Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton.

BACKGROUND: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place. INTERVENTION AND METHODS: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was >/=7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program. RESULTS: A total of 4222 participants (0.76% of all persons aged >/=18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG >/= 7.8 mmol/L and 1.8% had both RBG >/= 7.0 mmol/L and A1c >/= 6.5. Untreated blood pressure >/=140/90 mmHg and/or untreated cholesterol >/=5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600. CONCLUSION: A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign.

Trends in prevalence, awareness, treatment and control of hypertension in the Republic of Seychelles (African region) between 1989 and 2013 [Poster]

Background: Few data exist on secular trends of high blood pressure (HBP) detection and control in low and middle income countries, particularly in the African region. This study examines trends of HBP over 25 years based on 4 independent population surveys. In the Seychelles, heath care is free to all inhabitants within a national health system, inclusive all HBP medications. Previous studies have shown a transition from traditional to cardiometabolic cardiovascular risk factors in Seychelles. Age adjusted cardiovascular disease mortality rates is high but decreasing over the last two decades.

Analyse der Hepatitis-C-Situation bei den drogenkonsumierenden Personen in der Schweiz

Die Analyse der Hepatitis-C-Situation bei den drogenkonsumierenden Personen in der Schweiz beruht auf verschiedenen Methoden: Analyse der publizierten und grauen Literatur zu diesem Thema, Sekundäranalyse verfügbarer Daten, Befragung nationaler Fachpersonen, Befragung drogenkonsumierender Personen (DU), Fallstudien in vier Kantonen (Zürich, Waadt, Aargau, Wallis), Internetumfrage bei den Einrichtungen, die DU stationär oder ambulant behandeln, sowie bei den niederschwelligen Einrichtungen zur Risikominderung. In den vergangenen zwei Jahrzehnten erreichte die Zahl der neu gemeldeten Infektionen mit dem Hepatitis-C-Virus (HCV) Ende der 90er-Jahre eine Spitze mit mehr als 2500 Fällen pro Jahr, wobei mehr als 30 % dieser Fälle Personen betrafen, die intravenös Drogen konsumieren (IDU). Die Zahl neu gemeldeter Fälle sank anschliessend bis auf 1500 Fälle im Jahr 2011 und stieg dann wieder auf mehr als 1700 Fälle im Jahr 2013 an. Der Anteil der IDU belief sich auf etwas mehr 20 % (436 Fälle, kein Wiederanstieg der Anzahl neuer Fälle in dieser Bevölkerungsgruppe). Die für die Gesamtbevölkerung der Schweiz geschätzte Prävalenz der HCV-Infektionen bewegt sich je nach Autor zwischen 0,7 % und 1,75 %. Bei Männern, die Sex mit Männern haben (MSM), ist dieser Wert etwas höher (2 %). Bei Staatsangehörigen aus Ländern mit einer höheren Prävalenz (Afrika südlich der Sahara, bestimmte Länder des Nahen Ostens und Südostasiens) ist die Prävalenzrate vermutlich erhöht; es sind jedoch keine Werte bekannt. Auch in Gefängnissen ist die HCV-Prävalenz höher als in der Gesamtbevölkerung, da DU und Staatsangehörige aus Ländern mit höherer Prävalenz stärker vertreten sind (zwischen 5 und 10 %). Es wird davon ausgegangen, dass es bei etwa zwei Drittel der Fälle zu einem chronischen Krankheitsverlauf kommt.

An attempt to go beyond conventional financial accounting information

Conventional financial accounting informationis slanted in favour of certain economic interests. This paper argues in favour ofaccounting information capturing and showingrelevant aspects of the economic-social situation,and of decision-making based on it allowingfor decisions to be taken with economic-social,and not purely economic-weighted, awareness.

Os Problemas Ambientais em Cabo Verde - Políticas e Medidas de Protecção Ambiental

A presente dissertação teve como finalidade analisar os Problemas Ambientais em Cabo Verde, com destaque para as políticas e medidas implementadas no período que decorre de 1975 a 2010. Para tal, centrou-se no confronto de resultados de estudos que permitiram uma comparação entre os Concelhos da Praia e de São Salvador do Mundo, localizados no sul e no centro da ilha de Santiago, respectivamente. Como ponto de partida, fez-se uma caracterização climática/ambiental do país, salientando a sua fragilidade ambiental através de uma estreita ligação entre as suas características naturais e o estado de ambiente para delinear a evolução das medidas políticas e jurídicas tomadas no sentido de combater ou minimizar os problemas existentes. Todo o trabalho empírico foi realizado nos concelhos acima referidos, com base nos inquéritos efectuados junto dos moradores, escolas, técnicos e políticos que lidam com a problemática ambiental nesses Concelhos. Posteriormente, foi possível analisar profundamente as principais causas da degradação ambiental nos dois Concelhos como a pobreza, a escassez de água, o saneamento básico, o aumento da população, o êxodo rural e as construções clandestinas, estabelecendo uma correlação entre estas e o desenvolvimento económico-social e a qualidade de vida dos seus habitantes. Finalmente, expôs-se o trabalho realizado e o que se perspectiva fazer para sua mitigação, privilegiando a vertente pedagógica, destacando a importância do envolvimento de grupos comunitários para prossecução de acções diversificadas de sensibilização, de programação e da formação em paralelo com o reforço de fiscalização para melhor aplicação de normas existentes.

your Ticket to Safety: Bloodborne Pathogen Awareness, January 16, 2001

This handbook has been prepared to complement the informational videotape, Your Ticket to Safety: Bloodborne Pathogen Awareness for Transit Professionals. The handbook also provides a personal and ready reference regarding bloodborne pathogens for public transit system personnel, including managers, drivers, mechanics, other employees and service providers. Additional copies of this handbook and the videotape are available through the Office of Public Transit.