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G R A D U AT E P R O G R A M I N P U B L I C H E A LT H &
EPIDEMIOLOGY
G R A D U AT E S C H O O L O F H E A LT H A N D M E D I C A L S C I E N C E S
UNIVERSITY OF COPENHAGEN
Public Health & Epi News
NO. 3, 1
ST
VOLUME, JANUARY 2015
GRASPH Summer School 2015
I wish you a happy New Year and
congratulate all those who defended
their PhD’s in 2014. Please
remember that PhD Graduates from
2014 with their families and their
supervisors are invited to the
Graduation Ceremony taking place in
the University’s Ceremonial Hall on
February 26 at 17-19. I am looking
forward to celebrating your
achievements with you.
The annual GRASPH Summer
School is an important event in the
research program. Our aim is to
create an environment where
students and supervisors can share
some inspiring days centred on
scientific discussions and social
activities. The meeting will take place
in Korsør on May 26-27 and it is free
to participate. I highly encourage both
students and supervisors to
participate. Please see the program
and the registration details in the
newsletter.
Finally, I am proud to announce that
Elise Harder Christensen from the
Danish Cancer Society, Anne Holm
and Camilla Lawaetz Wimmelmann,
both from Department of Public
Health are the three “PhD’s of the
month”. A description of their
interesting studies can be found in
the newsletter.
Conference calendar
Causal Inference
Annual Meeting in Danish Epidemiological Society, 23 April, 2015
http://www.dansk-epidemiologiskselskab.dk/
Society for Epidemiological Research, 48th annual meeting 2015
16-19 June 2015
Denver, Colorado
http://epiresearch.org/annualmeeting/2015-meeting/
Abstract deadline: 2 February, 2015
European Congress of Epidemiology
- Healthy Living
25-27 June 2015
Maastricht - The Netherlands
http://www.healthyliving2015.nl/
Extended abstract deadline: 9 February,
2015
NordicEpi in Oslo September 2015
Naja Hulvej Rod
Head of the Graduate
Program in Public
Health and
Epidemiology
www.nofe.no/
Abstract deadline: 15 April, 2015
ACE 2015 Annual Meeting
26-29 September, 2015 in Atlanta, The
US
http://www.acepidemiology.org/content/s
ave-date-ace-2015-annual-meeting
Editorial info
Activities in the PhD School
Public Health & Epi News is distributed to PhD students and supervisors affiliated with the
graduate program in Public Health and Epidemiology.
PhD Day, 21 May 2015 at approx. 9-16
All PhD students and research year
students are invited to the PhD Day
which is organized with poster walks and
a series of oral presentations. The aim
of the day is to provide a friendly and
collaborative environment for students to
present and receive feedback on their
research from fellow PhD students and
supervisors with different fields of interest.
It is published every second month. The newsletter is meant to be a dynamic platform for
exchanging information within the graduate program and any inputs on events, new books,
international courses, writing groups etc. are very welcome.
Please send your input in an e-mail to Lisbeth Lyng Hansen, [email protected].
Editors: Naja Hulvej Rod, [email protected] and Lisbeth Lyng Hansen, [email protected]
Deadline for next issue of Public Health & Epi News is 9 March, 2015.
PhD’s of the Month
Elise Harder Christensen, the Danish Cancer Society Research Center
Department of Virus, Lifestyle and Genes
Cervical cancer screening in Denmark
Screening against cervical cancer
was established in some regions
in Denmark in the 1960s because
the annual incidence of cervical
cancer was high (~30 new cases
per 100,000 women). Primary
cervical cancer screening is now
nationally implemented and the
aim of the program is to reduce
the incidence of and mortality
from the disease by identifying
and treating women with highgrade cervical intraepithelial neoplasia (CIN) who are at risk for
subsequently developing invasive
cervical cancer. Cervical cancer
occurs in women in virtually all
age groups with around 50% of
women being diagnosed before
the age of 45-50 years. Genital
persistent infection with human
papillomavirus (HPV) is identified
as necessary for the development
of cervical cancer and its precursor lesions.
Today the incidence of cervical
cancer in Denmark is 10 per
100,000 women, corresponding to
around 380 women diagnosed
with cervical cancer every year.
However, the incidence of the
disease has not decreased in the
last 10 years and is the highest
compared to other Nordic countries like Sweden and Finland,
with incidence rates of 7 and 4,
respectively. Non-attendence are
one of the biggest threats to the
success of a screening program,
and despite national recommendations and a health care system
building on free and equal access
to health care, almost 25% of all
Danish women between 23 and
64 years did not attend the program in 2012. Studies have
shown that among women diagnosed with cervical cancer, almost half have a deficient cervical
screening history or have never
been screened. There has been
an increasing focus on the possibility to increase the uptake in
cervical cancer screening among
non-attendees by self-sampling
methods where test for high risk
HPV is used.
The overall aim of my PhD project
is to investigate aspects of cervical cancer screening, with a specific focus on women who do not
attend the national primary cervical cancer screening programme.
We aim to investigate determinants for non-attendance to cervical cancer screening, both among
women who do not respond to
invitation letters and among women who actively unsubscribe from
the programme. Further, in collaboration with the pathology department at Hvidovre University
Hospital, it is the aim to investigate determinants for accepting
an HPV self-sampling test as an
alternative screening method. To
assess the acceptance of selfsampling in a Danish setting,
Hvidovre University Hospital has
initiated the Copenhagen Selfsampling Initiative (CSI), where
25,000 regular non-attendees are
invited to perform a self-sampling
of material from the cervix with a
brush and return it for further
analysis. This sample will be tested for the presence of HPV DNA.
Women who are HPV positive will
be encouraged to contact their
doctor to have a gynecological
examination including a cervical
cytology sample. To obtain personal information on the nonattendees, we are conducting a
questionnaire survey, sending out
questionnaires to women invited
for the CSI. The questionnaire
contains questions on e.g. general health, life style, sexual habits, previous experience with cervical cancer screening, and reasons for not attending the routine
cervical cancer screening program.
I graduated in public health science in 2013. I worked as a scientific assistant at the department of
Virus, Lifestyle and Genes before
I started my PhD programme in
June 2014.
My supervisors are Professor
Susanne Krüger Kjær, and Postdoc Kirsten Egebjerg Juul from
department of Virus, Lifestyle and
Genes, Danish Cancer Society
Research Center, and Senior statistician Kirsten Frederiksen from
the department of Statistics, Bio
informatics and Registries, Danish
Cancer Society Research Center.
Contact: Elise Harder Christensen
[email protected]
Anne Holm, Section of General Practice, Department of Public Health
Improved Diagnostics and Treatment for Uncomplicated Urinary
Tract Infection in General Practice, Denmark.
Urinary tract infection is a common
condition in general practice. The condition is self-limiting and rarely leads to
serious complications, but the symptoms are painful and bothersome and
the duration of symptoms can be
shortened with the use of antibiotics.
Why study a condition that is selflimiting or can be easily treated with
antibiotics?
During the past decades, awareness
about the implications of antibiotic resistance has risen. The world is now
facing pan-resistant bacteria - that is
bacteria resistant to all known antibiotics.
Use of antibiotics is known to be the
strongest driver of antibiotic resistance
and primary care prescribes 90 % of
all antibiotics in Denmark. Urinary tract
infection is the second-most common
cause of a prescription for antibiotics
in primary care.
A precise diagnosis is necessary both
to reduce overtreatment and to avoid
treating with an antibiotic to which the
infecting bacteria is resistant. Bacterial
culture and susceptibility testing is the
most precise diagnostic tool and userfriendly kits for point of care culture
and susceptibility testing has been
developed and validated. Susceptibility
testing is to determine if the bacteria in
the patient’s sample are resistant to
any of the commonly used antibiot-
ics.
on own clinical practice can improve
prudent use of antibiotics for urinary
tract infection. The GPs register clinical data on patients with urinary tract
infection and get a report on their performance. The reports are discussed,
and the registration is repeated. Their
performance before and after is compared.
Figure 1: Medium for point of care culture and susceptibility testing
How is prudent use of antibiotics
investigated in this PhD?
The first part of the PhD aims to determine the value of point of care susceptibility testing through a randomized controlled trial (RCT). Patients
with uncomplicated urinary tract infection in primary care are randomized to
either point of care culture and susceptibility testing or point of care culture without susceptibility testing. The
two groups are compared in regards of
correct choice of antibiotics, microbiological and clinical cure.
Figure 3: The quality circle
The project is part of the UC-CARE
project at University of Copenhagen
My background
I graduated as a medical doctor in
2009 and started my specialization as
a GP in 2011. At the moment I have
leave from my specialization to enroll
as a PhD.
Figure 2: Design of RCT
The second part of the PhD is investigating if an intervention towards a
group of general practitioners (GPs)
with targeted teaching and reflection
Contact: Anne Holm,
[email protected]
Camilla Lawaetz Wimmelmann, Section for Health Services
Research, Department of Public Health
The Travel of an Overweight Prevention Policy
Overweight prevention policies
During the past decades overweight has reached epidemic
proportions and needs to be controlled as it is one of the greatest
st
health challenges of the 21 century. Subsequently, prevention of
overweight has received great
political attention, especially in
Western countries. However, the
prevalence of overweight continues to increase and former as
well as current overweight policies
show limited signs of effect –
maybe because we don’t know
how they actually work in practice?
In most Western countries, the
responsibility of establishing disease prevention is delegated to
local communities. Consequently,
the influence of health policies is
related to their ability to spread
geographically – the policies must
move across and within organisational levels. As the executors of
health policies, the local policy
workers are located in the borderland between the government/bureaucracy and the population the policy is designed to
serve. These local policy workers
function as the means by which
new health policy practices and
the ideas informing them are put
into practice. By studying the
practice of an overweight prevention policy, it becomes visible how
political macro ambitions (based
in policies, guidelines and recommendations for the organisation of overweight prevention) are
not readily implemented, but are
likely to undergo various translations and negotiations on micro
level, i.e. in the local communities’
daily activities and in their meetings within each administrative
area as well as between those
different administrative areas –
consequently, the local communities are particularly interesting as
sites of investigations.
As a study subject, overweight
prevention policies and programs
have been studied and debated
intensively. Despite offering a
wide range of perspectives on
overweight prevention, the extensive literature of overweight prevention policies primarily consists
of studies of one singular aspect
of overweight prevention policy,
such as political problematization
of obesity, stigmatisation and/or
allegation caused by obesity
measures. Alternatively, they focus on the effects of specific
overweight prevention programs.
Given the considerable attention
on prevention of overweight in
Western countries, it is paradoxical that the actual practice of policy seems to be a strangely new
unexplored territory in the academic literature on overweight
prevention policies.
The aim of the PhD-project
This PhD-project sets out to explore “how overweight prevention
policy is practiced in Danish municipalities?”
To investigate the addressed
question, I take the Danish
‘Health Promotion Package
against Overweight’ as a case.
The Health Promotion Package
was developed by the Danish
Health and Medicine Authority
(DHMA). It is state-of-the-art within overweight prevention policies
and is topical in the municipalities’
current work.
I investigate the policy’s enactments by visiting and interviewing
policy workers in Danish municipalities. In addition to the interviews, I gain insights into the field
through ‘appointed observations’.
In policy production and policy
decision-making, several different
attitudes, agendas and private
interests often come into play and
the translations of policies always
serves a purpose, and therefore
an interest. By combining interviews and observations, I am able
to investigate how the promotion
package is practiced and to shed
light on the enactments that otherwise might be tacit because
they are in conflict with the intentions of the policy or with the municipal’s strategic agenda.
The project is part of the ‘Governing Obesity’ project that aims to
provide novel means for governing obesity via effective interventions at the societal and individual
level, from an early stage towards
the morbidly obese individuals,
while avoiding unintended and
negative effects.
My background
I graduated from Public Health
Science in winter 2013 and commenced my PhD in February
2014. My supervisors are Professor Signild Vallgårda, and Assistant Professor, Anja Marie Bornø
Jensen.
Contact: Camilla L. Wimmelmann,
[email protected]
Welcome to the new PhD students
6 new PhD students have been enroled between 15 October and 1st December, 2014.
Name
Title of Project
Supervisor
Filippa Nyboe Norsker
Late effects in survivors of neuroblastoma in Scandinavia
Nils Aage Brünner
Helle Gybel Juul-Larsen
Epidemiological strategies for adapting
Ove Andersen
Disease Management Programs to older
persons with multimorbidity
Janni Uyen Hoa Lam
HPV-Based Self-Sampling to improve
Cervical Cancer Screening Coverage
Heavy resistance training for women
undergoing adjuvant chemotherapy at
risk of developing breast cancer related
lymphedema
Elsebeth Lynge
Michaela Høj
RENEW-DK Education and network oriented support for young people with
mental vulnerabilities
Sidse Marie Hemmingsen
Arnfred
Maria Krystyna Jakowlew Wessman
HIV infected women in the Nordic countries - focus on fertility, sexuality and
menopause
Nina Margrethe Weis
Kira Brisson Nielsen Bloomquist
Frederik Tygstrup
Up-coming PhD courses
At HEALTH-UCPH:
Public Health courses
Statistics courses
Introduction to Qualitative Methods in Health Science
Course director: Ingrid Egerod
10-12 March, 2015
Use of the statistical software R
Course director: Theis Lange
16-20 March, 2015
Advanced Social Epidemiology: A focus on
Methodology, Context and Lifecourse
Course director: Ingelise Andersen
5-9 October, 2015
Regression models
Course director: Per Kragh Andersen
Start 13 April, 2015
Questionnaires in clinical and public health research:
development, validation and evaluation
Course director: Mogens Grønvold
4-10 December, 2015
Applications through the Graduate School:
https://phdkursus.sund.ku.dk/frontPlanner/Default.aspx
Use of SAS statistical software
Course director: Esben Budtz-Jørgensen
27-29 May, 2015
Introduction to scale validation
Course director: Karl Bang Christensen
10 June
Modern scale validation using IRT and Rasch models
Course director: Karl Bang Christensen
17-19 June, 2015
GRASPH Network
GRASPH Summer School 2015
26-27 May 2015, Comwell Klarskovgård, Korsør
See program at the following pages or at www.grasph.dk
Programme for GRASPH Summer School, 26-27 May, 2015
The meeting is held at Comwell Klarskovgaard, Korsør Lystskov 30, DK-4220 Korsør
Registration: http://www.survey-xact.dk/LinkCollector?key=UUGQDDZE3NCP
The registration deadline is 20 February, 2015. Abstract submission deadline is 10 April, 2015. Participation is free for
both PhD students and supervisors.
Tuesday 26 May
09.45-10.10
Arrival, coffee/ tea and rolls
10.10-10.15
Welcome by associate professor Bernard Jeune
10.15-11.00
Plenary lecture:
Professor emeritus Niels Keiding: Highlights from the development of biostatistics – is
there a Danish model?
11.15-12.15
Group session 1: Presentations of PhD projects in the groups with comments from supervisors and participants
12.15-13.30
Lunch
13.30-15.00
Group session 2: Presentations of PhD projects in the groups with comments from supervisors and participants
15.15-16.00
Plenary lecture:
Medical writer dr. Claire Gudex: How do I write a good article and get it published?
16.00-16.30
Coffee/ tea and cake + check in at the rooms
16.30-18.00
Plenary lecture:
Medical writer dr. Claire Gudex: What is responsible and ethical writing?
18.30-19.00
Drinks and snacks on the terrace (if the weather allows)
19:00-
Dinner
21:00-
Party and live music (?)
Wednesday 27 May
7.30-9.00
Breakfast + check out
9.00-10.00
Group session 3: Presentations of PhD projects in the groups with comments from supervisors and participants
10.00-10.15
Break
10.15-11.00
Plenary lecture:
Associate professor Lau Caspar Thygesen: When the entire population is the sample:
strengths and limitations in register-based epidemiology.
11.00-11.15
Coffee/ tea and snacks
11.15-12.15
Group session 4: Presentations of PhD projects in the groups with comments from supervisors and participants
12.15-13.15
Lunch
13.15-14.15
Group session 5: Presentations of PhD projects in the groups with comments from supervisors and participants
14.30-15.15
Plenary lecture:
Professor Niels Chr. Hvidt: Faith and health - can faith really move mountains or do mountains move faith?
15.15-15.30
Evaluation and closing of the meeting
Coffee/ tea and cake to be enjoyed during the session
15.30
Departure
PhD defenses
23 January 2015 at 13:00-16:00
Ina Olmer Specht
Effects on male reproductive function of phthalates and
other environmental xenobiotics in humans
http://healthsciences.ku.dk/phd/calendar/q12015/phdforsvar_specht230115/
6 February 2015 at 14:00-17:00
Michael Simon Nixon
Organising medication discontinuation: An explorative
study of GPs’ decisions and practices when discontinuing
statins
Coaching sessions
We offer coaching sessions to PhD students that experience extraordinary challenges in their projects. We have
contact to three coaches with specific experience in PhD
coaching.
http://healthsciences.ku.dk/phd/calendar/q12015/phdforsvar_nixon060215/
27 February 2015 at 14:00-17:00
Louise Ohlhues Baandrup
Drugs with potential chemopreventive properties in relation
to epithelial ovarian cancer – a nationwide case-control
study
http://healthsciences.ku.dk/phd/calendar/q12015/phdforsvar_baandrup270215/
This is an on-going offer, so if you feel in need of this kind
of support, please contact Lisbeth Lyng Hansen,
[email protected]. She can mediate the contact to the
coaches. All requests will be handled confidentially.