Developments in medical education in the U.S.S.R. in the last decade

The modern medical school in the Soviet Union today is undergoing many different and significant changes. The chief consideration of great importance is that today's students are the doctors of the future, and the health of the community will be in their hands.     

The contribution of international medical graduates to diversity in the U.S. physician workforce: graduate medical education

PURPOSE: To describe the ethnicity/race and gender distribution of the international medical graduates (IMGs) qualified to enter graduate medical education (GME) and those who are actually in GME. METHODS: The Educational Commission for Foreign Medical Graduates (ECFMG) database and the American Medical Association's Masterfile provided ethnicity/race and gender data for the pool of IMGs qualified to enter GME (ECFMG certificants from 2000-2005) and those in GME in 2005. Data for U.S. medical graduates come from Association of American Medical Colleges' publications. RESULTS: Compared with USMGs, both the pool of available IMGs and those in graduate training have a larger percentage of Asians and Hispanics, a lower percentage of Blacks and American Indian/Pacific Islanders, and a much lower percentage of Whites. The groups had comparable percentages of women. CONCLUSIONS: International medical graduates provide much-needed diversity in GME. Since most IMGs remain in the U.S. after training, this diversity can lead to a richer training environment, increased access to health care, and better health care outcomes.     

Physicians and the state in the U.S.A. and Israel.

The paper focuses on two patterns of policy-making: a professional pattern in which physicians dominate, and a political pattern in which state authorities take the lead. It looks into the causes of the emergence of each of these patterns and their consequences, in terms of the equity of the health services and their efficiency. The U.S.A. and Israel provide examples for the professional and political patterns of health policy making. The causes for the development of the political pattern in the U.S.A. are grounded in the social salience of medical care, in physicians' economic power, and in the individualistic political culture. The politicization of health services in Israel came about owing to the low placement of health on the social agenda, the proletarianization of physicians, and the hierarchical administrative culture. Analysis of the results indicates that Israel portrays more equity in health services. However, in terms of efficiency results are mixed. In both countries, changes are taking place in opposite directions: more politicization in the U.S.A.; less in Israel.     

U.S. drinking water challenges in the twenty-first century

The access of almost all 270 million U.S. residents to reliable, safe drinking water distinguishes the United States in the twentieth century from that of the nineteenth century. The United States is a relatively water-abundant country with moderate population growth; nonetheless, current trends are sufficient to strain water resources over time, especially on a regional basis. We have examined the areas of public water infrastructure, global climate effects, waterborne disease (including emerging and resurging pathogens), land use, groundwater, surface water, and the U.S. regulatory history and its horizon. These issues are integrally interrelated and cross all levels of public and private jurisdictions. We conclude that U.S. public drinking water supplies will face challenges in these areas in the next century and that solutions to at least some of them will require institutional changes.     

Using an integrated measurement system as a common language: lessons from the U.S. Army medical department

The Process of developing an integrated measurement system for the U.S. Army Medical Department (AMEDD) is examined in this study. A fundamental issue is whether the measures of performance accumulated by any information system are the correct ones and whether these measures appropriately reflect managers' decision making. Measurement is proposed as a solution to performance barriers. The four steps involved in building the AMEDD integrated measurement system (IMS) model are set out. Strategy is explored as the key input to the IMS model. An activity-based management (ABM) model that can support the required IMS cost-based measures is also described and the interrelationship between the two models is illustrated. The key test for application of the IMS model will be whether linking strategy and measurement results in information that improves decision making.     

医学模式转变对英美国家健康教育发展的影响

健康教育指主动为学习创设机会,包括设计某些形式的交流以提升健康文化、知识水平及发展对个体、社区健康有利的生活技能[1],通过传播健康相关信息,动员全社会参与,营造有益于健康的环境,增强人们健康意识和自我保健能力,改变不健康生活方式,从而达到预防控制疾病,提高生命、生活质量,提高全民健康素质的目的。