Evaluation of a mass hypertension screening program

Mass screening for hypertension in a population is one means of identifying persons requiring medical care and follow-up in order to reduce the risk of cardiovascular disease and its sequelae. In 1973, the first mass screening for high blood pressure in a major metropolitan area was performed in New Orleans, Louisiana. In a 2-day period, 30,329 adults were screened; 9,053 individuals were found to have elevated blood pressure and were then referred for further examination. Through mailed questionnaires and telephone interviews, data were obtained from 6,101 (67%) of those referred. Of the respondents, 5,493 (90%) were seen by physicians. Hypertension was confirmed in 3,684 (67%) of these persons, and 3,077 (84%) were found to be taking medication for hypertension. Of this latter group of 3,077 individuals, 1,685 (55%) had been unaware of their hypertension at the time of screening. Initially, mass screening was a means of identifying individuals at risk in certain population groups under certain circumstances, and of stimulating community awareness of the problem. However, in the context of coordinated, large-scale community control of health problems, mass screening should be considered as only part of the overall effort, which must also include the appropriate mechanisms for long-term follow-up and control if it is to be successful.     

Disparities between persons with and without disabilities in their participation rates in mass screening

Objectives: The purpose of this study was to determine the numberof persons with and without disabilities who participated inthe National Health Insurance (NHI) chronic disease mass screeningprograms in South Korea. Methods: The data were obtained frommass screening claims submitted to the NHI and National DisabilityRegistry. Factors affecting the participation rate includeddemographic variables, socioeconomic status, residential region,and disability type and severity. A multiple logistic regressionanalysis was used to evaluate the relationship between participationrates and disability type and severity adjusted for confoundingfactors. Results: The analysis revealed that persons with adisability were less likely to participate in mass screeningprograms than those without a disability (35.8% vs. 40.2%).Multiple logistic regression analysis indicated that personswith severe disabilities had lower participation rates thanthose without disabilities [adjusted odds ratio (aOR): 0.64,95% confidence interval (CI): 0.63–0.64]. In particular,persons with severe disabilities such as limb, brain, visualand internal organ impairment, were less likely to participatein the mass screening programs. However, persons with mild disabilityhad higher participation rates than those without disabilities(1.03, 1.02–1.03). Conclusions: Although the prevalencerates of chronic diseases are higher among persons with disabilities,various types of impairments such as limb, brain, visual andinternal organ impairment, hinder participation in mass screeningprograms for chronic diseases. The reasons for this disparitymust be investigated and health policies must be altered tomake preventative treatments more accessible to persons withdisabilities.     

Evaluation of the organization of the mass screening program for cervix cancer in northern Limburg]

The 1990 programme for screening of cervical cancer in North Limburg in the Netherlands was evaluated with a view improving the programme. Information was gathered from women in the screening programme, general practitioners, the health insurance company, the laboratory, and the city councils. With data from literature estimates were made of the effects of the screening in the region. All participants in the screening programme were satisfied with the set-up of the programme. 52% of all women did respond to the invitation for a smear, (in the first 7 months 3620 smears were made). 31% of the women did not need a smear because the uterus had been completely removed or because a smear had been made shortly before. 5% of the women did not receive an invitation. Only 11% of the women who needed a smear did not respond to the invitation, because of lack of time or objections. A so-called 'protection degree' for cervical cancer of 83% was achieved. The degree of protection was the same for different villages, age groups and income levels. The invitation of 12,000 women each year for a smear, leads to an estimate of 185 follow-up tests, detection of 20 women with abnormal results, unnecessary (minor) treatment of 12 women, prevention of two to three major treatments and of one to two deaths per year. Because of the limited positive effects and the relatively large negative effects the authors think that the cervical screening programme is questionable.(ABSTRACT TRUNCATED AT 250 WORDS)     

Group screening for cognition disorders in elderly persons

Prevalence rates of cognitive impairment in persons aged 75 to 85 years are in the range of 10 to 19 percent, and 20 to 47 percent after the age of 85 years. Screening for dementia in persons aged 75 years and older would therefore identify a significant number of impaired persons. When screening for dementia, group testing would be more cost-effective than individual testing. We modified the Folstein Mini-Mental State examination (MMSE) for screening in a group setting. Community volunteers were tested at a geriatric health fair and at a special exercise class for the elderly. Subjects were subsequently tested individually using the standard Folstein MMSE. Analysis using Pearson correlation and a paired t-test indicates a high degree of concurrent validity between the two methods of administering the MMSE. This pilot study suggests that when screening elderly persons for dementia, a group-administered instrument can be a useful method to obtain a preliminary sample of cognitively impaired individuals.     

Day-care clinics in mass screening of the population

Day hospital at the out-patient department may be well included into the organizational and technological links of the dispensarization of population. The effective introduction of a day hospital into the dispensarization system does not take place automatically but require the complex of administrative pressures, regulation and purposeful completion of which is ensured by the use of organizational projecting technique.     

Evaluation of mass screening activity for cardiovascular disease risk factors in a rural environment

The aim of this study was to evaluate the immediate and short-term impacts of a cardiovascular mass screening activity in a rural environment. A posttest-only control group design was used. Concerning the immediate impact, the results showed that the participants of the experimental group had, compared to the participants in the control group, a higher intention to participate regularly in physical activities and a higher intention to reduce their fat consumption. The participants' intention to stop smoking was not modified by the screening activity. After four months, the results revealed an increase in participation in physical activities and a decrease in fat consumption. The proportion of participants who smoked did not decrease. In conclusion, it is suggested that a cardiovascular mass screening activity such as the one performed in this study could be effective in motivating a population to adopt heart health-related behaviours. Others studies are necessary however to confirm the short-term impact of this type of activity on behaviour modification with regard to cardiovascular health.     

The immune reactivity characteristics of persons engaged in the manufacture of protein-vitamin concentrates]

Immunologic studies in 130 protein-vitamin concentrate production workers of Angarsk showed the characteristic changes in clinically healthy individuals, suffering from allergic conditions. The changes are: increased levels of T lymphocytes, T killers, T helpers, B lymphocytes, decreased levels of T suppressors and IgA. Immunologic reactivity predisposing to allergic conditions and chronic course of inflammations was found to appear in the workers engaged in protein-vitamin concentrate production.