Tuesday, April 29, 2008

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Industrial health services. During the epoch of the So¬viet Union and the Soviet bloc. industrial health service generally developed more fully in those countries than in the capitalist countries. At the larger industrial establish¬ments in the Soviet Union, polyclinics were created to provide both occupational and general can for workers and their families. Occupational physicians were responsible for preventing occupational diseases and injuries, health screening, immunization and health education. advair pneumonia The vast number of nonmedically qualified health staff, upon whom the health-care system greatly depends, in-cludes both full-time and part-time workers. The latter include so-called barefoot doctors, who work mainly in rural areas, worker doctors in factories, and medical workers in residential communities. None of these groups is medically qualified. They have had only a three-month period of formal training, part of which is done in a hospi¬tal, fairly evenly divided between theoretical and practical work. This is followed by a varying period of on-the-job experience under supervision. kavuru advair studies The obvious alternative to general practice is the direct access of a patient to a specialist. If a patient has problems with vision, he goes to an eye specialist, and if he has a pain in his chest (which he fears is due to his heart), he goes to a heart specialist. One objection to this plan is that the patient often cannot know which organ is respon¬sible for his symptoms, and the most careful physician, after doing many investigations, may remain uncertain as to the cause. Breathlessness—a common symptom—may be due to heart disease, to lung disease, to anemia, or to emotional upset. Another common symptom is gen¬eral malaise—feeling run-down or always tired; others are headache, chronic low backache, rheumatism, abdominal discomfort, poor appetite, and constipation. Some patients may also be overtly anxious or depressed. Among the most subtle medical skills is the ability to assess people with such symptoms and to distinguish between symptoms that are caused predominantly by emotional upset and those that are predominantly of bodily origin. A specialist may be capable of such a general assessment, but, often, with emphasis on his own subject, he fails at this point. The generalist with his broader training is often the better choice for a first diagnosis, with referral to a specialist as the next option, advair alternative The advantages of general practice and specialization are combined when the physician of first contact is a pediatrician. Although he sees only children and thus acquires a special knowledge of childhood maladies, he remains a generalist who looks at the whole patient. Another combi¬nation of general practice and specialization is represented by group practice, the members of which partially or fully specialize. One or more may be general practitioners, and one may be a surgeon, a second an obstetrician, a third a pediatrician, and a fourth an internist. In isolated communities group practice may be a satisfactory com¬promise, but in urban regions, where nearly everyone can be sent quickly to a hospital, the specialist surgeon work¬ing in a fully equipped hospital can usually provide better treatment than a general practitioner surgeon in a small clinic hospital. advair cost Patients in the United States may also choose to be treated by doctors of osteopathy. These doctors are fully qualified, but they make up only a small percentage of the country's physicians. They may also branch off into specialties, hut general practice is much more common in their group than among M.D.'s. advair frequency Because physicians are scarce, their skills must be used to best advantage, and much of the work normally done by physicians in the rich countries has to be delegated to auxiliaries or nurses, who have to diagnose the common conditions, give treatment, take blood samples, help with operations, supply simple posters containing health ad¬vice, and carry out other tasks. In such places the doctor has lime only to perform major operations and deal with the more difficult medical problems. People are treated as far as possible on an outpatient basis from health centres housed in simple buildings; few can travel except on foot, and, if they are more than a few miles from a health centre, they tend not to go there. Health centres also may be used for health education. advair and blurred visionIn most rural rayony the responsibility for public health lay with the chief physician, who was also medical director of the central rayon hospital. This system ensured unity of public health administration and implementation of the principle of planned development. Other health personnel included nurses, feldshers, and midwives. advair package insert Physicians in Japan have tended to cluster in the urban areas. The Medical Service Law of 1963 was amended to empower the Ministry of Health and Welfare to control the planning and distribution of future public and non¬profit medical facilities, partly to redress the urban-rural imbalance. Meanwhile, mobile services were expanded.advair and synthroid dry mouth advairFamily health care. In many societies special facilities are provided for the health care of pregnant women mothers, and their young children. The health care needs of these three groups, are generally recognized to be so closely related as to require a highly integrated service that includes prenatal care, the birth of the baby. the postnatal period, and the needs of the infant. Such a continuum should be followed by a service attentive to the needs of young children and then by a school health service. Family clinics are common in countries that have state-sponsored health services, such as those in the United Kingdom and elsewhere in Europe. Family health care in some devel¬oped countries, such as the United States, is provided for low-income groups by state-subsidized facilities, but other groups defer to private physicians or privately run clinics. MEDICAL PRACTICE IN. DEVELOPED COUNTRIES advair and manufacturer SCREENING PROCEDURES advair discus 500 50 side affectsDevelopments in modem medical science have made it possible to detect morbid conditions before a person actually feels the effects of the condition. Examples arc many: they include certain forms of cancer; high blood pressure; heart and lung disease; various familial and congenital conditions; disorders of metabolism, like diabetes; and acquired immune deficiency syndrome (AIDS), the con¬sideration to be made in screening is whether or not such potential patients should be identified by periodic exam¬inations. To do so is to imply that the subjects should be made aware of their condition and, second, that there are effective measures that can be taken to prevent their condition, if they test positive, from worsening. Such so-called specific screening procedures are costly since they involve large numbers of people. Screening may lead to a change in the life-style of many persons, but not all such moves have been shown in the long run to be fully effective. Although screening clinics may not be run by doctors, they are a factor of increasing importance in the, preventive health service. advair hfa formulary interchange In France there are still general practitioners, but their number is declining. Many medical practitioners advertise themselves directly to the public as specialists in inter¬nal medicine, ophthalmologists, gynecologists, and other kinds of specialists. Even when patients have a general practitioner, they may still go directly to a specialist. Attempts to stem the decline in general practice are being made hy the development of group practice and of small rural hospitals equipped to deal with less serious illnesses, where general practitioners can look after their patients. fda approved advair for copd Other developing countries. A main goal of the World Health Organization (WHO), as expressed in the Alma-Ata Declaration of 1978, is to provide to all the citizens of the world a level of health that will allow them to lead so¬cially and economically productive lives by the year 2000. By the late 1980s, however, vast disparities in health care still existed between the rich and poor countries of the world. In developing countries such as Ethiopia, Guinea, Mali, and Mozambique, for instance, governments in the late 1980s spent less than $5 per person per year on public health, while in most western European countries several hundred dollars per year was spent on each person. The disproportion of the number of physicians available between developing and developed countries is similarly wide.advair and prednisone In the developed countries. Those concerned with pro¬viding health care in the developed countries face a differ¬ent set of problems. The diseases so prevalent in the Third World have, for the most part, been eliminated or are readily treatable. Many of the adverse environmental con¬ditions and public health hazards have been conquered. Social services of varying degrees of adequacy have been provided. Public funds can be called upon to support the cost of medical care, and there are a variety of private insurance plans available to the consumer. Nevertheless, the funds that a government can devote to health care are limited and the cost of modern medicine continues to in¬crease thus putting adequate medical services beyond the reach of many. Adding to the expense of modern medical practices is the increasing demand for greater funding of health education and preventive measures specifically directed toward the poor.

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