Action research--a strategy for evaluation of medical interventions.

Medical intervention commonly addresses issues which can rarely be controlled and measured experimentally. The zeal for standardization of the intervention may lead to premature closure of a development process, in which the intervention method and its implementation are omitted from systematic evaluation. However, evaluation strategies other than the experimental ones do exist and can overcome these limitations.

Shifting attention from objective risk factors to patients' self-assessed health resources: a clinical model for general practice.

The study was designed to present and apply theoretical and empirical knowledge for the construction of a clinical model intended to shift the attention of the general practitioner from objective risk factors to self-assessed health resources in male and female patients. Review, discussion and analysis of selected theoretical models about personal health resources involving assessing existing theories according to their emphasis concerning self-assessed vs. doctor-assessed health resources, specific health resources vs.

Antioxidant activity of fruit exudate and C-methylated dihydrochalcones from Myrica gale.

Antioxidant and radical scavenging effects were studied of a diethyl ether extract of the fruit exudate of Myrica gale L., and of C-methylated dihydrochalcones isolated from it. Isolated hepatocytes and liver mitochondria from the rat were incubated with tertbutyl hydroperoxide, and lipid peroxidation measured by the yield of thiobarbituric acid reactive substances.

Simulated patients for the practical examination of medical students: intentions, procedures and experiences.

This paper presents intentions, procedures and experiences related to a simple method for training simulated patients for undergraduate examinations set up as clinical consultations. The examinations took place in the final year of medical school, at the Division for General Practice, University of Bergen, Norway. Thirty-six medical students were assessed by the use of five primary-school teachers serving as simulated patients and 18 authentic patients.

[Better consultations with patients' help--a method for quality assurance in general practice].

The authors have developed an instrument which is intended to improve consultations in general practice through feedback from patients. The instrument consists of a set of questionnaires with identical questions to patient and physician regarding a recently accomplished consultation. The physician is also asked to fill in a summary evaluation form.

[Gender, work load and list profile in general practice. Experiences from a patient listing project].

A list patient project was carried out in four Norwegian municipalities in 1993. Female general practitioners from one of the involved communities soon showed frustration about the their experience that the new system had increased their work load. Although the new system was intended primarily to serve the needs of the population, the problems experienced by the female doctors were taken as warnings about future problems for the servants of the system.

[A simple survey of post-traumatic stress disorders among Bosnian war refugees in Norway].

150 Bosnian war refugees (100 men and 50 women) were followed for 12 months by means of a brief screening procedure to determine prevalence and course of symptoms of post-traumatic stress disorder. 88 men and 18 women had spent some time in Serbian concentration camps before arriving in Norway. A short check list for interview and a simple self-assessment questionnaire based on stressor and symptom criteria for post-traumatic stress disorders according to DSM-III-R were used three times.

The legitimacy of clinical knowledge: towards a medical epistemology embracing the art of medicine.

The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice.

[Clinical examination in general practice--a consulatation. Experiences after the first examination].

In 1994 the first examination in general practice was arranged for graduate students at the medical school in Bergen. The examination consisted of a written part, and an oral, clinical examination. We report some experiences and reflections concerning the latter.

[Mass screening against cervical cancer--what are the viewpoints of female general practitioners?].

Female general practitioners play a central role in the national programme for organized cervical mass screening. The article presents results from a study among Norwegian female general practitioners (n = 720) on their view of the benefit of the screening programme and about the recommendations they give their patients regarding routine Pap-smear. The response rate was 95%.

Patients' stories: science, clinical facts or fairy tales?

Objective: To explore potentials and attributes of the qualitative research interview as a tool for acquiring knowledge about illness.

Design: A qualitative approach, comparing knowledge about consultations originating from 1) data from interviews with immigrant female patients, and 2) evaluative data from registration forms from the doctors.

Setting And Subjects: 24 Pakistani female patients, recruited from the appointment list at a primary health care centre in central Oslo were interviewed in their homes.

Effect of cholesterol feeding on the susceptibility of lipoproteins to oxidative modification.

In previous studies we have shown that the liver endothelial and Kupffer cells in hypercholesterolemic rabbits are very active in endocytosis of low-density lipoprotein (LDL) and beta-very-low-density lipoprotein (beta-VLDL) (Nenseter et al. (1992) J. Lipid Res.

Key questions--a strategy for modifying clinical communication. Transforming tacit skills into a clinical method.

Background: A clinical communicative method designed to promote the doctor's understanding of women's "undefined" disorders is presented and discussed. The method is composed of key questions, which are problem-oriented speech acts, inviting the patient to share with the doctor her conception of illness. The questions are directed towards specific clinical problems, and are not meant as global devices for better doctor-patient communication in general.

[Cervical cytological tests among female general practitioners. A study of health habits of physicians].

The authors present results from a study which focused on physicians' own routines for health controls, using pap-smear screening as example. The study was designed as a survey where a questionnaire was mailed to all Norwegian female general practitioners (720). The response rate was 95%.

Iron supplementation in pregnancy. General practitioners' compliance with official recommendations.

Unlabelled: OBJECTIVE--To compare general practitioners' routines regarding iron supplementation in pregnancy with national recommendations.

Design: Mailed questionnaire to general practitioners.

Setting: A county in western Norway.

[Clinical knowledge--facts or something more? Some theoretical views].

Origins, contents and validation procedures of medical knowledge are rarely discussed in medicine. Clinical knowledge is the core of medicine. Analysis of the procedures and strategies for seeking clinical knowledge, and the content of this knowledge, may enlighten the development of medical theory as well as constitute a basis for quality assurance of medical practice.

Antioxidant and radical scavenging effects of anthraquinones and anthrones.

The activity of seven anthraquinones and four anthrones against nonenzymatic and enzymatic lipid peroxidation in vitro and their ability to scavenge free radicals have been studied. In nonenzymatic peroxidation in rat hepatocytes induced by t-butyl hydroperoxide, dithranol and anthrone were the strongest antioxidants, having IC50 values of 8 +/- 1 and 24 +/- 5 mumol/l, respectively. Rhein (IC50 64 +/- 2 mumol/l) and aloe-emodin (IC50 65 +/- 3 mumol/l) showed the highest inhibitory activity against peroxidation of linoleic acid catalyzed by soybean 15-lipoxygenase.

A note on the complex metabolism of danthron infused into the rat.

Danthron infused intravenously in rats shows a complex dose-dependent pattern of metabolism and excretion. The metabolites, particularly the more polar ones, are in general excreted predominantly in bile, to a lesser extent in urine. They can be separated as metabolite groups according to polarity and molecular size on a Sephadex LH 20 column.

Strategies for empowering women's voices in the medical culture.

Power and knowledge are closely connected, and this is no less true for the medical profession than it is for any other sphere of life. Knowledge is constructed by voice. Unfortunately, women's voices are often silent in the factory where medical knowledge is produced.

Shared understanding of the qualitative research process. Guidelines for the medical researcher.

The qualitative research process is presented and discussed as a model, emphasizing matters frequently experienced as unfamiliar by the medical researcher. This model represents a prescriptive methodology, implying underlying values on construction of scientific knowledge where shared understanding--intersubjectivity--is considered as essential. Various stages of the research process are demonstrated, drawing attention to matters that influence analysis and the paths to knowledge, especially preconceptions and theoretical frames of reference.