Recruiting residents from disadvantaged neighbourhoods for community-based health promotion and disease prevention services in Denmark-How, why and under what circumstances does an active door-to-door recruitment approach work?

Residents living in disadvantaged neighbourhoods have higher mortality and morbidity and participate less in health services than people living in more prosperous areas. Studies on how and why different approaches work for recruiting residents from disadvantaged neighbourhoods to health services are needed. Conducting face-to-face meetings with obliging health professionals (HPs) as part of an active recruitment strategy increases interest in service use, particularly among the most vulnerable residents. The services offered must be free, flexible and easily accessible for residents from disadvantaged neighbourhoods to consider their use. Residents immediately consider and 'translate' the relevance and acceptability of health services presented to them in light of their current situation, which affects their response. Individual contextual circumstances such as current health issues or difficult life circumstances, either promote or dampen their interest in using the services. This study is a realist evaluation of active face-to-face recruitment where HPs go from door-to-door to visit residents in disadvantaged neighbourhoods and offer them community-based health promotion and disease prevention services. A programme theory explicating the assumptions behind this recruitment approach was tested empirically in the present study. Eight direct observations of the active recruitment process in three different neighbourhoods and 17 realist interviews with residents were conducted. Sampling of residents was purposeful and opportunistic. Data were collected between March and August 2018. The findings support the use of active face-to-face recruitment in disadvantaged neighbourhoods to increase participation in health interventions. A broad range of health services should be presented to residents to accommodate their different needs and interests. Refusal to have services presented during active recruitment was rare, but more knowledge about these reasons for declining services is needed.

Health is not all about salads: An ethnographic study on health perceptions and health behavior among socially marginalized Danish men.

BACKGROUND: The effects of social marginalization and health are well-documented, revealing a complex association between health perceptions and health behavior. This is especially evident among socially marginalized men. OBJECTIVE: This study aims to explore health perceptions and health behaviors influencing overall health among socially marginalized men who seem to not benefit from existing municipal health care in a large Danish municipality. These men have varying health challenges and engage in risky health behaviors, such as alcohol drinking, tobacco smoking, and lack of physical activity. DESIGN AND SAMPLE: This was an ethnographic study including 200 hr of participant observations and 25 interviews with socially marginalized men aged 45-65. RESULTS: Health was perceived as related to the ability to participate in daily life activities, such as getting around effortlessly and the ability to work. Alcohol drinking appeared to be part of a complex approach in managing everyday life, including various personal physical and mental health challenges and admission to social networks. CONCLUSION: Overall, the results provide important insight into how health perceptions and health behaviors are embedded in the men's everyday lives. This knowledge may be used by public health nurses and other health professionals in providing and developing health services.

Talk to Me, Not at Me: An Ethnographic Study on Health-Related Help-Seeking Behavior Among Socially Marginalized Danish Men.

Research shows that men tend to have delayed health-related help-seeking behavior. In this ethnographic study, we explored influential factors related to health-related help-seeking behavior among socially marginalized men who seem not to benefit from existing municipal health care services in a large Danish municipality. The study included 200 hours of participant observations and 25 ethnographic interviews with men between 45 and 65 years of age in their own homes and in public parks among their peers. In this study, we found that the men had several complex and interacting social- and health-related conditions, which seemed to affect their health-related help-seeking behavior. We conclude that collaborative initiatives between the outreach team who occasionally visits bench sites in the public parks and the municipal health care services in the local areas could lay the groundwork for encouraging men's health-related help-seeking behavior and aid men in supporting each other.

Improving posthospital medication management in a Danish municipality: A process evaluation.

AIMS AND OBJECTIVES: To evaluate an intervention developed to improve patient safety in posthospital medication management carried out by visiting nurses working in a municipality in Denmark. The intervention consisted of three elements: an initial interdisciplinary home visit by nurses, two subsequent scheduled visits and the use of an organising tool. BACKGROUND: As a consequence of specialised treatment plans and new treatment possibilities, patients with complex care needs can now be discharged from hospital more rapidly-and in greater numbers-than previously. Medication management is identified as the most challenging component of a discharge from the hospital to the home, in which discrepancies have been found in up to 94% of medication lists. DESIGN: A process evaluation inspired by the UK Medical Research Council's guidance. METHODS: The process evaluation was conducted for three months in a visiting nurses' department. Data consisted of visiting nurses' self-reports of performance of the intervention and group interviews (n = 4) with visiting nurses (n = 14). Self-reports were analysed to evaluate implementation performance and elaborated with interview data to illuminate mechanisms of impact and contextual factors. RESULTS: The implementation of the intervention highlighted the importance of the nurse-patient relationship, nursing assessment and logistics, and professional values in posthospital medication management. Complex care needs were a mediator in the high implementation rate, which involved 31 of the 38 patients in the target group. CONCLUSION: For patients with complex care needs, posthospital medication management may be improved by a reconsideration of the activity-based funding of home health care, a recognition of the importance of organising work and a critical consideration of standard systems. RELEVANCE TO CLINICAL PRACTICE: An increase in the number of patients with complex care needs in home health care is an international issue that affects many healthcare systems. This study points at contextual challenges and possible methods for facilitating the future development of posthospital care for these patients.

Visiting nurses' posthospital medication management in home health care: an ethnographic study.

BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. AIM: The aim of this study was to explore visiting nurses' medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety. METHOD: Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients' homes, medication lists and medical records. Field notes were analysed in four steps. FINDINGS: The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients' actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home. CONCLUSION: The nurse-patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses' medication management in patients' homes after hospital discharge. The implications for practice were the following: to ensure nurses' opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients' needs and the adjustment of care and treatment; to clarify expectations to nurses' responsibility and patients' privacy.

The association between physical activity, cardiorespiratory fitness and self-rated health.

OBJECTIVE: To investigate the joint association between self-reported physical activity as well as cardiorespiratory fitness and self-rated health among healthy women and men. METHOD: Data from 10,416 participants in The Danish Health Examination Survey 2007-2008 which took part in 13 Danish municipalities were analyzed. Leisure time physical activity level and self-rated health were based on self-reported questionnaire data. Optimal self-rated health was defined as "very good" or "good" self-rated health. Cardiorespiratory fitness (mL O2·min(-1)·kg(-1)) was estimated from maximal power output in a maximal cycle exercise test. RESULTS: A strong dose-response relation between cardiorespiratory fitness and self-rated health as well as between physical activity level and self-rated health among both women and men was found. Within categories of physical activity, odds ratios for optimal self-rated health increased with increasing categories of cardiorespiratory fitness, and vice versa. Hence, participants who were moderately/vigorously physically active and had a high cardiorespiratory fitness had the highest odds ratio for optimal self-rated health compared with sedentary participants with low cardiorespiratory fitness (odds ratio=12.2, 95% confidence interval: 9.3-16.1). CONCLUSION: Although reluctant to conclude on causality, this study suggests that an active lifestyle as well as good cardiorespiratory fitness probably increase self-rated health.

Harmful alcohol use and frequent use of marijuana among lifetime problem gamblers and the prevalence of cross-addictive behaviour among Greenland Inuit: evidence from the cross-sectional Inuit Health in Transition Greenland survey 2006-2010.

BACKGROUND AND OBJECTIVES: Public health research has pointed to alcohol and substance abuse as the most significant public health challenges in Greenland with the negative impact on families and communities that entail, but few studies have investigated the role of problem gambling as addictive behaviour among Inuit. The objectives of the present study were to investigate (a) the association between lifetime problem gambling and harmful alcohol use as well as frequent use of marijuana and (b) the prevalence of cross-addictive behaviour among Greenland Inuit. DESIGN: A representative cross-sectional study among Greenland Inuit (n=2,189). Data was collected among adults (18+) in 8 towns and 13 villages in Greenland from 2006-2010. Lifetime problem gambling, harmful alcohol use and frequent use of marijuana were measured through a self-administered questionnaire. RESULTS: The odds ratio for harmful alcohol use and frequent use of marijuana was significantly higher among lifetime problem gamblers compared to non-problem gamblers/non-gamblers. One or more addictive behaviours were present among more than half of the men (53%) and one third of the women (37%), and the co-occurrence of lifetime problem gambling with either harmful alcohol use, frequent use of marijuana or both was found among 12.2% of men and 3.7% of women. The prevalence of one or more addictive behaviours was 44% in households with children. CONCLUSIONS: For lifetime problem gamblers, the gambling problems were more often than not combined with harmful alcohol use, frequent use of marijuana or both--especially among men. The high prevalence of addictive behaviours in households with children indicates that many families are presently affected negatively by alcohol, gambling and marijuana. This suggests that pathological gambling should be included systematically in future public health strategies, treatment programs and interventions in Greenland.

Drinking contexts and the legitimacy of alcohol use: findings from a focus group study on alcohol use in Denmark.

AIM: To examine the perceptions and meanings of alcohol use in Denmark with specific focus on drinking contexts. METHODS: A qualitative study using focus group interviews. The sample consisted of five focus groups of adults with one group for each of the following age groups: 16-20; 21-34; 35-44; 45-64; and 65-82 years. The groups consisted of both men and women with five to six participants in each group (27 in total). RESULTS: Alcohol use is perceived as legitimate in many social contexts with few being defined as inappropriate. Drinking alone is mostly associated with having alcohol-related problems, but considered legitimate if it is characterized by activity. Drinking socially plays an important role in people's considerations of legitimate use and seems to overrule the actual alcohol amount consumed. Different contexts influence different meanings of drinking with context and purpose changing with age and life stages. CONCLUSIONS: The social drinking context is pivotal in people's perception of the legitimacy of their alcohol use, leaving the alcohol amount less important. This calls for the need to focus on and incorporate the drinking context within public health initiatives aimed at reducing high risk drinking, just as the focus on the actual amount of alcohol people consume or their frequency of use.

Gambling behavior and problem gambling reflecting social transition and traumatic childhood events among Greenland Inuit: a cross-sectional study in a large indigenous population undergoing rapid change.

An increase in social pathologies is a key feature in indigenous populations undergoing transition. The Greenland Inuit are a large indigenous population constituting a majority in their own country, which makes it possible to investigate differences within the population. This led us to study gambling behavior and problem gambling among Greenland Inuit in relation to the ongoing social transition and traumatic events during childhood. A large representative cross-sectional study was conducted among Greenland Inuit (n = 2,189). Data was collected among adults (18+) in 9 towns and 13 villages in Greenland from 2005 to 2010. Problem gambling, gambling behavior and traumatic childhood events were measured through a self-administered questionnaire. The lie/bet screen was used to identify past year and lifetime problem gambling. Social transition was measured as place of residence and a combination of residence, education and occupation. The lifetime prevalence of problem gambling was 16 % among men and 10 % among women (p < 0.0001); and higher in towns (19 %) compared to the capital of Nuuk (11 %) and in villages (12 %) (men only, p = 0.020). Lifetime problem gambling was associated with social transition (p = 0.023), alcohol problems in childhood home (p = 0.001/p = 0.002) and sexual abuse in childhood (women only, p = 0.030). A comparably high prevalence of lifetime problem gambling among Greenland Inuit adds problem gambling to the list of social pathologies in Greenland. A significant association between lifetime problem gambling, social transition and traumatic childhood events suggests people caught between tradition and modern ways of life are more vulnerable to gambling problems.

Effect of a Web-based intervention to promote physical activity and improve health among physically inactive adults: a population-based randomized controlled trial.

BACKGROUND: Many people in Western countries do not follow public health physical activity (PA) recommendations. Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level. OBJECTIVE: To examine whether access to a website with individually tailored feedback and suggestions on how to increase PA led to improved PA, anthropometrics, and health measurements. METHODS: Physically inactive adults (n = 12,287) participating in a nationwide eHealth survey and health examination in Denmark were randomly assigned to either an intervention (website) (n = 6055) or a no-intervention control group (n = 6232) in 2008. The intervention website was founded on the theories of stages of change and of planned behavior and, apart from a forum page where a physiotherapist answered questions about PA and training, was fully automated. After 3 and again after 6 months we emailed participants invitations to answer a Web-based follow-up questionnaire, which included the long version of the International Physical Activity Questionnaire. A subgroup of participants (n = 1190) were invited to a follow-up health examination at 3 months. RESULTS: Less than 22.0% (694/3156) of the participants logged on to the website once and only 7.0% (222/3159) logged on frequently. We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups. By dividing participants into three groups according to use of the intervention website, we found a significant difference in total and leisure-time PA in the website group. The follow-up health examination showed no significant reductions in body mass index, waist circumference, body fat percentage, and blood pressure, or improvements in arm strength and aerobic fitness in the website group. CONCLUSIONS: Based on our findings, we suggest that active users of a Web-based PA intervention can improve their level of PA. However, for unmotivated users, single-tailored feedback may be too brief. Future research should focus on developing more sophisticated interventions with the potential to reach both motivated and unmotivated sedentary individuals. TRIAL REGISTRATION: Clinicaltrials.gov NCT01295203; http://clinicaltrials.gov/ct2/show/NCT01295203 (Archived by WebCite at http://www.webcitation.org/6B7HDMqiQ).

Associations between deprived life circumstances, wellbeing and self-rated health in a socially marginalized population.

BACKGROUND: Previous studies of self-rated health among socially marginalized people provide insufficient understandings of what influences their self-rated health. This study aimed to examine how disadvantaged life circumstances (homelessness, substance abuse, poverty) and general well-being were associated with poor self-rated health among the socially marginalized. METHODS: In a nationwide survey in Denmark, 1348 users of shelters, drop-in centres, treatment centres and social psychiatric centres answered a self-administered questionnaire. We analysed data using logistic regression. RESULTS: Disadvantaged life circumstances and well-being were associated with self-rated health, also when controlling for illness, mental disorder and age. Male respondents exposed to two or more disadvantaged life circumstances had higher odds of poor self-rated health [odds ratio (OR): 2.96; 95% confidence interval (CI): 1.80-4.87] than males exposed to fewer disadvantages. A low sense of personal well-being implied higher odds of poor self-rated health among both men and women. Among men, not showering regularly (OR: 1.81; 95% CI: 1.17-2.79), and among women, not eating varied food (OR: 2.24; 95% CI: 1.20-4.20) and exposure to physical violence (borderline significant) implied higher odds of poor self-rated health. Male and female respondents reporting lack of sleep and loneliness (borderline significant among women) had higher odds of poor self-rated health. CONCLUSIONS: The poor self-rated health among socially marginalized is strongly associated with massive social problems, poor living conditions and poor well-being. This study elucidates the need for more broadly based and holistic initiatives by both the health sector and the social services, incorporating health promotion initiatives into social work.

A population-based randomized controlled trial of the effect of combining a pedometer with an intervention toolkit on physical activity among individuals with low levels of physical activity or fitness.

OBJECTIVES: To examine if receiving a pedometer along with an intervention toolkit is associated with increased physical activity, aerobic fitness and better self-rated health among individuals with low levels of physical activity or fitness. METHODS: The intervention was nested in the Danish Health Examination Survey (DANHES) and carried out in 2008. Participants were randomly assigned to either a pedometer group (n=326) or a control group (n=329). Physical activity, aerobic fitness, and self-rated health were measured at baseline and at 3-month follow-up, and differences were tested by Wilcoxons signed rank tests and Chi-squared tests. RESULTS: At follow-up, no significant differences in physical activity, aerobic fitness and self-rated health were found between the groups. However, the oldest participants in the pedometer group reported significantly more walking time compared to the controls (controls=368 min/week, pedometer group=680 min/week, P=0.05). Among participants who completed the intervention, a significant effect on total walking time was observed (median difference=225 min/week, P=0.04). CONCLUSIONS: The results suggest that receiving a pedometer and along with an intervention toolkit can increase walking time in older individuals, but not in younger individuals. Thus, this type of intervention offers great potential for promoting physical activity in older individuals. TRIAL REGISTRATION NUMBER: NCT01071811.

Acceptance and expectance: Cultural norms for alcohol use in Denmark.

Alcohol consumption levels in Denmark are high with the risk of increased morbidity and mortality in the population. It is suggested that people's views of "normal" use of alcohol must be the platform for formulating effective alcohol education and prevention strategies. However, little is known about the cultural norms for alcohol use. The aim of this article is to examine the perceptions of cultural norms for alcohol use in Denmark among different age groups and the similarities and differences between the groups, including examining how people construct and negotiate the cultural norms for drinking. Five focus group interviews were conducted with one group per the following age groups: 16-20; 21-34; 35-44; 45-64; and 65-82. These groups consisted of both men and women with five to six participants in each group (a total of 27). Thematic analysis was performed with the aim of developing themes that reflected the cultural norms for alcohol use. The unifying theme of this research was Danish people's acceptance and expectance of social drinking. Alcohol is widely accepted and associated with mutual expectations to drink, leading to identification of cultural influences and facilitation to drink. The social drinking context plays an important role in people's perceptions of the normality of drinking. This includes the selection of particular beverages, and regularly leads to consumption above the recommended levels for low risk to health. This calls for public health attention that promotes low risk drinking in the social context and aims to prevent and reduce serious alcohol-related harm and health problems across the population.

The Danish Health Examination Survey 2007-2008 (DANHES 2007-2008).

AIMS: The Danish Health Examination Survey (DANHES 2007-2008) was carried out by the National Institute of Public Health, University of Southern Denmark, in 13 Danish municipalities in 2007-2008. The focus of the survey was diet, smoking, alcohol, and physical activity. The aim of the survey was to establish a research database for future cross-sectional and follow-up studies. METHODS: DANHES 2007-2008 included internet-based questionnaires and a health examination. There were two different questionnaires: a basic questionnaire on socio-demography, health behaviour, self-reported health status, and living conditions, and a supplementary food frequency questionnaire. The health examination contained measurements of blood pressure, resting heart rate, height, weight, fat percentage, waist and hip circumference, blood and hair samples, spirometry, bone mineral density, physical performance, muscle strength, and aerobic fitness. RESULTS: A total of 76,484 people completed the basic questionnaire, and 18,065 adult individuals participated in the health examination, corresponding to a response rate of 14% and a participation rate of 10%, respectively. CONCLUSIONS: The database from DANHES 2007-2008 is unique in its size and diversity of measurements and questionnaire contents. Data can be linked to various registers through the Danish civil registration system, and blood samples are stored in a biobank allowing for genetic analyses. Hence, DANHES 2007-2008 forms the basis for future research projects with a focus on health behaviour and prevention of lifestyle-related diseases.

Effects of school district factors on alcohol consumption: results of a multi-level analysis among Danish adolescents.

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

The Danish Youth Cohort: characteristics of participants and non-participants and determinants of attrition.

AIMS: The aim of this paper is to describe the design and methods used in the Danish Youth Cohort and to give a description of the study participants with special attention to a comparison between participants and non-participants regarding sociodemographic characteristics. METHODS: A total of 1,945 schools were invited, out of which 506 participated. The participating 7th grades comprised a total of 12,498 responding adolescents. The response rate for the Danish Youth Cohort established in 2005 was 63%. The sample of 12,498 adolescents represents 18.2% of all pupils (n = 68,764) in the 7th grade (mean age: 13.4 years) in Danish schools in 2005. The cohort was followed up in spring 2006 and spring 2007, where the adolescents were in the 8th (mean age: 14.4 years) and 9th (mean age: 15.3 years) grades, respectively. RESULTS: We found that compared with non-participants the participants were significantly more likely to be girls, to be of Danish ethnicity, and to live in one-family houses. Furthermore, participants more often came from families with two or three children, were more likely to have parents with a high occupational status, parents who were married and parents with a higher total income. Loss to follow-up was only associated with adolescents' higher probability of drinking and use of tobacco, and none of the other factors were associated with attrition. CONCLUSIONS: The participants in the Danish Youth Cohort represent a great variety of different groups of socio-demographic factors, although they differ from non-participants as regards a range of socio-demographic factors. This should be taken into account in future analyses.

Readiness to change level of physical activity in leisure time among physically inactive Danish adults.

AIMS: The study examined readiness to change the level of physical activity in leisure time among physically inactive adults, the sociodemographic, lifestyle-related and social factors associated with readiness to change, and finally the various kinds of help to become more physically active required by people who are ready to change and by those not ready to change. MATERIALS AND METHODS: Data were derived from the national representative Danish Health Interview Survey 2005 and included 9,160 physically inactive persons between 16 and 79 years of age. Data were analysed using multiple logistic regression and multiple correspondence analysis. RESULTS: In all, 52 % of the physically inactive respondents stated they were ready to change their level of physical activity. Men had higher odds of being ready to change than women. Readiness to change decreased with age and increased with increasing levels of education. Those ready to change led an active and social lifestyle characterized by considerable health-oriented engagement, while the opposite characterised those not ready to change. Those ready to change wanted help to become more physically active in the form of e.g. opportunities for physical activity at work or help and support from the family. Those not ready to change wanted help from a general practitioner or did not want help at all. CONCLUSIONS: Those ready to change and those not ready to change were characterized by very different sociodemographic, lifestyle-related and social factors. This knowledge will benefit prevention initiatives and elucidates the necessity of targeting the initiatives.

What characterizes persons with high levels of perceived stress in Denmark? A national representative study.

AIMS: Stress is a growing public health problem, but there are only a few studies with national representative samples on the occurrence of stress. The aim of this study was to assess the level of stress, measured by the Perceived Stress Scale, in Denmark, and to identify and characterize the group with high levels of stress by factors measured at both the individual and neighbourhood levels in a national representative sample of the Danish population. METHODS: The 10,022 participants in the National Health Interview Survey 2005 were asked about perceived stress and individual factors in a cross-sectional design. Information on neighbourhood factors was derived from a national registry. Data were analysed by means of logistic regression models. RESULTS: Low education, heavy smoking, physical inactivity, lack of social network and poor working conditions were associated with perceived stress. For women, living in a neighbourhood with low average education, and for men, living in a neighbourhood with a high rate of crime and a low degree of ethnic diversity, were associated with higher perceived stress. Perceived stress was also related to indicators of morbidity. CONCLUSIONS: The group with high perceived stress is characterized by individual and neighbourhood factors with negative impacts on quality of life and risk of illness. This knowledge can guide future stress prevention efforts. Additionally, the results suggest a negative social component where perceived stress, unhealthy lifestyle and low social status are accumulated, and perceived stress might be used as a measure to identify groups characterized by accumulation of risk factors.

Predictors of changes in physical activity in a prospective cohort study of the Danish adult population.

AIM: To investigate predictors of changes in physical activity, in a prospective population-based study. METHODS: Data were from the Danish Health Interview Surveys in 1994 and 2000, and included persons between 16 and 64 years of age who answered the questions on physical activity and various covariates in 1994, and who were re-interviewed in 2000. In total 2,957 subjects participated (62% of the original sample). Data were analysed using logistic regression. RESULTS: Predictors of physical inactivity were, for men and women respectively, heavy smoking (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.24-3.48, and OR 2.23, 95% CI 1.34-3.71), poor self-rated health (OR 2.11, 95% CI 1.25-3.58, and OR 1.75, 95% CI 1.10-2.80), and believing that one's own effort has no effect on health (OR 1.86, 95% CI 1.20-2.88, and OR 1.63, 95% CI 1.00-2.65). For men, further predictors for physical inactivity were obesity as compared to normal weight (OR 2.10, 95% CI 1.11-3.98), and being unmarried as compared to being married (OR 2.22, 95% CI 1.40-3.51). The only predictor for becoming physically active among initially sedentary respondents was meeting often with family (p=0.011). CONCLUSIONS: Our results show a number of strong predictors for physical inactivity. Variables of an unhealthy lifestyle tend to cluster in some individuals, and physical inactivity interventions may therefore be more successful if they also address smoking, self-belief, and obesity. Interventions tailored to raise inactive people's level of activity should focus on social support from the family.

[The occurrence of hangovers among Danish men and women]. / Forekomsten af tømmermaend blandt danske kvinder og maend.

We have examined the occurrence of hangovers i Danish men and women. Among 36,228 participants, the occurrence of a list of different hangover symptoms as well as of severe hangovers was higher in women than in men. For example, the odds ratio was 1.53 (95% CI: 1.41-1.66) for experiencing headache and 1.97 (95% CI: 1.75-2.21) for severe hangovers after an episode of binge-drinking in women compared with men. This finding could not be explained by weekly alcohol intake, type of alcohol ingested, frequency of binge drinking episodes or by the proportion of alcohol consumed with meals.