Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position. A Danish population-based study

AbstractBackgroundCancer-related health behaviours may be affected by barriers to healthcare seeking and beliefs about cancer. The aim was to assess anticipated barriers to healthcare seeking and beliefs about cancer in a sample of the Danish population and to assess the association with socio-economic position.MethodsA population-based telephone interview with 3000 randomly sampled persons aged 30years or older was performed using the Awareness and Beliefs about Cancer measure from 31 May to 4 July 2011. The Awareness and Beliefs about Cancer measure includes statements about four anticipated barriers to healthcare seeking and three positively and three negatively framed beliefs about cancer. For all persons, register-based information on socio-economic position was obtained through Statistics Denmark.ResultsTwo anticipated barriers, worry about what the doctor might find and worry about wasting the doctor's time, were present among 27% and 15% of the respondents, respectively. Overall, a high proportion of respondents concurred with positive beliefs about cancer; fewer concurred with negative beliefs. Having a low educational level and a low household income were strongly associated with having negative beliefs about cancer.ConclusionThe fact that worry about what the doctor might find and worry about wasting the doctor's time were commonly reported barriers call for initiatives in general practice. The association between low educational level and low household income and negative beliefs about cancer might to some degree explain the negative socio-economic gradient in cancer outcome

"Det gør en forskel-at turde se dem-forskellene"— om mangfoldighedsledelse som virksomhedsstrategi

Forskelle i medarbejdergruppen er en uudnyttet ressource i mange organisationer. Hvis de bliver brugt, er de en kilde til kreativitet, innovation og nyt samspil mellem talenter. Mangfoldighedsledelse er en ny forretningsstrategi for virksomheder, som sætter ledelse af forskelle i centrum, hvilket giver 'human resources' en ny strategisk rolle. Evnen til at skabe en inkluderende organisation bliver på sigt en vigtig konkurrenceparameter

Multiple perspectives on symptom interpretation in primary care research

BACKGROUND: Assessment and management of symptoms is a main task in primary care. Symptoms may be defined as 'any subjective evidence of a health problem as perceived by the patient’. In other words, symptoms do not appear as such; symptoms are rather the result of an interpretation process. We aim to discuss different perspectives on symptom interpretation as presented in the disciplines of biomedicine, psychology and anthropology and the possible implications for our understanding of research on symptoms in relation to prevalence and diagnosis in the general population and in primary care. DISCUSSION: Symptom experiences are embedded in a complex interplay between biological, psychological and cultural factors. From a biomedical perspective, symptoms are seen as possible indicators of disease and are characterized by parameters related to seriousness (e.g. appearance, severity, impact and temporal aspects). However, such symptom characteristics are rarely unambiguous, but merely indicate disease probability. In addition, the GP’s interpretation of presenting symptoms will also be influenced by other factors. From a psychological perspective, factors affecting interpretation are in focus (e.g. internal frame of reference, attention to sensations, illness perception and susceptibility to suggestion). These individual factors cannot stand alone either, but are influenced by the surroundings. Anthropological research suggests that personal experiences and culture form a continuous feedback relationship which influence when and how sensations are understood as symptoms of disease and acted upon. SUMMARY: The different approaches to symptom interpretation imply that we need to be cautious and conscious when interpreting survey findings that are based on symptom prevalence in the general population or in primary care. These findings will reflect a variety of interpretations of sensations, which are not equivalent to expressions of underlying disease. Furthermore, if diagnosis of disease is based exclusively on the presence of specific symptom characteristics, we may risk reinforcing a dualistic approach, including medicalisation of normal phenomena and devaluation of medically unexplained symptoms. Future research in primary care could gain from exploring symptoms as a generic phenomenon and raised awareness of symptom complexity

Førskolebarn som stammer: Foreldres opplevelse av det logopediske samarbeidet

Masteroppgave i logopedi - Nord universitet 202

Stream restoration and ecosystem functioning in lowland streams

Restoration has been increasingly applied over the last decades as a way to improve the ecological conditions in stream ecosystems, but documentation of the impact of restoration on ecosystem functions is sparse. Here, we applied a space-for-time approach to explore effects of stream restoration on metabolism and organic matter decomposition in lowland agricultural streams. We included stream reaches that were restored >10 years ago and compared ecosystem functioning in these streams with those in channelized and naturally meandering stream reaches from the same geographical region. Specifically, we tested the following hypotheses: 1) rates of stream metabolism (gross primary production, GPP, and ecosystem respiration, ER) and organic matter decomposition in restored reaches resemble rates in naturally meandering reaches more than rates in channelized stream reaches and 2) higher resemblance in ecosystem metabolism and organic matter decomposition between restored reaches and meandering reaches can be attributed to the improved physical habitat conditions in the restored stream reaches. Overall, we did not find that stream metabolism or organic matter decomposition differed among restored, channelized and naturally meandering stream reaches even though habitat conditions differed among the three stream types. Instead, we found a large variation in ecosystem function characteristics across all sites. When analyzing all stream types combined, we found that GPP increased with increasing plant coverage and that ER increased with increasing stream size and with the coverage of coarse substratum on the stream bottom. Organic matter decomposition, on the other hand, only slightly increased with the number of plant species and declined with increasing concentrations of nutrients. Overall, our findings suggest that physical habitat improvements in restored stream reaches can affect ecosystem functions, but also that the restoration outcome is context-dependent since many of the physical characteristics playing a role for the measured functions were only to some extent affected by the restoration and/or clouded by interference with factors operating at a larger-scale.publishedVersio

Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding:A Danish population-based cohort study

OBJECTIVES: We examined the impact of liver cirrhosis on the risk of thromboembolic events and bleeding complications in patients with atrial fibrillation or flutter (AFF). METHODS: This population‐based cohort study used data from Danish health registries. We identified all patients with a first‐time diagnosis of AFF during 1995 to 2015, and followed them from their AFF diagnosis until the end of 2016. Patients were categorized according to the presence or absence of liver cirrhosis. We computed incidence rates per 1000 person‐years and hazard ratios (HRs) with 95% confidence intervals (CIs) based on Cox regression analyses, adjusting for age, CHA(2)DS(2)VASc score, and Charlson Comorbidity Index score. RESULTS: We identified 273 225 patients with AFF. Of these, 1463 (0.54%) had liver cirrhosis. During 0 to 5 years of follow‐up, compared to patients without liver cirrhosis, patients with liver cirrhosis had higher incidence rates and hazards of ischemic stroke (29.7 vs 21.6; HR, 1.3; 95% CI, 1.1‐1.6), venous thromboembolism (9.2 vs 5.5; HR, 1.5; 95% CI, 1.2‐2.3), but not myocardial infarction (10.2 vs 11.2; HR, 0.9; 95% CI, 0.7–1.2). Patients with liver cirrhosis also had higher rates of hemorrhagic stroke (5.8 vs 3.3; HR, 1.7; 95% CI, 1.1‐2.6), subdural hemorrhage (5.3 vs 1.6; HR, 3.2; 95% CI, 2.1‐4.9), hemorrhage of the lung or urinary tract (24.6 vs 15.2; HR, 1.6; 95% CI, 1.3–2.0), and gastrointestinal hemorrhage (34.5 vs 10.4; HR, 3.3; 95% CI, 2.7–3.9). CONCLUSION: In patients with AFF, liver cirrhosis was associated with an elevated risk of ischemic stroke, venous thromboembolism, and all evaluated bleeding complications

Bright light exposure during simulated night work improves cognitive flexibility

Under embargo until: 2023-03-28Night work leads to sleepiness and reduced vigilant attention during work hours, and bright light interventions may reduce such effects. It is also known that total sleep deprivation impairs cognitive flexibility as measured by reversal learning tasks. Whether night work impairs reversal learning task performance or if bright light can mitigate reversal learning deficits during night work is unclear. In this counterbalanced crossover study (ClinicaTrials.gov Identifier NCT03203538), young healthy individuals completed a reversal learning task twice during each of three consecutive simulated night shifts (23:00–07:00 h). The night shifts were performed in a laboratory under a full-spectrum (4000 K) bright light (~900 lx) and a standard light (~90 lx) condition. Reversal learning task performance was reduced towards the end of the night shifts (04:50 h), compared to the first part of the night shifts (00:20 h) in both light conditions. However, with bright light, the reversal learning task performance improved towards the end of the night shifts, compared to standard light. The study shows that bright light may mitigate performance deficits on a reversal learning task during night work and implies that bright light interventions during night work may be beneficial not only for vigilant attention but also for cognitive flexibility.acceptedVersio