ABSTRACT.Purpose: The aim of this study was to investigate the effect of near-work on development and progression of myopia among adults exposed to high educational demands. Methods: A three-year longitudinal refraction study was performed among 224 Norwegian engineering students (mean age 20.6 years, 117 females and 107 males) measuring their refraction at the beginning and the end of the period. The examinations included automated and clinical refraction in cycloplegia and a questionnaire regarding time spent on different kinds of near-work was filled in by the participants. A total of 192 students (100 females and 92 males) completed the study. Results: The mean refractive change of ª0.51∫0.49 D (nΩ192) during the three-year period was statistically significant (pΩ0.0001). A significant relationship between refractive change towards myopia and time spent on reading scientific literature (pՅ0.001) and on practical near-work (pՅ0.05), respectively, was found. Also, a significant relationship between refractive change towards myopia and time spent at lectures was revealed (pՅ0.001). No relationship was found between refractive change and time spent at working with video display terminals (VDT) or watching television, respectively. Conclusions:The results indicate that intensive near-work could initiate myopia or lead to its progression in young adults. The time spent on near-work seems to play a significant role in that process.

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A series of six patient management problems, with clinical case histories from the authors' own practices, was presented in a Norwegian medical journal (Utposten) during 1981 and the spring of 1982. The readers were asked to respond to a number of statements which related to each case history, using a 5-point rating scale. The answers were prepared from return forms mailed anonymously to the authors, leaving the doctors with copies of their own answers. The following issue of the journal then presented the distribution of all incoming answers by giving histograms and mean values of the ratings for each question. In addition, the case history author gave his own ratings, a review of the answers, and more details about the case. In this way the respondents were given a possibility of comparing their own diagnostic skills and management decisions with those of their colleagues. There was a total of 406 incoming answers from 243 different participants, among whom 210 were general practitioners or district physicians. Background characteristics of these doctors are discussed, as well as the results of an evaluation questionnaire. This experiment with problem solving by mail was well received by the readers, mainly as a supplement to their continuing medical education. The method in this study, which permits quantification of clinical decision, may be a useful tool for medical audit activities.

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Medisinsk nytt Mikrometastaser ved tykktarmskreft1438 Påvisning av epitelspesifikke mRNA i vaktpostlymfeknuter ved tykktarmskreft ser ut til å vaere en lovende strategi for å identifisere pasienter med mikrometastaser.