В качестве социальных предикторов, определяющих рост частоты психических заболеваний, рассматривают процессы урбанизации, стрессогенные события и другие социал...ные тенденции современного мира. Отмечается их прямая связь с манифестацией психических расстройств, в том числе шизофренией. Наиболее подвержены психическим расстройствам лица, находящиеся в неблагоприятной жизненной ситуации или малоимущие. По тяжести социальных последствий и по нарушению адаптации шизофрения продолжает лидировать в психиатрии. Течение шизофрении является одним из основных клинических предикторов медицинского и социального прогноза. Проведенное исследование устанавливает, что клинические предикторы, определяющие тяжесть состояния больных с незлокачественным течением шизофрении, не являются облигатными в социализации данной категории больных.
http://www.ssmj.ru/system/files/201201_105-107_.pdf
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Во Всемирном докладе о наркотиках содержится комплексная информация по положению в области незаконных наркотиков. В нем представлены подробные оценки и тенденци..., относящиеся к производству, незаконному обороту и потреблению на рынках опиума/героина, коки/кокаина, каннабиса и стимуляторов амфетаминового ряда. Масштабы проблемы наркотиков удается ограничивать, но существуют признаки того, что стабилизация, достигнутая за последние несколько лет, может подвергаться риску. Среди этих признаков – расширение культивирования в 2007 году опийного мака и коки, некоторый прирост потребления в развивающихся странах и в определенной степени развитие новых схем незаконного оборота. Также отмечалось обнадеживающее сокращение некоторых из основных потребительских рынков.
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Cervical cancer, along with maternal deaths, has been identified as a national priority in
South Africa as well as other Sub-Saharan African countries. Cervical cancer is the
second most common cancer among women in South Africa, after breast cancer. Due
to limited access to prevention, early dia...gnosis and treatment, cervical cancer is often
fatal.
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Специальный доклад- Уполномоченного по правам человека в Томской области
К Уполномоченному по правам человека в Томской области жители региона обращаются по сам...м разным вопросам, но чаще всего содействие правозащитника бывает нужно при решении трудовых и жилищных проблем, также беспокойство у людей вызывают качество и доступность медицинской помощи, недостаточная безопасность среды обитания, трудности с получением бесплатной юридической помощи. О своих проблемах омбудсмену пишут пенсионеры, одинокие матери, лица из числа детей-сирот, люди с ограниченными возможностями здоровья. Регулярно корреспонденция поступает от отбывающих наказание в виде лишения свободы. В общей массе обращений писем от граждан, страдающих психическими расстройствами, немного. Но они есть, и информация о нарушенных правах таких лиц неоднократно находила свое подтверждение.
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В этой главе мы попытаемся представить современные взгляды на классификацию, эпидемиологию, этиологию, клиническую картину, оценку, прогноз и лечение РАС. Мы надее...мся, что данные материалы
окажутся полезными врачам, активно настроенным на изменение в глобальном масштабе отношения к этой группе пациентов и их семьям.
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Показано, что под названием марихуана, гашиш или каннабис подразумевается трава дико растущей
конопли «Cannabis sativa», из которой незаконно могут быть приготовлены ку...ительные смеси, известные в России под названиями спайс, арома микс, макона, а также жидкий экстракт на молоке, известный под жаргонным названием «манага» (или «молочище»). Указано, что ингаляционное введение в организм дыма от курительных смесей и энтеральное введение жидкого экстракта вызывает у наркоманов улучшение настроения и позволяет им получать удовольствие, поскольку трава, стебли, листья и соцветия конопли содержат каннабинолы, которые обладают галлюциногенным эффектом.
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It is estimated that more than 311 000 women die of cervical
cancer each year. Of these deaths, 91% occur in low- and
middle-income countries. Demographic changes and a lack of
action mean that the number of deaths per year is projected
to reach 460 000 by 2040.
Globally, 311,000 women die of cervical cancer every year, 85 percent of them
in resource limited regions of the world. To address this grave threat to women,
the WHO made a call to action in 2018, resulting in accelerated plans to improve
cervical cancer control under the elimination threshold w...ith respect to cervical
cancer incidence. As part of WHO’s approach to cervical cancer control, availability of high quality,
affordable medical devices for HPV screening, and treatment of precancerous
lesions in low resource settings is indispensable.
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This film explains the importance of screening, early detection and treatment of cervical cancer. This film is for use in skilled health worker training. Available in English, French, Somali and Swahili
Self-care interventions are evidence-based, quality drugs, devices, diagnostics and/or digital products which can be provided fully or partially outside of formal health services and can be used with or without the direct supervision of health care personnel.
Where HPV tests are available as part o...f the national programme, HPV self-sampling offers an additional option to improve cervical cancer screening coverage.
Self-sampling can help reach a global target of 70% coverage of screening by 2030. Women may feel more comfortable taking their own samples, rather than going to see a health worker for cervical cancer screening.
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Cervical cancer is the fourth most common cancer in women worldwide in 2018, with 570,000 new cases and 311,000 deaths occurring annually.T he highest incidence rates are in Southern Africa, Eastern Africa, SubSaharan Africa, Western Africa, Melanesia, and Middle Africa . It also ranks as the leadin...g cause of cancer-related death in most African countries. More than 85% of these deaths occur in low- and middle-income countries . In addition, women living with human immunodeficiency virus (HIV) are six times as likely to have cervical cancer
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This guide provides a systematic, practical approach to support primary care and other healthcare professionals to improve the care of peopel over the age of 18 years with difficult to manage asthma.
Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Although asthma is very common, affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world, which results in both over- and under-diagnosis. A taskforce was set up by the European Respiratory Society to systematically review the literature on the dia...gnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
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This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.
Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the importance to make a correct diagnosis based, most importantly, on the clinical history and supported by inv...estigations. Further, the appropriate drug and device must be chosen to achieve good asthma control. It explains that patients must be followed up regularly and their asthma control must be assessed so that the treatment can then be adjusted according to the level of control. Additionally, Asthma education and adherence are important components of management of the condition.
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Asthma prevalence is increasing worldwide and surveys indicate that the majority of patients in developed and developing countries do not receive optimal care and are therefore not well controlled. The aim of these guidelines is to promote a better standard of treatment based on advances in the unde...rstanding of the pathophysiology and pharmacotherapy of asthma and to encourage uniformity in the management of asthma.
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This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks. It emphasi...zes the importance to include advice in the personalised
action plan on minimising indoor air pollution and reducing exposure to outdoor air pollution.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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