to those in the middle 20-80 %, those in the lowest and highest 1 % of LDL-PRS had odds ratios for IHD of 0.58 (95 % CI, 0.38-0.88) and 1.83 (95 % CI, 1.33-2.53). The corresponding odds ratios for CAD-PRS were 0.61 (95 % CI, 0.41-0.92) and 2.06 (95 % CI, 1.49-2.85). CONCLUSIONS: The top 1 % of LDL-PRS and CAD-PRS conferred effects on LDL-C and risk of IHD comparable to those seen for carriers of rare FH-causing variants in APOB or LDLR. These results highlight the potential value of implementing such PRS clinically.


Assuntos
Apolipoproteína B-100 , LDL-Colesterol , Doença da Artéria Coronariana , Predisposição Genética para Doença , Hiperlipoproteinemia Tipo II , Herança Multifatorial , Isquemia Miocárdica , Receptores de LDL , Humanos , LDL-Colesterol/sangue , Isquemia Miocárdica/genética , Isquemia Miocárdica/sangue , Isquemia Miocárdica/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Dinamarca/epidemiologia , Idoso , Receptores de LDL/genética , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/epidemiologia , Doença da Artéria Coronariana/genética , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Apolipoproteína B-100/genética , Apolipoproteína B-100/sangue , Heterozigoto , Medição de Risco , Fatores de Risco , Adulto , Fenótipo , Biomarcadores/sangue
4.
Scand J Trauma Resusc Emerg Med ; 32(1): 92, 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39300552

RESUMO

BACKGROUND: During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic. Furthermore, we investigated the overall mortality of the ambulance population, the main reason for calling the emergency medical dispatch centre, and the diagnosis assigned to the admitted patients. METHODS: The study was a nationwide registry-based cohort study based on the national prehospital medical records and the Danish National Patient Registry. The primary outcome was the requested number of ambulances. Secondary outcomes included the primary reason for contact with the dispatch centre (reflected by the dispatch criteria), patient mortality, and the diagnoses assigned to the patients transported to the hospital by ambulance during the COVID-19 pandemic in Denmark in March-December 2020. Comparisons were made using a similar period in 2019 before the pandemic. RESULTS: In comparison with the baseline values before the pandemic, the total number of patients treated by the EMS was reduced by 4.5% during the COVID-19 pandemic. The number of patients transported to the hospital during the pandemic was similarly reduced by 3.5%. Compared with baseline values, fewer were patients hospitalised with respiratory diseases during the pandemic (a reduction of 53.3% from April 2019 to April 2020). Compared to the baseline period, there were significant increases in both the 48-h mortality (from 1.4% to 1.5%) and the 30-day mortality (from 4.9% to 5.4%) (p < 0.03 and p < 0.001, respectively), in patients hospitalised during the pandemic. CONCLUSION: During the first wave of the COVID-19 pandemic, the Danish EMS experienced an overall reduction in the requests for and the use of ambulances and, especially, in the number of patients admitted to hospitals for respiratory diseases. Despite the overall reduction in EMS requests, the mortality of the ambulance population increased, indicating that despite the reduced ambulance use, the prehospital population was more severely ill during the pandemic.


Assuntos
Ambulâncias , COVID-19 , Serviços Médicos de Emergência , Sistema de Registros , Humanos , COVID-19/epidemiologia , Dinamarca/epidemiologia , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Masculino , Ambulâncias/estatística & dados numéricos , Pessoa de Meia-Idade , SARS-CoV-2 , Pandemias , Idoso , Adulto
5.
BMJ ; 386: e080664, 2024 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-39231578

RESUMO

OBJECTIVE: To investigate associations between long term residential exposure to road traffic noise and particulate matter with a diameter <2.5 µm (PM2.5) and infertility in men and women. DESIGN: Nationwide prospective cohort study. SETTING: Denmark. PARTICIPANTS: 526 056 men and 377 850 women aged 30-45 years, with fewer than two children, cohabiting or married, and residing in Denmark between 2000 and 2017. MAIN OUTCOME MEASURE: Incident infertility in men and women during follow-up in the Danish National Patient Register. RESULTS: Infertility was diagnosed in 16 172 men and 22 672 women during a mean follow-up of 4.3 years and 4.2 years, respectively. Mean exposure to PM2.5 over five years was strongly associated with risk of infertility in men, with hazard ratios of 1.24 (95% confidence interval 1.18 to 1.30) among men aged 30-36.9 years and 1.24 (1.15 to 1.33) among men aged 37-45 years for each interquartile (2.9 µg/m3) higher PM2.5 after adjustment for sociodemographic variables and road traffic noise. PM2.5 was not associated with infertility in women. Road traffic noise (Lden, most exposed facade of residence) was associated with a higher risk of infertility among women aged 35-45 years, with a hazard ratio of 1.14 (1.10 to 1.18) for each interquartile (10.2 dB) higher five year mean exposure. Noise was not associated with infertility among younger women (30-34.9 years). In men, road traffic noise was associated with higher risk of infertility in the 37-45 age group (1.06, 1.02 to 1.11), but not among those aged 30-36.9 years (0.93, 0.91 to 0.96). CONCLUSIONS: PM2.5 was associated with a higher risk of an infertility diagnosis in men, whereas road traffic noise was associated with a higher risk of an infertility diagnosis in women older than 35 years, and potentially in men older than 37 years. If these results are confirmed in future studies, higher fertility could be added to the list of health benefits from regulating noise and air pollution.


Assuntos
Poluição do Ar , Exposição Ambiental , Material Particulado , Humanos , Dinamarca/epidemiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Exposição Ambiental/efeitos adversos , Poluição do Ar/efeitos adversos , Material Particulado/efeitos adversos , Material Particulado/análise , Estudos Prospectivos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/etiologia , Ruído dos Transportes/efeitos adversos , Ruído dos Transportes/estatística & dados numéricos , Fatores de Risco , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Infertilidade/epidemiologia , Incidência
6.
Acta Oncol ; 63: 746-754, 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39319939

RESUMO

BACKGROUND AND PURPOSE: Bladder cancer (BC) is a common malignancy in the Western World with men being diagnosed almost four times as often as women. The etiology of bladder cancer may involve sex hormones. Prostate cancer (PCa) patients treated with chemical castration, such as androgen deprivation therapy, or surgical castration, may therefore have a lower risk of developing bladder cancer. PATIENTS/MATERIAL AND METHODS: In a nation-wide population-based cohort study using national Danish registry data, we included a cohort of men with a first-time PCa diagnosis between 2002 and 2018 divided according to antihormonal treatment in the first year after PCa diagnosis and a comparison cohort consisting of 10 age-matched persons for each PCa patient. Each individual was followed from 1 year after PCa diagnosis until death or end of follow-up. We computed cumulative incidences (risk) and hazard ratios (HRs) for BC. In a second cohort analysis, we determined overall survival and BC-specific mortality, determined from date of BC diagnosis until death. RESULTS AND INTERPRETATION: We included 48,776 PCa patients of whom 13,592 were treated with chemical castration, 2,261 with surgical castration, and 32,923 received no antihormonal treatment. The 5-year risk of BC for each PCa group was 1.1%, 0.7%, and 1.3%, respectively, corresponding to an adjusted HR of 1.13 (95% CI 0.98; 1.31), 0.95 (95% CI 0.62; 1.47), and 1.18 (95% CI 1.09; 1.28) compared to individuals without PCa. Patients receiving antihormonal treatment had a slightly lower incidence of BC compared to individuals without PCa, however, this was not supported by the HRs. The treatment, however, was not associated with overall survival.


Assuntos
Antagonistas de Androgênios , Neoplasias da Próstata , Sistema de Registros , Neoplasias da Bexiga Urinária , Humanos , Masculino , Idoso , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/terapia , Dinamarca/epidemiologia , Incidência , Pessoa de Meia-Idade , Estudos de Coortes , Sistema de Registros/estatística & dados numéricos , Antagonistas de Androgênios/uso terapêutico , Idoso de 80 Anos ou mais , Orquiectomia
7.
Dan Med J ; 71(9)2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39320062

RESUMO

INTRODUCTION: Child abuse increases the risk of substance abuse and non-suicidal self-injury, but the topic of school absenteeism and number of offspring has not been studied prospectively. This study presents the first assessment of these four outcomes among children evaluated for exposure to child abuse. METHODS: In the 2001-2007 period, the Department of Forensic Medicine, Aarhus University, Denmark, evaluated 375 children for exposure to abuse. These children were age- and gender-matched to children from population registries at a 1:6 ratio. Excluding siblings, 2,573 children were analysed. We used the Danish Education Register, the National Patient Register and the Central Civil Register to estimate outcomes and covariates. Negative binomial or Poisson models were used. Follow-up included data until 2016. RESULTS: For children aged 10-16 years, the incidence rate ratio (IRR) of substance abuse was increased for suspected abuse. The IRR of severe non-suicidal self-injury was 5.03 (95% confidence intervals (CI): 2.59-9.77) for children ≥ 7 years old. School absenteeism had an IRR of 1.30 (95% CI: 1.01-1.68) among children aged 0-3 years. The number of offspring was increased among children aged 12-16 years with suspicion of sexual abuse, IRR = 1.67 (95% CI: 1.27-2.20), and for children aged 8-11 years with suspicion of any abuse, IRR = 3.93 (95% CI: 2.14-7.22). CONCLUSIONS: Children evaluated for exposure to child abuse differed from their peers on all measured outcomes. The health and social services should devote attention to this group and the families they form. FUNDING: This study received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints presented in relation to the materials are the responsibility of the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund. TRIAL REGISTRATION: Not relevant.


Assuntos
Absenteísmo , Maus-Tratos Infantis , Sistema de Registros , Transtornos Relacionados ao Uso de Substâncias , Humanos , Criança , Adolescente , Dinamarca/epidemiologia , Feminino , Masculino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologia , Pré-Escolar , Comportamento Autodestrutivo/epidemiologia , Lactente , Incidência , Estudos Prospectivos , Recém-Nascido
8.
Dan Med J ; 71(9)2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39320063

RESUMO

INTRODUCTION: The prevalence of age-related physiological impairments and conditions may influence clinical practice protocols on care delivery, risk assessment and current facilities. We aimed to characterise the acutely admitted geriatric patient using medical records and comprehensive assessments performed within 24 hours of admission. METHODS: Patients aged ≥ 65 years were included from the acute ward at Bispebjerg Hospital, Denmark, (n = 1,071). Body composition was investigated using bioelectrical impedance analyses. Physical function was assessed using handgrip strength and sit-to-stand ability. Cognitive impairment and malnutrition were assessed using questionnaires. Self-reported fall incidents within the year leading up to the admission were obtained. Clinical information was obtained from medical records. RESULTS: Severe comorbidity and polypharmacy were present in 58% and 73% of the cohort, respectively, with men showing a higher prevalence of severe comorbidity. Moderate-to-severe cognitive impairment and risk of severe malnourishment were present in 27% of the patients. Low muscle mass and muscle strength were present in 33% and 47% of the patients, respectively, and low muscle strength was more prevalent in men than women. More than 50% of the patients had fallen within the past year. CONCLUSIONS: Along with highly prevalent multimorbidity and polypharmacy, we demonstrate that a substantial number of patients are cognitively and functionally impaired, are malnourished and have low muscle mass. Thus, they are at high risk of falls and deconditioning during hospitalisation. FUNDING: This work was supported by funding from the Novo Nordisk Foundation; grant number NNF18OC0052826. TRIAL REGISTRATION: Not relevant.


Assuntos
Acidentes por Quedas , Disfunção Cognitiva , Avaliação Geriátrica , Desnutrição , Polimedicação , Humanos , Masculino , Idoso , Feminino , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Desnutrição/epidemiologia , Disfunção Cognitiva/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Força da Mão , Hospitalização/estatística & dados numéricos , Prevalência , Comorbidade , Composição Corporal , Força Muscular
9.
Ugeskr Laeger ; 186(36)2024 Sep 02.
Artigo em Dinamarquês | MEDLINE | ID: mdl-39320073

RESUMO

Sales of over-the-counter decongestant nasal sprays in Denmark from 2011 to 2023 have doubled. This article highlights the potential risks associated with prolonged use of decongestant nasal sprays, such as rhinitis medicamentosa. We conclude that there is an urgent need for increased patient education on proper use and possible side effects of over-the-counter decongestant nasal sprays, as well as a need for more substantial data on side effects related to decongestant nasal sprays to guide health authorities in future regulation.


Assuntos
Descongestionantes Nasais , Medicamentos sem Prescrição , Rinite , Humanos , Descongestionantes Nasais/efeitos adversos , Descongestionantes Nasais/administração & dosagem , Descongestionantes Nasais/uso terapêutico , Medicamentos sem Prescrição/efeitos adversos , Medicamentos sem Prescrição/administração & dosagem , Rinite/tratamento farmacológico , Rinite/induzido quimicamente , Dinamarca , Sprays Nasais
10.
Mycoses ; 67(9): e13802, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39323058

RESUMO

BACKGROUND: Tinea pedis is one of the most prevalent superficial fungal infections. Initial antifungal treatment is often acquired over-the-counter (OTC) without previous consultation with a physician. OBJECTIVE: Lately, increasing antifungal terbinafine resistance has been documented in Denmark and globally and it is therefore of interest to assess how Danish pharmacies advise customers with tinea pedis. METHODS: One hundred Danish pharmacies were randomly selected and an employee interviewed from each. A structured question guide was followed, with the possibility to add further comments. RESULTS: Interviews of 94 pharmacies were conducted. Six pharmacies never replied. Terbinafine as standard dose or cutaneous solution terbinafine one time application (Lamisil Once (R)) were recommended by 99% of the pharmacy employees as first-line treatment. The customer was advised to seek medical attention when tinea pedis was recurring (93%), or when treatment duration was > 2 weeks (77%). The majority (88%) of the pharmacy employees had no knowledge about antifungal resistance. CONCLUSION: Only few pharmacy employees were aware of the current problem of antifungal resistance and the majority advised costumers to initiate treatment using OTC topical terbinafine. The problem of emerging antifungal resistance requires attention in order to provide customers with tinea pedis effective treatment and prevent further societal spread of resistance to antifungals.


Assuntos
Antifúngicos , Farmacorresistência Fúngica , Terbinafina , Tinha dos Pés , Humanos , Antifúngicos/uso terapêutico , Dinamarca , Terbinafina/uso terapêutico , Tinha dos Pés/tratamento farmacológico , Tinha dos Pés/microbiologia , Farmácias , Aconselhamento , Feminino , Masculino , Inquéritos e Questionários , Medicamentos sem Prescrição/uso terapêutico
11.
Ugeskr Laeger ; 186(37)2024 Sep 09.
Artigo em Dinamarquês | MEDLINE | ID: mdl-39323249

RESUMO

Diabetic retinopathy (DR) is the most common complication in patients with diabetes, and screening for sight-threatening end-stages is indicated to avoid severe visual loss. Screening of DR is nationally implemented in Denmark according to evidence-based national guidelines, which includes the use of individualised screening intervals. Treatment is indicated for proliferative DR and diabetic macular oedema, and treatment modalities include retinal laser therapy, intravitreal angiostatic therapy, and vitrectomy. In this review, we summarise the current guidelines for screening and treatment of DR in Denmark.


Assuntos
Retinopatia Diabética , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/terapia , Humanos , Dinamarca , Guias de Prática Clínica como Assunto , Programas de Rastreamento , Vitrectomia , Edema Macular/terapia , Edema Macular/diagnóstico , Edema Macular/etiologia
12.
Ugeskr Laeger ; 186(37)2024 Sep 09.
Artigo em Dinamarquês | MEDLINE | ID: mdl-39323246

RESUMO

The Danish healthcare system is currently undergoing a transformation towards increased use of virtual healthcare services. In this review, we propose a structured risk-stratified model to delineate the differences between homecare, homemonitoring, and hospital-at-home, while discussing their current status and addressing barriers hindering the widespread adoption and scaling of home-based care incl. technological limitations, regulatory complexities, and cultural considerations. We advocate for establishing a national central support function to expedite the shift towards home-based care.


Assuntos
Serviços de Assistência Domiciliar , Humanos , Dinamarca , Serviços Hospitalares de Assistência Domiciliar , Telemedicina
13.
Dan Med J ; 71(10)2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39323256

RESUMO

INTRODUCTION: Patient and public involvement (PPI) in research integrates patient and public perspectives to improve research relevance and quality. The experiences of PPI partners have revealed mixed findings in countries where PPI is well established, but accounts from areas less accustomed to PPI in research are limited. This study aimed to explore the knowledge, motivations, expectations and experiences of PPI representatives in such a setting. METHODS: This was a qualitative study based on semi-structured interviews. Patient and public partners who had recently been engaged in a PPI collaboration to redesign the written patient material for a clinical study were interviewed. The interviews were analysed using inductive content analysis in which quotations were extracted, coded, categorised and interpreted into themes. RESULTS: Interviews indicated a lack of knowledge concerning PPI in research. Despite their motivation to collaborate, the PPI partners expressed anxiety and doubts about their abilities as laypeople. A sense of societal obligation to collaborate was noted. Groups-based, repetitive sessions fostered productivity, while challenges included off-topic discussions and skepticism. CONCLUSIONS: The findings provide valuable insights for shaping PPI processes and recruitment strategies in regions that are new to PPI. This highlights the need to describe the PPI concept when recruiting participants elaborately and to utilise repetitive group-based sessions in the design. FUNDING: Supported by the Novo Nordisk Foundation and the Chief Scientist Office, Scotland. TRIAL REGISTRATION: Not relevant.


Assuntos
Participação do Paciente , Pesquisa Qualitativa , Humanos , Masculino , Feminino , Pesquisa Biomédica , Motivação , Adulto , Pessoa de Meia-Idade , Participação da Comunidade , Entrevistas como Assunto , Dinamarca , Comportamento Cooperativo
14.
Dan Med J ; 71(10)2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39323257

RESUMO

INTRODUCTION: Evidence in child abuse cases can be scarce and is often centred around the child's testimony. However, child testimony varies with the child's development. Here, an overview of suspects, case decisions and court verdicts from a cohort of children is presented, stratified across children aged 0-3, 4-7, 8-11, and 12-15 years. METHODS: Children seen at the Department of Forensic Medicine, Aarhus University, Denmark, in 2001-2013 were analysed, including all case files from the police, courts and healthcare services. RESULTS: A total of 647 cases were presented. The most frequent suspect was the child's parents. The police referred to the prosecutor in 69% of all cases, and 37% were tried in court. The lowest proportion of cases of tried cases was found among children aged 0-3 years (20%) and the highest among children aged 8-11 years (57%). Across ages, no corroborating evidence, the accused's refusal of guilt and no case to pursue (insufficient strong evidence) were the most frequent reasons for case closure. Cases relating to children aged 0-3 years were frequently dismissed because the fault could not be placed, whereas cases relating to children aged 12-15 were frequently rejected because of lacking evidence of compulsion (non-consent). CONCLUSION: Results show variations across ages regarding children tried in court and case dismissal. A dedicated child court may be considered to ensure equal access to justice. Questioning during the forensic examination and the use of psychologists may strengthen the available evidence. FUNDING: These materials have received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints made evident from the materials belong to the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund. TRIAL REGISTRATION: Not relevant.


Assuntos
Maus-Tratos Infantis , Humanos , Criança , Pré-Escolar , Maus-Tratos Infantis/legislação & jurisprudência , Maus-Tratos Infantis/estatística & dados numéricos , Dinamarca , Adolescente , Lactente , Feminino , Masculino , Fatores Etários , Recém-Nascido , Medicina Legal/legislação & jurisprudência
15.
Dan Med J ; 71(10)2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39323261

RESUMO

INTRODUCTION: We aimed to explore the impact of social distancing on the incidence, severity and microbiology of patients with acute tonsillitis (AT). METHODS: In this single-centre study, we retrospectively included all patients with AT referred to the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark, in the two years preceding versus the two years after the COVID-19 lockdown in Denmark (11 March 2020). RESULTS: In total, 425 patients were included. The incidence of AT was significantly lower in the post-lockdown period (n = 128) than in the pre-lockdown period (n = 297) (p less-than 0.001). Reduced incidence was observed across all age groups. No significant differences were found in patient characteristics between periods. The proportion of hospitalised patients was significantly lower in the post- than in the pre-lockdown period (36% versus 25%, p = 0.032). Prevalent culture findings were Streptococcus pyogenes (15%), S. anginosus group (11%) and Fusobacterium necrophorum (5%). No statistically significant differences in the relative prevalence of individual bacteria were found between periods. CONCLUSIONS: The incidence of patients with AT referred to hospital decreased by 57% in the two-year period after the COVID-19 lockdown compared with the period leading up to the lockdown. Our findings suggest that this decrease mirrored a general decline in AT incidence rather than altered referral patterns. FUNDING: None. TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency (#1-16-02-134-23) and the Danish Patient Safety Authority (#1-45-70-41-23).


Assuntos
COVID-19 , Tonsilite , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Tonsilite/epidemiologia , Tonsilite/microbiologia , Incidência , Dinamarca/epidemiologia , Feminino , Masculino , Estudos Retrospectivos , Adulto , Adolescente , SARS-CoV-2 , Adulto Jovem , Criança , Pessoa de Meia-Idade , Doença Aguda , Streptococcus pyogenes , Pré-Escolar , Fusobacterium necrophorum/isolamento & purificação , Distanciamento Físico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/prevenção & controle
16.
Cephalalgia ; 44(9): 3331024241269758, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39324203

RESUMO

BACKGROUND: Migraine presents significant health and economic challenges. Despite the widespread use of triptans, some patients discontinue them because of insufficient relief or adverse effects. Using national registers, the present study investigates the excess costs and labour market disaffiliation of Danish patients discontinuing triptan treatment. METHODS: The study included all individuals ≥18 years ("patients") who discontinued redemption of triptan prescriptions between 1998 and 2019. They were categorized by number of distinct triptans redeemed before discontinuation: one, two or three or more. A control group was established from the general population without triptan redemptions, three per patient, matched by year of birth, sex and region of residence. We estimated excess direct and indirect costs from 5 years prior ("year -5") to 10 years post ("year 10") the first triptan redemption. RESULTS: We identified 211,026 patients who discontinued triptan redemption, 82% after one, 14% after two and 4% after three or more distinct triptans. Over the period from year -5 to year 10, average excess healthcare costs per patient in these cohorts were EUR 9,554, EUR 10,942 and EUR 12,812 respectively. Over the same period, these patients earned EUR 27,964, EUR 35,920 and EUR 50,076 less than their respective controls, and received higher public transfer payments of EUR 20,181, EUR 23,264 and EUR 26,459. CONCLUSIONS: Triptan discontinuers, who appear to have exhausted all current treatment avenues, face high direct and very high indirect excess costs attributable to migraine, and experience substantial increased labour market disaffiliation.


Assuntos
Efeitos Psicossociais da Doença , Transtornos de Enxaqueca , Sistema de Registros , Triptaminas , Humanos , Transtornos de Enxaqueca/economia , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Dinamarca/epidemiologia , Triptaminas/uso terapêutico , Triptaminas/economia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Custos de Cuidados de Saúde/estatística & dados numéricos , Adulto Jovem
17.
J Am Heart Assoc ; 13(18): e035115, 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39258557

RESUMO

BACKGROUND: The congenital heart disease (CHD) population is growing and aging. We aim to examine the impact by describing the temporal trend and causes of lifetime hospitalization burden among the CHD population. METHODS AND RESULTS: From the Danish National Patient Registry, 23 141 patients with CHD and their hospitalizations from 1977 to 2018 were identified, excluding patients with extracardiac malformation. Patients with CHD were categorized into major CHD and minor CHD, and each patient was matched with 10 controls by sex and year of birth. The rate of all-cause hospitalization increased over time from 28.3 to 36.4 hospitalizations per 100 person-years (PY) with rate difference (RD) per decade of 2.5 (95% CI, 2.0-3.1) hospitalizations per 100 PY for the patients with CHD, compared with the increase from 10.8 to 17.0 per 100 PY (RD per decade, 2.0 [95% CI, 1.8-2.2] per 100 PY) for the control group (RD for CHD versus control, P=0.08). The all-cause hospitalization rate remained constant for the major CHDs (RD per decade, -0.2 [95% CI, -1.2 to 0.9] per 100 PY) but increased for the minor CHDs (RD per decade, 5.2 [95% CI, 4.3-6.0] per 100 PY). For all patients with CHD, the cardiovascular hospitalization rate remained constant over time (RD per decade, 0.2 [95% CI, -0.3 to 0.6] per 100 PY) whereas the noncardiovascular hospitalization rate increased (RD per decade, 2.1 [95% CI, 1.6-2.7] per 100 PY). The length of all-cause hospital stays for all patients with CHD decreased from 2.7 (95% CI, 2.6-2.8) days per PY in 1977 to 1987 to 1.6 (95% CI, 1.6-1.7) days per PY in 2008 to 2018. CONCLUSIONS: Compared with previous decades, patients with CHD have an increasing hospitalization rate, similar to the general population, but a decreasing length of hospital stay. The increase in hospitalization rate was driven by noncardiovascular hospitalizations, with the patients with minor CHD being the key contributor to the increasing rate.


Assuntos
Cardiopatias Congênitas , Hospitalização , Sistema de Registros , Humanos , Dinamarca/epidemiologia , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/terapia , Feminino , Masculino , Hospitalização/tendências , Hospitalização/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Fatores de Tempo , Adolescente , Adulto Jovem , Criança , Pré-Escolar , Lactente , Recém-Nascido
18.
Health Res Policy Syst ; 22(1): 126, 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39289710

RESUMO

PURPOSE: The purpose of this study is to explore line managers' perspectives on data as tool in the management of sickness absence in public sector workplaces in Denmark. METHODS: The study is a qualitative study based on 19 semi-structured interviews with line managers from four public sector workplaces characterized by high levels of sickness absence or poor work environment. The interviews were analysed inductively using thematic analysis. RESULTS: The findings show that line managers primarily use data to identify employees at risk of sickness absence. The experiences highlighted related to how and when data are perceived as a valuable tool by the line managers, and that nuances in the data, accessibility of the data and how data are presented are important factors to ensure appropriate follow-up on sickness absence. CONCLUSIONS: The findings suggest that for line managers to use data to manage sickness absence appropriately, the data must be easily accessible, simple for line managers to understand and provide line managers with a sufficient overview of sickness absence in their work units. It is also important to consider other factors affecting sickness absence, such as the work environment, when aiming to reduce sickness absence.


Assuntos
Setor Público , Pesquisa Qualitativa , Licença Médica , Local de Trabalho , Humanos , Dinamarca , Feminino , Masculino , Absenteísmo , Adulto , Pessoa de Meia-Idade , Saúde Ocupacional , Entrevistas como Assunto
19.
BMC Res Notes ; 17(1): 256, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39256756

RESUMO

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.


Assuntos
Grupo Associado , Dinamarca , Humanos , Reprodutibilidade dos Testes , Pesquisadores
20.
BMC Med ; 22(1): 379, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39256870

RESUMO

BACKGROUND: Helicobacter pylori colonizes the human stomach and may affect the inflammatory response, hormone production related to energy regulation, and gastrointestinal microbiota composition. Previous studies have explored a potential association between H. pylori infection and pediatric obesity with varying results. Considering the immunomodulatory effects of early-life infection with H. pylori that can confer beneficial effects, we hypothesized that we would find an inverse relationship between H. pylori seropositivity and obesity among Danish children and adolescents. METHODS: We assessed H. pylori seroprevalence in 713 subjects from an obesity clinic cohort and 990 subjects from a population-based cohort, aged 6 to 19 years, and examined its association with obesity and other cardiometabolic risk factors. RESULTS: No association was found between H. pylori and body mass index standard deviation score (BMI SDS). H. pylori seropositivity was, however, significantly associated with higher fasting plasma glucose levels and the prevalence of hyperglycemia. CONCLUSION: While we did not find an association between H. pylori seropositivity and BMI SDS, we observed a significant association with higher fasting plasma glucose levels and increased prevalence of hyperglycemia, suggesting that H. pylori infection may contribute to impaired glucose regulation in Danish children and adolescents.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Hiperglicemia , Humanos , Adolescente , Criança , Dinamarca/epidemiologia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/sangue , Masculino , Feminino , Hiperglicemia/epidemiologia , Hiperglicemia/sangue , Estudos Soroepidemiológicos , Adulto Jovem , Obesidade Infantil/epidemiologia , Obesidade Infantil/sangue , Obesidade Infantil/microbiologia , Estudos de Coortes , Índice de Massa Corporal , Prevalência , Glicemia/análise
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