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Biomedical subjects

M Halvorsen

Publications and source records attributed to M Halvorsen.

5 recordsLinked to original sources

[Measures to promote healthy dietary habits among schoolchildren].

The Norwegian National Nutrition Council has, over the past years, implemented a number of measures designed specifically to promote well-organized school meals and increase the consumption of fruit and vegetables among school children. These measures include the development of national guidelines for organizing school meals, economic support for trying out new methods of operating a school cafeteria, national campaigns to promote the traditional Norwegian packed lunch, open community meetings with political and administrative leaders at municipality level, the introduction of a system whereby pupils can purchase fresh fruit and vegetables at school, and advocacy through mass media. Results of an ongoing evaluation seem to indicate that these measures have had a positive effect on the organization of school meals. More young children are attended to by an adult during mealtimes, more pupils are allowed at least 20 minutes for their lunch break, and a growing number of secondary schools are introducing school cafeterias. However, only half of the total number of schools seem to be aware of the new guidelines, and much more work is required in order to ensure all students are provided with a well-organized school meal. Health personnel play a critical role in ensuring that this work is given political priority, also at the local level.

Adult

[How shall we set priorities among experimental treatment methods?].

There is an increasing demand from patients to have access to new and promising treatment for severe diseases. Norway has recently started ordinary public funding of large-scale clinical investigation of treatment effect and safety for new treatment modalities. The government has thus established a new principle for funding a sub-category of clinical research: investigational medicine. How should we prioritize between promising clinical protocols when resources are scarce? The article examines criteria for priority setting in investigational medicine: quality of evidence; magnitude of expected benefit from treatment; balance between risks and benefits; quality of the research protocol; cost; and size of patient population. These criteria are applied on a controversial clinical examples, high-dose chemotherapy with hematopoietic stem cell support for metastatic breast cancer.

Antineoplastic Agents

[Prioritizing in hospital departments].

A framework for decision-making is introduced in which two out of five patients will be denied treatment. Certain resource constraints are accepted in this hypothetical example. The authors' own ranking of five patients from a department of internal medicine are presented. It was not difficult to select the highest prioritized patients. However, ranking of the remaining patients revealed considerable controversy. Emphasis is therefore laid on the reasons given for each ranking. An interesting finding is that variations in awarding priority to some cases are clearly based on disagreement about facts, not values. The article concludes by suggesting a classification of selection criteria for priority setting based on a distinction between necessary, controversial and unacceptable criteria. The article is presented in an attempt to stimulate a debate about priority setting in everyday hospital work.

Decision Making