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Biomedical subjects

K Schaapveld

Publications and source records attributed to K Schaapveld.

18 recordsLinked to original sources
PubMed2000

Effects of screening for disorders among the elderly: an intervention study in general practice.

BACKGROUND: Preventive assessment of prevalent disorders may be considered as an instrument to maintain independence in the elderly. However, the outcomes of studies on these types of screening differ considerably regarding their effects. OBJECTIVES: The aim of the present study was to assess the effects of GPs' screening of the elderly on four highly prevalent disorders with possibilities for treatment: hearing and visual disorders, urinary incontinence and mobility disorders. METHODS: In an intervention study in 12 general practices, 1121 subjects aged 75 years and over were screened. Randomization was done by practice into an intervention group (576) and a control group (545). In the intervention group, all elderly patients were screened for the four disorders during the first year of the study. When the GP and patient agreed on intervention, usual care was provided by the GP. The patients in the control group were not screened in the first year. In the second year, all patients in both groups were screened for the four disorders. RESULTS: For none of the four disorders was a measurable effect of the screening at the population level found. In the first year, 1013 new disorders were found involving 479 of 576 people. The GPs considered information to be new in 293 cases. In 245 cases (out of 293), the GP discussed the new information with the patient. Of the 89 cases in which the patient agreed with an intervention, improvement was reported in 17 cases. CONCLUSIONS: Implementing a standardized screening programme for four highly prevalent disorders for elderly people is not recommended. Preventive assessment of the elderly should be applied in ways other than by screening. Preventive care should pay attention to the individual needs of the elderly, should be started before the age of 75 years and should be offered in a flexible way.

Aged↗
PubMed1999

[Milestones in prevention in the past century].

The prevention of disease and premature death expanded enormously in the 20th century, greatly changing the pattern of disease and death in the Netherlands. This is most clearly apparent where infectious diseases are concerned. In part, the improvement of public health is not a direct result of specific programmes against specific health problems but of general improvement in socioeconomic circumstances. The other part of the improvement is mostly due to specific prevention both within and without the institutionalized health care. Within public health care this means, for instance, prenatal and adolescent health care. Outside health care it includes activity in the areas of hygiene, lifestyle and safety.

History, 20th Century↗
PubMed1997

[Current developments in preventive health care].

On the occasion of the publication of the second revised edition of the Preventiegids (Prevention guide), some recent developments in preventive health care can be analysed and priorities for the near future can be formulated. Some controversies have been resolved (e.g. periconceptional use of folic acid, influenza vaccination of all elderly), a number of others still exist (e.g. postmenopausal oestrogen substitution, screening for hypertension and hypercholesterolaemia). Further health benefit can be obtained by preventive activities, albeit to a limited extent. The focus should be on correct implementation (standardisation) of existing prevention programmes plus evaluation, with improvements where possible. There will also be opportunities for new prevention programmes (e.g. use of the triple test in screening for Down syndrome). It will be possible to discontinue existing inefficient programmes (e.g. routine pregnancy ultrasonography, routine administration of iron to pregnant women.

Adolescent↗
PubMed1996

[Potential role for family physicians in pushing back age-related impairment: hearing and vision disorders, incontinence and arthrosis].

OBJECTIVE: To determine which age-related disorders lend themselves for screening followed by intervention in general practice. SETTING: Department of General Practice Medicine, University of Leiden. DESIGN: Descriptive. METHODS: This study concerned eight frequent age-related disorders: auditory and visual disorders, cognitive limitations, vertigo, incontinence, prostate symptoms, osteoarthritis and depressive symptoms. Four criteria (diagnostic possibilities, therapeutic possibilities, suitability of general practice for screening and intervention, the benefit of the programme to the elderly) were applied to selected literature (from Medicine and the electronic article files of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) and of Huisarts en Wetenschap (GP and Science) to find out whether screening followed by intervention appeared useful. RESULTS: With regard to three disorders (auditory and visual disorders and incontinence) it appeared possible to reduce the impairments caused by them, while in osteoarthritis, screening and intervention might lead to better mobility. CONCLUSION: With reference to recent literature, it appears theoretically possible to reduce the impairments caused by auditory and visual disorders, incontinence and osteoarthritis.

Aged↗
PubMed1996

The whispered voice: the best test for screening for hearing impairment in general practice?

Hearing loss is an important health problem in the elderly which sometimes leads to social isolation. In a study with 62 patients, the diagnostic value of four simple tests for screening for hearing loss in general practice was examined. When paying attention to the loudness of the whispering, the whispered voice test can be a valuable test for assessment of hearing loss in general practice.

Aged↗
PubMed1995

[Zoonoses as a public health problem].

Zoonoses can be defined as infectious diseases that are transmitted from vertebrate animals to man under natural conditions. Applying this definition, a review is presented of zoonoses, occurring in the Netherlands. Data about this group of infectious diseases were collected from public health and veterinary data sources. From the results of the inventory it can be concluded that the major part of the zoonoses is caused by foodborne infections. It has been estimated that yearly a total number of 420,000 persons suffer from Salmonella and Campylobacter infections. The remaining zoonoses under study were found to be of limited importance for the general population; because of their concentration in some professional groups and because of the availability of preventive measures, these infections are important in certain subgroups of the population.

Animals↗
PubMed1995

The European health potential: what can we learn from each other?

In this paper global differences in health between the 12 countries of the European Union are compared and related to variations in so-called determinants of health, especially socio-economic and life style factors and characteristics of the health care system in each country. This leads to two main conclusions. The first conclusion is that the health differences that exist within the European Union can only be partially explained by variations in determinants of health. Still, the comparison offers intriguing clues for improving health, containing cost and further research in the European Union. The second conclusion is that considerable data on health and determinants of health are collected in each country, but that international comparability is still limited. The ongoing activities in the standardization of European data collection need our full support.

Cross-Cultural Comparison↗
PubMed1992

Setting priorities in prevention.

In the last few years prevention has again become the focus of attention because of various international developments such as the WHO strategy for Health for All by the year 2000. When resources are scarce, it is all the more important to set priorities. This applies to prevention as well as to curative care. In this paper, we describe a method for comparing prevention programmes with one another, using efficiency as the final parameter. To determine efficiency it is necessary to collect facts about a number of aspects of the health problems to be prevented: size of the health problem, degree of preventability, monetary and other costs involved and the probability that the prevention programme will cause changes in the overall pattern of morbidity and/or mortality. These aspects are discussed and some examples given.

Cost-Benefit Analysis↗
PubMed1989

Cancer in The Netherlands. From scenarios to health policy.

Future scenarios on cancer in The Netherlands were made with the help of existing trends, demographic changes and expected developments in cancer research, prevention, screening and treatment. Until the year 2000, cancer incidence will probably increase by 1.5% per year, by nearly 3% per year and the need for health care facilities accordingly. Upon the request of Parliament, the Dutch government used this information to formulate a long-term cancer control policy. Faced with a restricted budget and a growing demand for care, the government plans to increase its efforts in the areas of prevention and screening and to improve the efficiency of cancer care. More attention will be paid to the quality of life of those patients who cannot be cured. Support for cancer research will be maintained at its present level.

Female↗