Danish Experience Research Articles

Enhancing Wind Power Integration through Optimal Use of Flexibility in Multi-Carrier Energy Systems from the Danish Perspective

Denmark’ goal of being independent of fossil energy sources in 2050 puts forward great demands on all energy subsystems (electricity, heat, gas and transport, etc.) to be operated in a holistic manner. The Danish experience and challenges of wind power integration and the development of district heating systems are summarized in this paper. How to optimally use the cross-sectoral flexibility by intelligent control (model predictive control-based) of the key coupling components in an integrated heat and power system including electrical heat pumps in the demand side, and thermal storage applications in buildings is investigated.

Varicella Vaccination of Children With Leukemia Without Interruption of Maintenance Therapy: A Danish Experience.

Varicella-zoster virus (VZV) can be fatal or cause severe complications in children with acute lymphoblastic leukemia (ALL). This analysis set out to investigate the morbidity and mortality of VZV vaccination without interruption of maintenance therapy in children with ALL. Files of 73 seronegative children with ALL were examined for data regarding VZV vaccination and infection, and long-term seroconversion was measured. Criteria before VZV vaccination were (1) seronegative, (2) in complete remission, (3) age ≥ 1.0 year, (4) lymphocyte count ≥ 0.6 × 10/L at time of vaccination and (5) receiving maintenance therapy. Forty-five children were vaccinated. No child died or experienced serious adverse events due to VZV vaccination. Nine children developed late chickenpox despite vaccination. Long-term protection was found in 86% of children not receiving acyclovir and 78% of the entire population. Long-term seroconversion was found in 52% of the children. There were no severe cases of varicella infection. Acyclovir prophylaxis postvaccination was associated with an increased risk of late chickenpox [hazard ratio = 5.40 (1.43, 20.41), P = 0.01]. In contrast, a vaccine-induced rash reduced the risk of late chickenpox [hazard ratio = 0.08 (0.01, 0.66), P = 0.02]. No child had interruption of maintenance therapy at the time of vaccination, but 33% experienced discontinuation of therapy due to vaccine-induced rash. Dexamethasone was associated with an increased risk of vaccine-induced rash [hazard ratio = 2.9 (1.21, 6.90), P = 0.02]. This analysis indicates that VZV vaccination is feasible and justified in seronegative children with ALL, in countries where VZV vaccination is not part of the national vaccination program.

Slow Shift—Developing Provisions for Talented Students in Scandinavian Higher Education

For decades, Scandinavian culture effectively prohibited the development of special provisions for talented students in higher education. However, in recent years, a cultural shift has gradually made more room for excellence and talent development in the national discourses. This paper analyzes the climate for talent development in Denmark, Sweden, and Norway. Following a first inventory of honors programs in Scandinavian higher education in which the only programs were found in Denmark, 10 experts were interviewed to analyze their national situation and reflect on the leading role of Denmark. In this country, external incentives, focus on quality, pioneers, and an open atmosphere were found to produce a culture more appreciative of excellence over the last decade. Starting from the Danish experience, the situation in Norway and Sweden is analyzed, showing that the combination of factors leading to change in Denmark is not yet present here. Lessons for other countries are highlighted, notably the importance of sharing information and exchanging knowledge at an international level.

Comparing econometric and survey-based methodologies in measuring offshoring: The Danish experience

Offshoring, understood as the geographical relocation of companies’ activities to another country, is a key feature of contemporary globalization and has growing social, political and economic implications. However, the phenomenon remains poorly examined at aggregated macro levels such as the national or regional level. Most macro analyses are based on proxies and trade statistics with limitations. Drawing on unique Danish survey data, this article demonstrates how survey data can provide important insights into the national scale and impacts of offshoring, including changes of employment, which are difficult to measure with other methods.

Safety and tolerability of regadenoson for myocardial perfusion imaging – first Danish experience

ABSTRACTObjectives. Evaluating safety and tolerability of the selective A2A receptor agonist, regadenoson, in patients referred for single photon emission computed tomography myocardial perfusion imaging (MPI). Design. Observational study of patients referred for MPI stress testing using a 400 μg regadenoson (Rapiscan®) bolus. Hemodynamic variables and severity of adverse events (AE) were recorded before, during, and after administration. Results. A total of 232 patients were included. One or more AE were reported in 90% of patients; the AEs were graded mostly mild to moderate in severity, resolved spontaneously, and were mainly dyspnea, headache, and chest pain. No advanced heart block or bronchospasm were seen. Transient ST-segment changes developed in 10 patients. The maximum increase in heart rate was 19 ± 11 beats/minute. The mean systolic blood pressure decreased from 144 to 139 mmHg (p < 0.0001). Medical intervention was required in three patients: one case with severe hypotension and two cases with chest pain that was relieved with sublingual nitroglycerin. One patient died the day after stress MPI for reasons considered unrelated to regadenoson. Conclusion. Regadenoson for MPI is easy to use with a high frequency of AEs, which are generally mild in severity, transient, and resolve spontaneously.

Simultaneous colorectal and liver resection – A danish two-centre experience

Aims: The aim of the study was to evaluate the feasibility and safety of simultaneous colorectal and liver resection (SCLR) in patients with colorectal cancer and synchronous liver metastases. The primary endpoints evaluated were: complication rate, length of stay (LOS), 90 days perioperative mortality. Secondary endpoints was 3-yars overall survival and 3-years disease free survival. Methods: Consecutive patients undergoing SCLR in the period 2011–2013, coming from two HPB centres in Denmark, were included in this retrospective study. Results: Twenty-nine patients were included in the study. Twenty-sex patients had colon cancer and three patients had rectal cancer. All patients underwent open surgery. Large liver resections (>3 lesions) were performed in ten patients and colorectal resections with primary anastomosis were performed in all patients. The overall complication rate was 12/29 with a Clavien Dindo complications score with 4/29 type I, 3/29 type II, 4/29 type IIIa and 1/29 type IIIb. No anastomotic leakages were detected. The median LOS was 7 (4–28) days. Four patients needed readmission in additional median 15.5 (14–21) days. The 90-day mortality was 0/29 (0%). Twelve patients had local recurrence in the liver after median 13 months. No local recurrence was seen on colon and rectum. The 3-year overall survival rate and disease free survival rate was 48.5% (CI:38.0–53.4%) and 40.8% (CI:16.7–64.9%), respectively. Conclusions: Simultaneous colorectal and liver resection for synchronous colorectal cancer and liver metastases in selected cases is feasible and safe in a Danish two-centre setting.

Quality registries: exciting opportunities.

Quality registries: exciting opportunities.

How can the research potential of the clinical quality databases be maximized? The Danish experience.

In Denmark, the need for monitoring of clinical quality and patient safety with feedback to the clinical, administrative and political systems has resulted in the establishment of a network of more than 60 publicly financed nationwide clinical quality databases. Although primarily devoted to monitoring and improving quality of care, the potential of these databases as data sources in clinical research is increasingly being recognized. In this review, we describe these databases focusing on their use as data sources for clinical research, including their strengths and weaknesses as well as future concerns and opportunities. The research potential of the clinical quality databases is substantial but has so far only been explored to a limited extent. Efforts related to technical, legal and financial challenges are needed in order to take full advantage of this potential.

Assisted Peritoneal Dialysis for Older People with End-Stage Renal Disease: The French and Danish Experience.

Older people are the largest and fastest growing group of patients with end-stage renal disease (ESRD), and, due to advanced age and a heavy burden of comorbidities, they are usually not candidates for renal transplantation or home-based dialysis treatment. Some of the barriers for home treatment are non-modifiable, but the majority of physical disabilities and psychosocial problems can be overcome provided that assistance is offered to the patients at home.In the present review, we describe the programs for assisted peritoneal dialysis (PD) in France and Denmark, respectively. In both nations, assisted PD is totally publicly funded, and the cost of assisted PD is comparable to the cost of in-center HD. Assisted continuous ambulatory PD (aCAPD) is the preferred modality in France whereas assisted automated PD (aAPD) is the preferred modality in Denmark. Assistants are professional nurses or healthcare technicians briefly educated by expert PD nurses from the dialysis unit.The establishment of a program for assisted PD may increase the number of patients actually treated with PD and may reduce the risk of PD technique failure and prolong PD duration. Compared with autonomous PD patients, patients on assisted PD may have shorter patient survival and peritonitis-free survival indicating that, besides advanced age and the burden of comorbidities, dependency on help may be an independent risk factor for poorer outcome.Assisted PD is an evolving dialysis modality, and may in the future prove to be a feasible complementary alternative to in-center hemodialysis (HD) for the growing group of dependent older patients with ESRD.

Denmark in Europe 1973-2015: Processes of Europeanization and ‘Denmarkization’

Since becoming a member of the European Community in 1973, Denmark has conducted seven referenda on its involvement in the process of European integration. Five of the referenda have produced a ‘yes’ to accession and further integration while the remaining two have resulted in ‘noes’. The Danish approach of using referenda, of claiming opt-outs after ‘noes’ and of setting up parliamentary controls to check government policy in Brussels has been a way of checking Europeanization - in this article termed ‘denmarkization’. For a long period, the two processes of Europeanization and denmarkization have co-existed and helped to create equilibrium and legitimacy behind Danish European policy. However, this seems to have changed lately as denmarkization by centre-right and populist parties no longer appears efficient in safeguarding Danish sovereignty in the vital welfare domain. This has provoked a situation in which Europeanization and denmarkization according to the interpretation of this article are heading for collision, which will necessitate some form of reconfiguration of Danish European policy. This article investigates and discusses this dual-faced aspect of the Danish membership experience and finally raises the question of whether this experience finds parallels in other EU member states

Examining the efforts of a small, open economy to reduce carbon emissions: The case of Denmark

It is generally understood that greenhouse gasses produced by human activities are having a warming effect on the climate. Discussions concerning efforts to curb carbon dioxide emissions often focus on large countries. However, considerable resources have been spent to reduce carbon dioxide emissions by relatively small, open economies. Although, these economies are small players in international markets, international trade has an important influence on their economies. Investigating the outcome of efforts to curb emissions by these small, open economies provides insights into the situation faced by a large set of the world's economies. This paper has three objectives: (1) investigate the outcome of Denmark's efforts to reduce its carbon emissions by characterizing the relationship between Denmark's macroeconomic activity and carbon emissions; (2) determine the carbon content of Danish trade and document the important effects that growing trade with China has had on Danish consumption emissions; and (3), investigate the robustness of measures of consumption emissions under varying information requirements. Our analysis of the outcomes of Danish efforts to reduce carbon emissions suggest two, related lessons. First, small, open economies, should track both production and consumption emissions when evaluating their progress towards reducing carbon emissions. Second, international trade should be considered in the design of environmental policy. The Danish experience indicates that increasing trade with a much larger and more emission intensive country can have substantial influence on consumption emissions.

WHO classification 2008 of myeloproliferative neoplasms: a workshop learning effect--the Danish experience.

We examined the learning effect of a workshop for Danish hematopathologists led by an international expert regarding histological subtyping of myeloproliferative neoplasms (MPN). Six hematopathologists evaluated 43 bone marrow (BM) biopsies according to the WHO description (2008), blinded to clinical data. All panelists then participated in the workshop. The case biopsies - mixed with 251 other MPN BM biopsies - were reviewed again. Consensus regarding the histological subtype was significantly improved; from 49% to 72% (Fleiss kappa value 0.302 pre-workshop, 0.474 post-workshop; p=0.004). There was no significant effect on the isolated morphological characteristics. Agreement between cases with histological consensus and clinical diagnosis was 86% without significant change during workshop sessions. Our study demonstrates that experienced hematopathologists can significantly improve their diagnostic ability by a workshop led by an international expert; not by improving the evaluation of individual histological parameters but by weighting these in their conclusive diagnosis.

Social democracy after the Third Way: restoration or renewal?

Given the ill-fated political experience with the Third Way, one would not expect social democratic parties that return to office after long opposition spells to take up again the liberal, supply-side oriented policies that were so typical for the Third Way. A case study of Denmark, however, shows that that is precisely what happens and that it has the same disastrous electoral consequences. Taking a comparative perspective and learning from the Danish experience, we conclude that other future social democratic governments are likely to pursue many elements of the updated Third Way we found in the Danish case.

Tailoring cancer radiotherapy through genotyping, how close are we?

Tailoring cancer radiotherapy through genotyping, how close are we?

Smørrebrød or Smörgåsbord: the Danish and Swedish drug users unions: contexts, aims, activities, achievements

Purpose – The purpose of this paper is to first, inform readers of the roles, activities and contexts of drug users unions in Denmark and Sweden. Second, to show the achievements and impacts of the two. Third, to illustrate the differing social and political situations in the two countries and how they determine the priorities and activity of the unions. Design/methodology/approach – The paper is written by a UK commentator who bases the text on meetings, interviews and conversations with members and representatives of the two unions. Spokespersons for both unions have contributed to, commented on and clarified draft texts and provided contextual papers and information. Findings – The two unions have differing roles and levels of acceptance and influence according to the political and legal situations in the two countries. There are differing situations and needs in Denmark and Sweden, reflected in the levels of drug-related deaths. There is no “Scandinavian” model. In Denmark the users union is involved in high-level discussions on policy making and practice. In Sweden the new unions are starting to be involved in local discussions about provision and practice. Research limitations/implications – Danish experience shows how political acceptance of the existence of a drug using population is leading to improved health and well-being amongst that population, and to social policy responses which are inclusive of this and other marginalised groups, and to a reduction of stigma and demonisation. Swedish experience differs and can be seen as essentially prohibitionist and punitive. Many Swedish drug users are moving to Denmark because of the levels of service and social attitudes. It may be of interest to UK policy to adopt a similar approach to drug users organisations – as distinct from service users’ voices. Practical implications – Strengthening the role of drug users unions in all countries and including them in national policy making discussion and debate. Social implications – Accepting the existence and needs of drug using groups in society and developing responses informed by their views and experience. Adopting inclusive social policies and recognising the variety of need and choices in treatment. Combatting stigma and demonisation. Originality/value – The paper is based on extensive interviews and conversations whose results and content are recorded, not interpreted. The Danish work was conducted in Danish, adding to the number of voices and conversations it was possible to include. A distinction between policy and practice in Denmark and Sweden is established which may run counter to UK impressions of “Scandinavian” rather than national realities.

Research-based knowledge to corporate businesses: the Danish experience

One of the goals in the Danish Government’s strategy for growth in Denmark is to promote the awareness, access and use of research-based knowledge to citizens and institutions, both private and public. In gaining better use of research-based knowledge, Denmark’s chances of being able to play a prominent role as a knowledge society, both nationally and internationally, will substantially increase. To transform the strategy into practice Denmark’s Electronic Research Library, deff, has been created. In this article business consultant of deff, Anders Mejlbjerg, describes how deff is working to expand the awareness of research-based knowledge to various public institutions and to small and medium-sized private enterprises, known as SMEs.

The Danish experience with trabectedin treatment for metastatic sarcoma: Importance of hyponatremia

Background. Trabectedin was in Europe approved for treatment of metastatic soft tissue sarcoma (STS) in 2007 based on results of a phase II study with relatively few patients. The purpose of this nationwide retrospective study was to assess efficacy and safety of using trabectedin in the entire unselected cohort of patients with metastatic sarcoma and to test known, as well as new prognostic factors that may affect overall survival (OS).Patients and methods. Between January 2008 and April 2013, 117 patients were treated with trabectedin for metastatic sarcoma in the three specialized sarcoma centers in Denmark. Known prognostic factors such as age, gender and performance status, the histopathology as well as other new factors such as response to previous chemotherapy and hyponatremia were tested.Results. Median age was 59 years. Lipo- and leiomysosarcomas (L-sarcomas) represented 43% of the cases and 18% had hyponatremia before the start of trabectedin. The median number of previous lines of chemotherapy was two (range 0–6) and the median number of chemotherapy cycles given before trabectedin was nine (range 0–85). The median number of trabectedin cycles was three (range 1–17). The median OS for the whole cohort was seven months. Poor performance status, non-L-sarcomas, and hyponatremia were statistically significant adverse prognostic factors with median survival of: 4, 5, and 2 months compared to 9, 12 and 13 months, respectively. Moreover, having achieved clinical benefit [complete response (CR), partial response (PR) or stable disease (SD)] from previous chemotherapy was a favorable prognostic factor for response to trabectedin. In multivariate analysis hyponatremia was the only independent significant poor prognostic factor affecting OS.Conclusions. This retrospective study confirmed the previously published safety and efficacy of trabectedin in patients with metastatic sarcoma and showed hyponatremia to be a strong independent statistically significant poor prognostic factor.

Competitive low-tech manufacturing and challenges for regional policy in the European context--lessons from the Danish experience

Today, low-tech firms in high-wage countries are focusing on increasing investments in highly skilled labour and advanced machinery, incremental innovation and high value-added niches. Danish policy, however, gives little attention to the new specificities of low-tech manufacturing, and the understanding of innovation in national and regional strategies is dominated by a science-based perspective. There is a strong policy focus on human capital and research and development in manufacturing. Human capital is vital to manufacturing in general, but the latter is of less importance for low-tech firms. Conversely, user–producer interactions and machinery investments, which are critical to low-tech competitiveness, are disregarded by policies.

Trade unions as knowledgeable participants in workplace innovation

Purpose – This article aims to demonstrate that trade unions possess unique knowledge of how organisations really work and that they are repositories of experience embracing many different situations and stretching over many years. Closing the gap between best practice and common practice needs knowledgeable advocates to actively demonstrate what workplace innovation is and how it benefits organisations and individuals. Design/methodology/approach – This article demonstrates that trade unions possess unique knowledge of how organisations really work and that they are repositories of experience embracing many different situations and stretching over many years. Yet, this experience and understanding is often an underused resource in workplaces. Findings – At the frontline, union representatives can release their members’ tacit knowledge and ideas for improvement and innovation. At strategic level, unions can deliver robust advice and consultancy, securing trust from employees and employers alike. Actively involving unions in dialogue about challenges and opportunities is the key to unlocking this potential. Practical implications – The paper draws upon examples of collaborative working and the role of unions from the USA, Ireland and Norway, while a more detailed analysis of the “Danish Experience” demonstrates how Ideas, high levels of knowledge and strong relationships between unions and employers able to handle both shared and conflicting interests, impacts on trade unions ability to “stimulate, resource and sustain workplace innovation”. Originality/value – The paper concludes with a call to action showing how a mass movement of workplace innovation can be achieved through shared learning case studies and resources and from the creation of the European Workplace Innovation Network Knowledge Bank to help people to share their knowledge and experience.

Contact therapy: A feasible option for local treatment of rectal cancer in non-operable patients—A Danish experience.

e14543 Background: The median age of rectal cancer patients is high and an increasing fraction of patients suffer from significant co-morbidity precluding surgical procedures. Contact X-ray (CXR) d...