Asunto(s)
Salud Pública/tendencias , Política Pública , Humanos , Administración en Salud Pública , RolRESUMEN
A feasibility study on the introduction of systematic screening for cervical cancer (CC) by General Practitioners (GPs) in two sectors of Ghent is described. The aim was to verify if CC screening by the GPs improved the participation rate. All of the GPs of the two sectors (N = 22) were offered both theoretical and practical training in taking Pap smears. The study lasted for 1 year. Results were as follows: The total population covered was 30,000, of whom 7,000 were women at risk between ages 30 and 65 years. Total number of the smears was 444 (participation rate, 6%). The distribution of Pap smears during the year shows that the numbers diminished during the summer and rose during autumn. Anatomopathological results were as follows: class I, 44; class II, 389; class III, 6; class IV, 0; class V, 2; and unknown, 3. As for the participation rate considered for each GP, we obtained attendance rate as high as 21% for the five best screening GPs. This result shows that, in the situation of primary health care in Belgium, this type of screening cannot yield higher attendance rates than traditional screening. Nevertheless, the good results of some GPs indicate that screening for CC is possible in primary health care in specific situations, e.g., with highly motivated GPs.
Asunto(s)
Neoplasias del Cuello Uterino/prevención & control , Bélgica , Femenino , Humanos , Tamizaje Masivo , Prueba de Papanicolaou , Aceptación de la Atención de Salud , Médicos de Familia , Frotis Vaginal/estadística & datos numéricosRESUMEN
The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference in risk profile change was greatest at two years, intermediate at four years and minimal at six years. Total and cause-specific mortality rates were systematically followed from the 6th to the 10th year. Follow-up at 10 years was 99.3% complete. The differences between intervention and control groups in total, coronary and cardiovascular mortality reduced from the 6th to the 10th year. The results suggest that changes in risk profile are rapidly followed by changes in cardiovascular mortality, but this applies in both directions. Thus risk reduction should be maintained in order to achieve a long-lasting preventive effect.
Asunto(s)
Enfermedad Coronaria/prevención & control , Adulto , Bélgica , Ensayos Clínicos como Asunto , Enfermedad Coronaria/mortalidad , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Factores de RiesgoAsunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Brucelosis/epidemiología , Enfermedades Profesionales/epidemiología , Mataderos , Adolescente , Adulto , Anciano , Bélgica , Brucelosis/prevención & control , Industria Lechera , Femenino , Educación en Salud , Humanos , Masculino , Industria para Empaquetado de Carne , Persona de Mediana EdadAsunto(s)
Personal Militar , Fumar , Adolescente , Adulto , Bélgica , Etnicidad , Educación en Salud , Humanos , Masculino , Prevención del Hábito de FumarAsunto(s)
Política de Salud , Derechos Humanos , Clase Social , Justicia Social , Adulto , Niño , Personas con Discapacidad , Europa (Continente) , Humanos , Recién Nacido , Esperanza de Vida , MortalidadRESUMEN
Results are presented from the Belgian Heart Disease Prevention Project, part of the WHO European Collaborative Trial in the Multifactorial Prevention of Coronary Heart Disease (CHD). 19 409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038). Coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5% (p = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).
Asunto(s)
Enfermedad Coronaria/prevención & control , Educación en Salud , Programas Nacionales de Salud/organización & administración , Adulto , Bélgica , Ensayos Clínicos como Asunto , Enfermedad Coronaria/mortalidad , Consejo , Femenino , Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Medicina del Trabajo , Distribución Aleatoria , RiesgoAsunto(s)
Indicadores de Salud , Encuestas Epidemiológicas , Mortalidad , Clase Social , Adolescente , Adulto , Anciano , Bélgica , Niño , Preescolar , Política de Salud , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Esperanza de Vida , Persona de Mediana Edad , Países Bajos , Factores SocioeconómicosAsunto(s)
Personal Militar , Fumar , Adolescente , Adulto , Bélgica , Educación en Salud , Humanos , Masculino , Muestreo , Prevención del Hábito de FumarAsunto(s)
Estudios de Factibilidad , Tamizaje Masivo , Neoplasias del Cuello Uterino/epidemiología , Adulto , Anciano , Bélgica , Estudios de Evaluación como Asunto , Medicina Familiar y Comunitaria , Femenino , Humanos , Persona de Mediana Edad , Prevención Primaria , Neoplasias del Cuello Uterino/prevención & controlAsunto(s)
Investigación sobre Servicios de Salud , Atención Primaria de Salud/organización & administración , Bélgica , Servicios de Salud Comunitaria/provisión & distribución , Necesidades y Demandas de Servicios de Salud , Medicina , Servicios de Salud Mental/provisión & distribución , Dinámica Poblacional , EspecializaciónAsunto(s)
Contaminantes Ocupacionales del Aire/efectos adversos , Contaminantes Atmosféricos/efectos adversos , Polvo , Enfermedades Pulmonares/epidemiología , Enfermedades Profesionales/epidemiología , Fumar/complicaciones , Adulto , Anciano , Bronquitis/epidemiología , Bronquitis/mortalidad , Enfermedad Crónica , Femenino , Volumen Espiratorio Forzado , Humanos , Lactante , Gripe Humana/mortalidad , Enfermedades Pulmonares/etiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Neumonía/epidemiología , Neumonía/mortalidad , Capacidad VitalRESUMEN
Belgians have been gradually shifting from a low ratio of polyunsaturated/saturated fat in their food to a higher one with lower total fat and cholesterol. This has occurred predominantly in the north, where the most obvious change is a decrease in butter consumption and an increase in margarine consumption. The northerners have a four to five times smaller intake of butter than the southerners and nearly double the intake of margarine. Evidence gathered over the past ten years reveals in the north a decreasing serum-cholesterol and in the south a significantly higher serum-cholesterol, associated with higher coronary morbidity and mortality. Life expectancy of males in the north is 2-4 years higher at birth and 2-2 years higher at the age of 30. It is concluded that the food habits of a population can be changed, with great benefit.