Negotiating Normalcy: Epistemic Errors in Self-Diagnosing Late-ADHD.

In this paper, I share insights from ongoing ethnographic fieldwork among adult Danes who identify as having Attention Deficit Hyperactivity Disorder (ADHD) but do not meet the clinical standards and have yet to receive a diagnosis. These individuals are particularly relevant to the ongoing debates about under- and overdiagnosis of ADHD, as their claims to the diagnosis influence and mirror societal perceptions of what is considered normal and what is seen as a condition. Despite their symptoms not strictly meeting diagnostic criteria, thus risking overdiagnosis and associated psychiatric labeling, they perceive themselves as distinct from 'normal' people.

Medicalization of Old Age: Experiencing Healthism and Overdiagnosis in a Nordic Welfare State.

In Denmark, people are expected to take responsibility for their health, not least as their bodies age and they experience signs of physical or mental decline. Drawing on fieldwork among older Danes, I illustrate that an excessive focus on health gives rise to social and structural controversies and disparities, linking ideas of healthy behavior at the individual level with the societal framing of disease and aging. I argue that this emphasis contributes to the unwarranted diagnosis of bodily variations that naturally occur in the aging process, a phenomenon referred to as overdiagnosis, adding to a broader medicalization of old age.

General practitioners' experiences of providing somatic care for patients with severe mental illness: a qualitative study.

Background: Patients dealing with severe mental illnesses (SMI) often face suboptimal clinical outcomes and higher mortality rates due to a range of factors, including undetected physical health conditions. The provision of care for individuals with SMI is frequently disjointed, as they engage with diverse healthcare providers. Despite this fragmentation, primary care, particularly general practitioners (GPs), assumes a pivotal role in the care of SMI patients.

Rethinking the logic of early diagnosis in cancer.

To reduce morbidity and mortality of cancer, more countries have implemented strategies to detect cancer, based on the logic of 'the sooner the better'. is thereby an essential component in how cancer research, policies, and prevention are practiced today. Where the logic of early diagnosis benefits some, the logic also produces harms.

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Overdiagnosis is the process of making people into patients unnecessarily. Besides undermining the quality of care and patient outcomes, overdiagnosis (and overuse) prompts the urge to look at how to reduce low-value care to face the climate crisis. It is estimated that 80% of the total CO2 emission from the healthcare sector stems from clinical activity and that 40% of this is low-value care.

Challenges in reaching patients with severe mental illness for trials in general practice-a convergent mixed methods study based on the SOFIA pilot trial.

Background: Patients with severe mental illness (SMI) die prematurely due to undetected and inadequate treatment of somatic illnesses. The SOFIA pilot study was initiated to mend this gap in health inequity. However, reaching patients with SMI for intervention research has previously proven difficult.

Older adults' perceptions of navigating eye health care in Denmark: a qualitative study.

Background: Vision impairment can have an impact on cognition, health, and social function. Vision loss may be avoided if detected early and treated promptly. Eye health is a minor topic in general practice, but the ongoing relationship between doctor and patient has the potential to assist the patient in navigating the healthcare system and guaranteeing timely healthcare service delivery.

Generating Items for Measuring Needs-Based Quality of Life and Self-Perceived Health Inequity in Patients with Multimorbidity: Development of the MultiMorbidity Questionnaire (MMQ).

Purpose: To describe the processes of developing domains and items for the MultiMorbidity Questionnaire (MMQ), a multimorbidity-specific PROM for the assessment of Needs-based QoL.

Patients And Methods: We developed items and domains for the MMQ through 17 qualitative content validity questionnaire interviews with adults with multimorbidity by testing items from an item bank (covering items with content inspired by existing Needs-based QoL measures for single diseases). The interviews alternated between an explorative part and more focused cognitive interview techniques.

Measuring needs-based quality of life and self-perceived health inequity in patients with multimorbidity: investigating psychometric measurement properties of the MultiMorbidity Questionnaire (MMQ) using primarily Rasch models.

Background: Multimorbidity is a burden for the individual and to the healthcare sector worldwide, leading to a rising number of intervention studies towards this patient group. To measure a possible effect of such interventions, an adequate patient-reported outcome measure (PROM) is essential. The aim of this study was to assess the draft MultiMorbidity Questionnaire (MMQ), a PROM measuring needs-based quality of life and self-perceived inequity in patients with multimorbidity, for its psychometric properties and to adjust it accordingly to create a content- and construct valid measure.

The SOFIA pilot study: assessing feasibility and fidelity of coordinated care to reduce excess mortality and increase quality of life in patients with severe mental illness in a general practice setting; a cluster-randomised pilot trial.

Objective: To evaluate the feasibility and fidelity of implementing and assessing the SOFIA coordinated care program aimed at lowering mortality and increasing quality of life in patients with severe mental illness by improving somatic health care in general practice.

Design: A cluster-randomised, non-blinded controlled pilot trial.

Setting: General Practice in Denmark.

Pressure-controlled versus manual facemask ventilation for anaesthetic induction in adults: A randomised controlled non-inferiority trial.

Background: Pressure-controlled face mask ventilation (PC-FMV) with positive end-expiratory pressure (PEEP) after apnoea following induction of general anaesthesia prolongs safe apnoea time and reduces atelectasis formation. However, depending on the set inspiratory pressure, a delayed confirmation of a patent airway might occur. We hypothesised that by lowering the peak inspiratory pressure (PIP) when using PC-FMV with PEEP, confirmation of a patent airway would not be delayed as studied by the first return of CO , compared with manual face mask ventilation (Manual FMV).

Fictitious cases as a methodology to discuss sensitive health topics in focus groups.

Purpose: It can be challenging to research aspects of people's health behaviour, attitudes, and emotions due to the sensitive nature of these topics. We aimed to develop a novel methodology for discussing sensitive health topics, and explore the effectiveness in focus groups using prostate cancer and screening as an example.

Method: We developed a fictitious case and employed it as a projective technique in focus groups on prostate cancer and screening.

DETECT: DEveloping and testing a model to identify preventive vision loss among older paTients in gEneral praCTice - protocol for a complex intervention in Denmark.

Introduction: The number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people experiencing visual impairment and their relatives.

Questioning 'Informed Choice' in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context.

Participation in medical screening programs is presented as a voluntary decision that should be based on an informed choice. An informed choice is often emphasized to rely on three assumptions: (1) the decision-maker has available information about the benefits and harms, (2) the decision-maker can understand and interpret this information, and (3) the decision-maker can relate this information to personal values and preferences. In this article, we empirically challenge the concept of informed choice in the context of medical screening.

Women's experiences of age-related discontinuation from mammography screening: A qualitative interview study.

Introduction: In Denmark, women are discontinued from mammography screening at age 69 due to decreased likelihood of benefits and increased likelihood of harm. The risk of harm increases with age and includes false positives, overdiagnosis and overtreatment. In a questionnaire survey, 24 women expressed unsolicited concerns about being discontinued from mammography screening due to age.

Conceptualisation of a measurement framework for Needs-based Quality of Life among patients with multimorbidity.

Background: Multimorbidity is both an individual and societal problem. For society, patients with multimorbidity increase healthcare costs. For the individual, living with multimorbidity is complex, and there is an inverse relationship between a patient's Quality of Life (QoL) and their number of chronic conditions.

Potent TRIM21 and complement-dependent intracellular antiviral immunity requires the IgG3 hinge.

Humans have four IgG antibody subclasses that selectively or differentially engage immune effector molecules to protect against infections. Although IgG1 has been studied in detail and is the subclass of most approved antibody therapeutics, increasing evidence indicates that IgG3 is associated with enhanced protection against pathogens. Here, we report that IgG3 has superior capacity to mediate intracellular antiviral immunity compared with the other subclasses due to its uniquely extended and flexible hinge region, which facilitates improved recruitment of the cytosolic Fc receptor TRIM21, independently of Fc binding affinity.

[Social inequality in health].

Social inequality is a significant challenge in the Danish healthcare system, and in general practice the inequality has many faces. To give more to those who need most is a difficult task, and research shows the diversity of the challenges experienced in the primary healthcare sector. However, as argued in this review, through innovative research we may be able to find new directions in how to provide patient centered healthcare, and in taking on this task general practice is centrally positioned as the place at which most patients are seen on a regular basis.

Spaces out of reach? Service user involvement in residents' meetings at recovery-oriented social housing facilities for young people with mental health disorders.

Through anthropological fieldwork among people with severe mental health disorders, this article focuses on these service users' interactions and relations with the professionals and with other service users at recovery-oriented housing facilities in Denmark. We discuss how recovery-oriented spaces designed for the service users may feel out of reach to them, hence making the service users feel awkward and reluctant to participate. The study shows how service users, initially recognized as "unengaged," rather are to be understood as active actors involved in their recovery and forming social bonds.

Prioritizing social identities: Patients' perspective on living with multimorbidity.

Objective: This article explores experiences of people with multimorbidity, and attempts to advance understandings of the complexity of living with multimorbidity outside the medical encounter in a social identity theoretical framework.

Method: This is a qualitative study using individual semi-structured interviews among nine persons living with multimorbidity. The interviews are analysed inductively according to thematic content analysis.

Experiences of barriers to trans-sectoral treatment of patients with severe mental illness. A qualitative study.

Background: Patients with severe mental illness (SMI) have shorter life expectancy than people without SMI, mainly due to overmortality from physical diseases. They are treated by professionals in three different health and social care sectors with sparse collaboration between them, hampering coherent treatment. Previous studies have shown difficulties involved in establishing such collaboration.

A complex intervention for multimorbidity in primary care: A feasibility study.

Aim: To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics.

Methods: Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic conditions (diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart conditions), and a hospital contact during the previous year. The CIM included extended consultations and nurse care manager support in general practice and intensified cross-sectorial collaboration.

TRIM21-From Intracellular Immunity to Therapy.

Tripartite motif containing-21 (TRIM21) is a cytosolic ubiquitin ligase and antibody receptor that provides a last line of defense against invading viruses. It does so by acting as a sensor that intercepts antibody-coated viruses that have evaded extracellular neutralization and breached the cell membrane. Upon engagement of the Fc of antibodies bound to viruses, TRIM21 triggers a coordinated effector and signaling response that prevents viral replication while at the same time inducing an anti-viral cellular state.