05.09.2022: Mobile stroke units save time from symptom onset to treatment in cases of acute ischaemic stroke, have a sustainable cost-benefit profile and are now recommended in European guidelines. We should investigate the use of mobile stroke units in the pre-hospital healthcare service in Norway as well. The idea to introduce mobile stroke units first came in the early 2000s as a measure to give thrombolytic treatment as soon as possible to patients who had suffered an ischaemic stroke, since the effect is highly time-dependent (1, 2). The first mobile stroke unit rolled out onto German roads in 2008...

27.06.2022: In South-Eastern Norway Regional Health Authority, health workers and technologists have collaborated on improving and simplifying medication management in the maternity wards. 'There's too much clicking! This takes up far too much time!' We often hear such statements from health workers who have started using digital tools. It takes many clicks on the computer to obtain an overview of necessary information or perform a single task. Poor functionality arouses frustration. In South-Eastern Norway Regional Health Authority we have collaborated to simplify a digital work process that at the...

22.03.2022: In large parts of the world, professional psychiatric resources are unavailable. Training laypeople to provide treatment could help extend service provision. Worldwide, mental illness represents a greater burden of disability than any other disease category (1). In large parts of the world, there is a gap between the need for and the availability of professional psychiatric resources. In 2011, the World Health Organization estimated that 76–85 % of psychiatric patients in low-income countries receive no treatment (2). In those parts of the world, there is a widespread shortage of trained...

10.10.2021: Tongue-tie in infants can cause difficulties with breastfeeding. New evidence-based guidelines for healthcare professionals will make it easier to obtain help. Healthcare professionals in Norway have long called for guidelines on the management of tongue-tie (ankyloglossia) in infants. If tongue-tie gives rise to difficulties with breastfeeding, breastfeeding counselling is to be offered first. If this does not lead to improvement a frenotomy may be considered. There is a sufficient evidence base to support this primary recommendation, which is also consistent with the recommendations of...

20.07.2021: Will decentralising medical education in Norway enhance learning, reduce the burden on university hospitals and increase recruitment in rural areas? The conditions for educating doctors have changed. As the demand for doctors has increased, the annual intake of students at Norway's four medical education programmes has gradually crept up from 367 in 1973 to 636 in 2019 (1). The Grimstad Committee has recommended adding a further 440 study places, with the aim of educating 80 % of Norway's doctors domestically (1). Eighty new study places have recently been allocated to the four universities...

28.06.2021: Can COVID-19 cause epilepsy, or increase the tendency to seizures in those with epilepsy? Is it safe for persons with epilepsy to be vaccinated against COVID-19? The Epilepsy Association's advisory service has noted a marked increase in enquiries since the outbreak of the pandemic. Patients and their families primarily ask for more specific information about COVID-19 and epilepsy. Many have difficulty applying the general information to their particular health and life situation. We conducted a literature search and used a discretionary selection of this literature to provide answers to key...

27.05.2021: The everyday lives of children and adolescents have changed drastically during the COVID-19 pandemic. Can increased use of digital devices affect the risk of developing myopia? Since March 2020, the COVID-19 pandemic has been triggering alarm bells and restrictions throughout the world. Various measures have been implemented to limit the spread of the virus in the population, and the use of digital aids has rocketed. For children and adolescents, the closure of schools and the introduction of home learning have led to prolonged periods in front of a computer screen. Leisure activities, sports...

21.05.2021: Hand sanitiser is both flammable and explosive. During the COVID-19 pandemic, the use of hand sanitiser has seen a dramatic increase, exposing patients and healthcare personnel to significant risk of injury. Hand sanitiser contains ethanol, a highly flammable substance that can be ignited by static electricity. When ethanol ignites, the flame is almost completely invisible and does not produce smoke (1, 2). The problem of burns when using and storing alcohol-based sanitiser should be well known, and Norwegian health institutions are obliged to carry out ongoing HSE work. In my role as fire...

23.04.2021: Quality assurance of surgical procedures and interventions requires suitable tools and the necessary resources. It is not uncommon to see sensational reports in Norwegian media about the poor quality of services in certain hospital departments, sometimes related to specific surgeons. Therefore, a surgical department should have a complete overview at all times of activities, types of procedures, risk factors and outcomes (fatalities, complications, length of hospitalisation, etc.) so that the management can review adverse events. Most of this information requires structured data that currently...

14.04.2021: Should past mistakes play a role in how medical assistance is prioritised? If so, the debate on the prioritisation of health resources will take on a whole new dimension. If Oslo receives more vaccine doses because of its infection rate, this would be a kind of 'reverse reward' (1). It was the mayor of the town of Molde, Torgeir Dahl, who expressed this view in a discussion on the skewed distribution of COVID-19 vaccines based on where infection rates are highest. The reason was that he was not impressed by what Oslo, the capital of Norway, had achieved. According to Dahl, the infection rate...

07.04.2021: There are plans to sell nicotine-containing e-cigarettes freely in Norway. In our view, the harmful effects of nicotine, particularly on young people and during pregnancy, should not be understated. These new nicotine products can be very attractive to young people and women of childbearing age who might not otherwise have started using such products. E-cigarettes are regarded as being less harmful than cigarettes, and some researchers recommend them as a harm-reduction tool (1). People who need help to stop smoking can currently use oral moist snuff (snus) or nicotine replacement therapy (NRT...

06.04.2021: Implicit bias in health personnel leads to disparities in the treatment of patients. The Norwegian Medical Association needs to address this issue. We constantly make more or less well-considered generalisations when interacting with other people. Psychologists refer to such subconscious thought processes based on pattern recognition as implicit bias (1). The phenomenon also manifests itself when doctors, other healthcare workers and clinical researchers meet patients. But are they aware of how this affects their professional practice? Unequal treatment A number of studies have shown that...

22.03.2021: Keratoconus is a progressive corneal disease that can impair vision. Early diagnosis and treatment can be crucial for preventing severe and permanent loss of vision. Estimates for the prevalence of the corneal disease keratoconus have varied. Historically the condition was considered relatively rare, with a reported prevalence of around 0.05 % (1, 2). However, several recent studies have found the prevalence to be higher. In a Norwegian study, we estimated it to be 0.19 % in the general population (and higher in younger age groups) (3), while a study from the Netherlands calculated a...

22.03.2021: The prevalence of diabetes is increasing in Norway. We believe that primary healthcare teams consisting of a doctor, a diabetes specialist nurse and a medical secretary are a suitable response to this challenge in general practice. New data show that the prevalence of diabetes, especially type 2, is increasing in Norway (1). Approximately 350 000 people have diabetes, most of whom have type 2. This trend can be expected to continue, given the increasing bodyweight and ageing of the population. Good treatment of diabetes requires follow-up of blood sugar levels, blood pressure, lipids and...

22.02.2021: It's high time to examine how medical expertise is being used to change the legal basis for political interventions. The Norwegian government seeks to add a curfew to its COVID-19 control toolbox by putting in place legal authority for this measure ahead of a potential situation with escalating infection rates. A draft bill was recently circulated for comments (1). The Minister of Justice, Monica Mæland, wants to be able to 'act quickly, if necessary' (2), but how can a curfew possibly be an appropriate 'tool'? Would it add anything other than a false sense of security? The authorities are...

27.01.2021: Some frail nursing home residents in Norway have died after being vaccinated against COVID-19. Vaccination is an important measure for preventing outbreaks and deaths in nursing homes, but some of the frailest residents with serious health problems should not be vaccinated. Nursing homes in Norway and other countries have experienced multiple and serious outbreaks of COVID-19 with a high mortality rate (1, 2). As a result, the health authorities put nursing home residents at the top of the priority list for vaccination (3). Vaccination in Norwegian nursing homes started on 27 December 2020...

25.01.2021: Emollient creams and bath oils do not prevent atopic eczema in infants. Emollients are nevertheless important for those who suffer from eczema. Atopic eczema is a chronic skin disease that affects approximately one in five children in Norway (1). Children with atopic eczema have a higher risk of developing other allergies, such as food allergies, asthma and allergic rhinitis (2). Researchers all over the world have tried to find interventions that will prevent the development of eczema. Such primary preventive measures must be distinguished from secondary prevention which aims to prevent a...

14.12.2020: The National Health Service in England has committed to becoming carbon neutral by 2040. Now the Norwegian health service needs to take action. It has become virtually impossible to ignore the ever-growing evidence of the consequences of climate change (1). Until recently, health has largely been distanced from wider political efforts to tackle climate change, both related to cause (greenhouse gas emissions from the health sector) (2) and to the health consequences of climate change (3). Therefore, it is fortunate that the National Health Service (NHS) in England has committed to achieving net...

14.12.2020: Air pollution is a well-known risk factor for various diseases, and perhaps also for COVID-19. Air pollution is one of the most critical environmental health risk factors worldwide, and a contributory factor to cardiovascular disease, impaired pulmonary development and function, COPD, and increased incidence and exacerbation of asthma (1). Fine particulate matter appears to cause most damage to health, but gases and larger road dust particles also contribute. Air pollution probably also increases the risk of acute infections of the upper and lower respiratory tract (2, 3). Increased risk of...