A scoping review on the effects of Varroa mite (Varroa destructor) on global honey bee decline.

Arguably the most ecologically and economically valuable pollinators worldwide, honey bees play a significant role in food production and enrich biodiversity through pollination. Varroa destructor is an invasive ectoparasitic mite that attacks and feeds on European honey bee, Apis mellifera. Because literature on the effectiveness and sustainability of various treatment modalities available for Varroa mite control in honey bee colonies are scattered, this scoping review was conducted to serve as a guiding document with a focus on: (1) identifying the detrimental impact Varroa mites have on the European honey bee; (2) determining current methods for Varroa mite control and their limitations; (3) examining current market landscape and key players in the pesticide market; and (4) identifying opportunities for more sustainable Varroa mite control methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, 397 articles published between 1998 and 2022 were screened; of which 65 articles were retained using inclusion/exclusion criteria, which were systematically analyzed in-depth, information extracted, and included in this scoping review. The results suggest that Varroa mites are one of the predominant causes of global honey bee decline as they lack natural resistance to Varroa mites, thereby negatively affecting honey bee reproduction and immunity, killing broods, and transmitting pathogenic viruses to colonies. Further, our findings suggest that: apiarists have many options for Varroa control, but no method has proven to be effective, safe and nonpersistent in the environment; adoption of nano-pesticides and development of sustainable alternatives to traditional pesticides are key drivers for growing pesticide market; and nano-pesticides may have potential to serve as an effective, safe and non-ecopersistent pesticide for Varroa mite and associated virus control. In conclusion, this review highlights an unmet need for effective and sustainable control strategies and tools for Varroa mite and virus control.

Health and Well-Being in Older Adults With a Surgically Closed or an Unrepaired Ventricular Septal Defect.

Background Older adults with a congenital ventricular septal defect (VSD) recently exhibited reduced heart rate variability and exercise capacity. It is unknown whether these findings affect health-related quality of life. Methods and Results Adults with VSDs and healthy controls, all concurrently included as part of another clinical study, completed the Danish National Health Survey questionnaire. Questionnaire data distributed to the general population were included and matched 10:1 with patients. Thirty patients with surgically closed VSDs (mean±SD age, 51±8 years), 300 adults from the general population (mean±SD age, 50±8 years), and 30 controls (mean±SD age, 51±9 years), as well as 30 patients with unrepaired VSDs (mean±SD age, 55±11 years), 300 adults from the general population (mean±SD age, 55±12 years), and 30 controls (mean±SD age, 55±10 years) completed the questionnaire. Educational level, social relations, and physical activity were comparable between groups. A larger proportion of patients with unrepaired VSDs compared with the general population experienced migraine (47% versus 24%; P=0.04), whereas more patients with surgically closed VSDs were affected by depression (13% versus 4%; P=0.02). For health-related quality of life, patients with surgically closed VSDs reported lower physical functioning (P<0.01), physical component summary (P<0.01), general health perception (P<0.01), and higher stress score (P=0.03) compared with the general population and healthy controls. Patients with unrepaired VSDs reported lower scores on physical functioning (P=0.03), bodily pain (P<0.01), and mental health (P=0.02), and a higher stress score (P=0.03), than controls. Conclusions Older patients with VSDs report lower self-perceived physical functioning, lower general health, and higher stress levels, all in line with previous findings, like lower exercise capacity and dysfunctional cognitive abilities, in adults with VSDs. Incessant follow-up is paramount, as neither successfully closed nor hemodynamically insignificant VSD is equivalent with untroubled healthy aging. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03684161.

Trends in social inequality in mortality in Denmark 1995-2019: the contribution of smoking- and alcohol-related deaths.

BACKGROUND: During the past decades, social inequality in mortality has increased in several countries, including Denmark. Modifiable risk factors, such as smoking and harmful alcohol consumption, have been suggested to moderate the association between socioeconomic position and health-related outcomes. The present study aims to investigate the contribution of smoking- and alcohol-related deaths to the trends in educational inequality in mortality in Denmark 1995-2019 among individuals aged 30-74 years. METHODS: Nationwide data on mortality and highest attained educational level divided into quartiles were derived from administrative registers. Alcohol-related mortality was directly estimated using information on alcohol-related deaths from death certificates. Smoking-related mortality was indirectly estimated using the Peto-Lopez method. The contribution of smoking- and alcohol-related deaths to the social inequality gap in mortality 1995-2019 was calculated. RESULTS: Alongside a decrease in all-cause mortality in Denmark 1995-2019, absolute differences in the mortality rate (per 100 000 person-year) between the lowest and the highest educational quartile increased from 494 to 607 among men and from 268 to 376 among women. Among both men and women, smoking- and alcohol-related deaths explained around 60% of the social inequality in mortality and around 50% of the increase in mortality inequality. CONCLUSION: Smoking and harmful alcohol consumption continue to be important risk factors and causes of social inequality in mortality, with around half of the increase in Denmark 1995-2019 being attributable to smoking- and alcohol-related deaths. Future healthcare planning and policy development should aim at reducing social inequality in modifiable health risk behaviours and their negative consequences.

Self-reported reasons for discontinuation or continuation of antipsychotic medication in individuals with first-episode schizophrenia.

AIM: Many individuals with schizophrenia discontinue initially prescribed antipsychotics. Knowledge on reasons for discontinuation among individuals with first-episode schizophrenia is sparse. We aimed to describe reasons for discontinuation and continuation, differences between individuals discontinuing and continuing, and factors predicting reasons for discontinuation or continuation. METHODS: This was a prospective cohort study with a post hoc design. Individuals with first-episode schizophrenia were included from early intervention teams in Denmark from 2009-2012. Sociodemographic and clinical variables were collected at baseline and reasons for discontinuation and continuation of antipsychotics were assessed at 3.5-year follow-up. RESULTS: Among 215 patients, 76 reported reasons for discontinuation and 139 for continuation. The most frequent reasons for discontinuation were "side effects" and "patient believed he/she no longer needed the medication because he/she was now better". The most frequent reasons for continuation were "benefits for positive symptoms" and "another person told them to". Individuals who discontinued antipsychotics were at baseline younger, had longer DUP, less negative symptoms, better social function, lower compliance, higher self-belief of coping, and fewer used antipsychotics compared to those continuing antipsychotics. CONCLUSIONS: The effect of antipsychotics is the main reason to continue, whereas side effects were the main reason to discontinue. Knowledge of reasons to discontinue or continue is helpful in shared decision-making, identifying individuals with high odds of discontinuation, improving adherence, and helping with safe discontinuation.

Conflict and synergy in health promotion partnerships: a Danish case study.

Intersectoral partnerships constitute a central approach in health promotion. By combining different perspectives, knowledge and resources from different sectors, partnerships are important for addressing complex health problems. When successful, intersectoral partnerships create synergy, which is suggested to be a proximal outcome that links partnership functioning to health effects. Nonetheless, partnerships are also difficult and time-consuming and may result in conflicts, hostility and power struggles. Such antagonist outputs are expected to produce negative results. However, conflicts may also be a source of valuable learning. This article explores the relationship between conflict and synergy in health promotion partnerships. The empirical material is derived from an evaluation of a 4-year Danish government partnership program. Data consist of survey data collected from 35 partnerships and in-depth qualitative case studies of 10 partnerships. The analysis was inspired by realist evaluation. The qualitative data were coded, and cases written up. Cross-case analysis was conducted and triangulated with survey data. Surprisingly, disagreements and conflicts of interests between partners were common and associated with synergy creation. Moreover, the partnerships' experiences of synergy were often linked to their attribution of differences rather than to common goals or value congruences. The study identifies that a potential for synergy lays in the productive confrontation between partners different perspectives. Moreover, a key mechanism enabling productive conflicts was inclusive dialog, in which the partners' differences were valued, and all voices were included. The study thus builds on the existing synergy literature and adds nuance to the understanding of conflicts in health promotion partnerships.

Agreement between self-reported diseases from health surveys and national health registry data: a Danish nationwide study.

BACKGROUND: Agreement may be low when comparing self-reported diseases in health surveys with registry data. The aim of the present study was to examine the agreement between seven self-reported diseases among a representative sample of Danish adults aged ≥16 years and data from medical records. Moreover, possible associations with sociodemographic variables were examined. METHODS: Nationally representative data on self-reported current or previous diabetes, asthma, rheumatoid arthritis, osteoporosis, myocardial infarction, stroke and cancer, respectively, were derived from the Danish National Health Survey in 2017 (N=183 372). Individual-level data were linked to data on the same diseases from medical records in registries. Logistic regression models were used to explore potential associations between sociodemographic variables and total agreement. RESULTS: For all included diseases, specificity was >92% and sensitivity varied between 66% (cancer) and 95% (diabetes). Negative predictive value (NPV) was >96% for all diseases and positive predictive value (PPV) varied between 13% (rheumatoid arthritis) and 90% (cancer). Total agreement varied between 91% (asthma) and 99% (diabetes), whereas the kappa value was lowest for rheumatoid arthritis (0.21) and highest for diabetes (0.88). Sociodemographic variables were demonstrated to be significantly associated with total agreement for all diseases, with sex, age and educational level exhibiting the strongest associations. However, the directions of the associations were inconsistent across diseases. CONCLUSION: Overall, self-reported data were accurate in identifying individuals without the specific disease (ie, specificity and NPV). However, sensitivity, PPV and kappa varied greatly between diseases. These findings should be considered when interpreting similar results from surveys.

Tapered discontinuation vs. maintenance therapy of antipsychotic medication in patients with first-episode schizophrenia: Obstacles, findings, and lessons learned in the terminated randomized clinical trial TAILOR.

Aim: Evidence is insufficient regarding the consequences of discontinuing vs. maintaining antipsychotic medication in patients with first-episode schizophrenia. Our aim was to examine tapered discontinuation vs. maintenance treatment regarding remission of psychotic symptoms and impact on other areas. Methods: Patients included had a diagnosis of schizophrenia, were treated with antipsychotic medication, and were in remission of psychotic symptoms. Participants were randomized to tapered discontinuation or maintenance treatment with antipsychotic medication. Assessments were undertaken at baseline and after 1-year. The primary outcome was remission of psychotic symptoms without antipsychotic medication. Results: The trial was terminated due to insufficient recruitment. In total, 29 participants were included: 14 in the tapering/discontinuation group and 15 in the maintenance group. Adherence to maintenance treatment was poor. At 1-year follow-up, remission of psychotic symptoms without antipsychotic medication for 3 months was observed in five participants in the tapering/discontinuation group and two in the maintenance group. Conclusion: Due to insufficient recruitment this study does not provide a conclusion on whether unfavorable outcomes or advantages follow tapering of antipsychotic medication. Recruitment and adherence to maintenance treatment encountered obstacles. Based on experiences from this trial, we discussed alternative study designs as consistent evidence is still needed on whether to continue or discontinue antipsychotic medication in remitted patients with first-episode schizophrenia. Clinical trial registration: https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-000565-23/DK, EU Clinical Trials Register-EudraCT no. 2016-000565-23.

The impact of non-response weighting in health surveys for estimates on primary health care utilization.

BACKGROUND: Low response rates in health surveys may affect the representativeness and generalizability of results if non-response is systematically related to the indicator of interest. To account for such potential bias, weighting procedures are widely used with an overall aim to obtain less biased estimates. The aim of this study was to assess the impact of applying calibrated weights on prevalence estimates of primary health care utilization among respondents compared to the entire sample of a representative Danish survey of adults aged ≥16 years. METHODS: Registry-based 1-year prevalence data on health care utilization of chiropractor/physiotherapist, dentist and psychologist in 2016 were linked to the entire sample (n = 312 349), including respondents (n = 183 372), from the Danish National Health Survey in 2017. Calibrated weights, which applied information on e.g. sex, age, ethnic background, education and overall health service use were used to assess their impact on prevalence estimates among respondents. RESULTS: Across all included types of health care, weighting for non-response decreased prevalence estimates among respondents, which resulted in less biased estimates. For example, the overall 1-year prevalence of chiropractor/physiotherapist, dentist and psychologist utilization decreased from 19.1% to 16.9%, 68.4% to 62.5% and 1.9% to 1.8%, respectively. The corresponding prevalence in the entire sample was 16.5%, 59.4% and 1.7%. CONCLUSIONS: Applying calibrated weights to survey data to account for non-response reduces bias in primary health care utilization estimates. Future studies are needed to explore the possible impact of weighting on other health estimates.

The Danish Health and Wellbeing Survey: Study design, response proportion and respondent characteristics.

AIMS: This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. METHODS: The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N=12,000) and 2019 (N=14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N=13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. RESULTS: The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. CONCLUSIONS: The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study.

Therapy-dependent inconsistencies in self-reported use of complementary and alternative medicine in the general population: findings from a longitudinal study.

OBJECTIVE: Information on the use of complementary and alternative medicine (CAM) in the general population is often collected by means of surveys, causing the reliability of data to rely on the memory accuracy of the respondent. The objective of this study was to examine the consistency in self-reported CAM use using data from two survey waves 4 years apart. DESIGN: Longitudinal study. SETTING/PARTICIPANTS: Data were obtained from the Danish Health and Morbidity Surveys. A nationally representative subsample of the individuals invited in 2013 was reinvited in 2017. In all, 2297 individuals (≥16 years) completed the self-administered questionnaire in both waves, including questions on for example, CAM use. MAIN OUTCOME MEASURES: The use of six different CAM therapies (acupuncture; craniosacral therapy; faith healing and/or clairvoyance; nutritional counselling; massage; osteopathy or other manipulative therapies; reflexology) was assessed by the response categories 'Yes, within the past 12 months', 'Yes, but previously than within the past 12 months' and 'No'. For each CAM therapy, an inconsistent response was defined as either the response combination (1) 'Yes, within the past 12 months' in 2013 and 'No' in 2017, or (2) 'Yes, within the past 12 months' or 'Yes, but previously than within the past 12 months' in 2013 and 'No' in 2017. RESULTS: The inconsistency percentages varied across CAM therapies. The highest levels of inconsistency for CAM use within the past 12 months were observed for nutritional counselling (64.9 %) and faith healing and/or clairvoyance (36.4 %). The lowest proportion of inconsistent responses was observed for acupuncture (18.3%). Overall, the same pattern was observed for lifetime CAM use. CONCLUSIONS: The results highlight the difficulty in obtaining reliable prevalence estimates on the use of CAM in the general population. Future studies should take these findings into account when interpreting similar analyses.

Trends in dentate status and preventive dental visits of the adult population in Denmark over 30 years (1987-2017).

This study analyzed the trend in self-reported dentate status over 30 years (1987-2017) among Danish adults, the self-reported frequencies of preventive dental visits undertaken annually during the period 1987-2013, and the self-reported use of the 2016 recall scheme for preventive dental check-ups. The impact of social determinants (education, employment, civil status, and ethnic background) on these dental outcome variables in 2017 was explored. Questionnaire data were obtained from the Danish Health and Morbidity Surveys conducted from 1987-2017, and they were analyzed by tri-variate frequency distributions and multivariate analyses. The prevalence of complete tooth loss was 17.7% in 1987 but 3.4% in 2017. The frequency of adults having 20 or more teeth grew markedly from 1987 (65.9%) to 2017 (85.1%). Educational inequality in dentate status persisted over the period. The frequency of preventive dental visits at least annually increased from 1987 to 2013, although visits were less frequent for young people. In 2017, preventive dental check-ups were reported in intervals: less than 12 months (56.4%), 12-18 months (18.9%), 19-24 months (4.8%), and more than 24 months (5.2%). In 2017, dentate status and preventive dental check-ups varied profoundly by social determinants. In conclusion, social policies should be implemented to tackle the persistent inequities in dentate status and public health policies should target Universal Health Coverage.

Pharmacodynamics of propofol and alfaxalone in rattlesnakes (Crotalus durissus).

To characterise the effect of two common induction agents, propofol and alfaxalone, on mean arterial blood pressure (MAP) and heart rate (HR), we equipped 19 adult South American rattlesnakes (Crotalus durissus) with an indwelling arterial catheter approximately 24 h prior to recording of baseline resting values. Then, seven snakes received alfaxalone (15 mg kg-1) intravascularly (IV) through the catheter, while groups two and three (both n = 6) received propofol (15 mg kg-1 IV). The first two groups were not handled, while the group 3 was manually restrained for 2 min for a mock injection of 0.2 ml saline into the ventral tail vein. Baseline HR was similar in all groups and handling caused a significant tachycardia (p = 0.031) in group three. When given IV to undisturbed animals, both propofol and alfaxalone induced a significant increase in HR (p = 0.0022 and p = 0.0045, respectively) lasting approximately 30 min, but with values only significantly exceeding baseline for the first 5 min for propofol and the first 10 min with alfaxalone. Handling caused a significant increase in MAP (p = 0.0313). Propofol did not affect MAP (p = 0.1064), while alfaxalone caused a marked hypertension (although only significant at 2 min; p = 0.031). Manual restraint significantly increases both HR and MAP, which may lead to a masking of true cardiovascular effects of anaesthetic agents.

Effect of Routine Cytochrome P450 2D6 and 2C19 Genotyping on Antipsychotic Drug Persistence in Patients With Schizophrenia: A Randomized Clinical Trial.

Importance: Genetic polymorphism of genes encoding the drug metabolizing enzymes, cytochrome P450 2D6 and 2C19 (CYP2D6 and CYP2C19), is associated with treatment failure of and adverse reactions to psychotropic drugs. The clinical utility of routine CYP2D6 and CYP2C19 genotyping (CYP testing) is unclear. Objective: To estimate whether routine CYP testing effects the persistence of antipsychotic drug treatment. Design, Setting, and Participants: This single-masked, 3-group randomized clinical trial included patients aged 18 years or older who had been diagnosed within the schizophrenic spectrum (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, F20-F29) and not previously genotyped. A total of 669 of 1406 potentially eligible patients from 12 psychiatric outpatient clinics in Denmark were approached between July 2008 and December 2009. Overall, 528 patients were genotyped and randomly allocated to 1 of 3 study groups or exclusion in a sequence of 1:1:1:3 using a predictive enrichment design, aiming to double the proportion of poor or ultrarapid metabolizers for CYP2D6 or CYP2C19. Outcome measurements were recorded at baseline and 1-year follow-up. Data analysis was performed in December 2012 and updated March 2019. Interventions: The trial included 2 intervention groups, where antipsychotic drug treatment was guided by either CYP test (CYP test-guided [CTG]) or structured clinical monitoring (SCM), in which adverse effects and factors influencing compliance were systematically recorded at least once quarterly, and 1 control group. Main Outcomes and Measures: Primary outcome was antipsychotic drug persistence, ie, days to first modification of the initial treatment. Secondary outcomes were number of drug and dose changes, adverse effects, and psychotic symptoms, ie, hallucinations and delusions. Results: A total of 528 participants were genotyped, and 311 (median [interquartile range {IQR} age, 41 [30-50] years; 139 [45%] women; median [IQR] duration of illness, 6 [3-13] years) were randomly allocated to 1 of 3 study groups. Overall, 61 participants (20%) were extreme metabolizers. There was no difference in antipsychotic drug persistence between the CTG group and the control group (hazard ratio [HR], 1.02; 95% CI, 0.71-1.45) or SCM and the control group (HR, 0.88; 95% CI, 0.61-1.26). Subanalyses among extreme metabolizers showed similar results (CTG: HR, 0.99; 95% CI, 0.48-2.03; SCM: HR, 0.93; 95% CI, 0.44-1.96). Conclusions and Relevance: The results of this randomized clinical trial do not support routine CYP testing in patients with schizophrenia. Trial Registration: ClinicalTrials.gov Identifier: NCT00707382.

Comparing older people's drinking habits in four Nordic countries: Summary of the thematic issue.

Aim: The present article summarises status and trends in the 21st century in older people's (60-79 years) drinking behaviour in Denmark, Finland, Norway and Sweden and concludes this thematic issue. Each country provided a detailed report analysing four indicators of alcohol use: the prevalence of alcohol consumers, the prevalence of frequent use, typical amounts of use, and the prevalence of heavy episodic drinking (HED). The specific aim of this article is to compare the results of the country reports. Findings: Older people's drinking became more common first in Denmark in the 1970s and then in the other countries by the 1980s. Since 2000 the picture is mixed. Denmark showed decreases in drinking frequency, typically consumed amounts and HED, while in Sweden upward trends were dominant regarding prevalence of consumers and frequency of drinking as well as HED. Finland and Norway displayed both stable indicators except for drinking frequency and proportion of women consumers where trends increased. In all four countries, the gender gap diminished with regard to prevalence and frequency of drinking, but remained stable in regard to consuming large amounts. In Norway the share of alcohol consumers among women aged 60-69 years exceeded the share among men. During the late 2010s, Denmark had the highest prevalence of alcohol consumers as well as the highest proportion drinking at a higher frequency. Next in ranking was Finland, followed by Sweden and Norway. This overall rank ordering was observed for both men and women. Conclusion: As the populations aged 60 years and older in the Nordic countries continue to grow, explanations for the drivers and consequences of changes in older people's drinking will become an increasingly relevant topic for future research. Importantly, people aged 80 years and older should also be included as an integral part of that research.

Trends in alcohol consumption among older adults in Denmark in the 21st century.

Background: Previous studies have indicated that the alcohol consumption among older Danish individuals has increased during the last three decades of the 20th century. However, the research is limited and, hence, the aim of the present article is to describe the trends and peculiarities in the development of the present situation in older people's drinking patterns in Denmark. Methods: Data were obtained from the Danish Health and Morbidity Survey (2005) and the Danish National Health Survey (2010, 2013, and 2017). Data used in this study were collected via self-administered questionnaires from random samples of the adult (≥ 16 years) Danish population. Response rates varied between 50.8% (2005) and 59.5% (2010). Drinking patterns are described using the following indicators: alcohol consumption during the past 12 months; alcohol consumption at least two days a week; mean number of standard drinks consumed in a typical week and heavy episodic drinking (at least monthly). Results are presented as percentages or means. Results: The prevalence of overall 12-month alcohol use in all individuals aged 60 years or older has slightly increased between 2010 (83.9%) and 2017 (85.2%). On the other hand, the prevalence of consuming alcohol at least twice a week has overall decreased slightly between 2010 (54.0%) and 2017 (52.0%) in the same age group. A decrease was also observed in the mean number of standard drinks consumed in a typical week, from 8.3 in 2010 to 7.0 in 2017. Additionally, the prevalence of consuming at least five standard drinks on one occasion at least monthly decreased markedly from 24.8% in 2005 to 14.8% in 2013 (the prevalence remained stable between 2013 and 2017). The trends in prevalence of various alcohol indicators varied by sex and age. Conclusions: The findings of this study suggest an overall decline in alcohol consumption among older Danes in the study period. The continuation of this trend will be the subject of future studies.

Neighbour noise annoyance is associated with various mental and physical health symptoms: results from a nationwide study among individuals living in multi-storey housing.

BACKGROUND: Noise exposure is considered a stressor that may potentially exert negative health effects among the exposed individuals. On a population basis, the most prevalent and immediate response to noise is annoyance, which is an individually experienced phenomenon that may activate physiological stress-responses and result in both physical and mental symptoms. Health implications of traffic noise have been investigated thoroughly, but not of neighbour noise. The aim of the present study was to examine the associations between neighbour noise annoyance and eight different physical and mental health symptoms. METHODS: Cross-sectional data from the Danish Health and Morbidity Survey 2017 were used. The present study included a random sample of 3893 adults living in multi-storey housing. Information on neighbour noise annoyance and various health symptoms (e.g. pain in various body parts, headache, sleeping problems, depression, and anxiety) during the past two weeks was obtained by self-administered questionnaires. The question on neighbour noise annoyance and health symptoms, respectively, had three possible response options: 'Yes, very annoyed/bothered', 'Yes, slightly annoyed/bothered', 'No'. The associations between neighbour noise annoyance and very bothering physical and mental health symptoms were investigated using multiple logistic regression models. RESULTS: Being very annoyed by neighbour noise was significantly associated with higher odds of being very bothered by all eight health symptoms (adjusted OR = 1.73-3.32, all p-values < 0.05) compared to individuals not annoyed by noise from neighbours. Statistically significant interactions were observed between sex and two of the eight health symptoms. Among women, a strong association was observed between neighbour noise annoyance and being very bothered by pain or discomfort in the shoulder or neck, and in the arms, hands, legs, knees, hips or joints. Among men, no associations were observed. CONCLUSIONS: Based on the findings from this study, neighbour noise annoyance is strongly associated with eight different physical and mental health symptoms. Future studies are encouraged to 1) determine the direction of causality using a longitudinal design, 2) explore the biological mechanisms explaining the sex-specific impact of neighbour noise annoyance on symptoms of musculoskeletal pain or discomfort and the other outcomes as well.

Alcohol's harms to others: the self-rated health of those with a heavy drinker in their lives.

BACKGROUND: Studies have examined the self-rated health (SRH) of the drinker, but only few have examined the health of those affected by a heavy drinker. This Nordic study aimed to examine the association between exposure to heavy drinkers and SRH. METHODS: Data come from surveys from the five Nordic countries that participated in the Reducing Alcohol-Related Harm Standardized European Survey in 2015 (n = 7065 aged 18-64 years). Variables included a five-point Likert-scale question on one's SRH, a question on whether the respondent knew a heavy drinker in the last 12 months, and covariates. The 'fair', 'poor' and 'very poor' response categories were combined and are referred to as poor SRH. Multiple logistic regression models were used to examine the relationship between knowing a heavy drinker and one's SRH. RESULTS: Country-pooled adjusted analyses showed a significant relationship between knowing (and being negatively affected by) a heavy drinker and poor SRH [odds ratios (OR) = 1.39, 95% confidence intervals (CI): 1.02-1.89 for heavy drinker in household; OR = 1.23, 95% CI: 1.07-1.42 for other known heavy drinker, compared to not knowing a heavy drinker or knowing a heavy drinker, but not being negatively affected]. A graded relationship appeared such that increasing proximity of the known heavy drinker increased likelihood to report poor SRH. CONCLUSION: Knowing and being negatively affected by someone close who drinks heavily increases the likelihood of reporting poor SRH. These results have implications for public health messaging regarding the well-being of relatives of heavy drinkers.

The Danish health and morbidity surveys: study design and participant characteristics.

BACKGROUND: Reliable data from health surveys are essential to describe the status and trends in health indicators by means of information not available from official registers. In Denmark, nationally representative health surveys (the Danish Health and Morbidity Surveys) have been carried out among adults during the past three decades by the Danish National Institute of Public Health, University of Southern Denmark. The aim of the present study is to describe the study design of the three most recent surveys in 2010, 2013, and 2017, including the survey mode and response rates. METHODS: In 2010, 2013, and 2017, the samples (n = 25,000 each) were based on random sampling of individuals aged 16 years or older with a permanent residence in Denmark. A subsample of previously invited respondents was also re-invited in subsequent survey waves. Data were collected through self-administered questionnaires, yet with a concurrent mixed-mode approach, allowing for the invited individuals to complete either a web questionnaire or an identical paper questionnaire. In 2010 and 2013, survey invitations were sent by regular postal mail, whereas a secure electronical mail service, Digital Post, was used to invite the majority (90.1%) of the sample in 2017. RESULTS: The overall response rate decreased from 60.7% in 2010 to 57.1% in 2013 and 56.1% in 2017. Between 2010 and 2017 the response mode distribution for the web questionnaire increased markedly from 31.7 to 73.8%. The largest increase in the proportion which completed the web questionnaire was found in the oldest age group. CONCLUSIONS: Data from the Danish Health and Morbidity Surveys reveal an increasing proportion of the respondents to complete web questionnaires instead of paper questionnaires. Even though the response rate remained relatively stable in 2017, declining response rates is a major concern in health surveys. As the generalizability to the Danish population may be compromised by a low response rate, efforts to increase the response rate or keep it stable are crucial in future surveys. Thus, efforts should be made to ensure convenience and feasibility in relation to access to and the completion of survey (web) questionnaires.