Non-Communicable Diseases: NPCDCS ... - SIHFW Rajasthan

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Measuring waist circumference Locate the top of the hip bone Place the tape measure evenly around the bare abdomen at the level of this bone Read the tape measure and record the same Ensure the tape is sung but does not push tightly into the skin. Measure waist circumference after breathing out normally; do not “suck in” the stomach. <strong>SIHFW</strong>: an ISO 9001: 2008 certified Institution 140
Why is this happening Drivers of the obesity epidemic Societal changes + Worldwide nutrition transition. Economic growth Modernization Urbanization Globalization of food markets <strong>SIHFW</strong>: an ISO 9001: 2008 certified Institution 141
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Non-Communicable Diseases: NPCDCS &
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Risk factors and NCDs largely preve
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Drivers of NCDs SIHFW: an ISO 9001:
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SIHFW: an ISO 9001:2008 certified I
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Epidemiological Transition Communi
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Challenges Many communicable disea
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SIHFW: an ISO 9001:2008 certified I
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Magnitude SEAR-2008: 14.5million t
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50 45 40 35 30 25 Estimated %of pre
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Trends in estimated %of deaths 80%
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Estimated and Projected Deaths due
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Pop.(2010): 1 224 614 327 Age stand
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Metabolic Risk factor Trends 126 Me
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26 Mean BMI 24 22 Male 20 Female 18
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Reported Cases & Deaths due to NCD-
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Total Number of Diabetic Cases - Ra
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Reported Deaths :Type 1 DM- Distric
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District Reported Deaths of Type 2
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Reported Cases of Deaths Due to Can
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District -wise reported Cancer Deat
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SIHFW: An ISO:9001:2008 certified I
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Implications of ↑ burden of NCDs
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MDG-6 NCD burden threatenst the (Co
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2% annual reduction in Chronic Dise
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Answer to the problem: ACT NOW Prev
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Risk factor/disease Tobacco use: Us
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Action at National Level: Two comp
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Strategies Prevention through beha
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Services Preventive, promotive , c
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Facility DH Services Early diagnosi
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Institutional Framework Integratio
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Screening MO to do: To conduct com
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Work closely with other sectors/ de
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Surveillance Surveillance is the on
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Risk Factor Surveillance: Focus …
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Risk factors common to major non-co
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Levels of Risk Factor Surveillance
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Actions at Hospitals Proper depict
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Structure re of presentation Risk
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Risk factor in NCD Any attribute,
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Risk factors May be truly causativ
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NHD of NCD Changes in life style st
Page 89 and 90: The WHO STEP approach to Surveillan
Page 91 and 92: STEPS emphasizes that small amounts
Page 93 and 94: SIHFW: an ISO 9001: 2008 certified
Page 95 and 96: Step1:Questionnaire Based Assessmen
Page 97 and 98: Step 3: Biochemical Measurements D
Page 99 and 100: Core Items Expanded Items Optional
Page 101 and 102: Behavioral Risk Factors “Actions/
Page 103 and 104: Modifiable Risk Factor: 2008 estima
Page 105 and 106: B. Diabetes ‣ Obesity ‣ Sedenta
Page 107 and 108: D. Cancer ‣ Environment ‣ Life
Page 109 and 110: Risk factors and level of NCD preve
Page 111 and 112: Goals of implementing these guideli
Page 113 and 114: Follow up Once the condition of th
Page 115 and 116: High risk With established cardiov
Page 117 and 118: If cholestrol can not be measured S
Page 119 and 120: Prevention of CVD (according to ind
Page 121 and 122: NPCDCS Components Prevention throu
Page 123 and 124: Thank you SIHFW: An ISO:9001:2008 c
Page 125 and 126: Problem on the rise : NCDs MI HT CO
Page 127 and 128: Major diet related NCDs Diabetes Ca
Page 129 and 130: Type of cancers Risk factors Diet R
Page 131 and 132: Prominent risk factor Disease Heart
Page 133 and 134: Life Style Modification Primary Pr
Page 135 and 136: Burden of the Bulge In India 1 in
Page 137 and 138: Android : Upper-body obesity--apple
Page 139: Assessment of central obesity Wais
Page 143 and 144: Nutrition transitions: Absolute cau
Page 145 and 146: Body Mass Index (BMI ) Quetlet’s
Page 147 and 148: Classification BMI Classification W
Page 149 and 150: Sleep apnea and respiratory problem
Page 151 and 152: Weight management Weight gain Calor
Page 153 and 154: Weight loss goals Realistic Achie
Page 155 and 156: Lifestyle medicine: Need for change
Page 157 and 158: Dietary interventions Managing g /
Page 159 and 160: Life style modification & Diet Bala
Page 161 and 162: SIHFW: an ISO 9001: 2008 certified
Page 163 and 164: Total energy requirement Total ener
Page 165 and 166: Diet for NCD: Main focus ‣ Gradua
Page 167 and 168: Promoting Healthy lifestyle le Tra
Page 169 and 170: Strategies for Obesity Prevention e
Page 171 and 172: Tips for weight reduction Slow and
Page 173 and 174: ‣ Avoid fried foods and bakery pr
Page 175 and 176: When to eat Set aside a time for
Page 177 and 178: Way to eat Eat slowly. Chew prop
Page 179 and 180: Recommendations in preventing diabe
Page 181 and 182: Calculating balanced diet Know Rec
Page 183 and 184: How to calculate balance diet Step
Page 185 and 186: Key recommendations -Diet • Frui
Page 187 and 188: Thank you SIHFW: an ISO 9001: 2008
Page 189 and 190: Structure re of presentation Basic
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What is Cancer SIHFW: an ISO 9001:
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Growth of Cells • Undesirable •
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Common Cancer sites Male- • Mout
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Prefix adeno- chondro- Meaning Nami
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India 0.8 million new cases/year
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Five Common Cancers Rank World Indi
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Issues in Cancer control Burden of
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Cancer patterns Predominance of To
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Prevention ention and screening Se
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Early diagnosis ‣ Individual’s
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Diagnosis Radiological Biochemica
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Cancer Interventions in different E
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350 Age wise distribution of deaths
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Common Cancer in Male 50000 45000 4
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No of Cancer Deaths -India 350 300
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Cancer Deaths -Rajasthan 60 50 40 5
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District wise Reported Cancer Death
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Projected Cases of Oral Cancer in I
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Age - wise distribution of Deaths d
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Symptoms of Cervical Cancer Post-m
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Evaluation and Management after Pap
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VIA Category Negative Positive Crit
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Cryotherapy (ablation) Management
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Age - wise distribution of Deaths d
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Sign and Symptoms A lump or thicke
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Diagnosis Breast awareness & breas
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Health professionals can - Key Mess
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Projected Cases of Lung Cancer in I
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Symptoms Persistent cough or worse
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National Programme SIHFW: An ISO:90
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National Cancer Registry Programme
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Schemes under NCCP Recognition of
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District Services under NCCP Healt
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Medical college Health Promotion &
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Why include Cancer In NPCDCS No u
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Objective e of TCC Scheme Develop
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Thank You For more details log on t
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Definition ‣ Group of brain dysfu
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Burden of Disease 7000000 6000000 5
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Risk Factors ‣ Age and Sex ‣ Hy
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Cerebrovascular Accident Risk Facto
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Cerebrovascular Accident Anatomy of
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Ischemic Cascade Cerebrovascular Ac
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‣ Trouble in walking Symptoms ‣
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Identification of an acute event S
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Diagnosis: CT without contrast Cer
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Cerebrovascular Accident Classifica
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CVA Recognition SIHFW: An ISO:9001:
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Cerebrovascular Accident Thrombotic
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Cerebrovascular Accident Common Sit
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Cerebrovascular Accident Embolic St
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Cerebrovascular Accident Goals for
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Cerebrovascular Accident Hemorrhage
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Cerebrovascular Accident Hemorrhagi
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Delayed Neurological deficit in Re
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Hemorrhagic-Subarachnoid Cerebral A
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Cerebrovascular Accident Clinical i
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Cerebrovascular Accident Clinical M
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Cerebrovascular Accident Treatment
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Cerebrovascular Accident Diagnostic
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CVA - Treatment Goals Surgical Tre
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Drug Therapy Cerebrovascular Accide
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Cerebrovascular Accident Rehabilita
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Cardio-Vascular Diseases SIHFW: An
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Source: WHO Burden of Disease Numb
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Cardiovascular Diseases group of di
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Newly emerging CVD risk factors ‣
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Resource Scenario-1 Scenario-2 Scen
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Prevention of CVD Heart disease and
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Hypertension “ high blood pressur
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Classification Primary / Essential
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Epidemiological Determinants Risk/
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Symptoms ‣ Headache ‣ Drowsines
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Criteria for diagnosing high blood
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Headache (severe hypertension) < mo
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Physical examination should include
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Desirable: (at CHC/sub-district/dis
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Life style advice is advocated for
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Treatment Goals The aim should be
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Diuretics Thiazide Inhibit Na + /C
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Beta blockers Act by decreasing ca
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α adrenergic blockers Lower BP by
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Medicines are tailored depending on
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‣ Start with calcium channel bloc
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Compelling Indications for Compelli
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Management of Hypertension at diffe
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Follow-up and Monitoring Patients
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Ischemic Heart Disease Myocardial i
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Burden of IH Disease 10000000 22367
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Symptoms ‣ Abrupt, unexpected car
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Treatment of IHD ‣ Medical treatm
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Management & Prevention: Modifying
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‣ Weakness in sternocleidomastoid
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Prevention ention ‣ Strokes are p
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‣ Physical therapy to improve str
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Rheumatic heart diseases ‣ Compli
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‣ Breathlessness ‣ Fatigue ‣
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Prevention ‣ Seek immediate medic
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Conceptualization ation of NPHCE U
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Objectives es Provide Preventive,
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Ageing Ageing is a progressive biol
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Ageing means….. Demographers: A
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Ageing Progressive and generalized
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Some Facts! World population of 6.
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Projections 60+ 24 million in 1961
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India: Some Facts! Life expectancy
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Household population p + 60 Age By
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Ageing: Common Myths Most elderly
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Integumentary System Production of
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Circulatory System Heart muscle be
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Nervous System Progressive loss of
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Urinary System Decreased circulati
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Reproductive e System Female: vagi
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Psychosocial Changes of Aging Lone
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Psychosocial changes can be a major
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Dementia Term used to describe a l
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Alzheimer’s Disease (continued)
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Meeting the Needs of the Elderly G
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Gender and Ageing g in India Discr
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Care - Services for Elderly l in In
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Primary Health Center Training of
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How to achieve it Ati Active advoc
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Mental Health : Problem, Strategies
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Health "Health is a state of compl
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Mental Health Problems in India 1%
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Extent of the problem… Mental He
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Mental Health Resources In India Ma
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Mental Health Resources In India…
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Mental Health Resources in India 2
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Objectives National Mental Health P
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Essentials of DMHP 1. A decentraliz
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Restrategised NMHP 2003 Components
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Integration of NMHP in NRHM Nation
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DMHP Evaluation Independent evalua
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NMHP Achievement Scheme Financial S
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Failures It is top down approach
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Urban Mental Health Meta analysis b
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NGO Work In INDIA SCARF (Schizophr
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Mental Health NGO Activities Treat
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Community Awareness Role of media
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Tobacco As per Global Adult tobacc
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Stepped Care Approach in Substance
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Future Direction Vision i 2020: Roa
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For more details log on to www. sih
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