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[Smoking habits in France among general practitioners and the general male population over a twenty-five year period (1966-1991)].

Epidemiological surveys are presented regarding smoking habits among two populations: the general practitioners in France since 1966 to 1991 and the general population of adult men in the same period of time. We add some European and foreign surveys in the same groups of population. These data show a regular and rather slow reduction of percentage of smokers during the last 25 years. We can see, in general, the behaviour of the general practitioners are in advance comparing with the general population of ten to twenty years. If we compare the French data with the foreign one we can see that France is not in a very good situation regarding the decreasing tendency of smoking among the general practitioners and in the general population. This study justify the strengthening of the fight against smoking among adults and doctors. We remind that the very roots of the tabagism are in the youth: specific studies might take in account this core problem.

Adult↗

Exploratory study of general practitioners' orientations to general practice and responses to change.

BACKGROUND: Research into general practitioners' responses to the changes in the health service has focused on the quantifiable dimensions of workload, stress, job satisfaction and mental health. AIM: This study set out to investigate general practitioners' practice orientations and responses to change. METHOD: The study was undertaken in 1992. 'Young principals' who had attended MSD Foundation regional courses were invited by letter to reflect on recent change in general practice and to give their views on morale and recruitment. RESULTS: Forty nine young principals responded (response rate 45%). Responses were found to cluster around four orientations to practice: collectivism, pragmatism, traditionalism, and alienation. These varied in terms of four underlying values: autonomy, individualism, external referent and optimism. CONCLUSION: General practitioners' responses to change are more complex than is currently understood and are influenced by orientation to practice. In a relatively homogeneous 'enthusiastic' subgroup of general practitioners there is striking variation in practice orientation.

Adult↗

Attitudes to antipsychotic drugs and their side effects: a comparison between general practitioners and the general population.

BACKGROUND: Attitudes towards antipsychotic medication play an important part in the treatment for schizophrenia and related disorders. We aimed measuring general practitioners' attitudes to antipsychotic drugs and their adverse side effects and comparing these with the attitudes of the general population. METHODS: Analysis and comparison of two representative samples, one comprising 100 General Practitioners (GPs), the other 791 individuals randomly selected from the general population. The setting was the German speaking cantons of Switzerland. RESULTS: General practitioners have significantly more positive attitudes towards anti-psychotic drugs than the general public. They reject widespread prejudices about the use of anti-psychotic medication significantly more than the general population. In particular the risk of dependency was assessed as 'low' by GP's (80%), in contrast to only 18% of the general population sample. In no instance did a majority of the GPs advise not tolerating any of the 10 possible adverse effects presented in this study. This is in marked contrast to the general population sample, where a majority recommended discontinuation for movement disorder (63%), strong tremor (59%), risk of dependency (55%) and feelings of unrest (54%). CONCLUSION: As well as effective management of side-effects being a vital aspect of patient and carer education, prescribing doctors need to be aware that their mentally ill patients are likely to be confronted with extremely negative public attitudes towards antipsychotic medication and with strong pressures to stop taking their medication in the event of side-effects.

Adolescent↗

[The updated guideline 'Gastric complaints' of the Dutch College of General Practitioners; a reaction from a general practitioner].

Three working diagnoses in gastric complaints are presented: aspecific gastric complaints, ulcer complaints, reflux complaints; these assist the general practitioner in formulating the initial diagnostic and pharmacological interventions and in evaluating the effects of therapy. The guidelines state that eradication treatment of Helicobacter pylori is indicated only in gastritis caused by H. pylori, grade IV bulbitis, a duodenal bulb malformation or peptic ulcers.

Gastritis↗

[Summary of the guideline 'Hearing impairement' from the Dutch College of General Practitioners. The Dutch College of General Practitioners].

Hardness of hearing is a growing problem; toward the year 2000 there will be 1.5 to 2 million persons with hardness of hearing in the Netherlands. The Dutch College of General Practitioners has published a guideline 'Slechthorendheid' [hardness of hearing] with instructions for the diagnosis and treatment of patients with hardness of hearing in primary care. Many patients with hardness of hearing do not visit the GP (e.g. mentally handicapped). The whispered speech test or screening audiometry plays an important part in the diagnosis. In case a hearing loss > or = 30 dB is detected consultation of or referral to an ENT specialist is an option. In most cases a plug of earwax is the cause of the hardness of hearing.

Adolescent↗

Do age, gender and marital status influence job strain development for general practitioner?

BACKGROUND: General practice is one of the most stressful workplaces among health care workers and is characterized by higher rates of job strain than in reference population. We need to take into account that respondents are influenced by quite similar working conditions and health status differently. Thus this article aimed to review the subjective processes, which make general practitioners more vulnerable to the job strain. METHODS: Computerized database Medline was searched. Search included data for 1983-2003. In this review data form many comparative cross-sectional studies found in this database were included. A data collection form was developed, prepared and filled up on reading each article. RESULTS: Collected studies highlighted that age, gender and marital status influence job strain development for general practitioner but were very controversial on how and whom they influence. We found that outcomes of job strain have higher impact for females than for males. We also found data that males have also high rates of job strain working in general practice. The age impact on job strain between females and males increases in older age groups. The rate of job strain is the highest among middle-aged general practitioners and depends on marital status. Married females have the worst health and are most vulnerable to job strain. CONCLUSIONS: Magnitude of job strain varies depending on age, gender and marital status of general practitioner. The highest rates of job strain are mostly observed in married females, younger or older general practitioners. Sociodemographic factors contribute to this. The development of job strain, in some extent, can be explained within social context.

Adult↗