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

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700 600 Age-standardized mortality rates per 100 000 population by sex, South- East Asia Region, 2008 800 736.36 561.08 NCD mortality rates are higher in males than females 500 400 300 200 100 357.56 278.79 Male Female 130.47 113.04 99.2 64.33 26.66 26.16 0 All NCDs CVDs Cancer Chronic Respiratory diseases Source: Global Health Observatory. World Health Organization 2011. Diabetes SIHFW: an ISO 9001:2008 certified Institution 18
Trends in estimated %of deaths 80% 70% 60% by cause of death, SEA Region, 2004 and 2030 51% 74% NCD deaths are projected to increase in the coming years 50% 40% 37% 2004 2030 30% 20% 14% 13% 12% 10% 0% CD* NCDs Injuries *Communicable diseases , maternal and perinatal conditions, nutritional deficiencies Source: Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine 2006, 3(11):e442. SIHFW: an ISO 9001:2008 certified Institution 19
Page 1 and 2: Non-Communicable Diseases: NPCDCS &
Page 3 and 4: Risk factors and NCDs largely preve
Page 5 and 6: Drivers of NCDs SIHFW: an ISO 9001:
Page 7 and 8: SIHFW: an ISO 9001:2008 certified I
Page 9 and 10: Epidemiological Transition Communi
Page 11 and 12: Challenges Many communicable disea
Page 13 and 14: SIHFW: an ISO 9001:2008 certified I
Page 15 and 16: Magnitude SEAR-2008: 14.5million t
Page 17: 50 45 40 35 30 25 Estimated %of pre
Page 21 and 22: Estimated and Projected Deaths due
Page 23 and 24: Pop.(2010): 1 224 614 327 Age stand
Page 25 and 26: Metabolic Risk factor Trends 126 Me
Page 27 and 28: 26 Mean BMI 24 22 Male 20 Female 18
Page 29 and 30: Reported Cases & Deaths due to NCD-
Page 31 and 32: Total Number of Diabetic Cases - Ra
Page 33 and 34: Reported Deaths :Type 1 DM- Distric
Page 35 and 36: District Reported Deaths of Type 2
Page 37 and 38: Reported Cases of Deaths Due to Can
Page 39 and 40: District -wise reported Cancer Deat
Page 41 and 42: SIHFW: An ISO:9001:2008 certified I
Page 43 and 44: Implications of ↑ burden of NCDs
Page 45 and 46: MDG-6 NCD burden threatenst the (Co
Page 47 and 48: 2% annual reduction in Chronic Dise
Page 49 and 50: Answer to the problem: ACT NOW Prev
Page 51 and 52: Risk factor/disease Tobacco use: Us
Page 53 and 54: Action at National Level: Two comp
Page 55 and 56: Strategies Prevention through beha
Page 57 and 58: Services Preventive, promotive , c
Page 59 and 60: Facility DH Services Early diagnosi
Page 61 and 62: Institutional Framework Integratio
Page 63 and 64: SIHFW: An ISO:9001:2008 certified I
Page 65 and 66: Screening MO to do: To conduct com
Page 67 and 68: 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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SIHFW: An ISO:9001:2008 certified I
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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
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The WHO STEP approach to Surveillan
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STEPS emphasizes that small amounts
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SIHFW: an ISO 9001: 2008 certified
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Step1:Questionnaire Based Assessmen
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Step 3: Biochemical Measurements D
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Core Items Expanded Items Optional
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Behavioral Risk Factors “Actions/
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Modifiable Risk Factor: 2008 estima
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B. Diabetes ‣ Obesity ‣ Sedenta
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D. Cancer ‣ Environment ‣ Life
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Risk factors and level of NCD preve
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Goals of implementing these guideli
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Follow up Once the condition of th
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High risk With established cardiov
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If cholestrol can not be measured S
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Prevention of CVD (according to ind
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NPCDCS Components Prevention throu
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Thank you SIHFW: An ISO:9001:2008 c
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Problem on the rise : NCDs MI HT CO
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Major diet related NCDs Diabetes Ca
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Type of cancers Risk factors Diet R
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Prominent risk factor Disease Heart
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Life Style Modification Primary Pr
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Burden of the Bulge In India 1 in
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Android : Upper-body obesity--apple
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Assessment of central obesity Wais
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Why is this happening Drivers of th
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Nutrition transitions: Absolute cau
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Body Mass Index (BMI ) Quetlet’s
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Classification BMI Classification W
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Sleep apnea and respiratory problem
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Weight management Weight gain Calor
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Weight loss goals Realistic Achie
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Lifestyle medicine: Need for change
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Dietary interventions Managing g /
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Life style modification & Diet Bala
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SIHFW: an ISO 9001: 2008 certified
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Total energy requirement Total ener
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Diet for NCD: Main focus ‣ Gradua
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Promoting Healthy lifestyle le Tra
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Strategies for Obesity Prevention e
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Tips for weight reduction Slow and
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‣ Avoid fried foods and bakery pr
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When to eat Set aside a time for
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Way to eat Eat slowly. Chew prop
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Recommendations in preventing diabe
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Calculating balanced diet Know Rec
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How to calculate balance diet Step
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Key recommendations -Diet • Frui
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Thank you SIHFW: an ISO 9001: 2008
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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
Page 491 and 492:
Future Direction Vision i 2020: Roa
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