[Aims and evaluation in health education and health information. Report of a work group].
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Biomedical subjects
Publications and source records attributed to R Mühlemann.
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From a historical point of view it was the federal tuberculosis law of 1928 which gave an impulse to the Swiss School health services. Almost simultaneously a psychological service for school children was established in Basle. Besides physicians and psychologists, the present staff comprises speech pathologists and scientific coworkers. The mandate issued by the canton's government is mostly geared toward prevention of somatic, psychological and social disorders in the individual child and in risk groups, in the sense of social pediatrics. Carrying out this mandate requires a unity of investigation methods and the decisions resulting from findings. The statistical evaluation of epidemiological data depends on efficient computer use. High priority is given to data protection. With reference to the basic possibilities and limitations of activities in preventive medicine, questions of goals, acceptability and acceptance, curability and cost-benefit are discussed. The competitive situation between therapy and prevention is critically considered. An interdisciplinary approach including all the helping professions is strongly suggested.
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In a representative inquiry we found significant differences in the self-assessment of 4082 20-year-old Swiss men, as to whether their consumption of alcohol and drugs is high, low, or zero. The heavy users of alcohol and drugs describe themselves as men with frequent personal difficulties and psychosomatic disturbances. They tend to separate earlier from their family and prefer a less conventional, more consume-orientated, and passive way of life than the remainder.
Old patterns of education are being replaced in some European countries by the different ideological norms of the various groups composing modern society. Youth has lost the sure feeling to belong to a certain culture. Drug abuse primarily represents an attempt to get over this insecurity. In an inquiry in Swiss military schools, recruits were questioned about drug and alcohol use and cigarette smoking, and this was related to the home situation. Juveniles who do not have enough affective support in the primary group seem to be more subject to the conflicts of norms going on in our society. Three general factors seem to be responsible for the drug use among juveniles: (1) the family situation of childhood, (2) the conflicts of norms of the society in which they are involved, and (3) the milieu provocation.
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By means of written questionnaires and (with every third or fourth subject, selected at random) standardized interviews, 4082 recruits from various regions of Switzerland were asked about their alcohol and drug consumption and smoking habits in civilian life. To estimate the consumption pattern during military training all recruits still available towards the end of military service (64.3 percent) were questioned again regarding intake of alcohol, tobacco and drugs during military service. The inquiry showed that in civilian life only 10.4 percent were alcohol abstainers, 39.8 percent were non-smokers and 77 percent had no drug experience. 8.6 percent reported a weekly alcohol consumption of more than 350 g alcohol 100 percent (an amount corresponding to 9 1 beer, 41/2 1 wine, 1 1 brandy), 17.4 percent had smoked more than 24 g tobacco per day (corresponding to more than 24 cigarettes daily), and 10.6 percent had taken drugs more than 6 times in their lives. The study was also designed to demonstrate the relations between family or socioeconomic data and intake of alcohol, tobacco and drugs. It was found that French and Italian speaking recruits indicated a higher alcohol consumption, that the lower socioeconomic class was exposed to be greater risk with regard to alcohol and tobacco consumption and the separately interviewed group of pupils to the greatest risk of drug experinece. Sons of divorced or separated parents, of parents married after the subject's birth or of parents who are heavy alcohol, tobacco or medicament consumers represent a higher percentage among the highest consumption class for alcohol, tobacco and drugs than subjects who had grown up in stable families or whose parents had been non-consumers or only moderate consumers of alcohol, tobacco or drugs. Finally, a correlation was also found between use of leisure time and alcohol, tobacco and drug consumption. It was in the groups of recruits who spent their spare time rather passively that the highest percentage of subjects in the upper consumption classes for alcohol, tobacco and drugs was observed. During military training consumption patterns withregard to alcohol and tobacco hardly changed, and only a small number of subjects (7.7 percent of 2587) took drugs during this time.
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By means of a standardized multiple-choice-questionnaire, the knowledge concerning "alcohol and traffic" of 251 students attending military courses or mainly courses of further education was examined. A critical attitude but also some lacks of knowledge could be observed. More discussions on this subject especially amongst future and younger drivers have to be recommended.
Morbidity of of alcoholic employees. Results of a case/control study on 2 samples of civil servants. The data of this retrospective study were obtained mainly from files kept at the centralized medical service. The observation period was 10 years. The alcoholics (n = 64) lost in the average 19.3 or 16.1 days more per year through sickness absence and they spent considerably more days in hospitals than their control groups. Significant differences occurred also concerning frequences of medical diagnoses.
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