The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events.
Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change.
Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group.
Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.
The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team.
A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed.
Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers.
The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described.
Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation.
Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived.
The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned.
Mutations in the BRCA1 and BRCA2 genes significantly contribute to hereditary breast cancer and ovarian cancer, but the phenotypic effect from different mutations is insufficiently recognized. We used a western Danish clinic-based cohort of 299 BRCA families to study the female cancer risk in mutation carriers and their untested first-degree relatives. Founder mutations were characterized and the risk of cancer was assessed in relation to the specific mutations. In BRCA1, the cumulative cancer risk at age 70 was 35 % for breast cancer and 29 % for ovarian cancer. In BRCA2, the cumulative risk was 44 % for breast cancer and 15 % for ovarian cancer. We identified 47 distinct BRCA1 mutations and 48 distinct mutations in BRCA2. Among these, 8 founder mutations [BRCA1 c.81-?_4986+?del, c.3319G>T (p.Glu1107*), c.3874delT and c.5213G>A (p.Gly1738Glu) and BRCA2 c.6373delA, c.7008-1G>A, c.7617+1G>A and c.8474delC] were found to account for 23 % of the BRCA1 mutations and for 32 % of the BRCA2 mutations. The BRCA1 mutation c.3319G>T was, compared to other BRCA1 mutations, associated with a higher risk for ovarian cancer. In conclusion, founder mutations in BRCA1 and BRCA2 contribute to up to one-third of the families in western Denmark and among these the BRCA1 c.3319G>T mutation is potentially linked to an increased risk of ovarian cancer.
BACKGROUND: Using inadequate growth references when screening child health could lead to false conclusions concerning individual growth. We were concerned that this might apply to the official Danish growth reference. AIM: The study aimed to describe the current growth pattern of 0-1-year-old children in Denmark and compare it with national and international references, especially concerning differences that might cause misclassification regarding growth. SUBJECTS AND METHODS: The study population comprised the Copenhagen County Child Cohort 2000 (CCCC2000) birth cohort, which consisted of 6090 children born during the year 2000. Weight and length measurements were obtained from the National Birth Registry and from standardized records of public health nurses. Anthropometric measurements were available from 99% of the birth cohort. Growth curves were constructed using Cole's LMS method. The curves were compared with Danish and international references, including the NCHS, the CDC and the Euro Growth references. RESULTS: The CCCC2000 curves differed from all the chosen references. The CCCC2000 children were heavier and longer and with a substantially higher weight-for-age gain between 1 and 6 months. Shape-wise, the CCCC2000 weight curves resemble the new Euro Growth reference. CONCLUSIONS: The degree of differences concerning weight curves is large enough to cause misclassification and there seems to be a need for updated growth curves concerning infancy.
The aim of the study was to examine the implementation of the shared medication record (SMR) and the barriers to lack of implementation. The research was done in three hospitals in Denmark. Data showed that SMR was not used systematically in the period 5-19 March 2012 at a hospital in the Capital Region of Denmark. We found that motivation, technical problems, time, and competencies were barriers to using SMR. Although all the doctors liked the idea of SMR, they did not find the present version of SMR to be fully developed for use in practice.
The risk of cancer in men from BRCA1 and BRCA2 families is relevant to define to motivate genetic testing and optimize recommendations for surveillance.
We assessed the risk of cancer in male mutation carriers and their first-degree relatives in 290 BRCA1 and BRCA2 families with comparison to matched controls with the aim to motivate genetic testing and optimize recommendations for surveillance.
Mutation carriers in BRCA1 families were not at increased risk of cancer, whereas mutation carriers in BRCA2 families were at increased risk of male breast cancer and prostate cancer with cumulative risks of 12.5% and 18.8%, respectively. Breast cancer developed at a mean age of 59 years, typically as ER/PR positive ductal carcinomas. Prostate cancer developed at a mean age of 68 years, with Gleason scores = 8 in 40% of the tumors. The hazard ratio for BRCA2-associated prostate cancer was 3.7 (p
To examine mechanisms underlying the increased inflammatory state of HIV-infected patients, by investigating the association of HIV-related factors, demography, lifestyle, and body composition with the inflammatory marker soluble urokinase plasminogen activator receptor (suPAR).
suPAR was measured in EDTA-plasma and associated with HIV-related factors (HIV-duration, combination antiretroviral treatment (cART), nadir CD4+ cell count, CD4+ cell count, and HIV RNA); demography; lifestyle; and body composition determined by Dual energy X-ray Absorptiometry (DXA) scan, in multiple linear regression analyses adjusted for biological relevant covariates, in a cross-sectional study of 1142 HIV-infected patients.
Increased suPAR levels were significantly associated with age, female sex, daily smoking, metabolic syndrome and waist circumference. cART was associated with 17% lower suPAR levels. In cART-treated patients 10-fold higher HIV RNA was associated with 21% higher suPAR, whereas there was no association in untreated patients. Patients with CD4+ cell count
Cites: Blood. 2000 Dec 15;96(13):4091-511110678
Cites: Int J Cardiol. 2013 Aug 10;167(3):781-522459389
OBJECTIVE: The purpose of this study is to examine whether mental vulnerability is a risk factor for the development of ischemic heart disease (IHD) after adjustment for well-established risk factors. METHODS: In three prospective cohort studies in Copenhagen County, Denmark, we recorded the level of mental vulnerability and possible risk factors to IHD at baseline. For follow-up, the sample was linked to relevant registries to identify all cases of fatal and nonfatal IHD. The relationship between mental vulnerability and IHD was examined using both Kaplan-Meir and Cox proportional hazard models adjusting for possible confounding factors. RESULTS: Mental vulnerability was significantly associated with the risk for IHD (medium mental vulnerability: hazard ratio 1.41, 95% confidence interval 1.04-1.91; and high mental vulnerability: hazard ratio 2.05; 95% confidence interval 1.46-2.88), after adjusting for confounders. CONCLUSION: Our results imply that mental vulnerability is an independent risk factor for IHD.
Soluble urokinase plasminogen activator receptor (suPAR) is the soluble form of the membrane-bound receptor (uPAR) expressed predominantly on various immune cells. Elevated plasma suPAR concentration is associated with increased mortality in various patient groups, and it is speculated that suPAR is a low-grade inflammation marker reflecting on disease severity. The aim of this prospective observational study was to determine if the plasma concentration of suPAR is associated with admission time, re-admission, disease severity/Charlson Comorbidity Index Score, and mortality.
We included 543 patients with various diseases from a Danish Acute Medical Unit during a two month period. A triage unit ensured that only medical patients were admitted to the Acute Medical Unit. SuPAR was measured on plasma samples drawn upon admission. Patients were followed-up for three months after inclusion by their unique civil registry number and using Danish registries to determine admission times, readmissions, International Classification of Diseases, 10th Edition (ICD-10) diagnoses, and mortality. Statistical analysis was used to determine suPAR's association with these endpoints.
Increased suPAR was significantly associated with 90-day mortality (4.87 ng/ml in survivors versus 7.29 ng/ml in non-survivors, P
The use of potentially inappropriate medications (PIMs) is common in the older population. Inappropriate medications as well as polypharmacy expose older people to a greater risk of adverse drug reactions and may result in hospitalizations.
To evaluate the prevalence of PIMs among acutely hospitalized patients aged =65 years in an acute medical unit, and to investigate the relationship between use of PIMs and weakness.
This longitudinal observational study was undertaken in the Acute Medical Unit, Hvidovre Hospital, University of Copenhagen, Denmark.
Patients aged =65 years admitted to the acute medical unit during the period October to December 2011 were included. Patients were interviewed at admission and at a follow-up visit 30 days after discharge. Data included information about medications, social status, functional status, cognitive status, handgrip strength, health-related quality of life, visual acuity, days of hospitalization, and comorbidities, and was prospectively collected. Polypharmacy was defined as regular use of 5 or more drugs. The Charlson Comorbidity Index was used to categorize comorbidities.
The prevalence of PIMs and the association with PIMs and functional status handgrip strength, HRQOL, comorbidities, social demographic data and vision.
Seventy-one patients (55 % men) with a median age of 78.7 years participated. The median number of medications was eight per person. Eighty percent were exposed to polypharmacy. PIMs were used by 85 % of patients, and PIMs were associated with low functional status (p = 0.032), low handgrip strength (p = 0.006), and reduced health-related quality of life (p = 0.005), but not comorbidities (p = 0.63), age (p = 0.60), sex (p = 0.53), education (p = 0.94), cognition (p = 0.10), pain (p = 0.46), or visual acuity (p = 0.55).
Use of PIMs was very common among older people admitted to an acute medical unit. The use of PIMs is associated with low functional status, low handgrip strength, and reduced health-related quality of life.