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Design and content of classroom activities are crucial to foreign/second (L2) language learners' motivation, be they children or adults. Lifeworld relevance and learner autonomy are two important aspects in building motivational L2 curricula for adults (e.g.), but such considerations rarely filter through to primary school learners due to institutional-curricular priorities. Presenting a single-case micro-analysis of the interactional practices that ensue from a pupil's presentation of her favourite song and music video in a 4th grade English as a Foreign Language (EFL) classroom in Denmark, this paper showcases an example of a classroom activity with a participation framework that is sustained by the pupils' participation and substantiated by the pupils' own interests without losing pedagogical impetus. Our data come from an audio-video corpus of EFL classes in six Danish primary schools.

Following the call in Sandlund, Sundqvist, and Nyroos (2016) for incorporating discursive approaches into the field of oral second language (L2) testing, this paper proposes an interactional usage-based approach to the analysis of oral L2 performance. Based on Eskildsen (2018a), we combine analytic tools from usage-based linguistics and conversation analysis. We draw on usage-based linguistics to analyze performance in terms of test-takers' inventories of linguistic constructions and on conversation analysis to understand their interactional competence in terms of the relation between the linguistic constructions and the actions they are used to accomplish. Performance assessment is thus constructional "and" interactional. Participants in this pilot study were two Danish primary school children who performed two consecutive oral tasks: a semi-guided interview and a picture-elicited narrative task. Data were analyzed by means of cross-child comparisons and cross-task comparisons within each child. Our data confirm the observation from previous research that simple question-answer(-assessment) sequences dominate oral test formats, but also that the format is sometimes abandoned, which allows for the accomplishment of new social actions. Moreover, the picture-description task affords a different speech exchange system with the interviewer participating more as an active listener when the children do not voluntarily carry out the requested task.

The early life movement patterns of long-lived, large raptors, such as the white-tailed eagle (Haliaeetus albicilla), remain largely unexplored. In this study, we have tracked 22 individuals of white-tailed eagles hatched in Denmark to investigate key parameters, including survival rates, causes of death, nest site fidelity, geographical distribution, and dispersal behaviors. Our analyses are based on approximately 340,000 GPS/GSM telemetry positions from the 22 individuals. We found that survival rates were lower in the first year of life, especially among females, but increased in subsequent years. The primary causes of death were wind turbine collisions and avian influenza. Movement analyses revealed that juvenile eagles frequented nest sites in August and September, with females showing earlier exploratory flights and dispersal. Both males and females spent most of their first calendar year near their nest sites. In the second calendar year, a significant proportion of their time was spent at well-known white-tailed eagle resting areas in Denmark, as well as visiting neighboring countries. Notably, one individual set a new distance record for a Danish GPS-tagged white-tailed eagle, venturing at least 1750 km away from its nest site to visit Sweden, Finland, Russia, and Norway. Our results, indicating that juvenile white-tailed eagles continue to utilize nest sites into September, suggest an extension of the recommended time period for nest protection zones provided by BirdLife Denmark (DOF). [ABSTRACT FROM AUTHOR]

BACKGROUND: Prolonged tracheal tube placement following severe traumatic brain injury (TBI) can cause serious complications. Safe removal requires sufficient ability for independent breathing and airway protection. Thus, identifying important factors for time to removal of the tracheal tube (decannulation) is essential for safe and efficient weaning. This study aimed to identify significant factors for time to decannulation in a Danish population of subjects with tracheostomy after TBI. METHODS: This was a retrospective register-based cohort study. Subjects with moderate and severe TBI and a tracheal tube were selected from the Danish Head Trauma Database between 2011--2021. Time to decannulation was calculated as time from injury to decannulation. Associations between selected explanatory variables representing demographic and clinical characteristics and time to decannulation were analyzed using linear regression models. RESULTS: A total 324 subjects were included with a median of 44 d to decannulation. Primary analysis found that an improvement in swallowing ability during the initial 4 weeks of rehabilitation was associated with an 8.2 d reduction in time to decannulation (95% CI -12.3 to -4.2, P < .001). Change in overall sensorimotor ability reduced time to decannulation by 0.94 (95% CI -0.78 to -0.10, P = .03) d. Change in cognitive abilities from rehab admission to 4-week follow-up did not significantly affect the number of days to decannulation (P = .66). Secondary analysis showed pneumonia was associated with the largest estimated increase of 24.4 (95% CI 15.9--32.9, P < .001) d and that increased cognitive functioning at rehabilitation admission was associated with a significant reduction in time to decannulation. CONCLUSIONS: This study found that a change in swallowing ability is a potentially significant factor for reducing time to decannulation. Identifying factors that could explain differences in time to decannulation is essential for patient outcomes, especially if these factors are modifiable and could be targeted in rehabilitation and treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to systematically evaluate the validity of variables related to pregnancy, delivery, and key characteristics of the infant in the Danish National Patient Register using maternal medical records as the reference standard. Patients and Methods: We reviewed medical records of 1264 women giving birth in the Region of Southern Denmark during 2017. We calculated positive (PPV) and negative (NPV) predictive values, sensitivity, and specificity to estimate the validity of 49 selected variables. Results: The PPV was ≥ 0.90 on most pregnancy-related variables including parity, pre-gestational BMI, diabetes disorders, and previous cesarean section, while it was lower for hypertensive disorders, especially mild to moderate preeclampsia (0.49, 95% CI 0.32– 0.66). Sensitivity ranged from 0.80 to 1.00 on all pregnancy-related variables, except hypertensive disorders (sensitivity 0.38– 0.71, lowest for severe preeclampsia). On most delivery-related variables including obstetric surgical procedures (eg cesarean section and induction of labor), pharmacological pain-relief, and gestational age at delivery, PPV's ranged from 0.98 to 1.00 and the corresponding sensitivities from 0.87 to 1.00. Regarding infant-related variables, both the APGAR score registered five minutes after delivery and birthweight yielded a PPV of 1.00. Conclusion: Obstetric coding in the Danish National Patient Register shows very high validity and completeness making it a valuable source for epidemiologic research. Plain Language Summary: Danish register data are often used for epidemiological research in reproduction. The registers are based on coded information to the registers based on information from medical records. The quality of the register data is highly dependent of the validity of the codes. Yet there is a lack in our knowledge of the validity of data related to pregnancy, childbirth, and the characteristics of the newborn baby. We therefore aimed to validate the Danish National Patient Registry data related to pregnancy and childbirth by comparing the registered code with information from the medical records. We scrutinized medical records from 1264 women giving birth in the Region of Southern Denmark during 2017. We compared the registration in the medical record with the registered code in the Danish National Patient Registry by calculating how accurate the register data are according to 49 different variables. Results showed that registered codes in the Patient Registry for pregnancy- and childbirth-related conditions and key infant characteristics were to a high degree in agreement with the data from the medical report with few exceptions. In conclusion, the study revealed that the Danish National Patient Register provides highly accurate and comprehensive data for most pregnancy, delivery, and infant-related variables. This underscores the register's value as a reliable source for epidemiologic research in reproductive health. [ABSTRACT FROM AUTHOR]

Patient-reported return-to-work and job functioning 6 and 12 months after hospital discharge and received rehabilitation interventions and unmet rehabilitation needs were explored in a consecutive population of out-of-hospital cardiac arrest survivors. Patients working prior to cardiac arrest were invited to participate in a telephone administered survey. Thirty-eight surveys were conducted and included for analysis, equivalent to a minimum response rate of 95%. Survivors of out-of-hospital cardiac arrest had extensive challenges returning to work. Six- and 12-months post-arrest, 58% and 45% were respectively on full time sick leave or working notably less (>10 h/week) and with extensive unmet rehabilitation needs. [ABSTRACT FROM AUTHOR]

Current guidelines in HER2-positive metastatic breast cancer (mBC) recommend the combination of trastuzumab and a chemotherapeutic agent for 3rd line or later treatments. This study aims to describe the treatment of HER2-positive mBC in 3rd line or later after previous treatment with T-DM1 for mBC in a real-world setting. This observational population-based study included all women diagnosed with HER2-positive mBC in Denmark, previously treated with T-DM1 in the metastatic setting. Patients were included on the date of progression leading to initiation of 3rd line treatment if the patient had received T-DM1 in 1st or 2nd line. If the patient received T-DM1 in 3rd line or later the inclusion was based on the date of progression on T-DM1. The primary end points were overall survival (OS) and progression-free survival (PFS). The study included 272 women with a mean age of 59 (27–86) and a median of 3 (2–11) treatment lines prior to inclusion. At index, all patients had received T-DM1 and 167 (62%) patients had received pertuzumab in the metastatic setting. During follow-up 183 patients received chemotherapy. Of these patients, 120 received chemotherapy combined with trastuzumab, 50 received chemotherapy combined with other HER2-targeted therapy, and 13 received chemotherapy as monotherapy. The remaining 89 patients received either HER2-targeted monotherapy (41), endocrine therapy (31), experimental treatment (10), or no treatment (7). Median PFS was 5.5 months (95% CI, 4.8–6.5) and median OS was 18.5 months (95% CI, 16.2–21.3). In this real-world study, we found that patients were treated with a wide variety of anti-cancer agents with modest efficacy. However, patients in this study did not have access to newer therapies like tucatinib and T-DXd. [ABSTRACT FROM AUTHOR]

We calculated the relative habitat use (RHU) of birds in Denmark to study the use of nine different habitats as well as trends of habitat use between 1975 and 2021. We found that during the breeding season, habitat specialists were declining in all natural habitats. In contrast, most habitat categories showed positive trends in winter, which might arise from increasing numbers of winter guests that due to climate warming are able to spend the mild winters in Denmark. [ABSTRACT FROM AUTHOR]

Background Absence of certain leadership behaviours, such as lack of feedback, recognition and involvement in employee development, has been associated with long-term sickness absence. We tested the hypothesis that absence of eight specific behaviours predicts health-related early exit from employment, and investigated differential effects in subgroups to guide future preventive initiatives. Methods Using Cox-proportional hazard modelling, we examined the prospective association between absence of leadership behaviours and health-related early exit from employment in a sample of 55 364 employees during 4.3 years follow-up. Leadership behaviours were measured by employee ratings in national surveys from 2012 to 2016. Exit from employment included disability pension and related measures of health-related early exit, retrieved from a national registry. Results We identified 510 cases of health-related early exit from employment during follow-up. A high level of absence of leadership behaviours, was associated with an increased risk of exit from employment (hazard ratio: 1.57, 95% CI: 1.31; 1.89). Subgroup analyses showed that the association between absence of leadership behaviours and exit from employment was similar for women and men and across age groups. The association was stronger for employees with high level of education than for employees with medium/low education, and the association was not observed among employees with a prevalent depressive disorder. Conclusions Absence of the eight leadership behaviours is a risk factor for health-related early exit from employment in the Danish workforce. More studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Background: Patient‐centred care (PCC) including collaborative practices is the core component of modern health care. Despite this, it has proven difficult to implement. Aims: To examine (1) healthcare professionals' (HCPs') perception of whether they perceive a PCC culture, their attitudes towards involving patients in decisions and their experiences of barriers for PCC; and (2) variables that may contribute to explain differences in perceived person‐centred culture. Methods: A questionnaire survey of HCPs from 27 different departments from two university hospitals in Denmark. HCPs were eligible if they held a profession as physician, Registered Nurse, nurse assistant, physiotherapist, occupational therapist, dietician, midwife or psychologist and excluded if they reported not being involved in patient treatment and care. The questionnaire consisted of four items from the Context Assessment Index (CAI). The remaining items were purpose‐designed. Results: In total 1140 (24% response rate) HCPs completed the questionnaire and were included in the analyses. Most of the HCPs perceived a culture of PCC (e.g. 91% agreed or agreed to a high degree that patients were provided with opportunities to participate in decisions). Most HCPs also held positive attitudes towards involving patients in decisions. Time and prioritisation from the management were perceived as barriers for PCC, and many HCPs also believed that involving patients in decisions could be difficult for the patients. The HCPs who were least involved in treatment and care, and working in the acute setting or in surgery, were least likely to perceive a PCC culture. HCPs with the longest or shortest educations, and HCPs working primarily with outpatients or with planned inpatients, were most likely to perceive a person‐centred culture. Conclusion: The HCPs generally perceived a culture of PCC and held positive attitudes towards involving patients in decisions. To further promote PCC, time and prioritisation must be invested at an organisational level. [ABSTRACT FROM AUTHOR]

Objective Previous studies on effects of emotional demands on depression have relied on self-reported exposure data and lacked control for potential confounding by pre-employment risk factors for depression. This study used a register-based design to examine the risk of hospital-treated depressive disorder in relation to occupational levels of emotional demands at work, furthermore addressing the role of risk factors for depression before workforce entry. Methods We analyzed data from two Danish register-based cohorts - Job Exposure Matrix Analyses of Psychosocial Factors and Healthy Ageing in Denmark (JEMPAD, N= 1 665 798) (17) and Danish Work Life Course Cohort (DaWCo, N=939 411), which link assessments of emotional demands by job exposure matrices to records of hospital-treated depressive disorder among employees aged 15-59 years at baseline (average follow up: 9.7 years in JEMPAD, 7.3 years in DaWCo). Potential confounders comprised sociodemographics, job control, work-related violence and physical demands at work. In DaWCo, we followed individuals from their entry into the workforce, and also included data on risk factors for depression before workforce entry (eg, parental income, education, and psychiatric diagnoses). Results Employees in occupations with high emotional demands had an increased risk of hospital-treated depressive disorder with confounder-adjusted hazard ratios of 1.32 [95% confidence interval (CI) 1.24‒1.41] and 1.19 (95% CI 1.09‒1.30) in JEMPAD and DaWCO, respectively. This association remained after controlling for risk factors before workforce entry. Conclusions This study suggests that employees in occupations with high emotional demands are at increased risk of hospital-treated depressive disorder. This increased risk was neither attributable to reporting bias nor explained by the included risk factors for depression recorded before workforce entry. [ABSTRACT FROM AUTHOR]

Aims An individuals' ability to perform basic activities of daily living (ADL) is said to be one of the strongest predictors of performance ability and independent living within the community. The Assessment of Motor and Process Skills (AMPS) tool was designed to assess global functional level during ADL by investigating motor and process skills. The purpose of this study was to assess ADL performance ability by investigating motor and process skills in a consecutive cohort of adult survivors of out-of-hospital cardiac arrest at the time of discharge from hospital. Methods and results  This cross-sectional study uses data from a prospective cohort of cardiac arrest survivors admitted to the Copenhagen University Hospital, Rigshospitalet. The specific data used in this study were obtained at the time of the days or the day before hospital discharge. Adult survivors of out-of-hospital cardiac arrest due to cardiac causes were eligible for inclusion. Assessment of Motor and Process Skills was used to assess ADL performance ability by investigating motor and process skills. The ADL ability of 61 individuals was assessed. The mean ADL ability measures recorded were AMPS process 1.40 logits (0.48) and AMPS motor 1.82 logits (0.40). Based on the dichotomized AMPS results, 23% were most likely to need assistance to live independently in the community. Conclusion  Performance ability during ADL revealed difficulty in the performance of process skill and an increased need for rehabilitation among survivors of out-of-hospital cardiac arrest at the time of hospital discharge. [ABSTRACT FROM AUTHOR]

Recent declines of many European bird species have been linked with various environmental changes, especially land-use change and climate change. Since the intensity of these environmental changes varies among different countries, we can expect geographic variation in bird population trends. Here, we compared the population trends of bird species among neighbouring countries within central Europe (Czech Republic, Denmark, Germany, Switzerland) between 1990 and 2016 and examined trait-associations with population trends at both national and international scales. We found that Denmark had the highest proportion of declining species while Switzerland had the lowest. Species associated with farmland had negative trends, but the effect size tended to differ among countries. A preference for higher temperature was positively associated with population trends and its effect size was similar among countries. Species that were increasing across all four countries were associated with forest; while species that were decreasing across all countries were long-distance migrants or farmland birds. Our results suggest that land-use change tends to be a more regionally variable driver of common bird population trends than climate change in central Europe. For species declining across all countries, international action plans could provide a framework for more efficient conservation. However, farmland birds likely need both, coordinated international action (e.g. through a green agricultural policy) to tackle their widespread declines as well as regionally different approaches to address varying national effect trajectories. [ABSTRACT FROM AUTHOR]

The marsh fritillary (Euphydryas aurinia) is a critically endangered butterfly species in Denmark known to be particularly vulnerable to habitat fragmentation due to its poor dispersal capacity. We identified and genotyped 318 novel SNP loci across 273 individuals obtained from 10 small and fragmented populations in Denmark using a genotyping‐by‐sequencing (GBS) approach to investigate its population genetic structure. Our results showed clear genetic substructuring and highly significant population differentiation based on genetic divergence (FST) among the 10 populations. The populations clustered in three overall clusters, and due to further substructuring among these, it was possible to clearly distinguish six clusters in total. We found highly significant deviations from Hardy–Weinberg equilibrium due to heterozygote deficiency within every population investigated, which indicates substructuring and/or inbreeding (due to mating among closely related individuals). The stringent filtering procedure that we have applied to our genotype quality could have overestimated the heterozygote deficiency and the degree of substructuring of our clusters but is allowing relative comparisons of the genetic parameters among clusters. Genetic divergence increased significantly with geographic distance, suggesting limited gene flow at spatial scales comparable to the dispersal distance of individual butterflies and strong isolation by distance. Altogether, our results clearly indicate that the marsh fritillary populations are genetically isolated. Further, our results highlight that the relevant spatial scale for conservation of rare, low mobile species may be smaller than previously anticipated. [ABSTRACT FROM AUTHOR]

Objective: Individual patient characteristics are important in trying to understand why people respond differently to group CBT. Only a few studies have explored therapists' perceptions of within-patient attributes that may be hindering in group CBT in a mental health setting. Method: We explored the perception of individual patient characteristics and related obstacles in 12 psychotherapists in Danish Mental Health Services through semi-structured interviews. The interviews were analyzed using a descriptive qualitative framework. Results: The results revealed four distinct themes that the therapists pointed to as important for the outcome of a 14-week group CBT intervention for social phobia, panic disorder, agoraphobia and major depressive disorder. The four themes were Complexity & severity, External circumstances, Attitudes & coping and Cognitive ability & reflection level. The therapists explained how they perceived higher complexity and severity in the patients as an obstacle, they highlighted that a calm and stable outside environment aided therapeutic change, whilst stressors were hindering. They perceived active coping mechanisms, positive attitudes and high readiness to change as positive factors, whilst dependent and hostile coping mechanisms and negative attitudes were seen as obstacles. Finally, the therapists pointed to cognitive abilities and reflection level, explaining how it could be difficult to obtain good outcomes for patients who's cognitive abilities were debilitated due to psychopathological factors or for patients with a generally low reflection level. Conclusions: The results indicated that the therapists experience group CBT as an intervention that requires certain prerequisites of the patients, and that the four themes should be considered when deciding on treatment options for any given patient. The clinical utility and theoretical implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Background: Only about half of all patients with anxiety disorders or major depression respond to cognitive behaviour therapy (CBT), even though this is an evidence-based treatment. Personalized treatment offers an approach to increase the number of patients who respond to therapy. The aim of this study was to examine predictors and moderators of (differential) treatment outcomes in transdiagnostic versus diagnosis-specific group CBT. Methods: A sample of 291 patients from three different mental health clinics in Denmark was randomized to either transdiagnostic or diagnosis-specific group CBT. The study outcome was the regression slope of the individual patient's repeated scores on the WHO-5 Well-being Index. Pre-treatment variables were identified as moderators or predictors through a two-step variable selection approach. Results: While the two-step approach failed to identify any moderators, four predictors were found: level of positive affect, duration of disorder, the detachment personality trait, and the coping strategy of cognitive reappraisal. A prognostic index was constructed, but did not seem to be robust across treatment sites. Conclusions: Our findings give insufficient evidence to support a recommendation of either transdiagnostic or diagnosis-specific CBT for a given patient or to predict the response to the applied group therapies. [ABSTRACT FROM AUTHOR]

Aim: To investigate the ecological relationship between breeding and wintering in specialist and generalist long‐distance migratory species, and the links between densities and range sizes. Location: Denmark, Senegal and Ghana. Methods: We use radio tracking to study spatial behavior and habitat use in three morphologically and ecologically similar and closely related Phylloscopus species on their widely separated breeding and wintering distributions. During wintering and breeding, willow warblers P. trochilus (winter: n = 9, breeding: n = 13), chiffchaffs P. collybita (n = 11, n = 7), and wood warblers P. sibilatrix (n = 17, n = 14) were tracked. Results: Willow warblers P. trochilus increased home range sizes in winter, whereas it was similar in chiffchaffs P. collybita and wood warblers P. sibilatrix, in both seasons. Home ranges overlapped more in winter than in the breeding season. In winter, home range overlap was similar among species but larger overlap during breeding was indicated for willow warblers. Tree cover was unrelated to home range size but significantly higher in breeding than in winter in all species. However, whereas willow warblers and wood warblers maintained some degree of tall tree cover inside their home ranges in winter, chiffchaffs changed from more than 80% to <1% tree cover, indicating a niche shift. Main conclusions: Individuals of all three species showed changes between breeding and wintering areas in spatial behavior and habitat availability, with larger overlap in winter. The differences in patterns were potentially related to being generalist (willow warbler) or specialist (chiffchaff and wood warbler). These ecological relationships are important for the conservation of migrants and for understanding the link between breeding and wintering distributions and ecology. [ABSTRACT FROM AUTHOR]

Objectives: The 10-item Connor-Davidson Resilience Scale (CD-RISC 10) is a brief instrument measuring resilience in adults. The scale has shown sound psychometric properties in different populations and cultures. Our objectives were to cross-culturally adapt the CD-RISC 10 into Danish and to establish the psychometric properties of the Danish version in terms of internal consistency, construct validity and longitudinal validity. Methods: The CD-RISC 10 was translated using established guidelines. Employees (N=272) at hospitals in the Central Denmark Region completed questionnaires at baseline and three months follow-up. Questionnaires included the translated Danish version of the CD-RISC 10 and the 10-item Perceived Stress Scale (PSS-10). Internal consistency was assessed by Cronbach’s alpha and construct and longitudinal validity by correlating CD-RISC 10 and PSS-10 baseline scores and change scores from baseline to follow-up. Results: The Danish CD-RISC 10 provides acceptable internal consistency (Cronbach’s alpha = 0.87). Analysis of construct validity revealed a negative correlation with the PSS-10 at baseline (r=−.63 [95%CI: −.70; −.55], p<.0001). Analysis of longitudinal validity similarly demonstrated a negative correlation on change scores from baseline to follow-up (r=−.51 [95%CI: −.62; −.39], p<.0001). Conclusions: The scale has acceptable psychometric properties as an instrument for measuring resilience in a Danish-speaking population. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark.Methods: We conducted an anonymous Internet-based survey distributed through e-mails to Danish public anaesthesia departments. The survey consisted of 15-17 short questions regarding the use of objNMM.Results: A total of 653 (27%) anaesthetists from 90% of the hospitals answered the questionnaire. ObjNMM was always used by 58% of the anaesthetists and 86% used objNMM at least 75% of the times. Despite the frequent use, 75% of the anaesthetists experienced difficulties with objNMM in at least 25% of the cases. The likelihood of using objNMM was higher among nurse anaesthetists vs. anaesthesiologists (odds ratio (OR) 2.24 [95% confidence interval (CI): 1.62-3.08]), if the department had an employee with special interest in objNMM (OR 1.66 [95% CI: 1.12-2.47]), if the anaesthetist had < 5 years of experience (OR 1.88 [95% CI: 1.29-2.73]), or if experiencing difficulties with objNMM < 25% of the cases (OR 1.60 [95% CI: 1.00-2.57]).Conclusion: In this survey, Danish anaesthetists frequently, in an international perspective, use objNMM, but the use is often associated with technical difficulties. [ABSTRACT FROM AUTHOR]

The conservation status of European temperate forests is overall unfavorable, and many associated species are listed in national or European red-lists. A better understanding of factors increasing survival probability of red-listed species is needed for a more efficient conservation effort. Here, we investigated the importance of current forest cover, historical forest cover and a number of soil and climate variables on the incidence and richness of red-listed forest species in Denmark. We considered eight major taxa separately (mammals, saproxylic beetles, butterflies, vascular plants and four groups of fungi), using mainly citizen science data from several national mapping projects. Taxa were selected to represent important forest habitats or properties (soil, dead wood, forest glades and landscape context) and differ in dispersal potential and trophic strategy. For all groups, presence and richness of red-listed species was positively related with current forest cover, but - for most taxa - forest cover 200 years ago was an even better predictor. The intersection of past and current deciduous forest was used to identify the area of continuous, lost and new forest. Continuous and lost deciduous forest cover were strong predictors of red-listed species occurrence in most groups, but surprisingly species richness of butterflies and hydnoid fungi, and presence of mammals, was significantly, positively affected by coniferous forest area. The positive effect of lost deciduous forests on red-listed species, suggest an extinction debt of at least 200 years, with some areas hosting more red-listed species than the current area of old forest can sustain in the long run. Our results suggest that current priorities for forest conservation in Denmark are not efficient in protecting red-listed forest species, and that more focus should be put on conserving deciduous forest with long continuity. Furthermore, a multi-taxa approach including a wide array of organism groups with contrasting habitat affiliations, results in a more comprehensive understanding of the requirements of red-listed forest species and necessitate a more focused approach to conservation planning. [ABSTRACT FROM AUTHOR]

Objectives The aims of the present study were to (i) cross-culturally adapt a Danish consensus version of the 10-item Perceived Stress Scale (PSS-10) and (ii) evaluate its psychometric properties in terms of agreement, reliability, validity, responsiveness, and interpretability among patients with work-related stress complaints. Objectives The aims of the present study were to (i) cross-culturally adapt a Danish consensus version of the 10-item Perceived Stress Scale (PSS-10) and (ii) evaluate its psychometric properties in terms of agreement, reliability, validity, responsiveness, and interpretability among patients with work-related stress complaints. Results The face validity, reliability, and internal consistency of the Danish consensus version of the PSS-10 were satisfactory, and convergent construct validity was confirmed. Receiver operating characteristic (ROC) curves of the change scores showed that the ability of the PSS-10 to correctly classify patients as improved or unchanged according to the patients' own judgment was acceptable. The estimates of minimal clinically important change were 11 points and 28% for absolute and relative change scores, respectively. Conclusion The Danish consensus version of the PSS-10 appears to be feasible for use in clinical research settings and has good psychometric properties in terms of agreement, reliability, validity, responsiveness, and interpretability. [ABSTRACT FROM AUTHOR]

Summary: Chronic obstructive pulmonary disease (COPD) and systemic glucocorticoid exposure are well-known risk factors of osteoporosis. We evaluated alendronate prescription practices related to COPD and exposure to systemic corticosteroids from 1996 to 2008 and showed an increasing targeting of alendronate treatment in patients with COPD and patients with systemic corticosteroid exposure. Introduction: COPD and systemic glucocorticoid exposure are well-known risk factors of osteoporosis and fragility fracture, but osteoporosis is often underdiagnosed and undertreated in these patients. This study aims to evaluate alendronate prescription practices related to COPD and/or to exposure to systemic glucocorticoids among Danish women. Methods: A total of 388,314 female subjects >50 years old, 64,719 of whom initiated treatment with alendronate, and 323,595 age- and gender-matched controls were retrospectively identified between 1996 and 2008 from national health registers. Multivariate logistic regression was used for examining prescription practices, specifically if these risk factors (COPD or glucocorticoid exposure) increased or decreased the likelihood of beginning alendronate therapy. Results: A diagnosis of COPD was associated with an increased likelihood of using alendronate (odds ratio (OR) 1.4, 95 % confidence interval (CI) 1.4-1.5, p < 0.001). Further, a diagnosis of COPD was associated with an increasing tendency of initiating alendronate treatment in the study period (OR 1.3 (95 % CI 1.1-1.5, years 1996-1999) to 1.5 (95 % CI 1.4-1.6, years 2006-2008), p < 0.01). Exposure to systemic glucocorticoids was associated with a significantly increasing (OR 3.6, 95 % CI 3.3-3.9 to OR 5.5, 95 % CI 5.3-5.8) probability of receiving alendronate treatment in the same observation period. Conclusion: This nationwide register-based study on alendronate prescription practices in Denmark shows an increasing targeting of alendronate treatment in patients with COPD and an even stronger trend for patients with systemic glucocorticoid exposure, perhaps indicating increased awareness of well-known and associated conditions. [ABSTRACT FROM AUTHOR]

Summary: Persistence with osteoporosis therapy remains low and identification of factors associated with better persistence is essential in preventing osteoporosis and fractures. In this study, patient understanding of dual energy X-ray absorptiometry (DXA) results and beliefs in effects of treatment were associated with treatment initiation and persistence. Introduction: The purpose of this study is to examine patient understanding of their DXA results and evaluate factors associated with initiation of and persistence with prescribed medication in first-time users of anti-osteoporotic agents. Self-reported DXA results reflect patient understanding of diagnosis and may influence acceptance of osteoporosis therapy. To improve patient understanding of DXA results, we provided written information to patients and their referring general practitioner (GP), and evaluated factors associated with osteoporosis treatment initiation and 1-year persistence. Methods: Information on diagnosis was mailed to 1,000 consecutive patients and their GPs after DXA testing. One year after, a questionnaire was mailed to all patients to evaluate self-report of DXA results, drug initiation and 1-year persistence. Quadratic weighted kappa was used to estimate agreement between self-report and actual DXA results. Multivariable logistic regression was used to evaluate predictors of understanding of diagnosis, and correlates of treatment initiation and persistence. Results: A total of 717 patients responded (72%). Overall, only 4% were unaware of DXA results. Agreement between self-reported and actual DXA results was very good ( κ = 0.83); younger age and glucocorticoid use were associated with better understanding. Correctly reported DXA results was associated with treatment initiation (OR 4.3, 95% CI 1.2-15.1, p = 0.02), and greater beliefs in drug treatment benefits were associated with treatment initiation (OR 1.4, 95%CI 1.1-1.9, p = 0.006) and persistence with therapy (OR 1.8, 95% CI 1.2-2.7, p = 0.006). Conclusion: Our findings suggest that written information provides over 80% of patients with a basic understanding of their DXA results. Communicating results in writing may improve patient understanding thereby also improve osteoporosis management and prevention. [ABSTRACT FROM AUTHOR]

This section opens with a nationwide Danish study on the risk of fractures in prostate cancer, as well as assessing the impact of exposure to androgen deprivation. The authors found that there was a marked increase in the risk of fractures, especially of the hip. Authors from the USA address the outcome of cytoreductive nephrectomy for metastatic RCC, finding that it can be predicted by the fraction of tumour volume removed. They give an informative review of the topic and describe their experience in this type of surgery. Treatment options for hormonerefractory prostate cancer are rather limited and authors from the USA present the results of a phase II trial into the use of gefitinib as a single therapy in patients with non-metastatic refractory disease. They found an absence of PSA response but confirmed the well-established favourable tolerability profile of this agent. OBJECTIVE To assess the risk of fracture attributable to prostate cancer, and the impact of exposure to prescribed gonadotrophin-releasing hormone agonists and antiandrogens on this risk in a nationwide, population-based case-control study. PATIENTS AND METHODS Data from the Danish National Hospital Discharge Register, the National Bureau of Statistics, and the National Prescriptions Database were merged. The analysis covered 15 716 men aged >50 years presenting with a fracture at any hospital in Denmark in 2000, and 47 149 age-matched control men. A previous diagnosis of prostate cancer had been recorded in 1.3% of controls and 2.5% of those with a fracture. RESULTS Prostate cancer was associated with an increased odds ratio (95% confidence interval) for all fractures of 1.8 (1.6–2.1), for hip fractures of 3.7 (3.1–4.4), but no increased risk of vertebral fractures. The increased fracture risk became apparent early after diagnosis and remained pronounced even in long-term survivors. Androgen deprivation therapy (ADT) with an odds ratio of 1.7 (1.2–2.5; P < 0.01) and orchidectomy, at 1.7 (1.2–2.4; P < 0.01) added to the overall fracture risk. In all, 3.1% of hip fractures in Danish men aged >50 years are attributable to prostate cancer. CONCLUSION Prostate cancer, orchidectomy and the use of ADT are associated with a markedly greater risk of fractures, especially of the hip. The risk of hip fracture is not confined to the very old, neither is the risk made negligible by the excess mortality in patients with advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to identify the drivers of absenteeism and gives information of the relationship between absenteeism and personal and organizational characteristics in the Nordic countries. Design/methodology/approach -- The theoretical assumptions are tested empirically on data from a survey carried out in Denmark, Norway, Sweden and Finland. 10.748 employees from randomly selected households participated. Differences were examined using analysis of variance. Findings -- Among the findings are that Danish employees are less absent than employees in Norway, Finland and Sweden. Employees working in the public sector, more specific the municipalities, have a higher level of absence compared to the private sector. According to the personal characteristics, women are more absent than men in all Nordic countries, but the effect of age differs according to the country in question. If the manager however is a woman and the employee likewise, then the level of absence is higher in Denmark, Norway and Finland compared to the other gender constellations. Originality/value -- Because of the lack of international comparative studies of absenteeism in the Nordic countries, this paper brings new and a deeper understanding of the area as a basis of further empirical research and/or management concern. [ABSTRACT FROM AUTHOR]

An empirical study of the determinants of absenteeism in a large Danish bank is performed. The study is based on information from approx. 7,000 employees in 500 different units. Based on a review of the absence literature a model combining the psychological and economic approaches to absence studies is constructed. The model is based on hedonic theory and uses the frequency metric when measuring absence. The results of the empirical study show that there is indeed a significant negative relationship between job satisfaction and absence. Furthermore, the study shows that demographic variables for both employees and employers play an important role for the frequency of absence. One very interesting result is that the absenteeism for employees is very clearly related to observed absence by the unit manager. [ABSTRACT FROM AUTHOR]

This paper analyses the time dependency as well as industry differences of the drivers of customer satisfaction and customer loyalty in the EPSI rating framework. The analysis is carried out on data from Danish mobile phone companies, banks and supermarkets from 2000 to 2002. The analyses indicated that the model structure of the EPSI Rating framework is stable across industries as well as stable across time with respect to the overall effects on customer loyalty. The analyses furthermore revealed that there is an increasing effect of image on customer satisfaction over the three year time span and that service quality is more important for banks than for supermarkets. Finally the overall effect of expectation turned out to be insignificant. [ABSTRACT FROM AUTHOR]

This paper analyses the differences between private and public sector organisations in Denmark in relation to the penetration of holistic management models, how companies achieve excellent results and the empirical weight structure of the European Foundation for Quality Management (EFQM) excellence model. The results show that the penetration of holistic management models is greater among public organisations. Furthermore private and public organisations do not achieve excellent results in the same way. Private companies put higher emphasis on the systems dimension whereas public organisations put higher emphasis on the people dimension. In relation to the empirical weight structure of the EFQM excellence model two significant differences were found. Private companies put higher emphasis on the criteria "leadership" and "policy and strategy" than public organisations. [ABSTRACT FROM AUTHOR]

Background: This paper reports on the process of involving former and current cancer patients and carers as co-researchers in a Danish mixed methods research project on patient empowerment of cancer patients in follow up (The Empowerment study 2015–2019). User-Involvement in health care research is a relatively new practice in Denmark and the Empowerment project was one of the first to systematically involve patients and carers in its research design, conduct and reporting. The paper has two aims: first, it provides a detailed account of the process of involving co-researchers in the Empowerment project and second, it presents findings from a workshop held with academic researchers and co-researchers on the project to discuss their experiences and recommendations for user-involvement in the Danish context. Methods: The Empowerment project adopted a consultative and collaborative approach to user involvement and co-researchers were involved from the early stages and all through the project. Users gave feedback on the proposal, helped develop project documents and research tools, acted as peer interviewers in qualitative interviews, participated in data analysis and development of questionnaires, and co-authored journal articles. The workshop held with the academic researchers and co-researchers consisted of two parallel focus groups and a joint group discussion, following an interactive and informal format to facilitate discussion and exchange of ideas. Findings: The focus group resulted in eleven recommendations for the further development of user-involvement in Denmark. Key issues encountered were the general lack of guidelines on user-involvement in the Danish context and the need for more organisational support. Particular issues, such as payment, recruitment and training, need to be carefully considered within individual projects and within the national context in which projects are carried out. Conclusion: The paper adds to the current very limited knowledge base on user-involvement in the Danish context and provides a set of early recommendations for the further development of the practice in Danish Health Research. User-involvement needs to be developed with consideration to the local context, but common challenges also emphasise the usefulness of cross-country comparisons and knowledge exchange. [ABSTRACT FROM AUTHOR]

Abstract: It has recently been stated that the global goal of halting the loss of biodiversity by 2010 has not been met highlighting the urgent need to monitor trends in biodiversity. Our study suggests that existing indicators of bird biodiversity in Denmark are inaccurate and we present a new objective method for accurately assessing trends in specific habitats using common bird species. Bird species were selected for creating habitat specific indicators by calculating their relative habitat use (RHU) in nine different habitat categories. RHU indicates the degree to which a habitat is preferred (RHU>2) or avoided (RHU<0.5) by a species, relative to other habitats. Indicator sets were constructed for each habitat type using species with an RHU>2 and revealed that existing habitat indicators, based on species lists from the Pan-European Common Bird Monitoring Scheme (PECBMS), often included species that did not in fact have preferences for those particular habitats in Denmark. Habitat specific indicators based on the new species selection method showed significant negative trends in three of nine habitat categories: coniferous forest, bog/marsh and heath. Habitat classes were further combined to create overall indicators for forest, farmland and freshwater. A comparison of these indicators with the existing indicators revealed a negative overall trend for forest habitat, which had previously been overlooked, suggesting that species selection is crucial for the development of informative indicators. The habitat specific farmland indicator confirmed the negative trend in the current farmland indicator. The methodology for indicator species selection presented here could potentially be applied for use in a global context for a wider range of taxonomic groups. [Copyright &y& Elsevier]

• Late toxicity is substantial in all examined organs at risk. • Associations between dose to the optic nerve and ocular toxicity was present. • Across all examinations, 74% had late toxicity in more than one organ. • The severity of toxicity increased with increasing number of organs affected. To evaluate the occurrence of late toxicity after curatively intended intensity modulated radiotherapy (IMRT) for sinonasal cancer and assess dose–response associations. Patients treated with IMRT in 2008–2016 were included. Cross sectional examinations of toxicity from the optic pathway, the brain, the pituitary gland and the nose were performed along with quality of life – (QoL) and dose–response analyses. Twenty-seven patients were enrolled; median age was 67 years (range 47–83). Five patients (19%) had radiation-related ocular toxicity. The risk of visual acuity impairment increased with increasing dose (grade 2 odds ration (OR) 1.12, p = 0.01; grade 3 OR 1.14, p = 0.02) and dose constraint violations (grade 2, OR = 21, p < 0.01; grade 3, OR = 41, p < 0.01). Six patients (22%) exhibited evidence of radiation-related hypopituitarism, but no dose–response association was detected. Seventeen patients (63%) had impaired olfactory function. The risk of olfactory impairment increased with higher stage (OR = 3.32, p = 0.03). Three patients (11%) had structural abnormalities in irradiated areas of the brain, and impaired cognitive function was present in 17 patients (63%). Cognitive, physical, role functioning as well as fatigue and insomnia were affected the most in QOL analyses. Fifteen patients (56%) had grade 2 radiation-related impairment in at least one organ. Grade 3 toxicity was only present in patients with toxicities in >3 organs and in patients initially treated for T4 tumours. Three patients (11%) had radiation-related impaired function in all examined OARs. Late toxicity after radiotherapy was substantial in all examined organs, with dose–response associations between visual acuity impairment and the optic nerve. The results have led to changed praxis for follow-up examinations in Denmark. [ABSTRACT FROM AUTHOR]

Introduction: In psychotherapy, having a reliable tracking tool is vital for effective treatment. We have validated the Danish version of the 'Overall Depression Severity and Impairment Scale' (ODSIS), which is used in the Unified Protocol for Emotional Disorders (UP) and other cognitive behavioural therapies. This five-item self-rating scale is expected to correspond closely to the gold-standard Beck Depression Inventory-II (BDI-II), but also to self-rating scales addressing daily functioning and well-being., Methods: Internal consistency is assessed using Cronbach's alpha and McDonald's omega. Criterion validity is explored through Pearson's correlation coefficient with BDI-II, the Work and Social Adjustment Scale (WSAS), the Five-Item World Health Organization Well-Being Index (WHO-5) and scatter plots, and an optimal cut-off score is determined using a receiver operating characteristic curve. The study included 340 respondents: 234 from a recent clinical trial, 56 psychiatric patients from inpatient/outpatient units and 50 healthy volunteers., Results: ODSIS demonstrates strong internal consistency (Cronbach's alpha: 0.887-0.956, McDonald's omega: 0.888-0.957). Correlations with BDI-II, WSAS and WHO-5 highlight its strong criterion validity (BDI-II: 0.847, WSAS: 0.751, WHO-5: 0.771). The optimal cut-off score (> 7.5) for detecting depression shows great sensitivity (0.862) and specificity (0.731)., Conclusion: The Danish version of ODSIS proves to be a reliable instrument for quantification of a combination of depression level and functional impairment from the symptoms. Its high correlation with established BDI-II makes it a brief and handy tool for repeated measurement in clinical and research settings., (© 2024 The Author(s). Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

Background: The Work and Social Adjustment Scale (WSAS) is a self-administered measure designed to assess the level of inability to function socially as a consequence of a defined problem or disorder., Methods: A total of 230 patients with emotional disorders completed the Danish translation of the WSAS, measures of anxiety and depression, the Level of Personality Functioning Brief Form, the Personality Inventory for DSM-5 Short Form, and the World Health Organization Five-Item Well-Being Index (WHO-5). We conducted a confirmatory factor analysis of the previously suggested factor structure of the instrument. We furthermore evaluated the construct validity of the WSAS by means of its relationship with depression, anxiety, personality functioning, and overall well-being. Finally, we evaluated the utility of the WSAS to identify those on long-term sick-leave by conducting receiver operating characteristic (ROC) curves., Results: The instrument had a poor to average fit with the previously reported single-factor structure, but a better fit to a modified single-factor structure. Cronbach's alpha and McDonald's omega showed good internal scale reliability (α = .79, ωtotal = .85). WSAS was positively correlated with measures of anxiety ( r = .33), depression ( r = .44), and personality functioning ( r = .23 and r = .20), and negatively correlated with WHO-5 wellbeing ( r = -.57). The optimal cut-off point in the ROC-analyses was 23, which yielded a sensitivity of 74% and a specificity of 55% in the prediction of sick-leave status., Discussion: The Danish WSAS shows promising psychometric properties, but has limited external validity insofar as predicting long-term sick leave in psychiatric patients with emotional disorders.

Background: The Positive and Negative Affect Schedule (PANAS) was designed to measure trait positive affect (PA) and trait negative affect (NA)., Methods: The Danish PANAS was administered to outpatients with depression and anxiety disorders. Internal consistency was assessed using Cronbach's alpha and McDonald's omega and factorial structure was evaluated using confirmatory factor analysis (CFA). Convergent validity was evaluated by means of correlations with the negative affectivity and the detachment domain of the Personality Inventory for DSM-5 Short Form (PID-5-SF), the Hamilton Anxiety Rating Scale 6 (HARS-6) and the Hamilton Depression Rating Scale 6 (HDRS-6)., Results: PANAS Scores of 256 patients were analyzed. Cronbach's alpha and McDonald's omega showed good internal consistency for both the PA score (alpha = .84 and omega = .89) and the NA score (alpha = .86 and omega = .90). CFA analysis confirmed a structure with two factors corresponding to the PA and NA factors. PA was negatively correlated with the detachment domain of PID-5 (r = -.47), HARS-6 (r = -.15) and HDRS-6 (r = -.37). NA was positively correlated with PID-5-SF negative affectivity domain (r = .43), HARS-6 (r = .51) and HDRS-6 (r = .52)., Discussion: The Danish PANAS has promising internal consistency and construct validity, which are comparable to other studies of the instrument., (© 2023. The Author(s).)