Effect of an electronic reminder of follow-up screening after pregnancy complicated by gestational diabetes mellitus:a randomized controlled trial

AIM: To determine the effectiveness of despatching an electronic reminder of participation in screening for gestational diabetes. The reminder was sent to the women 1–8 years after delivery. METHODS: A registry-based, randomized controlled trial in the North Denmark Region among women with gestational diabetes. Randomization was made, which included seven groups stratified by the child’s birth year (2012–2018). The intervention group received standard care supplemented by an electronic reminder through a secure nationwide email system (n = 731), while the control group received only standard care (n = 732). The primary outcome was based on blood testing for diabetes (OGTT, HbA1c or fasting P-glucose). RESULTS: A total of 471 (32.1%) women participated in screening. The primary outcome was experienced by 257 women (35.1%) in the intervention group and 214 women (29.2%) in the control group. The effect of the reminder seemed to increase with recipient’s age, non-western origin, urban dwelling, and multiparity. Of those who participated in follow-up screening, 56 (3.8%) were diagnosed with type 2 diabetes. CONCLUSION: Electronic reminders, based on the principles of informed choice and patient-centred care, to women have been shown to support life-long participation in follow-up screening. Attempts to further stimulation of coverage could however be considered. TRAIL REGISTRATION: ISRCTN registry (22/04/2022, ISRCTN23558707)

Follow-up after gestational diabetes:a qualitative study of perspectives from general practices

BACKGROUND: Women whose pregnancies are complicated by gestational diabetes mellitus (GDM) are approximately eight times more likely to develop type 2 diabetes mellitus (T2DM). Although regular participation in follow-up screening increases the chance of early detection of diabetes, participation rates are often suboptimal. A better understanding of general practice as a key contextual setting for screening could help inform the development and adoption of, for example, electronic reminder interventions to support women’s participation. AIM: To explore the perspectives of GPs and relevant staff members engaged in early detection of diabetes after gestational diabetes in order to identify barriers to and facilitators of follow-up screening. DESIGN & SETTING: A qualitative interview study undertaken in general practices in the North Denmark Region. METHOD: Based on a purposive sample strategy, 18 semi-structured interviews of 12 GPs and six staff members, who were either nurses or midwives, were analysed using a reflexive thematic analytical approach. RESULTS: The following three main themes were formulated: (1) challenges of addressing women’s risk; (2) prioritisation of early detection of diabetes; and (3) system influence on clinical procedures. CONCLUSION: Follow-up screening was facilitated by knowledge of guidelines. Professional collaboration and adaptation support were found to lead to successful implementation of guidelines in general practice. Supporting GPs and their staff’s reflection and discussion of ways to engage in communication and decisionmaking processes with women is, however, important; it was found to create an important barrier to follow-up screening. Overall, the findings can help inform the future development of interventions to increase uptake

Parental mental health, socioeconomic position and the risk of asthma in children—a nationwide Danish register study

BACKGROUND: Parental mental illness affects child health. However, less is known about the impact of different severities of maternal depression and anxiety as well as other mental health conditions. The objective of this study was to examine the impact of different severities of maternal and paternal mental health conditions on child asthma. METHODS: This nationwide, register-based cohort study included all children in Denmark born from 2000 to 2014. Exposure was parental mental health conditions categorized in three severities: minor (treated at primary care settings), moderate (all ICD-10 F-diagnoses given at psychiatric hospital) and severe (diagnoses of severe mental illness). The children were followed from their third to sixth birthday. Child asthma was identified by prescribed medication and hospital-based diagnoses. Incidence rate ratios were calculated using negative binomial regression analyses. RESULTS: The analyses included 925 288 children; 26% of the mothers and 16% of the fathers were classified with a mental health condition. Exposed children were more likely to have asthma (10.6–12.0%) compared with unexposed children (8.5–9.0%). The three severities of mental health conditions of the mother and the father increased the risk of child asthma, most evident for maternal exposure. Additive interaction between maternal mental health conditions and disadvantaged socioeconomic position was found. CONCLUSION: We found an increased risk of asthma in exposed children, highest for maternal exposure. Not only moderate and severe, but also minor mental health conditions increased the risk of child asthma. The combination of mental health condition and disadvantaged socioeconomic position for mothers revealed a relative excess risk

Association of perceived work pace and physical work demands with occupational accidents:a cross-sectional study of ageing male construction workers in Denmark

BACKGROUND: Occupational accidents continue to be a significant public health challenge worldwide. Construction workers in particular are at high risk of occupational accidents, and thus it is of major importance to identify possible predictors of occupational accidents among construction workers. We aimed to investigate the association between self-reported work pace and physical work demands and occupational accidents among ageing male construction workers in Denmark. METHODS: Data on perceived work pace, physical work demands, and occupational accidents was acquired from questionnaires sent to ageing construction workers in Denmark in 2016 as part of the ALFA project (ALdring og Fysisk Arbejde; Ageing and Physical Work). A sample of 1270 Danish male construction workers above 50 years of age was included in the present study. Multiple logistic regression models were applied, with adjustments for age, smoking, body mass index, musculoskeletal disorders, occupation, work experience, and support at work. RESULTS: Of 1270 construction workers, 166 (13.1%) reported an occupational accident within the last 12 months. There was no significant association between perceived work pace and occupational accidents, but physical work demands were associated with higher odds for occupational accidents, with an odds ratio of 2.27 (95% confidence interval 1.26–4.10) for medium physical work demands and 2.62 (95% confidence interval 1.50–4.57) for high physical work demands. CONCLUSIONS: Ageing male construction workers with high physical work demands had statistically significant higher odds of having an occupational accident. By contrast, perceived work pace was not associated with occupational accidents in this large cross-sectional study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12461-6

’Rigtige mænd’ på retræte? Bygningshåndværkeres sociale køn og forestillinger om tilbagetrækning

Later life processes of withdrawal from the labour market are gendered – but often we only focus on sex differences between men and women thereby underestimating the importance of the gender and excluding discussions of non-structural causes of withdrawal behavior. The purpose of this paper is to examine gender differences among male construction workers asking whether differences in gender identity and gender ideals translate into differences in expected retirement age and type of withdrawal from the labour market as well reasons for this withdrawal? The data used for the paper stems from a random sample of male construction workers aged 50+ years (N = 1,760) who were asked about their retirement plans and expectations of withdrawal from the labour market as well as aspects of their gender identity and gender ideals. The results show that gender in different ways is associated with expectations of withdrawal – and in some respects so strongly associated as self-rated health. As the study group consists of a relatively homogeneous group of men, we would expect to fi nd even greater gender differences if we examined the problem in a random sample among all men in the labor market. We fi nd that, men with more traditional gender ideals (for example, that men ought to be the main provider of their family) are more likely to expect to leave the labor market for health related reasons than men who abandon such ideals. And men who identify more strongly with traits traditionally associated with femininity (for example, being ‘loving’ and ‘gentle’) are more likely to expect to leave the labour market in an effort to spend more time on family as well as on leisure time activities. The study therefore points out that even men in one of the most male-dominated industries are more heterogeneous than they are often portrayed, and it could therefore be argued that for this reason one should create better opportunities to gradually withdraw from the labor market to give way to these elements of life especially in the transition phase between being full time employed and retiring completely.Tilbagetrækning fra arbejdsmarkedet er en kønnet proces, men ofte fokuserer forskning kun på forskelle mellem mænd og kvinder. Dermed negligeres betydningen af maskulinitet, ligesom det vanskeliggør at sætte fokus på ikke-strukturelle faktorer for tilbagetrækningsadfærd, der har en kønsdimension. Formålet med denne artikel er at undersøge forskelle i maskulinitet i en gruppe af mandlige bygningshåndværkere: er forskelle i kønsidentitet og kønsidealer associeret med forskelle i forventninger til tilbagetrækningsalder, former for tilbagetrækning samt årsager til at forlade arbejdsmarkedet? Spørgsmålene undersøges ved hjælp af en tilfældig stikprøve af mandlige bygningshåndværkere i alderen 50+ år (N = 1,760), som blev spurgt om deres forventninger til tilbagetrækning ligesom aspekter af deres kønsidentitet (Bem Sex Role Inventory) samt kønsidealer (Male Role Norms Inventory-Revised) blev målt for at afdække forskelle i socialt køn mellem mændene. Resultaterne viser, at socialt køn på forskellig vis er associeret med forventninger til tilbagetrækning – og i visse henseender har sammenhængen en størrelse, der er lige så stor som den, der fi ndes mellem tilbagetrækning og selvvurderet helbred

Six-year-old children had greater risks of functional gastrointestinal disorders if their parents had mental health conditions

AIM: This study examined any associations between parents' mental health conditions and hospital diagnoses of functional gastrointestinal disorders (FGIDs) in offspring at the age of six. We also examined any associations between children who met these criteria and attended routine Danish preventive child health appointments. METHODS: Nationwide registers identified all children born in Denmark from 2000 to 2011 and parents' mental health conditions. Negative binomial regression analyses estimated the incidence rate ratios (IRRs) with 95% confidence intervals (CIs) of children receiving their first hospital diagnosis for an FGID at the age of six. RESULTS: We identified 750,379 children and 38% had at least one parent with a mental health condition: 24% were minor, 12% were moderate, and 2% were severe. These children faced a higher risk of an FGID diagnosis than children whose parents did not have mental health conditions. The IRRs were highest for maternal exposure: minor (1.35, 95% CI 1.29–1.42), moderate (1.58, 95% CI 1.48–1.67) and severe (1.58, 95% CI 1.38–1.81). Attending routine preventive child health examinations was associated with a higher risk of FGIDs associated with parents' mental health conditions. CONCLUSION: Paediatric FGIDs were associated with parents' mental health conditions, especially mothers, and attending routine preventive child health examinations

The risk of preterm birth in combinations of socioeconomic position and mental health conditions in different age groups:A Danish nationwide register-based cohort study

Abstract Background Inequality in preterm birth is a world-wide challenge that has proved difficult for maternity care services to meet. Reducing the inequality requires identification of pregnant women at particularly high risk of preterm birth in order to target interventions. Therefore, the aim was to estimate the risk of preterm birth in women with different combinations of socioeconomic position, mental health conditions, and age. Methods In this nationwide register-based cohort study, we included all first-time mothers that gave birth to a singleton liveborn infant in Denmark between 2000 and 2016. The absolute and relative risk of preterm birth (< 37 weeks of gestation) was examined in different combinations of educational level (high, intermediate, and low) and mental health conditions (no, minor, and moderate/severe) in three age strata (≤23, 24–30, and ≥ 31 years). We estimated the relative risk using Poisson regression with a robust error variance. As additive interaction can help identify subgroups where limited resources can be of best use, we measured the attributable proportion to assess the risk that is due to interaction of the different exposures. Results Of the 415,523 included first-time mothers, 6.3% gave birth prematurely. The risk of preterm birth increased with decreasing educational level and increasing severity of mental health conditions in all age strata, but most in women aged ≥31 years. The highest absolute risk was 12.9% [95% CI: 11.2;14.8%] in women aged ≥31 years with low education and moderate/severe mental health conditions resulting in a relative risk of 2.23 [95% CI: 1.93–2.58] compared to the unexposed reference group in that age strata. We found positive additive interaction between low education and mental health conditions in women aged 24–30 and ≥ 31 years and between age ≥ 31 years and combinations of mental health conditions and educational levels. Conclusion The inequality in preterm birth increased with increasing age. To reduce inequality in preterm birth focused attention on women with higher age further combined with lower educational levels and mental health conditions is essential