During the second half of 2009 the Norwegian people experienced the first pandemic influenza since the Hong-Kong disease in 1968. The pandemic was initially believed to be severe, but it soon became evident that the disease was milder than anticipated. In spite of this the health authorities increased the level of threat and recommended general vaccination and exempt of oseltamivir (Tamiflu) from prescription requirements. In the paper we critically evaluate the evidence-base and consequences of these recommendations.
Anne Eskild er overlege på Kvinneklinikken ved Akershus universitetssykehus og professor II ved Institutt for klinisk medisin, Universitetet i Oslo. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. ATLE KLOVNING Atle Klovning er fastlege ved Frogner helsesenter i Oslo og førsteamanuensis ved Institutt for helse og samfunn, Universitetet iOslo. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. ELISABETH SWENSEN Elisabeth Swensen er spesialist i allmennmedisin, fast skribent Klassekampen og redaksjonell medarbeider i Tidsskriftet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. KJELL Å. SALVESEN Kjell Å. Salvesen er klinikksjef for Kvinneklinikken ved St. Olavs hospital og professor II ved Institutt for klinisk og molekylaermedisin, Norges teknisk naturvitenskaplige universitet. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. De nye retningslinjene for glukosebelastningstesting av de fleste gravide bryter med sentrale forutsetninger for et screeningprogram.
Context: Rural medical practice in Norway has an honourable 400 year history, but this has diminished since the end of World War II. Despite official intention to support a decentralised population, rural and remote populations have continuously reduced in Norway over the last 10 years. A consequence of the accompanying reduction in rural and remote GP services has been a distinct reduction in opportunities for medical student and intern placements. In 1999 the University of Tromsø implemented some projects to stimulate rural medical practice, funded by the government. This culminated in the 2007 foundation of the Norwegian National Centre of Rural Medicine (NCRM) in Tromsø. Issue:A key challenge of the NCRM is to identify factors that influence young doctors to choose rural careers. This is reflected in the three concurrent aims or perspectives of the NCRM: (1) to bridge the gap between the academy and rural medical practice (the principal perspective); (2) to promote research, education and networking among rural health professionals (the operational perspective); and (3) to contribute to the recruitment, stability and quality of rural health care (the political perspective). Lessons learned:The NCRM has had a number of achievements that include a publication that provides a narrative perspective on rural practice, the role of the rural doctor, and how rural culture and context influence proper clinical decision-making. Another achievement is a professional development and research program that has been successful in fostering a number of major studies, and led to the formation of a supportive PhD research group. The NCRM has also facilitated networking between rural practitioners and academics, at conferences and via its rural doctor website, and promoted cooperative international activities. In these ways the NCRM has fostered the transformation of rural doctors' experience into theory to enhance medical knowledge,
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