Region Zealand Research Articles

Clinical and Histological Characteristics of Mycosis Fungoides and Sézary Syndrome: A Retrospective, Single-centre Study of 43 Patients from Eastern Denmark.

Diagnosis of mycosis fungoides and Sézary syndrome can be very challenging. Clinical and histopathological data for patients with mycosis fungoides and Sézary syndrome in Denmark are limited. A retrospective study was performed in Region Zealand, Denmark from 1990 to 2016. A total of 43 patients with mycosis fungoides or Sézary syndrome were identified during the period. At the time of diagnosis the patients' mean age was 64.3 years and 74.5% had early-stage (≤IIA) disease. The mean time from onset of skin disease to diagnosis was 4.4 years. Surprisingly, 43% progressed to a higher disease stage, and risk of disease progression was higher for stage IB than IA (p = 0.01). All cases displayed some degree of epidermotropism and the infiltrates consisted of pleomorphic lymphocytes with a T-helper (CD4+/CD8-) phenotype. This study describes, for the first time, all aspects of clinical and histopathological findings in patients with mycosis fungoides and Sézary syndrome in a well-characterized Danish cohort.

Differences in mortality in Fusobacterium necrophorum and Fusobacterium nucleatum infections detected by culture and 16S rRNA gene sequencing.

Fusobacterium species are components of the normal microbiota of the oral cavity, gastrointestinal tract, and female genital tract. They are increasingly recognized as causative agents of oral, laryngeal, and tonsillar infections. Several fusobacterial species are involved in infections, with F. necrophorum and F. nucleatum being the most commonly cultured subtypes. In this study, we aimed to investigate clinical and prognostic differences in terms of mortality and association with malignancy between F. necrophorum and F. nucleatum detected by culture and 16S rRNA gene sequencing. This is a systematic, comparative, retrospective, non-interventional study. Data were extracted from the Department of Clinical Microbiology, Region Zealand, Denmark: all patients with F. necrophorum or F. nucleatum detected by culture or 16S rRNA gene sequencing from 1st of January 2010 to 30th of June 2015 were included. In total, F. necrophorum was detected in samples from 75 patients, and F. nucleatum in samples from 68 patients (total: n = 143). Thirteen patients had a current cancer diagnosis at the time of fusobacterial sampling. Multivariate analyses revealed a significant association of "current cancer" with 30-day mortality. Fusobacterial subtype was not associated with mortality neither in overall nor in subgroups with or without current cancer. Despite differences in clinical disease pattern between F. necrophorum and F. nucleatum, mortality was unaffected by fusobacterial subtype. Mortality was significantly related to comorbidity, especially a current diagnosis of cancer. Our data highlights the current debate whether fusobacterial involvement in cancer may have disease-altering properties, rather than being opportunistic pathogens secondary to cancer disease.

Author Correction: Precision medicine in the clouds.

This corrects the article DOI: 10.1038/nbt.4210.

Prevalence of Capillaria plica in Danish wild carnivores.

Capillaria plica is a parasitic nematode belonging to the family Capillariidae. The adult parasites reside in the urinary tract of wild and domestic canines. The infection is most often asymptomatic, but can cause a wide range of symptoms including urinary bladder inflammation, pollacisuria, dysuria and hematuria. Canines acquire the infection by ingesting the intermediate host, the earthworm (Lumbricidae). Epidemiological studies on C. plica infection in wildlife are few and only one previous Danish study examined the prevalence in red foxes, while studies on prevalence in other animals are limited. We examined the urine sediment or urinary bladder from 375 Raccoon dogs (Nyctereutes procyonoides), 247 red foxes (Vulpes vulpes), 20 beech martens (Martes foina), 16 wild mink (Neovison vison), 14 otters (Lutra lutra), nine European polecats (Mustela putorius), three European badgers (Meles meles) and one golden jackal (Canis aureus) received as a part of Danish wildlife surveillance. Capillaria plica was detected in 73.7% of red foxes, 20.0% of beech martens, 0.5% of raccoon dogs, and in the Golden jackal. Red foxes originating from all 5 regions of Denmark were infected, although with a significantly higher prevalence in the three regions in Jutland compared to Region Zealand.

Lolland-Falster Health Study: Study protocol for a household-based prospective cohort study

Introduction: Lolland-Falster consists of two islands in the southern part of Denmark where income is lower and life expectancy is shorter than in the general Danish population. It is a mixed rural-provincial area with approximately 100,000 inhabitants. The Lolland-Falster Health Study was initiated to gain knowledge on the determinants of health in this disadvantaged area. Methods: The study is a household-based prospective cohort study including people of all ages. The entire household of randomly selected inhabitants is allocated either to an invited group or to an uninvited, non-contacted control group. The data collection encompasses questionnaires, physical examination and biological samples, i.e. blood and urine for same-day analysis and biobank storage, and saliva and faeces also for biobank storage. The civil registration number links collected data for each individual, family and household, with information in Danish registers. The data collection started in February 2016 and is estimated to end by 2019 after the enrolment of 20,000 people. Analysis: A number of in-depth sub-studies are planned. Emphasis will be given to analysis of intra- and inter-family variations in health determinants, genetics, lifestyle and health status. Ethics: Region Zealand’s Ethical Committee on Health Research (SJ-421) and the Danish Data Protection Agency (REG-24-2015) approved the study. Trial registration: Clinicaltrials.gov (NCT02482896). Strength and limitations of this study: The strength of this study is that Lolland-Falster Health Study is a useful scientific resource for investigating cross-sectional difference and time trends within and between individuals, families and households. LOFUS adds diversity to the previously collected Danish population studies in urbanized areas. The limitation is that data collection is expensive. Conclusions: LOFUS will contribute to the knowledge on health in disadvantaged, rural-provincial areas.

High mortality from pyogenic vertebral osteomyelitis: a retrospective cohort study.

Retrospective cohort study. In this pilot study, we aimed to assess the incidence, diagnostic strategies, treatment regimens, and outcomes of pyogenic vertebral osteomyelitis (PVO), in a non-urban, Northern European population during 1 year. Region Zealand, Denmark. All patients admitted to a hospital in Region Zealand during 2013 and subsequently discharged with a diagnosis of PVO or discitis were eligible for screening. Discharge diagnosis codes were obtained from a central register and patients were identified with unique identification numbers from the Danish Civil Registration System. Forty-one consecutive patients were included. Patients presented with back pain (78%), fever (76%), elevated C-reactive protein levels (95%), and bacteremia (76%). Nine patients (22%) were treated empirically, as no bacterial etiology was isolated from blood culture or biopsy. The median duration of antibiotic treatment was 92 days, and we report an in-hospital mortality of 15%. This study supports previous findings of increasing incidence of PVO. In addition, we found a high rate of bacteremia and a high mortality in this single year cohort. Treatment regimens were heterogeneous and prolonged, due to delayed diagnosis and various or unknown microbial etiology. The study suggests that back pain, fever, and increased C-reactive protein levels are frequent in patients with PVO, and efforts should be made on securing early diagnosis and microbial etiology. Further studies of predictors of different clinical outcomes are warranted. Treatment of culture-negative cases and clinical value of bone biopsies are of special interest.

(Australia and New Zealand's Ties with Asia and Their Implications)

Korean Abstract: 본 연구는 호주·뉴질랜드의 경제적, 전략적 중요성을 살펴보고, 호주·뉴질랜드와의 협력 증대방안을 모색하고자 하였다. 이를 위하여 아시아 주요국을 중심으로 호주와 뉴질랜드의 경제관계 및 통상전략을 분석하고, 한-호주, 한-뉴질랜드 경제관계 및 기발효된 FTA를 점검하였다. 더 나아가 양국간 경제협력 확대 방안을 교역, 서비스 및 투자, 농업, 금융, 정부간 협력 등 다방면에서 모색하였다. English Abstract: Australia and New Zealand are classified as developed countries, but hitherto they have not been among the primary concerns of the Korean economy, due to their small populations, and the high logistics costs resulting from their isolated geographic location. When considering the areas of politics, diplomacy, and value chains in the Asia-Pacific region, however, Australia and New Zealand are countries that deserve great notice. Australia and New Zealand support the rules-based international order and multilateral trading system, and are key participants in the CPTPP and RCEP. They are among the most important countries that will influence the shape of the regional order. Australia and New Zealand also share a complementary industrial structure with Korea, which can provide mutual benefits through long-term economic cooperations. Therefore, this study examines the economic and strategic importance of Australia and New Zealand, and investigates ways for Korea to strengthen its ties with Australia and New Zealand.

The effect of implementation of an early detection team: A nationwide register-based study of characteristics and help-seeking behavior in first-episode schizophrenia in Denmark

BackgroundIn an effort to make people with signs of psychosis seek help as early as possible, Region Zealand launched in 2012 an early detection team project as the first and only in Denmark. The project consisted of a combination of easy access and an information campaign targeting the public. This nation-wide study examined characteristics and help-seeking behavior of patients with first-episode schizophrenia (FES) in the early detection region in comparison with other Danish regions. MethodData from the Danish National Schizophrenia register on all Danish patients diagnosed with first-episode schizophrenia during 2012 to 2015 were linked to demographic and health care data drawn from official national registers. Binary logistic regression analyses examined the difference between the early detection region and other regions controlling for demographic characteristics and utilization of mental health care services and contacts to general practitioner (GP). ResultsPatients in the early detection region were younger (OR = 0.51; CI: 0.42–0.62; p < 0.000) than in regions without early detection teams. Furthermore, they were more likely to be of Danish origin, and less likely to have contact with mental health services and GPs prior to FES. ConclusionThe study suggests that implementing an early detection team in combination with an information campaign contributed to detecting patients with first-episode schizophrenia earlier than in regions without the early detection team. The study gives an indication of different pathways among patients in the early detection region.

UNEMPLOYMENT DYNAMICS IN THE ASIA-PACIFIC REGION: A PRELIMINARY INVESTIGATION

This study empirically examined unemployment dynamics in 12 countries in the Asia-Pacific region, namely, China, Hong Kong, Taiwan, South Korea, Japan, Indonesia, Malaysia, the Philippines, Singapore, Thailand, Australia and New Zealand. It used quarterly data on the unemployment rates from the first quarter of 1980 to the first quarter of 2013. This paper employed three different econometric methods, including the recently-developed powerful unit root test with structural break (Lee and Strazicich, 2003, 2004) and the nonlinear unit root test (Enders and Lee, 2012). The findings indicated that the unemployment rates in five countries of the region, namely, China, Taiwan, South Korea, the Philippines and Thailand, had highly dynamic labor markets in which higher-than-normal unemployment rates would revert to the normal level. The other seven Asia-Pacific countries had less dynamic labor markets. The findings of this study have some important policy implications.

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes

It is unclear whether a lifestyle intervention can maintain glycemic control in patients with type 2 diabetes. To test whether an intensive lifestyle intervention results in equivalent glycemic control compared with standard care and, secondarily, leads to a reduction in glucose-lowering medication in participants with type 2 diabetes. Randomized, assessor-blinded, single-center study within Region Zealand and the Capital Region of Denmark (April 2015-August 2016). Ninety-eight adult participants with non-insulin-dependent type 2 diabetes who were diagnosed for less than 10 years were included. Participants were randomly assigned (2:1; stratified by sex) to the lifestyle group (n = 64) or the standard care group (n = 34). All participants received standard care with individual counseling and standardized, blinded, target-driven medical therapy. Additionally, the lifestyle intervention included 5 to 6 weekly aerobic training sessions (duration 30-60 minutes), of which 2 to 3 sessions were combined with resistance training. The lifestyle participants received dietary plans aiming for a body mass index of 25 or less. Participants were followed up for 12 months. Primary outcome was change in hemoglobin A1c (HbA1c) from baseline to 12-month follow-up, and equivalence was prespecified by a CI margin of ±0.4% based on the intention-to-treat population. Superiority analysis was performed on the secondary outcome reductions in glucose-lowering medication. Among 98 randomized participants (mean age, 54.6 years [SD, 8.9]; women, 47 [48%]; mean baseline HbA1c, 6.7%), 93 participants completed the trial. From baseline to 12-month follow-up, the mean HbA1c level changed from 6.65% to 6.34% in the lifestyle group and from 6.74% to 6.66% in the standard care group (mean between-group difference in change of -0.26% [95% CI, -0.52% to -0.01%]), not meeting the criteria for equivalence (P = .15). Reduction in glucose-lowering medications occurred in 47 participants (73.5%) in the lifestyle group and 9 participants (26.4%) in the standard care group (difference, 47.1 percentage points [95% CI, 28.6-65.3]). There were 32 adverse events (most commonly musculoskeletal pain or discomfort and mild hypoglycemia) in the lifestyle group and 5 in the standard care group. Among adults with type 2 diabetes diagnosed for less than 10 years, a lifestyle intervention compared with standard care resulted in a change in glycemic control that did not reach the criterion for equivalence, but was in a direction consistent with benefit. Further research is needed to assess superiority, as well as generalizability and durability of findings. clinicaltrials.gov Identifier: NCT02417012.

Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial.

BackgroundEvidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages in diagnosing adolescent BPD, there is a lack of cost-effective evidence-based treatment programs for adolescents. Mentalization-based treatment is an evidence-based program for BPD, originally developed for adults.Methods/DesignAims/hypotheses: We will investigate whether a specifically designed mentalization-based treatment in groups is an efficacious treatment for adolescents with BPD or subthreshold BPD compared to treatment as usual. The trial is a four-center, two-armed, parallel-group, assessor-blinded randomized clinical superiority trial. One hundred twelve patients aged 14 to 17 referred to Child and Adolescent Psychiatric Clinics in Region Zealand are randomized to 1 year of either mentalization-based treatment in groups or treatment as usual. Patients will be included if they meet at least four DSM-5 criteria for BPD. The primary outcome is self-reported borderline features at discharge. Secondary outcomes will include self-harm, depression, BPD criteria, externalizing and internalizing symptoms, and social functioning, together with parental reports on borderline features, externalizing and internalizing symptoms. Measures of attachment and mentalization will be included as mediational variables. Follow-up assessment will take place at 3 and 12 months after end of treatment.DiscussionThis is the first randomized controlled trial to test the efficacy of a group-based mentalization-based treatment for adolescents with BPD or subthreshold BPD. If the results confirm our hypothesis, this trial will add to the treatment options of cost-effective treatment of adolescent BPD.Trial registrationClinicaltrials.gov NCT02068326, February 19, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1431-0) contains supplementary material, which is available to authorized users.

Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group.

The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. Every individual presenting with a non-affective first-episode psychosis (F20-29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for; peer support diminished the risk of psychosis caused by childhood adversities by 10%. Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.

Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials

Study question Is methylphenidate beneficial or harmful for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents?Methods Electronic databases were searched up to February 2015 for parallel and crossover...

Cutaneous malignant melanoma in situ: A Danish cross-sectional study on patient and tumour characteristics in 144 cases: Population-based cross-sectional study

IntroductionCutaneous malignant melanoma in situ (MIS) has not been subject to much attention or investigation. Little is known of the characteristics of patients and tumours. The aim of this study was to elucidate important tumour characteristics in patients treated for MIS. MethodsBased on data from the Danish Melanoma Register, patient and tumour characteristics were evaluated in a cross-sectional study including all patients diagnosed with cutaneous malignant melanoma in Health care Region Zealand between 2012 and 2013. ResultsA total of 144 patients were identified with malignant melanoma in situ; more females were affected than males, and the males were older than females. Patients with lentigo maligna were older than patients with superficial spreading MIS, which were predominantly found in the head and neck region. Among patients treated for MIS, 28% were previously treated for other skin malignancies. ConclusionThe anatomical distribution of MIS differed with patient age and tumour subtype. The anatomical distribution was different in comparison to invasive malignant melanomas, and MIS cases were generally older. This suggests a non-linear relation between malignant melanoma in situ and invasive malignant melanoma.

The Impact of High Risk Advertising on Thai Social Values: The Role of Piracy Websites

Recent research indicates that users of piracy websites face significant risks, since much of the advertising has the potential to cause harm to users. This type of advertising is called “high risk”, and includes ads from the sex industry, gambling, malware and scams. Some studies have focused on naming and shaming mainstream advertisers on piracy sites (Taplin, 2013) – there remain significant numbers of these advertisers in Asia, placing ads through ad networks that focus on local language and local content. A number of studies have recently investigated the role played by mainstream internet advertising in supporting the revenue of piracy websites. Such advertising by household names – including multinational corporations, governments and charities – generates enormous profit margins for operators of these websites.However, the advertisements which have the potential to cause the greatest harm are also those which may be contrary to Thai values. While vigilance against these harms is often promoted within the physical environment in Thailand – such as The Gaming Act (B.E. 2478) and The Prevention and Suppression of Prostitution Act (B.E. 2539) – policing the online environment to protect Thai citizens from these activities may be more challenging.A first step in understanding the risk to users is to measure the prevalence of such material. Recent studies have measured the scale of the problem in the Asia-Pacific region, including Singapore, Malaysia, Hong Kong, Taiwan, Canada, Indonesia, Australia and New Zealand. Generally speaking, the pattern seems to be that high risk advertisers tend to target those sites which are promoting Hollywood and/or other international content in English, whereas mainstream advertisers tend to promote their goods and services on local language sites, with local content.The goal of this study was to measure the problem in Thailand. A sample of 430 webpages from the most popular piracy websites in Thailand piracy was downloaded and analysed, to reveal the prevalence of both mainstream and high-risk advertising. The sample was derived from the use of a snowball technique to generate a list of sites using vocabulary terms linked to illegal downloading. Snowball sampling replicates the path taken by users as they search for infringing content by using search engines. It also acts as a proxy measure for popularity, since the most “relevant” search terms are always returned by ranking. Analysis of the data reveals that 6.26% of the ads found on the most popular piracy websites in Thailand were mainstream, and 93.74% were high-risk, of which a substantially high percentage (62.22%) were sex industry ads, and 16.05% were for gambling. The results are discussed in the context of policing the online environment with regard to Thai social policy.

Biostratigraphy and palaeoecology of Middle–Late Ordovician conodont and graptolite faunas of the Las Chacritas River section, Precordillera of San Juan, Argentina

AbstractA conodont-graptolite biostratigraphic study was carried out on the top strata of the San Juan, Las Chacritas and Las Aguaditas formations in the La Trampa Range, Precordillera of San Juan in western Argentina. Significant conodont records in the San Juan and Las Chacritas formations allow for the recognition of theYangtzeplacognathus crassus, Eoplacognathus pseudoplanus(Microzarkodina hagetianaandM. ozarkodellasubzones) andEoplacognathus suecicuszones of Darriwilian age. Index species and co-occurrences of graptolites and conodonts were recorded in the Las Aguaditas Formation allowing the identification of theNemagraptus gracilisand thePygodus anserinuszones, which represent the Sandbian Stage. These data indicate a hiatus between the Las Chacritas and the Las Aguaditas formations, corresponding to thePygodus serraZone and thePterograptus elegansandHustedograptus teretiusculuszones (upper Darriwilian). A total of 7287 identifiable conodont elements were recorded from the study section. The species frequency registered for each zone shows thatPeriodonandParoistodusare the most abundant taxa, which are indicative of open marine environments. The records of particular conodont taxa, such asHistiodella, Periodon, Microzarkodina, EoplacognathusandBaltoniodus, allow a precise global correlation with other regions such as south-central China, Baltoscandia, North America, Great Britain, Southern Australia and New Zealand. The graptolite fauna identified here are recognized worldwide in equivalent strata in the Baltic region, Great Britain, North America, China, southern Australia and New Zealand. The presence of graptolites in the ribbon limestones of the Las Chacritas Formation is documented for the first time.

Less pitfalls and variation in population based cancer survival comparisons within the European Union: Lessons from colorectal cancer patients in neighbouring regions in Denmark and Germany – The Fehmarn Belt project

BackgroundInternational comparisons of cancer registry based survival are often used as a marker of the performance of health care services on cancer. These are debated for comparability, validity and lack of detail with respect to prognostic factors. With a view to cross border collaborative cancer research and care in the European Union (EU), we used the established routine registration systems for cancer in the neighbouring regions Zealand, Denmark, and Schleswig-Holstein, Germany, to study if available routine registration suffices for the study of diagnosis, treatment and follow-up for colorectal cancer patients. The aim was to assess to which extent differences in survival between the regions could be explained. MethodsColorectal cancer patients recorded 2004–2010 in Schleswig-Holstein (colon: 10,631; rectum 5683) and region Zealand (colon: 3205; rectum 1747) were studied. Excluding cases aged 90+ or only known from death certificates, one- and four-year relative survival by stage for the periods 2004–2006 and 2007–2009 (one-year) were calculated. FindingsA high proportion of patients in Schleswig-Holstein were known only from death certificates (colon 11%; rectum 6.9%) compared to <0.3% in region Zealand. Colon cancer incidence (asr-e) (men 36; women 28) and mortality (men 12; women 8.7) in Schleswig-Holstein were 10 per 100,000 lower than in Zealand; minor differences were seen for rectum cancer. One and four-year overall survival increased in both regions but was superior in Schleswig-Holstein. For patients with reported stage I–III, negligible differences in survival were seen; with further restriction to patients with treatment reported, even so in stage IV patients 2007–2009. InterpretationImproved data quality and comparability than presently used in the large international survival studies is needed. If stage and treatment is taken into account, more valid international comparisons of cancer survival are possible. Reporting and follow-up must be improved and cases only known from death certificates (DCO) minimised. A high proportion DCO (excluded from analyses) may produce higher survival, whereas a low the opposite. Co-morbidity and socio-economic status should be included alongside other prognostic variables in survival studies. Barriers towards proper follow-up and monitoring of outcome e.g. privacy legislation must be considered with a view to future patient mobility.

Do Rogue Websites and High Risk Advertising Undermine Social Policy in Vietnam?

Recent research indicates that users of rogue websites face significant risks, since much of the advertising has the potential to cause harm to users. This type of advertising is called “high risk”, and includes ads from the sex industry, gambling, malware and scams. Some studies have focused on naming and shaming mainstream advertisers on rogue sites (Taplin, 2013) –there remain significant numbers of these advertisers in Asia, placing ads through ad networks that focus on local language and local content. A number of studies have recently investigated the role played by mainstream internet advertising in supporting the revenue of rogue websites. Such advertising by household names – including multinational corporations, governments and charities – generates enormous profit margins for operators of these websites. However, the advertisements which have the potential to cause the greatest harm are also those which are often forbidden under Vietnamese law. While vigilance against these harms is often promoted within the physical environment in Vietnam, policing the online environment to protect citizens from these activities may be more challenging. A first step in understanding the risk to users is to measure the prevalence of such material. Recent studies have measured the scale of the problem in the Asia-Pacific region, including Singapore, Malaysia, Hong Kong, Taiwan, Canada, Indonesia, Australia and New Zealand. Generally speaking, the pattern seems to be that high risk advertisers tend to target those sites which are promoting Hollywood content in English, whereas mainstream advertisers tend to promote their goods and services on local language sites, with local content. The goal of this study was to measure the problem in Vietnam. A sample of 600 webpages from rogue sites was downloaded and analysed, to reveal the prevalence of both mainstream and high-risk advertising. The sample was derived from the use of a snowball technique to generate a list of sites using vocabulary terms linked to illegal downloading. Snowball sampling replicates the path taken by users as they search for infringing content by using search engines. It also acts as a proxy measure for popularity, since the most “relevant” search terms are always returned by ranking. Analysis of the data reveals that 60.98% of the ads were mainstream, and 39.02% were high-risk, of which 37.77% were gambling ads, and 27.08% were sex ads. The results are discussed in the context of policing the online environment with regard to Vietnamese social policy.

How Risky are Piracy Websites for Indonesians? The Role of Search

Recent research indicates that users of rogue websites face significant risks, since much of the advertising has the potential to cause harm to users. This type of advertising is called risk, and includes ads from the sex industry, gambling, malware and scams. Some studies have focused on naming and shaming mainstream advertisers on rogue sites (Taplin, 2013), and there are significant numbers of these advertisers in Asia, placing ads through ad networks that focus on local language and local content. A number of studies have recently investigated the role played by mainstream internet advertising in supporting the revenue of rogue websites. Such advertising by household names – including multinational corporations, governments and charities – generates enormous profit margins for operators of these websites.However, the advertisements which have the potential to cause the greatest harm are also those which are forbidden under Islamic jurisprudence. While vigilance against these harms is often promoted within the physical environment in Indonesia (eg, Jakarta Post, 2014), policing the online environment to protect citizens from haram activities (Assyaukanie, 2009) may be more challenging.A first step in understanding the risk to users is to measure the prevalence of such material. Recent studies have measured the scale of the problem in the Asia-Pacific region, including Singapore, Malaysia, Hong Kong, Taiwan, Canada, Australia and New Zealand. Generally speaking, the pattern seems to be that high risk advertisers tend to target those sites which are promoting Hollywood content in English, whereas mainstream advertisers tend to promote their goods and services on local language sites, with local content.The goal of this study was to measure the problem in Indonesia. A sample of 1,000 webpages from rogue sites was downloaded and analysed, to reveal the prevalence of both mainstream and high-risk advertising. The sample was derived from expert opinions as well as the use of a snowball technique to generate a list of sites using vocabulary terms linked to illegal downloading. Snowball sampling replicates the path taken by users as they search for infringing content by using search engines. It also acts as a proxy measure for popularity, since the most relevant search terms are always returned by ranking. Analysis of the data reveals that 16.05% of the ads were mainstream, and 83.95% were high-risk, of which 75% were gambling ads. The level of gambling advertising was unprecedented and not observed in any other country. The results are discussed in the context of policing the online environment with regard to Indonesian social policy.

A multicenter, randomized, controlled study of Training Executive, Attention, and Motor Skills (TEAMS) in Danish preschool children with attention-deficit/hyperactivity disorder: Rationale and description of the intervention and study protocol

Abstract Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder that is often detected during the preschool years. Neuroimaging data indicate that children with ADHD have brains that are characterized by growth and functional anomalies. Data suggest that the diminution of ADHD symptoms is correlated with improved neural functioning and growth. On the basis of these findings, interventions that target neural growth, which indicates neural development, can possibly lead to a more enduring treatment for ADHD. Training Executive, Attention, and Motor Skills (TEAMS) is a non-pharmacological neurocognitive intervention program that targets preschool children with ADHD. The program is designed to stimulate neurocognitive growth through physical activity and play in combination with psychoeducation and guidance for the parents. Population: Children between the ages of three and six years from Region Zealand in Denmark who have been diagnosed with ADHD are offered participation in the trial. According to a calculation of the strength needed to result in a statistically significant outcome, the estimated group size should be, at minimum, 87 children. On the basis of Region Zealand’s visitation history records, the cohort is expected to include approximately 100 to 120 children. Method: The intervention groups participate in eight weekly group sessions that consist of separate parent and children’s groups. The control groups receive the standard treatment program as outlined by the clinical guidelines of Region Zealand. The ADHD Rating Scale-IV and the Danish version of the Strengths and Difficulties Questionnaire are used to assess ADHD symptom severity before and after the intervention and to monitor the duration of the outcome. A comparative analysis of data from the intervention and control groups will illustrate the study’s results. Study aim: This is a multicenter, randomized, controlled, single-blind, parallel-group study with the primary aims of testing the TEAMS concept and investigating whether the intervention significantly lowers ADHD symptoms and increases the functionality level after the intervention as compared with the control group. A secondary aim is to monitor the duration and endurance of the outcome for six months after the intervention. This study is currently in progress. Full results and conclusions will be reported after the study’s completion in 2015.