There is little doubt that the present results are important to curriculum (re)designers and those interested in the evaluation of curriculum reforms.

The differential impact on knowledge acquisition of conventional and innovative curricula has seldom been studied in a longitudinal and cross-sectional design. This study confirmed our assumptions about the potential of an integrated contextual curriculum. The differences observed in ICMC students were attributed to the stronger emphasis on clinically relevant basic sciences in the early years of the ICMC and to the stronger integration of basic and clinical sciences in the ICMC.

In 1990-1991 the Belgian sentinel network of general practitioners recorded suicide and suicide attempts within their practices. The annual attempted suicide rate is estimated at 13.0 cases per 10,000 inhabitants. The highest incidence rates are found among women and young people. The annual suicide rate is estimated at 2.3 cases per 10,000 inhabitants, with the highest rates in men and in elderly people. The highest incidence rates of suicide attempts as well as of suicide are found among divorced people. About 30% of the attempters and committers made at least one earlier attempt. Drug overdose and hanging are the most frequently used methods, respectively when attempting and committing suicide. About 60% of both committers and attempters contacted their general practitioner within a period of 1 month preceding the attempt. Nearly half of the attempters and of the committers were treated for a mental disorder in the year preceding the attempt.

The study provides empirical support for expected effects of traditional and innovative curricula which thus far were not well supported by empirical studies.

Objective-To examine trends in some sexually transmitted diseases in Belgium and to discuss them in the light of the European background. Design-Analysis of the time trends of C trachomatis and N gonorrhoeae infections diagnosed by a network of microbiological laboratories, and of male urethritis diagnosed by a network of general practitioners. Setting-Belgium. Subjects-Reports of C trachomatis and N gonorrhoeae infections by a network of microbiological laboratories, and of male urethritis by a network of general practitioners, to the Institute of Hygiene and Epidemiology. Results-Whereas an increase in the number of C trachomatis infections, more pronounced among women, was observed up to 1986, a small decrease has been observed afterwards in males. The mean number of chlamydial infections per laboratory and per year was 4-2 in 1983, 15-7 in 1986 and 13.9 in 1989. A decrease in the number of N gonorrhoeae infections, more pronounced among men, has been observed. The mean number of cases of gonorrhoea per laboratory and per year was 10-9 in 1983 and only 2-2 in 1989. The same declining trend has been observed in another surveillance programme of male urethritis, based on a network of general practitioners. The number of cases of male urethritis per 100 patient encounters went down from 0-06 in 1982-3 to 0.04 in 1988-9. Conclusion-The declining trend in Western Europe in incidence of gonococcal infections and of urethritis in men is also occurring in