Lønpræmie for lønmodtagere dækket af en overenskomst? Danmark som case

Udenlandske studier, primært i USA og England, har påvist, at lønmodtagere, der er medlem af en fagforening, får en lønpræmie i forhold til lønmodtagere, der ikke er medlem af en fagforening. Det vil sige, at der opnås en lønmæssig gevinst ved at være fagforeningsmedlem sammenlignet med ikke at være det. I artiklen her undersøger vi, på baggrund af et unikt dansk empirisk løndatamateriale, om de udenlandske resultater genfindes på det danske arbejdsmarked. Vores undersøgelse viser, at overenskomstdækning giver faggrupperne i bunden af lønhierarkiet de største løngevinster og giver en samlet, gennemsnitlig løngevinst for lønmodtagere, der er dækket af en kollektiv overenskomst sammenlignet med lønmodtagere, der ikke er overenskomstdækket

Diagnoses and mortality among prehospital emergency patients calling 112 with unclear problems:a population-based cohort study from Denmark

BACKGROUND: Patients calling for an emergency ambulance and assessed as presenting with ‘unclear problem’ account for a considerable part of all emergency calls. Previous studies have demonstrated that these patients are at increased risk for unfavourable outcomes. A deeper insight into the underlying diagnoses and outcomes is essential to improve prehospital treatment. We aimed to investigate which of these diagnoses contributed most to the total burden of diseases in terms of numbers of deaths together with 1- and 30-day mortality. METHODS: A historic regional population-based observational cohort study from the years 2016 to 2018. Diagnoses were classified according to the World Health Organisation ICD-10 System (International Statistical Classification of Diseases and Related Health Problems, 10th edition). The ICD-10 chapters, R (‘symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified)’ and Z (‘factors influencing health status and contact with health services”) were combined and designated “non-specific diagnoses”. Poisson regression with robust variance estimation was used to estimate proportions of mortality in percentages with 95% confidence intervals, crude and adjusted for age, sex and comorbidities. RESULTS: Diagnoses were widespread among the ICD-10 chapters, and the most were ‘non-specific diagnoses’ (40.4%), ‘circulatory diseases’ (9.6%), ‘injuries and poisonings’ (9.4%) and ‘respiratory diseases’ (6.9%). The diagnoses contributing most to the total burden of deaths (n = 554) within 30 days were ‘circulatory diseases’ (n = 148, 26%) followed by ‘non-specific diagnoses’ (n = 88, 16%) ‘respiratory diseases’ (n = 85, 15%), ‘infections’ (n = 54, 10%) and ‘digestive disease’ (n = 39, 7%). Overall mortality was 2.3% (1-day) and 7.1% (30-days). The risk of mortality was highly associated with age. CONCLUSION: This study found that almost half of the patients brought to the hospital after calling 112 with an ‘unclear problem’ were discharged with a ‘non-specific diagnosis’ which might seem trivial but should be explored more as these contributed the second-highest to the total number of deaths after 30 days only exceeded by ‘circulatory diseases’. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13049-022-01052-y

How Patients Who Are Transported by Ambulance Experience Dyspnea and the Use of a Dyspnea Scale: A Qualitative Study

Approximately 7% of all dispatched ambulances in Denmark are for patients for whom breathing difficulties are the main cause for using ambulance services. Objective measurements are routinely carried out in the ambulances, but little is known of the patients’ subjective experience of dyspnea. The purpose of this study was to investigate how patients with acute dyspnea, transported to hospital by ambulance, experience their situation, along with their experience of the use of a dyspnea scale. The study was carried out in the North Denmark Region. Transcribed patient interviews and field notes were analyzed and interpreted with inspiration from Paul Ricoeur. For interviews, we included 12 patients with dyspnea who were transported to the hospital by ambulance: six women and six men all aged 60 years or above. Observations were made over six ambulance transports related to dyspnea. Three themes emerged: “anxiety”, “reassurance in the ambulance” and “acceptance of the dyspnea measurements in the ambulance”. Several patients expressed anxiety due to their dyspnea, which was substantiated by observations in the ambulance. The patients expressed different perspectives on what improved the situation (treatment, reassurance by ambulance professionals). The patients and the ambulance personnel were, in general, in favor of the dyspnea scale

"Det er ikke lov å grue seg til å komme på sykehusskolen" - En kvalitativ studie av fire sykehuslæreres fortellinger om hva som er viktig ved undervisning av elever med kreft

Temaet for denne masteroppgaven er hva sykehuslærere vektlegger og vurdere som viktig når de gir undervisning til kreftsyke elever. Det ble gjennomført en kvalitativ forskningmed observasjon og intervju av fire sykehuslærere på en bestemt sykehusskole. Intervjuspørsmålene handlet om hva lærerne tenker over når de gir undervisning, og hvordan de forholder seg til elevens sykdom, foreldre, og hjemmeskolen. Teorien er baserer seg mye fra Skaalvik og Skaalvik (2011,2012), om motivasjon, medbestemmelse, og mestringsopplevelser. Dette er temaer som kom fram i intervjuetmed sykehuslærerne. På sykehusskolen ble det diskutert mye om hvor mye av undervisningen som skulle bestå av sosialisering. Derfor vil også dette bli nevnt i teorien. Sykehusskolen er et viktig sted for eleven, både for å få fokus vekk fra selve sykdommen, og for å gjøre hverdagen så normal som mulig. I forskningen kom det fram at det er viktig at skolen blir en positiv opplevelse for eleven. Sykehuslærerne brukte medbestemmelse og mestringsopplevelser som strategier for å øke eleven motivasjon, og skape positive opplevelser. Når et barn får kreft, vil de få et stort fravær på hjemmeskolen. Det vil ikke være så lett for denne eleven å holde kontakt med elevene på hjemmeskolen, eller andre venner. På sykehusskolen vil det ikke være så mange barn, eller andre jevnaldrene å kunne sosialiser seg med. Derfor jobbet sykehuslærerne med å opprettholde kontakten med elevene på hjemmeskolen. I tillegg er det viktig at sykehuslærere ikke prioriterer bare fag, men også trivselsaktiviteter med dem, eller andre elever på sykehusskolen. Det er viktig at sykehusskolen ikke bare hjelper eleven til å henge med faglig, men også det sosiale

Comorbidity and mortality of narcolepsy

STUDY OBJECTIVES: To identify the factual morbidity and mortality of narcolepsy in a controlled design. SETTING: National Patient Registry. PATIENTS: All national diagnosed patients (757) with health information at least 3 years prior to and after diagnose of narcolepsy. CONTROLS: Randomly selected four citizens (3,013) matched for age, sex, and socioeconomic status from the Danish Civil Registration System Statistics. RESULTS: Increased morbidity prior to narcolepsy diagnosis included (odds ratio, 95% confidence interval):- diseases of the endocrine, nutritional, and metabolic systems (2.10, 1.32-3.33); nervous system (5.27, 3.65-7.60); musculoskeletal system (1.59, 1.23-2.05); and other abnormal symptoms and laboratory findings (1.66, 1.25-2.22). After the diagnosis, narcolepsy patients experienced diseases of the endocrine, nutritional, and metabolic (2.31, 1.51-3.54), nervous (9.19, 6.80-12.41), musculoskeletal (1.70, 1.28-2.26), eye (1.67, 1.03-2.71), and respiratory systems (1.84, 1.21-2.81). Specific diagnoses were diabetes (2.4, 1,2-4.7, P < 0.01), obesity (13.4, 3.1-57.6, P < 0.001), sleep apnea (19.2, 7.7-48.3, P < 0.001), other sleep disorders (78.5, 11.8-523.3, P < 0.001), chronic obstructive pulmonary disease (2.8, 1.4-5.8, P < 0.01), lower back pain (2.5, 1.4-4.2, P < 0.001), arthrosis/arthritis (2.5, 1.3-4.8, P < 0.01), observation of neurological diseases (3.5, 1.9-6.5, P < 0.001), observation of other diseases (1.7, 1.2-2.5, P < 0.01), and rehabilitation (5.0, 1.5-16.5, P < 0.005). There was a trend towards greater mortality in narcolepsy (P = 0.07). CONCLUSIONS: Patients with narcolepsy present higher morbidity several years prior to diagnose and even higher thereafter. The mortality rate due to narcolepsy was slightly but not significantly higher. CITATION: Jennum P; Ibsen R; Knudsen S; Kjellberg J. Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study. SLEEP 2013;36(6):835-840

Development and inter-rater reliability of a simple prehospital mobility score for use in emergency patients

Background: Mobility assessment enhances the ability of vital sign-based early warning scores to predict risk. Currently mobility is not routinely assessed in a standardized manner in Denmark during the ambulance transfer of unselected emergency patients. The aim of this study was to develop and test the inter-rater reliability of a simple prehospital mobility score for pre-hospital use in ambulances and to test its inter-rater reliability. Method: Following a pilot study, we developed a 4-level prehospital mobility score based of the question”How much help did the patient need to be mobilized to the ambulance trolley”. Possible scores were no-, a little-, moderate-, and a lot of help. A cross-sectional study of inter-rater agreement among ambulance personnel was then carried out. Paramedics on ambulance runs in the North- and Central Denmark Region, as well as The Fareoe Islands, were included as a convenience sample between July 2020—May 2021. The simple prehospital mobility score was tested, both by the paramedics in the ambulance and by an additional observer. The study outcomes were inter-rater agreements by weighted kappa between the paramedics and between observers and paramedics. Results: We included 251 mobility assessments where the patient mobility was scored. Paramedics agreed on the mobility score for 202 patients (80,5%). For 47 (18.7%), there was a deviation of one between scores, in two (&lt; 1%) there was a deviation of two and none had a deviation of three (Table 1). Inter-rater agreement between paramedics in all three regions showed a kappa-coefficient of 0.84 (CI 95%: 0.79;0.88). Between observers and paramedics in North Denmark Region and Faroe Islands the kappa-coefficient was 0.82 (CI 95%: 0.77;0.86). Conclusion: We developed a simple prehospital mobility score, which was feasible in a prehospital setting and with a high inter-rater agreement between paramedics and observers.</p