Louise Hjort Nielsen

Bio: Louise Hjort Nielsen is an academic researcher from University of Southern Denmark. The author has contributed to research in topics: Poison control & Risk assessment. The author has an hindex of 7, co-authored 19 publications receiving 319 citations. Previous affiliations of Louise Hjort Nielsen include Odense University & Aarhus University.

International Perspectives on the practical application of violence risk assessment : a global survey of 44 countries

Abstract: Mental health professionals are routinely called upon to assess the risk of violence presented by their patients. Prior surveys of risk assessment methods have been largely circumscribed to individual countries and have not compared the practices of different professional disciplines. Therefore, a Web-based survey was developed to examine methods of violence risk assessment across six continents, and to compare the perceived utility of these methods by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations. Surveys were completed by 2135 respondents from 44 countries. Respondents in all six continents reported using instruments to assess, manage, and monitor violence risk, with over half of risk assessments in the past 12 months conducted using such an instrument. Respondents in Asia and South America reported conducting fewer structured assessments, and psychologists reported using instruments more ...

A Danish Model for Treating Victims of Rape and Sexual Assault: The Multidisciplinary Public Approach

Abstract: Most centers for rape and sexual assault victims today build on the original principles proposed in Boston by Burgess and Holmstrom in the 1970s (Burgess, 2006; Burgess & Holmstrom, 1973). In line with technological advances, scientific developments, and societal changes, the standards of and the framework behind these centers must be assessed and developed further to accommodate the growing need for rape trauma services in Europe and worldwide. This article describes the experiences of a public Danish center for rape victims and proposes a management model for current and future rape victim centers.

Drugs and femoral neck fracture: a case-control study.

Abstract: Two hundred consecutive patients with femoral neck fractures (FNF) and 200 controls matched by age, sex, nursing home residency and number of admissions within the last 2 years, were interviewed about recent drug use. The matching criteria were chosen to achieve case and control groups that were comparable with regard to overall physical disability. Thus a preliminary study had shown FNF to be strongly associated with nursing home residency and to be correlated with the number of recent hospital admissions. FNF was found to be negatively associated with use of coronary drugs (OR = 0.27; 95% CI = 0.11-0.70) and positively associated with drug use in general (OR = 2.00; 95% CI = 1.04-3.05). The OR for the various classes of psychotropic drugs was consistently greater than 1., although this was not statistically significant. An inherent problem in interpreting such findings is that underlying disease may predispose the subject to both FNF and drug use, thus creating a non-causal relationship.

Posttraumatic Stress Disorder Among Bereaved Relatives of Cancer Patients

Abstract: The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients and their relatives. The prevalence of current probable PTSD was 40% in the bereaved sample. A hierarchical logistic regression analysis indicated that full-time employment, perceived control, and a secure attachment style moderated the risk for PTSD. Moreover, a long period of caretaking, high levels of somatization, and dissociation were all associated with an increased risk of PTSD.

Attrition in Danish rape reported crimes

Abstract: This study investigated attrition in reported rape crimes in the earlier processing phases, including decisions by the police and the prosecution regarding case closure. Furthermore, this study examined potential differences in attrition patterns and legal decisions regarding case closure between a group of victims in contact with a specialized multidisciplinary treatment unit for rape victims compared to a group of victims not in contact with this unit. The study was conducted as a case-file analysis of all rape cases reported to a regional Danish police department (n=282) over a three-year period. Most cases were closed in the initial processing phases, with the police closing 61.7 % of the cases and the prosecution closing 53.7 % of the cases referred by the police. Insufficient evidence and the victim’s unwillingness to participate in the investigation were important factors for attrition. We found no significant differences in attrition patterns or legal reasons regarding case closure between the group of victims who had been in contact with the specialized multidisciplinary treatment unit for rape victims and those who had not. More research is needed to explore effects of specialized multidisciplinary treatment units for rape victims on the legal process following a rape crime.

Psychotropic medications and the risk of fracture: a meta-analysis.

Abstract: Background: Older adults throughout the developed world are at significant risk of osteoporotic fractures. Many studies have examined the relationship between the use of psychotropic medications and the risk of fractures, but these studies have reported conflicting results. Purpose: To resolve discrepancies, we carried out a meta-analysis to assess the risk of fractures among users of several classes of psychotropic drugs. Data sources: We retrieved studies published in any language by systematically searching MEDLINE, LILACS, EMBASE and ISI Proceedings databases and by manually examining the bibliographies of the articles retrieved electronically as well as those of recent reviews. Study selection: We included 98 cohort and case-control studies, published in 46 different articles, that reported relative risk (RR) estimates and confidence intervals (CIs) or sufficient data to calculate these values. Data synthesis: Study-specific RRs were weighted by the inverse of their variance to obtain fixed- and random effects pooled estimates. The random effects RR of fractures was 1.34 (95% CI 1.24, 1.45) for benzodiazepines (23 studies), 1.60 (95% CI 1.38, 1.86) for antidepressants (16 studies), 1.54 (95% CI 1.24, 1.93) for non-barbiturate antiepileptic drugs (13 studies), 2.17 (95% CI 1.35, 3.50) for barbiturate antiepileptic drugs (five studies), 1.59 (1.27, 1.98) for antipsychotics (12 studies), 1.15 (95% CI 0.94, 1.39) for hypnotics (13 studies) and 1.38 (95% CI 1.15, 1.66) for opioids (six studies). For non-specified psychotropic drugs (10 studies), the pooled RR was 1.48 (95% CI 1.41, 1.59). Limitations: Main concerns were the potential for residual confounding and for publication bias. Conclusion: Globally, the increase in the risk of fractures among psychotropic drug users is moderate. Further research is needed, especially to examine high-risk populations and newer medications. Future studies should be prospective and emphasise control of confounding bias.

Effects of antihypertensive drug treatments on fracture outcomes: a meta-analysis of observational studies.

Abstract: Objective To quantitatively pool findings from observational studies on the risk of fracture outcomes associated with exposure to five antihypertensive drug classes: angiotensin-converting enzyme (ACE) inhibitors, diuretics (in particular thiazide diuretics), β-blockers, calcium-channel blockers and alpha-blockers Design Systematic review and meta-analysis Data sources Publications listed in the MEDLINE, EMBASE and LILACS databases, the ISI proceedings, and bibliographies of retrieved articles Sources were searched from the earliest possible dates through December 2005 Review methods We included case–control and cohort studies presenting relative risks and confidence intervals (CIs) for the association between exposure to antihypertensive agents and fracture outcomes Data were extracted onto a standardized computer worksheet Study quality was assessed using a 10-point questionnaire specific to case–control or cohort study design Results Fifty-four studies were identified Pooled estimates were computed using the software HEpiMA The pooled relative risk (RR) of any fracture with use of thiazide diuretics was 086 (95% CI 081–092) and 114 (95% CI 084–154) with use of nonthiazide diuretics There was a statistically significant reduction of any fracture with use of β-blockers, (RR 086, 95% CI 070–098) The one study with ACE inhibitor data showed protection (RR 081, 95% CI 073–089) No significant associations were found between fractures and exposure to α-blockers or calcium-channel blockers Conclusions Thiazide diuretics and β-blockers appear to lower the risk of fractures in older adults However, these agents cannot be recommended as preventive therapies for fractures until data from randomized controlled trials have established their efficacy Patients who use these inexpensive drugs as treatments for hypertension may also benefit from a reduction in fracture risk

Menopausal Estrogen Therapy and Hip Fractures

Abstract: The association between menopausal estrogen therapy and hip fracture was studied in a retirement community. Ninety-one hip fracture cases during a 5-year period in female residents under a...

Thiazide diuretics and the risk of hip fracture

Abstract: Background Thiazide diuretics are one of the most commonly prescribed antihypertensive agents worldwide. Thiazides reduce urinary calcium excretion. Chronic ingestion of thiazides is associated with higher bone mineral density. It has been suggested that thiazides may prevent hip fracture. However, there are concerns that diuretics, by increasing the risk of fall in elderly, could potentially negate its beneficial effects on hip fracture. Objectives To assess any association between the use of thiazide diuretics and the risk of hip fracture in adults. Search methods We searched eligible studies up to December 2008 in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Pharmaceutical Abstracts, the Database of Abstracts of Review of Effects (DARE) and reference lists of previous reviews and included studies. Selection criteria All randomized controlled trials and observational studies, which assessed the association between thiazide diuretic use and hip fracture. Data collection and analysis Two review authors independently applied the selection criteria, extracted data and assessed risk of bias of each study selected. The results were summarized descriptively and quantitatively. Cohort studies and case control studies were analysed separately. Main results No randomized control trials were found. Twenty-one observational studies with nearly four hundred thousand participants were included. Six of them were cohort studies and 15 were case-control studies. Two cohort studies appear to involve the same cohort so there were only 5 unique ones. The risk of bias was assessed with the Newcastle-Ottawa Scale (NOS). Five cohort studies had low risk of bias and one had moderate risk of bias. Seven case control studies had low risk of bias and 8 had moderate risk of bias. Meta-analysis of cohort studies showed that thiazide use was associated with a reduction in risk of hip fracture by 24%, pooled RR 0.76 (95% CI 0.64-0.89; p = 0.0009). We chose not to provide a pooled summary statistics for case-control studies because of high heterogeneity (Tau2 = 0.03, I2 = 62%, p = 0.0008). Authors' conclusions Thiazides appear to reduce the risk of hip fracture based on observational studies. Randomized controlled trials are needed to confirm these findings.

Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis.

Abstract: Background Hip fractures in the older person lead to an increased risk of mortality, poorer quality of life and increased morbidity. Benzodiazepine (BNZ) use is associated with increased hip fracture rate, consequently Z-drugs are fast becoming the physician’s hypnotic prescription of choice yet data on their use is limited. We compared the risk of hip fracture associated with Z-drugs and BNZ medications, respectively, and examined if this risk varied with longer-term use. Methods and findings We carried out a systematic review of the literature and meta-analysis. MEDLINE and SCOPUS were searched to identify studies involving BNZ or Z-drugs and the risk of hip fracture up to May 2015. Each included study was quality-assessed. A pooled relative risk of hip fracture was calculated using the generic inverse variance method, with a random effects model, with the length of hypnotic usage as a subgroup. Both BNZ, and Z-drug use respectively, were significantly associated with an increased risk of hip fracture (RR = 1.52, 95% CI 1.37–1.68; and RR = 1.90, 95% CI 1.68–2.13). Short-term use of BNZ and Z-drugs respectively, was also associated with the greatest risk of hip fracture (RR = 2.40, 95% CI 1.88–3.05 and RR = 2.39, 95% CI 1.74–3.29). Conclusions There is strong evidence that both BNZ and Z-drugs are associated with an increased risk of hip fracture in the older person, and there is little difference between their respective risks. Patients newly prescribed these medicines are at the greatest risk of hip fracture. Clinicians and policy makers need to consider the increased risk of fallings and hip fracture particularly amongst new users of these medications.