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Biomedical subjects

C Junker

Publications and source records attributed to C Junker.

11 recordsLinked to original sources
PubMed2001

Motivation for smoking cessation: what role do doctors play?

PRINCIPLES: Cigarette smoking causes an estimated 13% of all deaths in Switzerland. Though most smokers will eventually become ex-smokers of their own volition, physicians play an important role in accelerating the process of quitting among smoking patients. Even brief advice from physicians is effective in doing so. The purpose of this study was to investigate which smokers were asked about their smoking habits, and how often, whether they received advice to quit, and how this correlates with the patient's desire to quit. METHODS: Telephone interviews were carried out with a random sample of smokers and ex-smokers from the German-speaking Swiss population (n = 993). We collected information on personal characteristics, smoking habits, and recall of physicians' advice. Data was analysed descriptively and by logistic regression. RESULTS: 88% recalled being asked by a doctor about their smoking habits. In contrast, only 34% of smoking patients recalled being advised to stop. Women, older people and those in poor subjective health were asked more frequently. Heavier smokers and those in poor subjective health were advised more frequently. Current smokers more frequently express the desire to quit if they are heavier smokers and have been advised to quit by their physician, compared with those who have not received such advice. CONCLUSIONS: Similarly to the international findings, smoking patients in Switzerland receive brief advice with insufficient frequency. Action should therefore be taken to encourage health professionals not only to question all smoking patients but to advise and motivate them to quit smoking.

Adolescent↗
PubMed2001

[Does the structure of medical services affect the proportion of death in hospitals? An ecological analysis in the mobility regions of Switzerland?].

OBJECTIVES: With the discussion about measures to reduce over-capacities in the health services in mind, we examined the influence of medical supply structures and services on hospital utilisation directly before death. METHODS: Based on the specification of the place of dying from the death certificates, we determined the proportions of deaths in hospitals in an ecological study. We analysed deaths of persons above age 65 in each of the 106 mobility regions of Switzerland in the years 1979 to 1980. RESULTS: The proportion of deaths occurring in hospitals varied between 27% and 81%. Despite missing data regarding stationary and ambulatory care services, more than half of the variance could be explained by means of a multivariate regression analysis. Our results imply an inverse relation between the proportion of deaths in the hospital and the number of consultations provided by primary care physicians, as well as the number of nursing home beds. Further, we observe a direct relation to the number of hospital beds in a region. All indicators are calculated per inhabitant. CONCLUSIONS: In health care supply planning, such systematic associations should be taken into account. We recommend to analyse regularly interregional differences in supply and outcome of medical performances with the best available data.

Adolescent↗
PubMed1999

Occupational class and ischemic heart disease mortality in the United States and 11 European countries.

OBJECTIVES: Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences. METHODS: Data on mortality by occupational class among men aged 30 to 64 years were obtained from national longitudinal or cross-sectional studies for the 1980s. A common occupational class scheme was applied to most countries. Potential effects of the main data problems were evaluated quantitatively. RESULTS: A north-south contrast existed within Europe. In England and Wales, Ireland, and Nordic countries, manual classes had higher mortality rates than nonmanual classes. In France, Switzerland, and Mediterranean countries, manual classes had mortality rates as low as, or lower than, those among nonmanual classes. Compared with Northern Europe, mortality differences in the United States were smaller (among men aged 30-44 years) or about as large (among men aged 45-64 years). CONCLUSIONS: The results underline the highly variable nature of socioeconomic inequalities in ischemic heart disease mortality. These inequalities appear to be highly sensitive to social gradients in behavioral risk factors. These risk factor gradients are determined by cultural as well as socioeconomic developments.

Adult↗
PubMed1997

Language bias in randomised controlled trials published in English and German.

BACKGROUND: Some randomised controlled trials (RCTs) done in German-speaking Europe are published in international English-language journals and others in national German-language journals. We assessed whether authors are more likely to report trials with statistically significant results in English than in German. METHODS: We studied pairs of RCT reports, matched for first author and time of publication, with one report published in German and the other in English. Pairs were identified from reports round in a manual search of five leading German-language journals and from reports published by the same authors in English found on Medline. Quality of methods and reporting were assessed with two different scales by two investigators who were unaware of authors' identities, affiliations, and other characteristics of trial reports. Main study endpoints were selected by two investigators who were unaware of trial results. Our main outcome was the number of pairs of studies in which the levels of significance (shown by p values) were discordant. FINDINGS: 62 eligible pairs of reports were identified but 19 (31%) were excluded because they were duplicate publications. A further three pairs (5%) were excluded because no p values were given. The remaining 40 pairs were analysed. Design characteristics and quality features were similar for reports in both languages. Only 35% of German-language articles, compared with 62% of English-language articles, reported significant (p < 0.05) differences in the main endpoint between study and control groups (p = 0.002 by McNemar's test). Logistic regression showed that the only characteristic that predicted publication in an English-language journal was a significant result. The odds ratio for publication of trials with significant results in English was 3.75 (95% CI 1.25-11.3). INTERPRETATION: Authors were more likely to publish RCTs in an English-language journal if the results were statistically significant. English language bias may, therefore, be introduced in reviews and meta-analyses if they include only trials reported in English. The effort of the Cochrane Collaboration to identify as many controlled trials as possible, through the manual search of many medical journals published in different languages will help to reduce such bias.

Bias↗
PubMed1986

[Determinants in decisions for the utilization of an ambulatory medical service].

The purpose of this research is to know more about the factors determining the decision to see a doctor. Especially the influence of characteristics of the delivery system (e.g. differences between urban and rural regions) and characteristics of users (e.g. social class) are investigated. In this article the conceptual frame of the study is described. The model is based on assumptions of the action-decision-theory. It structures the process of decision and action into four phases: the first two, perception and interpretation, are summarized as "process of attention"; the subsequent ones, coping and evaluation, as "process of acting". The model describes the social system (the total of demographic, socio-structural and socio-economic variables) and the memory system (contained within the individual life history) as mediating factors influencing the decision to act.

Ambulatory Care↗
PubMed1986

[Expectations concerning physician consultation].

Immediately prior to their consultation of a physician 259 ambulatory patients were interviewed concerning their expectations of the interaction with the physician, the course and results of the consultation. From the responses received to open and closed questions several quasi-scales were developed. These scales showed correlations to variables such as nature of the medical problem, type of practice and socio-economic indicators.

Ambulatory Care↗
PubMed1980

[Experience with timolol in consulting patients (author's transl)].

Experience obtained in the treatment of 78 eyes of patients suffering from open-angle glaucoma with the beta-blocker Timolol 0.25% and 0.5%. Timolol was only given to patients whose intraocular pressure could no longer be adequately regulated by the medications previously employed. A synopsis is given of the medications used over many years. The intraocular pressures of the eyes that responded to Timolol remained below 23 mmHg even after prolonged use, so that a fistulizing operation was initially unnecessary.

Clonidine↗
PubMed1976

[Vision against the light as an aid to indication for cataract operation (author's transl)].

The examination of visual acuity against the light may help the decision, whether or not a senile cataract should be operated on. We examined 84 eyes with different lens opacities, the visual acuity was analysed in relation to the axial, cortical and capsular cataract. We found in all cases a marked reduction of the visual acuity against the light. This has been general ophthalmological experience especially in the capsular cataract. This additional examination, we propose, is easily performed, and was given helpful information for all kinds of cataracts, where the indication for surgery was not clearcut.

Cataract↗
PubMed1976

[First experience with highly hydrophilic therapeutic soft contact lenses (With special reference to herpetic corneal disease) (author's transl)].

74 therapeutic problem-cases of various corneal diseases were treated with the highly hydrophilic Weicon 72 (W 72) which proved to be a valuable therapeutic tool. Additional applications of hypertonic saline and of industrial preparations of steroids, antivirals and antibiotics were tolerated without observable side effects. Additional therapy is often inevitable to achieve an optimal therapeutic effect. Nearly all treated cases of chronic herpetic keratitis - mainly metaherpetic corneal diseases - responded well or excellently to W 72 therapy. If, however, the indication for soft lens therapy is somehow inadequate, if additional therapy is wrong or not applied at all and if the patient does not keep strictly to the therapeutic regime undesired side effects are likely to develop.

Anti-Bacterial Agents↗