[Registration of activities performed by general practitioners]. / Registrering av aktivitet under legevakt.

BACKGROUND: We studied what kind of action general practitioners in a Norwegian rural community choose to take in order to solve problems raised by patients who contact the primary health service off-hours. Problems are solved either on the phone or by allowing the patient to consult the doctor in the surgery, by a home call, or by an emergency call with ambulance. MATERIAL AND METHODS: The community has a population of 4,556. All five GPs in the community registered all off-hour patient contacts over a period of six weeks (off-hours defined as the period from 3.30 PM to 8.00 AM on week-days, plus the weekend). RESULTS: 450 patients contacts were registered. 33% were solved on the phone, 48% through consultations in the surgery, 18% by home calls. Only two out of 450 contacts were emergencies. DISCUSSION: GPs performing off-hour services serve their patients with ordinary consultations. Less than 1% of patient contacts were actual emergencies.

Effects of a school-based smoking prevention program among subgroups of adolescents.

In autumn 1995 The Norwegian Cancer Society in cooperation with The Research Center for Health Promotion, University of Bergen started a study of school-based interventions aiming at preventing smoking among pupils in Norwegian secondary schools. The study comprised a nationwide sample of 4441 students at 99 schools (195 classes). This panel of students is followed through annual data collections till they graduate in spring 1997. Written consensus from students and parents was obtained from 95%. Schools were systematically allocated to one of four groups: Group A, control; Group B, intervention, containing classroom program, involvement of parents and teacher courses; Group C, like B, but without teacher courses; Group D, like B, but without parental involvement. Baseline data were collected by questionnaires administered in class in November 1994 and the first follow-up survey was carried out in May 1995. At follow-up the proportion of smokers had increased by 8.3 percentage points in Group A (control) and by 1.9 percentage points in Group B (most extensive intervention). As expected, the recruitment of smokers was higher in Groups C and D than in the ideal intervention, but lower than in the control group. Effects of the most extensive program among subgroups of students were examined by comparing Groups A and B. Students are categorized as high risk or low risk based on scores on scales measuring sensation seeking, physical maturity, antisocial behavior and parental smoking. The effect of the program on recruitment of smokers seems to have been at least as strong or even stronger among 'high-risk' students than among other students.

[Expectations from a system of personal general practitioners. A questionnaire study among general practitioners in the municipality of Bergen]. / Forventninger til fastlegeordningen. Spørreskjemaundersøkelse blant allmennpraktiserende leger i Bergen kommune.

Four municipalities in Norway have tested out a system of personal general practitioners, where all inhabitants aged 12 or more could choose their personal doctor. The doctor's responsibility, work-load and economy were determined by his/her specified list of patients. Doctors employed in primary health care showed a significant interest in the subject, and the ongoing personal doctor trial. To prepare for possible reorganization to this new system in the municipality of Bergen, a survey was carried out in January 1995 among all 145 general practitioners in Bergen, of whom 70% responded. Data from the survey indicated that a larger share of women than men had low expectations concerning a system of personal general practitioners. Only 19 out of 101 general practitioners were positive to introducing such a system.

[Distance diagnosis of skin diseases]. / Fjerndiagnostisering av hudsykdommer.

During a period of eight weeks in late 1989, doctors in general practice in Kirkenes brought 27 dermatological patients to a studio at the local hospital. Video images were transmitted via a two-way telephone and video network, which enabled the patient and the doctor in Kirkenes to consult a specialist in dermatology in Tromsø. All the patients received written information before the consultation. Anamnestic information and clinical manifestations were presented from the studio at Kirkenes sykehus. The dermatologist diagnosed the disease and prescribed treatment from the studio at the hospital in Tromsø. The technical equipment satisfied our demands for remote diagnostics in dermatology. All the patients were positive to remote consultations.

Expression of oncogenes in thyroid tumours: coexpression of c-erbB2/neu and c-erbB.

The receptor-type oncogenes c-erbB2/neu and c-erbB have been found amplified and/or overexpressed in a number of tumours of epithelial origin. We have studied the expression of oncogenes in biopsies from human thyroid tumours. The c-erbB2/neu and c-erbB oncogenes showed two- to three-fold higher levels of RNA in papillary carcinomas and lymph node metastases as well as in one adenoma when compared to non-tumour tissue. The nuclear oncogenes c-myc and c-fos were found to be expressed at varying levels in both non-tumour and tumour tissue. RNA transcripts specific for the platelet-derived growth factor A and B chains and the N-ras oncogene were detected in one anaplastic carcinoma. Neither rearrangements nor amplifications of oncogenes were observed in the thyroid tumours. These data are particularly interesting in light of the recent findings that epidermal growth factor induces proliferation and dedifferentiation of normal thyroid epithelial cells in vitro. We suggest that the epidermal growth factor or other ligands for the c-erbB and c-erbB2/neu receptors may contribute to the development and/or maintenance of the malignant phenotype of papillary carcinomas of the thyroid.