OBJECTIVE: To clarify the importance of health beliefs and some socio-demographic data for accepting an invitation to take part in a health examination by comparing attenders and non-attenders with respect to health beliefs and social status. DESIGN: Multipractice study including questionnaires for men. SETTINGS: 65 GPs in two areas in the county of Aarhus, Denmark, invited 2452 40-49 year old men to a health examination for ischaemic heart disease. The examination was free in one area, whereas there was a fee in the other. All 1272 attenders and 423/1180 non-attenders completed the questionnaire. RESULTS: The attendance rate was 66% in the area with free examination and 37% in the fee-paying area. The attendance was significantly higher for cohabitants than for single men in both areas. There was a slightly higher attendance of men with an occupational training in both areas, but the difference was not significant. In general, all agreed that IHD is a serious disease, and that it can be prevented by a personal effort. There were only minor differences in the attenders' and non-attenders' health beliefs. CONCLUSION: The main conclusion is that 40-49 year old men are in general concerned about IHD. Whether they want to have a health examination for IHD depends mainly on its availability (exemplified here as fee versus free), since the differences were small with respect to health beliefs between attenders and non-attenders.
The object of this investigation was to examine general practitioners' attitudes to prophylaxis, assessment of the significance of a series of risk factors for the development of heart disease and how much emphasis they employed in attempting to alter the risk factors. In addition, the general practitioners' own health habits were investigated and it was assessed whether there was any connection between health habits and assessment of risk factors and the priorities given to these efforts. The general practitioners' advice and current behaviour as regards risk factors were investigated. The investigation was carried out as a questionnaire investigation in the County of Aarhus where all doctors received a questionnaire. A total of 313 general practitioners replied to the questionnaire which corresponds to a percentage participation of 84. The investigation revealed that general practitioners are interested in prophylaxis but find it difficult. By and large, general practitioners regarded the usual risk factors as being of great significance for the development of ischaemic heart disease and considered that it was important to alter these. A connection was present between their own health habits, assessment of risk factors and the priority awarded to these. Practitioners who had had their own serum cholesterol measured, considered that hypercholesterolaemia was important and awarded efforts to correct this greater priority than practitioners who had not had their serum cholesterol measured. The general practitioners abilities in taking case histories and giving dietary advice in cases of hypercholesterolaemia showed that they had only few deficiencies, but that there was a great scatter in their intervention limits for hypercholesterolaemia.
The objects of the investigation were to investigate the smoking habits of general practitioners, their assessment of tobacco as a risk factor for ischaemic cardiac disease, attitudes to intervention to stop smoking and to assess whether there was a connection between these. The project was carried out as a questionnaire investigation in the County of Aarhus, where all of the general practitioners received questionnaires. A total of 313 general practitioners replied to the questionnaire which corresponds to 84% participation. 33% of the general practitioners smoked and nine were chain smokers. The majority of the general practitioners accepted that smoking was a risk factor for ischaemic heart disease and were prepared to make great efforts to combat smoking. A connection was present between smoking habits and attitudes: Non-smokers considered that smoking was of great significance as a risk factor for ischaemic heart disease and were prepared to make efforts to alter the smoking habits of their patients. General practitioners doubted the effect of their advice about stopping smoking.
Bacteriuria in pregnancy with or without clinical symptoms is frequent and increases the risk of pyelonephritis, preterm labour, and low birth weight infants. Commonly used antibiotics such as ampicillin (pivampicillin), amoxicillin, trimethoprim, and sulphonamide are currently associated with a high degree of resistance of the most common pathogen in the urinary tract, Escherichia coli. During the past few decades a number of new and efficient antibacterial antibiotics have been developed. The presumption that a specific drug is safe for both the pregnant woman and the foetus depends on how widely the drug has been used. A recent survey among general practitioners and obstetricians in Denmark, Finland, Norway, and Sweden confirmed that the beta-lactam antibiotic pivmecillinam and nitrofurantoin are the most commonly used agents in the treatment of bacteriuria in pregnancy in the Nordic countries. However, a surprisingly high number of physicians reported that they prescribe sulphonamides during the first two trimesters in spite of resistance of E. coli and possible adverse effects on the foetus.
Bacteriuria in pregnancy, with or without clinical symptoms, is frequent. If left untreated, it can in 20-30% of cases lead to acute pyelonephritis, which is a serious threat to the mother and fetus, increasing the risk of preterm labour and low birthweight infants. This paper is a review of the literature concerning antibacterial treatment of bacteriuria in pregnancy. It is crucial to ensure that drugs to be used in pregnancy are safe and effective. Established first-line drugs such as ampicillin (pivampicillin) and amoxycillin, and other commonly used treatments such as trimethoprim-sulphamethoxazole, are associated with a high degree of resistance in Escherichia coli, the most common pathogen in the urinary tract. A recent survey of physicians in Denmark, Finland, Norway and Sweden confirms that beta-lactam antibiotics (particularly pivmecillinam) and nitrofurantoin are the drugs of first choice in the treatment of bacteriuria in pregnancy in the Nordic countries. No teratogenic effects have been associated with these agents. In contrast to nitrofurantoin, pivmecillinam is also efficient against pyelonephritis. In spite of resistance in E. coli and possible adverse effects on the fetus, many physicians still prescribe sulphonamides during the first two trimesters of pregnancy.
BACKGROUND AND OBJECTIVES: This study's purpose was to determine how conditions of payment influence attendance at preventive health examinations. METHODS: A multi-practice study of 65 general practitioners (GPs) was conducted in two areas in the county of Aarhus, Denmark. The GPs invited 2,452 men aged 40-49 to a preventive health examination for coronary heart disease (CHD). The examination was free in one area but cost $40 in the other area. A risk profile was estimated, based on a summation of points for risk factors for CHD, including blood pressure, serum cholesterol, smoking behavior, body mass index, and family history of CHD. RESULTS: Attendance at the examinations was 37% in the required payment area and 66% in the free area. Of the total attenders, 13% had an increased risk of CHD. A slight but significant tendency, a lower risk for developing CHD, existed among attenders who paid for the examination. CONCLUSION: A requirement for payment for health examination leads to fewer patients obtaining examinations.
OBJECTIVE--To examine the psychological reactions in 40-49 year old men diagnosed as having an increased risk for the development of ischaemic heart disease at a health examination in general practice. DESIGN--A multipractice study including a questionnaire about the psychological well-being before and 6 months after a health examination aimed at finding an increased risk for ischaemic heart disease. SETTING--General practice in the county of Aarhus, Denmark. Sixty five general practitioners. PARTICIPANTS--123 men with and 150 men without an increased risk of ischaemic heart disease. OUTCOME MEASURES--Psychological well-being was measured by the General Health Questionnaire (12 item version). RESULTS--No significant change in GHQ-scores after the screening examination. CONCLUSION--Information about increased risk of IHD in 40-49 year old men at a health examination in general practice did not change the psychological well-being as measured by a General Health Questionnaire 6 months after the examination.