Prevention strategies. Organization of CVD medical prevention in clinical practice
Head post-graduate specialist of the Ministry of Health of Ukraine for medical prophylaxis, director of the State Scientific and Preliminary Center for Preventive Medicine Sergiy Boytsov rozpov AiF.ru about those, that it is very important to dispensary, because I often criticize, not about the matter.
- Sergiy Anatoliyovych, all I know, is it also prevention, but is it effective?
- Prevention - tse effective way the improvement of the development of the ailment or the sharpening of the ailment.
Prophylactic visits to the first Lanka have already brought their effectiveness long ago. Heads of active prophylactic visits, carried out on Likarskiy dilyantsi, for 10 years, it is possible to achieve a significant decrease in incidence and mortality from ischemic ailments heart. Tse is supported by the insight of our friends: in the 80s. In the polyclinics of the Cheremushkinsky district of Moscow, a dispensary was organized to guard against ailments with heart-and-death ailments, as a result, the mortality rate on these small houses decreased by 1.5 times, as a result of the out-of-home practice. Navigate until the end of the last 10 years.
- What are the best practices for unique methods? Who's got the stench?
- Three strategies are seen in the implementation of preventive visits: population strategy, high risk strategy and secondary prevention strategy.
Population strategy transferring the formation of a healthy way of living for the purpose of informing the population of the proprietors of the rizik. Realization of the central strategy to go beyond the boundaries of the health protection system - here the role of education, education, culture is important.
It is important to create a comfortable mind for people who have changed the way of life: for example, a person who threw a fire is guilty of the mother's ability to eat in a quiet environment. For the entire Ministry of Health Protection of the Russian Federation, a distribution of regional and municipal programs has been launched, which are focused on the comprehensive systems for the prevention of non-infectious diseases and the formation of a healthy way of life for the population of the Russian Federation, including
- What is the strategy of a viscous rizik? Who's got a field?
- Vona polyagaє in the chance to see people with the advancement of the factors in the development of non-infectious ailments: ailments of the blood circulation system, diabetic diabetes, oncology, broncholegenic ailments. Qia strategy is implemented for the additional help of the system and the protection of health. Naybilsh dієviy іnstrument - dispensary in the first lance.
Prior to the speech, the current method of clinical examination of the sutta is to be seen from that which was practiced in our land earlier. Todi lіkаlіsya to know all the ailments without central attitudes, and it’s shukaєmo persh for all those ailments, from which people most often die. For example, my ailments are the cause of death for 75% of the population. Infection in the basis of the dispensary method of screening: for the recommendation of the All-round organization of health protection, screening programs to take revenge on the early detection of factors in the diagnosis of chronic non-infectious causes of death.
The third strategy is secondary prevention. Vona realizes in an outpatient and inpatient hospital. For example, a skin doctor is guilty of a brother for a skin hypertension after a medical examination.
- Guilty, but take what is right? Are there any signs of information about registration in the regions?
- So, at the same time a number of 3MI criticism of dispensary examination, and efficiently, in some cases, is carried out insufficiently summarily. Tse to produce up to a breakdown of indicators - statistics of mortality and statistics of evildoers of malignant new creatures to grow up in time for an hour. You can navigate within the framework of one district, you can get rid of the growing quality of the medical examination. However, a large number of people accept the idea of prophylactic caregivers - a very efficient way to prevent getting sick
- How can you change the situation?
- It is important to consider the quality of medical aid in the first place. For example, for the assessment of the situation of the Ministry of Health, for the first time in history, by launching a project according to the enormous rating of the Polyclinic of Russia, it is possible to assess the skin medical pledge for the whole of low effective indicators.
On the other hand, it is necessary to carry out medical examinations more beautifully or orderly. In addition, it is necessary to change special structures - an update and a cabinet of medical prophylaxis. For these robots, it is enough to connect two doctors, either a paramedic or a doctor. The organization is responsible for taking responsibility for the preparation of all the necessary documentation. The duties of a medical therapist include only the first step - the diagnosis and the value of the health group. For a whole whistach 10-12 chilines. Such reports and offices are already working in the regions, in addition to this, I will help you to remove such deposits, such as tyutiunopalinnya, consider consultations on healthy harvesting.
- How can the population be motivated to get vaccinated?
- Here the population robot is to blame for the results of the ZMI and social advertising. Infectious vaccination is actively developing - the current medicine is spreading scraps for the treatment of such ailments, such as atherosclerosis or arterial hypertension.
The main proponents of the vaccination idea, madly, are guilty of buty drugs of the first Lanka. It is important to think that it’s important, but it’s not just a way to uncover ailments. For example, the flu vaccine reduces the development of heart-and-bladder ailments. Shrinkage of pneumococcal infections, but it significantly reduces the mortality rate of people.
- Everyone who has been over-fucked can be robbed and robbed of drugs. And how can she herself be killed for the purpose of prophylaxis?
- Zagalnovіdomo, which the main reasons for the development of ill health - chicken, malignant alcohol, inefficient food, low physical activity And as inheritance - overwhelming mass or obesity, and distant arterial hypertension and atherosclerosis with further development of myocardial infarction or insult. That is why it is considered to be healthy, control of arterial grip, rational eating, sufficient level of physical activity, intermingling with alcohol, normalizing the mind - you need to be healthy for a healthy person.
- Chi є zhvoryuvannya, for which prophylactic marn?
- Sorry, є. Quite ailments are genetically significant, and bureaucrats haven’t left the place where they don’t appear to be infused into their development. Yak the butt will bring diffuse ailments from the resulting fabric.
- Oncological illnesses are also one of the most important topics in contemporary medicine. Chi є how to get rid of cancer? What methods of prevention are effective? And in what kind of vіtsі varto think over the cim nourishment?
- The most effective way to find a disease is the prevention of ailments and diagnostics in the early stages. Early infectious disease. Cancer at the 1st and 2nd stages within the framework of clinical examination can reach 70% of all types of cancer, only more than 50% of the patients have been diagnosed with cancer. Only for cancers of the reproductive sphere in women, the tse allowed to save 15 yew. Zhitiv. Exercising importantly and regularly, for women it is necessary to undergo mammography and cytological pre-detection of a smear of the cervix, for choloviks - a quick diagnostics will be carried out before the throat, for all - an analysis of feces for the home.
- What kind of pardons do people most often admit when they wipe themselves out of ailments?
- The pompies are mainly promoted in the ways of lowering the weight and the hardening.
I am an opponent of the mass "morzhuvannya", so I vvazhayu, so that bathing in kryzhan_y water often bring to an acceleration, not to a healthier. We will do our best to get started, and we will be able to lie down in a cold shower.
If you are afraid of diet, then it is important not to provoke anorexia. The method of controlling mass is guilty of being the norm of life. As the methods of thinning are not vigaduval, everything is made up to a fast number of calories and, apparently, only a few times. The ratsioni is not guilty of having a good reason - it is not possible to live only with alcohol or with carbohydrates. Be-like mono-dyti є in the region unbalanced and produce to the utmost health.
- Yak vi can you comment on the flooded population of dietary supplements?
- Biologically active additives to bag a grubby race, without preserving the body with the necessary microelements. However, virobniks do not want to see the correct concentration of words. As a result of the intake of dietary supplements, you can make yourself healthy. In order to reduce the risk, the price of food is necessary to comply with the legislation. We have a clear regulation of the pharmaceutical market - from my point of view, it is necessary to expand the procedure to the market of biologically active additives.
- Can you tell us about the growth of mortality, which is widely discussed in ЗМІ?
- I would like to specify bi to assess the demographic processes for pivroku or ric not. Statistics can be tied to previous demographic processes, such as happened ten years ago.
We have a growing number of people who have been kidnapped and infused into the indicators. Another factor that could be included in the indicators is mortality, "lost" by medical involvement. Tse paciєnti with important forms of oncologic illnesses, whose life has gone into prodovzhiti.
It is important to remember that medicine is less important for mortality. The addition of social factors is more than one hundred percent.
- Who should be at once to be afraid to bring the negative processes to the minimum?
- It is important to think that science does not stand on the ground. The triviality of life, the life of the Lithuanian people, develops in a heroic way. Methods of treatment and health protection are satisfied.
As for prophylaxis, then in general the number of people who are amazed by prophylactic glances is growing. More than half of the population of the country took part in the infection in a large-scale dispensary program - 92.4 million people. In 2014, 40.3 million children passed through the clinical examination and prophylactic visits, including 25.5 million adults and 14.8 million children. More and more people will take away the high-tech medical assistance - in the last year it has increased, and not in 2013, by 42%.
And it is especially important that since 2013 the dispensary has become a part of the programs for obovazkovoye medical insurance - it means that prophylactic looks will become more care-free for the skin giant. Ale, krym ourselves, all one thing cannot save our health. It is especially important for this to have a unique factor in the risk of living a healthier life.
Catad_tema Atherosclerosis - statistics
Prevention strategies. Organization of CVD medical prevention in clinical practice
All-Russian Science Association of Cardiologists. Moscow 2011
| |2. Strategies for prevention
The concept of FR, broken up in the 60s of the last century, laid the foundation for the prevention of CVD. Based on the concept, there are three strategies for prevention: population, high risk and secondary prevention.
1. Population strategy is focused on the population as a whole. Vaughn includes mass propaganda of ZSZH, promotion of medical information of the population, and the formulation among the people of the general public to good health. We have found the environment for the success of the population strategy and the establishment of minds for the implementation of the process on the basis of the development of legislative, state, economic and suspension mechanisms in the whole process. Population strategy is of great importance for reducing cardiovascular disease and mortality, so as to prevent a decrease in the level of FR in a population without hundreds of vitrates on medical services.
2. The strategy of high risk patients is to focus on CVD in the population of individuals with high risk and on making active preventive visits to them, including medical visits (including medication). In the first place, there are healthy individuals with signs of preclinical atherosclerosis. Dana strategy, as a population, is tailored for the prevention of new types of CVD (primary prevention).
3. Secondary prophylaxis - early detection, correction of FR and treatment of patients, which may also cause CVD. In the highest category of special prophylactic confessions, the blame is carried out most aggressively, with the aim of accelerating the speeding up of fatal problems.
It is imperative that you have gone to first and second prevention in a reasonable way. On the right, in the fact that the progress of visualization techniques in the last few years allows the diagnosis of atherosclerosis in individuals who are accepted as "practically healthy". At the link of the tsim of the sumarny rhizik, one can see the yak without interruption, the characteristic - the continuum.
The greatest medical and social-economic effect is attainable with the one-hour consumption of all three professional strategies. The main role in the implementation of the strategy of high risk and secondary prevention is to lay down the medical workers of the first Lanka to protect health, who constantly contact with patients and can penetrate their ailments on the OZH. The step of pouring into the meaning of the world is to lay aside the evidence of doctors and nurses in the field of professional counseling, as well as mechanisms that stimulate medical workers before the inclusion of proactive entry into a practical robot. The effectiveness of prophylactic visits to clinical practice is trained in the methods of prophylaxis of illnesses in the framework of the diploma education.
For the implementation of the population strategy, the fate of the state, the civilian structures of the strongholds (federal, regional, municipal), the health of the Partnerships with uncommon organizations (professional splits), the private sector, the institutions of the community support. Large-scale prophylactic programs aim at political decisions aimed at the root of the nimble midst and the formation of new priorities in the population for health and healthy lifestyle (Dodatok 1). In a series of two entries - acceptance of legislative and legal acts, such as: a fence for implantation of Tyutyun virobes and alcohol in large murals (with a special blame); a fence for the sale of tyutyun and alcoholic products to persons who did not reach 18 years; fence for advertising tyutyunovyh virobs, alcohol, unhealthy food in ЗМІ; adjustment of prices for tyutyunov and alcoholic products for tax-excise tax payments; unification of packaging and marketing of products for the purpose of all ingredients in a product in a clear and true vision and in.
The population of strategy can work on the international level for the participation of a great number of countries. The Moscow Declaration, adopted by the robot bags of the First Global Ministerial Conference with ZSZ and NIZ (April 2011r), can serve as a primary butt. In the adopted document it is emphasized that the effective prevention and control of NCDs are effective in the use of the health and safety Mistobuvannya, ecology, practice, industry and trade, finance and economic development. Make economically efficient visits to reduce the risk of low incomes, which are available for the countries with a low level of income and can save millions of early deaths on the market, including going in to fight against a child, reduce alcohol and reduce alcohol consumption. I especially respect the promotion of healthy eating (low consumption of saturated fat, transfat, salt and tsukra, significant consumption of fruits and vegetables) and physical activity in the primary and secondary profile.
For the introduction of the population to the principles of HLS in Bagatyokh regions, the principle of social marketing has been successfully adopted. The essence of this field is in the growth of adaptability for the population of the HLS, as a socially rich model of behavior (for the active participation of the HMI) and the development of social rationality, which is likely to be developed by the HLS, in which, for example, it’s necessary to be alcoholic and healthy.
In the last hour in Russia, the state information and communication campaign is being implemented according to the form of ZSZH "Health Russia" beep. The central element of the information and communication campaign is becoming the Internet portal www.takzdorovo.ru, which reveals great content on the HLS (for example, the function of the program-assistant is shown as a source of information). A large-scale information campaign can also be held on TV, radio, call and Internet services.
Organization of CVD medical prevention in clinical practice
Prevention of NCDs, including CVDs, in medical organizations, for providing first-rate medical and sanitary assistance, for individual and group events, to be able to work in case of brutalities in them to drive some medical professionals, focused on saving the life and health of workers in the process of labor activity, as well as in case of increased importance of factors and steps in the development of low and fast development, as well as rejection of the methods of professional advice on
An assessment of the risk factor for the development of NCDs is carried out in all individuals, an assessment of the risk of CVD of atherosclerotic genesis - in individuals over 30 years of age, who have turned up for the first time in a flow test, whether I am brought in for a general practitioner. dilnychny, lykarya home practice(Sіmeynogo lіkarya) ambulatorії, pіdpriєmstva i organіzatsії, polіklіnіki, polіklіnіchnogo vіddіlennya medichnih organіzatsіy, ofіsіv, lіkarya-kardіologa polіklіnіki, lіkaryam іnshih spetsіalnostey that іnshim fahіvtsyam scho pratsyuyut in vіddіlennyah (kabіnetah) medichnoї profіlaktiki, centers Health Protection i centers medichnoї profіlaktiki, as well as a paramedic of a health point, a paramedic-obstetrician of a paramedic-obstetric station. Information about the manifestation, the degree of turnover of the main FRs for the development of NCDs, about the patient's recommendations and results, should be entered by medical personnel into the list of control of the FRs for the development of chronic NCDs.
1.3 Individual and population strategies for the prevention of risk factors
In the effective control of chronic non-infectious illnesses, there is a great deal of importance in the form of partnerships in the control of the state of affairs.
A key way for the implementation of the concept of partnership is the development of the sick through prophylactic individual and group consultations on the peculiarities of the specialties of growing older people and the formulation of motivation for the improvement of health behavior.
Tsi specialties principally guide the process of preventive consultation of methods of sanitary education; Methods of prophylactic counseling є in the most appropriate way for the prevention of illness and can be carried out prior to behavioral therapy. Because of the fact that some of the fastidious-consultant volodya are the main tips for effective communication, to keep the effectiveness of the consultation. It is important to provide food and nutrition in the system of uninterrupted medical education, especially at the diploma level, since the car already has a lot of practical robots, and they have to look at the help of others.
Health information and behavioral profile and willingness to take part in prophylactic programs. The importance of the awareness of health in the population is overwhelmed by the fact that the negative self-assessment is linked to the great risk of CVD. On the thought of bagatokhs of presenters, to deal with the problems of prevention, come from the primary prevention of CVD, it is necessary to work with the advancement of the knowledge of the population of the current problem.
For the data of V.V. Gafarov, in the minds of psychological difficulties, high levels of negative psychosocial factors and social deprivation of the population, there is a large breadth of behavioral factors in the risk of: curriculum, irrational mental low Installed, scho in the period of the social and economic crisis of 1988-1994 rr. a high heap of women evaluated their health as “not healthy” and “ailments” and meant a high rate of sickness with a serious ailment lasting 5-10 rockets (56%). Dynamics of female females to behavioral factors (1988-1994) Changes in the part of the children from the daytime of such a FR yak NPA on the most significant increase in stress in the homeland and on the working mission, in the period from 1988 p.
On the smallest, good self-assessment of health is tied to a shorter vision and lower indicators of illness, even on the ear of the 1980s, self-assessment of health looked like a strong predictor of mortality; With a quiet connection between self-assessment health and active healthy inheritance for health, dozens of populace is supported by dozens of populations in the middle of culture. Today the frequency of low self-esteem of the health of the middle of women is typical for countries that develop.
Self-assessment of health is a strong and "dose-long-term" predictor of mortality, association in the meaning of the world is not negligible because it is insidious and has become a significant stretch for ten years. Prescriptions held in Great Britain have shown that self-assessment of health is a strong predictor of fatal incidents and non-fatal heart-punishment in a healthy, middle-aged population. Deyaky from the association are explained by the way of life, rather than self-assessment of health, to become a strong predictor of amendments to social-demographic, clinical and behavioral FRs and ten rockets of caution.
It is possible to build a family, but the self-assessment of health is clearly integrated into the health of the population of all classics, and it can be safely referred to a number of other nosological units. Otriman dans allow me to be healthy, to be healthy, to be able to achieve a simple check on health, as one of the most important indicators of individual and population health.
In the singing world, the process of prophylactic counseling will lie down with group methods, which can be used by schools and health, for example, for patients from AG, who are modified and unmodified FR and in the future.
Change behavior and behavioral winks, especially, with a preventive measure, the growth of people in the region is foldable. Psychological officials and specialties of the doctor play an important role in effective preventive counseling and can, as an increase in their effectiveness, so as to create a bar for the child's help. By the way, with the recommendations of the European Association of Cardiologists in 2007, the family of a sick person took place in such cases, but the sickness of the patient was not the only thing that was necessary.
To ensure the effective implementation of the conceptual foundations of preventive counseling in practice in the world of allowing the new children in health schools, so the form of group preventive counseling, based on the principles of effective. However, in case of individual prophylactic counseling, it is necessary to know the basics of effective prophylactic counseling, in the presence of a disease.
History of school for children with chronically chronically ill children in Russia ~ 10 years. Enough riches have been accumulated for the visit of the children to the schools at dear ones: Sugar diabetes, arterial hypertension, bronchial asthma, coronary heart disease, etc.
At the present hour, one of the types of vimoga will have to induce the algorithms for the Russian Federation onsutnі. At the same time, the need for the unification of the technology of consultation is obvious and is dictated by the conceptual principle of the need for a comprehensive technology of professional consultation - "informing and developing motivation"
In the midst of the problems of prophylaxis of the ChNIZ, being in the competence and zones of the progress of the health protection system, and in the midst of the problems of the health protection system, in the case of health problems, the key for a background on the presentation of conceptual ambushes of effective preventive consulting. At the same hour, it’s a principle not to be very important to clean up the partner’s uzgodzhenikh dіy lіkar and patient in the health-improving behavioral calls, but to lie at the base of the bagatokh FR KhNIZ.
Screening conditions allow the appearance of individuals with "prehypertension", as well as those of primary autonomic dysfunction, functional instability of the myocardium and subclinical atherosclerotic lesions of arterial disease. In addition, all patients, in some cases, for the development of CVD, require a modification of the way of life, additional laboratory and instrumental support for the development of organ-target therapy and nutritional support for preschool assessment.
In case of a pre-admission of symptoms about the risk of an advanced arterial vise and the placement of patients before the prevention of arterial hypertension Three regions of the Russian Federation for the addition of a one-time anonymous questionnaire has been established, but more than half of the licenses have a system of old professional glances at the forecast and prevention of AG. Prognozuvannya riziku i profіlaktika AG zasnovanі in danogo contingent on lіkarіv traditsіynіy modelі zahvoryuvannya: fahіvtsі not spriymayut pіdvischennya arterіalnogo vise yak FF prognozuyut ymovіrnіst rozvitku uskladnen AG on pіdstavі sub'єktivnih Skarga ailing, skeptical up to approximately Poperedjennia rozvitku urazhen organіv-mіsheney, obmezhuyut profіlaktichnі come in Before hypertensive crises, we can serve as a barrier to the path of prevention of hypertension and, therefore, the need for active development of this category of clinicians for usuning their wrong attitudes and coping with the habits of strategy to preventative.
On the thought of O.M. Britova, the planning and implementation of the population's prophylactic programs in the field of health care not only for the incapacitation and traditional FR, but also for the psychosocial characteristics of the population groups. Tsei visnovok vyplya with otrimany results in psychological analysis, in which there is a strangulation, projection, substitution; The respondents, having poorly formed navik virishuvati, are confronted with the situation with the urahuvannya of a special model of behavior in confl ict, the moral potential is not realized, the tendency to its centrism is mentioned.
The results of the recent EURIKA (high school, international, and the last time for the participation of the 12 regions) show that the main sub of pro ... At the same hour, unfortunately, that part of the population of the country, as in the greatest world, is sick to the heart of the heart and the judiciary, and the people themselves are> 40 years old, who may think that it’s special in addition to the structure of FD, in the world of medicine actively do not use the CVD prevention system. The results of the given doslіdzhen inform about those that the current system of medical prevention of CVD in Russia needs to be thoroughly understood, especially the preventive robots aimed at correcting the FR KhNIZ in the population of young people.
1.4. Clinical examination as a model of management of a high cardiometabolic risik
Social and economic reforms in the country have led to the fall of the CPSR to a speedy prophylactic program, which called for a significant speedy triviality of life and growth of sickness, including the BSK. In this hour, the prevention and improvement of the health of the population will be seen as the one who has directly developed the protection of the health of the Russian Federation. The activization of prophylactic robots has become a spur of modernization of health protection during the implementation of the priority national project "Health", one of the main efforts to provide an insight into the primary medical and sanitary assistance, a new dispensary medical look- medical screening with the start of early detection and advance development of illnesses from victorious prophylactic and rehabilitation visits. In the middle of the contingents, who are taking dispensaries, a special role was given to the primary population.
Prophylactic robots in health protection systems are carried out in the main by municipal prophylactic facilities at the primary medical and sanitary assistance. In the Danian hour of organіzatsіyno-strukturnoї the form of koordinatsії is the Venue of profіlaktichnih zahodіv Je centerand i vіddіlennya (kabіneti) medichnoї profіlaktiki outpatient polіklіnіchnogo mortgage abo spetsіalіzovanogo dispensary, SSMSC zdіysnyuyut his dіyalnіst vіdpovіdno to the "Regulation about vіddіlennya (kabіnetі) profіlaktiki" zatverdzhenim the behest of the Ministry of Health RF №455 від 23.09.2003 р "About the thoroughness of the health of the organs and the establishment of health protection from the prevention of ill health in the Russian Federation."
The importance of pro-active robots in protecting and improving the health of the population, improving the triviality of life is to be found in the program document for the modernization of protecting health. The revision of the global problem and there is plenty of room for the development and implementation of entering into a healthy way of living, correcting factors in the development, early detection of the most widespread and socially significant ailments.
In 2006, a preliminary dispensary examination was carried out in the middle of the rural population from 35 to 55 years, occupied in the budgetary sphere, in the current period of the congregation of the nobility. The procedure for conducting pre-medical dispensary examination is stipulated by the regulatory documents of the Ministry of Health Protection and Social Development of the Russian Federation, including the examination of Fakhivts (therapist, endocrinologist, surgeon, ophthalmologist, neurologist, neurologist functional pre-diagnostics (clinical analysis of blood and blood cells, pre-development in the blood of females, cholesterol, lipoproteins of low scholarship, triglycerides; electrocardiography - for mammography, photofluorography for 45 years).
At the connection with the cysts, it is important to formulate scientifically grounded evidence that the formulation of the doctor himself or the medical nurse / paramedic is proactively arranged to preserve the vigorous health and improve one's way of living in the future on the professional basis. , corrections of the FR and the activity of prophylactic counseling of patients.
Of interest is the development of the wideness of the FR and the steps of the correction of the middle of the likars themselves. Such an endeavor of the boule of the blessings of the great doslidzhen in Europe, India, China
In scientific preliminaries of the last years, they rejected the need to prove the clinical and social and economic efficiency of the primary programs for patients, the protection of patients from the AG, which should be carried out in the outpatient clinic.
Navchannya of medical practitioners to practical tips for prevention and correction of basic FRs heart-and-heart disease In the past, the preservation of vlast health allowed not only the adjustment and the reduction of the relative factors in the risk, but the frequency of prophylactic counseling in 95.5% of the respondents, while the number of additional medical personnel increased the number of medical professionals.
Victims of pre-medication in the therapeutic profile in the Russian regions showed that it is difficult in the absence of knowledge of the basic principles associated with evaluation ... It is possible to explain and explain the fact that the effectiveness of the medication correction of the FR in the patients with the disease was deficient, when included in the preliminaries of the disease, they often underestimated the strong heart-blistering rhizic.
The emergence of a lack of information in the field of cardiovascular prophylaxis in the field of cardiovascular prophylaxis and tips in the field of preventive consulting dictates the need to carry out cycles in the thematic improvement of family education
In this day, the criteria for methodical acceptance and evaluation of the effectiveness of the centers and services (offices) of medical prophylaxis, the principle of payment for practice, based on the result, for the personnel have been established for the personnel. The main directions of development and detailed prevention have been clarified, based on the system of economic motivation given directly to the robot.
Vikoristannya prog of dіagnostiki that korektsії rіvnya vzhivanie habits i problems pov'yazanih of getting used alcohol at kompleksnіy robotі kabіnetu medichnoї profіlaktiki lіkuvalno-profіlaktichnogo mortgage of organіzovanim virobnichim kolektiva dozvolyaє uniquely posiliti efektivnіst profіlaktichnih zahodіv, spryamovanih on zmіtsnennya Zdorov'ya that zberezhennya profesіynoї dіyalnostі ...
Doslidzhennyakh N.P. Fedorovoї at otsіntsі efektivnostі prog lіkuvannya tyutyunovoї zalezhnostі in Minds kabіnetu profіlaktiki tyutyunopalіnnya on bazі Center of Health Protection patsієntam nizkim stage zalezhnostі proponuvavsya nonmedicamental vіdmova od kurіnnya, foundation lіkuvannya sklali povedіnkova terapіya, іndivіdualnі besіdi i grupovі zanyattya in Minds shkіl Health Protection. Anti-nicotine therapy has been promoted by individuals from the middle and the highest level of tyutyunovy oleznosti Bula, spilo with individual demons and group employment in schools of health. After 6 months, the number of successful images from the home in the first group was 35.5%, in the 2nd and 3rd groups - up to 65.0%, about half of them had a relapse on aphids stressful situations, In 2/3 vypadkіv tse buli cholovіki. Otrimanі danі sіdchat, so rorennya in the minds of health centers around the offices of prophylaxis of tyutyunopalіnnya є with an effective call to help reduce the patients.
Great dosvіd doslіdnikіv of uzagalnennya dosvіdu robot kabіnetіv profіlaktiki AG district of St. Petersburg showing scho stvorennya kabіnetu profіlaktiki zahvoryuvannya gave mozhlivіst nalagoditi system navchannya patsієntіv of such risk factors, yak AG i kurіnnya, rozroblenі tsіlespryamovanі kompleksnі prog navchannya in kabіnetі profіlaktiki arterіalnoї gіpertenzії formuyut Activity zhittєvu pozitsіyu at the patient, I will paint the motivation before the prophylactic visits. Vprovadzhennya navchannya ailments z arterial hypertension in the system of medical and social health care, it is possible to reach significant efficiency, which means a friendly prognosis for getting sick. On the smallest modern tendencies of prophylactic robots, the economic factor ceases to be used as a headache for the application of drug recommendations. Doslidzhennya Lavrova A.N., to analyze the medical, social and economic efficiency of the complex of preventive visits for patients from the AG also showed the significant effectiveness of these visits.
Otrimani Petrovim D.V. the result is to turn to crimson wide sucking the scale of sub-active well-being as a screening method for assessing the risk of illness (in a broad, nonspecific meaning) and for all the contamination of mental maladjustment. The assessment of the scale of sub-active well-being in the comprehensive provision of patients in the medical prophylaxis room allows not only a little change in the assessment of individual health, but quite a few changes in the possibilities of professionalism in the case of a professional
When carrying out a detailed analysis of the technological change of two organizational forms of individual prevention - the Health Center and Cabinets of Wellness and Prophylactic Consulting, it is shown the advancements of the technology of nosological research in the technological development.
On the basis of the conducted by O.P. Schepina in 2011, the development of the role of the dispensary in the prophylactic disease of the population in the municipal district showed that the legal basis of the dispensary robotics was formed, the formation of regional-sound documentation. Neobhіdno rotate in dispanserizatsії oglyadovі kabіneti i opituvalnі Listi of metoyu personіfіkovanogo oblіku poshirenostі FR Sered population zatverditi perelіk naybіlsh іnformativno znachuschih for dіagnostiki laboratory that іnstrumentalnih vidіv obstezhennya, rozvivati Ekspres-dіagnostiku, іndivіdualnі that populyatsіynі ozdorovchі tehnologії, іnformatsіynu system ohoronі Zdorov'ya ...
In porіvnyalnomu kontrolovanomu bagatorіchnomu doslіdzhennі vikonanomu in Іnstitutі profіlaktichnoї Medicine showed scho School Health Protection, held at scho robochem mіstsі i orієntovana on konkretnі factorization riziku i gotovnіst to їh korektsії dozvolyaє zniziti serednі rіvnі pіdvischenogo arterіalnogo vise zagalnogo cholesterol i virazhenіst psіhemotsіonalnih faktorіv riziku.
In 2013, in the Russian Federation, the outbound clinical examination of the population is being carried out. With a whole key organizing structure є establish an outpatient-polyclinic, and the status of the process of being liable for an appointment, either for a medical prophylaxis office or for a doctor-therapist. The Ministry of Health of Russia has already approved the low normative acts, which regulate the organization of visits to dispensary for an elderly population.
The analysis of scientific publications in http://elibrary.ru/ with the key words “dispensary examination of the population” represents 57 scientific robots assigned to this nutrition. At the same time, a large number of them demonstrate either the results of a one-time transverse preliminaries in the singing region of the Russian Federation, or the dynamics of growth over the years, and the reduction of these parameters, such as changes in the wider chronology of professional factors, We didn’t have the same robots to create the dynamics of the FR KhNIZ on the basis of the robotic office and / for the purpose of providing prevention in the municipal establishment of the primary health care system in prospective detectives / or retrospectively visually є The appearance of the report analysis of the FR, which was the beginning of the meta and the beginning of the report.
For a quote: Embersoni D., Winkap P., Morris R., Walker M., Ebra Sh. The role of population strategy and strategy of high risk in the first prevention of heart-bladder ailments // RMZ. 2008. No. 20. S. 1320
Entry
Entry
To find out two main strategies for the first prevention of heart-and-heart disease (CVD) - this is the name of the "strategy of high risk", all population. For those who want to know, I can help my practitioner with the problems of getting sick in specific patients, more natural є the strategy of a high risk. Some of the CVDs are not found in a small cohort of maximum risk, but in the middle of a larger group of individuals, not so high as a population strategy. In that hour, as the insult came, the bully was formed, its potential significance knew the change. So, the strategy of a high risk is allowed, from one side, to assess the absolute risk of CVD (and not a single factor of risk, as it is accepted traditionally) and, from the other side, consider a few schemes of deception, skin for ) an independent change in the number of CVDs in the cohort of patients with a high risk. However, it is now obvious that the effectiveness of the population strategy was underestimated earlier. The price is tied to a time when it is not possible to regress for a breeding process (underestimation of the significance of factors in a breeding, as a result of the analysis of economic values), and the magnitude of the arterial grip) in the entire population can lead to an unsupported high decrease in the incidence of CVD.
For the first time in Europe, for the first time in the prevention of CVD, they often choose a strategy of a high risk rather than a population strategy. For example, in Great Britain it is especially important to be found to have a predicted 10-year CVD risk of 30% or more (according to the formula for the CVD risk factor, the victorian period of the Framingham Dos.) Lowering the level of cholesterol in the blood and arterial grip of the population as a whole, navpaki, come to all, not a lot of respect. However, leave as soon as deprived of the past, the presenters have become overwhelmed by the assessment of the potential for the development of a high risk and population strategy, such as overtaking preventive treatment of CVD, as well as an underestimation of the population development strategy. The lower is the analysis and the determination of the potential efficiency of the strategy of high risk AT and blood cholesterol) in the representative vibrations of the British of the middle age. Oskіlki emphasis on the primary prophylaxis, since the last few years we included patients with CVD verification, as they singingly rejected pharmacotherapy, and the rhizik of the present heart-so-sous-distrust was especially high in them.
It would be desirable to infuse the population strategy and strategy of a high risk to the frequency of the population of the first main cardiovascular disease (myocardial infarction (IM) or an insult with deadly according to CVD (British Regional Heart Disease) and meta-analysis of the results and randomized clinical vyprobuvannyh, there is a reduction in the prevalence of CVD risk.
CVD prevention strategies
peeped out a few strategies for the prevention of high risk:(1) detecting and monitoring individual officials: (a) setting the threshold level for cholesterol in the blood and using statins; (B) the value of the threshold level of arterial vise and treatment with β-blockers or diuretics; (2) the value of the boundary value of the indicator of 10-rhizik according to the Framingham preschool data (according to the recommendations in the UK, it should be ≥30%, and in Europe - ≥20%) and the use of (a) statins, (b) β-blockers and , (c) acetylsalicylic acid (ASA) in combination with a β-blocker or a diuretic, an ACE inhibitor and a statin. In the course of an additional analysis, they assessed the effectiveness of the preventive scheme, depending on the type of fallowness. Combined Likuvannya ASA, β-blocker or diuretic, ACE inhibitor and statin. The I Hoch all bіlshe vchenih skhilyayutsya before scho rozrahunki for formulas Framіngemskogo doslіdzhennya zavischuyut realnі pokazniki riziku Sered єvropeytsіv at provedennі tsogo doslіdzhennya boule vikoristanі sama tsі pochatkovі formulas dwellers results boule zrozumіlі of pozitsіy Suchasnyj posіbnikіv (korektsіya zavischenih pokaznikіv prizvede to zmenshennya chiselnostі groupies high rhizik, and at the same time, in his own devil, underestimate the efficiency of the strategy of a high rhizik). At the present time, some of the most important clinicians in the field of testing and meta-analysis of the results have been shown to reduce the level of cholesterol in the blood on the basis of statin therapy by 24%, and - by 31%, and - by 31%. Decrease in the value of AT for the first time hypotensive drugs in the first row (diuretics or β-blockers) reduced the IM by 18%, and in stroke - by 38%. In the middle of a high sum of scores according to the Framingham scale, the assessment of ASK changes and insults by 26 and 22% according to the reason, and the response by the ACEs by 20 and 32% of the cases. It’s just a little quicker, but it’s a lot of times of the first few times of the first few times of the first time and the first time of the first few days of the first 4: 1 (in the first 10 years of the last two Rizik ІМ plus 1/5 of the change in the tolerable risk of the stroke) can be reduced, the indicators of the tolerable risk of the combined CVD symptoms may change. The efficiency of the test will be accepted, and in the end-to-end bag [the combination of the change in the tolerance on the basis of the ASC, statin, ingibitoriv APF and β-block-to-riv / di-68% (1 × statini] × 0.78 [ іngіbіtori APF] × 0.78 [β-blockers / duretics]). The decrease in the frequency of the population of the main CVDs in the development of the strategy of the high risk can be correlated with the following in the case of the growth of the three growing populations: (a) the change in the average level of cholesterol in the population; (B) a decrease in the average value of AT in the population as a whole; (B) the decrease in the mean level of cholesterol and the mean value of AT in the population as a whole.
British regional
doslіdzhennya heart
British Regional Doslidzhennya Heart ( BRHS) - a prospective CVD consultation, which was carried out at home practice courses in 24 British cities from 1978 to 1980. Have a preschool bully included children in the 40-59 years of age. Indicators of mortality and structural morbidity for CVD are traced; vibulo with viprobuvan less than 1% of participants. The current data of the physical situation and biochemical analyzes were presented earlier in the report. In two places (with high and low mortality rates from CVD), the patients were re-examined after 16 or 20 years of caution, at the same time an arterial grip was applied and the level of blood tests was evaluated. The price allowed evaluating the inflow of internal personal views (the efficiency of the regression for the breeding process) on the result of long-term results.
CVD history assessment
In the course of the cob, the test subjects were examined for a history of IM, insult or angina pectoris, as well as swollen pain in breast cancer Triviality is not less than 30 khvili, as they zmusili used to turn to lykar. In addition, the patients used the patient's doctor for stenocardia, which allowed the obvious symptoms of angina pectoris to be detected. A history of ІМ, angina pectoris or insult, swelling pains in the chest cavity, obvious symptoms of angina pectoris, based on the results of the responses to Rose's questionnaire, led to anxiety.
CVD analysis
For the collection of information about the hour and the cause of death, the Vikorists used the standard procedure of "targeting", transferred by the registries of the State Service for the Protection of Health in Southport (England and Wales) and Edin-bour-ha (Scotland). Coronary events with deadly inheritance began like death on the heart ischemic ailments (the main reason), including the effects of raptus deaths imovin through problems with the heart (ICD-9 410-414), and with 30 -438 according to ICD-9. The data on the frequency of heart attacks and strokes without a fatal result were discarded at the offices of the doctors, and supplemented by the results of systematic examinations every 2 years right up to the end of the test. Diagnosis of a heart attack without a fatal result was put on the basis of criteria, hardened by the WHO. Before strokes without a fatal result, all cerebrovascular events were diagnosed, which were supervised by the development of a neurological deficiency, which took more than 24 years. As for the robots, the group of major CVD bullets includes fatal drops as a result of coronary heart disease or stroke, as well as IM and stroke without a fatal result.
methods of statistical
processing of results
Correlation of the exposure of the primary CVDs to the diagnosis of the main CVDs was given for the additional logistic regression; In the course of the analysis, corrections were made for hi, the level of cholesterol in the blood, the value of AT, the status of the course (in the last hour, in the past, nicholas), the index of the mass, the level of physical activity (the level of physical activity, the level of blood cholesterol, insignificant) Diabetes and small living (small counties, central counties and Wales, small counties, Scotland). Asociative infusion of the level of cholesterol in the blood (deep cholesterol and concentration cholesterol / HDL), as well as the value of systolic (blood pressure) sist.) I diastolic (BP diast.) AT on the predicted risk of the main CVDs was assessed in the higher scored model by the prevalence of plausibility χ 2 (instead of LPVShch at all, they didn’t take it until they were respected, the only ones were scored only in 18 minutes from 24). It was boiled over, but the level of cholesterol and the value of AT was measured with a pardon, and at the end of the hour, the indicators became aware of the internal personal views. Efekta Tsikh vіdhilen analіzuvali protyagom 4 rokіv (vikoristovuyuchi danі sposterezhen through 16 i 20 rokіv) of tim, dwellers opisati spravzhnі korelyatsії in Pershi 10 rokіv sposterezhen in porіvnyannі of empіrichnimi "vihіdnimi" correlations (for obchislennya zvichaynogo ochіkuvanogo rіvnya ekspozitsії i іstinnih values koefіtsієntіv regresії performed її kalibruvannya).
W urahuvannyam naybіlshoї іnformativnostі rіvnya cholesterol krovі i largest AT for prognozuvannya riziku CVD (i pіslya correcting koefіtsієntіv regresії on її zmіschennya for rakhunok rozvedennya) potentsіynu іnformativnіst kozhnoї Zi strategіy profіlaktiki Visoko riziku prognozuvali for Relief logіstichnoї regresії (results vimіryuvan rіvnya cholesterol krovі i AT values were given for repeated calibrations). Even if the forecast for the vibrator was robbed at the presentation of the gifts, they were taken away from the quiet individuals themselves, in the number of indications in the risik they could win a few pounds (and it would take an hour to finish them). Tom risik was predicted from victorian sov. the "folding knife" method, allowing you to put down a lot of pardons. The average indicator in the predicted risk was a survey of the absolute 10-day risk of CVD in the population prior to the implementation of the prevention strategy (which, in accuracy, is indicative of the empirical indicator of the risk of CVD). In quiet patients, since the empirical level of the development of the risk is high for the acceptance of a positive decision about the ear of preventive treatment (tobto in the group of the high risk), the indicators of therapies in the predicted risk of the disease were carried out. Then the average indicators of the predicted risk were counted in the implementation of the prevention strategy, which allowed us to estimate the value of the reduction in the risk of the main CVDs as a result of the implementation of the strategy of prevention of high risk. As soon as there are population strategies, then the decrease in the frequency of diagnostics of the main CVDs for 10 years was analyzed by the way of predicting the predicted indicators of the CVD risk in terms of the absolute vibrations of the same indicators of the same At the time of stagnation of the number of strategies, the rapid frequency of occurrence of the main CVDs indicated the predicted change, as the increase in blood cholesterol and the value of AT in some of this vibration was lost.
results
Of 7735 people who were examined during the basic screening, 1186 (15.3%) had boules with symptoms of CVD, and more than 210 people took hypotensive or hypotensive drugs from the ear itself. For 5997 patients (zresti), they received a new set of tributes for such officials. The specific characteristics of cyclic vascular tests are presented in Table 1. In 165 patients without such symptoms of CVD, they did not take any hypotensive drugs at the time of treatment through 16 or 20 cases, 20 rock). Coefficient of compensation for regression for breeding for low cholesterol levels of 0.79; for the logarithm of sp_vv_doshennya cholesterol / HDL - 0.88; for blood pressure sist.- 0.75; for blood pressure diast. - 0,65.
In the first 10 years of age, 450 people (7.5%) have a history of the main CVD. "Vіdnosnu іnformativnіst" vplivu rіznih rіvnіv cholesterol arterіalnogo i vise prognozovany rizik CVD otsіnyuvali in povnіstyu skorigovanoї logіstichnoї regresіynoї modelі on vіdnoshennyu pravdopodіbnostі x 2. We porіvnyannі of vmіstom zagalnogo cholesterol sirovattsі krovі koefіtsієnt LPVSCH / cholesterol viyavivsya Mensch іnformativnim by 55%, and in Porіvyannі z AT sist. i AT diast.- by 67%. To predict the risk of CVD with the most informative, two criteria are known - the change in cholesterol and arterial grip sist..
the effectiveness of the strategy
prevention of high rhizik
Table 2 presents data on the transmission of the effectiveness of the skin scheme for the prevention of high risk in the presence of certain specific threshold values, when they are able to repair the addiction, and for the little one, the therapy is displayed as a border of the population. as before to the opposite diagram. If there is a time to decrease (that is, the growing part of the population is growing), we will remember the decrease in the incidence of CVD in the population. If you talk about the environment of the taken type of treatment, then the efficiency of the development of the disease in general From the position of prophylaxis, the combined therapy is to bring more changes in proportion to the signs of only hypotensive or hypotensive drugs. However, if you receive a decal lykarsky zasobiv a decrease in the frequency of the population of the first period of major CVDs, based on the implementation of the prevention strategy at a threshold value of ≥30% (calculated for the equivalent risk of Framingham until 11 and recommended in the UK). If the change in the rate of 10-fold risk up to ≥20% (according to the recommendations of the European Committee for Coronary Prophylaxis), then the decrease in the frequency of the population of the first period of the main CVD up to ≥15%, - 49%. Thus, with a number of threshold values, one quarter and half of the population without CVD symptoms, apparently, is guilty of being prevented from taking preventive measures.
Pіdbіr therapy tіlki at fіdstavі vіku
Of 450 patients, among those who had 10 years of age after being cautious, 296 (65.8%) were older than 55 years at the time of development of the disease. If you take 4 drugs with a prophylactic method, you will be able to get 201 first episodes of CVD (296x 0.68). Also, approximately 45% of all the first types of major CVDs for 10 years (201/450) can be guided by a specific strategy for the prevention of high risk As long as there is a prophylactic therapy for 50 years, then a part of such specialties grows up to 60% (399x 0.68 / 450).
efficiency of population
prevention strategies
For baby 2 and in table 2, the predicted efficiency of the cutaneous population is shown. Reducing the amount of cholesterol in the systolic blood and systolic arterial vise by 5% (by 0.3 mmol / L and 7 mm Hg, as a matter of fact) for a trivial hour, and a decrease in the frequency of the first 10% increase by 10% Decrease in the value of cich indicators by 10% - by 45%.
Injection zsuvu regression
for breeding
Zsuv regressions for breeding do not spoil any kind of inflow on the ochikuvan the effectiveness of the strategies of a high risk, at that time it’s injected into the efficiency of the population’s approaches is significant. The scored indicators, presented in Table 2 and per baby 2, were found to be 20-30% higher, and not corrected.
Negotiation
Analyzing the potential for the effectiveness of early strategies for the prevention of CVD, high risk and population strategies, it is necessary to take into account the inaccuracy, as to be recognized when the level of cholesterol in the blood is reduced and such arteries In the last few years, it is important to inform about the changes in the frequency of cardiovascular diseases that the United Kingdom sees in the change in the frequency of cardiovascular diseases. % of the cleaned up riziku in the ric according to the accepted in the European recommendations). Potentially, the rate of two key factors in the risk of disease (instead of cholesterol in blood and the value of AT) in the scale of the entire population can be reduced to a significant decrease in the incidence of major CVDs.
admitting
Grunting the primer, the strategy of a high-risk person, and the hypothetical efficiency of the strategy and the legitimacy of the strategy. The effectiveness of statins, ASA and hypotensive drugs in the first series can be judged by the meta-analysis of the results of randomized control of the test, and of the ACE inhibitors - the specific large-scale control of the large-scale test. In hodі Venue of doslіdzhennya chastіshe vikoristovuvali tsі rozrahunki instead obchislennya, zroblenі in protsesі analіzu cohorts oskіlki analіz cohort dozvolyaє otsіniti vpliv rіznitsі mіzh pokaznikami riziku, yak vinikaє vnaslіdok trivalih Change log rіvnya ekspozitsії riziku, in one hour yak klіnіchnі viprobuvannya give mozhlivіst viyaviti, naskіlki werewolves on the same therapy as epidemiological correlations. In addition, in the course of clinical trials, during the conduct of training, it is taken to respect and neglect the plan of treatment, some results and to be obtained as much as possible. "By the principle of a signified likuvannya" (I want in the general practice of medicine), the real efficiency of the preparation can be re-evaluated, some of them are often tried, as they do not get ready to prepare the scheme for taking the children’s additional processes. As a rule, the effectiveness of the therapy is carried out in a group of individuals with high risk (including in patients with CVD in history), and in addition, the extrapolation of such patients on tests without prior cardiovascular disease is also considered prior to Quite rightly, in the winter, for the ACE young people, the information about the effectiveness of those is based on the results of the preliminaries held in patients with verified CVD diagnosis. When statins and ASCs are recognized, the boiling point will be more primed, so that the indicators of viscous risk will decrease to reach stably in a wide range of groups of ailments. So far, if it’s possible, if there’s a big factor in the injection, then the efficiency of reappraisal of the efficiency of the intake of all the drugs (for example, the ingibitories of the APF can evolve in the combination of efficiency) Viciousness of the small combination of drug use (including some drugs in a small dose), it is possible to achieve a higher reduction in CVD risk from the statistic data, such as the guidance in the number of the results of our dosage (for example, if on the basis of the intake of the combined pill, the decrease in the true value of the risk of becoming 85% in Table 2).
The effectiveness of population strategies for prevention lies in the first place in the form of a turn through changes in the scale of the entire population, which are really possible to reach in practice. The change in the average level of cholesterol and arterial grip in the range from 5 to 15% in the scale of the entire population (Table 2) is insignificant; by an analogous value, the value of the cich indicators can decrease during a dim singing activity. If you are talking about the change in cholesterol, then in the course of the last week on the island of Mauritius, the bulo was established, in order to switch to the living of natural (and not palm) oil and the introduction of programs aimed at promoting a healthy way of living a life, for 5 down 15%. Meta-analysis of the results of the last days, carried out in the sov. Metabolic chambers, to indicate those, that 60% of the living fat is replaced by the other fat, and if the number of cholesterol goes up by 60%, then you can ask for such a decrease in the value of indicators. Ogra-ni-chennya with the help of salt accumulates a decrease in arterial grip on the scale of the entire population by about 10%, I want to appear less effective in clinical practice. I would like, given the increase in cholesterol and the level of AT in young populations, that the value of these indicators in the populations generally changes insignificantly, our assessment of the potential for the population Dovgo-cha-menni trend rivnya AT is also strong enough to turn in a stretch to reach short intervals in an hour; Thus, in the period from 1948 to 1968, the average value of systolic arterial vise in Glasgow students decreased by 9 mm Hg. , І independent of the hypotensive therapy and the dania bully otrimanі for the results of the clinical examination in England. Nareshti, the implementation of preventive schemes, directing to a decrease in the activity of the population in lieu of cholesterol and the value of AT, to fix an additional positive injection into the plan of some of the largest factors in cardiovascular disease, such as mass index
In general, it is important to know about cholesterol change, antioxidant antibodies and other methods of pharmacological correction of indications, and nutrition, which can be infused with chicken on the rhizic of CVD, destroyed bully. As much as we respect this aspect, the effectiveness of both the strategies of the high risk and the population strategies is becoming more obvious (for example, the speed of the number of deaths at the same CVD in the last two ten years is about one-third of the number of people involved in the disease itself). If you want to know how to improve the potential efficiency of both prevention strategies, you should become unimportant.
Injection zsuvu regression
for breeding
In the course of the analysis, corrections were made to compensate for the regression for breeding (underestimation of the correlation among the most important factors in the risk and risk of illness, summed up by internal personal failures). At the time of the implementation of the strategy of a high risk, the phenomenon was not infused into the effectiveness of the approach (some of the data about the effectiveness of the treatment were taken from the results of the classroom tests), however, when the population was introduced to such a strategy. Such a difference will be explained by the fact that the true growth of the magnitude of the exponentiation of the magnitude of the exponential growth is explained by the fact that the internal personal vision cannot be taken into account until it is respected. Already, when analyzing the effectiveness of population strategies in the region, it is important to make amendments to compensate for regression for breeding. In addition, it is great that the effectiveness of the approach will be underestimated in the world.
practical
storing results
Otrimanі results and inform about those who inflow for one factor of the risk of nadalization in for the frequency of the population of CVD in the population. When oblіku dekіlkoh faktorіv pokaznik riziku, prognozovanogo of formula Framіngemskogo doslіdzhennya in tsіlomu zabezpechuє bіlsh detailed otsіnku on pіdstavі yakoї pіdbirayut circuit lіkuvannya, nіzh rozrahunki, zroblenі of urahuvannyam єdinogo chinnika riziku, napriklad, zmіstu zagalnogo cholesterol abo arterіalnogo vise (Hoch tsі vіdmіnnostі viyavlyayutsya it is less of a problem, if therapy is carried out in sufficient quantity for a large amount of vibration; Table 2). Guided by the fact not to overlook the previously published danim, we should be able to inject hypotensive and hypotensive treatment on the risk of CVD. Aleksei, for reducing the risk of CVD, medications are recognized in combination, in the context of the strategy of the first pharmacological prophylaxis of a high risk, all one will be taken until quietly, if the United Kingdom is not to be taken into account in the budget ). In order to eliminate the passages, as it is possible to reduce them, which would allow a decrease in the level of cholesterol and arterial pressure by 10% on the scale of the entire population, it is necessary to reduce the symptoms of 4 drugs for about a third of the number of patients without symptoms. About the same, it’s in the peeped over glances of the Third General Committee for the Prevention of CVDs, thanks to the fact that the key respect should be given to patients with an indicator of 10-fold risk of developing CVDs less than 5% for a project; with such a significant criterion, 36% of the participants in the BHRS pre-session will go to the group of high rhizik. However, the implementation of the treatment in the numerical group of clinically healthy individuals є to achieve vitality, and as a result of the economical efficiency of pharmacotherapy, as a warehouse part of the strategy for the prevention of high risk, to decrease in absolute value, to decrease in size. At the same hour, the population strategy is highly effective in the economic plan, and besides (which is even more important), the stench is accentuated not just on the inflow of factors in the risk, but on the determi- nation of the rise. Population-qi-tsіynі go to the big world to allow the progression of atherosclerosis, at that time, as the strategy of the high rhizik, the prolonged lіkuvannya іnіkuvannya іn thе middle іn thе patients, thаt аrе drug therapy.
The presented data will be used to demonstrate the hypothetical reversal of the population strategies for the prevention of high risk. In accordance with international standards, the average level of cholesterol and arterial cholesterol among the inhabitants of the United Kingdom is high, and for the last ten years the values of these indicators have decreased insignificantly. The policy of national health protection for the prevention of CVD, which is currently being carried out in this day near the UK, deprives the minimum of the need to change in the place of extravagant cholesterol and the development of arterial hypersensitivity in the population of all tsi changes (it could have been, for example, adopted by the law on the exchange of salt and fat in grocery products). As soon as I see it, if it’s a priority for populations to reduce the frequency of cholesterol and arterial pressure, then it’s worth saving those successes, as bullets stayed in the professional cycle of two CVDs for diabetes, as well as a little-ruhlivy way of life.
Abstract of preparations by Є.B. Tretiak
for materials of statistics
J. Emberson, P. Whincup, R. Morris,
M. Walker, S. Ebrahim
"Evaluating the impact of population
and high-risk strategies
for the primary prevention
of cardiovascular disease "
European Heart Journal 2004, 25: p. 484-491
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Healthy people are rich in why they start with behavioral signs and reactions of the suspension to the behavior of specialness in the way of protecting health. If you are focused on changing the norms of behavior, you can mobilize great resources and one of the most effective health polls.
Decrease of the level of sickness can be reached by the way of victorious deciles. Medical pidhid straightening on a sick person, yogo meta - for a unavailable help for ailments on IXC). Підхід, group orders high rhiziku , vyavlya indivіduumіv with a high risk and without providing intensive prophylaxis in the whole group (for example, screening for arterial hypertension and further development). first-rate preventionє Trying to reduce ailments, zavdyaki pouring in on a large number of people with an admittedly low level of health (for example, the popularization of children with low fat). Individual perception is realized in case of non-mediated contact with the patient for the way of life and for the whole range of problems (food, physical activity, etc.).
Vikoristannya bezlichі strategiy advancing the effectiveness of preventive programs. For securing systemic and individual changes, it is necessary to go. Vikoristannya only one strategy is inadequate, spiteful for health, infuse ineffective bureaucrats.
the main strategies in the field of prevention of illness and improvement of health є:
- a change of mindsі social norms (the fate of presi, social organizations, leaders);
beefy health improvement policies(Fence of the chicken-house, safety-free service on the working machine);
- economical incentives(Gifts for cigarettes, fines for violating the rules of safety for the work machine);
- adjustment of knowledge and navichok(Osvitni campaign, screening and further caution);
Health protection system ( cover the population health nutrition with vikoristannyh recommendations);
- holy mortgage, Robochі mіstsya (programs for children and grown-ups for a healthy way of life);
- community organizations(Organize zustrіchі, zbori, vistupi in presі z nutrition, protect and improve health);
Інші possibilities.
Stagnation of new programs cannot do without participation in them professional physicians, Tom y medical nurses / paramedics the main statements about the scope of the program and the role of medical practitioners in them have been formed. Medical sisters / paramedics for participation in the programs are responsible for food preparation and protection of health, psychology, communes, especially respect for such food, such as planning, the majesty of alcohol consumption.
Dosvid of the implementation of the lackluster programs in the regions of the country by demonstrating effectiveness of prevention in low incidence and health of the population.
For Russia the document " Good Russia: Policies and strategies for the prevention of non-infectious diseases "(M., 1994), in which the analysis of the health of the population is based on the data of official statistics, recommendations for the prevention of diseases for the important groups of the population are presented. navchannya population healthy way of living MAY zdіysnuvatisya for additional differentiated information programs, addressing and adapting pre-singular groups of the population, with regard to education, education, social status and other characteristics.
The International Group of Experts has broken up and adapted for Russia Kerivnistvo "Prevention through primary health protection", in which it is presented material on the development of advances in the field of factors that can be added to health, as well as to take revenge on the recommendations, which are necessary for robots in the population. These recommendations are published in the journal "Prevention of Illness and Health Improvement" (scientific and practical journal).
Riziku factories
FACTOR RIZIKU(Risk factor) - characteristic sign Such is the name of the people (for example, the palinnya), for the infusion of the presence of the midst of the midst of the schoolyard, as a result of which the development of the people is getting worse. Qia depletion є depriving one of the possible reasons for the development of debility, that її її will develop from a causal factor. (Great Tlumachny Medical Glossary. 2001)
Cause
1) pіdstava, privіd for yakhios dіy
butt: An important reason; Laugh for no reason; U zyazku z tim ..; s tієї cause scho .., union (book) - through those scho.
2) apparition, wiklikє, I will summarize the diagnosis of іnshisha
butt: The reason for the burn; The reason for the rush is that it’s not the hour.
The concept of the factor of risk is one of the most important principles to be the basis happy news about the possibilities of that directly prophylactic medicine. Mabut, the factors of risk were named by such officials, who associate with a great frequency of quiet people who are ill. Tse takі factors, the fight against yakim is aimed at reducing the frequency of diagnoses of ailments, decreasing the incidence, or the withering of quiet ailments. From the great number of factors, mabut, to the extent that there are two main groups of factors in the study, which may be more important for carrying out prophylactic visits.
To the first group of social and cultural officials, the following can be brought to the risik:
- sedentary (inactive) way of living, including one hour;
- with stresses and conflicts, mind the bitter life;
- ineffective eating;
- ecological imbalance;
- unhealthy way life, including shkіdlivі calls.
Another group - internal factors of risk є ti chi іnshі physiological and biochemical damage in the body of people (obesity, arterial pressure, increase). Having shown bagatoh z chih internal officials may be tied to genetic traits (decline in power).
Deyak_specialty factors_in risik:
- їх pouring on the body of a person to lie down as a step, turn and triviality of the skin from them and as a result of the reactivity of the body itself;
- a part of the factors in the risk of being in causal connections in the form of ailments. For example, it is not rational to eat, being a factor of risk, when it comes to the recognition of the other factor of risk - obesity;
- rich chinniks to repair risiku in a child's vіtsі. To that pro_lactichny come in to carry out the yakomog earlier;
- The development of ailments is significant when combined with factors in the disease. Butt: if the rate of malnutrition in cancer patients is 1.5 times, and the malignancy of alcohol - in 1.2, then on the other hand - in 5.7 times;
- revealing the factors of risk is one of the main tasks of preventive medicine, meta and the use of an obvious factor of risk, or to ease it into the body of people;
- Pay attention to one and the same people - not just one, but a combination of factors in risk, in conjunction with which to end up often to go about anti-factor prophylaxis.
Factor_in the rizik to finish the bagato. They are specific for the development of singular ailments, for example, an excess of kitchen salt in case of hypertensive ailments or an excess of high-caloric consumption with foods rich in cholesterol, with atherosclerosis. Up to the number of the most practically significant officials, they include:
- recession;
- stress in the flow;
- ineffective eating;
- low physical activity;
- ecological imbalance;
- unhealthy way of life;
- shkіdlivі calls;
- obesity.
Factori riziku zahvoryuvan - tse factories, which increase the quality of the diagnosis of that one who has become ill. The main factors of risk are given in table. 1.
