Full Description
Since the historieal conference held in Alma Ata in 1978, it has been possible to observe a reorientation of the medical profession. More and more, issues of health enter the stage and curative medicine is not just loosing ground but some interest. 'How effective is health education?' and 'Whose task is primary pre- vention?' are questions which stimulate great concern and public debate. It seems also to be the first time since the last decades of the 19th century that the social dimension of health receives adequate consideration. Thus the reeent publication of the so-called Black Report on Inequalities in Health (Penguin 1982) led to a heated discussion in Great Britain, certainly of relevance to many other countries. The 6 years since 1978 are much too short a time to proceed far towards 'Health for All', as the slogan of the World Health Organization puts it, but the concepts are spelled out, vaguely but convincing to many of us. It is the right time to discuss first experiences and to move from philosophy to empiri- eal work.
This work - as it relates to the process evolving since Alma Ata - is characterized by participation, cooperation and prevention: Participation, because 'disease' concerns only the individual patient, his or her family and immediate social environment, while 'health' concerns everyone and should involve everyone. It is a task of the whole of society rather than the domaine of a single profession or party.
Contents
I The Physician and Primary Health Care.- A. Changing Mentality in Medical Training.- Changing Mentality in Medical Education.- Medical Education: Proposals for the Future.- Education in Social Medicine.- Community Health in Primary Care - A Workshop on Community-Oriented Primary Care.- Seminars in Clinical Preventive Medicine.- The Migration of Physicians to the United States - A Study of Candidates for ECFMG Certification, 1969-1982.- B. Primary Health Care by the Physician and Allied Personnel.- Cooperation Between Different Professions and Lay Personnel.- The Group Medical Practice - A Prospect for Doctors and Patients?.- Division of Tasks and Cooperation: Learning Processes in Inter-professional Group Practices.- Legal, Institutional and Educational Conditions for Interdisciplinary Teamwork Between Allied Health Professions.- Social Work in Health Care Services.- Telephone Medicine: A Training Need in a Technological Society.- Family Counselling Services in the Veneto Region of Italy: Structural and Functional Aspects.- Health Counselling - A Pilot Programme.- Primary Prevention by the General Practitioner?.- Medical and Psychosocial Problems in Primary Care.- Mental Health Problems in the Offices of General Practitioners and Internists.- Diagnostic Language in Primary Health Care - A Structural and Semantic Analysis of Diagnoses on Health Service Medical Cards.- Early Detection of Disorders of Peripheral Circulation in General Practice: A Model for a Research Project of the German Society for General Medicine.- Effects of the Social Situation on Health and Utilization of Medical Care Services: Results from the Munich Follow-up Study.- Social Class and Utilization of Primary Medical Care Services: Class-Specific Patterns of Utilization Behaviour in the Munich Follow-up Study.- Choice of Best or Cheapest Drugs: A Note on Regulating Drug Supplies.- Epidemiology of Digitalis Use - Results from a Random Sample of the Munich Population.- II Special Groups for Primary Health Care.- A. Maternal and Child Care.- Some Relevant Ecological Factors and Their Influence on Pregnancy.- Some Maternal and Social Factors in Relation to the Birth Weight of Infants.- The Diagnosis of "Minimal Brain Dysfunction" - Implications for Social Medicine.- B. Childhood and Adolescence.- Physical Fitness of Obese Children and Its Relationship to Age, Sex and Nutritional Intake.- Knowledge, Habits and Standpoints of Novi Sad Adolescents in Relation to Cardiovascular Diseases and Possibilities of Their Prevention as Part of a Comprehensive Community Cardiovascular Control Programme.- Review of the Results and Recommendations of the Cologne Study.- Analysis of Suicides in Adolescents and Young Adults: Implications for Prevention.- "Health Education" - A New Subject in the Secondary Schools of SR Slovenia, SFR Yugoslavia.- Some Results of the "Schulerstudie Gesundheitserziehung Hamburg".- An Ecological Concept of Health Promotion in Child and Youth Work - Projekt Gesundheit/Bund Deutscher Pfadfinder.- Growing Up into the 1980s: An Ecological Framework for Health Promotion for Youth.- C. The Occupational Setting.- Industrial Jobs and Coronary Heart Disease.- Coronary Prone Behaviour Related to Occupational Stress in a Sample of Male Workers.- Work Stressors and Coronary Risk: Two Perspectives.- Some Aspects of the Return to Work After Myocardial Infarction.- Vocational Rehabilitation in Hypertension and Renal Diseases.- Occupational Performance of Patients with Multiple Sclerosis.- Mortality and Accidents in the Electrical Industry.- Nutritional Habits and Their Relation to Health in the Occupational Environment.- Alcohol in the Working Environment.- D. Environmental Risks.- Air Pollution and Health Indicators: Regional Findings for the Netherlands.- Possibilities and Limits of Data Drawn from the "Gesundenunter-suchung" for an Epidemiological Study of the Connection Between Air Quality and Chronic Bronchitis.- Biological Effect of the Air Quality Measured at the Population Level.- E. The Chronically Ill.- Family Rehabilitation in Chronic Illness.- Family Psychology and "Family Confrontation".- Who Treats the Chronically Ill: The General Practitioner or the Internist?.- Compliance - A "Risk Factor" for Chronic Diseases?.- Non-fatal Myocardial Infarction in Women Under 50 Years of Age, with Reference to Oral Contraceptive Use in Belgrade.- Rehabilitation After Surgery for Chronic Vascular Disease: Goal and Reality.- Multiple Sclerosis and Geophysical Factors.- Chronic Mental Illness: Social Factors and Rehabilitation Outcomes.- Longitudinal Pattern of Aftercare in a Cohort of Recent Onset Schizophrenics.- Efforts at Compensation with Regard to Basic Disorders Among Schizophrenics.- Identification of Specific Patterns of Work Incapacity Related to Chronic Illness: Analysis of Data Gathered by the Health Insurance Funds in Western Germany.- F. Migrants in Germany.- Migration and Health.- Sickness in the Process of Migration.- Illness and Health of Turkish "Citizens" in West Germany as Seen Against the Background of Their Personal Life Narratives.- Studies on Social Hygienic Problems Appertaining to Foreign Children and Their Families in the Federal Republic of Germany.- The Living Conditions and Education of Turkish Infants in the Federal Republic of Germany: Report on a Model Project in Nurnberg.- Are New Counselling and Psychotherpeutic Patterns Necessary for Children of Foreign Employees (Guest-workers)? Results of an Epidemiological Study.- Migration and Health - Thoughts on Past and Current Research.- III Health Education in Primary Health Care.- A. Education for Health through Participation.- Health for All by the Year 2000: A Challenge for the Education of Health Personnel.- Primary Health Care: The Challenge of Participation.- The Promotion of Health Through Changes in Life-style: Epidemiological, Psychosocial and Ethical Aspects.- Social Support and Coronary Risk Factors.- B. Learning from the Third World Experience.- Maternal and Perinatal Death in Indonesian University Obstetrics: Risk Display for Selected Social and Biological Determinants.- Maternal Transmission of Hepatitis B and Its Prevention.- Psychosocial Factors in Childhood Diseases in Nigeria: A Preliminary Study.- Primary Health Care and Feasibility of Yaws Eradication in India.- Human Resources for Primary Health Care in Developing Countries.- Evaluation of Polyclinic Services Run by Primary Health Care (PHC) Nurses in Soweto.- Primary Health Care - A New Strategy? Lessons to Learn from Community Participation.- C. Modification of at Risk Behaviours.- The Relation of Pattern of Support for Smoking and Achievement Motive in Young Women.- On the Effectiveness of Smoking Cessation Treatment Methods.- Cigarette Smoking, COHb Level and Physical Fitness.- Reduction of Cigarette Consumption as the Most Important Task of Preventive Medicine and Health Policy.- A New Approach to Diet Counseling of Overweight Patients and Diabetics.- Adiposity - A Challenge to the General Practitioner in Therapy and Prevention.- IV Cooperative Prevention Programmes in Primary Health Care.- A. The Control of Elevated Blood Pressure in the Community 1. Presuppositions for Community-Wide Blood Pressure Control.- 1. Presuppositions for Community-Wide Blood Pressure Control.- High Blood Pressure Control in the Community.- Epidemiological Study of Hypertension and Stroke in Taiwan.- Home Blood Pressure Measurement - A Useful Tool in the Management of High Blood Pressure?.- An Education Program for Instruction in Self Blood Pressure Measurement.- Serum Insulin and Glucose Tolerance in Obese Patients with or Without Associated Arterial Hypertension.- The Treatment of High Blood Pressure: Non-Pharmacological and Pharmacological Measures.- What Can Be Learnt from the Results of the High Blood Pressure Trials?.- Medical Care Utilization and Self-Reported Health of Hypertensives: Results of the Munich Blood Pressure Study.- 2. Blood Pressure Control Programmes and Their Effectiveness.- The American National High Blood Pressure Education Program.- Epidemiological Situation of Cardiovascular Diseases in Slovenia and Possibilities for Prevention and Control.- Application of Epidemiology in Primary Health Care - Treatment of Hypertension.- Severity Rating of Hypertension as a Measure of Individual Rehabilitation Effects.- Cost-Effectiveness of Treating Hypertensives in the Federal Republic of Germany: A Model Analysis.- B. Community Health Promotion by Lay Involvement.- Social Differences in the Long-Term Effects of Health Education in Reducing Coronary Risk.- The Tromso Heart Study: The Effect of Dietary Intervention in Hyperlipaemic Men - 5-Year Follow-up.- Health Committees - A Way to Consumer Participation in Health Care Systems.- A Model for Co-ordinated and Integrated Lifelong Health Security.- Community Prevention: The Program of the People's Medical Society.- The Role of Health Insurance Companies in Primary Prevention.- Health Work in a Working-Class District of Mannheim.- Health Promotion in A Large Citty.- Lay Involvement in the Primary Prevention of Cardiovascular Disease: The Rhein-Neckar Community Study (GRN).
