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Biomedical subjects

E Schei

Publications and source records attributed to E Schei.

18 recordsLinked to original sources
PubMed1999

[Should we make a bid for SATS? Evaluation of a new educational project in family practice].

A new method for education of general practitioners and for quality assurance in primary health care has been employed in Norway since 1996. The practitioners collect data from their own practices using computerized medical records. Peer groups of four to ten general practitioners meet regularly to present their results, agree on local standards and plan improvements. They may choose among four medical topics. This article presents an external evaluation of participants' experiences conducted by focus group interviews of five groups. Satisfaction with the project was partly dependent on the topic addressed by the group. Groups of participants who felt that they improved their medical knowledge were most favourable to the project. Data collection from their own practices, presented and discussed in the group, was considered a very good basis for learning. Although the project's aim was not properly clarified, we regard this method as promising.

Clinical Competence↗
PubMed1999

[Home-brew and alcohol drinking of adolescents].

Studies have shown that adolescents in Nordland county consume more alcohol than the national average, and that home-made liquor is an important element in the local alcohol traditions. We conducted a school based survey of 435 high school students in the municipality of Alstahaug, Nordland county, with a response rate of 85%. We found that home-made liquor was frequently consumed by students of all ages. Boys started drinking at an earlier age than girls, and continued drinking higher amounts. Access to alcohol was easy for students of all ages. The students bought alcohol themselves, had others buy it for them, or they made their own liquor. Nearly all interviewees who drank much beer, wine or brandy, also had a high consumption of home-made liquor. The consumption of liquor among adolescents in the Alstahaug community seems to be unusually high and warrants preventive action.

Adult↗
PubMed1999

Adolescent smoking prevention--primary health care in cooperation with local schools. A controlled intervention study.

OBJECTIVE: To evaluate a secondary school smoking prevention program in a small rural Norwegian municipality. DESIGN: The project applied grade specific intervention strategies to all students grades 6-9 and comprised a total of 32 lessons over a period of 3 years, with high student activity. A non-randomised control group was constituted by all 6th-9th grade students in municipalities of similar characteristics in the same county. Results were recorded in annual class-based surveys. SUBJECTS: The intervention group totalled 187 and the control group 364 students. MAIN OUTCOME MEASURES: Prevalence of daily and occasional smoking and number of cigarettes smoked, during the intervention period. RESULTS: An 80% lower rate of daily smoking and 50% fewer cigarettes smoked by daily smokers. Lower rates of smoking in 9th grade occurred mostly among girls. CONCLUSION: The project resulted in a lower recruitment of daily smokers up to grade 9, as well as fewer cigarettes smoked by daily smokers. The intervention was more successful among girls than boys.

Adolescent↗
PubMed1998

[Practice is learned by practice].

Efficient continuing education for experienced physicians should build upon and reflect doctors' concrete everyday experiences and self-defined learning needs. Reciprocal practice visits among general practitioners, afford excellent opportunities for colleagues to see and be seen, to reflect, discuss, learn from each other and develop networks, using commonly experienced consultations as a starting point. Practice visits have been credited within the Norwegian continuing medical education system since 1989, but very few practitioners have made use of the method. We have developed a course where groups of 10-12 experienced general practitioners conduct four whole day practice visits over a 2-month period. Group sessions, totalling 20 hours, are used to develop cohesion and trust among colleagues through discussions and exercises. In the later stages, plenary sessions are used to present and discuss experiences from all of the practice visits, and participants are encouraged to develop ideas and strategies concerning their professional future. The participants in the three courses arranged so far (n = 31) were general practitioners with, on average, ten years of experience. Evaluations were positive, and emphasized the value of the course as an opportunity to break the relative isolation of general practice, and share experiences, insights, frustrations and ideas with colleagues.

Clinical Competence↗
PubMed1998

[How does professional competence develop?].

The reality of medical practice demands not only proficiency but also educational provisions, an aspect which traditionally has been given little attention in medicine. The competence of a general practitioner does not consist solely of professional knowledge and practical skills; it consists to a large extent of personal (intuition and creativity based on personal experience) and communicative elements, both of which are necessary in managing the unpredictable complexity and the many controversies of general practice. Such competence is difficult to develop outside the practice. By sharing the experience of actual consultations with experienced colleagues, and reflecting upon this experience within a small group, general practitioners will probably develop better professional judgement and increased awareness of their learning needs, as well as of their limitations and potential. This article discusses these topics using the authors' personal experiences in the continuous medical education effort which is based on reciprocal practice visits among a small group of experienced general practitioners.

Clinical Competence↗
PubMed1998

[Competence centers fo clinical skills for general practitioners].

For a number of years not enough attention has been paid to training in practical skills, neither in pre- nor postgraduate medical education. Lack of training and experience poses particular problems for the general practitioner, who often works alone with little opportunity for assessment by and feedback from colleagues. The Clinical Skills Training Centre was established to develop and implement methods for training general practitioners in clinical skills. Its main objective is to develop teaching methods that will encourage doctors to adapt their professional behaviour as and when necessary. The centre has developed a series of short, 2-day courses for small groups of 10-12 participants where focus is on selected clinical topics. The courses are continuously evaluated including assessment by the participants themselves of their procedural proficiency. Results are encouraging, with the majority of doctors reporting implementation of one or more of the relevant procedures at the final evaluation. An interesting new concept is a programme of reciprocal visits among groups of 10 to 12 general practitioners. The intention of the programme is to break the isolation of the consultation and utilize the potential for learning that exists when colleagues are able to observe each other at work and draw on each other's experiences.

Clinical Competence↗
PubMed1998

[Compulsory collegial guidance. What do candidates in general practice think about training of practical procedures?].

In 1994 a new module addressing the quality of practical procedures was added to the Norwegian general practice specialisation programme. Over a five-year period 31 practical procedures must be performed under the supervision of fellow GPs. In 1995 a survey was carried out by questionnaire among all specialist candidates registered in the new programme (n = 165, response rate 83%) and a control group consisting of all candidates registered in 1993 (n = 162, response rate 62%). The aims of the survey were to evaluate the candidates' motivation, self-rated level of competence, and the presence of barriers to programme implementation. The main group and control group were almost identical; mean age has 36.5 years, 37% were females. There were no differences in the self-rated levels of competence between the groups. The majority (80%) reported a need to improve their performance of practical procedures, and 93% stated that mutual guidance with colleagues would be of considerable benefit by improving technical performance, professional confidence and the quality of relationships with colleagues. The main barriers to mutual guidance were shortage of time, lack of structured opportunities for performing procedures in the presence of colleagues, and lack of instruction manuals or videos detailing the correct performance of procedures.

Adult↗
PubMed1994

The impact of military service on young men's smoking behavior.

In a cross-sectional study of 2,112 Norwegian army conscripts ages 18 to 25, the prevalence of daily smoking was 50.9%. Among the smokers, 55.7% had increased smoking during military service, and 7.8% of the nonsmokers had started to smoke. These changes in smoking behavior were correlated with having a best friend who smoked, with dissatisfaction with the military service, with physical inactivity, and with frequent alcohol consumption. Ninety percent lived in dormitories when cigarette smoking occurred regularly. Attitudes toward smoking restrictions were determined mainly by the subjects' smoking behavior and subjective discomfort caused by cigarette smoke. Smokers as well as nonsmokers having a best friend who smoked were significantly less bothered by cigarette smoke than others. The findings support the conclusion that military service has a negative influence on the smoking behavior of young Norwegian men. Intervention strategies are recommended.

Adolescent↗
PubMed1994

A strengthening experience? Mental distress during military service. A study of Norwegian army conscripts.

Conscription compels 70% of male Norwegians to invest 1 year of their lives in military training. For 19-to 20-year-old men, the military service is an important arena of secondary socialization. In a cross-sectional study of mental health in army conscripts using the 12-item General Health Questionnaire (GHQ), the case prevalence was 48% (cut-off 2/3). This was remarkably high, given that the study population had been screened for mental disease on several occasions, and a large number of recruits with symptoms of mental disease had been excluded before the survey began. Statistical analyses indicated that the high case prevalence was mainly due to situational factors. Four dimensions were identified: (1) social relations with officers, peers and family, (2) structural factors inherent in the system of obligatory military service, (3) the meaningfulness of daily tasks and (4) financial problems. GHQ caseness was statistically associated with physical inactivity and consumption of junk-food, tobacco, alcohol and cannabis. It is concluded that military service in its present form may have undesirable consequences both for civilian society and for military efficiency. Recruits need help to cope with the complex psychosocial and transactional challenges of military service.

Adaptation, Psychological↗
PubMed1992

Tobacco habits, lifestyle, and reactions to smoking restrictions among Norwegian military officers.

A 1989 cross-sectional study revealed that Norwegian army and air force officers smoked considerably less than civilian men. The prevalence of smokeless tobacco use, on the other hand, was higher than among civilians and similar to that of conscripted soldiers. Reactions to new smoking restrictions were largely neutral, but smokers were more negative than non-smokers. A majority of the officers reported low compliance with smoking regulations. Smokers generally belonged to the oldest cohorts and had less education, higher alcohol consumption, less physical activity, and more unhealthy dietary habits than the other subjects, whereas snuff use was more common among the youngest and more healthy officers. This indicates that the health hazards of prolonged snuff use are underestimated, and that this habit may gain increased popularity if nothing is done to prevent it. Intervention strategies are suggested.

Adult↗
PubMed1991

[Smoking of crushed tobacco tablets. An epidemic among young people in a distant municipality in Nordland].

Smoking of crushed pills mixed with tobacco, a form of drug abuse not previously reported in Norway, occurred during the winter of 1988/89 in a rural coastal municipality in northern Norway. All pupils aged 12 to 17 years (N = 356) were included in a study use of alcohol, drugs and tobacco. The overall response rate was 94%. The number who had smoked pills at least once was 16 (eight of each sex). Use of all three substances was significantly higher among pill smokers than among the rest of the sample. Use of illegal drugs was practically non-existent. Only two subjects had tried smoking cannabis. Pill smokers had less contact with parents and other adults, but reported close relationships with peers. The attitudes of parents towards alcohol and smoking, as perceived by the adolescents themselves, were more permissive among pill smokers (31% believed that their parents accepted occasional drunkenness, 69% believed that they accepted smoking) than among the rest of the sample (9% as regards drunkenness and 16% as regards smoking). Interviews with two pill smokers revealed that the phenomenon of combining crushed pills with tobacco was of local origin.

Adolescent↗
PubMed1991

[Smoking and use of snuff among young people in 2 municipalities in Nordland].

A survey of the entire youth population (grades 6 to 9) in two coastal municipalities of northern Norway (N = 356, response rate 94%) showed that the percentage of smokers increased from 6% (with no daily smokers) in 6th grade to 30% (25% daily smokers) in 9th grade, and was higher among girls in all grades. Smoking among young people does not seem to have declined in this country since 1985. 4% of the boys and 2% of the girls used smokeless tobacco regularly, whereas common percentages in nation-wide studies are 10% among boys and 0 to 1% among girls. Smoking and use of smokeless tobacco were strongly correlated with use of intoxicants. The strongest social predictor of smoking was the attitude of parents towards smoking, as perceived by the adolescents themselves, followed by degree of closeness to parents.

Adolescent↗
PubMed1991

[Use of alcohol and snuff among young people in 2 municipalities in Nordland].

Among 356 pupils in grades 6 to 9 (response rate 94%), the percentage who had tried drinking alcohol increased from 40% in grade 6 to 82% in grade 9. Alcohol consumption and inhalation of solvents were strongly interrelated, and both covaried with smoking and having sometime tried smokeless tobacco. 35% believed that a young person who did not drink alcohol would feel that he/she would be regarded by others as somewhat childish, cowardly or stupid. In fact, only 10% reported that they would look upon an abstainer in this way. This finding indicates that many young people exaggerate the risk of losing status among their peers because they abstain from drinking. Parental tolerance towards drunkenness and lack of a trustful relationship with parents were strong predictors both of alcohol use and intoxication from inhalants.

Adolescent↗
PubMed1991

[On the so-called lack of physicians in Norway].

Norwegian authorities plan to increase the number of medical students. The article points out that the number of doctors is rising exponentially and will increase by 3,000, or 27%, by the turn of the century. It is argued that the demand for medical services cannot be viewed as expressing the need for such services. The estimation of this need must be based on medical and ethical considerations.

Health Services Needs and Demand↗
PubMed1990

Use of smokeless tobacco among conscripts: a cross-sectional study of Norwegian army conscripts.

In a cross-sectional study of 2,112 Norwegian army conscripts ages 18 to 25 years, 10% reported daily use of wet snuff, while 23% were occasional users. Nearly half of the snuff users had started or increased their consumption during the military service. Cigarette smoking, alcohol consumption, and having a best friend using snuff were positively correlated with starting to use snuff. Daily use was associated with high physical activity. Use of snuff did not vary significantly with length of education when adjusting for other variables. Nearly all subjects believed prolonged snuff use to be a hazard to health. Forty percent of the snuff users believed they would give up snuff after the military service. Giving up during the service was statistically associated with having a steady relationship with a girlfriend and with length of time served. The relatively high percentage of occasional users and the high rate of stopping and starting reflect the novelty of snuff use among Norwegian youth. The widespread intention to give up seems to indicate that a large proportion of snuff users have ambivalent attitudes toward their own behavior. Therefore, future intervention measures in the armed forces could have a substantial impact on young males' use of smokeless tobacco.

Adolescent↗