Ceskoslovenske zdravotnictvi最新文献

The District Institute of National Health in Benesov uses automation of information oriented above all on therapeutic and preventive care. At present analyses on the assembled information are under way and are compared with the structure of analyses needed for the management of the health services. The first stage deals with the structure of dispensarized diseases which will be published by the authors.

The author investigated the absence from work in employees of the chancellor's office of the Comenius University on account of care of a family member, and factors, which influence it and consequent economic losses. A substantial part of care of family members is on account of infectious diseases (94.8%), in particular diseases of the airways which accounted for as much as 76.6% of all illnesses requiring treatment and care. The highest mean ratio of required treatment was recorded in three-year and two-year old children. These children were treated 3-4 times per year. At the chancellor's office of the Comenius University absence from work on account of care of a family member caused a loss of 4346 work days, which corresponds to an all-year absence of cca 17 employees and an economic loss of 243,470 crowns paid as sickness benefits. This fact stimulated reflections on the possible prolongation of maternity leave to three years.

The author deals with causes of inequalities of health care in different regions. He thinks that it is due to the professional and economic management of the health services. Local decision of the Communist Party and the national committees was frequently at variance with the competence of the state health administration and thus gave preference to some types of health institutions, while others were neglected. To ensure an even development it is important to introduce more consequential vertical management. The author mentions controversies between resolutions of the Communist Party and state organs and reality in conjunction with deceiving the public by maintaining that health care is developing and improving. Actually the health services deteriorated and only narrow specialized branches developed further. The authority of general practitioners declined and so did the satisfaction of patients whose health deteriorated and whose life expectancy declined. At present the objective is to eliminate existing disproportions and restore to the general practitioner his original mission and to enable him to become a family doctor. Subsequently the author deals with the use of the doctor's working hours, inadequate function of the ambulatory services because of technical shortcomings, training of doctors and the reduced ratio of paramedical personnel per doctor.

The Institute of Health Information and Statistics organized in 1988 a survey to assess citizens' views on the health services. The purpose was to reveal the citizens' views and to provide data which would be used by the Ministry of Health and Social Affairs during the implementation of provisions to eliminate shortcomings and to improve the standard of provided services. The authors present the results of the survey.

The author gives an account of care of diabetics above 60 years of age who live in their homes and require permanent insulin substitution therapy. Insulin administration in the evening and on non-work days is ensured by the emergency medical service. The author recommends other organizational provisions as regards care of elderly diabetics living in their homes and requiring substitution therapy.

The philosophical heritage of T.G. Masaryk is still meaningful today. His work contains principles of humanism which always influenced and will influence above all medicine in its human mission. It is deserving that after many years Masaryk's Humanitarian Ideals were re-published, the ideas of which can be applied and elaborated in all medical disciplines, in theoretical disciplines, as well as in prophylactic or experimental medicine. Clinical medicine is also imbued by the principles of humanism most closely where the object of interest is man as patient and the subsequent state of his physical mental and social welfare. Human health thus becomes the prerequisite of self-realization in creative work and the basic prerequisite of life in the cultural, spiritual and material sphere. Masaryk's philosophical and theoretical heritage stimulates the development of principles of humanism in modern contemporary medicine.

In six districts of the Czech Republic where the MONICA programme is implemented as well as Hypertension control of the population, the authors compared the drug consumption used in the treatment of hypertension in comparable DDD/1000/D units during the period from September 1984 to August 1985 and the corresponding period two years later. For this purpose four groups were selected according to the ATC classification: diuretics, hypotensive drugs (antihypertensive drugs in the narrower sense of the word), single-component betablockers and fixed combinations of beta-blockers with hypotensive drugs. Six districts selected to match the investigated ones were selected as controls, and the drug consumption was also investigated. The results for the group of diuretics, hypotensive drugs and single component beta-blockers revealed unequivocally a greater increase of consumption in the districts included in the MONICA survey than in the control districts. Only the group of beta-blockers combined with hypotensive drugs revealed a greater increase of consumption in the control districts. The districts with the highest drug consumption in the investigated drug groups is according to other surveys the only one in the country where in recent years a decline of cardiovascular mortality, in particular cerebrovascular mortality, was recorded.

The subject of our interest was to investigate the response of the organism to mental strain in an atypical sports discipline. To this end we examined 10 chess players. We assessed their pulse rate at rest, before a contest, immediately after the contest and after 5 mins. recovery. Statistical evaluation revealed an increased heart rate before the contest, as compared with rest at a level of significance of 0.01; after the contest as compared with the status before the contest at a level of 0.02; in the recovery stage, as compared with rest, at the 0.01 level. As a control group we examined 10 hockey players under the same conditions and the results were compared with the chess players. For scientific practice it is necessary to find a way to monitor the internal environment during a chess game (catecholamines, lactate, glucose, fatty acids, cholesterol and others). As soon as this will be possible without disturbing the reflection process of the chess player, we shall be able to obtain more information on the adaptation of the organism to mental strain during a game of chess.

In the historical part of the article the author tried to draw the readers' attention to undergraduate and postgraduate training of leading workers in the health services, as discussed by conferences of the Communist Party and conferences of Ministers of Health from Socialists countries. In the second part the author draws attention to an analysis of the age and qualification structure of public health officers (incl. tables), and the third and final part is devoted to comments on postgraduate training in the discipline, based on some new findings and reflections on the personality of the leading public health officer in the Czechoslovak health services.