Published in 2021

'Standing together - at a distance': Documenting changes in mental-health indicators in Denmark during the COVID-19 pandemic

Clotworthy, A., Dissing, A. S., Nguyen, T-L., Jensen, A. K., Andersen, T. O., Bilsteen, J. F., Elsenburg, L. K., Keller, A., Kusumastuti, S., Mathisen, J., Mehta, A., Pinot de Moira, A., Rod, M. H., Skovdal, M., Strandberg-Larsen, K., Tapager, I. W., Varga, T. V., Vinther, J. L., Xu, T., Hoeyer, K. & Hulvej Rod, N., feb. 2021, I: Scandinavian Journal of Public Health. Supplement. 49, 1, s. 79-87 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Aims: There is a need to document the mental-health effects of the COVID-19 pandemic and its associated societal lockdowns. We initiated a large mixed-methods data collection, focusing on crisis-specific worries and mental-health indicators during the lockdown in Denmark. Methods: The study incorporated five data sources, including quantitative surveys and qualitative interviews. The surveys included a time series of cross-sectional online questionnaires starting on 20 March 2020, in which 300 (3×100) Danish residents were drawn every three days from three population groups: the general population (N=1046), families with children (N=1032) and older people (N=1059). These data were analysed by trend analysis. Semi-structured interviews were conducted with 32 people aged 24-83 throughout Denmark to provide context to the survey results and to gain insight into people's experiences of the lockdown. Results: Absolute level of worries, quality of life and social isolation were relatively stable across all population groups during the lockdown, although there was a slight deterioration in older people's overall mental health. Many respondents were worried about their loved ones' health (74-76%) and the potential long-term economic consequences of the pandemic (61-66%). The qualitative interviews documented significant variation in people's experiences, suggesting that the lockdown's effect on everyday life had not been altogether negative. Conclusions: People in Denmark seem to have managed the lockdown without alarming changes in their mental health. However, it is important to continue investigating the effects of the pandemic and various public-health measures on mental health over time and across national contexts.

Originalsprog Engelsk
Bogserie Scandinavian Journal of Public Health. Supplement
Vol/bind 49
Udgave nummer 1
Sider (fra-til) 79-87
Antal sider 9
ISSN 1403-4956
DOI
Status Udgivet - feb. 2021

A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

Barbateskovic, M., Koster, T. M., Eck, R. J., Maagaard, M., Afshari, A., Blokzijl, F., Cronhjort, M., Dieperink, W., Fabritius, M. L., Feinberg, J., French, C., Gareb, B., Geisler, A., Granholm, A., Hiemstra, B., Hu, R., Imberger, G., Jensen, B. T., Jonsson, A. B., Karam, O., Kong, D. Z., Korang, S. K., Koster, G., Lai, B., Liang, N., Lundstrøm, L. H., Marker, S., Meyhoff, T., Nielsen, E. E., Nørskov, A. K., Munch, M. W., Risom, E. C., Rygård, S. L., Safi, S., Sethi, N., Sjövall, F., Lauridsen, S. V., van Bakelen, N., Volbeda, M., van der Horst, I., Gluud, C., Perner, A., Møller, M. H., Keus, F. & Wetterslev, J., 6 feb. 2021, (E-pub ahead of print) I: Journal of Clinical Epidemiology. 135, s. 29-41 13 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.

STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.

RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age; sex; patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention; timing; control intervention; cointerventions);and outcome (definition of outcome; timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.

CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

Originalsprog Engelsk
Tidsskrift Journal of Clinical Epidemiology
Vol/bind 135
Sider (fra-til) 29-41
Antal sider 13
ISSN 0895-4356
DOI
Status E-pub ahead of print - 6 feb. 2021
Originalsprog Engelsk
Tidsskrift Archives of Physiotherapy
ISSN 2057-0082
Status Afsendt - jun. 2021

A systematic review and meta-analysis of observational studies on the association between animal protein sources and risk of rheumatoid arthritis

Asoudeh, F., Jayedi, A., Kavian, Z., Ebrahimi-Mousavi, S., Nielsen, S. M. & Mohammadi, H., jul. 2021, I: Clinical nutrition (Edinburgh, Scotland). 40, 7, s. 4644-4652 9 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

OBJECTIVE: The aim of this study was to investigate the linear and nonlinear dose-response associations of animal-based dietary protein intake and risk of developing rheumatoid arthritis (RA).

METHODS: A systematic search of MEDLINE, Scopus and Embase was conducted up to October 2020. Observational studies that report risk estimates of RA for animal-based protein consumption were included. We calculated pooled relative risks (RRs) by using a random-effects model. Linear and non-linear dose-response analyses were performed to examine the dose-response relations between animal-based protein consumption and RA.

RESULTS: Seven cohort studies (n = 457,554) with 3545 incident cases and six case-control studies with 3994 cases and 5252 controls were identified. Highest compared with the lowest category of fish consumption was inversely associated with risk of RA (RR: 0.89; 95% CI, 0.80 to 0.99; I2 = 0%, n = 10). Also, a 100 g/day increment in fish intake was associated with a 15% decreased risk of RA. Dose-response analysis showed a modest U-shaped association between fish consumption and incidence of RA, with the lowest risk at a fish intake of 20-30 g/day (Pnon-linearity = 0.04). We found no significant association between consumption of red meat, poultry or dairy and the risk of RA.

CONCLUSION: The present study revealed a significant reverse association between fish consumption and risk of RA. While we observed no association between red meat, dairy or poultry consumption and risk of RA. Further well-designed prospective studies are needed to support our findings.

Originalsprog Engelsk
Tidsskrift Clinical nutrition (Edinburgh, Scotland)
Vol/bind 40
Udgave nummer 7
Sider (fra-til) 4644-4652
Antal sider 9
ISSN 0261-5614
DOI
Status Udgivet - jul. 2021

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992-2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6-24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2-30.7)) than among boys (18.5 (18.0-19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0-5 years and 12-15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

Originalsprog Engelsk
Artikelnummer 8331
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 18
Udgave nummer 16
ISSN 1661-7827
DOI
Status Udgivet - 6 aug. 2021

Appraisal of Candidate Instruments for Assessment of the Physical Function Domain in Patients with Psoriatic Arthritis

Leung, Y. Y., Orbai, A-M., Ogdie, A., Hojgaard, P., Holland, R., Goel, N., Chau, J., Coates, L. C., Strand, V., Gladman, D. D., Mease, P. J., Christensen, R. & Tillett, W., 1 jan. 2021, I: Journal of Rheumatology. 48, 1, s. 58-66 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.

METHODS: A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.

RESULTS: Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.

CONCLUSION: Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 48
Udgave nummer 1
Sider (fra-til) 58-66
Antal sider 9
ISSN 0315-162X
DOI
Status Udgivet - 1 jan. 2021

By utilizing historical changes in Danish legislation related to mandatory vitamin D fortification of margarine, which was implemented in the mid 1930s and abruptly abandoned in June 1985, the studies in the D-tect project investigated the effects of vitamin D on health outcomes in individuals, who during gestation were exposed or unexposed to extra vitamin D from fortified margarine. This paper reviews and narratively summarizes the analytic approaches alongside the results of the societal fortification experiment studies from the D-tect project and addresses the challenges in designing societal experiment studies and evaluating their results. The latter are discussed as lessons learned that may be useful for designers of similar studies, expected to be extensively utilized while researching the health consequences of the COVID-19 pandemic by comparing individuals born before and after the epidemic. In the D-tect project, 16 articles based on the societal fortification experiment were published analyzing 10 different outcomes and using different statistical approaches. Lessons learned included the detail of the analysis of the historical information on the exposure, availability and validity of the outcome data, variety of analytical approaches, and specifics concerning vitamin D effect evaluation, such as consideration of the influence of sunshine or season. In conclusion, the D-tect project clearly demonstrated the cost-effectiveness and research potential of natural- or societal-experiment-based studies.

Originalsprog Engelsk
Artikelnummer 8136
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 18
Udgave nummer 15
ISSN 1661-7827
DOI
Status Udgivet - 31 jul. 2021

OBJECTIVE: We assessed the association of suPAR (soluble urokinase plasminogen activator receptor) plasma levels with fibrotic and vascular manifestations in patients with systemic sclerosis (SSc).

METHODS: suPAR plasma levels were measured in 121 consecutive patients with SSc and correlated to pulmonary and vascular features of SSc, including interstitial lung disease as characterized by percentage of predicted CO diffusing capacity (DLco) and forced vital capacity (FVC), pulmonary fibrosis by computed tomography, and pulmonary arterial hypertension, telangiectasias, and digital ulcers.

RESULTS: Overall, 121 SSc patients (84% females; mean age, 57 ± 12 [range: 22-79] years) were enrolled; 35% had diffuse cutaneous SSc. suPAR plasma levels ranged from 1.3-10.2 [median: 2.9 (p25-p75: 2.3-3.9)] ng/mL. Log(suPAR) levels correlated with DLco (r = -0.41, p <0.0001) and FVC (r = -0.26, p = 0.004), also when adjusted for age, sex, and pulmonary hypertension. A suPAR cut-off level of >2.5 ng/mL showed a sensitivity of 91% for identifying patients with either DLco <50% or FVC < 60% of the predicted values. Similarly, 19 (90%) had a suPAR >2.5 ng/mL among those diagnosed with pulmonary fibrosis vs. 59 (60%) among those who did not (p = 0.008). suPAR values were not associated with vascular manifestations.

CONCLUSION: suPAR levels strongly correlated with pulmonary involvement in SSc. Future studies should test if suPAR estimation can be used for surveillance of severe pulmonary involvement in SSc.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 16
Udgave nummer 2
Sider (fra-til) e0247256
ISSN 1932-6203
DOI
Status Udgivet - 22 feb. 2021

Pickiness is an eating behavior that many families with young children face. Having joint family meals may impact the child's pickiness, for instance by influencing their willingness to try novel foods. Moreover, picky children have been shown to display greater emotionality. The aim of this study was to investigate if children's mental well-being and parent-reported conflicts during mealtime were associated with pickiness among obesity-prone children. Data was obtained from the baseline examination of the Healthy Start intervention study, the Danish Medical Birth registry and the Danish Health Visitor's Child Health Database, and included 635 children aged 2-6 years that were all at high risk for becoming overweight later in life. Children's mental well-being was measured by the strengths and difficulties questionnaire. Crude and adjusted ordinal logistic regressions were used to investigate the cross-sectional associations. Children had a higher odds associated with changing from a category of less pickiness to a category of more pickiness for each one point higher SDQ score (ORadj. = 1.35, 95% CI = 1.14; 1.61) and lower odds (ORadj. = 0.57, 95% CI = 0.38; 0.86) associated with changing pickiness category towards more pickiness for each one point higher SDQ prosocial score. Moreover, children with conflicts during mealtime had higher odds of being in a worse pickiness category compared to children without conflicts (ORadj. = 3.37, 95% CI = 2.27; 5.01). This study showed that among obesity-prone children, behavioral problems, as well as conflicts during mealtime, were associated with more picky behaviors. Further longitudinal studies are needed to confirm the findings, as are studies including general child population subsets.

Originalsprog Engelsk
Artikelnummer 5621
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 18
Udgave nummer 11
ISSN 1661-7827
DOI
Status Udgivet - jun. 2021

BACKGROUND: Cross-sectional studies indicate that parental stress may be a barrier for healthy dietary behaviours among children. However, there is a lack of evidence from longitudinal studies on the association between parental stress and changes in dietary intake among toddlers. The aim of this study was to examine the association between parental stress and changes in dietary intake and quality among preschool children susceptible to obesity.

METHODS: In the Healthy Start study, parents to 250 preschool children had completed a modified version of the Parental Stress Index and assessed the dietary intake of their children at baseline and after 15 months of follow up. The association between parental stress and changes in dietary intake and quality was examined using multiple linear regression analyses with adjustment for potential confounders. We tested for potential effect modification by group allocation and sex.

RESULTS: There were no significant associations between parental stress and subsequent changes in child total energy intake, intake of macronutrients or intake of fruit, vegetables, sugar sweetened beverages, fish or starch, or dietary quality.

CONCLUSION: This study provides no evidence to support an association between parental stress and subsequent change in dietary intake and quality of their children.

TRIAL REGISTRATION: ClinicalTrials.gov, Trial number: NCT01583335, Registered: 31 March 2012, retrospectively registered.

Originalsprog Engelsk
Artikelnummer 3590
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 18
Udgave nummer 7
ISSN 1661-7827
DOI
Status Udgivet - apr. 2021

Awareness and Expectations Surrounding Family Planning and Pregnancy Among Danish Patients with Chronic Inflammatory Disease of the Skin or Joints: Results from an Online Survey

Johansen, C. B., Laurberg, T. B., Egeberg, A., Jensen, U. F. A., Hansen, A. L., Skov, L., Kristensen, L. E., Thomsen, S. F. & Schreiber, K., 14 aug. 2021, I: Rheumatology and Therapy. 8, 3, s. 1419-1433 15 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background: Patients with chronic inflammatory diseases (CIDs) may encounter challenges in their family planning journey. Here, we report on the access to family planning and pregnancy (FPP) information and the concerns among patients in Denmark with CIDs. Methods: Patients aged 18–50 years with CIDs participated in an online survey. Patients were recruited through patient advocacy groups and were asked to report information on their diagnosis, concerns related to FPP and perceptions of access to FPP information. Descriptive statistics were applied. Results: Of the eligible respondents, 368 had rheumatological diagnoses (rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis or axial spondyloarthritis; mean age 40 years; 83% women, 17% men) and 95 had dermatological diagnoses (psoriasis or psoriatic arthritis; mean age 38 years; 67% women, 33% men). Approximately 70% of all patients reported seeking FPP information from patient advocacy groups; 57% of both cohorts used the internet as information sources; and 73% and 42% of rheumatological and dermatological cohorts used their hospital and specialist doctor, respectively. Despite this, 58% and 67% of patients with rheumatological and dermatological diagnoses reported limited or no access to FPP information, with > 70% of dermatological patients of early/mid-reproductive age reporting a lack of access to this information. Overall, 68% of patients with rheumatological and 73% with dermatological diagnoses had biological children, amongst whom 24% and 18%, respectively, indicated their disease affected the number of children they ultimately decided to have. The most frequent FPP concerns among patients who did not want any/more biological children were disease worsening, heredity and taking care of the child. Conclusions: Despite awareness of available sources of FPP information, patients expressed experiencing a feeling of limited access to information and having concerns that affect key decisions regarding FPP. The results of this survey highlight a need for improved and more standardised FPP information for patients with CIDs in Denmark.

Originalsprog Engelsk
Tidsskrift Rheumatology and Therapy
Vol/bind 8
Udgave nummer 3
Sider (fra-til) 1419-1433
Antal sider 15
ISSN 2198-6576
DOI
Status Udgivet - 14 aug. 2021

Bibliografisk note

Funding Information:
The authors also acknowledge Vanessa Omnou, MSc, and Beverley Wilson, PhD, Costello Medical, UK, for medical writing and editorial assistance based on the authors’ input and direction. This study was funded by UCB Pharma in accordance with Good Publication Practice (GPP3) guidelines ( http://www.ismpp.org/gpp3 ).

Funding Information:
The authors thank the participants, the patient advocacy groups (The Arthritis Association [Gigtforeningen], The Association for Spinal Arthritis and Bechterew's Disease [Foreningen for Rygs?jlegigt og Morbus Bechterew] and The Psoriasis Association [Psoriasisforeningen]), the investigators and their teams who took part in this study. Survey implementation and data collection was managed by Incentive Denmark. This study and Rapid Service Fee was funded by UCB Pharma. The authors also acknowledge Vanessa Omnou, MSc, and Beverley Wilson, PhD, Costello Medical, UK, for medical writing and editorial assistance based on the authors? input and direction. This study was funded by UCB Pharma in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3). All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Substantial contributions to study conception and design: C?cilie B Johansen, Trine B Laurberg, Alexander Egeberg, Ulla-Fie A Jensen, Asbj?rn L Hansen, Lone Skov, Lars E Kristensen, Simon F Thomsen and Karen Schreiberf. Substantial contributions to analysis and interpretation of the data: C?cilie B Johansen, Trine B Laurberg, Alexander Egeberg, Ulla-Fie A Jensen, Asbj?rn L Hansen, Lone Skov, Lars E Kristensen, Simon F Thomsen and Karen Schreiberf. Drafting the article or revising it critically for important intellectual content: C?cilie B Johansen, Trine B Laurberg, Alexander Egeberg, Ulla-Fie A Jensen, Asbj?rn L Hansen, Lone Skov, Lars E Kristensen, Simon F Thomsen and Karen Schreiberf. Final approval of the version of the article to be published: C?cilie B Johansen, Trine B Laurberg, Alexander Egeberg, Ulla-Fie A Jensen, Asbj?rn L Hansen, Lone Skov, Lars E Kristensen, Simon F Thomsen and Karen Schreiberf. An abstract summarising data from this manuscript was submitted to, and accepted for poster presentation at the European Alliance of Associations for Rheumatology (EULAR) 2020 Virtual Congress (from 3 June 2020; online): Schreiber K, Johansen C, Jensen UF, et al. PARE0024 Awareness about family planning and pregnancy expectation among patients with chronic inflammatory disease of the skin or joints (Annals of the Rheumatic Diseases 2020;79:1297?1298). C?cilie B Johansen: Advisory Boards for UCB Pharma; honoraria as consultant and/or speaker for Galderma, Estee Lauder Companies L'Or?al. Trine B Laurberg: Consultant and/or Advisory Boards for AbbVie and UCB Pharma. Karen Schreiberf: Consultant and/or Advisory Boards for UCB Pharma. Alexander Egeberg: Research funding from AbbVie, Bristol-Myers Squibb, the Danish National Psoriasis Foundation, Eli Lilly, Janssen Pharmaceuticals, the Royal Hofbundtmager Aage Bang Foundation, the Simon Spies Foundation, Novartis and Pfizer; honoraria as consultant and/or speaker from AbbVie, Almirall, Bristol-Myers Squibb, Dermavant, Eli Lilly, Janssen Pharmaceuticals, Galapagos NV, Galderma, LEO Pharma, Mylan, Novartis, Pfizer, Samsung Bioepis Co. Ltd., Sun Pharmaceuticals and UCB Pharma. Ulla-Fie A Jensen: Employee of UCB Pharma. Asbj?rn L Hansen: Former employee of UCB Pharma. Lone Skov: Speaker for AbbVie, Sanofi, Eli Lilly, LEO Pharma and Novartis; consultant and/or Advisory Boards for AbbVie, Almirall, Eli Lilly, Janssen Pharmaceuticals, LEO Pharma, Novartis, UCB Pharma, BMS and Sanofi; research and educational grants from AbbVie, Janssen Pharmaceuticals, LEO Pharma, Novartis, BMS and Sanofi. Lars E Kristensen: Consultant and/or Advisory Boards and/or speaker for AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen Pharmaceuticals, MSD, Novartis, Pfizer, Sanofi and UCB Pharma. Simon F Thomsen: Consultant and/or Advisory Boards for AbbVie, Almirall, Celgene, Eli Lilly, Janssen Pharmaceuticals, LEO Pharma, Novartis, Pfizer, Roche and Sanofi; speaker for AbbVie, Eli Lilly, LEO Pharma, Novartis, Sanofi and UCB Pharma; research support from Abbvie, LEO Pharma, Janssen Pharmaceuticals, Novartis, Sanofi and UCB Pharma. Ethics approval was not required for this study. Under Danish legislation, questionnaire survey projects not involving human biological material are exempt from the obligation to notify the scientific ethics committee (Section 14 (2) of the Committee Act). Respondents were provided information on the conduct of the survey and had to provide consent before participating. Respondents were informed that the knowledge collected in the survey would be published and had to provide consent before participating. Data from non-clinical studies is outside of UCB?s data-sharing policy.

Publisher Copyright:
© 2021, The Author(s).

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Breast cancer rate after oophorectomy: A Prospective Danish Cohort Study

Koch, T., Jørgensen, J. T., Christensen, J., Dehlendorff, C., Priskorn, L., Simonsen, M. K., Duun-Henriksen, A. K., Andersen, Z. J., Juul, A., Bräuner, E. V. & Hickey, M., 1 aug. 2021, I: International Journal of Cancer. 149, 3, s. 585-593 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The association between oophorectomy and risk of breast cancer in the general population is uncertain. The aim of our study was to determine the breast cancer rate in women from the general population after oophorectomy (performed before/after menopause), and whether this varies by use of hormone replacement therapy (HRT), hysterectomy, body mass index (BMI) and shift work. The study included 24 409 female nurses (aged ≥45 years) participating in the Danish Nurse Cohort. Nurses were followed from cohort entry until date of breast cancer, death, emigration or end of follow-up at 31 December 2018, whichever came first. Poisson regression with log-transformed person-years as the offset examined the association between oophorectomy and breast cancer (all ages and stratified by menopausal status at time of oophorectomy). The potential modifying effect of HRT use, hysterectomy, BMI and shift work on the associations was estimated. During 502 463 person-years of follow-up, 1975 (8.1%) nurses were diagnosed with breast cancer. Bilateral oophorectomy was associated with a reduced breast cancer rate compared to nurses with preserved ovaries, adjusted rate ratio (95% confidence interval): 0.79 (0.64; 0.99). Similar associations (magnitude and direction) were detected for unilateral oophorectomy and when stratifying according to menopausal status at time of oophorectomy, but without statistical significance. Unilateral and bilateral oophorectomy is associated with a reduced breast cancer rate in women from the general population. This association is not modified by use of HRT, hysterectomy, BMI or shift work.

Originalsprog Engelsk
Tidsskrift International Journal of Cancer
Vol/bind 149
Udgave nummer 3
Sider (fra-til) 585-593
Antal sider 9
ISSN 0020-7136
DOI
Status Udgivet - 1 aug. 2021

Unintended negative outcomes on child behavior due to lockdown and home confinement following the corona virus disease (COVID-19) pandemic needs highlighting to effectively address these issues in the current and future health crises. In this sub-study of the ODIN-study, the objectives were to determine whether the Danish lockdown and home confinement following the COVID-19 pandemic affected changes in emotional-behavioral functioning of pre-school-aged children using the validated Strength and Difficulties Questionnaire (SDQ) answered by parents shortly before lockdown and 3 weeks into lockdown, and moreover, to examine whether baseline family and social characteristics could predict change in child emotional-behavioral functioning during lockdown. Parents of 40 (82%) children with a mean(SD) age of 5.0(0.7) completed the baseline questionnaire and the lockdown follow-up questionnaire. The SDQ-Total difficulties score (SDQ-TD) and Prosocial Behavioral score (PSB) changed significantly from pre- to lockdown [SDQ-TD mean(SD): 6.0(3.8) and 7.9(5.2); P = 0.02, respectively and PSB mean(SD): 8.5(1.4) and 7.9(1.5); P = 0.03, respectively]. Attending leisure time activities before lockdown was a predicting factor of changes to the worse in the children's SDQ-TD scores, with a mean difference in SDQ-TD between those with and without activities of 3.16 (95%CI 0.27-6.12); P = 0.03. In conclusion, the study showed a modest decrease in child-emotional behavioral functioning during the COVID-19 lockdown, potentially due to parental stress. Although these results might not be generalizable due to small sample size and selected population, the results point to a need of a greater awareness of child mental wellbeing during a lockdown situation.

Originalsprog Engelsk
Artikelnummer 643057
Tidsskrift Frontiers in Psychology
Vol/bind 12
Sider (fra-til) 643057
ISSN 1664-1078
DOI
Status Udgivet - 31 maj 2021

INTRODUCTION: Patients addicted to alcohol or drug often have additional unhealthy lifestyles, adding to the high mortality and morbidity in this patient group. Therefore, it is important to consider lifestyle interventions as part of the usual addiction treatment.

OBJECTIVE: The aim was to identify predictors of successful changes in lifestyle risk factors among patients in treatment for alcohol or drug addiction.

METHODS: We conducted a secondary analysis of a trial using a 6-week intensive integrated lifestyle intervention: The very integrated program (VIP). Patients were recruited in Addiction Centres Malmö and Psychiatry Skåne, Sweden. The primary outcome was successful changes in lifestyle, measured as quitting tobacco, exercising 30 min per day, and not being over- or underweight after 6 weeks and 12 months.

RESULTS: A total of 212 patients were included in the RCT, and 128 were included in this secondary analysis: 108 at 6 weeks and 89 at 12 months of follow-up. A total of 69 patients were respondents at both follow-ups. The follow-up rates were 51 and 42%, respectively. More education, having at least 2 lifestyle risk factors and having a high quality of life were predictors of a successful change in lifestyle after 6 weeks. After 12 months, the predictors for a successful outcome were having 3 or more risk factors, while an education level up to 3 years was a negative predictor.

CONCLUSIONS: Having several unhealthy lifestyles in addition to alcohol and drug addiction was a significant predictor of successful lifestyle changes in the short- and long term after the VIP for lifestyle interventions. Likewise, education was significant. The results should be considered in future development and research among this vulnerable group of patients.

Originalsprog Engelsk
Tidsskrift European addiction research
Vol/bind 27
Udgave nummer 2
Sider (fra-til) 123-130
Antal sider 8
ISSN 1022-6877
DOI
Status Udgivet - mar. 2021

OBJECTIVES: To explore the prognostic value of pre-specified comorbidities on treatment outcomes in PsA, and to compare baseline data with cutaneous psoriasis without arthritis and healthy controls (HC).

METHODS: Patients initiating conventional synthetic/biological disease-modifying antirheumatic drugs were enrolled in this clinical observational cohort study, and data on comorbidities, and clinical and patient-reported outcomes were retrieved at baseline and after 4 months. Pearson's chi-squared tests were performed to investigate the prognostic value of pre-specified comorbidities and achievement of ACR20, DAPSA50 and MDA. Mann-Whitney U tests were used to compare OMERACT PsA Core Outcome Set (COS) measures at baseline and follow-up for the pre-specified comorbidities.

RESULTS: A total of 100 PsA patients were included at baseline. Statistically significantly fewer patients with obesity achieved DAPSA50 compared with patients without obesity (P =0.035), and fewer patients with hypertension (P =0.034) and Charlson Comorbidity Index (CCI) ≥1 (P =0.027), respectively, achieved MDA compared with patients without these comorbidities. Patients with obesity, hypertension, widespread pain, and CCI ≥1 had significantly worse COS measures at follow-up compared with patients without these comorbidities. At baseline, patients with PsA had higher disease burden compared with patients with cutaneous psoriasis and HC, including higher pain (P <0.001) and fatigue (P <0.001) scores, and more widespread pain (P =0.002).

CONCLUSION: Obesity, hypertension and CCI ≥1 were prognostic factors for poorer treatment outcome rates in PsA. Pain and fatigue were more frequently reported among patients with PsA compared with patients with cutaneous psoriasis and HC.

TRIAL REGISTRATION: The Danish National Committee on Health Research Ethics: H-15009080; Data Protection Agency: 2012-58-0004; ClinicalTrials.gov: NCT02572700.

Originalsprog Engelsk
Tidsskrift Rheumatology (Oxford, England)
Vol/bind 60
Udgave nummer 7
Sider (fra-til) 3289-3300
Antal sider 12
ISSN 1462-0324
DOI
Status Udgivet - 1 jul. 2021

Comparison of treatment retention and response to secukinumab versus tumour necrosis factor inhibitors in psoriatic arthritis

Lindström, U., Glintborg, B., Di Giuseppe, D., Schjødt Jørgensen, T., Gudbjornsson, B., Lederballe Grøn, K., Aarrestad Provan, S., Michelsen, B., Lund Hetland, M., Wallman, J. K., Nordström, D., Trokovic, N., Love, T. J., Krogh, N. S., Askling, J., Jacobsson, L. T. H. & Kristensen, L. E., 2 aug. 2021, I: Rheumatology (Oxford, England). 60, 8, s. 3635-3645 11 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: To compare treatment retention and response to secukinumab vs adalimumab, including the other four TNF inhibitors (TNFi) as comparators, in PsA.

METHODS: All patients with PsA starting secukinumab or a TNFi in 2015-2018 were identified in the biologic registers of the Nordic countries. Data on comorbidities were linked from national registers. One-year treatment retention and hazard ratios (HRs) for treatment discontinuation were calculated. The proportion achieving a 6 month 28-joint Disease Activity Index for Psoriatic Arthritis (DAPSA28) remission was determined together with odds ratios (ORs) for remission (logistic regression). Both HRs and ORs were calculated with adalimumab as the reference and adjusted for baseline characteristics and concurrent comorbidities. All analyses were stratified by the line of biologic treatment (first, second, third+).

RESULTS: We identified 6143 patients contributing 8307 treatment courses (secukinumab, 1227; adalimumab, 1367). Secukinumab was rarely used as the first biologic, otherwise baseline characteristics were similar. No clinically significant differences in treatment retention or response rates were observed for secukinumab vs adalimumab. The adjusted HRs for discontinuation per the first, second and third line of treatment were 0.98 (95% CI 0.68, 1.41), 0.94 (0.70, 1.26) and 1.07 (0.84, 1.36), respectively. The ORs for DAPSA28 remission in the first, second and third line of treatment were 0.62 (95% CI 0.30, 1.28), 0.85 (0.41, 1.78) and 0.74 (0.36, 1.51), respectively. In the subset of patients previously failing a TNFi due to ineffectiveness, the results were similar.

CONCLUSION: No significant differences in treatment retention or response were observed between secukinumab and adalimumab, regardless of the line of treatment. This suggests that even in patients who have failed a TNFi, choosing either another TNFi or secukinumab may be equally effective.

Originalsprog Engelsk
Tidsskrift Rheumatology (Oxford, England)
Vol/bind 60
Udgave nummer 8
Sider (fra-til) 3635-3645
Antal sider 11
ISSN 1462-0324
DOI
Status Udgivet - 2 aug. 2021

Concurrent Validity Between Electronically Administered Physical Activity Questionnaires and Objectively Measured Physical Activity in Danish Community-Dwelling Older Adults

Larsen, R. T., Korfitsen, C. B., Juhl, C. B., Boje Andersen, H., Langberg, H. & Christensen, J., aug. 2021, I: Journal of Aging and Physical Activity. 29, 4, s. 595-603 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

AIM: To investigate the concurrent validity of the International Physical Activity Questionnaire-short form (IPAQ-SF) and the Nordic Physical Activity Questionnaire-short (NPAQ-short) when compared with objectively measured daily steps among older adults.

METHODS: Spearman's ρ between IPAQ-SF and NPAQ-short and objectively measured steps using Garmin Vivofit 3 physical activity monitors.

RESULTS: A total of 54 participants were included. The IPAQ-SF subscales' moderate physical activity (PA), moderate to vigorous PA (MVPA), and sedentary time showed little or no correlation with daily steps. The NPAQ-short subscales' vigorous PA, moderate PA, and MVPA showed little or no correlation. The IPAQ-SF subscales' vigorous PA and walking showed fair correlation. Only the IPAQ-SF metabolic equivalent of task minutes showed moderate to good correlation with daily steps. The IPAQ-SF categories and NPAQ-short categorization of World Health Organization compliance were significantly different, but the magnitudes were small and distributions indicated problems with the categorization.

CONCLUSION: The concurrent validity is low, as the scores did not reflect objectively measured daily steps.

Originalsprog Engelsk
Tidsskrift Journal of Aging and Physical Activity
Vol/bind 29
Udgave nummer 4
Sider (fra-til) 595-603
Antal sider 9
ISSN 1063-8652
DOI
Status Udgivet - aug. 2021

Couple Counseling and Pelvic Floor Muscle Training for Men Operated for Prostate Cancer and for Their Female Partners: Results From the Randomized ProCan Trial

Karlsen, R. V., Bidstrup, P. E., Giraldi, A., Hvarness, H., Bagi, P., Lauridsen, S. V., Albieri, V., Frederiksen, M., Krause, E., Due, U. & Johansen, C., 3 jun. 2021, I: Sexual Medicine. 9, 3, s. 100350

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

INTRODUCTION: Patients with prostate cancer (PC) who undergo radical prostatectomy (RP) experience impaired sexual and urinary function.

AIM: To compare the effect of early couple counseling and pelvic floor muscle training (PFMT) with usual care for sexual and urinary dysfunction after RP.

METHODS: The ProCan study was a randomized controlled trial (RCT) with two parallel treatment arms and 1:1 allocation. Between January 2016 and December 2017, candidates for RP were invited to a longitudinal questionnaire study and provided baseline measures before surgery. Patients who underwent RP, had a female partner, and were sexually active were invited to the ProCan RCT. Couples who provided informed consent were allocated to usual care or usual care and up to six couple counseling sessions, up to three instructions in PFMT and a video home-training program. All couples filled in follow-up questionnaires at 8 and 12 months and non-participants provided 12 months' follow-up. Linear mixed-effect models and 95% confidence intervals were used to measure effects of the intervention.

MAIN OUTCOME MEASURE: Primary outcome was erectile function, measured with The International Index of Erectile Function, at 8 and 12 months follow-up. Secondary outcomes were sexual and urinary function and use of treatment for erectile dysfunction (ED) by patients; sexual function in female partners; and relationship function, health-related quality of life, anxiety, depression, and self-efficacy in both patients and female partners.

RESULTS: Thirty-five couples were randomized. No significant effect of the intervention was found on erectile function at 8 months (estimated difference in change, 1.41; 95% CI; -5.51 ; 8.33) or 12 months (estimated difference in change, 0.53; 95% CI; -5.94; 6.99) or in secondary outcomes, except for significantly increased use of ED treatment at 8 months.

CONCLUSION: We found no effect of early couple counseling and PFMT, possibly because of the limited number of participants. Karlsen RV, Bidstrup PE, Giraldi A, et al. Couple Counseling and Pelvic Floor Muscle Training for Men Operated for Prostate Cancer and for Their Female Partners. Results From the Randomized ProCan Trial. Sex Med 2021;9:100350.

Originalsprog Engelsk
Tidsskrift Sexual Medicine
Vol/bind 9
Udgave nummer 3
Sider (fra-til) 100350
ISSN 2050-1161
DOI
Status Udgivet - 3 jun. 2021

OBJECTIVE: To summarize the literature on trans-arterial embolization in inflammatory musculoskeletal conditions, focusing on efficacy and safety.

MATERIALS AND METHODS: PRISMA guidelines were followed. A systematic literature search revealed 19 studies, with a total of 394 participants, eligible for inclusion.

RESULTS: The included studies consisted of case reports/series and non-randomized interventional studies, with knee osteoarthritis and adhesive capsulitis of the shoulder as the most frequent conditions. In all studies except one, pain was reduced up to four years after treatment. All adverse events were transient. Due to high heterogeneity, meta-analysis was not possible.

CONCLUSION: The included early studies showed encouraging results regarding efficacy and safety. However, randomized, placebo-controlled trials are warranted.

Originalsprog Engelsk
Tidsskrift Cardiovascular and Interventional Radiology
ISSN 0174-1551
DOI
Status E-pub ahead of print - 2 sep. 2021

Danish translation, cultural adaptation and initial validation of the Self-Assessment of modes questionnaire (D-SAMQ)

Sampedro Pilegaard, M., Sithamparanathan, T., Nielsen, K. T., Taylor, R. & Waehrens, E. E., maj 2021, I: Scandinavian Journal of Occupational Therapy. 28, 4, s. 285-293 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: The Self-Assessment of Modes Questionnaire (SAMQ) was developed for occupational therapists (OTs) to identify their therapeutic style when interacting with clients. To provide Danish Occupational Therapists (OTs) with access to the SAMQ, a rigorous translation, cultural adaptation and validation are required.

AIM: To describe the process of translating and culturally adapting the SAMQ into Danish (D-SAMQ) and examining initial validation of the SAMQ in terms of relevance and comprehensiveness in a Danish context.

MATERIAL AND METHODS: A 10-step process for translation and cultural adaptation was followed: (1) Preparation, (2) Forward translation, (3) Reconciliation, (4) Back translation, (5) Back-translation review, (6) Harmonization, (7) Cognitive debriefing, (8) Review of cognitive debriefing results and finalization, (9) Proofreading and (10) Final report. The cognitive debriefing also involved validation.

RESULTS: Seven OTs and one OT student were included in the cognitive debriefing. Adaptations were made in eight of twenty cases, and modifications regarding the choice of words, sentence structure, and rephrasing were performed. The participants suggested more contextual details in the case descriptions.

CONCLUSION: The SAMQ was translated into Danish (D-SAMQ) and adapted and validated by Danish OTs. The D-SAMQ may enable OTs to identify their therapeutic style, and thereby improve the client-therapist relationship.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Occupational Therapy
Vol/bind 28
Udgave nummer 4
Sider (fra-til) 285-293
Antal sider 9
ISSN 1103-8128
DOI
Status Udgivet - maj 2021

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