[Guidance on use of contraceptive methods. What contraceptive method should be used?].
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Contraception↗
Biomedical subjects
M Osler
Publications and source records attributed to M Osler.
Clinical experience with the GYNE-T 380 postpartum intrauterine device.
OBJECTIVE: The insertion of conventional intrauterine devices (IUDs) during the 1st 10 days after delivery is associated with a high rate of expulsions. DESIGN: The GYNE-T 380 (Ortho Pharmaceutical [Canada] Ltd., Toronto, Ontario, Canada) IUD was modified by the addition of a loose loop of knotted biodegradable no. 2 catgut to the top of the IUD (GYNE-T 380 postpartum IUD). After delivery, a special inserter was used to imbed the knotted portion of the loop into the myometrium of the uterine fundus. PATIENTS, PARTICIPANTS: This modified IUD was evaluated in a phase II trial involving 190 women at four clinical sites. MAIN OUTCOME MEASURES: There were no pregnancies during the 1st year of the study. The continuation rate was 74 per 100 women and a life table expulsion rate of 9.6 and 13.3 per 100 women was observed at 6 and 12 months, respectively. RESULTS: Complications associated with the insertion and the use of this IUD were minimal. Large scale trials evaluating this IUD are in progress.
Equipment Design↗
A dietary study of the elderly in the City of Roskilde 1988/1989 (II). A nutritional risk assessment.
In winter 1988/1989, a total of 435 randomly selected men and women aged 70-75 years and living in the city of Roskilde were invited to participate in a diet and health study. Nutritional status was assessed through a dietary interview, antropometric and biochemical measurements on 188 of the invited elderly. Assessed in relation to dietary recommendations, the average fat intake was found to be high (41% energy), whereas intakes of vitamin B6 and D were found to be below recommended levels in 22-26% of the subjects. The prevalences of obesity (12% had BMI over 30 kg/m2) and elevated levels of serum cholesterol (16% had serum levels over 7.5 mmol/l) were relatively high, the percentages being higher for females than for males. Many of the elderly had low levels of 25-hydroxy-vitamin D in plasma (30% under 30 nmol/l) indicating a marginal status. The prevalences of low blood levels of vitamin B6 (40% under 30 mmol/l) and betacarotene (26% under 0.3 mumol/l) were also high among the elderly. The prevalence of anaemia was 3%. It is concluded that osteoporosis-related parameters and risk factors for cardiovascular diseases are prevalent among the elderly in Denmark. The origin of these risk factors have to be studied in more detail, and consequences of any changes occurring must be monitored.
Aged↗
Life-style: physical activities and activities of daily living. Euronut SENECA investigators.
In 19 towns and cities across Europe, physical activity and activities of daily living were studied in 2586 elderly people born between 1913 and 1918. Data were obtained as part of a standardized questionnaire. Large variations in both levels of physical activity and activities of daily living existed among research towns and cities. Altogether, women spent more hours per day on physically active tasks than men, including more time on housework (2.6-3.9 h/day versus 0.7-2.3 h/day for men) and on leisuretime activities (2.0-4.2 h/day versus 0.9-2.3 h/day for men). According to 16 items of functioning, including both items of personal functioning and more complex tasks, functioning was rated as good in most of the elderly. In all centres good functioning was most prevalent in men, and in the younger elderly born in 1917 or 1918. In further cross-sectional analyses the relationship between physical activity, nutrition and other life-style factors, on the one hand, and anthropometry, health and performance, on the other hand, will be examined.
Activities of Daily Living↗
Dietary habits and attitudes. Euronut SENECA investigators.
This chapter describes data on dietary behaviour collected from 2586 elderly persons, born between 1913 and 1918 and living in 19 towns from 12 European countries, who participated in the Euronut SENECA Study on Nutrition of the Elderly in Europe. Groups of elderly subjects with particular dietary habits were identified. They included those persons having low or high meal frequencies, those not having regular cooked meals, those consuming home-produced foods, those having special interest or awareness in nutrition, those eating alone and those with food-budgeting problems. In future analyses, we shall endeavour to determine whether the dietary intake, nutritional status and health of these groups are related to their dietary habits.
Aged↗
[Food habits and knowledge among Frederiksberg schoolchildren].
In 1989, 674 school pupils in the sixth and eight grades in nine elementary schools replied to a questionnaire with questions about dietary habits and knowledge. More than 70% of the pupils preferred skim-milk products to full milk. Half of the pupils always used butter or margarine on bread. The main reason for using some form of fat on the bread was that, without this, the bread would become too dry. Approximately 75% of the pupils ate brown bread, fresh fruit and vegetables daily. These same pupils had "healthy" dietary habits in many respects. 75% of the pupils avoided one or more types of food because they considered that these were not good for them. The item most frequently avoided was fat meat. 83% of the pupils included some foodstuffs in the diet because they considered that these were good for them. The items most frequently involved were fruit and vegetables. The sex and age differences between the actual diet and the ideal diet were insignificant. More than half of the pupils could state correctly whether 11 different foodstuffs contained much fat, sugar or dietary fiber. No connection was found between the pupils' dietary knowledge and their actual or ideal diets. It is thus probable that dietary advice which emphasizes foodstuffs e.g. eat more dietary fiber, is difficult for them to understand and live up to. More definite dietary information e.g. eat more vegetables, would probably have been easier for the pupils to understand and live up to. School pupils of today are very much aware of the significance of diet for their health.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Smoking and alcohol drinking habits among school children in the Frederiksberg community].
In 1989, a total of 674 pupils in the sixth and eighth grades of nine elementary schools in the Municipality of Frederiksberg replied to a questionnaire which included questions about their habits and attitudes concerning smoking and alcohol. 50% of the girls in the eighth grade smoke, 30% of these daily. Compared with previous investigations, these results support the general impression that the frequency of smoking in girls is increasing. Compared with previous investigations, the frequencies of smoking in boys show a decreasing tendency: 24% of the boys in the eighth grade are smokers and 12% smoke daily. Great agreement was expressed with the negative assertion about smoking and 98% were aware that smoking was dangerous. The commonest reasons given for smoking were that it is a sociable habit, is relaxing and tastes good. Evidence was found that the advantages of smoking should be utilized in anti-smoking campaigns and the disadvantages should be emphasized and that campaigns should be directed to teenage girls. Girls in the eighth grade also drink alcohol more frequently than boys do. 62% of the pupils who had a monthly alcohol intake considered that alcohol was dangerous. A definite connection was found between the consumptions of tobacco and alcohol. No connection was found between active efforts to be healthy and not to smoke or drink. Girls living with a single father employed tobacco and alcohol more frequently.
Adolescent↗
[Diet and dietary supplements of the elderly in Denmark].
In 1988-1989, 202 men and women aged 70-75 years and living in the Municipality of Roskilde participated in a dietary interview investigation. The investigation revealed that the diets of elderly persons contained a great deal of fat as 41% of the energy came from fats. The protein intake was adequate while the intake of carbohydrates, including dietary fibers was low. As regards the intake of vitamins and minerals in the diet, the supplies of vitamin A and calcium were sufficient and the vitamins B1, B2 and C and iron were acceptable. On the other hand, the intake of vitamin B6 and vitamin D were low as compared with the recommended values. 10-15% of the elderly persons ate very little and were at a particular risk of developing deficiency conditions because the low energy intake was associated with an absolutely lower nutrient intake. Elderly persons who eat least constituted a composite group as regards social background, physical activity, relative weight and self-assessment of health. 62% of the elderly persons took one or more dietary supplements daily with vitamins and minerals (corresponding to one vitamin tablet daily). No differences were observed between the users' and non-users' average intake of nutrients via the diet. The persons who employed dietary supplements thus did not have any particularly low intake of nutrients so that they had special dietary requirements.
Aged↗
[The dietary awareness of Danish adults].
By means of an interview investigation of a representative sample comprizing 4,753 adult Danes over the age of 15 years, the attempted dietary principles of the population are illustrated. 60% of the population try to avoid certain foodstuffs from the point of view of health and 75% include certain foodstuffs in their diets for the same reason. The persons who particularly follow the dietary recommendations made in recent years, which consist of avoiding fat and including coarse bread, vegetables and fruit in the diet are women, aged 25-44 years, individuals with high net incomes and persons living in the suburbs of the capital and in the three largest Danish provincial towns. The efforts to achieve healthy dietary habits are, in addition, associated with non-smoking and moderate alcohol consumption. During the past five years, the proportion of Danes who try to alter dietary habits has increased by approximately 10%. During the same period, the actual average diet has, however, not altered in the same positive direction. The dietary principles aimed at and which are reported here are, therefore, expression of Danes' awareness of dietary principles rather than the actual behaviour. Thus, despite optimal knowledge, barriers exist which prevent alteration of dietary behaviour.
Adult↗
Contraception survey: Denmark 1988.
In 1988 a survey** was conducted in 1,033 women living in Denmark, whose ages ranged from 15 to 44 years. The main aims of the study were to identify the influence, if any, of demographic and socioeconomic factors on contraceptive use and to assess the women's knowledge of selected facts concerning their own fertility. The study's additional objectives were to gain insight into factors influencing communication on the subject of contraception, such as advice obtained from professional counsellors, general information dissemination and discussion between partners, and to investigate women's attitudes and opinions regarding contraceptive methods and their use. The results are discussed in relation to the findings of other studies on the use of contraceptives both worldwide and in a number of European countries. The Danish findings are also examined in the context of possible action to reduce the relatively high rate of legally induced abortions in Denmark.
Adolescent↗
A dietary study of the elderly in the City of Roskilde 1988/89. Methodological aspects of the relative validity of the dietary history method.
In winter 1988/89, 194 elderly adults (96 men and 98 women, aged 70-75 years) were interviewed, using the dietary history method. The relative validity of a dietary history method used in this elderly population was assessed. The record of intake of energy and nutrients from the dietary history method was compared with that obtained in the same group by means of a 3-day food record completed during the same period. For daily intake of energy and nutrients, the differences in mean intake were generally below 15%. But mean differences were significant for energy, fat, dietary fiber, and calcium. The two dietary methods correlated well for energy and nutrients. Pearson's correlation coefficient varied from 0.80 (dietary fiber) to 0.24 (vitamin A). The two methods classified about half of the subjects similarly into tertiles for energy and most nutrients. Gross misclassification occurred for 2-17% of the subject. Agreement between the two methods were poorest for vitamin A. The results suggest that the dietary history method may be inadequate for determining the exact level of mean and distribution of dietary intake in a group or the precise intake of an individual. But the method could be used to test differences in means between groups and to rank subjects as to their dietary intake within the study.
Aged↗
Family planning services delivery. Danish experience.
The purpose of this article is to give an overview of the Danish family planning services delivery based on a description of the country, the people, and their opinions. All laws and regulations about contraceptive services, including abortion and sterilization, are described in historical perspectives. It is concluded that the system has been developed on the basis of the health care system of the country to such a degree that it broadly covers the prevailing general attitudes of the population and that the expectations of the population to the system are reasonably met. What remains unsatisfactory is a relatively high proportion of induced abortions. Future possibilities for solving this problem could be: to improve the education of physicians, health nurses, midwives, teachers, and social workers with regard to family planning and sexuality; to revise teacher's guidelines on sex education and intensified sex education in the schools; to intensify information to risk groups such as teenagers and single women; and to accomplish general organisation of school class visits to family planning clinics.
Abortion, Legal↗
A dietary study of the elderly in the city of Roskilde 1988/89. Methodological aspects of the relative validity of the dietary history method.
In winter 1988/89, 194 elderly adults (96 men and 98 women, aged 70-75 years) were interviewed, using the dietary history method. The relative validity of a dietary history method used in this elderly population was assessed. The record of intake of energy and nutrients from the dietary history method was compared with that obtained in the same group by means of a 3-day food record completed during the same period. For daily intake of energy and nutrients, the differences in mean intake were generally below 15%. But mean differences were significant for energy, fat, dietary fiber, and calcium. The two dietary methods correlated well for energy and nutrients. Pearson's correlation coefficient varied from 0.80 (dietary fiber) to 0.24 (vitamin A). The two methods classified about half of the subjects similarly into tertiles for energy and most nutrients. Gross misclassification occurred for 2-17% of the subject. Agreement between the two methods were poorest for vitamin A. The results suggest that the dietary history method may be inadequate for determining the exact level of mean and distribution of dietary intake in a group or the precise intake of an individual. But the method could be used to test differences in means between groups and to rank subjects as to their dietary intake within the study.
Aged↗
[An increased number of induced abortions in Denmark?].
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Abortion, Induced↗
[Pregnancy in women with congenital heart disease].
During the past decades, the incidence of pregnant women with heart disease in Denmark has decreased from 0.9% to 0.3%. Heart disease in connection with pregnancy still remains the commonest non-obstetric cause of death. Previously, rheumatic valvular heart disease constituted the majority of all forms of heart disease in pregnant women. At present, congenital heart disease constitutes at least 80% of the maternal heart disease. Progress in heart surgery has had the result that increasingly more complicated forms of cardiac deformities can be corrected so that more survive to adult life. The range of cardiac deformities has therefore increased in recent accounts concerning pregnant women with heart disease. Ventricular septum defect, atrial septum defect and persistent ductus arteriosus still constitute approximately 50% of the forms of heart disease in pregnant women. In Denmark, the incidence of congenital heart disease is approximately 0.6% but between 2.5% and 4.2% of infants of women with congenital heart disease also have heart disease. In counselling about the risks in pregnancy, the NYHA scale provides a good guideline. Alle conditions with pulmonary hypertension are contraindications for pregnancy. The greatest risk for death occurs early in the puerperium. Guidelines for control and treatment of pregnant women with heart disease are presented. It is concluded, that pregnant women with heart disease should be assessed and be followed up in centres with the necessary cardiac, obstetric and anaesthesiologic expertise.
Denmark↗
[Children and dietary supplementation].
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Child↗
[Prescription of benzodiazepines by general practitioners--how can habits be changed?].
During the period 23.11.1987-6.12.1987, the medical offices of health in the County of Copenhagen and in Frederiksberg undertook an analysis of prescriptions with the object of illustrating the prescriptions of benzodiazepines by ten general practitioners. The investigation included a total of 260 prescriptions for benzodiazepines. On an average, 92 defined daily doses were prescribed per 1,000 women over 15 and 52 defined daily doses per 1,000 men over 15 years. An age-corrected review of the prescriptions revealed scatter in the prescriptions by the practitioners of approximately 300% (29-102 defined daily doses per 1,000 patients per day). All of the practitioners prescribed most for women in the age group 40-70 years. Compared with a corresponding investigation in Roskilde County in 1986, the general practitioners prescribed fewer defined daily doses at a time, after the possibility for repeated issue of prescriptions for benzodiazepines was annulled as from 1.1.1987.
Adult↗
Tricuspid atresia and pregnancy.
Four cases of pregnancies in two women with tricuspid atresia (TA) are described. A review of the literature on this subject revealed 24 reported cases of which only 11 were reported in detail. Eight pregnancies resulted in deliveries (including our 3 cases). TA is still uncommon in adult patients, but due to successful palliative surgery in childhood more patients now reach the age of fertility. Guidelines about the management of these patients are discussed.
Adult↗