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Biomedical subjects

J Lous

Publications and source records attributed to J Lous.

At least 37 records · Page 2Linked to original sources
PubMed1998

Antibiotic treatment of acute otitis media. Criteria and performance in Danish general practice.

OBJECTIVE: To assess implicit criteria (i.e. what the general practitioner (GP) considers good clinical practice) for and performance (i.e. what the GP actually does) with regard to antibiotic treatment of acute otitis media in Danish general practice. DESIGN: a) Criteria assessed by survey among general practitioners. b) Performance assessed by prospective registration of consultations with general practitioners related to otitis media. SETTING: General practices in three Danish counties. SUBJECTS: a) All the GPs in the three countries (n = 790). b) 368 children with acute otitis media. MAIN OUTCOME MEASURES: a) Criteria for timing of treatment and first drug of choice for acute otitis media; b) prescribed antibiotics and multivariate analysis of factors predicting antibiotic prescription. RESULTS: a) The response rate was 72%. Only 51% (95% CI 47-55) of GPs would give antibiotics to all children with acute otitis media, and 79% (95% CI 76-82) of GPs would use penicillin-V as first drug of choice. b) Seventy-four per cent (95% CI 68-81) of children with acute otitis media were given antibiotics. Factors predicting the GPs' decision to prescribe antibiotics were the general condition of the child and the factors that are normally used in diagnosing the condition. CONCLUSION: Danish general practitioners' criteria for antibiotic treatment of acute otitis media are restrictive, with non-antibiotic treatment in cases of short duration and penicillin-V as first drug of choice. Performance suggests a less restrictive pattern.

Anti-Bacterial Agents↗
PubMed1997

[Prolonged sick-leave: the role of general practitioner].

The aim was to study why long sick leave benefit cases had taken a long time with special focus on the communication between the general practitioner and the social service department. An explorative study was made of the development and communication in 27 consecutive lengthy sick leave cases that had lasted more than 13 weeks, that were discussed at three audit panels with participation of the social worker/officer in charge, the general practitioner and the representatives from the local hospital. The study took place in Aarhus County in 1994. The results were that many of the same problems were found in various cases, such as insufficient certificates, inappropriate use of benefit certificates, waiting times for examinations, treatment and especially rehabilitation. In the more complicated cases, of which there were many, a coordinating person would have helped matters. The GP's were willing to take on this role. The main reasons for lengthy benefit cases were that the illness was medically complicated and of a long duration.

Adult↗
PubMed1995

Developmental implications of early-life otitis media.

This symposium addressed possible relationships between early-life otitis media (OM) and various components of child development. The existence and nature of such relationships are of substantial theoretical and practical consequence. Particularly at issue are policies concerning optimal frequencies of examination and screening for middle-ear disease as well as the relative appropriateness of conservative vs. aggressive regimens of management.

Age Factors↗
PubMed1995

Otitis media and reading achievement: a review.

Nineteen studies on the relationship between otitis media (OM) or otitis media with effusion (OME) (secretory otitis media (SOM)) and reading achievement were reviewed. The result is that the children catch up in cognitive development when their ears and hearing become normal at about school age. The correlations that have been found between SOM and reading achievement are so small that they have no practical importance for the average child. At the present time we have no knowledge that justifies intervention against SOM as a general preventive task to ensure the cognitive development, or reading achievement. The absent or very small correlation between SOM and reading in the reviewed studies, 'explaining' only 2-4% of the variance, has no implications in comparison with other important factors. Reading achievement was more closely correlated with cognitive, language, and linguistic factors, and to a series of socioenvironmental and classroom related factors. The high frequency of SOM, with resulting hearing loss, and the long duration and high rate of occurrence of OM in 'otitis-prone' children, and clinical observations underlines the need for further research.

Acoustic Impedance Tests↗
PubMed1993

Silent reading and secretory otitis media in school children.

In an unselected cohort of 366 8-year-old children, the relationship between secretory otitis media and reading achievement was investigated. The children underwent 10 impedance audiometries and 5 pure tone audiometries during their first year at school. At the beginning of the second grade they all had a Silent Reading Word Test (OS-400). The background parameters were recorded by an interview with one of the parents. There was a significant but small correlation between type B tympanograms in the first grade and silent word reading. No association between silent reading score and otological history or pure tone screening was found. In a stepwise multiple regression model, 37% of the variance could be 'explained' by the included variables. The 'classroom factor' could 'explain' about 17% of the variance, followed by phonology at the start of school (6%), gender (5%), social group of the mother (4%), type B tympanogram (2%), absence from school (2%) and allergy (1%).

Audiometry↗
PubMed1992

[Cardiovascular risk factors--extent and self-assessed risk in relation to prevention of cardiovascular diseases. A questionnaire among 3,956 men and women aged 24-65 years in Vejle County, Slangerup and Helsinge municipalities].

In autumn 1989, a material of 1,330 men and 1,561 women aged 20-65 years and resident in the County of Vejle replied to a standardized questionnaire about their knowledge and behaviour in relation to prophylaxis of cardiovascular disease. During the same period, 501 men 565 women in the Municipalities of Helsinge and Slangerup participated in a similar investigation. It was investigated whether the behaviours of the participants as regards tobacco, physical activity, diet, experience of stress and overweight were unsuitable in relation to prevention of cardiovascular disease. 22% of the men and 11% of the women had unfavourable behaviour in more than two of these factors. The percentage proportion with many unfavourable factors was greatest among persons with the lowest school education. The majority of the participants were aware of the factors which are of significance for the development of cardiovascular disease. The general level of knowledge was high. A majority of the participants with many unfavourable factors assessed their own risk of development of cardiovascular disease as great. The proportion of the participants who were aware that a personal effort was of significance to retain health was greatest in the group where the behaviour was most suitable both where men an women were concerned.

Adult↗
PubMed1992

[Smoking habits among adults--attitude and behavior in relation to prevention of cardiovascular diseases].

During the autumn 1989, a material of 1,330 men and 1,561 women aged 20-65 years and resident in the County of Vejle replied to a questionnaire about their smoking habits and knowledge in connection with the prophylaxis of cardiovascular disease. 47% of the men and 39% of the women stated that they smoked. During the past year, 44% of the male and 51% of the female smokers and ex-smokers had altered or considered altering their smoking habits. The main motives for altering smoking habits were health or financial reasons. The main reasons that an attempt to alter smoking habits did not succeed were side effects (restlessness/nervousness), the force of habit or that the desire was too great. The attitude that smoking was of significance for cardiovascular disease was related to non-smokers. In addition, a connection was observed between the knowledge that smoking is a risk factor for cardiovascular disease that the fact that these participants did not smoke. No interactions were observed between knowledge, attitudes and smoking habits i.e. that the attitude that it was important to stop smoking was identical among smokers and non-smokers, regardless of whether smoking was deleterious to health. On the basis of previous attempts to alter smoking habits, the conclusion was drawn that this is a difficult task. One of the reasons is that the cause of smoking are partially unknown and that smoking is probably an important factor in various social situations. In addition, the motivation to alter smoking habits is more than dominated by the discomfort involved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Knowledge, attitudes and cardiovascular risk factors in Danish adults.

A community cardiovascular disease (CVD) prevention programme was undertaken in 1989 in a Danish County (Vejle). A random sample of 5192 adults were asked to complete a mailed questionnaire on knowledge, attitudes, and behaviour in relation to CVD risk factors. The response rate was 56%. The questionnaire produced baseline data for programme planning and measuring the success of on-going interventions. Smoking, overweight, and unhealthy food habits were the most prevalent CVD risk factors. A CVD risk score was calculated from the data on smoking, food habits, exercise, stress, overweight, self-reported presence of hypertension, diabetes, and gender. A high score was commoner in men, in the least educated, in groups who judged their own risk as high, and in groups with negative health beliefs. The level of knowledge about CVD risk factors was high in general. Low knowledge was commonest in the youngest age group, in the least educated, in unskilled workers, and in groups with negative health beliefs. As social position and personality factors seem to play an important role in actions people may take in prevention of CVD, they should be considered in the planning of the health promotion activities in Vejle.

Adult↗
PubMed1991

[Danish exercise habits in the 1980's. Attitude and behavior in relation to prevention of cardiovascular disease].

The results concerning exercise habits from four Danish health investigations among school pupils in the sixth and eight forms in the Municipality of Frederiksberg, adults aged 20-65 years in the County of Vejle and in Glostrup and the surrounding district and persons aged 70-75 years in the County of Roskilde, respectively, are compared. 70-80% of the Danish population take part in sports in their leisure time. Men of all ages take part in more strenuous exercise than women. The physically most active are those who have the best education and who live in their own houses. In the course of the nineteen eighties, the population has become more aware of the significance of exercise for cardiovascular disease. Similarly, during the same period, the proportion who take part in exercise has apparently increased by approximately 15%. The attitude that exercise is of significance for cardiovascular disease was connected with personal participation in sport. The knowledge that too little exercise constituted a risk factor for cardiovascular disease was increasingly realised although the connection was not definite. The social differences in exercise habits may be an explanation of the corresponding differences which have been observed in several western countries during the past decades in the mortality from cardiovascular disease.

Adult↗
PubMed1991

[Food habits and knowledge among adults in the county of Vejle in relation to prevention of cardiovascular disease].

During autumn 1989, 1,330 men and 1,561 women aged 20-65 years residing in Vejle replied to a questionnaire about dietary habits and knowledge concerning prevention of cardio-vascular disease. The majority ate fresh fruit and potatoes and drank coffee daily. More than one third ate vegetables daily and also whole-fat cheese. Over one quarter drank whole milk while less than 10% ate fish or fish spreads, eggs, cakes and sweets. Men ate potatoes and drank whole milk more frequently than women who ate fruit and vegetables more frequently. 75% and 81% stated that they avoided or included several foodstuffs for the sake of their health. The foodstuffs which were most frequently avoided were fat meat while wholemeal bread or vegetables and fruit were the foodstuffs which the majority included. 17% of the men and 29% of the women consumed more than three foodstuffs which were good for the heart daily. In particular, married persons, persons from the higher social classes and non-smokers had dietary habits beneficial to the heart. More than 90% knew that it was of significance in the avoidance of cardiovascular disease to eat less butter and fat and more vegetables and fish. The results show that the population in the County of Vejle are aware of the significance of diet for the risk of cardiovascular disease. A great proportion of the population, therefore, attempt to alter their diets in a healthier direction. A number still exist who have unsuitable diets as regards prevention of cardiovascular disease. In the County of Vejle, continued efforts will be made in the campaign against cardiovascular disease.

Adult↗
PubMed1990

Secretory otitis media and phonology when starting school.

The relationship between previous middle ear disease, the presence of secretory otitis media, and phonology was investigated in 99% of a cohort of 387 unselected 7-year-old children from two Danish municipalities. All the pupils were tested with a phonological sentence repetition test called SITO, when starting school. The social and otological backgrounds were obtained from the parents. When using an analysis of variance, there was an association between phonology and tympanogram type in the better ear. No association with otological history or pure-tone screening was found. The correlation between tympanogram type and phonology was confirmed in a stepwise multiple regression analysis with nine possible confounding variables. In the statistical model, the tympanogram type could 'explain' 2-3% of the variation in phonology compared with the most important background variable, the social group of the mothers 'explaining' about 4-5% of the variation. About 15% of the variation could be 'explained' by the included variables.

Acoustic Impedance Tests↗
PubMed1988

Secretory otitis media and language development: a six-year follow-up study with case-control.

The 2nd Hjørring Cohort Study, a prospective cohort study, comprised 94% of the 463 three-year-old children residing in the municipality. Among this cohort we found 40 children (9%) who had constant signs of secretory otitis media (SOM), in one or both ears, at 4 examinations in the course of 6 months. Five years later, 12 of the children who had previously had long-lasting SOM had left the municipality. At the age of 8 years the entire cohort had a Silent Reading Word Test (OS-400). Six months later, the 26 children with long-lasting SOM who were still residing in the municipality and 26 control children were tested with the Revised Peabody Picture Vocabulary Test and the verbal part of the Wechsler Intelligence Scale for Children (WISC) test. The controls were matched by sex, age, school, grade level, and controlled for classroom and social stratum. The children with long-lasting SOM did not score lower than the control children on the 3 tests. In a separate analysis children with long-lasting bilateral SOM did not score lower than their controls. On the WISC and PPVT-R tests the variability in the case group was greater than in the control group. More comprehensive and varied studies seem needed to elucidate the relationship between language development and SOM.

Acoustic Impedance Tests↗