[Efficacy of caregiver support groups for dementia]. / Zur Wirksamkeit von Angehörigengruppen bei Demenzerkrankungen.

Counseling of caregivers is an essential component of the management of patients with dementia. According to the empirical research in this field, peer-led self-help groups have the potential to improve subjective outcomes including emotional support, social contact, and control over one's life and thus may facilitate caregiving and reduce psychological burdens. Self-help groups have not been shown, however, to modify objective outcomes such as the time spent for care or the frequency of nursing home admissions. The outcomes of counseling programmes led by professionals depend on the focus of intervention and may include benefits in psychological and psychosomatic symptoms, coping with stress, and managing behavioural disturbances. Studies in the U.S., Australia, and Finland have demonstrated that multimodal counseling programmes led by professionals significantly reduce the number of nursing home admissions and therefore may have considerable importance for health economics.

Prevention of hepatitis C virus infection.

In spite of advances made in our understanding of the biology of the hepatitis C virus (HCV), the epidemiology and natural history of HCV infection, and the treatment of chronic hepatitis C, the development and worldwide implementation of a comprehensive prevention and control strategy remains necessary. A World Health Organization informal consultation with the Viral Hepatitis Prevention Board was convened and met in Geneva, Switzerland, 13-14 May 2002, to review epidemiological and public health aspects of HCV infection, and the various prevention and control strategies that are currently in place. Based on the presentations and discussions, a number of specific recommendations were made, which should be considered in conjunction with previously published recommendations.

UN to pool resources in battle against AIDS.

PIP: A new UN initiative scheduled to begin in 1996 will pool the resources of its various agencies to fight HIV/AIDS. The new program, the UN Joint and Co-sponsored Program on AIDS (UNJCP), will replace the World Health Organization's (WHO) Global Program on AIDS, and will involve UNDP, UNICEF, UNESCO, UNFPA, WHO, and the World Bank. When the program is fully functional, a UNJCP advisor will be assigned to each of the 28 countries of Central and Eastern Europe and the Newly Independent States to coordinate the efforts of other UN agencies with those of nongovernmental and national organizations in planning and implementing country-specific programs. The main aim of the UNJCP is to strengthen the HIV/AIDS prevention and control efforts of individual countries by providing technical and financial assistance to the national programs. In collaboration with co-sponsoring agencies, a UNJCP advisor in any country will help the national AIDS coordinator to plan, implement, administer, monitor, and evaluate the national AIDS prevention program. The authors consider using WHO experience and key areas for UNJCP.^ieng

VHPB: summary of strategies and recommendations. Viral Hepatitis Prevention Board.

The Viral Hepatitis Prevention Board (VHPB) believes that stronger action is needed to control hepatitis B. Vaccinating those identified as at 'high risk' has failed to make a significant impact on the epidemiology of the disease. Many people with hepatitis B do not fall into any of the 'classic' high-risk groups and efforts to reach these groups have been unsuccessful. The VHPB supports the recommendation of the World Health Organization (WHO) that hepatitis B vaccine should be incorporated into national universal vaccination programmes by 1997. The recommendation came initially from the Global Advisory Group of the Expanded Programme on Immunization and was endorsed in 1992 by the World Health Assembly, the governing body of WHO which consists of representatives of all WHO member states. The WHO Working Group on the control of viral hepatitis in Europe, which met in Munich in 1991, concluded that the routine immunization of infants and adolescents should receive the highest priority. Universal infant and adolescent strategies have their own benefits and drawbacks; the VHPB has looked carefully into the rationale for and against these strategies. The prerequisites for implementing these strategies are discussed. A combined infant and adolescent strategy emerges as having many of the advantages of the individual approach and fewer disadvantages. Universal vaccination is clearly the most effective strategy for preventing hepatitis B. Its timely and successful implementation, even in countries with medium and low prevalence, is a priority. There is no reason why hepatitis B should not follow the success of smallpox, polio, diphtheria and measles vaccination.