PubMed · 7605713
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L D Levy. 1995-06-24. April fool.. https://doi.org/10.1038/sj.bdj.4808794
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Recruiting general practitioners to Northern Norway is increasingly difficult. In 1997, 28% of all positions in primary health care in the counties of Nordland, Troms and Finnmark were vacant. Problems were worst in the small municipalities with a population of less than 4,000 with 37% of all positions vacant. The insufficient coverage of curative and acute health services is in part compensated for by a great number of short stay physicians. A cross-sectional study in the three northern countries in october 1998 showed that 68% of all general practitioners had Norwegian as their native language. In the small municipalities less than half the physicians were Norwegians.
Coronary heart disease exhibits a winter peak and summer trough in incidence and mortality, in countries both north and south of the equator. In England and Wales, the winter peak accounts for an additional 20,000 deaths per annum. It is likely that this reflects seasonal variations in risk factors. Seasonal variations have been demonstrated in a number of lifestyle risk factors such a physical activity and diet. However, a number of studies have also suggested a direct effect of environmental temperature on physiological and rheological factors. We review the available evidence on seasonal variations in coronary heart disease and possible explanations for them.
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