Design School Kolding

Introduction Among lower extremity artery disease (LEAD), symptomatic carotid stenosis (SCS) and abdominal aortic aneurysm (AAA), the disease burden is insufficiently illuminated from a patient and societal perspective. Such knowledge is central to identifying patients at risk of poorer outcomes. Therefore, the Danish Vascular (DanVasc) survey aims to describe self-reported health status, health literacy, medication adherence and loneliness, including changes over time, and investigate characteristics associated with worse self-reported health at baseline and their associations with poorer outcomes within 1 year (healthcare utilisation and mortality) in patients with LEAD, SCS and AAA. Methods and analysis The DanVasc survey, a national prospective cohort study combining survey data measured at several time points with register-based data, includes validated patient-reported outcome measures (PROMs) and ancillary questions developed with patient representatives. Our baseline survey (T0) follows the index contact in vascular outpatient clinics with follow-up surveys determined by the patient’s trajectory: (1) newly referred patients in conservative treatment trajectories; the date for the outpatient visit activates 1-month (T1), 3-month (T2) and 12-month (T3) follow-ups. (2) Patients referred for vascular surgery; the surgery date activates 1-month (T1), 3-month (T2) and 12-month (T3) follow-ups. The included PROMs assess health-related quality of life (HRQoL), anxiety and depression, sleep, frailty status, health literacy, medication adherence and loneliness. For LEAD, a disease-specific PROM evaluates HRQoL. For AAA, disease-specific ancillary questions are added. Additionally, the DanVasc survey includes questions on health behaviour, preventive measures and sexual life. The DanVasc survey will be linked to national registries to obtain socio-demographic information and data on redeemed prescriptions, clinical information, healthcare utilisation, comorbidities and mortality. From December 2023 to December 2024, we aim to recruit approximately 5500 patients from all seven DanVasc surgery departments. Patient characteristics will be reported using descriptive statistics. Changes over time and factors associated with poorer health outcomes will be analysed using linear, logistic and Cox proportional hazard models, presented as univariate and multivariate regressions. Ethics and dissemination Approval for the collection of medical record data was granted by the Central Denmark Region, acting on behalf of all Danish regions (record 1-45-70-94-22). Consent to participate is obtained prior to answering the survey. Results will be disseminated through peer-reviewed scientific publications and conference presentations, and findings will be shared with patients and relevant stakeholders via public and social media.

Genetically modified (GM) foods have existed for decades, and governments internationally have legislated packaging disclosure statement language that typically incorporates the words genetic, modified, and organism. In 2018, the United States implemented the National Bioengineered Food Disclosure Standard (NBFDS) and introduced the term Bioengineered (BE) into GM disclosure language to help clarify consumer uncertainty regarding GM foods. Since then, the US consumer attitudes, perceptions, and knowledge of genetically modified foods remain negative, reflecting a contaminated interaction. Current mandated disclosure labels, utilizing engineering and science-based signifiers, are associated with this negative interaction. This research assesses whether food disclosure labels based on the signifier Design, unassociated with current contaminations, can positively impact the consumer perception of GM foods compared to the negatively contaminated science and engineering signifiers currently used. Two online studies of 1931 participants analyzed GM/BE food disclosure labels comparing four existing and six newly created engineering and science-based signifiers against four new design-based signifiers across fifteen attributes, including Price, Purchase Likelihood, Environmental Impact, Fair Trade, Safety, Nutrition, Healthfulness, Quality, Eating Experience, Comforting, Inviting, Frightening, Understandable, Ethical, and Sustainable. Across both studies, design-related labels consistently outperformed traditional engineering/science-based terms in fostering positive perceptions. However, even the best-performing labels did not fully overcome the entrenched skepticism associated with GM foods, underscoring the need for complementary strategies beyond linguistic changes.

This chapter examines both the textile manufacturing and textile recovery sectors in Denmark. It investigates the sustainability measures and circular strategies currently being actioned in the Danish textile manufacturing field and explores, across both sectors (manufacture and recovery), the role of digital technologies towards a circular economy. Using Danish Industrial Classification (DB07) codes and the Danish Central Business Register (CVR) database alongside expert knowledge, a list of 115 textile manufacturers and eleven recovery actors were found and included in the study. Websites from each company were studied and the data was analysed for circular strategies across materials, production, use, recovery and social activities. The findings demonstrate a focus on production and material related strategies and less emphasis on recovery within manufacture. Overall, there was a very limited uptake of digital technologies. The chapter concludes by exploring opportunities for new business models within repair, upgrade and recycling towards a Danish circular textile economy.

Traditionally, patients with a fracture of the distal radius are treated in a cast if they do not require surgery. If the fracture requires manipulation, the cast is moulded to hold the reduction and maintain normal anatomical alignment during healing. However, is a cast necessary for patients whose fracture does not require manipulation? Removable splints are an alternative treatment option. Such splints have the advantage that they can be adjusted to improve fit around the wrist as swelling reduces, and can be removed and reapplied for the purpose of washing or, in some cases, exercise. However, evidence for their safety and effectiveness in the management of distal radius fractures is lacking. DRAFT3 is a multicentre randomized non-inferiority trial and economic analysis designed to determine the safety and effectiveness of removable splints as an alternative to casts in the treatment of distal radius fractures that do not require manipulation. Cite this article: Bone Joint J 2025;107-B(1):7–9.

Cultural tourism is a fast‐growing segment in the tourism industry and is estimated to be around 40% of the tourist segments globally. After COVID‐19, this has come back with renewed force. Regional attractions such as experience centers, museums, event developers, city developers, tourism offices, and so forth need to work together to create enough “reason‐to‐go” and subsequent “reason‐to‐stay” experiential qualities in their tourism service value propositions. Through two larger cultural tourism case projects, we investigate how one can bring ecosystem tourism stakeholders together through codesign tangible methods to ideate on cross‐locational experiential service value propositions and what opportunities and difficulties seem to emerge through this. In the first project, three regional museums and a tourism destination office worked together to find shared themes and connected stories. In the second project, seven Second World War museums, three tourism offices, and design developers collaborated to extract three experiential journeys that visitors could follow. We illustrate how a series of codesign interventions can engage a cross‐disciplinary circle of stakeholders and lead to novel insights and shared understandings, establish common ground, and generate ideas with potential. In addition, we analyze the use and effect of introducing codesign methods that can support the development of shared themes and stories attracting visitors and international tourists. Through observations, video recordings, and interaction analysis, we outline both the opportunities and difficulties found in these collaborations. The opportunities point to the possibilities in providing an attractive offering through a series of connected stories that involve the value chain of travel, food, and accommodation providers and in training the front personnel to guide to the next places. The difficulties point to issues such as the gap between stories as marketing and the stories as they are experienced on location and the difficulty in aligning practices according to a central story line and overall service value proposition across various distances and time. From the perspective of experiential service design, the results have theoretical implications because a holistic service flows through cross‐locational and cross‐organizational touchpoints while the practical implications also point to the development of ecosystems of tourism actors working closely together.

Introduction: Due to the Danish fauna, reindeer are not immediately available should Santa Claus need to replace his reindeer while traveling across Denmark with Christmas gifts. Instead, Santa Claus should rely on roe deer, which are predominant in Denmark. However, the population of roe deer may be threatened by collisions between ambulances and roe deer. We decided to study the extent of the problem. Methods: We conducted a register-based study of all traffic accidents involving animals in the Region of Southern Denmark from 2017 through 2022. All traffic accidents were investigated and the number of roe deer accidents were registered. Results: During six years, 317,288 ambulances were dispatched. A total of 334 traffic accidents were reported. Of these, 32 roe deer accidents. Conclusion: To ensure the children that Santa Claus can replace his reindeer and thus contribute to the children's feelings of safety during Christmas, the emergency medical service in Denmark should consider finding means to reduce the number of collisions between roe deer and ambulances. Funding: None. Trial registration: None.

This paper discusses the use of a card-game design task to teach the implementation of Universal Design (UD) principles to undergraduate students. The underlying assumption is that in order to implement UD methods, designers need to select the right tools to gather information and they need to understand the theoretical basis of the tools chosen. The aim is to bridge the theory/practice gap by getting students to actively consider how each aspect of their design research contribute to the implementation of the theory. Work by Herriott (2023) shows that design researchers are not consistent in explaining or making transparent the underlying reasons for why a UD tool was chosen. UD theory is also somewhat weak on the topic of implementation, a necessary element of design theory according to Jones & Gregor (2007). The didactic purpose of the card-game design was to encourage students to become conscious of the reason they chose the design tools eventually used in their course project. It was also to examine how, from a UD theory standpoint, implementation of UD could be enhanced since this aspect of UD theory appears to be in need of reinforcement. The students developed in class a card-game which could be used to create and advance their designs and also to retrospectively analyse them upon completion. The in-class discussion of what was required for a game also focused studentst’ attention to the elements of UD and their possible implementation. The work shows that more time is needed to explain game design; mapping of UD concept to game affordances is necessary; the course learning outcomes require addition of demonstration of theory-to-implementation

Introduction Shared decision making (SDM) was introduced in hospital Lillebelt in 2019 and research reports that patients are more satisfied with their treatment, if they play an active role in choosing treatment. A Decision-Helper was constructed and introduced in the treatment for Colles fractures. This study aimed to understand how patients experience shared decision-making (SDM) for an acute illness, and how it affects them when making decisions about the treatment of their distal radius fracture. Method An exploratory, qualitative study design was performed to understand the patient's experience, during the choice of treatment with SDM. 12 were recruited when they came to their first follow-up 5 days after the injury, in the outpatient clinic. 10 were interviewed; 3 face to face and 7 by telephone. All women aged 57-87 years and all had a displaced Colles fracture, which had been reduced in the Emergency Room. Result Analyzing the interviews three themes emerged: 1) Acute situation. Patients was positive towards SDM, but found it demanding to participate in. Patients was still in crisis, 5 days after suffering from a fracture. Patients were unable to remember the information given in the ER, regarding the use of the Decision helper. Few had prepared themselves for the consult in the outpatient clinic. 2) Influence on treatment choice. It was unclear to the majority of patients, that cast or surgery, resulted in similar clinical outcomes. 3) The treatment decision was based on personal factors, more than the information received during the consult. Conclusion Patients wants to be included in the treatment decision. It is important to highlight that booth treatments are equal in clinical outcome, before introducing the Decision-Helper. The doctor´s demeanor is of great importance to the patient's experience. Introducing SDM in the clinical setting requires training and repeated observations, to succeed.

Introduction Plantar heel pain, or plantar fasciopathy (PF), is a common musculoskeletal complaint, affecting 39% of lower-extremity tendinopathies in general practice. Conservative management is recommended as the first-line treatment, yet many patients continue to experience symptoms even after ten years. There is a significant lack of high-quality evidence for the effectiveness of various treatments, highlighting the need for more research. Minimally invasive surgical options, such as endoscopic plantar fascia release and radiofrequency microtenotomy, have shown promise in reducing pain and improving outcomes. This systematic review aims to evaluate the effectiveness of these minimally invasive surgical treatments compared to non-surgical options in managing PF. Method The systematic review, registered on PROSPERO (CRD42024490498) and adhering to PRISMA guidelines, searched databases including PubMed, Embase, Cochrane, and others for studies from January 1991 to May 2024. Keywords included plantar fasciitis, plantar fasciopathy, and heel pain. Limited to human trials, the search strategy was refined with an information specialist and found no protocol duplicates. Result The systematic review identified eight studies involving 495 patients (56.2% women, average age 46.5 years). The studies compared various treatments, including endoscopic plantar fascia release (EPF), mini-scalpel needle (MSN) treatment, ultrasound-guided pulsed radiofrequency (UG-PRF), and needle electrolysis (NE), to non-surgical interventions and corticosteroid injections (CSI). Primary outcomes focused on pain reduction, with some needle treatments showing superior results (between-group diffence). No severe adverse events were reported. Conclusion In conclusion, plantar fasciopathy (PF) remains a prevalent and challenging condition, that can be resistant to conservative treatments. This systematic review highlights the potential of minimally invasive surgical options, such as endoscopic plantar fascia release and needle treatments, in reducing pain and improving functional outcomes. Despite some needle treatments showing superior results, the overall lack of high-quality evidence underscores the need for further research to establish the most effective management strategies for PF.

Immunocompromised patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have a longer duration of viral shedding and persistence of symptoms. The optimal treatment strategy for these patients remains to be established. This case describes a male in his late sixties with follicular lymphoma and persistent symptoms of infection with SARS-CoV-2 variant BA.2 who was treated with remdesivir five times over a period of six months. The clinical effect of remdesivir treatment decreased over time, and further viral sequencing revealed the emergence of mutations across the SARS-CoV-2 genome. Due to the lack of other treatment options, the patient was treated with a combination of remdesivir and molnupiravir for 10 days, and epcoritamab was discontinued, which led to the cessation of symptoms. This case illustrates the risk of a diminished effect of remdesivir with prolonged use and the need for treatment guidelines for immunocompromised patients with persistent COVID-19.

Cross‐sectional imaging supplements endoscopy in detecting disease manifestations in inflammatory bowel diseases (IBD). This study aimed to evaluate the accuracy of PET/MRI in a paediatric population suspected of IBD. This prospective study consecutively included patients aged 8–17 years under diagnostic evaluation for IBD. Forty‐three patients underwent a PET/MRI scan and subsequent ileocolonoscopy, of whom 26 patients diagnosed with IBD participated in a follow‐up scan, hereof 19 with Crohn's disease (CD), five with Ulcerative colitis and two with unclassified IBD. The results of PET alone, MRI alone, and PET/MRI combined were compared to a reference standard of endoscopy and histopathology. Of the 208 intestinal segments analysed, 109 showed inflammation, and 99 had no inflammation. In the per‐segment analysis PET had a sensitivity of 0.83 (95% CI 0.73–0.93), specificity of 0.59 (95% CI 0.47–0.71), and area under the receiver operating characteristic curve (AUROC) of 0.73 (95% CI 0.67–0.80). MRI had a sensitivity of 0.52 (95% CI 0.41–0.64), specificity 0.89 (95% CI 0.82–0.96), and AUROC of 0.72 (95% CI 0.66–0.77). PET/MRI had a sensitivity of 0.83 (95% CI 0.74–0.94), specificity of 0.57 (95% CI 0.44–0.69), and AUROC of 0.77 (95% CI 0.71–0.84). At follow‐up, PET and MRI scores decreased, and the change in MRI was able to identify patients with a clinical response. The accuracy of the PET/MRI scan in detecting inflammation in the terminal ileum and colon was moderate and not superior to either modality alone. With technological advances and combined reading, PET/MRI may still be valuable in selected cases.

Background Biomarker guided therapy could improve management of COVID-19 inpatients. Although some results indicate that antibody tests are prognostic, little is known about patient management using point-of-care (POC) antibody tests. Methods COVID-19 inpatients were recruited to evaluate 2 POC tests: LumiraDX and RightSign. Ease of use data was collected. Blood was also collected for centralized testing using established antibody assays (GenScript cPass). A nested case-control study assessed if POC tests conducted on stored specimens were predictive of time to sustained recovery, mortality, and a composite safety outcome. Results While both POC tests exhibited moderate agreement with the GenScript assay (both agreeing with 89% of antibody determinations), they were significantly different from the GenScript assay. Treating the GenScript assay as the gold standard, the LumiraDX assay had 99.5% sensitivity and 58.1% specificity while the RightSign assay had 89.5% sensitivity and 84.0% specificity. The LumiraDX assay frequently gave indeterminant results. Both tests were significantly associated with clinical outcomes. Conclusions Although both POC tests deviated moderately from the GenScript assay, they predicted outcomes of interest. The RightSign test was easier to use and was more likely to detect those lacking antibody compared to the LumiraDX test treating GenScript as the gold standard.

The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia. We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values. We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66–1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0–80) versus 40 (0–75) (adjusted mean difference: 4.8; 98.6% CI − 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0–0.81) in the lower-oxygenation group versus 0.43 (0–0.79) (p = 0.20) in the higher-oxygenation group, respectively. Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.

Introduction Traumatic injury of a vascular prosthesis-to-prosthesis anastomosis leading to an extravasation and pseudoaneurysm is rare. If not identified the complications associated with this condition can lead to high morbidity and mortality and require surgical treatment. Case We describe a patient who presented with a tear in prosthesis-prosthesis anastomosis eight years after implantation resulting in a pseudoaneurysm. The patient had a severe fall prior to the non-symptomatic leakage. The complication was successfully treated by re-lining the graft with a new anastomosis at the Department of Vascular and Endovascular Surgery, Kolding Hospital in Denmark. Discussion Cause of tear is speculated to be due to weakness at site of reconstruction, fabric degradation, and/or degradation of suture material. Conclusion Late prosthesis-prosthesis anastomosis tear caused by a traumatic event is rare. In the event of a late tear, anamnesis and histological analysis of involved material is important.

Background Functional neurological disorder (FND) is a common cause of neurological disability. Despite recent advances in pathophysiological understanding and treatments, application of this knowledge to clinical practice is variable and limited. Objective Our aim was to provide an expert overview of the state of affairs of FND practice across Europe, focusing on education and training, access to specialized care, reimbursement and disability policies, and academic and patient‐led representation of people with FND. Methods We conducted a survey across Europe, featuring one expert per country. We asked experts to compare training and services for people with FND to those provided to people with multiple sclerosis (MS). Results Responses from 25 countries revealed that only five included FND as a mandatory part of neurological training, while teaching about MS was uniformly included. FND was part of final neurology examinations in 3/17 countries, unlike MS that was included in all 17. Seventeen countries reported neurologists with an interest in FND but the estimated mean ratio of FND‐interested neurologists to MS neurologists was 1:20. FND coding varied, with psychiatric coding for FND impacting treatment access and disability benefits in the majority of countries. Twenty countries reported services refusing to see FND patients. Eight countries reported an FND special interest group or network; 11 reported patient‐led organizations. Conclusions FND is largely a marginal topic within European neurology training and there is limited access to specialized care and disability benefits for people with FND across Europe. We discuss how this issue can be addressed at an academic, healthcare and patient organization level.