University College Absalon

The present study included the first patients with COPD on long-term oxygen therapy who experienced second-by-second oxygen adjustments in their homes based on oxygen saturation. A device capable of automatically titrating the patient’s oxygen was installed in the patients’ home aiming at increasing the time spent within target saturation. We explored patients’ experiences with this automated home oxygen titration, focusing on how maintaining target saturation affected daily life. Semi-structured interviews were conducted with eight men and four women after installation. Systematic text condensation was used in the analysis. Three main themes emerged from patient narratives: (1) “This is my life” – Patients preferred maintaining stable oxygen saturation, associating hypoxemia with dyspnea, discomfort, and difficulties with daily tasks. (2) “Getting the oxygen, I need” – Many patients reported improved ability to perform daily activities when oxygen was automatically adjusted. (3) “New technology gives hope for my life” – Patients expressed optimism about the potential of home-based technology, offering suggestions to improve usability, mainly by reducing concentrator noise. Our findings suggested high acceptability of the automated oxygen in the patients’ home, as they believed it to increase the time spend with sufficient oxygen, especially during daily activities. Integrating patient insights is essential for implementation and acceptance of automated home oxygen therapy.

Background Individuals with type 2 diabetes (T2D) who have lower levels of education and income face an elevated risk of decreased participation in and adherence to diabetes rehabilitation programmes. Aim This study investigated how diabetes rehabilitation could be improved by revamping the organisation of the healthcare system and accommodating the actual needs of people with diabetes. It explored current diabetes rehabilitation interventions from the perspectives of healthcare professionals, managers and people living with T2D in a Danish municipality with a high proportion of people with low incomes and low levels of education. Methods The research is based on empirical investigations in a municipality in Denmark. Seven individual qualitative interviews with people living with T2D, 5 individual qualitative interviews with healthcare professionals were conducted and 2 focus groups with managers and physiotherapists, respectively. The data analysis was inspired by Malterud's systematic text condensation. A hermeneutic–phenomenological interpretative approach was taken. Results Three main categories were found: (1) The target group, (2) The municipality's efforts and (3) The organisational level. Based upon the analysis, the article discusses how both social relations and the municipal rehabilitation programmes are essential if diabetes rehabilitation is to be successful. For rehabilitation to be successful, intervention must be translated into everyday life. Conclusion Despite the dedicated efforts within the rehabilitation programme, individuals with T2D encountered challenges in altering their daily routines and habits. Healthcare professionals faced difficulties translating their diabetes expertise into tangible lifestyle changes for participants in the municipality's rehabilitation programmes. The fundamental importance of fostering supportive social relations both at home and within the community cannot be overstated for successful and effective rehabilitation.

Precision medicine has significantly advanced through the development of predictive biomarkers based on pharmacogenetic (PGx) testing. These tests identify interactions between drugs and genetic variants that influence patient responses to treatments. Understanding genetic variations in drug‐metabolizing enzymes, receptors and transporters and their impact on pharmacokinetics and pharmacodynamics allows for the prediction of drug effects and side effects, enabling tailored treatments for different patient groups. This review focuses on drugs metabolized by cytochrome P450 (CYP450) enzymes, for example, citalopram and clopidogrel or transported by the solute carrier organic anion transporter family member 1B1 (SLCO1B1), for example, atorvastatin and simvastatin, with PGx dosing guidelines, in the context of consumption in Scandinavian countries. A major barrier to the widespread adoption of PGx tests in clinical practice has been healthcare professionals' uncertainty about their efficacy, complexity in result interpretation and questions regarding the evidence base. However, recent studies have demonstrated PGx testing has the potential to improve treatment outcomes, reduce adverse drug reactions and achieve cost savings. These findings underscore the potential of PGx testing as a valuable tool in clinical decision making, promoting its use in a pre‐emptive manner to enhance patient care.

Introduction A recent upsurge of interest in the health benefits of crafts for mental health and well‐being has not been supported by systematic reviews of the effectiveness of crafts‐based interventions, prior to this review. Methods Five databases were searched: Scopus, CINAHL (EBSCO), APA PsycInfo (EBSCO), Eric (EBSCO), and ProQuest Dissertations and Theses. No date limitations were applied. The search was carried out in January 2024 and supplemented by citation searches in June 2024. Results The initial search yielded 14,115 papers; the citation search produced 226 additional references. Nineteen studies in total met the inclusion criteria. Across the 19 studies, there is a wide variety of research designs and a range of crafts used as media for therapy. Interventions were delivered or supervised by either art therapists, nurses, or occupational therapists. Only nine studies report the theoretical basis for the intervention. Treatment duration varies from 10 min to 16 weeks. Quality assessment revealed the quality of the studies varies considerably, with some studies of high‐quality and many suffering from methodological weaknesses. Common issues relating to risk of bias include failure to blind assessors; incomplete data and lack of clarity about how the intervention was administered. All the studies report short‐term improvements in the outcomes measured, which include anxiety, stress, depression, interest in life, self‐efficacy, social skills, sociability, mood, well‐being, self‐esteem, life satisfaction, health‐related quality of life, and hopelessness. Due to the wide variation in interventions, research designs, outcomes, outcome measures, and research quality, it is difficult to draw firm conclusions about the effectiveness of crafts‐based interventions. Conclusion There is some evidence that crafts‐based interventions may benefit mental health and well‐being, but more high‐quality research is needed, including on the mechanisms through which crafts‐based interventions operate. Consumer and community involvement No consumer or community involvement. PLAIN LANGUAGE SUMMARY Reports from the media suggest that doing crafts may improve mental health. Crafts are, for example, knitting, sewing, and pottery. Therapists have used crafts for years to treat mental illnesses. However, there is no strong proof that these treatments are effective for clients or worth the cost. This paper reviews the effects of craft‐based treatments. The review found 19 studies that looked at whether people felt better after doing crafts. The participants included men and women with various physical, mental, and social problems. These issues included mental disorders, osteoarthritis, epilepsy, and dementia. Pottery, embroidery, knitting, papercraft, and woodwork were used. Some people did crafts for 10 min, while others had several sessions over weeks. All 19 studies showed that mood and life satisfaction improved after the treatment. But, only one study checked if these improvements lasted in the weeks after. It is encouraging to see that people feel better after doing crafts. But, these 19 studies together do not prove that the benefits last long‐term. More research is needed to get clearer answers.

Introduction The degree of perceived enjoyment of performed physical activity may be a key aspect with relevance for the effort to get people to be physically active. Spinning, or indoor cycling, is a widespread physical activity that can be performed in a group or individually. The effect of the group element on the enjoyment of spinning remains unclear. Therefore, the purpose of the present study was to test the hypothesis that enjoyment was greater during spinning exercise performed in a group session as compared to individually. Methods Twenty recreationally active persons (56 ± 6 years, 1.74 ± 0.09 m, 81.0 ± 14.7 kg, and BMI of 26.5 ± 3.7) performed 44-min group and individual instructor-led spinning sessions. Values of power output, heart rate, and cadence were recorded during the sessions. Perceived enjoyment of the exercise was determined by means of a questionnaire (PACES-8) after the exercise. Results Values of power output, heart rate, and cadence were not different between the two sessions. Enjoyment was statistically significantly greater by 1.4 ± 2.1 points (p = 0.005) during spinning performed in a group session as compared to individually. As a reference framework, 56 points is the maximal sum score. Conclusions The difference in enjoyment between conditions was modest and clinically insignificant. In other words, the group element of the spinning session was considered to be of minor importance for the participants' perception of enjoyment.

Friendships are vital for the well-being of young adults, yet their social network is often reduced during episodes of life-disruptive mental distress, such as psychosis. Despite this, our study shows that young adults do either maintain or build friendships during such periods and that these relationships are crucial for recovery in youth. As research on the role of friendships in the recovery journey of this group is limited, this study explores the significance of friendships for young adults engaged in early psychosis interventions to generate insights that can inform mental health recovery practices. In-depth life-story and intensive interviews were conducted with six young adult users of early psychosis intervention OPUS. Using abductive thematic analysis, two main themes and four subthemes emerged: (1) "Seeking different kinds of recovery support with different types of friends" with subthemes (1.1) "Seeking safety in life-witnessing friendships" and (1.2) "Shaping identity with friends in communities of interest"; and (2) "Belonging and unbelonging with friends and their significance to recovery in youth" with subthemes (2.1) "Struggling with friendship expectations perpetuates social isolation" and (2.2) "Connecting with friends enables belonging to humanity as a whole." The findings highlight that, while social isolation can reinforce feelings of alienation, belonging with friends instills a sense of hope and meaning. The involvement of friends in early psychosis interventions may enhance social skills training, strengthen social bonds, and support the inclusion and well-being of young adults.

Background: Nutritional risks in older adults, such as malnutrition and sarcopenia, are often underdiagnosed. Screening practices frequently rely on Unplanned Weight Loss (UPWL), potentially overlooking at-risk individuals. This study aims to assess the prevalence of nutritional risk, identified by UPWL and sarcopenia, across different body mass index categories in a nursing home (NH) population. Methods: Cross-sectional data were collected from an NH in a Danish municipality, including those of all self-reliant participants who consented and excluding those of terminally ill older adults. Data on age, sex, height, weight, and chronic diseases were extracted from medical records. Nutritional risk was assessed using two markers: a UPWL of ≥1 kg during the last six months and muscle strength via a modified 30 s chair stand test as a marker of sarcopenia. An ANOVA and Fisher’s Exact Test were used to assess differences, followed by a post hoc Tukey test. Results: In our study of older adults (n = 93, mean age 83.2 ± 9.12 years, 63% female), 17 individuals (19%) had UPWL, and 27 (29%) had sarcopenia. Among those with obesity, twelve (48%) had sarcopenia, but only two (8%) had UPWL. In contrast, seven (21%) of those with normal weight had sarcopenia, while eleven (33%) experienced UPWL. Conclusions: Older adults in NHs are at nutritional risk, but the prevalence varies significantly depending on whether UPWL or sarcopenia markers are applied for categorization. Sarcopenia prevalence was the highest in the obesity group, suggesting a need for integrating muscle strength or quantity assessments into community care to identify older adults at nutritional risk better.

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.

Background Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by activity-induced pain along the distal medial tibial border. Current best practice includes rest and progressive resistance training. However, some patients with MTSS may be unable to tolerate the loading during exercise. Blood-flow restriction training using low loads (LL-BFR) may induce similar physiological and structural adaptations as heavy resistance training but without peak loads. This could potentially allow the athlete to continue sports activities during rehabilitation. Purpose The purpose of this case series was to describe an exercise program utilizing LL-BFR training for athletes with running-related MTSS. Study design Case series Methods Six recreational athletes (one handball player, one soccer player, and four runners) with MTSS were recruited. Inclusion criteria included pain along the distal two-thirds medial tibial border occurring during or after activity. Exclusion criteria were symptoms of compartment syndrome, tibial stress fracture, or contraindications for BFR training. Participants underwent a progressive six-week home-based LL-BFR training intervention with three sessions per week and were allowed to continue sports activities if pain was ≤ NRS 5. Outcome measures included change in standardized running performance (distance and pain level), pain pressure threshold (algometry), and self-reported physical function. Results Five athletes experienced improvements in running performance (pain and/or distance) and self-reported function. One athlete sustained an injury unrelated to the LL-BFR training, and therefore the running post-test could not be completed. Adherence to exercise was high, and post-test interviews revealed positive feedback on the training method, with no side effects reported. Conclusion This case series demonstrated that following a therapeutic exercise program utilizing LL-BFR training improvements in pain and function were seen in athletes with MTSS. BFR may allow clinicians to prescribe lower-load exercises, facilitating continued sports participation. Future research should compare the effectiveness of exercise programs for MTSS with and without LL-BFR training. Level of Evidence Level V

Introduction: Bitewing examinations are used to examine the pediatric dental status. The aim of this study was to compare the image quality and radiation dose between two different X-ray systems used for pediatric bitewing imaging. Materials and methods: Data were obtained from both pediatric in vivo bitewing studies and phantom studies. Two X-ray systems were used: Trophy CCX digital (TCCX) (Trophy Irix 70, Marne-la-Vallee, France) and Planmeca Pro X (PPX) (Planmeca, Helsinki, Finland). An Unfors dosimeter (Unfors EDD-30, Billdal, Sweden) was used to measure the skin dose. Image quality was evaluated blindly by three experienced dentists using a Likert scale of 1-5 based on the visual representation of the anatomical structures with emphasis on caries. Results: The highest scoring in vivo bitewing images were obtained with TCCX, but the skin dose was 36% higher (mean 3029 ± 613 μGy) and 113% higher (mean 1364 ± 276 μGy) with standard settings than with compared to PPX. The evaluation of image quality revealed a higher median value for all ratings of TCCX compared to PPX for both the patient and phantom studies, meaning that the images of TCCX were rated as higher quality than the images from PPX. No correlation was found between the median score and the skin dose or between the median score and the exposure times. Conclusion: A significant difference in radiation dose and image quality was found between TCCX and PPX in bitewing imaging. TCCX generally produced higher doses and better graded images, although all images were suitable for diagnosis.

Background The age of Danish women giving birth to their first child has risen throughout the last 50 years, and the number of women and men who are having their first child when they are at advanced maternal or paternal age is increasing worldwide. Postponing parenthood is not unique to Denmark, as the same pattern is seen especially in other European and Western countries. The aim of this study was in a social media setting to explore reflections on the timing of motherhood among Danish women of reproductive age who not yet had children. Method This study was a qualitative study based on three online focus groups on Facebook. Twenty-six women of reproductive age discussed the timing of motherhood for three days in January 2020. Data were analyzed using Systematic Text Condensation. Results Three main themes were identified: ‘Life before parenthood’, ‘To plan for a child’ and ‘A life without children’. Several external and internal conditions influence whether and if so when women consider becoming mothers. Regarding the biological capacity for having children, women compare themselves with their female relatives and friends and colleagues regarding the social norms surrounding motherhood. Women with no children often experience either positive or negative pressure from family, friends, and colleagues regarding when to have children. Conclusion Several internal and external considerations influence when and if women become mothers. Social surroundings such as family, friends, and colleagues have an impact on women’s reproductive considerations in terms of pressure to have children in the future. Danish women tend to compare their reproductive capacity to their female relatives and compare the social norms surrounding motherhood to their female friends. Women in this study were positive towards discussing the timing of motherhood with other women of reproductive age on social media.

Children with disabilities often become separated from their families when their place of residence and care is relocated outside the family home. These separations have both benefits and challenges, creating dilemmas for parents and professionals regarding what is in the child’s best interests. To better understand these circumstances, we explore, in this chapter, the nature of these separations in the contrasting national contexts of Tanzania and Denmark, examining their differences and similarities. We find that in Tanzania, factors such as poverty and superstition play a significant role in these separations, whereas in Denmark, parents’ ambivalent feelings towards separation emerge as a critical factor. However, regardless of the setting, the key to addressing these challenges is collaboration with parents. Whether the children continue to reside in institutions, apart from their families, or eventually return home after receiving institutional care, this collaboration is a priority. We conclude the chapter by exploring how this crucial collaboration with parents can be effectively facilitated in such circumstances.

This article presents insights gained from conversations with Arlie Hochschild, which challenged my initial assumptions and encouraged a nuanced integration of sociological and psychological perspectives in exploring children’s wellbeing through their experiences and management of emotional demands within institutional settings. Drawing on parallels between adults who are adept at managing emotions in societal contexts, such as flight attendants, and the challenges faced by children, Hochschild illuminated the distinctive nature of children’s emotional experiences. These insights enriched the theoretical foundation of my research, offering new perspectives on children’s emotion work within institutional settings. By investigating the emotional demands children face during their transition from kindergarten to school and after-school care, the article sheds light on the influence of schools’ approaches to children’s wellbeing and emotional experiences. The findings underscore the importance of considering children’s genuine emotional experiences in wellbeing initiatives, particularly in navigating expectations to be happy.

Protein increases satiety by, among other things, increasing the content of certain amino acids in the blood. Plant proteins generally have a lower digestibility than meat proteins. The digestibility increases after extrusion; thereby, extrusion potentially also increases the satiating effect. We investigated subjective appetite and ad libitum energy intake (adlib_EI) following ragú “bolognaise” meals with three different protein sources. We hypothesized that the satiating effect of texturized vegetable proteins (TVP) was comparable to that of animal protein (Meat) and that TVPs would have a stronger satiating effect than non-texturized legume proteins (Green). Test meals were theoretically designed to be similar in weight, energy (kJ), macronutrients and fiber. The in vitro protein digestibility (IVPD) and the amino acid composition were analyzed. A randomized, single-blinded, three-way, cross-over study including 25 healthy men was carried out. There were no significant differences between the three meals in terms of subjective appetite. The adlib_EI was significantly lower after the TVP meal (758 kJ) than after the Meat meal (957 kJ), with the Green meal in between (903 kJ). The IVPD was significantly higher in the Meat meal (30.72%) than in the Green meal (20.17%), with the TVP meal in between (21.05%). In conclusion, the TVP meal had a higher long-term satiating effect than a similar meal with meat.

Knowledge of how to treat chronic tendinopathy has advanced in recent years, but the treatment of early tendinopathy is not well understood. The main purpose of this prospective observational study was to investigate if changes occur in clinical and imaging outcomes over 12 weeks in elite athletes with recent debut of tendinopathy. Sixty‐five elite adult athletes (24 ± 5 years) with early Achilles or patellar tendinopathy (symptoms < 3 months) were examined at baseline and after 12 weeks. Patients were divided into groups based on the duration of symptoms at the time of inclusion: (T1): 0–1 month, (T2): 1–2 months, or (T3): 2–3 months. Pain‐guided activity modification was the only intervention. We assessed the following clinical outcomes: Questionnaires (Victorian Institute of Sports Assessment (VISA)) and pain scores (0–10 numeric rating scale, NRS), structural outcomes from ultrasonography: Thickness, echogenicity, and Doppler flow, and from magnetic resonance imaging: Cross‐sectional area (CSA), thickness and length. Tendinopathic Achilles and patellar tendons displayed no significant differences on imaging tendon structural outcomes between T1 (n = 19), T2 (n = 23), and T3 (n = 20) at baseline or after 12 weeks, with one exception: Patellar tendons in T1 were thicker than T2 and T3 at baseline. Although athletes improved clinically on VISA and most NRS scores after 12 weeks, affected tendons with greater thickness, CSA and Doppler flow than contralateral tendons at baseline remained unchanged after 12 weeks. In conclusion, these data suggest that early tendinopathy in elite athletes can improve clinically after 12 weeks while morphology remains unchanged.

Compositional changes in relation to musculoskeletal injuries are difficult to measure non-invasively. This study aims to use non-invasive label-free imaging with Multispectral Optoacoustic Tomography (MSOT) to evaluate compositional changes with injury. Five different patient groups were examined, covering diagnoses of Achilles or patellar tendinopathy, Achilles tendon rupture and gastrocnemius muscle strain injury. Injured and contralateral limbs were imaged using a commercial MSOT device. Hemoglobin, collagen, and lipid contents were estimated. Some patients were examined before and after exercise. Hemoglobin measures had high reproducibility and displayed systematic changes in response to exercise. The content and exercise response of hemoglobin was equal on both limbs. In contrast, collagen and lipid measures were inconsistent and did not display the expected distribution. In conclusion, MSOT is applicable to imaging of hemoglobin in musculoskeletal injuries, providing complimentary information to conventional ultrasound, but applicability to other components like collagen and lipids could not be shown.

Background Little is known about delivering telehealth from a healthcare provider’s perspective. Purpose To investigate physiotherapists’ (PTs) experiences in delivering live online exercise and education for people with knee osteoarthritis (OA). Methods This was a qualitative individual interview study with a thematic analysis approach. The interviewees were six PTs delivering 8 weeks of supervised online exercise and education for people with knee OA in secondary public care in Denmark. Results The three main themes were (1) From hands to words —on the transition from on‐site to on‐line physiotherapy, (2) Online selection —on the perceived barriers to managing a telehealth service and (3) Therapeutic relation under pressure —on the contextual difficulties in building relationships and alliances in online classes. Conclusion The PTs in this study seemed to gradually come to terms with delivering first‐line OA care online, appreciating advantages and new possibilities. PTs’ initial apprehension towards this new form of physiotherapy service may be rooted in the traditional conception of physiotherapy as a predominantly manual profession but also in a lack of formal training in physiotherapy telehealth services. This study underlines the growing need for better and more formalised training in physiotherapy telehealth services to meet growing demands.