Development In Denmark Research Articles

Monitoring the digital healthcare transition in Denmark: Challenges, achievements and future

Abstract Denmark is often mentioned as one of the countries that have introduced digital solutions early and extensively within the health care sector, including the launch of health portal sundhed.dk in 2003, the introduction of the e-record system ‘e-Journalen’ in 2007, and the establishment of a national infrastructure for telemedicine in 2012. Denmark is well advanced in digital health measurement, providing opportunities for researching the digital transition and its effects for healthcare organizations and Danish citizens. Most digital health data is collected through national population-based databases and registries. Additionally, annual surveys of health professionals and biennial surveys of citizens’ use of health IT are conducted. Recent data show that all general practitioners use electronic health records, mainly for receiving laboratory test results from hospitals, ordering prescriptions at pharmacies, exchanging records, and sending referrals to hospitals. This workshop provides an overview of developments in Denmark and a discussion of challenges, achievements, and prospects. Particular attention will be paid to the monitoring of digitalization progress and effects, and the use of digital solutions in primary and secondary care. Issues about implementation and evaluation of digital infrastructure will be discussed with examples from Danish health care. A key question is whether digital solutions can fulfill their promise of supporting integrated and home based health care in an era of changing demographics.

Setting a direction for continuing professional development in anesthesiology: A synthesis of the outcome from an Utstein style meeting.

An Utstein style meeting of key stakeholders from the existing collaboration surrounding post-graduate training was arranged to set a direction for continuing professional development (CPD) of anesthesiologists in Denmark. A 2-day meeting was planned to guide discussions about competencies in anesthesiology, facilitate the development of a blueprint for a portfolio-based CPD program and provide examples of how a portfolio can be used in practice. The meeting agenda was based on an adaptation of Kern's six-step approach to curriculum development. Twenty-four participants from the university hospitals in Denmark were invited. Prior to the meeting participants were informed of the objectives and the Utstein style process. Participants acknowledged a need for a more structured approach to CPD, preferably within the current organizational set up at the departmental level, and with a portfolio-based, individualized curriculum. It was recognized that CPD should contain an array of possibilities to accommodate needs and wants of both the individual and the department. It was emphasized that, while anesthesiologists are used to give feedback to trainees, many are less familiar in providing the same to peers, and psychological safety was identified as a prerequisite to support a culture where specialists can reflect openly on each other's performance. The results provide an insight into the attitudes, opportunities, and challenges of anesthesiologists in relation to continuing professional development in Denmark. Generally, participant suggestions are in line with the shift in medical education toward workplace-based learning, feedback and lifelong learning.

The contribution of renewable energy sector value added to the national economic development in Denmark: an empirical analysis

Abstract Examining the relationship between sustainability and economic development was covered by research over the past decades. The initial goal of the present research is to evaluate the contribution of renewable energy sector value added to the national economic development in Denmark. The research tasks of this study include assessment of carbon dioxide allowances and environmental taxation as well as the effect of other factors in terms of their contribution to the economic growth. The application of the regression analysis in order to examine the relationship between renewable energy industry and national economic development in Denmark shows that the increasing of renewable energy value added leads to the sizeable expansion of the gross domestic product. From the environmental-economic standpoint this is presumably the first research to make unambiguous conclusion, that proves significance of renewable energy value added for economic development in Denmark. Likewise, the results of the present study prove that expanding usage of carbon dioxide (CO₂) allowances in Denmark leads to quite considerable increase of the gross domestic product. Besides that, this study provided evidence regarding positive and statistically significant impact of the other factors on the economic growth.

S2-4 Physical literacy in Denmark: from concept to intervention

Abstract Purpose Physical literacy (PL) is a holistic concept describing individuals’ prerequisites for engaging in physical activities through the life course. Interest in research on PL has increased rapidly in Denmark in the recent years. Researchers from the three largest universities, the largest university college, as well as research centers at two regional university hospitals have initiated projects with either PL as their core subject or using PL as a guiding theoretical framework for or as an outcome of physical activity interventions. These research projects have a conceptual purpose (Elsborg, Ryom, et al., 2021), a methodological purpose such as development of assessment tools (Elsborg, Melby, et al., 2021), and a purpose of investigating health-related correlates (Elsborg, Heinze, et al., 2021; Melby et al., 2021). Furthermore, interventional research projects that focus on how PL development is best stimulated in different age groups and target groups have recently begun (Ryom et al., 2021; Elsborg et al., 2021). The researchers that have been inspired by PL and are currently conducting PL research in Denmark come mainly from a motivational / sport and exercise psychological and/or public health background and have a strong focus on developing health promotion interventions. Many of the research projects in Denmark are supported by strong collaborations with field leading international researchers. Methods Interest and utilization of the concept has also undergone a prodigious development in Denmark from a practice and policy perspective. The national sport for all organisation, DGI, has incorporated PL as one of their key concepts which guides all their activities. The national school sports organisation, Danish School Sports, has also adopted the concept and have currently funded an industrial PhD project, which investigates health-related correlates to PL while also spreading knowledge about the concept in the organisation and in schools. In 2018, a national cross-sectoral network for PL interested parties was established (https://www.pl-net.dk). Results and discussion This presentation will focus on providing a short overview and discussion of the research, practice and policy development in Denmark while exemplifying this development by presenting the recent interest from several large-scale school-based intervention projects in more detail.

Implementation of patient-centred care in Denmark: The way forward with shared decision-making

Legal and political landscape in shared decision makingCurrent Danish legislation empowers patients in securing their rights, but there are no present legislative developments in Denmark to support patient involvement. Policy initiatives within health care, however, show positive trends by, for example, including recommendations for shared decision making (SDM) in national clinical guidelines and the allocation of resources to fund projects in SDM. Within the last five years, three out of five regions have launched centers in patient involvement and SDM to focus on training, implementation of patient decision aids (PtDAs) and to foster the cultural change in SDM. A national dissemination of a template for easy building of PtDAs accessible via an online platform is one of the latest initiatives. The way forwardAlthough the political discourse on SDM is gathering speed, an unclear definition and purpose of SDM is a barrier to real-life implementation. Politicians, leaders and clinicians seem to be moving at different paces and in different directions and are lacking consensus on SDM as a paradigm requiring training, leadership and a patient-centered mindset. ConclusionMany relevant initiatives are underway. However, SDM is also challenged by the lack of legislation and a central push for real SDM implementation in Denmark.

Financial Role of Insurance on Economic Development in Denmark

The insurance plays an essential role in economic development by alleviating business risks occasioned by abrupt and disastrous incidents in established and developing nations. Thus, the research assessed the financial role of insurance on economic development in Denmark. The research adopted the descriptive research design. The target population was 200 insurance companies. The research study sampled 100 participants that were chosen from the target population of 200. The sampling technique that was considered the most appropriate was stratified. Questionnaires were utilized to gather the data. The study results showed that insurance is significant in impacting the economic development in Denmark. Insurance activity improves families and organizations' financial stability and helps with competitiveness and the growth of trade and business. Insurance companies help businesses mitigate risk and protect their employees, thus spurring economic development. In addition, insurance companies help finance economic development projects. The study recommended that more emphasis should be developed by all the stakeholders in Denmark, including the government, to ensure the insurance companies are sustainable. The regulatory authorities should establish policies to make it attractive for its residents to patronize the insurance business. This would certainly translate to enhanced insurance investment and more outcomes to the development of the economy because insurance investment has a positive link with GDP. Insurance policies must be made mandatory for people and enterprises to motivate and shield financiers and ensure sustained economic growth. Keywords: Insurance, Economic Development, Denmark

Validity Evidence Based on Relations to Other Variables of the eHealth Literacy Questionnaire (eHLQ): Bayesian Approach to Test for Known-Groups Validity.

BackgroundAs health resources and services are increasingly delivered through digital platforms, eHealth literacy is becoming a set of essential capabilities to improve consumer health in the digital era. To understand eHealth literacy needs, a meaningful measure is required. Strong initial evidence for the reliability and construct validity of inferences drawn from the eHealth Literacy Questionnaire (eHLQ) was obtained during its development in Denmark, but validity testing for varying purposes is an ongoing and cumulative process.ObjectiveThis study aims to examine validity evidence based on relations to other variables—using data collected with the known-groups approach—to further explore if the eHLQ is a robust tool to understand eHealth literacy needs in different contexts. A priori hypotheses are set for the expected score differences among age, sex, education, and information and communication technology (ICT) use for each of the 7 eHealth literacy constructs represented by the 7 eHLQ scales.MethodsA Bayesian mediated multiple indicators multiple causes model approach was used to simultaneously identify group differences and test measurement invariance through differential item functioning across the groups, with ICT use as a mediator. A sample size of 500 participants was estimated. Data were collected at 3 diverse health sites in Australia.ResultsResponses from 525 participants were included for analysis. Being older was significantly related to lower scores in 4 eHLQ scales, with 3. Ability to actively engage with digital services having the strongest effect (total effect –0.37; P<.001), followed by 1. Using technology to process health information (total effect –0.32; P<.001), 5. Motivated to engage with digital services (total effect –0.21; P=.01), and 7. Digital services that suit individual needs (total effect –0.21; P=.02). However, the effects were only partially mediated by ICT use. Higher education was associated with higher scores in 1. Using technology to process health information (total effect 0.22; P=.01) and 3. Ability to actively engage with digital services (total effect 0.25; P<.001), with the effects mostly mediated by ICT use. Higher ICT use was related to higher scores in all scales except 2. Understanding health concepts and language and 4. Feel safe and in control. Either no or ignorable cases of differential item functioning were found across the 4 groups.ConclusionsBy using a Bayesian mediated multiple indicators multiple causes model, this study provides supportive validity evidence for the eHLQ based on relations to other variables as well as established evidence regarding internal structure related to measurement invariance across the groups for the 7 scales in the Australian community health context. This study also demonstrates that the eHLQ can be used to gain valuable insights into people’s eHealth literacy needs to help optimize access and use of digital health and promote health equity.

Cross-professional collaboration and inclusive school development in Denmark

ABSTRACT The paper is based on a study of cross-professional collaboration in Denmark and its impact on inclusive school development. The study takes its starting point in the understanding that all kinds of schools constitute a social practice, which is created through inclusion and exclusion processes, and characterised by both individuality and diversity, collectivity and homogeneity. Hence, we argue that inclusion is a right and an obligation for students with and without special needs, and that inclusive education is primarily a matter of supporting all students in learning to be participants in learning activities and social life at school. It is also a matter of transforming the social structure so as to displace the border between inclusion and exclusion to better ensure equity for all students. Based on an analysis of how collaborative processes take place in a school practice, the present study offers a complex and nuanced understanding of cross-professional collaboration, influenced by many different mechanisms and factors that interact and affect each other. The study concludes that collaborative processes do not have any real impact on inclusive school development. The tendency is to focus on the student’s deficits, compensation, and treatment.

Onshore, offshore or in-turbine electrolysis? Techno-economic overview of alternative integration designs for green hydrogen production into Offshore Wind Power Hubs

Massive investments in offshore wind power generate significant challenges on how this electricity will be integrated into the incumbent energy systems. In this context, green hydrogen produced by offshore wind emerges as a promising solution to remove barriers towards a carbon-free economy in Europe and beyond. Motivated by the recent developments in Denmark with the decision to construct the world's first artificial Offshore Energy Hub, this paper investigates how the lowest cost for green hydrogen can be achieved. A model proposing an integrated design of the hydrogen and offshore electric power infrastructure, determining the levelised costs of both hydrogen and electricity, is proposed. The economic feasibility of hydrogen production from Offshore Wind Power Hubs is evaluated considering the combination of different electrolyser placements, technologies and modes of operations. The results show that costs down to 2.4 €/kg can be achieved for green hydrogen production offshore, competitive with the hydrogen costs currently produced by natural gas. Moreover, a reduction of up to 13% of the cost of wind electricity is registered when an electrolyser is installed offshore shaving the peak loads.

Advancing the structure-in-evolution approach: the case of social policy development in Denmark

ABSTRACT The structure-in-evolution approach has been proposed as a unified model of change in policy and institutional systems but heretofore has not been applied empirically. This article provides a first such application through an empirical case study of social policy development in Denmark, a country often referenced as its model environment. The case is constructed around a historical account of the country’s employment and social policies and institutions, and a systematic analysis of sequences and regularities in their evolution. Evolutionary patterns representing the structure and dynamics of change were identified both in the broader context of welfare policy development and at lower levels of abstraction, adding further support to this unified analysis and providing a valuable alternative to the conventional understandings of change in policy.

Forming issues and publics: participatory design things and uncertain rural futures

Through a case of civic action in relation to rural development in Denmark, this paper contributes its deliberations on rural participatory policy by shedding light on the unordered site of controversy where participatory-oriented policy meets public involvement practices that happen beyond procedural limits. Danish rural planning is marked by economic and population decline and by economic pressure on the municipal sector. In this uncertain situation, rural livelihood and development increasingly rely on citizens. Drawing on perspectives from participatory design, public involvement, and Science and Technology Studies, and mobilizing the concept of design Thing, the paper attempts to understand a citizen-initiated participatory design (PD) process as an experimental means of public involvement in a rural setting. It analyses the intersection between the micro-level activities of the PD process and national and municipal plans, policies and procedures. In doing so, it traces how the socio-material PD process was a civic attempt to contest institutional definitions and to move the power to define issues from the authorities to the community. It analyses the role of the PD process in the articulation of shared issues, and how this process was one event in the ongoing community practices of public-ization of issues and of forming publics, so as to define local trajectories for an uncertain future. Continuing the analysis, the paper considers that the process of issue and public formation is neither linear nor uncontested; there is no single public, but rather multiple and porous configurations of difference and change.

Integration of Buzzi and Heidelberg Cement Plants Into the First Operating and Planned CCUS Cluster Projects Worldwide, Using CLEANKER Project GIS Database

The main objective of EU Horizon 2020 project CLEANKER is a Ca-looping capture of CO2 emissions produced by the cement industry. One of the objectives is to define suitable Buzzi Unicem (BU) and HeidelbergCement Group (HCG) plants worldwide for CO2 capture, based on transport and storage opportunities of CCS clusters already well documented in the literature. Not all of the 12 projects reported in 2015 by IEA and initially planned to integrate with cement plants, are ongoing. Instead of the most developed in EU, but cancelled project ROAD, a new Porthos project is developing in the Netherlands. Collie Hub cluster project in Australia was cancelled because suitable cap rocks were not found in its storage site. Skagerrak/Kattegat cluster in the Nordic countries was transformed into the Northern Lights project in Norway and some ongoing developments in Denmark and Sweden. Technical and geological parameters of 12 largest CCUS cluster projects worldwide were collected into the CLEANKER ArcGIS database and integrated with 12 HCG and BU cement plants (CP) prospective for CO2 capture. CO₂ transport distance from the CP to the CO₂ storage site and maturity of the projects permitted to propose priority for the possible integration of the CPs. The HCG Norcem Brevik CP is the first in the world already included into the Longship project with Northern Lights infrastructure. The second prospective candidate is HCG Edmonton CP located in 170 km from Clive depleted oil field (DOF) of the ACTL project in Alberta in Canada. Among three operating CO2-EOR cluster projects in USA the best candidate for integration is BU Maryneal CP, located in 81 km from Sacroc DOF in the Denver City project in Texas. All the CPs proposed for integration into the European projects have relatively close location of about 50-300 km to the storage sites. Among three CPs, proposed for integration into UK clusters with offshore storage, the Padeswood CP is the nearest one to the possible storage site in the Hamilton gas field.

Public-private partnerships in the healthcare sector: limited policy guidelines, but active project development in Denmark

ABSTRACT How and why has the formal policy development on PPPs in Denmark evolved? How and why do PPP projects develop in Danish healthcare sector? Despite limited policy guidelines and no PPP Act, a regional approach to PPPs has occurred in the healthcare sector. There are active projects in five hospital cases that use the PPP model. PPP projects in the Danish healthcare sector develop from a mixture of reasons, which include strategic interventions from finance institutions, change in specific formal rules on financing, and necessity for regional governments to find alternatives to public financing.

Poison or Cure? a Study on the Periodic Sponge Effect in Denmark’s Tourism Industry

This paper investigates the crucial role of tourism with the periodic sponge effect played in the development of Denmark's industry structure. The existence of the periodic sponge effect between tourism and manufacturing is analysed by proposing an approach to calculate the periodic sponge effect index. This phenomenon describing wane and wax shifting between the industry sector and the service sector is jointly contributed by the natural seasonal variations in the tourism industry and the flexicurity labour market with flexible employment policies in Denmark. To prove that the service sector with periodic sponge effect will not cause the Dutch disease, the relationship between the service sector and GDP in Denmark are studied by adopting a unit root test, Johansen cointegration test and Granger causality test. The global disaster, including the global financial crisis, can be regarded as an outlier in the periodic economic oscillation. The impacts of the financial crisis of 2008 on the alteration of industry structure are revealed. Moreover, during this economic crisis, the de-industrialisation that is a replacement of the manufacturing proportion by tourism is discussed. In terms of the unemployment issue, the depression of manufacturing is the main factor to cause the unemployment problem. Tourism becomes a significant contributor to provide job opportunities. Furthermore, during the COVID-19 pandemic, the current situation of Denmark is discussed.

Comorbidities of alopecia areata: a population-based cohort study.

Previous studies have associated alopecia areata (AA) with a number of comorbidities. However, the timing between AA and the development of such comorbidities remains poorly understood. To examine the temporal relationship between AA diagnosis and comorbidity development in Denmark. A Danish nationwide register-based cohort study was performed on all individuals diagnosed with AA between 2007 and 2016 (n=1843), and each patient was matched for age and sex with 10 healthy controls (HCs). Time between AA and comorbidity development was assessed, and incidence rate ratios (IRRs) were calculated to assess risk of comorbidity following initial AA diagnosis. Use of antidepressant and anxiolytic drugs were mostly started prior to AA diagnosis, and these drugs were used more frequently before than after diagnosis with AA. Additional frequent comorbidities included thyroid disease, hyperlipidaemia, type 2 diabetes and asthma. Most comorbidities occurred prior to AA diagnosis; however, among those that occurred after AA diagnosis, antidepressants (IRR=1.26, 95% CI 1.01-1.56), anxiolytics (IRR=1.55, 95% CI 1.17-2.05), atopic dermatitis (AD; IRR=9.41, 95% CI 4.00-22.16), asthma (IRR=2.17, 95% CI 1.46-3.21), vitiligo (IRR=30.35, 95% CI 6.13-150.39), Crohn disease (CD; IRR=3.04; 95% CI 1.22-7.56) and thyroid disease (IRR=2.38; 95% CI 1.72-3.29) occurred more frequently among patients with AA compared with controls. A diagnosis of AA was significantly associated with risk of several comorbidities, most notably vitiligo, AD and CD. Nonetheless, the majority of patients appeared to have developed these comorbidities prior to AA diagnosis, suggesting that a thorough medical history screening by dermatologists at the initial visit may be appropriate.

Rural community development through competitions, prizes, and campaigns: The villagers’ perspective

Withdrawal of strategies and universal welfare ideals in relation to rural community development in Denmark has given more weight to initiatives such as competitions, campaigns, and prizes aimed at villages and awarded to villagers by public authorities, philanthropic foundations, and interest groups. For rural communities and villagers to obtain funding or win prizes, demonstration of villagers’ skills is required, for example, using private funds and volunteer work. Also required are positive outcomes, such as upgrading physical environments and increases in the number of inhabitants. This article analyses whether the criteria and qualifications required to secure funding or win prizes match theoretical understandings and recommendations for rural community development. Based on interviews with villagers and field observations from a prize ceremony, the article addresses how the competitive aspect affects the people involved in rural community development. It thereby provides a novel contribution by giving voice to the villagers on the opportunities and constraints related to competitions, campaigns, and prizes. The article concludes by discussing these initiatives as a new type of steering or metagovernance for rural community development in Denmark.

The institutionalization of public sector innovation

ABSTRACT Public innovation policies and programmes are increasingly governed by the central government. It is argued that this institutionalization process is rooted in cultural regimes that form our basic understanding of what innovation is and does, and it is argued that the institutionalization is unfolded in specific innovative arrangements operating within these regimes. Recent developments in Denmark are used to illustrate how this institutionalization process unfolds. In conclusion, it is suggested that an understanding of both the theoretical and the operational implications of this approach is needed, and we need to be wary of the political implications of the current institutionalization.

Resourcing the Fairytale Country with Wind Power: A Dynamic Material Flow Analysis.

Wind energy is key to addressing the global climate challenge, but its development is subject to potential constraints of finite primary materials. Prior studies on material demand forecasting of wind power development are often limited to a few materials and with low technological resolution, thus hindering a comprehensive understanding of the impact of microengineering parameters on the resource implications of wind energy. In this study, we developed a component-by-component and stock-driven prospective material flow analysis model and used bottom-up data on engineering parameters and wind power capacities to characterize the materials demand and secondary supply potentials of wind energy development in Denmark, a pioneering and leading country in wind power. We also explicitly addressed the uncertainties in the prospective modeling by the means of statistical estimation and sensitivity analysis methods. Our results reveal increasing challenges of materials provision and end-of-life (EoL) management in Denmark's ambitious transition toward 100% renewable energy in the next decades. Harnessing potential secondary resource supply from EoL and extending lifetime could curtail the primary material demand, but they could not fully alleviate the material supply risk. Such a model framework that considers bottom-up engineering parameters with increased precision could be applied to other emerging technologies and help reveal synergies and trade-offs of relevant resource, energy, and climate strategies in the future renewable energy and climate transition.

Real Wages, Labour Conditions and the Standard of Living in Denmark: 1500–1900

It is well established that Denmark is one of the richest economies in the world nowadays with high living standards and wages. But what about earlier times? This paper makes three contributions: firstly, it creates and describes a new and rich data set on historical wage developments in Denmark, based on data gathered by the Danish Price History Project for the period 1660‐1800; secondly, it tests the traditional view of Denmark being very poor during that period by offering insight into eighteenth century Danish living standards; and thirdly, it tests whether the country followed the traditional story of the Little Divergence by constructing a long run real wage series for 1500‐1900. Comparing real wages across Europe, I find incomes in the countryside actually converged in the sixteenth century. In this context, Denmark moved from being poor, to an average income level, becoming rich only in the nineteenth century. An analysis of the eighteenth century shows that the value of the skill premium was higher than that of leading countries in Europe, but the gender wage gap tended to close towards the end. Married women in skilled occupations earned more than unmarried ones, but no difference was seen for unskilled occupations.

Children's Doctor Games and Nudity at Danish Childcare Institutions.

This article presents the first Danish study of the acceptance of children's nudity and sexuality at Danish childcare institutions. The study revealed an important cultural shift in the attitude toward children's nudity and sexual games, the so-called doctor games. Although these were quite accepted at Danish childcare institutions until the beginning of this century, the study showed that new, pervasive regulations had been established to control the child's body and its sexuality. A new discourse revealed that fear of child sexual abuse, in particular, had influenced views of children's sexual games and nudity and that, at times, the child itself was viewed as a potential threat to other children. This marks a new development in Denmark, internationally known for its broadmindedness, and this article discusses the background to this cultural shift in the institutions, and possible implications for the children.