Metaphorically transmitted diseases. How do patients embody medical explanations?

Background: The examination was guided by recent theories on metaphors, holding that our conception of the physical world in many ways derives from personal bodily experiences. Such experiences are fundamental to the elaboration of abstract structures of meaning, which, through metaphorical projections, provide a constitutive role in our overall comprehension of the world. It is thus to be assumed that patients will bring their own cluster of metaphors into the consultation room to structure the doctor's explanations.

[Methaphors and understanding of diseases].

In the recent two decades it has been argued that our language and sense of reality is radically structured by metaphors. Metaphors are not just figurative expressions of existing similarities, but can create such similarities. Certain metaphors (root metaphors) may convey new world views and thus underpin new theoretical formations.

[Diagnosis and treatment of conjunctivitis].

Conjunctivitis is a frequent reason for consulting a doctor. Most often treatment consists of antibiotics, even though sensitive bacteria are only rarely demonstrated. In our part of the world conjunctivitis is self-limiting, and it may be worth considering the effect of treatment, if any.

[Diagnosis and treatment of conjuncitivitis].

Conjunctivitis is a frequent reason for consulting a doctor. Most often treatment consist of antibiotics, even though sensitive bacteria are only rarely demonstrated. In our part of the world conjunctivitis is self-limiting, and it may be worth considering the effect of treatment, if any.

The effect of reimbursement on the use of antibiotics.

Objective: To examine the effect of a reduction on the reimbursement of drugs on the use of antibiotics by general practitioners in Denmark.

Design: A prospective study using a questionnaire comparing the results with a similar study 3 years before, a period with normal reimbursement.

Participants: 553 general practitioners prescribed antibiotics for 5765 patients.

[General practitioners are carrying a heavy load of work, but they are satisfied with their choice of profession].

Seven hundred and seventy-six general practitioners (GPs) sampled randomly from the list of GPs in Denmark were asked about job satisfaction and professional attitudes by questionnaire. The majority (four-fifth) felt that they would decide to become GPs if they were to choose again. On the other hand, two-thirds complained about a workload which had negative effects on their family life.

Changes in prescription of antibiotics in general practice in relation to different strategies for drug information.

The worldwide use of antibiotics is increasing with increasing costs and resistant bacteria as a consequence. The Danish use of antibiotics is one of the lowest in DDD/1,000 inhabitants/year; however, the use of ampicillin and co-trimoxazole has been found to be too high. An information campaign in the beginning of 1987, using written material, stressed the importance of reducing the ampicillin and co-trimoxazole and increasing the penicillin usage in Denmark.

The role of thyroid tests in handling of patients in general practice. A phenomenologic study.

During a period of 2 months thyroid function tests, performed on out-patients referred to the laboratory from general practitioners, were studied. The relative informative value of the tests was estimated in relation to the reasons given for requesting the tests. In 86% of the samples from patients with no history of earlier thyroid disease the conventional thyroid tests were found within the reference intervals.

An information campaign--an important measure in controlling the use of antibiotics.

Denmark is one of the countries using the smallest quantity of antibiotics in proportion to its population. Nevertheless, the use of ampicillin and co-trimoxazole has been found to be undesirably high. An information campaign was carried out to reduce the ampicillin and co-trimoxazole usage and to increase the penicillin usage as a consequence.

Differences in referral rates from general practice.

There are many unexplained differences in the rates at which general practitioners make referrals to other medical specialists. This study investigated 17,586 referrals from 141 general practitioners to specialists in seven specialties in Ringkjøbing county in Denmark. As an expression of the referral rate, a referral index was estimated for every general practitioner.

Use of antibiotics in general practice in Denmark in 1987.

The worldwide usage of antibiotics is increasing making detailed information on prescribing patterns and intervention methods necessary. This investigation focused on the general practitioner's (GP's) usage of antibiotics in Denmark. Information on 7,607 patients treated by 602 GP's during 1 week in March 1987 were collected.

Variation in use of penicillin for treatment of sinusitis in general practice.

The present study describes the use of phenoxymethylpenicillin and broad-spectrum penicillin for the treatment of sinusitis in general practice, in relation to some variables related to the prescribing doctors: region (county), practice form (single-handed or partnership), and the doctors' seniority (year of graduation). Log-linear analysis was used to make it possible to evaluate the influence of single factors. There was considerable variation between the counties included in the study.

Changes in penicillin prescribing in general practice.

In the present study, we have analysed changes from 1979 to 1983 in the use of phenoxymethyl penicillin and broad spectrum penicillin in the treatment of sinusitis in general practice. The changes are related to the doctors' seniority and to their practice conditions. All GPs in five counties were invited to register all prescriptions of antimicrobials during two periods, from 19 to 23 March 1979 and from 21 to 25 March 1983.

Referral from general practice to dermatologists.

There are many unexplained differences in the rates at which general practitioners make referrals to other medical specialists. We investigated 5,082 referrals from 141 general practitioners to dermatologists in Ringkøbing county in Denmark. As an expression of the referral rate to dermatologists an index of referral to dermatologists was estimated for every general practitioner.

Use of antibiotics in general practice in Denmark. Prescribed daily dose, duration of treatment and number of treatments in general practice.

Prescribed daily dose (PDD) and duration of treatment is estimated for the most commonly used antibiotics in a multipractice study. In 1979 574 general practitioners and in 1983 625 general practitioners recorded 7 681 respectively 8 182 prescriptions of antibiotics over a five-day period. PDD and the number of treatments were compared with Defined Daily Dose (DDD) and DDD/1 000 inhabitants/day from the official statistics of drug consumption.