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Objectives To investigate the course of low back pain (LBP) in a general population over 5 years. Design Prospective population-based survey by postal questionnaires in 1991, 1992, and 1996. Setting The municipal of Ebeltoft, Denmark. Subjects Two thousand people aged 30 to 50 years, representative of the Danish population. Main outcome measure Number of days with low back pain during the past year. Results One thousand three hundred seventy were recruited of whom 813 (59%) were followed to 5 years. The responders could be divided into 3 groups with regard to LBP: no pain, short-term pain, and long-lasting/recurring pain. More than one third of people who experienced LBP in the previous year did so for >30 days. Forty percent of people with LBP >30 days at baseline remained in that group 1 and 5 years later, and 9% with LBP >30 days in year 0 were pain free in year 5. People with LBP in year 0 were 4 times more likely to have LBP in year 1, and 2 times more likely to be affected in year 5. Conclusions Low back pain should not be considered transient and therefore neglected, since the condition rarely seems to be self-limiting but merely presents with periodic attacks and temporary remissions. On the other hand, chronicity as defined solely by the duration of symptoms should not be considered chronic.

Udgivelsesdato: 2002-Jun OBJECTIVES: To investigate the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of a random population of patients. STUDY DESIGN: A population-based, randomized, controlled, 5-year follow-up trial conducted in a primary care setting. POPULATION: The study group consisted of 2000 patients, randomly selected middle-aged men and women aged 30 to 50 years from family practices in the district of Ebeltoft, Denmark. Of these patients, 1507 (75.4%) agreed to participate. Patients were randomized into (1) a control group who did not receive health screenings, (2) an intervention group that received 2 health screenings, (3) an intervention group that received both the 2 screenings and a 45-minute follow-up consultation annually with their general practitioner. OUTCOMES MEASURED: Cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and tobacco use. RESULTS: After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups compared with the control group. The improved outcome was greater in the baseline risk groups. The number of patients with elevated CRS in the intervention groups was approximately half the number of patients with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone. CONCLUSIONS: Health screenings reduced the CRS in the intervention groups. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half that expected, based on the prevalence/proportion in a population not receiving the health checks (the control group). The impact of intervention was higher among at-risk individuals. Consultations about health did not appear to improve the cardiovascular profile of the study population.

Udgivelsesdato: 2001-May BACKGROUND: Prophylactic strategies to counter acquired hearing impairment may involve routine audiometric screening of asymptomatic working-age adults attending general practice for regular health checks. AIM: To evaluate the effect of adult hearing screening on subsequent noise exposure and hearing. DESIGN OF STUDY: A randomised controlled population-based study of health checks and health discussions in general practice. SETTING: The project was initiated in the district of Ebeltoft, Aarhus county, Denmark. METHOD: Intervention group participants' hearing thresholds were determined audiometrically at 0.5, 1, 2, 3, and 4 kHz in each ear. Participants were advised to get their ears checked if the average hearing loss exceeded 20 dB hearing level (dBHL) in either ear. Noise avoidance was emphasised when thresholds exceeded 25 dBHL bilaterally at 4 kHz. Follow-up included questionnaires and audiometry. RESULTS: Hearing loss was observed among 18.9% of the study sample at baseline. At the five-year follow-up we recorded no significant differences between the control and the intervention groups regarding subjective or objective hearing, or exposure to occupational noise. However, there was a tendency towards reduction in exposure to leisure noise among intervention participants (P = 0.045). Approximately 20% reported hearing problems; 16.5% reported tinnitus-related complaints; 0.8% used hearing aids; 35.0% reported frequent noise exposure; and occluding wax was suspected in 2.1%. CONCLUSION: Preventive health checks with audiometry did not significantly affect hearing, but leisure noise exposure tended to become less frequent. The poor effect may be ascribed to inadequate audiological counselling or a higher priority to other advice, e.g. on cardiovascular risk or lifestyle.

Investigation of compulsory treatment and mechanical restraint in the Psychiatric Hospital in Arhus reveals that no great changes in the employment of compulsory measures in psychiatry during the period around introduction of the new Danish legislation on October 1 1989 have occurred. The total duration of mechanical restraint constituted 0.3% of the entire duration of psychiatric hospitalisation in acute admission wards after the introduction of the legislation. The mean duration of mechanical restraint was 4.3 hours (5 minutes-5.3 days) and was similar in men and women. In 55.5% of the cases of mechanical restraint, a waist-belt alone was employed while, in the remaining cases, wrist or ankle cuffs were employed in addition. A doctor was present in 48.9% of the cases when mechanical restraint was applied. No differences were observed between the sexes in the extent of mechanical restraint but female patients were seen by a doctor prior to restraint more frequently than male patients. A tendency to employ a waist-belt alone was observed as the first form of restraint in women whereas men were frequently restrained by means of wrist or ankle cuffs also. The most frequent reason for restraint was that the patients constituted a danger to themselves and others. Udgivelsesdato: 1992-Jun-22

This investigation shows that the rate of commitment to mental hospitals in Denmark increased from the year before the introduction of the new Danish psychiatric legislation when it was 24.4 (23.1-25.8) per 100,000 of the population till the year after when it was 28.4 (27.0-29.9) of the population. The increase in the commitment rate may, wholly or partially, be the result of the fact that the deprivation of liberty, which was previously more or less informal, was now registered. The results do not suggest that commitment of non-psychotic patients is employed more frequently than previously. The commitment rates for men and women were found to be identical after introduction of the new legislation. On the basis of data from the closed wards in the Psychiatric Hospital in Arhus, which receives approximately 11% of all committed patients in Denmark, it was found that the total number of admissions where patients were deprived of their liberty was nearly twice that of the number of involuntary admissions in the period immediately after introduction of the legislation. The average duration of involuntary detainment for committed patients was 20 days (1-101 days) and for patients admitted voluntarily but detained involuntarily 10 days (1-104 days). Involuntary detainment of patients admitted voluntarily occurred on an average two days (0-144 days) after admission. Following involuntary admission, significantly more women (51.5%) as compared with men (15.6%) were detained involuntarily whereas men had an excessive risk for deprivation of liberty for more than three days without formal involuntary detainment. Udgivelsesdato: 1992-Jun-22

Udgivelsesdato: 1990-Jul In 20 patients subjected to craniotomy for supratentorial cerebral tumours, the effect of scalp infiltration with bupivacaine before incision was evaluated by measuring mean arterial blood pressure (MABP) and cerebral arterio-venous oxygen content differences (AVDO2) repeatedly during the operation. All patients were given halothane 0.5% anaesthesia. Ten patients were given bupivacaine 0.25% and ten patients were given normal saline for scalp infiltration prior to incision. The study was performed in a double-blind randomized fashion. Significantly higher values of MABP (P less than 0.0005) after incision were found in the saline group compared to the bupivacaine group. Significantly lower values of AVDO2 (P less than 0.0005) after incision were seen in the saline group compared to the bupivacaine group. The results indicate that the increase in MABP associated with a decrease in AVDO2, suggesting an increase in CBF and cerebral hyperperfusion, is reduced by using bupivacaine scalp infiltration prior to incision.

This investigation consists of a cross-sectional study on 1 June 1989 of committed or compulsorily detained psychiatric patients in Denmark according to the legislation no. 118 of 13 April 1938. All of the departments which had received committed patients during the past five years participated. 87.2% replied. A total of 275 persons were found who were involuntarily admitted or compulsorily detained during their stay in hospital, or both. 59.9% of the patients were in closed departments and the remainder in open departments. The prevalence of committed or compulsorily detained patients was low compared with conditions in Norway and Sweden. Almost half of the patients were schizophrenic. The voluntarily admitted, but compulsorily detained patients comprised 28.8% of the reported patients. Notifications of compulsory detentions to the Ministry of Justice involved 34.4%. Half of the patients were admitted less than 2 1/2 months prior to the investigation but approximately 10% had been admitted for over ten years, which emphasizes the necessity of good physical and mental surroundings in psychiatric institutions. Udgivelsesdato: 1990-Oct-1