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1.
Euro Surveill ; 26(37)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34533117

RESUMO

BackgroundIn Denmark, influenza surveillance is ensured by data capturing from existing population-based registers. Since 2017, point-of-care (POC) testing has been implemented outside the regional clinical microbiology departments (CMD).AimWe aimed to assess influenza laboratory results in view of the introduction of POC testing.MethodsWe retrospectively observed routine surveillance data on national influenza tests before and after the introduction of POC testing as available in the Danish Microbiological Database. Also, we conducted a questionnaire study among Danish CMD about influenza diagnostics.ResultsBetween the seasons 2014/15 and 2018/19, 199,744 influenza tests were performed in Denmark of which 44,161 were positive (22%). After the introduction of POC testing, the overall percentage of positive influenza tests per season did not decrease. The seasonal influenza test incidence was higher in all observed age groups. The number of operating testing platforms placed outside a CMD and with an instrument analytical time ≤ 3 h increased after 2017. Regionally, the number of tests registered as POC in the Danish Microbiological Database and the number of tests performed with an instrument analytical time ≤ 3 h or outside a CMD partially differed. Where comparable (71% of tests), the relative proportion of POC tests out of all tests increased from season 2017/18 to 2018/19. In both seasons, the percentage of positive POC tests resulted slightly lower than for non-POC tests.ConclusionPOC testing integrated seamlessly into national influenza surveillance. We propose the use of POC results in the routine surveillance of seasonal influenza.


Assuntos
Influenza Humana , Dinamarca/epidemiologia , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Testes Imediatos , Estudos Retrospectivos , Estações do Ano
2.
Dan Med J ; 68(10)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34498585

RESUMO

INTRODUCTION: The epidemiology of children admitted to Scandinavian trauma centres remains largely unknown. This study aimed to describe the characteristics of severe injuries in children admitted to a Danish university-level trauma centre. METHODS: A descriptive study of all severely injured (Injury Severity Score ≥ 16) children aged 0-15 years who were admitted to the university level trauma centre at Odense University Hospital, Denmark, in the 2002-2018 period. Data were extracted from the South Danish Register and from medical records. RESULTS: A total of 152 children were included. The median age was 11 (range: 0-15) years. Boys accounted for 57% of the cases. Accidents accounted for 99% of the cases. In the youngest age group (0-4 years), the majority of injuries occurred in domestic areas, in the daytime, in the summer and around the weekends. In the oldest age group (11-15 years), most injuries occurred in traffic areas, in the autumn, on weekdays and in the afternoon. In all age groups, the majority of lesions were sustained to the head/face/neck, limbs and thorax. The overall median number of days in hospital was six. Overall, 39 (26%) children died. Almost half of the injuries were traffic related and this proportion increased with increasing age group. One-third of the traffic injured children died. CONCLUSIONS: Based on a regional trauma register, we described the characteristics of severely injured children. The study included several aspects regarding injury pattern and severity, which may be useful for risk identification, prevention of accidents and for hospital resource planning. FUNDING: none TRIAL REGISTRATION: not relevant.


Assuntos
Centros de Traumatologia , Ferimentos e Lesões , Acidentes de Trânsito , Adolescente , Criança , Pré-Escolar , Dinamarca/epidemiologia , Hospitalização , Humanos , Lactente , Recém-Nascido , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos , Estações do Ano , Ferimentos e Lesões/epidemiologia
3.
BMC Health Serv Res ; 21(1): 917, 2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482842

RESUMO

BACKGROUND: Significant resources are spent on hospital accreditation worldwide. However, documentation of the effects of accreditation on processes, quality of care and outcomes in healthcare remain scarce. This study aimed to examine changes in the delivery of patient care in accordance with clinical guidelines (recommended care) after first-time accreditation in a care setting not previously exposed to systematic quality improvement initiatives. METHODS: We conducted a before and after study based on medical record reviews in connection with introducing first-time accreditation. We included patients with stroke/transient ischemic attack, bleeding gastric ulcer, diabetes, chronic obstructive pulmonary disease (COPD), childbirth, heart failure and hip fracture treated at public, non-psychiatric Faroese hospitals during 2012-2013 (before accreditation) or 2017-2018 (after accreditation). The intervention was the implementation of a modified second version of The Danish Healthcare Quality Program (DDKM) from 2014 to 2016 including an on-site accreditation survey in the Faroese hospitals. Recommended care was assessed using 63 disease specific patient level process performance measures in seven clinical conditions. We calculated the fulfillment and changes in the opportunity-based composite score and the all-or-none score. RESULTS: We included 867 patient pathways (536 before and 331 after). After accreditation, the total opportunity-based composite score was marginally higher though the change did not reach statistical significance (adjusted percentage point difference (%): 4.4%; 95% CI: - 0.7 to 9.6). At disease level, patients with stroke/transient ischemic attack, bleeding gastric ulcer, COPD and childbirth received a higher proportion of recommended care after accreditation. No difference was found for heart failure and diabetes. Hip fracture received less recommended care after accreditation. The total all-or-none score, which is the probability of a patient receiving all recommended care, was significantly higher after accreditation (adjusted relative risk (RR): 2.32; 95% CI: 2.03 to 2.67). The improvement was particularly strong for patients with COPD (RR: 16.22; 95% CI: 14.54 to 18.10). CONCLUSION: Hospitals were in general more likely to provide recommended care after first-time accreditation.


Assuntos
Acreditação , Insuficiência Cardíaca , Dinamarca , Hospitais Públicos , Humanos , Melhoria de Qualidade
4.
Dan Med J ; 68(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34477097

RESUMO

INTRODUCTION: Women very rarely die during pregnancy and childbirth in Denmark. Although maternal deaths are registered worldwide, various studies indicate that underreporting does occur. This paper presents validated Danish register data for two periods between 1985 and 2017. METHODS: Maternal deaths were identified from 1985 to 1994 and from 2002 to 2017 by linking four national health registers, death certificates and notifications from maternity wards. A group of obstetricians categorised and assessed all medical records, classifying each case by cause of death. RESULTS: Linkage of four registers yielded valid data, leading to the identification of 143 maternal deaths in the abovementioned periods. From 1985-1994 there were 73 deaths and 618,021 live births, resulting in a maternal mortality rate of 11.8 per 100,000 live births with a non-significant 2% annual increase (95% confidence interval (CI): -6.0-11.0%). From 2002 to 2017 there were 70 maternal deaths and 999,206 live births, resulting in a maternal mortality rate of 7.0 per 100,000 live births (95% CI: 5.5-8.9) with a significant 9% annual decrease (95% CI: 4.0-14.0%). CONCLUSIONS: Overall maternal mortality decreased in the course of the two periods (n = 33 years), with a significant decrease during the last period. This is suggested to be a result of multiple clinical and organisational improvements as discussed in the paper. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
Mortalidade Materna , Complicações na Gravidez , Causas de Morte , Dinamarca/epidemiologia , Feminino , Humanos , Registros Médicos , Gravidez
5.
Artigo em Inglês | MEDLINE | ID: mdl-34501520

RESUMO

Health risk communication plays a crucial role in preventing the spread of infectious disease outbreaks such as the current coronavirus (SARS-CoV-2). Yet, migrants are far too often forgotten in health risk communication responses. We investigate the challenges and efforts made by migrants in Denmark-in the initial months of the pandemic-to access information about COVID-19. We draw on 18 semi-structured interviews conducted in May and June 2020. All interviews are thematically coded and analyzed. Our analysis reveals that many of the migrants faced several challenges, including accessing information in a language understandable to them and navigating constant streams of official news flows issuing instructions about which actions to take. However, we also note that the participating migrants found numerous creative ways to address some of these challenges, often aided by digital tools, helping them access crucial health and risk information. This paper highlights that migrants constitute an underserved group in times of crises. They are vulnerable to getting left behind in pandemic communication responses. However, we also identify key protective factors, social resources, and agentic capabilities, which help them cope with health and risk information deficits. National governments need to take heed of these findings to inform future pandemic responses.


Assuntos
COVID-19 , Migrantes , Dinamarca/epidemiologia , Surtos de Doenças , Humanos , Pandemias , SARS-CoV-2
6.
Int J Chron Obstruct Pulmon Dis ; 16: 2433-2443, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465989

RESUMO

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that is mainly caused by smoking, and most patients with COPD are either former or current smokers. The optimal way to slow down disease progression and reduce overall mortality is for patients to stop smoking. Patients with COPD are known to have lower socio-economic status and to be more nicotine-dependent than most other smokers and therefore face difficulties when attempting to quit smoking. Pharmacological smoking cessation treatment is known to be the most effective. However, the extent to which this treatment is actually offered to Danish smokers with COPD is unknown. Aim: The aim of this study was to investigate if patients with COPD were more likely to redeem a prescription for smoking cessation medication compared with matched controls. Materials and Methods: The study was designed as a registry-based, non-interventional case-control study. All Danish patients with COPD (ICD-10-code J 44 chronic obstructive pulmonary disease) diagnosed between 2009 and 2015 were included (130,797 cases). Controls (252,216) were matched on age, gender and geography. Primary outcome was the number of redeemed prescriptions for smoking cessation medication. Results: We found that 12% of patients with COPD redeemed a prescription for smoking cessation medication during the eight-year study period. The odds ratio (OR) for redeeming a prescription on smoking cessation medicine was OR 6.22 for patients with COPD compared with their matched controls. We also found that patients with COPD were more likely to redeem smoking cessation medication if they were younger, female or single. Conclusion: There is substantial room for improvement with respect to pharmacological smoking cessation treatment in Danish patients with COPD. In-depth knowledge of factors contributing to the patients choice of smoking cessation treatment might allow for more personalized guidance of patients with COPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Abandono do Hábito de Fumar , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Dispositivos para o Abandono do Uso de Tabaco , Vareniclina
7.
BMJ ; 374: n1954, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497091

RESUMO

OBJECTIVE: To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia. DESIGN: Nationwide prospective register based cohort study. SETTING: Denmark. PARTICIPANTS: 1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017. MAIN OUTCOME MEASURES: Incident cases of all cause dementia and dementia subtypes (Alzheimer's disease, vascular dementia, and Parkinson's disease related dementia), identified from national hospital and prescription registries. RESULTS: The study population included 103 500 participants with incident dementia, and of those, 31 219 received a diagnosis of Alzheimer's disease, 8664 of vascular dementia, and 2192 of Parkinson's disease related dementia. Using Cox regression models, 10 year mean exposure to road traffic and railway noise at the most (Ldenmax) and least (Ldenmin) exposed façades of buildings were associated with a higher risk of all cause dementia. These associations showed a general pattern of higher hazard ratios with higher noise exposure, but with a levelling off or even small declines in risk at higher noise levels. In subtype analyses, both road traffic noise and railway noise were associated with a higher risk of Alzheimer's disease, with hazard ratios of 1.16 (95% confidence interval 1.11 to 1.22) for road Ldenmax ≥65 dB compared with <45 dB, 1.27 (1.22 to 1.34) for road Ldenmin ≥55 dB compared with <40 dB, 1.16 (1.10 to 1.23) for railway Ldenmax ≥60 dB compared with <40 dB, and 1.24 (1.17 to 1.30) for railway Ldenmin ≥50 dB compared with <40 dB. Road traffic, but not railway, noise was associated with an increased risk of vascular dementia. Results indicated associations between road traffic Ldenmin and Parkinson's disease related dementia. CONCLUSIONS: This nationwide cohort study found transportation noise to be associated with a higher risk of all cause dementia and dementia subtypes, especially Alzheimer's disease.


Assuntos
Demência/epidemiologia , Ruído dos Transportes/estatística & dados numéricos , Idoso , Causalidade , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ruído dos Transportes/efeitos adversos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Sistema de Registros
8.
BMC Health Serv Res ; 21(1): 980, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34535148

RESUMO

BACKGROUND: People with musculoskeletal pain seek more healthcare than the general population, however little is known about the long-term effect on healthcare use. The aim of this study was to examine the consequences of number of musculoskeletal pain sites on long-term care-seeking and healthcare-related costs and explore how health anxiety influences this relationship. METHODS: We conducted a Danish population-based longitudinal cohort study of 4883 participants combining self-reported survey data from 2008 with ten-year follow-up data from national health registers. Using a causal inference framework, we examined associations between number of pain sites (range 0-7)/level of health anxiety (high/low level) and face-to-face healthcare contacts/healthcare-related costs. Data were analyzed using negative binomial regression with generalized estimating equations. Regression models were adjusted for sex, age, duration of pain, level of education, comorbidity, personality traits, risk of depression, marital status, physical job exposure, and previous healthcare utilization. RESULTS: For each additional pain site general healthcare contacts (Incidence Rate Ratio (IRR): 1.04 (95% CI: 1.03-1.05)), healthcare-related costs (IRR: 1.06 (95% CI: 1.03-1.08) and musculoskeletal healthcare contacts (IRR: 1.11 (95% CI:1.09-1.14) increased. Those with high levels of health anxiety at baseline had a slightly higher number of general healthcare contacts (IRR 1.06 (1.01-1.11), independent of number of pain sites. However, level of anxiety did not influence the effect of number of pain sites on any healthcare use or cost outcomes. CONCLUSIONS: We found evidence for a causal association between increasing number of pain sites and greater healthcare use and cost, and high levels of health anxiety did not increase the strength of this association. This suggests that number of pain sites could be a potential target for biopsychosocial interventions in order to reduce the need for future care-seeking.


Assuntos
Dor Musculoesquelética , Estudos de Coortes , Atenção à Saúde , Dinamarca/epidemiologia , Humanos , Estudos Longitudinais , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/terapia
9.
BMC Health Serv Res ; 21(1): 836, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407821

RESUMO

BACKGROUND: Patients diagnosed with inflammatory bowel disease may be treated with biologics, depending on several medical and non-medical factors. This study investigated healthcare costs and production values of patients treated with biologics. METHODS: This national register study included patients diagnosed with Crohn's disease (CD) and ulcerative colitis (UC) between 2003 and 2015, identified in the Danish National Patient Register (DNPR). Average annual healthcare costs and production values were compared for patients receiving biologic treatment or not, and for patients initiating biologic treatment within a year after diagnosis or at a later stage. Cost estimates and production values were based on charges, fees and average gross wages. RESULTS: Twenty-six point one percent CD patients and ten point seven percent of UC patients were treated with biologics at some point in the study period. Of these, 46.4 and 45.5 % of patients initiated biologic treatment within the first year after diagnosis. CD and UC patients treated with biologics had higher average annual healthcare costs after diagnosis compared to patients not treated with biologics. CD patients receiving biologics early had lower production values both ten years before and eight years after treatment initiation, compared to patients receiving treatment later. UC patients receiving biologics early had lower average annual production values the first year after treatment initiation compared to UC patients receiving treatment later. CONCLUSIONS: CD and UC patients receiving biologic treatment had higher average annual healthcare costs and lower average annual production values, compared to patients not receiving biologic treatment. The main healthcare costs drivers were outpatient visit costs and admission costs.


Assuntos
Produtos Biológicos , Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Produtos Biológicos/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/epidemiologia , Doença de Crohn/tratamento farmacológico , Doença de Crohn/epidemiologia , Dinamarca/epidemiologia , Humanos
10.
BMC Health Serv Res ; 21(1): 835, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407827

RESUMO

BACKGROUND: The objective is to examine hospital cost accounts to understand the foundation upon which healthcare decisions are based. More specifically, the aim is to add insights to accounting practices and their applicability towards a newly establish value-based agenda with a focus on patient-level cost data. METHODS: We apply a cost accounting framework developed to position and understand hospital cost practices in relation to government requirements. Allocated cost account data from 2015 from all Danish hospitals were collected and analyzed. These cost accounts lay the foundation for diagnosis related group (DRG) rate setting. We further compare the data's limitations and potential in a value-based healthcare (VBHC) agenda with the aim of implementing time-driven activity based costing (TDABC). RESULTS: We find exceedingly aggregated department-level data that are not tied to patient information. We investigate these data and find large data skewness in the current system, mainly due to structural variances within hospitals. We further demonstrate the current costs data's lack of suitability for VBHC but with suggestions of how cost data can become applicable for such an approach, which will increase cost data transparency and, thus, provide a better foundation for both local and national decision-making. CONCLUSIONS: The findings raise concerns about the cost accounts' ability to provide valid information in healthcare decision-making due to a lack of transparency and obvious variances that distort budgets and production-value estimates. The standardization of costs stemming from hospitals with large organizational differences has significant implications on the fairness of resource allocation and decision-making at large. Thus, for hospitals to become more cost efficient, a substantially more detailed clinically bottom-led cost account system is essential to provide better information for prioritization in health.


Assuntos
Grupos Diagnósticos Relacionados , Custos Hospitalares , Dinamarca , Estudos de Viabilidade , Humanos , Fatores de Tempo
11.
BMC Psychol ; 9(1): 122, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407891

RESUMO

BACKGROUND: Mental health represents an important public health issue, and mental health problems have been linked to school dropout. This study aimed to identify mental health groups of high school students using both positive and negative aspects of mental health and to examine whether these mental health groups longitudinally predict school dropout. METHODS: We conducted latent class analysis using the Danish National Youth Study 2014 (n = 60,526; mean 17.9 years) to identify clustering of mental health (11 items covering positive and negative aspects of emotional wellbeing and functioning in daily life), separately by sex. The relationship with subsequent school dropout was examined using logistic regression models, adjusted for age, ethnicity and socioeconomic status. Information on dropout status was obtained through educational registers. RESULTS: School dropout rates was highest among first-year students. Four mental health groups were identified: Flourishing (females: 38%, males: 55%), moderate mental health (females: 15%, males: 20%), emotionally challenged (females: 28%, males: 15%) and languishing (females: 19%, males: 10%). Compared to the flourishing group, adjusted odds ratio (AOR) for dropout were 3.43 (95% CI: 2.98, 3.95), 1.73 (95% CI: 1.45, 2.06) and 1.76 (95% CI: 1.52, 2.04) in the languishing, moderate mentally healthy and emotional challenged females. Results in males were comparable. CONCLUSIONS: Mental health in high school students cluster together in four categories among both males and females. Students who are languishing, emotionally challenged or moderate mentally healthy have about 1.5-fold to threefold higher risk of dropping out of high school compared with flourishing students. Universal mental health interventions may be a promising strategy, particularly in the first year of high school where most students drop out of school.


Assuntos
Saúde Mental , Evasão Escolar , Adolescente , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Instituições Acadêmicas , Estudantes
12.
Eur J Epidemiol ; 36(8): 861-872, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34420151

RESUMO

Human health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was - 32 g (95% CI-79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose-response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy.


Assuntos
Poluentes Atmosféricos/toxicidade , Anormalidades Congênitas/etiologia , Exposição Ambiental/efeitos adversos , Crescimento/efeitos dos fármacos , Exposição Materna/efeitos adversos , Bifenilos Policlorados/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Estudos de Coortes , Anormalidades Congênitas/epidemiologia , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Bifenilos Policlorados/análise , Gravidez , Resultado da Gravidez , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
13.
Sci Total Environ ; 791: 148301, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34412377

RESUMO

Ultrafine particles (UFP; particulate matter <0.1 µm diameter) emitted from motorized traffic may be highly detrimental to health. Active mobility (walking, bicycling) is increasingly encouraged as a way to reduce traffic congestion and increase physical activity levels. However, it has raised concerns of increased exposure to UFP, due to increased breathing rates in traffic microenvironments, immediately close to their source. The recent Coronavirus Disease 2019 (COVID-19) societal closures reduced commuting needs, allowing a natural experiment to estimate contributions from motorized traffic to UFP exposure while walking or bicycling. From late-March to mid-July 2020, UFP was repeatedly measured while walking or bicycling, capturing local COVID-19 closure ('Phase 0') and subsequent phased re-opening ('Phase 1', '2', '2.1' & '3'). A DiSCmini continuously measured particle number concentration (PNC) in the walker/bicyclist's breathing zone. PNC while walking or bicycling was compared across phased re-openings, and the effect of ambient temperature, wind speed and direction was determined using regression models. Approximately 40 repeated 20-minute walking and bicycling laps were made over 4 months during societal re-opening phases related to the COVID-19 pandemic (late-March to mid-July 2020) in Copenhagen. Highest median PNC exposure of both walking (13,170 pt/cm3, standard deviation (SD): 3560 pt/cm3) and bicycling (21,477 pt/cm3, SD: 8964) was seen during societal closures (Phase 0) and decreased to 5367 pt/cm3 (SD: 2949) and 8714 pt/cm3 (SD: 4309) in Phase 3 of re-opening. These reductions in PNC were mainly explained by meteorological conditions, with most of the deviation explained by wind speed (14-22%) and temperature (10-13%). Highest PNC was observed along major roads and intersections. In conclusion, we observed decreases in UFP exposure while walking and bicycling during societal re-opening phases related to the COVID-19 pandemic, due largely to meteorological factors (e.g., wind speed and temperature) and seasonal variations in UFP levels.


Assuntos
COVID-19 , Material Particulado , Ciclismo , Dinamarca , Humanos , Pandemias , Tamanho da Partícula , Material Particulado/análise , SARS-CoV-2 , Caminhada
14.
Eur J Obstet Gynecol Reprod Biol ; 264: 232-240, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34333366

RESUMO

INTRODUCTION: We aimed to estimate the prevalence of urinary incontinence (UI) in women with hypothyroidism and subclinical hypothyroidism and to examine the association of hypothyroidism and UI. METHODS: This cross-sectional study was based on the population-based Lolland-Falster Health Study (LOFUS), Denmark. Data comprising a questionnaire, physical examination, and blood samples were collected between 2016 and 2020. Multiple logistic regression was used to estimate odds ratios (OR) and control for possible confounders: age, body mass index, diabetes, smoking, and education. RESULTS: Of 7,699 women included in the study, 7.9% had hypothyroidism, and 2.4% had subclinical hypothyroidism. The prevalence of any UI in women with hypothyroidism, subclinical hypothyroidism, and a control group (normal level of thyroid hormones) was 43.6%, 38.1%, and 39.3%, respectively. After controlling for confounders, no association between hypothyroidism and any UI (OR 1.01, 95% CI 0.85-1.20) or frequent UI (OR 1.05, 95% CI 0.84-1.32) were demonstrated. Additional, no association between subclinical hypothyroidism and any UI (OR 0.87, 95% CI 0.64-1.18) or frequent UI (OR 1.15, 95 CI 0.79-1.69) were demonstrated. CONCLUSIONS: In our female sample, the prevalence of UI was high regardless of the thyroid status. No association between hypothyroidism and any or frequent UI was demonstrated. The prevalence of hypothyroidism was 7.9%.


Assuntos
Hipotireoidismo , Incontinência Urinária , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Incontinência Urinária/epidemiologia
15.
J Bodyw Mov Ther ; 27: 550-559, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34391286

RESUMO

BACKGROUND: The Danish Veterans Centre offers a body-orientated therapy, Basic Body Awareness Therapy (BBAT), in addition to the psychological trauma-focused therapy to military veterans suffering from symptoms of post-traumatic stress disorder (PTSD). This study explored how the veterans a) experienced BBAT as a physiotherapeutic approach and as an add-on treatment to their usual Cognitive Behavioural Therapy (CBT) and b) whether it makes sense for the individual veteran to incorporate BBAT into their treatment. MATERIALS AND METHODS: Individual semi-structured interviews with four veterans who had completed 12 BBAT sessions concurrently with their usual CBT treatment. Interviews were transcribed and analysed using Malterud's version of Giorgi's 4-step systematic text condensation. RESULTS: Three main categories emerged: "Effects of treatment", "The setting of the treatment" and "Complementary nature of BBAT and CBT". Within each category were 2-5 underlying subgroups. Participants found it made sense to combine BBAT with their CBT since it benefitted them differently and addressed their bodily symptoms and improved body perception/awareness. CONCLUSION: BBAT showed potential as a supplement to CBT and seemed to benefit the veterans through focusing on bodily symptoms and how to calm them. Future studies are needed because of the limited research on the topic.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos de Estresse Pós-Traumáticos , Veteranos , Conscientização , Dinamarca , Humanos , Entrevistas como Assunto , Transtornos de Estresse Pós-Traumáticos/terapia
16.
Acta Derm Venereol ; 101(9): adv00538, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34458924

RESUMO

To estimate the cost of illness in adult patients with moderate-to-severe atopic dermatitis (AD) a cohort study was conducted identifying Danish citizens (≥ 18 years) diagnosed with AD between 1997 and 2018 in the Danish National Patient Register. Moderate-to-severe AD was defined as ≥3 hospital contacts regarding AD the first year after diagnosis. Each patient with AD was matched to 3 reference individuals through the Central Person Registry. Societal costs included the direct costs for primary-sector visits, inpatient hospitalizations, outpatient contacts, prescription medicine and indirect costs of lost productivity 3 years before and 5 years after the index date (the study period). A total of 5,245 patients with moderate-to-severe AD were identified. The mean attributable healthcare costs for patients with moderate-to-severe AD were EUR 10,835 (p < 0.0001) during the study period. Moderate-to-severe AD among adults inferred substantial economic burden compared with a group of matched reference individuals.


Assuntos
Dermatite Atópica , Adulto , Estudos de Coortes , Efeitos Psicossociais da Doença , Dinamarca/epidemiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Custos de Cuidados de Saúde , Humanos
17.
Eur J Epidemiol ; 36(7): 715-725, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34420152

RESUMO

Seroprevalence studies have proven an important tool to monitor the progression of the coronavirus disease 2019 (COVID-19) pandemic. We present results of consecutive population-based seroprevalence surveys performed in Denmark in 2020. In spring, late summer and autumn/winter of 2020, invitation letters including a questionnaire covering symptoms were sent to representative samples of the population above 12 years and to parents of children below 18 years in the sample. Blood samples were analysed for total Ig and seroprevalence estimates per population segment were calculated and compared to other surveillance parameters. Based on 34 081 participants (participation rate 33%), seroprevalence estimates increased from 1.2% (95%CI: 0.3-1.9%) in May to 4.1% (95%CI: 3.1-4.9%) in December 2020. Seroprevalence estimates were roughly three times higher in those aged 12-29 years compared to 65 + and higher in metropolitan municipalities. By December 2020, 1.5% of the population had tested positive by RT-PCR. Infected individuals in older age groups were hospitalised several fold more often than in younger. Amongst seropositives, loss of taste/smell were the more specific symptoms, 32-56% did not report any symptoms. In more than half of seroconverted families, we did not see evidence of transmission between generations. Seroprevalence increased during 2020; adolescents were primarily infected in the autumn/winter. Denmark has a high per capita test rate; roughly one undiagnosed infection of SARS-CoV-2 were estimated to occur for each diagnosed case. Approximately half were asymptomatically infected. The epidemic appears to have progressed relatively modestly during 2020 in Denmark.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , SARS-CoV-2 , Adolescente , Adulto , Idoso , Criança , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Estudos Soroepidemiológicos , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-34444248

RESUMO

Engaging occupational safety and health (OSH) professionals has scarcely been evaluated as a means for transferring knowledge to practice about physical workload in the construction industry. The aim of this work was to examine how participants used and incorporate research-based knowledge from a three-day training course into practice. Twenty OSH professionals from the Danish construction industry participated in a workshop-training course. Researchers presented new knowledge and results about physically demanding work. The participants selected which themes they wanted to work with and developed an action plan. Evaluation was done using surveys and phone interviews. Analysis was based on how the OSH-professionals describe themselves, organizations, and the construction industry. Participant's average scores on the level of implementation of their chosen action plans were 3 (on a response scale from 1-5, where 1 is 'to a very low degree' and 5 is 'to a very high degree') immediately after the workshop program and 2.5 at follow-up. Qualitative evaluations showed that actions had been initiated, and some progress had been made. The participants were satisfied with the workshop course and the possibility to increase their knowledge through inputs from researchers and colleges and strongly believe that they would succeed with implementing their action plans in the future.


Assuntos
Indústria da Construção , Saúde do Trabalhador , Dinamarca , Pessoal de Saúde , Humanos , Carga de Trabalho
19.
Acta Otolaryngol ; 141(8): 791-795, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34340651

RESUMO

BACKGROUND: Health care workers (HCW) at otorhinolaryngological departments have an increased risk of contracting COVID-19, due to aerosol-inducing diagnostic and surgical procedures in the airways. The ongoing exposure to physical and psychological stressors could impact the mental health of HCW. AIM/OBJECTIVE: To investigate the impact on mental health in an otorhinolaryngological department during the COVID-19 pandemic. MATERIALS/METHOD: Cross-sectional questionnaire study, assessing symptoms of depression (PHQ-9) and anxiety (GAD-10). Physicians, nurses, and secretaries were included at a tertiary department of otorhinolaryngology in the Capital Region of Denmark during the COVID-19 lockdown in spring 2020. RESULTS: Positive screenings for stress reactions were found in 22% for depressive symptoms and 15.5% anxiety. 27% feared becoming infected, 47% feared infecting their families in relation to work. 27% felt others were distancing from them, and 38% isolated themselves from others because of their work. Women had an odds ratio of 9.18 (CI 1.49-179) for depressive stress reactions. CONCLUSION: HCW were primarily concerned with transmitting COVID-19 to their relatives. Secondarily, there was a concern about becoming infected despite feeling adequately protected by personal protective equipment. Women were at higher risk of more severe depressive symptoms when corrected for professions.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Estresse Ocupacional/epidemiologia , Otolaringologia , Recursos Humanos em Hospital/psicologia , Adulto , COVID-19/prevenção & controle , COVID-19/psicologia , Estudos Transversais , Dinamarca , Feminino , Departamentos Hospitalares , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Centros de Atenção Terciária
20.
Artigo em Inglês | MEDLINE | ID: mdl-34444082

RESUMO

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992-2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6-24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2-30.7)) than among boys (18.5 (18.0-19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0-5 years and 12-15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.


Assuntos
Artrite Juvenil , Artrite Juvenil/epidemiologia , Pré-Escolar , Dinamarca/epidemiologia , Emigração e Imigração , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Sistema de Registros
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