Rural Iceland Research Articles

The lay public's explicit and implicit definitions of drugs

Background The research project: Public Beliefs about Medicine was initiated in 2001, aiming at exploring people's views, hopes, and fears with respect to drugs/medicines, now and in the future. Objectives A part of the research project mapping public beliefs about medicines aimed at getting the public to discuss definitions of drugs/medicines to grasp their explicit and implicit definitions and understand their point of reference when using the term(s). Methods Eight focus groups were conducted in urban and rural Iceland, with 42 participants of both genders and varying age, a fifty-fifty mix of lay and educated groups. The interviews were transcribed verbatim and excerpts translated into English. Results The direct question about definition of drugs generally resulted in a consensus among the informants about drugs/medicines being used to combat diseases and/or symptoms. Some included only prescribed or physician-recommended drugs in their definitions, others also over-the-counter products. Inclusion/exclusion of vitamins, food supplements, herbal remedies, functional foods, and illicit drugs was discussed without consensus and defining drugs in chemical terms or as interfering with bodily functions also occurred. New nuances emerged spontaneously later in the discussions, like viewing drugs as profit-making products, preferably prudently marketed, wishing information about “new release” drugs for the informants' diseases, and being concerned about side effects, overuse, misuse, and abuse. Other implicit definitions included viewing drugs as a product-service package, or as a necessary evil and/or as products with increasing potency and associated future problems or considering drugs to exert unreliable minor influence. Conclusion Professionals should be aware of the variety of lay people's drug definitions when discussing drugs/medicines with them to avoid misunderstandings caused by definition discrepancies.

Out-of-hours service in rural areas: An observational study of accessibility, attitudes and quality standards among general practitioners in Iceland

Objectives - To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. Setting - All GPs (n=96) in rural Iceland. Main outcome measures - Answers to a postal survey. Results - The participation rate was 80%. The GPs estimated that in 97% of the cases they could be contacted within 5 minutes in an emergency. Under usual circumstances (weather conditions) and within a distance of 10 km, 70% of them could reach the patient within 30 minutes of receiving the call. In severe weather conditions, 50% of the GPs in smaller districts (650-6000 inhabitants) estimated that it could take up to 5 hours or more to reach the patient (which could happen once a year). In the least populated districts, 84% of the GPs had to be on call 14 days or more per month. Serious emergencies (involving special training such as cardiac resuscitation or tracheal intubation) were relatively rare, and GPs expressed the necessity for regular refresher courses in such fields. Conclusions - Modern telecommunication networks guarantee good access to out-of-hours service. The workload and on-call duties are great and do not comply with European Union (EU) recommendations regarding minimal rest time. If GPs in rural areas are to be expected to provide frontline health care, including in severe emergency situations, regular training courses are needed.

Prevalence of epilepsy in rural Iceland: a population-based study.

To determine the prevalence of epilepsy (recurrent unprovoked seizures) in the population of rural Iceland. Review of records of primary-care facilities for the population of rural Iceland supplemented by review of referrals to electroencephalographic facilities and neurologic specialists to identify all individuals with unprovoked seizures or receiving treatment for epilepsy in the calendar year 1993. Crude prevalence was 4.8 per 1,000 and was 4.8/1,000 after age adjustment to the 1970 United States population. Age-adjusted prevalence was higher in male (5.1) than in female subjects (4.4) and increased with advancing age. Sixty-two percent of prevalence cases were of unknown cause. Sixty-three percent of cases had major motor seizures without aura or generalized epileptiform pattern on EEG. Sixty-four percent of patients had had seizures in the year of observation. Seizure control was inversely correlated with number of medications. Ten percent of the prevalence group was taking no medication, although the frequency of seizures was high in this medication-free group. Prevalence of epilepsy in rural Iceland is consistent with that reported in recent studies in other developed countries. The data provide insights into the approaches of treatment and use of specialized diagnostic testing in the country. The prevalence is similar to that in other European countries but lower than that reported from rural areas in Latin America.

Transition into widowhood: a life-course perspective on the household position of Icelandic widows at the beginning of the twentieth century

Nous avons analysé la place des veuves âgées de 50 ans et plus dans les ménages ainsi que leurs occupations socio-professionnelles à partir du recensement islandais de 1901. Nous avons également utilisé les données longitudinales pour examiner la relation pouvant exister entre position dans le ménage (et migration) et temps ecoulé depuis le début du veuvage. Pour la plupart des Islandaises nées à la fin du XIXe siècle, perdre son mari signifiait moindres ressources. Cependant les moyens de subsistance comme la structure des ménages sont très différents selon que l'on considère zones urbaines ou zones rurales. Le pourcentage des veuves chefs de ménage était plus grand en ville qu'à la campagne: en général les veuves quittaient la campagne pour établir leur ménage en ville. La croissance urbaine donnait en effet aux femmes plus de possibilités de subvenir à leurs besoins. La taille moyenne et la composition des ménages de veuves urbaines ne varient pratiquement pas selon leur âge. Au contraire, la taille moyenne des ménages ruraux tenus par des veuves diminue rapidement à mesure qu'elles vieillissent – ce qui reflète leur appauvrissement. Nous montrons que la proportion de veuves vivant chez leurs enfants mariés est similaire à la ville et à la campagne. Cependant un pourcentage supérieur de veuves chefs de ménages urbains vivaient de ressources fournies par leurs enfants, établis séparément: l'environnement urbain favorisait la naissance ou le maintien de réseaux d'assistance de voisinage constitués par parents et amis.

Incidence of epilepsy in rural Iceland: a population-based study.

We wished to determine the incidence of epilepsy in the population of rural Iceland. Cases were identified through review of records of primary care facilities for the study population, supplemented by review of referrals to EEG facilities and neurologic specialists. The incidence of epilepsy (recurrent unprovoked seizures) was 47 in 100,000. Age-specific incidence was bimodal, highest in the youngest and oldest age groups. About one third of the patients had an identifiable etiology, and one third had partial seizures. Integration of imaging and neurophysiologic data did little to modify the distribution of etiology or seizure type. The present study confirms findings of other recent studies of incidence in Western Countries.