HEALTH FOR ALL
FACULTY OF HEALTH SCIENCES UNIVERSITY OF SOUTHERN DENMARK The Faculty of Health Sciences consists of eight departments:
DEPARTMENT OF CLINICAL RESEARCH
DEPARTMENT OF MOLECULAR MEDICINE
DEPARTMENT OF PUBLIC HEALTH
DEPARTMENT OF SPORTS SCIENCE AND CLINICAL BIOMECHANICS
NATIONAL INSTITUTE OF PUBLIC HEALTH
DEPARTMENT OF REGIONAL HEALTH RESEARCH
DEPARTMENT OF PSYCHOLOGY
DEPARTMENT OF FORENSIC MEDICINE
2
Ole Skøtt HEALTH FOR ALL
Health for all is intended for readers both by the upcoming joining of the University at and outside the University of Southern of Southern Denmark (SDU) and Odense Denmark. Health for all provides an insight University Hospital (OUH) at Campus into what the Faculty of Health Sciences is Odense. and what our strategic priorities are. The brochure provides examples of how We focus our efforts on developing health- our research and education programmes care in a broad sense. We do this through are specifically put to use in society and our research and education programmes, help influence the health agenda in through our cooperation with authorities, Denmark. private and public organisations and research communication.
Our tradition of collaboration with Happy reading! hospitals and municipalities has given us a position in translational research – Ole Skøtt a position set to be further strengthened Dean
3 A COMPRE- HENSIVE This is the profile brochure of the Faculty of Health Sciences. Here you can read PERSPECTIVE about some of our research and education programmes – and gain an insight into the areas that the faculty considers as currently DEVELOPS THE under rapid development. Our vision at the Faculty of Health Sciences is to contribute to improving human HEALTHCARE health. These are not just fancy words, but the focal point of our research, our educa- tion programmes and the development of the faculty, all in close collaboration with ARENA our numerous partners and stakeholders.
RESEARCH CREATING VALUE At the Faculty of Health Sciences, we believe in the importance of strong, focused research environments within our strategic priority areas. Strong internal environments form the basis for rewarding partnerships with other research environ- ments at SDU – and for cooperation with the clinical departments at OUH, other hospitals in the region, municipalities, and other public and private organisations.
The strategically important research per- spective – translational research – has proved a particular success. We believe that it leads to research of the highest international level, not to mention produc-
4 tive research that specifically contributes The Faculty of Health Sciences sees trans- of the high quality of research in this field Research articles that explore the subject. to improving human health. lational research in a broad perspective. at SDU. Under Education, we focus on Master's Not only are we involved with the trans- programmes for graduates, where, Our close cooperation with OUH and the lation of knowledge into implementation, Aging is and will remain an increasingly through its work with tailored and other hospitals in Southern Denmark is but we also contribute to the debates and important perspective in relation to the research-based master's programmes for unique and a key element in, and a pre- decisions that develop the health arena, social structure, prioritisations and treat- graduates such as nurses, physiotherapists, requisite for, the development of our and where the public can help define key ment strategies over the coming decades. midwives and occupational therapists, the visions. research questions. We see translational It is only natural, then, to take advantage Faculty of Health Sciences is helping to research as a method of collaboration of this powerful research in our coopera- raise the level of competence in Denmark. Also important to translational research whereby we reach out of our own organi- tion with Odense University Hospital And finally, public sector consultancy and are our students (undergraduate and sation to citizens, decision-makers, the (OUH), for example. The articles are: The projects, which may be a less familiar graduate) who form the link between press, the business world and the public grey-haired revolution; Can 77-year-old concept to many, but which are never- the university, society and the health sector. wherever research results can influence Mrs Jensen tolerate chemotherapy?; Pros- theless a crucial task for society. Authorities Furthermore, this application-oriented decisions and attitudes. pect of 500,000 diabetics; and When and decision-makers are the recipients of perspective paves the way for business grandpa drinks. research-based and independent analyses innovation. THE FOCUS AREAS OF THE BROCHURE that go towards ensuring decisions, proto- In this brochure, you can read about Other articles focus on how treatment of a cols and procedures are adopted that best A REWARDING COLLABORATIVE research projects that all have strong disease such as osteoarthritis (degenerative serve the public and society as a whole. CULTURE translational elements and illustrate the joint disease) is developing from the use of Translational research is about building fruitful cooperation between SDU, OUH, drugs and surgery towards increased use NEW OUH/SDU PUTS a collaborative structure and culture that and other hospitals and partners. of physical exercise for prevention and ODENSE ON THE WORLD MAP supports the rapid transmission of research treatment, how our psychological research In the brochure, we also refer to the New breakthroughs to its implementation at Several of the articles relate to aging is interacting with the Department of Car- OUH/SDU project – a unique construction individual or population level. Barriers research, which was given a significant diology at OUH, and finally an article about which has already attracted international between basic research and its implemen- boost at SDU with the Max-Planck one of the many widespread diseases we attention in the introductory phase. New tation are thus broken down, allowing the Odense Center on the Biodemography are focusing on: the relationship between OUH/SDU paves the way for close, direct results to be "translated" into practical of Aging. It is the first of its kind in kidney function and hypertension. collaboration between the university hos- application, for the benefit of human the Nordic Region, and it is based on pital and the university's five faculties. This health. The close relationships will also a cooperation between the Max Planck Under the three general headings of will give SDU a national and international allow constant focus on the most impor- Society, the Faculty of Health Sciences Research, Education and Research-based position of strength within translational tant research questions when it comes to and the Faculty of Science. The Public Sector Consultancy and Projects, this research that few research institutions in improving human health. Max-Planck label is a recognition brochures focuses on three topical themes: the world can match.
5 THE FACULTY OF HEALTH SCIENCES IS AN INTERNATIONAL CENTRE OF EXCELLENCE FOR HEALTH RESEARCH
At the Faculty of Health Sciences at the WORLD RANKINGS University of Southern Denmark (SDU), we conduct research at a high international 2013 Leiden (Biomedical, Health Science) ARWU level in areas relevant to public health, and the treatment and diagnosis of diseases. Mean Citation Mean Proportion of Proportion of (Shanghai) In short, we strive to improve human Score Normalised 10% publications international Clinical health. Citation Score (PPtop10%) collaborative Medicine- publication Pharmacy Research forms the foundation of the U Copenhagen 130 109 100 59 (51.4%) 101–150 work of the faculty. It allows us to provide qualified and demanding education SDU 193 168 131 47 (53.1%) 101–150 programmes, and to provide effective Aarhus U 235 191 197 38 (53.7%) 101–150 public-sector consultancy.
The Faculty of Health Sciences excels in the Leiden: Citations are counted until the end of 2012 in the above indicators. Author self citations are excluded. fields of prevention, diagnosis and treat- The PP(top 10%) indicator is more stable than the MNCS indicator, and we therefore regard the PP(top 10%) ment. We build bridges and work across indicator as the most important impact indicator of the Leiden Ranking. sectors and systems.
2009 2011 2013
Articles, peer reviewed 1066 1359 1803
PhD theses 40 55 94
6 TOTAL TURNOVER AT THE FACULTY OF HEALTH SCIENCES (MDKK PER YEAR)
800
700
600
500
400
300
200
100
0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
EXTERNAL TURNOVER AT THE FACULTY OF HEALTH SCIENCES (MDKK PER YEAR)
300
250
200
150
100
50
0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
7 WHEN GRANDPA DRINKS
8 The number of elderly patients receiving outpatient alcohol treatment has doubled FACTS: JOINT EFFORT BETWEEN in recent years, placing high demands on the treatment. A new international study MENTAL HEALTH SERVICES AND from the Faculty of Health Sciences examines the effect of a card and network-based THE JOB CENTRES intervention for the elderly. The foundation of good research is strong cooperation • SDU has been specifically between alcohol research, mental health services and the municipalities. conducting research into alcohol since 1990. • Alcohol treatment used to come under mental health services, More and more elderly people have such Clinical Professor of Psychiatry. He is head want to create new methods of treatment but became an independent a severe drinking problem that they have of research at the Research Unit of Clinical and continuity of care for patients, the area in Odense, when the new been referred for outpatient alcohol treat- Alcohol Research at the Research Unit of municipalities have to be involved. We municipalities were formed. ment. In the past, seven per cent of refer- Psychiatry, which is part of the Region of focus on clinical recovery – that the • Alcohol and psychiatric research rals were for people aged 60+. That figure Southern Denmark and the Faculty of patients recover or become free of symp- is conducted in close coopera- is now around 14 per cent. The old age Health Sciences at the University of toms. There is a lot of talk in the municipal tion, often also involving dependency ratio is increasing, so even Southern Denmark. system about personal recovery – the regions, municipalities, etc. more elderly people with alcohol problems ability to learn to live with one's illness can be expected. CLINICAL AND and still have a good quality of life. These • The Research Unit of Psychiatry PERSONAL RECOVERY are two different angles, but both angles is cooperating with the job "This group of patients has been shown The research project is being conducted are key," says Nielsen. centres in Odense on a major to have not nearly as many problems as in collaboration with Odense Municipality, randomised trial investigating younger patients with alcohol problems. Aarhus Municipality, the City of Copenha- The broad cooperation headed by the the possibilities for integrating So our basic theory is that elderly patients gen and two "municipalities" in Germany Faculty of Health Sciences has, among the severely mentally ill into require a shorter intervention. In the and in the US. This broad cooperation is other things, developed the Odense the labour market. research project, we investigate the effect essential to bridge the gap between model, which has inspired alcohol treat- • In a randomised trial, patients of an intervention of four weeks as research and everyday life in the munici- ment elsewhere in Denmark. are randomly split into groups to opposed to the normal intervention of palities. either receive an experimental six months. At the same time, many of treatment or a control treatment. the patients are widows or widowers, so "All prevention and follow-up work is • The trial is called IPS, Individual we also focus on how their network can carried out in the municipality, and they Placement with Support. help them with their alcohol problems," have significantly more contact with Cooperation: SDU – Mental Health Services in the More than 100 patients are Region of Southern Denmark – Danish and international explains Bent Nielsen, Consultant and patients than the health service. If you municipalities – Department of Clinical Research currently involved.
9 FIGHT PAIN WITH EXERCISE
10
Ewa M. Roos More than 832.000 Danes suffer from osteoarthritis, costing society 11.5 billion a FACTS: WHY "OSTEOARTHRITIS" AND year - for osteoarthritis alone. The rheumatic disease osteoarthritis (degenerative NOT "WEAR AND TEAR joint disease) is the main culprit, each year triggering a flood of prescriptions for DISEASE"? painkillers and operations. But it does not have to be like that. Research shows Osteoarthritis and wear and tear that physical exercise is effective in preventing and treating the disease. disease are one and the same thing – the changing and destruction of joint cartilage and bone tissue around the joints – Around one in 5 adults in Denmark for example, seen that supervised exercise treatments with as low risk as possible,” but osteoarthritis is the modern, self-report osteoarthritis. It is a socie tal provides effective pain relief and improves explains Roos. precise name of the disease. challenge because it is so common and physical function in patients with knee and Osteoarthritis becomes more because it is so expensive. For the individual, hip osteoarthritis, without the negative Our cooperation with primary practice common with age and has many osteoarthritis means pain, loss of function side effects of medicine. The analgesic and municipalities has increased, and we and poorer quality of life. effect of six weeks’ training is actually are also in the process of establishing pilot risk factors such as gender and about three times greater than the effect projects that focus on early treatment of heredity, but also sports injuries, A direct consequence of the disease of painkillers.” osteoarthritis patients in the Region of body weight and muscle weak- osteoarthritis is that large amounts of Southern Denmark. This approach is fully ness, which can be prevented. painkillers are prescribed and many surgi- COMBINES APPROACHES in line with the new clinical guidelines of The term "wear and tear disease" cal procedures are performed. However, The Faculty of Health Sciences and Odense the National Board of Health and thus is erroneously associated with research conducted over the past 15 years University Hospital (OUH) are key players improves the quality of the treatment the idea of wear and tear the shows an effective alternative to the in research into joints and diseases, and a available in the Region of Southern disease being an inevitable “hard” treatment methods. Ewa M. Roos, special area of focus is the importance of Denmark. fact of aging and suggests Professor at the Department of Sports the patient’s own input. A current joint that there is no possibility of Science and Clinical Biomechanics and research project is looking at whether Surgery is relevant for very few. Osteoar- prevention or treatment. Head of Research at the Research Unit for surgery can be postponed or avoided thritis develops slowly over many years, Musculoskeletal Function and Physiothera- entirely with physical exercise. and with the new knowledge we have py, Faculty of Health Sciences at the Uni- about risk factors the possibility of treat- versity of Southern Denmark, explains: “We have a number of translational ing early and preventing the development research projects with OUH in the new 3D of the disease is good. “Research shows that both pain and loss motion laboratory and research clinic for of function can be avoided, and – if you sports medicine. We combine the various “Traditionally, patients suffering from suffer from osteoarthritis – treated early tools and options in our toolbox – physio- musculoskeletal pain were offered pain- and effectively with patient education, logical, psychological, pharmacological, killers as the only treatment when they physical exercise and weight loss. We have, surgical, etc. – to find the most effective contacted the primary care sector. But
11 FACTS: In Denmark, more than 18,000 hip and knee replacements are carried out each year. FACTS: • Osteoarthritis is the most common rheumatic disease in Denmark. • More than 18% of the adult population suffer from modern osteoarthritis treatment should osteoarthritis. follow the so-called Pyramid model, which • 832.000 Danes suffer from means that patients should be offered osteoarthritis, costing society basic treatment with education, exercise 11.5 billion a year - for and possible weight loss first. If that is not osteoarthritis alone. enough, medication can be added, with surgery as a last resort. This minimises the risks and optimises the effect of the treat- ment,” says Roos.
She also explains that surgery is relevant for very few. An English study actually shows that it is only relevant for around 12% of people with knee pain, who approach primary practice. FACTS: And even if surgery is considered, it is The Faculty of Health Sciences effective to combine it with exercise. plays a pivotal role in the Interdisciplinary studies have shown that research into and dissemination people who exercise prior to surgery of knowledge about musculo- recover faster. skeletal disorders in Denmark. A number of researchers from the faculty are members of the Danish Council on Health and Disease Prevention (Vidensråd
Cooperation: Department of Sports Science and Clinical for forebyggelse). Biomechanics – primary health care – OUH – Department of Clinical Research
12
Ewa M. Roos In 2020, two out of three Danish cancer patients will be older than 65 years , posing a huge challenge to the treatment system. AgeCare at OUH and SDU is to CAN 77- develop effective ways of assessing elderly patients individually and thus determine the best treatment for them. Advanced genetic studies will help predict YEAR-OLD whether a person can endure and would benefit from intensive chemotherapy, or whether it would make for MRS JENSEN a better quality of life to omit treatment completely.
Cancer particularly affects elderly people, in addition to the treatment itself? TOLERATE and with the ageing population in These are just some of the questions Denmark, there is the prospect of a wave AgeCare has to answer,” says Jørn of elderly cancer patients. Today, more Herrstedt, Consultant and professor CHEMO- than 40% of those diagnosed with cancer at OUH and SDU. are aged 70 years or older and forecasts show that this figure will become much higher in the coming years, pushing the FACTS: AGECARE THERAPY? entire treatment system. More people will AgeCare (Academy of Geriatric be having treatment and that treatment Cancer Research) is a new elite will be different, because the elderly often research centre at Odense suffer from other diseases at the same University Hospital and SDU. time and may be unable to tolerate con- AgeCare is centered on seven ventional chemotherapy, for example. areas of research: Epidemiology, cancer biology, surgery, radio- “We know far too little about our elderly therapy treatment, medical cancer patients today. How do their body oncology treatment as well as and organs react to the treatments? How two areas in connection with can we help them cope best with the supportive care, which is about often demanding treatment? What par- the patient's quality of life. ticular problems do the elderly experience
13 “Our aim is to find the cancer patients the disease. We try to find molecular alter- who can be helped by and tolerate our ations that may provide an indication of treatments, and leave those who cannot what the patient can tolerate and how tolerate the treatments and do not get treatment can be tailored accordingly. anything other than side effects from In this way, the research is translational – them alone. Here we lean heavily on basic it goes from the patient to the laboratory and translational research at the Depart- and back to the patient,” says Professor ment of Molecular Medicine at the Faculty Henrik Ditzel, Dr. Med., SDU. of Health Sciences and Proteomics at the Department of Biochemistry and Molecular The AgeCare research project initially Biology at the Faculty of Science. We hope runs until 2019. to be able to pick out certain properties genetically, which can tell us in advance whether someone is a suitable candidate Cooperation: Department of Clinical Research – OUH – Department of Public Health – Department of Molecular for treatment,” concludes Herrstedt. Medicine – Department of Biochemistry and Molecular Biology, Faculty of Science, SDU MOLECULAR STUDIES Specifically, the cooperation between clini- cal and basic research means that blood and tissue samples are taken from all patients included in the clinical studies FAKTA: Among other things, the conducted under the auspices of AgeCare, Studies of new cancer treatments researchers will look at how which are then studied in the laboratory. and medicine are generally con- different cancer drugs are ducted on younger and middle- absorbed into the body, and “We examine the samples in the laborato- aged patients today, despite the assess whether there are ry for the amount of specific proteins, fact that the elderly account for differences in efficacy and protein modifications and RNA, and we the majority of patients. AgeCare side effects in younger and look for DNA mutations. In the past, only a cooperates with Clinical Pharma- older patients. few markers could be examined at a time, cology at SDU and OUH, which but advanced technology means we can is headed by Professor Kim now perform an analysis that looks at all Brøsen, Dr. Med. the individual’s genes at once, providing a far more accurate picture of the status of
14
Jørn Herrstedt CANCER RESEARCH AT THE REGIONAL HOSPITALS
International research collaboration with the University of Southern Denmark and the biotech company Genmab as the Danish participants leads to improved treatment of bone marrow cancer.
Based on extensive preclinical studies con- "Köhler and Milstein's invention of hybrid- through designation' in order to stimulate "The exciting thing about Daratumumab is ducted by the Danish company Genmab oma technology back in the 1970s made it the continued rapid development towards that the antibody on its own is surprisingly and researchers at the University Hospital possible to produce monoclonal antibodies marketing and availability of the antibody active in bone marrow cancer with few in Utrecht, Torben Plesner, Consultant at with defined specificity and on a large to patients with bone marrow cancer," side effects," says Dr Plesner. Vejle Hospital, Sygehus Lillebælt, and scale. This invention has paved the way for says Dr Plesner, who along with his col- Professor at the Department of Regional the development of more effective cancer leagues at Vejle Hospital has taken the The clinical trial is now being extended with Health Research, SDU, since 2007, has treatments within many disease entities," long haul to success for the new antibody. combinations of Daratumumab and other been involved in clinical trials with the explains Dr Plesner. drugs that are active against multiple monoclonal antibody Daratumumab for "The process has been slow because the myeloma, both in phase II and phase III treatment of bone marrow cancer, mul- Monoclonal antibodies can often be used safety measures surrounding the testing of trials. Genmab has entered a partnership tiple myeloma. with little or no side effects and are used a new antibody are, justifiably, extensive. with Janssen allowing launch of many phase both alone and in combination with con- We have been able to gradually increase III clinical trials and thus ensuring that, if suc- The treatment is based on the isolation ventional chemotherapy. the dose of the antibody, whilst learning cessful, Daratumumab will become available of immunoglobulins derived from mono- how to optimise dosing and minimise the to the patients in need as soon as possible. clonal cells. Monoclonal cells are a family Clinical trials with the antibody Daratu- side effects. We are now through dose of cells derived from a single cell and mumab, conducted in a collaboration escalation in phase I of the trial and have therefore identical with regard to the anti- between clinical scientists from Denmark, found the correct dose, which patients are body (immunoglobulin) they secrete. The the Netherlands, Sweden, Italy, France now treated with in phase II and now also antibody thus reacts in a well-defined and the US, have shown very promising phase III trials," says Dr Plesner. manner with a particular type of molecule. results. In the case of Daratumumab, the molecule Monoclonal antibodies can often be used binds to the surface of cancer cells in the "The U.S. Food and Drug Administration with little or no side effects, and can be bone marrow cancer called multiple FDA has, on the basis of these promising used both alone and in combination with myeloma. results, granted Daratumumab 'break- conventional chemotherapy.
15
Jørn Herrstedt 500,000 DIABETICS IN THE FUTURE
16
Henning Beck-Nielsen Diabetes is eating its way into the population. Today, 300,000 people in Denmark FACTS: suffer from diabetes, and this number increases by five per cent every year. A large • Endocrine Elite Research Unit proportion of them are elderly people with other diseases at the same time, and was established as an elite this puts pressure on the treatment system. SDU and OUH are working to design unit in 2013. • It is part of the Department tailored treatments by combining biomarkers with the latest clinical knowledge. of Endocrinology M, Odense University Hospital and the Department of Clinical The number of people with diabetes is "We focus on translational research and diabetes, and they often suffer from several Research, Faculty of Health increasing by around five per cent per year, maintaining an application-oriented per- diseases at the same time. If a patient has to Sciences, SDU. and if this trend continues, half a million spective at all times. As clinicians, we treat take medication for cardiovascular disease, • The unit works with the people in Denmark – i.e. almost one-tenth patients every day, but it is also important COPD and diabetes, we can easily find our- Faculty of Science. of the population – will be diabetics in 2020. that we are closely associated with and selves in a situation where we are giving the involved in the basic research to ensure patient too much medicine. This is a problem, "Unfortunately, there is nothing to that it matches the reality of people with so it is important to identify what is good suggest that we can do anything about diabetes. You could say it is about finding for the individual patient," says Beck-Nielsen. the five per cent. It is the same in almost the right pill for the right mouth," says in all countries and has been for some Beck-Nielsen. He explains that the increase in the number years. The number of diabetics is a huge of elderly people with diabetes also has an burden on the health system. This poses RISK OF OVERMEDICATION impact on the organisation of future treat- challenges in terms of how to organise The Endocrine Elite Research Unit at the ment. This applies both to the small practi- their treatment, and how to ensure that Department of Clinical Research is assisted calities – e.g. that some patients may have FACTS: everyone receives good treatment," says by the Department of Molecular Medicine, difficulty getting to the hospital for check- BIOMARKERS Professor Henning Beck-Nielsen, Head of which is investigating biomarkers to find a ups – to the overarching development of • Biomarkers can detect diseases Research at the Endocrine Elite Research more effective treatment for diabetes. new drugs, which are today based exclu- in their earliest stages. Unit at Odense University Hospital and the Once the biomarkers have been identified, sively on younger people. • Biomarkers can be used for Department of Clinical Research, SDU. blood samples can be taken from the clinical diagnosis, prediction of patient and from them determine what Worldwide, around 371 million people the development of a disease, IMPORTANT TRANSLATIONAL the patient needs. have been diagnosed with diabetes, corre- response to medication, etc. RESEARCH sponding to around eight per cent of the • A pregnancy test from the Diabetes research at OUH and SDU is inter- "This way we can tailor the treatment. This world population aged 20–79. supermarket, for example, nationally recognised, due, not least, to may involve a change of diet, surgery for gives the result on the basis the unique interplay between basic and obesity or special medication. There is an Cooperation: of a biomarker. Department of Clinical Research – OUH – Department clinical research. increasing number of elderly people with of Molecular Medicine – Faculty of Science, SDU
17 THE GREY-HAIRED REVOLUTION
18 James W. Vaupel Most children born today will celebrate their 100th FACTS: GERMAN THOROUGHNESS – birthday. But what impact will this have on our family DANISH PERSPECTIVE life and careers? And our hospitals? These are some of the questions that the Max-Planck Odense Center will • Max Planck is Germany's most successful research unit. attempt to answer. • Since its establishment in 1948, the unit has fostered 17 Nobel Prize winners. Today, people turning 100 are sent a person- first university in the Nordic Region to al letter of congratulations from the queen. have been given the prestigious Max • Max Planck publishes more It is a greeting and a recognition of having Planck label in recognition of its biode- than 15,000 scientific articles lived to a ripe old age. But if this tradition is mography research. a year. to be maintained in the future, an awful lot • There are 82 Max Planck of letters will have to be sent out. DECISION ON RETIREMENT AGE institutes in Europe – including One of the areas of research at the Max- the new one at SDU. “More than half of those born today can Planck Odense Center is called Forecasting • Max Planck Odense Center on expect to live to 100,” says Professor James and Policy. According to James W. Vaupel, the Biodemography on Aging W. Vaupel, PhD, head of the newly estab- it is an important area because forecasts is composed of researchers lished Max-Planck Odense Center on the can have a direct impact on our economy from both the Faculty of FACTS: Biodemography on Aging at SDU. and lives. Health Sciences and the THE HOSPITALS OF THE FUTURE Researchers in the fields of demography, Faculty of Science at SDU. • Ageing changes the organisa- epidemiology, medicine, biology, mathe- “We develop models and methods to predict • The centre has around 25 tion of the treatment system matics and statistics are conducting research how long we will live in the future, and how employees from all over the and hospitals. into the riddle of old age in an international long we will remain fit and healthy. Politi- world. • Today, there are numerous interdisciplinary collaboration. It deals with cians follow the area closely and, on the physicians who specialise in why some of us live to a very old age, and basis of our research, can make more the heart, lungs, intestines, etc. the consequences of ageing – both for informed decisions about our retirement age In the future, there will be a individuals and for society as a whole. and the entire pension system,” he explains. great need for physicians with an overview of the patient's The elite research centre collaborates with GREATER IMPACT THAN overall health picture. the Max Planck Society, a world-renowned CLIMATE CHANGE German research organisation. SDU is the Life expectancy has increased by 2.5 years
19 FACTS: per decade since 1840. That is three RESEARCH GROUPS AT THE months a year or six hours a day. FACTS: MAX-PLANCK ODENSE CENTER THE HOSPITALS OF THE FUTURE ON THE BIODEMOGRAPHY ON “It’s an age revolution. It has an enormous • Several diseases or disorders AGING impact on people’s lives and on society at are often present in elderly large. It is comparable to climate change, patients at once – comorbidity • Unit on Human Longevity: but here we are seeing the consequences • Odense University Hospital Focuses on how new survival faster. If children can expect to live to 100, specialises among other things patterns improve human would it be reasonable for them to work in geriatric medicine, which, health. until they are 80? Should they have one according to James W. Vaupel • Unit on Medical Demography: long career or two different ones? This of the Max-Planck Odense Focuses on the relationship raises a number of questions and challeng- Center on the Biodemography between health and mortality es the present-day organisation of the on Aging, will be a key area at throughout the life cycle. labour market,” notes Vaupel. the hospitals of the future. • Unit on Forecasting and Policy: He estimates that in the future we will, Will develop methods to for example, work for far more years, but predict and evaluate trends in fewer hours per week. health and life expectancy during the 21st century. “Today, we slog for 30-40 years to get • Unit on Evolutionary Biode- everything to run smoothly: our career, our mography: Focuses on prin cip- family and our leisure time. This is known les that govern the patterns as ‘The rush hour of life’. But then, you within health and (higher) have plenty of time, when you retire. life expectancy – not only for Demographic developments make it pos- humans, but for a wide variety sible – and perhaps even necessary – to of species. organise work in a different way, so you might work 25 hours per week, but spread the work over 50-60 years.”
Cooperation: SDU – Department of Public Health – Max Planck Institute for Demographic Research – Faculty of Science, SDU
20 James W. Vaupel One in four cardiac patients suffer from anxiety and depres- sion and die earlier than patients in emotional balance. Despite increasing recognition of the fact that the psychologi- FOCUS ON THE cal profile of patients may have an impact on the prognosis and quality of life of cardiac patients, it is not common to have a psychologist on board the multi-disciplinary team in HEART AND cardiology departments. At Odense University Hospital (OUH) and the University of Southern Denmark (SDU), things are different. A psychology professor from the Department MIND IN THE of Psychology, Faculty of Health Sciences, SDU, is working at the Department of Cardiology, OUH, two days a week, as a TREATMENT research collaboration agreement has been entered into between the two institutions. It is her task to bridge the OF PATIENTS gap between basic research and clinical practice.
Around a quarter of the many thousands ments. This has unfortunate consequences of patients admitted to cardiac units for patients and society alike. As the first WITH HEART suffer from anxiety and depression. Even in Denmark, the Faculty of Health Sciences if they are given the very best, state-of- at SDU has therefore allocated funding for the-art treatment, the result is not research in this interdisciplinary field, DISEASE encouraging: They have a poorer quality among other things with the appointment of life and apparently die earlier than of Susanne S. Pedersen, Professor of Cardiac comparable patients unburdened by Psychology. such symptoms. BOTH BEHAVIOUR AND This is just one of the many psychological THE IMMUNE SYSTEM challenges associated with the treatment With the aim of bridging the gap between of cardiovascular disease, but until now research and clinical practice, she is based there has been little focus on the psycho- at the Department of Cardiology, OUH, logical aspect at the cardiology depart- two days a week.
21 “I look at how patients’ treatment can be suddenly to a genetic heart defect, with which takes into account both the clinical optimised beyond everything that doctors the implication that the rest of the family and the psychological aspects of disease can do. I focus on the many cardiac patients needs to establish if they have the same and, for example, provides guidance on who suffer from depression or anxiety, and genetic defect,” she explains. how to deal with depression and anxiety. the consequences of this. In order to improve the treatment, it is important to “Cardiology has a range of state-of-the-art “It is important to have psychological look at both the behavioural factors, such as treatments. For example, patients can be expertise on board both in clinical research patients not taking their medication, and at fitted with an ICD (implantable cardioverter and practice, and my wish for the future is basic research on the immune system, etc., defibrillator), which intervenes and saves the that resources will be made available to because the mind and body interact,” says patient’s life in the event of a potentially appoint psychologists with knowledge of Professor Susanne S. Pedersen. life-threatening heart rhythm. But all tech- somatic disease on cardiology wards. The nology comes at a price, and we need to get benefit of having a psychologist present is She is part of everyday life at the Depart- better at asking patients what they want. that the psychologist has knowledge of the ment of Cardiology, but her work does not In a study from the Erasmus Medical Center, challenges and problems of cardiac involve therapy sessions with patients or the Netherlands, we have shown that patients, and is on hand to advise and individual counselling. Her focus is on the patieents prefer to have their ICD switched supervise staff. Naturally, this involves an overall perspective with emphasis on the off in the final stages of their life, and die a investment, but the question is whether we patient’s perspective: How does heart disease dignified death without multiple painful can afford not to for the sake of patients’ affect the mind? What are the implications shocks. Patient involvement and shared deci- well-being and prognosis,” says Pedersen. of having technology implanted into the sion-making is the future, and this is some- body? How does the disease affect relatives? thing of a paradigm shift in terms of what She points out that doctors are busy, And what can we offer those patients who doctors have been used to. It may even lead so one of the prerequisites of a good have difficulty adapting and moving on? Do to improved compliance among patients, as research collaboration is not only that patients receive sufficient information and they become more involved in their own psychologists are present in clinical prac- are they satisfied with their treatment, or treatment and thus likely feel more respon- tice, but also that they speak the doctors’ can we improve what we offer patients? sible. This is known as ‘patient empower- language. Susanne S. Pedersen reaps both ment’,” explains goodwill and effective input from working PATIENT INVOLVEMENT GIVES Pedersen. at the Department of Cardiology at OUH QUALITY OF LIFE two days a week. She is delighted that the Although the research is still in its infancy, THE MIND MUST BE INCLUDED IN opportunities for research collaboration Professor Pedersen has identified a clear INFORMATION MATERIAL and knowledge sharing will be even better need for psychological expertise on a The goal of the research is to become in a few years time when the new inter- cardiology ward. better at targeting treatment to the connected SDU and OUH are completed. individual patient, so it is as effective and “Cardiologists do not always feel equipped considerate as possible. The goal is also to Cooperation: Department of Cardiology, Odense University Hospital – to talk to a family which has lost a relative develop better information for patients, Department of Psychology, SDU
22 Susanne S. Pedersen FACTS:
• Around 420,000 people in Denmark live with cardio- vascular disease. • In a municipality with 50,000 inhabitants, around 3,800 people suffer from cardio- vascular disease. • More than a quarter of Danes die from cardiovascular disease. • Cardiovascular disease is the second most common cause of death in Denmark. • More than 54,000 people in Denmark are hospitalised each year as a result of cardio- vascular disease. Over the course of a year, this adds up to 120,000 admissions. Some 43,000 people a year in Denmark attend one or more outpatient consultations for cardiovascular disease at the hospital. • Patients hospitalised with cardi- ovascular disease cost the State DKK 4.6 billion a year – plus costs for prescription heart medication.
Source: The Danish Heart Foundation
23 KIDNEYS AND BLOOD PRESSURE – HOW THEY ARE CONNECTED
FACTS: Projects focus on patients with The Department of Molecular pre-eclampsia, type1 and type2 Medicine has three main areas of diabetes and nephrotic syndrome. research. Besides Cardiovascular This autumn a project on hyper- and Renal Research, there is tension in kidney transplant Cancer and Inflammation Research patients begins. Despite a “new” as well as Neurobiology Research. kidney, a significant proportion of Boye L. Jensen's research group transplanted patients display collaborates on research projects protein in the urine and high 24 on hypertension with Odense Uni- blood pressure. Boye L. Jensen versity Hospital and hospitals in the Region of Southern Denmark: New insight into the causes of hypertension provides better opportunities for FACTS: individual treatment for the 800,000 people in Denmark with high blood pressure, Boye L. Jensen's work with putting them at a higher risk of a stroke, heart attack and kidney damage. kidney disease, hypertension and protein in the urine is relevant to the disciplines of many of the Protein in the urine is a "danger" signal "forcing" blood pressure up when protein cause. But we believe we have discovered departments at Odense University that causes doctors to look for signs of pre- is leaked from the blood to urine. a mechanism that can contribute to Hospital. The various groups of eclampsia in pregnant women and renal dys- hypertension in patients with protein the research unit are currently function in diabetic patients. Protein in the "We have found it in rats and we have in the urine," says Jensen. cooperating with: urine is an indication that the kidneys' filters, found it in various groups of patients where the blood is purified, are "leaky", as (pre-eclampsia, diabetes, paediatric COOPERATION IS THE KEY • Department of Gynaecology protein from the blood is leaked into the nephrotic syndrome). Together with the TO PROGRESS and Obstetrics urine. Kidney filtration barrier damage is Department of Endocrinology, Odense All departments at Odense University • Department of Urology often seen concurrently with increased blood University Hospital, we have discovered Hospital dealing with kidney, blood pres- pressure. Blood pressure raised over a long that the enzyme may be affected by sure and urinary tract diseases contribute • Department of Nephrology period of time damages the kidneys. blood pressure medication," says Jensen. to and benefit from the translational • Department of Gastroenterology research conducted at the Department • Department of Pathology "It's a vicious cycle that starts when a kidney HYPERTENSION IS AN OVERLOOKED of Molecular Medicine's Department of • Department of Nuclear Medicine is "leaky". Once the kidneys are affected, it EPIDEMIC Cardiovascular and Renal Research. predicts a negative outcome," explains Boye Up to one in five adults in Denmark have • Department of Cardiac, Thoracic L. Jensen, Head of Research and Professor of high blood pressure. Only half of them “We have an excellent working relationship and Vascular Surgery Cardiovascular and Renal Research the know it, and only half of those who know with the departments. Without them we • Department of Endocrinology Department of Molecular Medicine. it get treatment. Of those, many do not would not be able to test our theories, and • Department of Clinical attain treatment goals, which are to lower their contact with so many patients gives us Biochemistry ENZYME PROVOKES RETENTION blood pressure sufficiently, preferably to extensive biological material to work with – • Department of Neurosurgery OF SALT under 140 mmHg. So there is a large urine, tissue and blood samples and the possi- Boye L. Jensen and his research team work group of people who are unaware that bility of intervention with medicines. It makes • Department of Cardiology closely with physicians at Odense University they are at increased risk. Hypertension, our basic research and our work with animal • Department of Neurology Hospital. As two researchers from the which in itself often has no symptoms, is models far more realistic, we can quickly test Department of Molecular Medicine and discovered by accident and sometimes, ideas out on patients and see that there is a the Department of Nephrology discovered unfortunately, following a "stroke". need for our research,” believes Jensen. five years ago, enzymes in the urine now appear to be a possible cause of the "In more than 90% of patients with Cooperation: Department of Molecular Medicine – OUH kidneys retaining salt and water and high blood pressure, we do not know the
25 EDUCATION
SUCCESS WITH QUOTA 2 SELECTION A large percentage of the stu- dents at the Faculty of Health Sci- ences are admitted via special selection (“Quota 2”). Candidates NEW GRADUATES DEVELOP THE HEALTHCARE SECTOR are assessed in relation to the formal requirements, their perfor- mance in a multiple-choice test The Faculty of Health Sciences is a beacon etc. – are very much the people who the Much of the teaching is a joint effort. and personal qualities such as within master’s programmes mimicking patients encounter. The bachelor degree The students get to know each other as motivation and ethics. Interviews real life. The Faculty recently had its programmes work well and the realistic professional groups while they are study- ensure a good match between master's programmes in occupational new master's programmes will, together ing, and the interdisciplinary competencies student and programme, reducing therapy, clinical nursing and midwifery with the bachelor programmes, help to match the reality they subsequently have the risk of students dropping out. science accredited – and this will have a create an even better health service in the to work with. positive impact on professions, personnel future," says Merete Munk, Head of Edu- and patients. cation at the Faculty of Health Sciences. ALTERNATIVE TO BROAD-BASED MASTER'S PROGRAMMES Nurses, occupational therapists and mid- It can be difficult to implement knowledge The thinking behind the new programmes wives can now take a master's degree in and new initiatives in a busy working day, is that there is a demand for more their subject at SDU, equipping them to so the programmes also focus on how the research-based knowledge in the respec- The special Quota 2 selection is develop the profession through a scientific knowledge is put into play, so that it tive fields and an alternative to the more used for Medicine, Clinical Biome- approach. The new master's programmes makes a difference to the day-to-day broad-based master's programmes, which chanics, Public Health, Sport & make a positive contribution to the health- work, extending all the way out to the have so far existed for bachelors in occu- Health and Psychology. Teachers care system because the students can act departments and the patients. Conse- pational therapy, nursing and midwifery and students alike are happy with as internal agents of change. They can quently, these programmes also include science. The new programmes have there- the scheme, and studies have challenge existing procedures and identify subjects such as project management, fore also been developed in collaboration shown that the Quota 2 students effective new procedures. On a scientific organisation and change processes. with both professional colleges and generally do better on the pro- basis, that is. employers. grammes than students admitted DAILY LIFE IS INTERDISCIPLINARY in an traditional way. "The bachelor degree programmes play a Interdisciplinarity is a crucial point of the key role in health care because they – the Faculty's master's programmes, as is the nurses, occupational therapists, midwives, case with the three new programmes.
26 FACTS: 2009 2011 2013 Students in total (no.) 2,982 3,496 4,388 The Faculty of Health Sciences offers the following programmes: Admission (graduates, undergraduates, options, • Medicine supplementation and masters) • Clinical Biomechanics Medicine 499 488 633 • Sport and Health Chiropractor (clinical biomechanics) 109 87 87 • Public Health Sciences • Master in Health Science Sport and Health 142 183 229 • MSc in Pharmacy (in coopera- Master in Health Science 26 31 48 tion with the Faculty of Science) MSc in Pharmacy - 12 20 • MSc in Physiotherapy • Psychology (in cooperation with Biomedicine 14 14 32 the Faculty of Business and Public Health Sciences 69 71 119 Social Sciences and the Faculty of Humanities) Audiologopaedics 31 25 18 • Biomedicine (in cooperation Physiotherapy - 28 31 with the Faculty of Science) • Audiology and Logopaedics Master in Health and Physical Activity 11 - - (in cooperation with the Faculty Audiology 25 45 59 of Humanities) Master of Rehabilitation 19 - 18 • Occupational Therapy • Clinical Nursing Master of Public Quality Management 17 20 17 • Midwifery Science Master of Medical Imaging 11 8 - • Master of Rehabilitation
Psychology - 114 206 • Master of Public Quality Management Supplementary Health Programme 32 31 63 • BSc in Engineering (Welfare In total 1005 1157 1580 Technology) (in cooperation with the Faculty of Engineering)
27 PUBLIC SECTOR CONSULTANCY AND PROJECTS
THE AUTHORITIES' RIGHT HAND FIRST EXAMPLE: STATE OF THE "The municipalities want to know how The Faculty of Health Sciences assists NATION IN A SINGLE DATABASE people are. We ask them about everything the public authorities with a number The National Institute of Public Health, from smoking and diet to sex and gambl- of tasks – from analysis of public health SDU, is a national research institute that ing addiction," explains Grønbæk. to investigation of causes of death. supplies research and data to all Danish municipalities and regions, and has a YOUNG PEOPLE DRINK LESS The Faculty of Health Sciences highly consultancy commitment to the Danish THAN BEFORE prioritises close interaction with the Ministry of Health. One result of the survey – which has sur rounding society. We do this a.o. received a great deal of attention – is that through public authority projects and "The Institute assures the University of young people aged between 16 and 24 knowledge sharing, bringing research Southern Denmark close ties with the drank less alcohol in 2013 than in 2010. into people’s everyday lives. National Board of Health and the Ministry because we contribute a vast database of "We can see a fairly sharp decline in The Faculty of Health Sciences provides figures and knowledge. The health of the alcohol consumption. It is still higher than independent, research-based public- Danish population can therefore be fol- in many other countries, but it is falling," sector consultancy with a fast response, lowed over time, showing how important says Grønbæk. FACTS: making the faculty an interesting and it is to make an extra effort," says Director The National Health Profile 2013 is reliable partner. The Faculty of Health Morten Grønbæk. When the responses in the questionnaires open to the public, so anyone can Sciences also holds a leading position show something as clear and sensational, search for data on the health, within the monitoring of public health Since 1987, the National Institute of Public many people question whether it can be well-being and morbidity of with strong research environments Health has been making random checks on true. Morten Grønbæk explains that the Danes at local, regional and within epidemiology and register our health behaviour. Most recently, in results are validated in a variety of ways. national level. In future, the based research as well as a sizeable 2010 and 2013, more than 150,000 Danes health profile will be compiled biobank. were asked to complete a questionnaire "We allow for drop-out, so that is not a every four years, ensuring that on health for the National Health Profile. factor, at least not when we look at the newly elected local councillors Below, we provide two specific examples In many municipalities, the results form changes. And from time to time, we sup- have fresh figures to work with. of how our professional knowledge bene- the basis of the work of many political plement the results with other population www.danskernessundhed.dk fits the authorities. committees. studies that have looked at physical exami- nations. For example, data analysis on
28 people who say they drink a lot shows the body, we change the anatomy. If, for FACTS: them to be far more likely to develop example, a man has sustained a blow to the cirrhosis than those who say they do not head with a crowbar, the skull fragments • CT scanning is an advanced drink. It is an indirect validation that the tends fall apart when we open the head at form of X-ray that provides answers given are more or less true – the autopsy. With CT we can view the 3D images instead of the even when talking about one's drinking cranial fractures in situ, and thereby evalu- traditional 2D X-ray image. habits," says Grønbæk. ate far easier if a given blunt instrument has • X-rays have been used in been used to produce this lesion or not. The forensic medicine for more SECOND EXAMPLE: CT SCANS CT images are also more suited to court- than a century, but CT scans PROVIDE BETTER FORENSIC MEDICINE room presentation than grisly autopsy have only been introduced Every year, the Department of Forensic photos, especially in jury trials," says Peter as standard over the past Medicine at the Faculty of Health Sciences Mygind Leth, Deputy Chief Forensic Patholo- few years. carries out a multitude of tasks for the gist, Specialist in Forensic Medicine at the • It takes about 10 minutes to authorities – in fact, it is the very DNA of Department of Forensic Medicine. complete a CT scan in Forensic the institution: Forensic medicine is Medicine. defined as "science and medicine used for Another advantage of CT scans in forensic the purposes of the law". medicine is that it is easy to store and send • The Department of Forensic the images, thereby facilitating second Medicine has used CT scans Since 2006, the Department has used CT opinion reviews and quality control. to help with an almost scans in its work as a supplement to stand- 1,000-year-old murder case ard autopsies. CT is an advanced X-ray "In short, CT scans ensure that we get a – the murder of Canute imaging technique that allows inner struc- better and more accurate diagnosis. CT is the Holy. tures to be seen in three dimensions as so effective that I believe some autopsies well as in cross-sections without opening can be avoided in the future, for the the body. benefit of the relatives and the authorities alike," says Peter Mygind Leth. ACCURATE DIAGNOSIS "CT images show the inner structures The Department of Forensic Medicine un disturbed by dissection. Once we open performs around 200 CT scans a year.
29 NEW OUH/SDU
UNIQUE NEW BUILDING PROJECT PROVIDES EXCEPTIONAL FACTS: RESEARCH AND EDUCATIONAL OPPORTUNITIES The New HEALTH covers 50,000 m2 and the building connects the existing campus with the The University of Southern Denmark and And an easily accessible and forward-looking Two concepts – Active Living and research new university hospital. Odense University Hospital are being built research communication will strengthen the communication – contribute to the together at Campus Odense.The New employees’ identity and knowledge about dynamic development of the collaborative Together, SDU and the New OUH OUH/SDU will be a unique design that will each other’s fields of research. culture, working environment and know- will cover an area of approxi- attract international attention. The New ledge sharing. At the same time, the sur- mately 500,000 m2 under one OUH/SDU will contribute to a strong and STIMULATING RESEARCH AND rounding nature will help make the work roof when the new buildings are close collaboration between a five-faculty STUDY ENVIRONMENT and study environment feel welcoming completed. The New OUH/SDU university and a university hospital. New HEALTH, i.e. the new building for the and stimulating. should also be viewed in connec- Faculty of Health Sciences at SDU, represents tion with Cortex Park, located The extraordinary opportunities offered by the physical link between SDU and the New just north of SDU, where resi- the New OUH/SDU to optimise cross-disci- OUH. New HEALTH will provide a framework dence halls have already been plinary research will provide SDU with a for both research and education, where NEW IOB established, and where buildings national and international position of interaction and cooperation are keywords for organisations and companies strength in translational research that will that will ensure quality and a high interna- ACTIVE AND HEALTHY LIVING are set to shoot up in the coming enhance the quality of research and tional level of New HEALTH’s core tasks. In 2013, the Department of Sports years. The experience of the strengthen implementation of new and Clinical Biomechanics moved entire campus area will be research in society as well as contribute to New HEALTH will be a pleasant and inspir- into its new building and training a dynamic, vibrant city of educational and business innovation. ing place to work and study, and a place stadium, which with its cutting- knowledge, which is marked that is welcoming to visitors and business edge interior will contribute to by the work of the university The linking of SDU and OUH is completely partners. The research areas are flexible the development of research, and the university hospital. central to this. Ideally, employees from SDU and support a dynamic research develop- education, entrepreneurship and OUH will not think about where they ment. The education facilities with class- and innovation – nationally and Completion of the New OUH/ are, whether in one organisation or the rooms and study zones form an excellent globally. SDU planned for 2022. other. They will be able to find workstations learning environment and provide a sense and meeting places where they need them. of belonging to the university.
30 COLOPHON Health for all, 2014 Published by: The University of Southern Denmark (SDU), Faculty of Health Sciences Editor-in-chief: Dean Ole Skøtt 5041 0601 Photography: SDU archives · Hyldager Fotografi Tryksag Design and production: Mediegruppen Turnover, Turnover, total (DKK million) 3.3 17.2 17 18 20 22.1 76.2 21.3 26.6 15.8 45.5 43.9 151.2 36.9 59.2 60.4 122.0 31.4 87.9 44.2 109.3 297 361 415 200 233 257 315 437 540 516 476 361 281 292 271 325 373 438 2009 2011 2013 1,258 1,322 1,313 Turnover, external activities (DKK million) 3 9 69 31 82 50 55 241 PhD students enrolled (no. as at 31.12) 5 47 38 23 16 25 82 41 84 Technical Technical and admini- strative (no.) staff 4.9 9.1 6.4 59.2 Technical and Technical administrative – TAP staff (FTEs) Forensic medicine services Ordinary activities (consumption) Economy (mDKK): services) External activities (excl. forensic medicine PhD students (no. as at 31.12) PhD students (no. as Technical and administrative staff (no.) and administrative staff Technical Technical and administrative staff (FTEs) and administrative staff Technical Academic staff (no.) Academic staff Personnel (FTEs) Academic staff Academic Staff (no.) 5.9 12 27.0 30.0 23.4 149 71.8 478 19.1 48 65.9 104 14.8 79.7 180 59.5 82.5 184 21.6 60.1 158 68.4 Academic – VIP staff (FTEs) The Faculty Secretariat Department of Forensic Medicine Department of Regional Health Research Department of Clinical Research Department of Psychology National Institute of Public Health Department of Public Health Department of Sports Science and Clinical Department of Sports Science and Clinical Biomechanics Institute 2013 Department of Molecular Medicine THE FACULTY OF HEALTH SCIENCES THE UNIVERSITY OF SOUTHERN DENMARK WWW.SDU.DK/HEALTH