Roskilde University

Aim To explore nurses' perceptions of reasons for missed nursing care. Design A multicentre qualitative descriptive study was undertaken from August 2022 to January 2023. Methods Interpretive description methodology was used. Individual interviews were conducted with 36 registered nurses and eight licensed practical nurses working in medical, surgical and intensive care units at three public university hospitals in Denmark. Using a semi‐structured interview guide, nurses were asked to share their perceptions of reasons for missed care. The analysis was guided by an inductive thematic approach. Results The nurses' immediate responses to reasons for missed nursing care circulated around limited time and busyness. However, further analysis unfolded layers of reasons described within three themes: being challenged by workload and patients' diverse care needs; falling short on competencies; and being governed by organisational structures and decisions. Conclusions The study underlines that reasons for missed nursing care are multiple and complex and extend from an individual to an organisational level. They can therefore not be seen nor targeted isolated. Furthermore, there is a need to draw attention to organisation of care and nurses' clinical decision‐making to ensure that patient's fundamental care needs are met. Implications for the Profession Reducing missed nursing care calls for interventions that require nurses to change their working practices, roles and value perceptions. This study provides valuable insight into nurses' perspectives on reasons for missed nursing care, which is pertinent for designing interventions targeting missed nursing care. Impact The study provides insight into nurses' perceptions on reasons for missed nursing care within hospital settings. The findings of the study show that reasons for missed nursing care are multiple and complex and cannot be limited to time and busyness. The findings can be used to inform future interventions aimed at reducing missed nursing care. Reporting Method The reporting of the study followed the consolidated criteria for reporting qualitative research. Patient or Public Contribution No patient or public contribution.

The replication of the two chromosomes in the pathogenic bacterium Vibrio cholerae is coordinated by the binding of initiator protein RctB to a checkpoint sequence, crtS. Replication of crtS on the primary chromosome (Chr1) triggers replication of the secondary chromosome (Chr2), but the details are poorly understood. Here, we analyze RctB binding patterns in the V. cholerae genome across various cell cycle stages. We find that RctB primarily binds to sites inhibiting replication initiation at the Chr2 origin (ori2). This inhibitory effect is counteracted when crtS is replicated on Chr1, causing a shift in RctB binding to sites that activate replication at ori2. Structural analyzes indicate the formation of diverse oligomeric states of RctB, coupled to the allosteric effect of DNA, which determine ori2 accessibility. We propose a synchronization model where, upon replication, crtS locally destabilizes the RctB inhibition complex, releasing the Chr2 replication origin.

Four novel nontuberculous mycobacteria were discovered from a historical strain collection at the International Reference Laboratory of Mycobacteriology at Statens Serum Institut in Copenhagen, Denmark. Phylogenetic analysis combining the 16S rrs , internal transcribed spacer and 23S rrl elements, as well as a single-copy core-gene ( hsp65 , rpoB+C , secA and tuf ) analysis of these freeze-dried mycobacteria, clinically isolated from gastric lavage samples between 1948 and 1955, showed to be associated with type strains grouping within the Terra and Fortuitum-Vaccae clade. Phenotypic characteristics, biochemical properties and fatty acid and mycolic acid profiles supported the classification as novel strains. A genomic comparison to the closest related type strain was done by calculating average nucleotide identity and in silico DNA:DNA hybridization values, which showed 87.9% and 33.0% for Mu0050, 85.2% and 27.4% for Mu0053, 85.3% and 27.6% for Mu0083 and 93.3% and 50.1% for Mu0102, respectively. The names proposed for the new species are Mycobacterium wendilense sp. nov. (Mu0050 T =ITM 501390 T =CCUG 77525 T ), Mycobacterium burgundiense sp. nov. (Mu0053 T =ITM 501391 T =CCUG 77526 T ), Mycobacterium kokjensenii sp. nov. (Mu0083 T =ITM 501392 T =CCUG 77527 T ) and Mycobacterium holstebronense sp. nov. (Mu0102 T =ITM 501393 T =CCUG 77528 T ).

Collaborative governance has developed into a well-established strand of public administration research. An impressive number of empirical studies document how collaborative governance processes can be relatively volatile, multi-vocal, distributed and heterogeneous. Hence, it is commonly observed that the actor composition changes over time, actors’ reasons for participating differ, the collaboration consists of multiple sub-projects, and there are many diverse outcomes. Bricolage theory and theories of robust governance provide insights that can make collaborative governance theory more attentive to such dynamics and draw a more nuanced picture of what enables actors to collaborate or prevent them from doing so. The contribution from bricolage theory and theories of robust governance is to recast collaboration as loosely coupled situated practices in which actors use what is available in terms of storylines, skills, tools and relationships to work together to produce different public-value outcomes. Based on these insights, we propose the study of collaborative governance as tangled moments of bricolage. We also provide some guidelines on how to conduct such studies and illustrate their usage with reference to a concrete case study of a collaborative governance process.

Background Involving parents in decisions about the care of their infant is common practice in most neonatal intensive care units. However, involvement is less common in neonatal research and a gap appears to exist in understanding the process of patient and public involvement. The aim of this study was to explore parents and researchers’ experiences of patient and public involvement in a neonatal research project. Methods A qualitative design was employed, consisting of two focus group interviews, one dyadic interview, and four individual interviews with parents and researchers. The interviews followed a semi-structured guide specific to both parents and researchers. Data were analysed using content analysis as described by Graneheim and Lundman. Results A total of nine parents and four researchers participated in the study. Seven themes were consolidated into three core concepts: Embracing the ethos and pathos of patient and public involvement, Finding the path to maximise meaningful involvement, and Becoming skilled in engaging patients and the public in research. The core concepts highlighted both similarities and differences, as well as challenges and facilitators, of the experiences of the patient and public involvement process. Conclusion Patient and public involvement in research was a mutually beneficial process, facilitating learning and reflective opportunities for parents and researchers. However, there were challenges that emphasised the need for rapport building between parents and researchers, valuing everyone’s unique perspective and expertise, with clear communication and well-defined roles and goals. These insights offer a contribution for future patient and public involvement in health research.

This chapter presents an introduction and an overview of the chapters in the book which were presented at the third conference on Relational Economics on “The Relational View on Economics—Challenges to a New Paradigm” in Roskilde, Denmark from September 28 to September 29, 2023. The conference was organized as a fruitful partnership between the Leadership Excellence Institute Zeppelin at Zeppelin University, Germany, and the Department of Social Sciences and Business at Roskilde University, Denmark. The chapter gives on this basis an outline of the topics of discussion on Relational Economics which were developed at the third conference on Relational Economics. The chapter presents the intentions of the third conference on Relational Economics with focus on the critical challenges to the new paradigm of economic theory to continue the discussions and reflections of the international research project on Relational Economics. The introduction gives an overview of the interdisciplinary, epistemological, and methodological aims of this conference on Relational Economics.

In this paper, I share insights from ongoing ethnographic fieldwork among adult Danes who identify as having Attention Deficit Hyperactivity Disorder (ADHD) but do not meet the clinical standards and have yet to receive a diagnosis. These individuals are particularly relevant to the ongoing debates about under- and overdiagnosis of ADHD, as their claims to the diagnosis influence and mirror societal perceptions of what is considered normal and what is seen as a condition. Despite their symptoms not strictly meeting diagnostic criteria, thus risking overdiagnosis and associated psychiatric labeling, they perceive themselves as distinct from ‘normal’ people. Through a critical anthropological lens, I argue that medicalizing variations in human personality represents a contemporary societal epistemic error, drawing on Gregory Bateson’s work. I highlight the dynamics of diagnosis versus notions of normality in diagnosing and self-diagnosing ADHD. Understanding these dynamics is crucial for addressing concerns of overdiagnosis as well as underdiagnosis and misdiagnosis. By illuminating the complexities of diagnostic processes and their societal implications, I aim to contribute to a richer understanding of mental health discourse and practice.

Objectives This study aimed to investigate patients’ use of electronic Patient-Reported Outcome Measures (ePROMs) and understand the demographic and clinical factors that may be correlated with patient responses to the BREAST-Q at the preoperative stage of breast cancer. The BREAST-Q is a PROM in questionnaire format, developed and validated to assess satisfaction and quality of life for breast surgery patients.The hypothesis tested is that considering disparities in geography, age and education among responders is essential for capturing a diverse patient population in future Patent-Reported Outcome Measures initiatives, examining how these characteristics are associated with Patent-Reported Outcome Measures utilisation and outcomes. Design Quantitative descriptive study. Setting Electronic Patient-Reported Outcome Measures were collected between 6 September 2021 and 5 September 2022 from patients recruited from an outpatient clinic at a Plastic- and Breast Surgery Department at a University Hospital in Denmark. Participants Participants include a total of 629 Danish-speaking women diagnosed with breast cancer and scheduled for breast cancer surgery, with a final participation rate of 468. Intervention Preoperative ePROMs and demographic data were collected between September 2020 and 2021 through patients’ secure national digital post-box. Main outcome measures Demographic variables of both responders and non-responders were assessed using t-tests, Mann-Whitney U tests and χ² tests. Linear regression models were employed to determine the demographic variables associated with BREAST-Q subscale scores. Results The response rate for ePROMs was 72.5% with a median age of responders at 62 years. Older patients reported lower breast satisfaction (unadjusted coefficient bu=−0.26 (95% CI −0.44; −0.07), p=0.006) but better physical well-being (adjusted coefficient ba=0.23 (0.08; 0.37), p<0.001). Lower educational achievement was correlated with reduced breast satisfaction and psychosocial and sexual well-being; for example, patients with a master’s/doctoral level education scored 14.29 points higher in psychosocial well-being (95% CI 6.50; 22.07, p<0.001) compared with those with lower secondary education. Cohabiting patients reported psychosocial well-being scores approximately four points higher than those living alone (ba=3.91 (0.06; 7.75), p=0.046). Body mass index (BMI) was negatively associated with sexual well-being, with a 0.75-point decline per additional BMI point (ba=−0.75, (-1.12; −0.37), p<0.001). Conclusions The present study demonstrates a positive attitude towards completing BREAST-Q as ePROMs among women diagnosed with breast cancer in the investigated region in Denmark. However, completion rates for ePROMs varied by demographic factors such as age, marital status and access to healthcare. Younger, more educated, married patients with lower BMI who lived near major cities were more likely to report better pretreatment outcomes.

Spatial databases play a vital role in a number of applications ranging from geographic information systems to location-based services. Application tasks typically access underlying spatial data to answer queries. However, non-experts lack the expertise necessary for formulating spatial queries. To fill in this gap, we propose an effective framework that translates na tural l anguage queries over spatial data into executable database queries, called NALSpatial. The framework consists of two core phases: (i) natural language understanding and (ii) natural language translation . Phase (i) extracts key entity information, comprehends the query intent and determines the query type by employing natural language processing techniques and deep learning algorithms. The key entities and query type are passed to phase (ii), which makes use of entity mapping rules and structured language models to construct executable database queries. NALSpatial supports dealing with five types of queries including (i) basic queries (e.g. distance and area) , (ii) range queries , (iii) nearest neighbor queries , (iv) spatial join queries and (v) aggregation queries . We develop NALSpatial in an open-source extensible database system SECONDO. Extensive experiments show that NALSpatial on average achieves response time of about 2.5 seconds, translatability of 95% and translation precision of 92%, outperforming three state-of-the-art methods.

This article argues that climate change and its mitigation risk threatening Indigenous Peoples' access to land and their ability to maintain their way of life. Focusing on the experiences of the Indigenous Sámi reindeer herders of the Swedish part of Sápmi, the article traces how the Östra Kikkejaure reindeer-herding association sees its lands increasingly fragmented by various encroachments, particularly the construction of the large-scale wind project, Markbygden, in Piteå municipality. At the same time, the herders are forced to adapt to the uncertain impacts of climate change. This double blow is presented through a political ecology analysis emphasizing how climate mitigation projects like Markbygden may trigger rights violations through encroachment, enclosure, exclusion, and entrenchment. Apart from a literature review, the article is based on two months of fieldwork in Sweden in 2021 and 2022. A total of 28 interviews and ten informal conversations were conducted with rights-holders and stakeholders involved in the Markbygden wind project. The article addresses the shortcomings of prevailing approaches to energy justice and seeks to contribute to discussions on how climate mitigation efforts, including energy transitions, are taking shape and how their impacts are evaluated and distributed.

Introduction We assessed the impact of recruitment criteria on lung cancer detection in a future Danish screening programme with low-dose CT. Methods We combined data from two Danish population-based health examination surveys with eligibility criteria from seven randomised controlled trials on lung cancer screening. Incident lung cancers were identified by linkage with the National Pathology Data Bank (Patobank). For an average of 4.4 years of follow-up, we calculated sensitivity, specificity, efficient frontier and number needed to screen (NNS) for lung cancer detection. Results When applying the different eligibility criteria to the 48 171 persons invited to the two surveys, the number of lung cancer cases identified in the target groups varied from 46 to 68. The National Lung Screening Trial (NLST) criteria had the highest sensitivity of 62.6% (95% CI 52.7 to 71.8) and the Dutch-Belgian NEderlands-Leuvens Screening ONderzoek (NELSON) criteria had the highest specificity 81.6% (95% CI 81.0 to 82.1). Sensitivity was higher for men than for women (NLST criteria 71.7% (95% CI 57.7 to 83.2) and 53.7% (95% CI 39.6 to 67.4), respectively). The NLST criteria identified the target population obtaining the lowest NNS with 46.3. The application of the NLST criteria showed that the higher the sensitivity, the lower the number of false-negative cases and, thus, the lower the NNS. Conclusions This study highlights the impact of the definition of the at-risk population on lung cancer screening efficacy. We found lower sensitivity among women regardless of screening criteria used. This should be carefully addressed in a possible screening programme.

In recent decades, governments have encouraged universities to conduct research that positively affects economic growth and social development. This has led to business and engineering researchers increasingly engaging with practitioners, for example, through industrial PhD projects. To achieve the ambition of creating useful knowledge for practitioners, action research (AR) represents a possible path. There are, however, challenges associated with this research approach. Specifically, AR combines elements of traditional research approaches with participation in real-world projects aimed at producing change. Consequently, researchers become highly involved in the study context instead of being detached observers. This poses challenges to research rigor, which may partly explain the relatively low number of AR studies in business and engineering journals as compared to, for example, case studies. To support future AR studies, this chapter defines five research strategies for increasing the rigor of AR. We argue that by using these strategies, researchers can achieve a level of rigor that may even exceed that of case studies. The AR approach may thereby become a more attractive alternative to more popular research approaches.

Background: Invasive pneumococcal disease (IPD) remains a significant public health concern, particularly in vulnerable populations such as the elderly. This study focuses on the Faroe Islands, a unique setting for monitoring pneumococcal disease trends due to its high vaccination coverage and geographic isolation. Objective: To examine the prevalence, trends and serotype distribution of IPD in the Faroe Islands from 2000 to 2023, focusing on the impact of pneumococcal conjugate vaccines (PCVs) on disease incidence and serotype replacement. Methods: Eighty-six pneumococcal isolates, representing all registered cases of IPD in the Faroe Islands, were analysed during the study period. Data on patient demographics, serotype identification and vaccination history were collected from national health records. Temporal trends in vaccine-type (VT) and non-vaccine-type (nVT) serotypes were analysed, particularly following the introduction of PCV13 in 2010. Results: Following the introduction of PCV13, a shift from VT to nVT serotypes was observed, while the overall IPD rate remained stable. Notably, there was an increase in IPD cases among the elderly population. The analysis indicated that serotype replacement contributed to a rise in nVT cases despite reducing VT-related IPD. Conclusions: The findings emphasise the need for ongoing evaluation of pneumococcal vaccine formulations and alternative strategies to address the increasing prevalence of nVT IPD. Higher-valency vaccines and sustained vaccination coverage are critical to mitigating the impact of serotype replacement and improving public health outcomes in the Faroe Islands.

Fritz Kauffmann (1899–1978) was a German/Danish microbiologist, who worked most of his years studying intestinal bacteria at Statens Serum Institut in Denmark. During his research, he implemented several diagnostic tools, which are still used in reference laboratories worldwide. Kauffmann was probably most known for developing the “Kauffmann‐White scheme” based on the O‐ and flagella antigens on the surface of Salmonella . He was a visionary in his field, working at the intersection of microbiology and public health, as his research enabled proper diagnosis and tracking of diseases around the world.

Introduction Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children and adolescents. The disorder negatively influences their academic performance and social relations, and their quality of life (QoL) is lower than that of peers without ADHD. The majority of children and adolescents with ADHD are treated with medication that potentially has an insufficient effect or frequently occurring adverse events. Physical activity is thought to alter the physiology of ADHD by affecting the same catecholaminergic system in the brain which is targeted by medication. Methods and analysis This protocol is written in accordance with the ‘Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols’ guideline. Randomised clinical trials with participating children and adolescents between the ages of 3 and 18 years with a primary diagnosis of ADHD or hyperkinetic disorder will be included in the systematic review. The main objective of the review is to examine the effect of physical activity on QoL, executive functions, symptoms and functional impairment in this population. Previous systematic reviews on the effect of physical activity in children and adolescents with ADHD have several methodological and conceptual limitations. These reviews, for example, included both randomised and non-randomised clinical trials or had restrictions regarding the frequency and intensity of the physical activity interventions they included. The present review will include the newest studies in the field and follow the main principles outlined in the ‘Cochrane Handbook for Systematic Reviews of Interventions’. Furthermore, it will be the first review in the field to include QoL as an outcome and to apply trial sequential analysis as part of the meta-analysis. Ethics and dissemination As the systematic review is a secondary analysis of data from primary trials, approval from an ethics committee is not required. The results of the review will be published in a peer-reviewed scientific journal and presented at relevant conferences. Trial registration number This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 16 August 2024 (CRD42024576670).

Traditions around second homes are well established in northern Europe, although there are variations between and within countries in terms of development patterns and the use of this type of housing. Focusing on coastal communities in Northern Norway and the Faroes, this study explored how year-round residents and second homers sharing the same location coalesce and form “open communities” that can tackle challenges such as depopulation and remoteness. We found that second-home tourism presents opportunities for small communities that are in accordance with the concept of “small tourism”. However, each local community has its own specificities that need to be taken into consideration when addressing and planning the development of second homes and community-based tourism. Depending on the different settlement patterns of second homes in Nordic coastal communities, second homers take part in “sharing places” in “open communities” in different ways.

Background In Denmark, specialized multiple sclerosis (MS) clinics offer free-of-charge treatment to people with MS. However, not all people with MS attend regular clinical follow-up. Objective To identify people with MS who do not attend Danish MS clinics and identify barriers to treatment. Methods The Danish Multiple Sclerosis Registry was linked to other national Danish registries with follow-up from 2000–2020. We used a time-dependent Cox regression to rank factors associated with low attendance to clinical follow-up visits based on the magnitude of hazard ratios (HRs). Results We included 10,175 adults with MS, of which 3862 (38%) had less than one visit annually. The five top-ranked factors that reduced the risk of visits occurring included never having received diseases modifying treatment (HR: 0.48; 95%CI: 0.46–0.49), been diagnosed with MS before 2009 (0.79; 0.78–0.81), association with MS center in an outer region of Denmark (0.82; 0.80–0.84), having progressive MS type (0.88; 0.86–0.91) and not having received symptomatic treatment at diagnosis (0.91; 0.89–0.93). Conclusion Our results highlight disease-specific and geographic inequalities in the management of people with MS in Denmark. Strategies to prevent this inequality, especially for people with progressive phenotypes and those who need supportive and non-medical treatment and care, should be implemented.