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(In)completing accounting:Financial managers and quality reforms in the Danish health system
No full textThis study investigates the way that managers operating in the Danish health system encounter, make sense of, and enact a series of different reforms equipping and encouraging them to attend to and improve the quality of medical care. Our attention focuses on the conditions under which managers are enabled to perceive the incompleteness of the accounting systems and metrics, which shape and are shaped by how the reforms are enacted and what they ultimately mean in practice. On this basis we offer novel insights into the process we refer to as incompleting accounting, which we show involves and relates to managerial actions and intentions, and design characteristics of the accounting systems themselves. Illuminating the relationship between incompleting accounting at the level of practice, and completing quality at the level of policy, also allows us to provide a normative assessment of the different quality improvement regimes. Finally, we contribute to debates about the breaking down of distinctions between medical and managerial forms of knowledge and action, highlighting among other things a new direction of hybridization brought about as an indirect effect of accounting for quality.</p
Brugerperspektiver på 4-parts videomøder (V4M) med den multisyge patient:En evaluering med praktikere fra hospital, almen praksis og kommune samt hjemmet
No full textÆldre patienter med multisygdom skrøbliggøres af mange indlæggelser og udfordrer det danske sundhedsvæsen. Rapporten evaluerer en drejebog for fireparts videomøder (V4M) med den ældre hospitalspatient, dennes pårørende, egen læge, hjemkommune og hospitalet. V4M er gennemført som et feasibility studie med 46 patienter og evalueret med mixed metoder, survey med 98 unikke brugere fra de fire domæner hospital, kommune, almen praksis og fokusgruppeinterviews med 19 informaner fra de respektive vidensdomæner. Evaluering svarer på brugernes oplevelse af V4M, selve samtalen, inddragelse af patienten, eget ansvarsområde, sammenhæng med respektive arbejdsgange, teknik, relationsopbygning og sammenhængskraft mellem parterne og deres indbyrdes forskelle. V4M giver mening for alle brugergrupperne men med ulige nytteværdi og forbrug af ressourcer. Parterne har kvalitative forslag til organisatorisk udviklinger, der understøtter den interorganisatoriske sammenhæng.<br/
Cladosporium species detoxify multiple water micropollutants of emerging concern
Get PDFThe accumulation of micropollutants of emerging concern in aqueous ecological niches raises safety concerns regarding biological systems and human health. Mycoremediation is a promising and green strategy to mitigate the micropollutant challenge. Hitherto, micropollutant transformation by white-rot Basidiomycota species has received most attention, whereas the potential of ascomycetes with respect to removal of micropollutants remains underexplored. Here, we assayed 53 Ascomycota isolates from 10 genera for the removal of 22 micropollutants, spanning large chemical diversity including mono- and multi-aromatic rings as well as different polarities, charge and halogen substitution. Functionally, the micropollutants included analgesic, antibiotics, antidepressant, anti-inflammatory, blood pressure regulating, and lipid-lowering drugs as well as anticorrosion agents, a herbicide, and an X-ray contrast agent. Notably, 9 out of the 22 micropollutants were removed from fungal culture supernatant at efficiencies > 45 %. Temporal analysis of the nine top-performing strains, highlighted a remarkable potency of the Cladosporium isolates in removal of multiple micropollutants. Importantly, Cladosporium species considerably reduced the toxicity of a cocktail of six micropollutants, based on growth assays. Metabolite network analyses identified different levels of oxidation and methylation biotransformation products for distinct micropollutants, whereas no products could be identified for other micropollutants, such as ciprofloxacin, sulfamethoxazole, and sertraline, hinting more extensive transformations. Genome sequencing and proteomic analyses were consistent with the observed transformations and tentatively identified the molecular apparatus, conferring micropollutant transformation. This study brings novel insight into the micropollutant transformation and detoxification capabilities of ecologically prevalent Cladosporium species, thereby revealing a considerable, albeit hitherto underappreciated potential of ascomycetes in micropollutant transformation.</p
Investigating the structure and fracture toughness of spodumene glass-ceramics using machine learning
No full textCrystals in glass-ceramics can impede crack propagation and cause crack deflection to prevent crack extension, improving the fracture toughness of the glass. However, detailed atomic-scale understanding of crack initiation and propagation in glass-ceramics remains elusive. In this work, we first experimentally investigate the fracture patterns of Li2O-Al2O3-SiO2 (LAS) glass-ceramics, finding enhanced crack deflection for higher crystallinity. To investigate the influence of different crystal morphologies on the fracture mode and understand the structure-mechanics relationships, we then simulate the fracture behavior of LAS glass-ceramics using molecular dynamics simulations. We find that a high frequency of Al coordination number changes (bond switching events) occur during the fracture process, consuming the fracture energy. We then use a classification-based machine learning model to calculate 'softness' based on the static structure. Subsequent simulations show that softness can predict Al bond switching and thus capture the long-term dynamic behavior of Al atoms. Notably, although we did not use crystallinity as the training dataset, the machine learning model can learn the structure features related to bond switching probability and differentiate the fracture behavior at different stages. As such, softness can effectively predict the fracture behavior, i.e., predict the microscopic failure mode of glass-ceramics based on their structure. This work thus reveals the influence of the initial atomic-scale structure on different fracture modes in glass-ceramics, which is beneficial for guiding the design of novel glass-ceramic compositions
Additional file 4 of Identification of two biological subgroups of complex regional pain syndrome type 1 by transcriptomic profiling of skin and blood in women
No full textAdditional file 4
Sexuality, masculinity, and fertility: A qualitative study of men's experiences during fertility treatment
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Women´s experiences with childhood sexual abuse, functional disorders and the encounter with the healthcare system
No full textBaggrund: Seksuelle overgreb i barndommen (Childhood Sexual Abuse, CSA) udgør et betydeligt folkesundhedsproblem og er forbundet med alvorlige, langvarige senfølger i voksenlivet. Disse omfatter psykiske, somatiske og relationelle problemer, herunder angst, depression, PTSD, selvmordsforsøg, misbrug og personlighedsforstyrrelser. Forskning viser desuden en sammenhæng mellem CSA og funktionelle lidelser, som rammer cirka 10 % af befolkningen i Danmark – med en overrepræsentation af kvinder. Årsagerne er komplekse og involverer biologiske, psykologiske og sociale faktorer. Der er begrænset viden om, hvordan CSA specifikt påvirker behandlingen af funktionelle lidelser, og mange læger finder det vanskeligt at inddrage temaet i patientkontakten, hvilket kan føre til manglende hjælp og støtte. Metode: Studiet anvender en kvalitativ tilgang med semistrukturerede interviews og en litteratursøgning i tværfaglige databaser. Interviews blev gennemført med fire kvinder, der havde været udsat for seksuelle overgreb før 16-årsalderen og senere udviklet funktionelle lidelser. Deltagerne blev rekrutteret fra to almen praksis, og interviewene blev udført personligt for at sikre tryghed. Data blev analyseret med en fænomenologisk og hermeneutisk tilgang, hvor centrale temaer blev identificeret gennem iterativ læsning. Resultater:Deltagerne beskrev en tydelig sammenhæng mellem deres tidlige traumer og deres senere fysiske symptomer. Flere nævnte at forståelsen heraf først opstod i mødet med professionelle, særligt i behandlingsforløb med fokus på traumer. Der blev også udtrykt en oplevelse af manglende viden og opmærksomhed fra sundhedsvæsenets side. Konklusion: Studiet belyser, hvordan kvinder med funktionelle lidelser og CSA-erfaringer forstår deres sygdomsudvikling og mødet med sundhedssystemet. Der er behov for større traumeopmærksomhed og systematisk opsporing i behandlingsforløb. En mere helhedsorienteret og traumeinformeret tilgang efterspørges for at sikre relevant støtte og behandling. Background: Childhood Sexual Abuse (CSA) represents a major public health issue and is associated with severe and long-lasting consequences in adulthood. These include psychological, somatic, and relational difficulties such as anxiety, depression, PTSD, suicide attempts, substance abuse, and personality disorders. Research also suggests a link between CSA and functional disorders, which affect approximately 10% of the Danish population, with a higher prevalence among women. The causes of functional disorders are complex, involving biological, psychological and social factors. There is limited knowledge about how CSA specifically influences the treatment of functional disorders, and many physicians report difficulties in addressing CSA with patients, potentially leading to inadequate care. Method: This study employed a qualitative approach using semi-structured interviews and a literature review across interdisciplinary databases. Interviews were conducted with four women who had experienced CSA before the age of 16 and later developed functional disorders. Participants were recruited from two general practices, and interviews were conducted in person to ensure a safe and trusting environment. The data were analyzed using a phenomenological and hermeneutic approach, identifying central themes through iterative readings. Results: Participants described a clear connection between their early trauma and later physical symptoms. Several reported that it was not until they encountered health professionals that they began to understand this link—particularly within trauma-informed treatment settings. They also expressed a general sense of insufficient awareness and knowledge within the healthcare system. Conclusion: The study highlights how women with functional disorders and a history of CSA understand their illness trajectories and experiences with healthcare services. Findings point to a need for improved trauma awareness and systematic screening in treatment settings. A more holistic and trauma-informed approach is needed to provide adequate support and care
The Omnibus Package: A Legal-Dogmatic Analysis of the Simplification of EU Corporate Sustainability Legislation
No full textDette speciale undersøger Kommissionens lovforslag, kaldet Omnibus-pakken, der blevet publiceret d. 26 februar 2025 og dets indvirkning på EU’s bæredygtighedsreguleringer for virksomheder. I forhold til metodisk fremgangsmåde anvender specialet den retsdogmatiske metode til at analyse og vurdere, om de foreslåede ændringer til Corporate Sustainability Reporting Directive (CSRD), Corporate Sustainability Due Diligence Directive (CSDDD) og EU Taxonomy Regulation (EUTAXR) er i overensstemmelse med EU’s overordnede klimamålsætninger, særligt den Europæiske Grønne Pagt og Paris-aftalen, og de retsprincipperne om retssikkerhed og proportionalitet, der gør sig gældende på EU-niveau. Specialet indledes med en historisk kontekstualisering af udviklingen fra soft law til bindende EU-retsakter (hard law) inden for området. På denne baggrund gennemføres en analyse af Omnibus-pakkens forslåede indhold samt den lovgivningsmæssige proces. Særligt de forslåede ændringer til lovgivningens omfang, tidsfrister, standarder og due diligence-forpligtelser. Indholdet i Omnibus-pakken vurderes løbende op mod EU’s overordnede politiske forpligtelser. Området for EU’s bæredygtighedsregulering for virksomheder har, i de sidste to årtier, været under markant udvikling. Specialet gennemgår denne udvikling med henblik på at redegøre, for tendenser og incitamenter, der har skabt udviklingen på området. Dernæst inddrages området tre nøgleinstrumenter, CSRD, CSDDD og EUTAXR, for at redegøre for dets indhold, set i lyset af den historiske udvikling samt den forestående analyse af Omnibus-pakken.Analysen sammendrager Omnibus-pakkens indhold, for at udlede bevæggrunde og den fremtidig retstilstand for området. Afslutningsvist konkluderer specialets, at Omnibus-pakken ikke eksplicit udgør en dergulering af området, men derimod en væsentlig justering af dens omfang, indhold og ambitionsniveau. De foreslåede ændringer forsøger at lette de administrative byrder og øge proportionaliteten, herunder særligt for små og mellemstore virksomheder. Det påpeges dog, at forslagene indebærer risiko for en reduceret gennemsigtighed og usikkerhed omkring den fremtidige retstilstand på området. Afhandlingen understreger desuden nødvendigheden af, at de overordnede målsætninger i den Grønne Pagt og Paris-aftalen bør fastholdes i implementeringsfasen, hvis EU skal kunne være i stand til at leve op til dens målopfyldelse