Search PubMed⌕ Search

Biomedical subjects

P Fugelli

Publications and source records attributed to P Fugelli.

At least 19 recordsLinked to original sources
PubMed1992

[Registration in practice as a tool in the compilation of a community diagnosis in Askvoll municipality].

When trying out various models for community diagnosis we registered a sample of doctor-patient contacts in Askvoll municipality over one year. One fifth of all contacts, 2,743, were registered. The contact rate per year was 3.8 per inhabitant. 79% of the contacts were consultations, 10% home visits and 11% telephone consultations. The three most commonly registered diagnostic groups were musculoskeletal diseases, cardiovascular diseases and "preventive medicine". Together with a household survey and an analysis of public statistics on mortality, morbidity and disability in our municipality, the registration of doctor-patient contacts form the basis of a community diagnosis. This community diagnosis will help to steer health planning and preventive work in our district in the right direction.

Adolescent↗
PubMed1992

Smoking habits in early pregnancy and attitudes towards smoking cessation among pregnant women and their partners.

One-hundred and eighty-seven general practitioners in western Norway recorded smoking habits among 2379 women, consulting for their first regular medical check-up in pregnancy. Forty-six per cent had been daily smokers the last 3 months before pregnancy. Thirty-nine per cent were still smoking at the time of their first check-up. Sixteen per cent of the daily smokers stopped smoking spontaneously during the first few weeks of pregnancy. Fifty-seven per cent of women younger than 20 and 28% of women 30 years and older, did smoke at the first check-up. Single women smoked more often than women living with a partner (58% versus 38%). Smoking habits were not associated with number of previous pregnancies. At the first check-up, 530 pregnant women, still smoking daily, 18-34 years of age, living with a partner, accepted to participate in a smoking intervention study. They filled in a questionnaire about their smoking habits, the smoking habits of their partners and their attitudes towards smoking cessation. Sixty-five per cent reported a reduction in their use of cigarettes after becoming pregnant. The mean reduction in the number of cigarettes smoked daily was 4.0 (31%). Most of the respondents expressed a strong motivation to quit or reduce their smoking habits during their pregnancy. Seventy-two per cent of the partners were daily smokers. Reduction in the consumption of cigarettes, negative attitudes towards smoking and determination to stop smoking was significantly higher among women who were encouraged by their partners to stop smoking and in those who perceived that their partners were willing to reduce their consumption.

Adolescent↗
PubMed1992

Recruitment and participation of general practitioners in a multipractice study of smoking cessation.

In May 1986, all 398 general practitioners (GPs) in western Norway were invited by letter to take part in a multipractice intervention study of smoking cessation among pregnant women. The aims of the intervention study were: 1) to find out how a smoking cessation model can be implemented in ordinary consultations in general practice, and 2) to compare smoking cessation in pregnant and non-pregnant women. The intervention study lasted for three years. 187 (47%) GPs completed the study. Working in a group practice, working on regular salary, having started specialization in general practice, being less than 40 years of age, and being a non-smoker were significantly more common among the participating GPs. They also had significantly fewer consultations per week than their non-participating colleagues. A stepwise multiple logistic regression analysis revealed that smoking habits predicted participation in the study far more than any other predictor.

Adult↗
PubMed1991

[Medical politics. Graffiti].

If doctors want to play a role in future health promotion, they have to leave their citadel, and come closer to life and society. Modern preventive medicine cannot be dissociated from basic political, cultural and religious values and processes. Genetic counseling and engineering, influencing lifestyle, community intervention and changing the health culture among patients and doctors all require ethical and political competence rather than traditional medical skills. The author advocates the development of a new discipline, medical politics, with two major commitments: -To define basic health rights -To study the public health consequences of political systems and decisions. In a polemic and provocative style the article enlightens the potentials and dangers associated with an expanded concept of preventive medicine.

Environmental Health↗
PubMed1991

[Perestroika--in medicine too].

The article criticizes the one-dimensionality of natural science and the one-way concept of causality in medicine. The crisis in medical practice and health economy is considered in the light of an outdated and rigid health ideology with parallels in the "scientific" dogmas that have now been discarded in Eastern Europe. In this article we try to point a way out of this unfortunate situation: how would a change of paradigm affect clinical practice, health ideology and our concept of social policy?

Economics, Medical↗
PubMed1991

[Bad custom].

Explore the source record for details and available documents.

Drug Industry↗
PubMed1991

Clinical assessment of haemoglobin values by general practitioners related to analytical and biological variation.

Twelve case stories were mailed to 273 general practitioners to study the clinical assessment of haemoglobin values. For each case the general practitioner was asked to fill in the haemoglobin value representing the minimal change from a given value considered necessary to take action. haemoglobin change corresponding to the median haemoglobin value stated was transformed to a so-called 'medically useful coefficient of variation' in order to relate clinical demands to analytical and biological variation. The average medically useful coefficient was calculated to 3.9% (range 2.3-7.8%). We found that general practitioners assess haemoglobin values rather uniformly, although their judgement varies substantially with the clinical situation; they are not fully aware of the consequences of analytical and biological variation, and the advantage of knowing a previous haemoglobin value is not recognized. The analytical imprecision of haemometers based on clinical demands should be 2.8%, and the analytical quality should be the same in primary and secondary care.

Adult↗
PubMed1990

[Written information from hospital to primary physician about discharged patients].

Discharge communications from hospitals to general practitioners in respect of 203 patients have been analyzed in two municipalities in Western Norway. The average interval between discharge from hospital and the first visit to the GP was 25 days (1-198 days). The mean period before arrival of the final report was 28 days (0-175 days). In 38% of the cases the GPs had received no written communication from the hospital upon first contact after discharge. 42% of the preliminary reports and 18% of the final reports were judged to be inadequate. At the first attendance, the GPs were uncertain about the drug regimen in 25% of the cases and about other forms of treatment in 32%. They felt uncertainty about follow-up procedures in the case of 44%. As evaluated by the GPs, in 22% of the cases the absence or inadequacy of the discharge letters might have had a negative influence on the patient's health. A survey of the literature provides a basis for the following recommendations: On leaving the hospital the patient should be given an interim discharge summary containing any information essential for immediate follow-up, to be delivered to the general practitioner by hand. The final discharge letter should focus upon topics of particular interest for the general practitioner: results from clinical examinations and laboratory investigations should be restricted to data necessary for making clinical decisions; treatment given in hospital, including adverse reactions, and drug regimen at discharge; any information on the nature and prognosis of the disease given to the patient and/or relatives during the stay in hospital; evaluation of prognosis and advice on sociomedical rehabilitation in everyday life and at work; a plan for future management of the patient with emphasis on well-defined sharing of tasks and responsibilities between the hospital, the outpatient department and the GP.

Medical Record Linkage↗
PubMed1990

[Use of public health statistics in the development of community diagnosis].

A community diagnosis which describes the health of the local population may be an important instrument in promoting health and preventing disease. Most general practitioners do not have time to carry out individual surveys in the local community. Therefore it seems relevant to look into the possibility of utilizing official health statistics as a basis for community diagnosis. We obtained and analysed demographic data, mortality data, statistics on cancer, data on causes of invalidity and risk factors for cardiovascular diseases for Askvoll municipality. This article demonstrates possibilities, obstacles and constraints in the use of such statistics. Suppliers of register data should make routine health statistics more available for use in the district health services. In this connection we recommend the development of a central health data information system.

Community Health Services↗
PubMed1989

Effect of fish oil on blood pressure and blood lipids in men with mild to moderate hypertension.

Forty men with mild to moderate hypertension were given one of two dietary supplements for 6 weeks: 20 capsules of fish oil (MaxEPA) or placebo (olive and corn oil). The MaxEPA supplement provided about 7 g omega-3-fatty acids pr day, whereas the placebo contained about 7 g omega-6-fatty acids and only 0.2 g omega-3-fatty acids. A clinical insignificant reduction in blood pressure was noted in both groups. In the fish oil group, the serum triglyceride levels fell by 30%. A decrease in the ratio total cholesterol/high density lipoprotein (HDL-) cholesterol was noted in both groups, most pronounced in the placebo group. No significant effect on total serum cholesterol level was observed during this study.

Adult↗
PubMed1989

Can regional differences in consumption of tranquillizers and hypnotics be explained by variations in general practitioners' threshold of prescribing? A methodological study.

Large differences exist in the consumption of tranquillizers and hypnotics within and between countries. The present study investigates the hypothesis that regional differences in the utilization of tranquillizers and hypnotics are associated with corresponding differences in thresholds of prescribing. A questionnaire that described in a standardized manner 12 patients with a symptomatology of anxiety and insomnia was sent to all general practitioners in two regions (south/north) in Norway. In the south, tranquillizers and hypnotics are used much more frequently than in the north. Based on written simulations of patients, no differences in thresholds of prescribing was found between the general practitioners in the two regions. Neither could the doctors' choice of drugs, nor their recommendations for dosage and duration of treatment, explain the different consumption of tranquillizers and hypnotics in the two regions. The method could, however, be criticized for insufficient validity, since our case stories were less controversial with respect to psychotropic drug prescribing than intended.

Drug Prescriptions↗
PubMed1989

The duration of acute respiratory tract infections in children.

In a rural district in Western Norway with 400 children under 16 years, we recorded all children with acute respiratory infections who attended their general practitioner during a period of four months. 90 cases were recorded, giving an incidence of 5.6% per month. Half of the patients contacted the doctor within four days from the initial symptom, every sixth waited more than two weeks. Their symptoms were monitored by the parents. Low fever, nasal discharge and cough were the most long-standing symptoms. After three weeks less than 50% of the patients were completely recovered. The children under one year of age recovered more quickly than the rest. No serious complications or sequelae were recorded.

Acute Disease↗