[Socialized medicine].
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The Collaborative HIV Prevention Research in Minority Communities Program was developed to address the simultaneous overrepresentation of communities of color among those with HIV and under-representation of researchers of color at the National Institutes of Health. The program is designed to help scientists develop their programs of research and obtain significant research funding. The 27-month program has the following elements: small grant funding, a structured summer program, individualized long-term research collaboration, access to behavioral science expertise, and internal peer review of all products. To date, the 19 program participants, eight of whom have not completed the program, have received almost $11,000,000 in research funding and have conducted culturally specific research with communities of color. In addition, a network of HIV prevention investigators of color has been created. Institutes throughout the National Institutes of Health (NIH) and other entities could use this model to develop investigators of color, improve the quality of research with communities of color, and begin to address health disparities.
Although American medicine has vastly improved the delivery of medical care during the last half-century, there are still many problems confronting our health care delivery system. The physician assistant concept is but one attempt of many to alleviate the problem of access to health care of an acceptable quality. Another concept is national health insurance as a measure to bridge the economic gaps in medical care not met by Medicare, Medicaid, and private health insurance; and to make better use of all health resources. Physician assistants can have a beneficial impact on health care under national health insurance by: improving access to care; keeping practice costs down; and improving the quality of care provided. A program of national health insurance will undoubtedly create increased public demand to provide more health services than currently offered by federal programs. National health insurance can succeed only if an appropriate financing mechanism is developed and valid attempts are made to utilize available manpower such as physician assistants. These issues are discussed.
The High-Performance Computing and Communications (HPCC) program is a multiagency federal effort to advance the state of computing and communications and to provide the technologic platform on which the National Information Infrastructure (NII) can be built. The HPCC program supports the development of high-speed computers, high-speed telecommunications, related software and algorithms, education and training, and information infrastructure technology and applications. The vision of the NII is to extend access to high-performance computing and communications to virtually every U.S. citizen so that the technology can be used to improve the civil infrastructure, lifelong learning, energy management, health care, etc. Development of the NII will require resolution of complex economic and social issues, including information privacy. Health-related applications supported under the HPCC program and NII initiatives include connection of health care institutions to the Internet; enhanced access to gene sequence data; the "Visible Human" Project; and test-bed projects in telemedicine, electronic patient records, shared informatics tool development, and image systems.
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During any given year in the 80s, an estimated 15 percent of the U.S. population--some 33 million people and more, as the population grows--will suffer a diagnosable mental disorder. An estimated two million Americans have been or will be diagnosed schizophrenic, ten to 14 million will suffer from depressive disorders, and more than one million will have organic psychoses of toxic or neurologic origin or permanently disabling mental conditions of various causes. Severe anxiety disorders, phobias, alcoholism, and drug dependence can be as debilitating as the psychoses mentioned above and require as much skilled care. Recent estimates place the direct clinical costs for mental health services annually at approximately $17 billion, about 12 percent of total national health care costs. This figure does not reflect indirect costs stemming from loss of productivity, chronic disability, and death. Nor does it fully reflect the findings of recent studies that mentally ill individuals experience higher than normal rates of physical illness and use general medical services at about double the rate of the mentally well.
The purpose of the article is to present the National Breastfeeding Promotion Programme in the Czech Republic in the course of the last decade. It summarizes the main strategies, education and training activities of the National Breastfeeding Committee, its collaboration with the Government, Parliament, IBFAN and UNICEF. The article reviews the relevant studies on infant feeding which illustrate the increase of the prevalence of breastfeeding in the course of the 1990's and reflect the effect of the programme. Recent negotiations with the Ministry of Health have outlined the implementation of the WHO global strategy for infant and young child feeding in the Czech Republic.
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