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Associations between plasma concentrations of PCB 28 and possible indoor exposure sources in Danish school children and mothers.

https://arctichealth.org/en/permalink/ahliterature275191
Source
Environ Int. 2016 Feb;87:13-9
Publication Type
Article
Date
Feb-2016
Author
Emilie Lund Egsmose
Elvira Vaclavik Bräuner
Marie Frederiksen
Thit Aarøe Mørck
Volkert Dirk Siersma
Pernille Winton Hansen
Flemming Nielsen
Philippe Grandjean
Lisbeth E Knudsen
Source
Environ Int. 2016 Feb;87:13-9
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Air Pollutants - blood
Air Pollution, Indoor - analysis
Child
Construction Materials - analysis
Denmark
Environmental Monitoring - methods
Female
Humans
Linear Models
Male
Mothers
Polychlorinated biphenyls - blood
Schools - standards
Students
Abstract
Polychlorinated biphenyls (PCBs) are ubiquitously present in the environment and are suspected of carcinogenic, neurotoxic and immunotoxic effects. Significantly higher plasma concentrations of the congener PCB 28 occur in children compared to adults. Exposure in schools may contribute to this difference.
To determine whether increased blood plasma concentrations of PCB 28 in Danish school children and mothers are associated with living in homes or attending schools constructed in the PCB period (1959-1977).
PCB 28 was analyzed in plasma samples from 116 children aged 6-11years and 143 mothers living in an urban and a rural area in Denmark and participating in the European pilot project DEMOCOPHES (Demonstration of a study to COordinate and Perform Human Biomonitoring on a European Scale). In Denmark, PCBs were used in construction in the period 1950-1977, and year of construction or renovation of the homes and schools was used as a proxy for indoor PCB exposure. Linear regression models were used to assess the association between potential PCB exposure from building materials and lipid adjusted concentrations of PCB 28 in plasma, with and without adjustment for potential confounders.
Among the 116 children and 143 mothers, we were able to specify home construction period in all but 4 children and 5 mothers leaving 111 children and 138 mothers for our analyses. The median lipid adjusted plasma PCB 28 concentration was 3 (range: 1-28) ng/g lipid in the children and 2 (range: 1-8) ng/g lipid in the mothers. Children living in homes built in the PCB period had significantly higher lipid adjusted plasma PCB 28 concentrations compared to children living in homes built before or after the PCB period. Following adjustment for covariates, PCB 28 concentrations in children were 40 (95% CI: 13; 68) percent higher than concentrations of children living in homes constructed at other times. Furthermore, children attending schools built or substantially refurbished in the PCB period also had significantly higher (46%, 95% CI: 22; 70) PCB 28 concentrations compared to children attending schools constructed before or after the PCB period, while their mothers had similar concentrations. Adjustment for the most prevalent congener, PCB 153, did not change this effect of home or school construction. When both home and school construction year were included in the models, the increase in lipid adjusted plasma PCB 28 for children living in or attending schools from the PCB period was no longer statistically significant. The individual effect of home and school construction periods could not be evaluated further with the available data.
Our results suggest that PCB exposure in the indoor environment in schools and homes constructed during the PCB period may contribute significantly to children's plasma PCB 28 concentration. Efforts to minimize PCB exposure in indoor environments should be considered.
PubMed ID
26638015 View in PubMed
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Comparing the effect of non-medical mechanical restraint preventive factors between psychiatric units in Denmark and Norway.

https://arctichealth.org/en/permalink/ahliterature269120
Source
Nord J Psychiatry. 2015 Aug;69(6):433-43
Publication Type
Article
Date
Aug-2015
Author
Jesper Bak
Vibeke Zoffmann
Dorte Maria Sestoft
Roger Almvik
Volkert Dirk Siersma
Mette Brandt-Christensen
Source
Nord J Psychiatry. 2015 Aug;69(6):433-43
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Cultural Comparison
Cross-Sectional Studies
Dangerous Behavior
Denmark
Female
Humans
Job Satisfaction
Male
Middle Aged
Norway
Nurse-Patient Relations
Psychiatric Department, Hospital - organization & administration
Psychiatric Nursing - organization & administration
Restraint, Physical - psychology - utilization
Social Environment
Utilization Review
Young Adult
Abstract
The use of mechanical restraint (MR) is controversial, and large differences regarding the use of MR are often found among countries. In an earlier study, we observed that MR was used twice as frequently in Denmark than Norway.
To examine how presumed MR preventive factors of non-medical origin may explain the differing number of MR episodes between Denmark and Norway.
This study is a cross-sectional survey of psychiatric units. Linear regression was used to assess the confounding effects of the MR preventive factors, i.e. whether a difference in the impact of these factors is evident between Denmark and Norway.
Six MR preventive factors confounded [?exp(B)> 10%] the difference in MR use between Denmark and Norway, including staff education (- 51%), substitute staff (- 17%), acceptable work environment (- 15%), separation of acutely disturbed patients (13%), patient-staff ratio (- 11%), and the identification of the patient's crisis triggers (- 10%).
These six MR preventive factors might partially explain the difference in the frequency of MR episodes observed in the two countries, i.e. higher numbers in Denmark than Norway. One MR preventive factor was not supported by earlier research, the identification of the patient's crisis triggers; therefore, more research on the mechanisms involved is needed.
None of the six MR preventive factors presents any adverse effects; therefore, units in Denmark and Norway may consider investigating the effect of implementing, the identification of the patient's crisis triggers, an increased number of staff per patient, increased staff education, a better work environment and reduced use of substitute staff in practice.
PubMed ID
25614990 View in PubMed
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Dementia and road traffic accidents among non-institutionalized older people in Denmark: A Danish register-based nested case-control study.

https://arctichealth.org/en/permalink/ahliterature299164
Source
Scand J Public Health. 2019 Mar; 47(2):221-228
Publication Type
Journal Article
Date
Mar-2019
Author
Jindong Ding Petersen
Volkert Dirk Siersma
René Depont Christensen
Maria Munch Storsveen
Connie Thurøe Nielsen
Mikkel Vass
Frans Boch Waldorff
Author Affiliation
1 Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Source
Scand J Public Health. 2019 Mar; 47(2):221-228
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Accidents, Traffic - statistics & numerical data
Aged
Aged, 80 and over
Case-Control Studies
Comorbidity
Dementia - drug therapy - epidemiology
Denmark - epidemiology
Female
Humans
Hypnotics and Sedatives - therapeutic use
Independent living
Male
Registries
Risk factors
Abstract
We used register-based data to estimate the effect of all-type dementia on road traffic accidents (RTAs) risk, combined with comorbidities or sedative medicines, among non-institutionalized older people in Denmark.
The source population was all residents in Denmark aged 65 years and older, alive as of January 1, 2008 ( n = 853,228). Cases were those who had any type of RTA in 2009-2014. Each case was matched for age, sex and geographic location to 4-6 controls. All-type dementia was ascertained using the International Classification of Diseases version 10 (ICD-10) diagnosis supplemented with prescribed medicine records. Eight chronic diseases were selected to assess comorbidities. Four types of medicines were categorized as sedative medicines for analysis. Conditional logistic regression with adjustment for education and marital status as well as either the number of comorbidities or sedative medications use was performed using STATA software.
Older people with dementia had lower RTAs risk compared to their controls (odds ratio = 0.43, 95% confidence interval (0.32-0.60), p
PubMed ID
29914317 View in PubMed
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Educational intervention and functional decline among older people: the modifying effects of social capital.

https://arctichealth.org/en/permalink/ahliterature105036
Source
Scand J Public Health. 2014 May;42(3):295-303
Publication Type
Article
Date
May-2014
Author
Tine Poulsen
Volkert Dirk Siersma
Rikke Lund
Ulla Christensen
Mikkel Vass
Kirsten Avlund
Author Affiliation
1Department of Public Health, University of Copenhagen, Denmark.
Source
Scand J Public Health. 2014 May;42(3):295-303
Date
May-2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cities
Denmark
Disabled persons - statistics & numerical data
Female
Follow-Up Studies
Geriatric Assessment - statistics & numerical data
Health Personnel - education
Health Services Research
Health Services for the Aged
House Calls
Humans
Male
Primary Health Care
Prospective Studies
Questionnaires
Social Support
Abstract
To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify this effect is still unknown.
We used the Danish Intervention Study on Preventive Home Visits - a prospective cohort study including 2863 75-year-olds and 1171 80-year-olds in 34 Danish municipalities - to analyse the modifying effect of different aspects of social capital on the effect of educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements.
We found that 80-year-olds living in municipalities with high bonding (B=0.089, p=0.0279) and high linking (B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention.
With the unique design of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability.
PubMed ID
24504008 View in PubMed
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The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice: a stepped-wedge randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature258555
Source
BMC Fam Pract. 2014;15:65
Publication Type
Article
Date
2014
Author
Tina Drud Due
Thorkil Thorsen
Marius Brostrøm Kousgaard
Volkert Dirk Siersma
Frans Boch Waldorff
Source
BMC Fam Pract. 2014;15:65
Date
2014
Language
English
Publication Type
Article
Keywords
Chronic Disease
Denmark
Diabetes Mellitus, Type 2 - diagnosis - therapy
Diagnostic Tests, Routine - statistics & numerical data
Disease Management
General Practice - methods - standards
Health Plan Implementation
Humans
Kaplan-Meier Estimate
Medical Audit
Physical Examination
Process Assessment (Health Care) - statistics & numerical data
Pulmonary Disease, Chronic Obstructive - diagnosis - therapy
Questionnaires
Self Report
Software
Spirometry
Time Factors
Treatment Outcome
Abstract
The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice; and in the Capital Region of Denmark a facilitator-based intervention was undertaken to support the implementation of the programmes in general practice. The purpose of the study was to assess the effectiveness of this semi-tailored facilitator-based intervention.
The study was a stepped-wedge, randomised, controlled trial among general practices in the Capital Region of Denmark. The intervention group was offered three one-hour visits by a facilitator. The intervention was semi-tailored to the perceived needs as defined by each general practice, and the practices could choose from a list of possible topics. The control group was a delayed intervention group. The primary outcome was change in the number of annual chronic disease check-ups. Secondary outcomes were: changes in the number of annual check-ups for type 2 diabetes (DM2) and chronic obstructive pulmonary disease (COPD); changes in the number of spirometry tests, changes in the use of ICPC diagnosis coding and patient stratification; sign-up for a software program for patient overview; and reduction in number of practices with few annual chronic disease check-ups.
We randomised 189 general practices: 96 practices were allocated to the intervention group and 93 to the delayed intervention group. For the primary outcome, 94 and 89 practices were analysed. Almost every outcome improved from baseline to follow-up in both allocation groups. At follow-up there was no difference between allocation groups for the primary outcome (p = 0.1639). However, some secondary outcomes favoured the intervention: a higher reported use of ICPC diagnosis coding for DM2 and COPD (p = 0.0050, p = 0.0243 respectively), stratification for COPD (p = 0.0185) and a faster initial sign-up rate for the software program.
The mixed results from this study indicate that a semi-tailored facilitator-based intervention of relatively low intensity is unlikely to add substantially to the implementation of disease management programmes for DM2 and COPD in a context marked by important concurrent initiatives (including financial incentives and mandatory registry participation) aimed at moving all practices towards changes in chronic care.
ClinicalTrials.gov: NCT01297075.
Notes
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PubMed ID
24716545 View in PubMed
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Eosinophilia in routine blood samples and the subsequent risk of hematological malignancies and death.

https://arctichealth.org/en/permalink/ahliterature113087
Source
Am J Hematol. 2013 Oct;88(10):843-7
Publication Type
Article
Date
Oct-2013
Author
Christen Lykkegaard Andersen
Volkert Dirk Siersma
Hans Carl Hasselbalch
Hanne Lindegaard
Hanne Vestergaard
Peter Felding
Niels de Fine Olivarius
Ole Weis Bjerrum
Author Affiliation
Department of Hematology, Roskilde University Hospital, Denmark; The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark.
Source
Am J Hematol. 2013 Oct;88(10):843-7
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Denmark - epidemiology
Disease-Free Survival
Eosinophilia - blood - complications - diagnosis - mortality
Female
Follow-Up Studies
Hematologic Neoplasms - blood - diagnosis - mortality
Humans
Leukocyte Count
Male
Middle Aged
Registries
Sex Factors
Survival Rate
Abstract
Eosinophilia may represent an early paraclinical sign of hematological malignant disease, but no reports exist on its predictive value for hematological malignancies. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356,196 individuals with at least one differential cell count (DIFF) encompassing the eosinophil count during 2000-2007. From these, one DIFF was randomly chosen and categorized according to no (
Notes
Erratum In: Am J Hematol. 2014 Jul;89(7):791-3
PubMed ID
23765950 View in PubMed
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Eosinophilia in routine blood samples as a biomarker for solid tumor development - A study based on the Copenhagen Primary Care Differential Count (CopDiff) Database.

https://arctichealth.org/en/permalink/ahliterature261364
Source
Acta Oncol. 2014 Sep;53(9):1245-50
Publication Type
Article
Date
Sep-2014
Author
Christen Lykkegaard Andersen
Volkert Dirk Siersma
Hans Carl Hasselbalch
Hanne Lindegaard
Hanne Vestergaard
Peter Felding
Niels de Fine Olivarius
Ole Weis Bjerrum
Source
Acta Oncol. 2014 Sep;53(9):1245-50
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Databases, Factual
Denmark - epidemiology
Eosinophilia - blood - complications - epidemiology
Eosinophils
Female
Humans
Leukocyte Count
Male
Middle Aged
Neoplasms - blood - complications - epidemiology
Urinary Bladder Neoplasms - blood - complications - epidemiology
Young Adult
Abstract
Eosinophilia may represent an early paraclinical sign of malignant disease and a host anti-tumor effect. The association between eosinophilia and the development of solid tumors has never before been examined in an epidemiological setting. The aim of the present study was to investigate eosinophilia in routine blood samples as a potential biomarker of solid tumor development in a prospective design.
From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356 196 individuals with at least one differential cell count (DIFF) encompassing the eosinophil count during 2000-2007. From these, one DIFF was randomly chosen and categorized according to no (
PubMed ID
24913152 View in PubMed
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GP and staff evaluation of the maturity matrix as a tool to assess and improve organisational development in primary care.

https://arctichealth.org/en/permalink/ahliterature146994
Source
Int J Health Care Qual Assur. 2009;22(7):686-700
Publication Type
Article
Date
2009
Author
Louise Loegstrup
Adrian Edwards
Frans Boch Waldorff
Volkert Dirk Siersma
Martin Sandberg Buch
Tina Eriksson
Author Affiliation
Institute of Public Health, Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark. louise_loegstrup@yahoo.dk
Source
Int J Health Care Qual Assur. 2009;22(7):686-700
Date
2009
Language
English
Publication Type
Article
Keywords
Allied Health Personnel
Cross-Sectional Studies
Denmark
Employee Performance Appraisal
Family Practice
Humans
Organizational Innovation
Organizational Objectives
Physicians, Family
Primary Health Care
Quality Assurance, Health Care
Quality Indicators, Health Care
Self-Assessment
Abstract
This paper aims to evaluate the maturity matrix (MM) a facilitated formative self-assessment tool for organisational development in primary care) on satisfaction, differences between GP and staff, the extent to which practice teams worked on goals set, and to identify suggestions for change to MM.
The approach taken was a cross-sectional survey administered to all participants by mail in 57 family practices, 278 participants, (143 GPs; 135 staff) in Denmark, one year after participating in the MM project.
At practice level 44 returned at least one questionnaire. At participant level, 144 returned the questionnaire: 82 GPs; 62 staff. A total of 93 gave positive statements on satisfaction with MM, 16 stated initial expectations were not met, 79 would recommend MM to colleagues. Differences between GPs and staff were only statistically significant regarding "increased insight into organisation of work after participation in the MM project". There was a tendency that GPs were more positive and likely to give an opinion. A total of 22 planned how to meet the goals set at the first MM meeting and 18 felt that they achieved them. In 24 out of 44 practices MM was stated to contribute new ways of working. A total of 12 of 144 stated that they needed more follow-up support.
The results indicate that MM is a workable method to assess and gain insight into practice organisation with no major differences between GPs and staff.
The paper examines participants views' on MM one year after introduction.
PubMed ID
19957823 View in PubMed
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Impact of social capital on 8-year mortality among older people in 34 Danish municipalities.

https://arctichealth.org/en/permalink/ahliterature121879
Source
J Aging Health. 2012 Oct;24(7):1203-22
Publication Type
Article
Date
Oct-2012
Author
Tine Poulsen
Volkert Dirk Siersma
Rikke Lund
Ulla Christensen
Mikkel Vass
Kirsten Avlund
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. tipo@sund.ku.dk
Source
J Aging Health. 2012 Oct;24(7):1203-22
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cause of Death
Denmark - epidemiology
Female
Humans
Interpersonal Relations
Male
Mortality - trends
Prospective Studies
Regression Analysis
Social Support
Abstract
To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline.
Prospective cohort study on preventive home visits including 2,863 seventy-five-year-olds and 1,171 eighty-year-olds in 34 Danish municipalities. The associations of the three aspects of social capital measures with mortality were tested in Cox regression models on time to death.
In the 80-year-old cohort significant associations were seen between mortality and both bridging (hazards ratio (HR)=1.24, 95% CI [1.07, 1.45]) and linking (HR=1.21, 95% CI [1.03, 1.43]), but the associations attenuated when controlling for relevant confounders. None of the social capital measures were associated with mortality among the 75-year-olds.
The measures of social capital used in the present study include key aspects of social capital that are associated to mortality in older populations via physical activity and mobility disability.
PubMed ID
22869899 View in PubMed
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Lacrimal gland lesions in Denmark between 1974 and 2007.

https://arctichealth.org/en/permalink/ahliterature125548
Source
Acta Ophthalmol. 2013 Jun;91(4):349-54
Publication Type
Article
Date
Jun-2013
Author
Sarah Linéa von Holstein
Marianne Hamilton Therkildsen
Jan Ulrik Prause
Göran Stenman
Volkert Dirk Siersma
Steffen Heegaard
Author Affiliation
Eye Pathology Institute, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Source
Acta Ophthalmol. 2013 Jun;91(4):349-54
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Biopsy
Child
Child, Preschool
Denmark - epidemiology
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Incidence
Infant
Infant, Newborn
Lacrimal Apparatus - pathology
Lacrimal Apparatus Diseases - classification - epidemiology - pathology
Male
Middle Aged
Registries
Retrospective Studies
Young Adult
Abstract
To evaluate the incidence rate, distribution, patient characteristics and indications for surgical intervention of lacrimal gland lesions in Denmark between 1974 and 2007.
All biopsied/surgically removed lacrimal gland lesions in Denmark during the period 1974-2007 were identified by searching two population-based registries. Specimens were collected and re-evaluated. The following data were collected: age, gender, indications for surgical intervention and local recurrence.
A total of 232 lesions from 210 patients with a histologically verified lesion of the lacrimal gland were included. The incidence rate of lacrimal gland lesions was 1.3/1 000 000/year. The overall annual age- and gender-adjusted incidence rate more than doubled during the study period, owing to an increase in non-malignant lesions. Approximately half of the lesions were neoplasms (119) and 55% (66) of these were malignant. Dacryops constituted 10% (24), inflammatory lesions 27% (62), normal tissue 12% (27), benign tumours 23% (53) and malignant tumours 29% (66). Patients with malignant neoplasms were significantly older than patients with benign neoplasms (63 versus 48 years, p
PubMed ID
22471375 View in PubMed
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13 records – page 1 of 2.