
medho vaikalyam

medho vaikalyam (idi), united kingdamlo saadhaarana abhyasa vaikalyam anie kooda pilustaaru mariyu gatamlo manasika mandagimpu, idhi gananeeyamgaa balaheenamaina medho mariyu anukuula panitiirutoe vargeekarinchabadina oka saadhaaraneekarinchina naraala abhivruddhi rugmata. idhi rojuvaaree, saadhaarana jeevitaanni prabhaavitam chese rendu ledhaa anthakante ekkuva anukuula pravartanalalo lopalatho paatu, 70 ellalopu iqu dwara nirvachinchabadutundi. medho vidhulu dsm-vii kinda tarkam, samasya parishkaram, pranaalika, nairoopya aalochana, teerpu, vidyaaparamaina abhyasam mariyu bodhana mariyu anubhavam nundi neerchukoevadam, mariyu clinical assessment mariyu praamaanika pareekshalu rendinti dwara dhruveekarinchabadina aacharanaatmaka avagahanagaa nirvachinchabaddaayi. anukuula pravartana anedi prajalu vaari rojuvaaree jeevitamlo chese panulatho kuudina sambhaavita, saamaajika mariyu aacharanaatmaka naipunhyaala paramgaa nirvachinchabadutundi.
medho vaikalyam syndromic medho vaikalyam gaa upavibhajana cheyabadindi, dheenilo itara vaidya mariyu pravartanaa sankethaalu mariyu lakshanaalatoo anubandhinchabadina medho lopaalu untaayi, mariyu syndromic kaani medho vaikalyam, dheenilo medho lopaalu itara asaadhaaranatalu lekunda kanipistaayi. down syndrome mariyu pelusugaa unde ex syndrome syndromic medho vaikalyalaku udaaharanalu.
medho vaikalyam saadhaarana janabhalo 2 nundi 3 saatam mandini prabhaavitam chestundi. baadhitulaloo debbai aidu nundi tombhai saatam mandhi telikapati medho vaikalyam kaligi unnaaru. eee kesulalo 30 nundi 50 saatam varaku naan-syndromic ledhaa idiopathic kesulu untaayi. naaluginta oka vanthu kesulu janyu rugmata valla sambhavistaayi, mariyu daadaapu 5 saatam kesulu vaarasatvamgaa vastaayi. teliyani kaaranaala kesulu sumaru 95 millionla mandini prabhaavitam chestaayi.
sankethaalu mariyu lakshanaalu.
medho vaikalyam (idi) baalyamlo spashtamgaa kanipistundi mariyu adhe vayassu gala sahacharulatho polchinappudu manasika saamarthyaalu, saamaajika naipunyaalu mariyu rojuvaaree jeevitamlooni pradhana karyakalapalalo (adls) lopaalu untaayi. janyu rugmatato sambandham unnappudu (udhaa.zii., down syndrome).
balaheenata sthaayi prati vyaktiki teevratalo untundi. konni prarambha sankethaalu ilaa undavachuhu
baalyamlo, pillalu paatasaala praarambhinchae varaku telikapati gurtimpu (iqu <id1>) spashtamgaa ledhaa gurtinchabadakapovachhu. paelavamaina vidya paniteeru gurtinchabadinappatiki, telikapati medho vaikalyanni nirdishta abhyasa vaikalyam ledhaa bhavodvega/pravartanaa rugmatala nundi vaeru cheyadaaniki nipunula anchanaa avasaram kaavacchu. telikapati gurtimpu unna vyaktulu tommidi nundi pannendu samvatsaraala vayassu gala saadhaarana pillala sthaayiki chadavadam mariyu ganita naipunhyaalanu neerchukoogalugutaaru. vaaru vanta cheyadam ledhaa sthaanika saamuuhika ravana vyavasthanu upayoginchadam vanti sweeya-samrakshana mariyu aacharanaatmaka naipunhyaalanu neerchukoevacchu. medho vaikalyalunna vyaktulu yuktavayassuku cherukune koddi, chaalaa mandhi swatantramgaa jeevinchadam mariyu laabhadaayakamaina upaadhini konasaginchadam neerchukuntaaru. gurtimpu unnavaarilo daadaapu 85 saatam mandiki telikapati gurtimpu unde avakaasam undhi.
mitamaina gurtimpu (iqu <id1>) jeevitam yokka modati samvatsaraalalo daadaapu ellappuduu spashtamgaa kanipistundi. prasangam alasyam mukhyamgaa mitamaina gurtimpu yokka saadhaarana sankethaalu. mitamaina medho vaikalyalunna vyaktulu puurtigaa paalgonadaaniki paatasaalalo, intlo mariyu samaajamlo gananeeyamaina maddatu avasaram. vaari vidya saamarthyam parimitam ayinappatikee, vaaru saadhaarana aarogya mariyu bhadrata naipunhyaalanu neerchukoevacchu mariyu saadhaarana karyakalapalalo paalgonavacchu. peddalugaa, vaaru tama thallidandrulatho kalisi, sahayaka samuuha gruhamlo ledhaa paakshikamgaa swatantramgaa kooda vaariki sahaayapadataaniki mukhyamaina sahayaka sevalatho nivasinchavacchu, udaaharanaku, vaari aardhika nirvahana. peddalugaa, vaaru aasrayam pondina varkshaaplo pani cheyavachu. gurtimpu unnavaarilo daadaapu 10 saatam mandiki mitamaina gurtimpu unde avakaasam undhi.
teevramaina gurtimpu (ii. keey. <ii. dii. 1>) unna vyaktulu, gurtimpu unna vyaktulalo 3.5 saatam mandhi, ledhaa deep idi (ii. keey. 19 ledhaa anthakante takkuva) unna vyaktulu, gurtimpu unna vyaktulalo 1.5 saatam mandhi, vaari jeevitaantam marinta teevramaina maddatu mariyu paryaveekshanha avasaram. vaaru konni vishayalanu neerchukoevacchu, conny yuktavayassu antataa samrakshakudi nundi nirantaram gananeeyamaina sahayam lekunda vyaktulu tamanu taamu swatantramgaa chusukolekapoyinappudu medho vaikalyam teevramainadi ledhaa lotainadigaa pariganinchabadutundi. lothaina gurtimpu unna vyaktulu anni adla kosam mariyu vaari saareeraka aarogyam mariyu bhadratanu kaapaadukoovadaaniki puurtigaa itarulapai aadharapadi untaaru. vaaru eee karyakalapalalo konnintiloo parimita sthaayilo palgonadam neerchukoevacchu.
saha-anaaroogyam.
autism mariyu medho vaikalyam.
medho vaikalyam mariyu autism spectrum desorder (asd) clinical lakshanaalanu panchukuntaayi, ivi rooga nirdhaarana chesetappudu gandaragolaniki daariteestaayi. eee rendu rugmatalanu ativyaapti cheyadam, saadhaaranamainappatikii, oka vyakti sreyassuku hanikaram. gurtimpu lakshanaalanu kaligi unna ASD unnavaarini saha-roganirdhaaranagaa vargeekarinchavachhu, dheenilo vaaru laeni rugmataku chikitsa pondutunnaru. adevidhamgaa, asd anie porapatuga bhaavinchina gurtimpu unnavaariki vaaru kaligi laeni rugmata lakshanaala kosam chikitsa cheyavachu. eee rendu rugmatala madhya thedaanu gurtinchadam valla vaidyulu tagina chikitsalanu andinchadaaniki ledhaa suuchimchadaaniki veelu kalpistundi. idi mariyu asd madhya sahavyadhi chaalaa saadhaaranam; idi unnavaarilo sumaru 40 saatam mandiki kooda asd undani anchanaa veyabadindi, mariyu asd unnavaarilo daadaapu 70 saatam mandiki kooda idi undani anchanaa veyabadindi. iteevala, parisoedhanalu asd unna vyaktulalo idi kosam sumaru 30 saatam prabalyanni suuchimchaayi. ASD mariyu ID rendintikee nirvachinche pramanaluga communication mariyu saamaajika avagaahanalo lopaalu avasaram.
thedaalanu nirvachinchandi.
2016loe nirvahinchina oka adhyayanamlo 2816 kesulanu survey chestu, idi mariyu asd unnavaari madhya thedaanu gurtinchadamlo sahayapade agra upasamitulu, "balaheenamaina asaabdika saamaajika pravartana mariyu saamaajika paraspara sambandham lekapovadam, [...]..] parimita aasaktulu, nityakrutyaalaku kathinamaina kattubadi undatam, moosaposina mariyu punaraavrutamayye motaru paddhatulu mariyu vastuvula bhaagaalato nimagnamai undatam. asd unnavaaru shareera bhasha mariyu saamaajika suuchanalanu ardham chesukovadam vanti asaabdika saamaajika pravartanalo ekkuva lopaalanu chuuputaaru. 2008loe vividha sthaayila gurtimpu unna 336 mandhi vyaktulapai chesina adhyayanamlo, gurtimpu unnavaaru punaraavruta ledhaa aachara pravartanala takkuva sandarbhaalanu pradarsistaarani kanugonabadindi. gurtimpu unna vaaritho poliste, asd unnavaaru tamanu taamu veruchesukuni, kanti sparsanu takkuvagaa chese avakaasam undani kooda idhi gurtinchindi. vargeekarana idi vishayaniki vasthe mariyu asd chaalaa bhinnamaina maargadarsakaalanu kaligi untaayi. idi maddatu teevrata scale (sis) anie piluvabade praamaanika anchanaanu kaligi undhi; idhi oka vyaktiki entha maddatu avasaramo daani chuttoo nirminchina vyavasthapai teevratanu kolustundi. avasaramaina maddatu dwara kooda ASD teevratanu vargeekaristundi, praamaanika anchanaa ledhu; vaidyulu tama sonta nirnayamtho teevratanu nirdhaarinchadaaniki swechchagaa untaaru.
kaaranaalu.
pillalalo, moodinta oka vanthu nundi sagam kesulaku medho vaikalyaaniki kaaranam teliyadu. daadaapu 5 saatam kesulu vaarasatvamgaa vachinave. medho vaikalyaaniki kaaranamayye, conny vaarasatvamgaa laeni janyu lopaalu, janyu abhivruddhilo pramaadaalu ledhaa utparivartanaala valla sambhavinchavachhu. ituvanti pramaadaalaku udaaharanalu adanapu chromosome 18 (trisomy 18) mariyu down syndrome abhivruddhi, idhi atyanta saadhaarana janyu kaaranam. desorge syndrome mariyu pindam alkahal spectrum rugmatalu rendu tadupari atyanta saadhaarana kaaranaalu. ayithe, aneka itara kaaranaalu unnaayi. atyanta saadhaaranamainavih
rooga nirdhaarana.
american association aann intellectual und developmental disabilities mariyu american psychiatric association yokka "diagnostic und statistical manueval off mental desorders" (dsm-aivi) rendinti prakaram, medho vaikalyam nirdhaaranaku moodu pramaanaalanu tappanisarigaa patinchali saadhaarana manasika samarthyalalo gananeeyamaina parimiti (medho paniteeru), bahula vaataavaranaalaloo anukuula pravartana yokka okati ledhaa anthakante ekkuva rangaalalo gananeeyamaina parimitulu (anukuula pravartana rating scale dwara kolustaaru, antey.ii. communication, sweeya-sahaya naipunyaalu, vyaktula madhya naipunyaalu mariyu marinni), mariyu baalyamlo ledhaa koumaaradasalo parimitulu spashtamgaa kanipinchaayi. saadhaaranamgaa, medho vaikalyalunna vyaktulu 70 kante takkuva iqu kaligi untaaru, conny kontha ekkuva iqu unna vyaktulaku clinical abheeshtaanusaaram avasaram kaavacchu, conny anukuula paniteerulo teevramaina balaheenata kaligi untaaru.
idhi iqu mariyu anukuula pravartana yokka anchanaa dwara adhikarikamga nirdhaarinchabadutundi. abhivruddhi kaalamlo praarambhinchaalsina moodava paristhiti medho vaikalyanni baadhaakaramaina medadu gayalu mariyu chittavaikalyam (algimers vyaadhitho sahaa) vanti itara paristhitula nundi vaeru cheyadaaniki upayoginchabadutundi.
telivitaetala bhaagam.
modati aangla bhasha iqu pareeksha, stanford-binnet intelligence scales, fraanslooni alfred binnet paatasaala placement kosam roopondinchina test battery nundi sweekarinchabadindi. levis terman binnet pareekshanu sweekarinchi, daanini "saadhaarana medhassu" koliche pareekshagaa pracharam chesaadu. terman pareeksha anedi "medhassu bhaagaswaamya" roopamlo skorlanu nivedinchadaaniki vistrutamgaa upayoginchina modati manasika pareeksha ("manasika vayassu" kalakramanusaram vayassu dwara vibhajinchabadindi, 100 thoo guninchabadutundi). prastuta pareekshalu "vichalanam iqu" roopamlo score cheyabadataayi, pareeksha teesukunevaari paniteeru sthaayini pareeksha teesukunevaari vayassu samuuhaaniki madhyastha skoru kante rendu praamaanika vichalanaalatho iqu 70 gaa nirvachistaaru. roganirdhaarana pramaanaala iteevali savarana varaku, 70 ledhaa anthakante takkuva iqu anedi medho vaikalyam nirdhaaranaku praathamika karakamga undedi, mariyu iqu skorlu medho vaikalyam yokka sthaayilanu vargeekarinchadaaniki upayoginchabaddaayi.
medho vaikalyam yokka prastuta rooga nirdhaarana kevalam iqu skorlapai aadharapadi undadu, conny oka vyakti yokka anukuula paniteerunu kooda parigananaloki teesukoovaali kabatti, rooga nirdhaarana kathinamgaa cheyabadadu. idhi medho skorlu, vyaktiki telisina evarainaa andinchina telisina saamardhyaala vivaranala aadhaaramgaa anukuula pravartana rating scale nundi anukuula paniteeru skorlu mariyu assessment examiner yokka pariseelanalu, vaaru ardham chesukogala, communicate cheyagala mariyu alanti vaatini vyakti nundi neerugaa kanugonagalaru. iqu assessment prastuta pareeksha aadhaaramgaa undaali. idhi flinn prabhavam yokka aapadanu nivaarinchadaaniki roganirdhaarananu anumatistundi, idhi kalakramena janabha iqu pareeksha paniteerulo maarpula phalitamgaa iqu pareeksha nibandhanalanu maarustundi.
itara vaikalyala nundi vyatyaasam.
vaidyaparamgaa, medho vaikalyam anedi medho saamardhyaalanu prabhaavitam chese abhignaa lotu ledhaa vaikalyala yokka upa rakam, idhi oka vistruta bhavana mariyu medho vaikalyam anie sarigga arhata pondadaaniki chaalaa telikapati ledhaa chaalaa nirdishtamaina (nirdishta abhyasa vaikalyam vale) medho lopaalu kaligi untundi, ledhaa pondina medadu gayalu ledhaa chittavaikalyam vanti neuro degenerative vyaadhula dwara jeevitamlo taruvaata pondabadutundi. abhignaa lopaalu yea vayasuloonainaa kanipinchavacchu. abhivruddhi vaikalyam anedi perugudala mariyu abhivruddhitho samasyala kaaranamgaa vachhe edainaa vaikalyam. eee padam manasika ledhaa medhoparamaina bhagalu laeni aneka puttukatho vachhe vaidya paristhitulanu kaligi untundi, ayinappatikee idhi kooda konnisaarlu medho vaikalyaaniki sabhyoktigaa upayoginchabadutundi.
okati kante ekkuva rangaalalo parimitulu.
anukuula pravartana ledhaa anukuula paniteeru anedi swatantramgaa jeevinchadaaniki avasaramaina naipunhyaalanu suuchistumdi (ledhaa vayassu prakaram kaneesa aamodayogyamaina sthaayilo). anukuula pravartananu anchanaa vaeyadaaniki, nipunulu pillala kriyaatmaka saamardhyaalanu adhe vayassu gala itara pillala saamardhyaalato poolchutaaru. anukuula pravartananu kolavadaniki, nipunulu nirmaanaatmaka interviewlanu upayogistaaru, dheenitho vaaru samaajamlo vyaktula paniteeru gurinchi samacharanni baga telisina vyaktula nundi kramapaddhatilo pondutaaru. aneka anukuula pravartana pramaanaalu unnaayi, mariyu okari anukuula pravartana yokka naanhyatanu khachitamaina anchanaa vaeyadaaniki clinical teerpu kooda avasaram. anukuula pravartanaku konni naipunyaalu mukhyamainavi, avih
itara nirdishta naipunyaalu oka vyaktini samaajamlo chaerchadaaniki mariyu tagina saamaajika pravartanalanu abhivruddhi cheyadaaniki keelakam kaavacchu, udaaharanaku pradhana jeevitakaala dasalato mudipadi unna vividha saamaajika anchanaala gurinchi telusukovadam (antey.ii., balyam, yuktavayassu, vruddhaapyam). vividha jeevitakaala dasalanu gurtinchadamlo gurtimpu unna peddala paniteeru nirdishta abhignaa saamardhyaalaku mariyu eee paniteerunu pareekshinchadaaniki upayoginche padaartham rakaniki sambandhinchinadani swiss adhyayanam phalitaalu suuchistunnaayi.
nirvahana.
chaalaa nirvachanaala prakaram, medho vaikalyam anedi "vyaadhi" kante "vaikalyam" gaa marinta khachitamgaa pariganinchabadutundi. medho vaikalyanni schizophrenia ledhaa depression vanti manasika anaaroogyam nundi aneka vidhaluga vaeru cheyavachu. prastutam, sthirapadina vaikalyaaniki "nivaarana" ledhu, ayithe tagina maddatu mariyu bodhanatho, chaalaa mandhi vyaktulu aneka panulu cheyadam neerchukoevacchu. puttukatho vachhe hypothyroidism vanti kaaranaalu, mundugaane gurtinchinatlayite, medho vaikalyam abhivruddhi chendakunda nirodhinchadaaniki chikitsa cheyavachu.
abhivruddhi vaikalyalunna vyaktulaku sahayam andinche vaelaadi agencylu prapanchavyaaptamgaa unnaayi. vaatilo prabhutva, labhapeksha, laabhaapekshaleni, praivaetu samsthalu unnaayi. oka agencylo puurtigaa sibbandi kaligina nivaasa gruhalu, sumaruga paatasaalalanu anchanaa vese roeju punaravasa karyakramalu, vikalaangulu udyogaalu pondagala varkshaaplu, samaajamlo udyogaalu pondadamlo abhivruddhi vaikalyalunna vyaktulaku sahayapade karyakramalu, vaari sonta apaartmentlu unna abhivruddhi vaikalyalunna vyaktulaku maddatu ichhe karyakramalu, vaari pillalanu penchadamlo vaariki sahayapade karyakramalu mariyu marenno vibhagalu undavacchu. abhivruddhi vaikalyalunna pillala tallidandrula kosam aneka agencylu mariyu karyakramalu kooda unnaayi.
antaku minchi, abhivruddhi vaikalyalunna vyaktulu praathamika jeevita naipunhyaalanu neerchukunee nirdishta karyakramalu unnaayi. eee "lakshyalu" saadhinchadaaniki chaalaa ekkuva samayam pattavacchu, conny antima lakshyam swaatantryam. idhi dantaalanu brush cheyadamlo swaatantryam nundi swatantra nivaasam varaku edainaa kaavacchu. abhivruddhi vaikalyalunna vyaktulu tama jeevitaantam neerchukuntaaru mariyu vaari kutumbaalu, samrakshakulu, vaidyulu mariyu eee vyaktulandari prayatnaalanu samanvayam chese vyaktula sahayamtho jeevitamlo chivari varaku kooda aneka kotta naipunhyaalanu pondavacchu.
samrakshakulu, samaja sabhyulu, vaidyulu mariyu vaastavaaniki, medho vaikalyam unna vyakti (la) nundi churukaina bhagaswamyanni anumatinche naalugu vistruta rangaalu unnaayi. veetilo manasika-saamaajika chikitsalu, pravartanaa chikitsalu, abhignaa-pravartanaa chikitsalu mariyu kutumba-aadhaarita vyuuhaalu unnaayi. manasika saamaajika chikitsalu pradhanamgaa preschool samvatsaraalaku mundu mariyu samayamlo pillala kosam uddesinchabaddaayi, endukante idhi jokyaniki saraina samayam. eee prarambha jokyamlo anveshananu prothsahinchadam, praathamika naipunhyaalalo maargadarsakatvam, abhivruddhi purogatini jarupukovadam, maarganirdesam chesina rehearsal mariyu kottagaa sampaadinchina naipunhyaala vistarana, asammati, teasing ledhaa siksha vanti haanikaramaina pradarsanala nundi rakshana mariyu goppa mariyu pratispandinche bhasha vaataavaranaaniki gurikavadam vantivi undaali. vijayavantamaina jokyaniki goppa udaaharana carolina abasidarian project, idhi baalyamlo praarambhamai, prii-school samvatsaraala varaku takkuva saamaajika aardhika sthithi gala kutumbaalaku chendina 100 mandiki paiga pillalatho nirvahinchabadindi. 2 samvatsaraala vayassu natiki, pillalu icchina jokyam niyantrana samuuha pillala kante ekkuva pareeksha skorlanu kaligi unnaarani, mariyu karyakramam mugisina 10 samvatsaraala taruvaata vaaru sumaru 5 paayintlu ekkuvagaa unnaarani phalitaalu suuchimchaayi. chinna vayasula natiki, jokya samuuhaaniki chendina pillalu vaari niyantrana-samuuha sahacharula kante merugaina vidya sadhana, upaadhi avakaasaalu mariyu takkuva pravartanaa samasyalanu kaligi unnaaru.
pravartanaa chikitsala yokka pradhana bhagalalo bhasha mariyu saamaajika naipunhyaala samuparjana unnaayi. saadhaaranamgaa, okariki okaru sikshana ivvabadutundi, dheenilo oka chikitsakudu saanukuula upabalaalato kalipi aakaram ichhe vidhananni upayogistaadu, idhi pillalu padaalu poortayye varaku aksharaalanu uchcharinchadamlo sahaayapadutundi. konnisaarlu chitraalu mariyu drushya sahayalanu kaligi, chikitsakulu prasanga saamarthyaanni meruguparachadam lakshyamgaa pettukuntaaru, tadwara mukhyamaina rojuvaaree panula gurinchi chinna vakyalu (udhaa.zii. bathroom vadakam, tinadam modalainavi.) pillavadu samarthavantamgaa communicate cheyavachu. idhe paddhatiloo, pedda pillalu panchukovadam, malupulu teesukovadam, bodhananu anusarinchadam mariyu navvadam vanti vaari saamaajika naipunhyaalanu padunu pettadam neerchukoevadam valla eee rakamaina sikshana nundi prayojanam pondutaaru. adhe samayamlo, saamaajika cherika anie piluvabade oka udyamam medho vaikalyam unna pillalu mariyu vaari vikalaangulu kaani thoti pillala madhya viluvaina paraspara charyalanu penchadaaniki prayatnistundi. abhignaa-pravartanaa chikitsalu, munupati rendu chikitsa rakaala kalayika, pillalaku ganitam, bhasha mariyu ghnaapakasakti mariyu abhyaasaaniki sambandhinchina itara praathamika naipunhyaalanu bodhinche vyuuhaatmaka-metastratogical learning tekniknu kaligi untundi. abhignaa sambandhaalu mariyu pranaalikalu cheyadam dwara vyuuhaatmaka alochanaparuduga undataaniki pillalaku neerpinchadam sikshana yokka modati lakshyam. appudu, vividha panula madhya vivaksha chuupadam neerpinchadam dwara mariyu prati paniki yea pranaalika ledhaa vyuuham saripotundo nirnayinchadam dwara vaidyudu pillalaku metastrategicalga undataaniki neerpistaadu. chivaraga, kutumba-aadhaarita vyuuhaalu vaari pillalu ledhaa medho vaikalyam unna pillalanu maddatu ivvadaaniki mariyu prothsahinchadaaniki avasaramaina naipunhyamtho kutumbaanni saktivantam cheyadamlo chorava chuuputaayi. saadhaaranamgaa, indulo drudhatva naipunyaalu ledhaa pravartana nirvahana paddhatulanu bodhinchadam, alaage poruguvaaru, vistarinchina kutumbam ledhaa day-cair sibbandi nundi sahayam elaa adagali. pillala vayassu perige koddi, tallidandrulu gruha/nivaasa samrakshana, upaadhi mariyu sambandhaalu vanti amsaalanu elaa sampradinchaalo neerputaaru. prati jokyam ledhaa saanketikataku antima lakshyam pillalaku svayampratipattini mariyu vaaru sampaadinchina naipunhyaalanu upayoginchi swaatantryam yokka bhavanni ivvadam. medho vaikalyam unna pillalu mariyu koumaaradasalo unnavaariki pathana jokyalu praarambhinchadam, dhwani avagaahanalo chinna nundi mitamaina merugudalalu, padha patanam, decoding, vyakteekarana mariyu grahana bhasha naipunyaalu mariyu pathana praaveenyata eee amsaalu bodhanaa jokyamlo bhagamainappudu 2019 cochrane sameekshalo gurtinchabaddaayi.
medho vaikalyaaniki nirdishta mandulu laenappatikee, abhivruddhi vaikalyalunna chaalaa mandiki marinta vaidya samasyalu untaayi mariyu aneka mandulu suuchimchabadavachchu. udaaharanaku, abhivruddhi alasyam unna autistic pillalaku vaari pravartanaku sahaayapadataaniki anticycotics ledhaa mood stabilizers suuchimchabadavachchu. medho vaikalyam unnavaarilo benzodiazipines vanti cycotropic aushadhaala vaadakaaniki paryaveekshanha mariyu apramattata avasaram, endukante dushprabhaavaalu saadhaaranamgaa sambhavistaayi mariyu tarachugaa pravartanaa mariyu manasika samasyaluga tappugaa nirdhaarinchabadataayi.
epidemiology.
medho vaikalyam saadhaarana janabhalo daadaapu 2-3% nuu prabhaavitam chestundi. prabhaavita vyaktulalo 75-90% telikapati medho vaikalyam kaligi untaaru. syndromic kaani ledhaa idiopathic idi khaataalu 30-50% kesulaku sambandhinchinavi. naaluginta oka vanthu kesulu janyu rugmata valla sambhavistaayi. teliyani kaaranaala kesulu sumaru 95 millionla mandini prabhaavitam chestaayi. idhi purushulalo mariyu takkuva nundi madhya aadaaya deshaalalo ekkuvagaa kanipistundi.
charitra.
medho vaikalyam charitra antataa vividha paerlatoe namodu cheyabadindi. maanava charitralo chaalaa varaku, samajam yea rakamaina vaikalyam unnavaari patla ayina nirdayagaa undedi, medho vaikalyam unnavaarini saadhaaranamgaa vaari kutumbaalapai bhaaramgaa bhaavinchevaaru.
taarkika saamardhyaalanu viluvainadigaa bhaavinche greeku, roman tatvavettalu, medho vaikalyam unnavaarini kevalam manavuluga avamaaninchaaru. medho vaikalyam gurinchi puraatana saareeraka drukpatham cree puu aidava sataabdam chivaralo hippocrates rachanalalo undhi, vaaru medadulooni naalugu hasyalalo asamatulyata valla idhi sambhavinchindani vishwasinchaaru. puraatana romlo medho vaikalyalunna prajalaku parimita hakkulu undevi mariyu saadhaaranamgaa vaarini takkuvagaa chusevadu. vaaru aastulugaa pariganinchabaddaaru mariyu vaari tandri banisaluga unchavacchu. eee vyaktulu vivaham chesukolekapoyaru, padavini nirvahinchalekapoyaru ledhaa pillalanu penchukolekapoyaru. vaarilo chaalaa mandhi baalyamlone champabaddaru, taruvaata vaaru samajampai bhaaram padakunda undataaniki tiberlo padesaru. ayithe, roman chattam prakaram vaaru chesina neeraala nundi minahayinchabaddaru, mariyu vaaru chinna shrama cheyadaaniki kooda upayoginchabaddaaru.
khaleef all-valid (r. 705-715) medho vaikalyalunna vyaktula kosam modati samrakshana gruhaalalo okadaanni nirminchindi mariyu daani sevallo bhaagamgaa medho vikalaangulaku vasati kalpinche modati aasupatrini nirminchindi. adanamgaa, all-valid prati medho vikalangudiki samrakshakudini niyaminchaadu.
airopalo ghnaanoodayam vachhe varaku, aaharam, aasrayam mariyu dustulu vanti praathamika saareeraka avasaralanu teerchadampai drushti saarinchi, kutumbaalu mariyu charchi (mathaalu mariyu itara mataparamaina samajalalo) samrakshana mariyu aasrayam kalpinchevaaru. aaa kaalamlooni saamaajika vaikharilo pratikuula moosaposalu pramukhamgaa undevi.
13va sataabdamloo, medho vaikalyalunna vyaktulu nirnayaalu teesukolekapoyarani ledhaa vaari vyavaharalanu nirvahinchalerani ingland prakatinchindi. vaari aardhika vyavaharalanu chepattadaaniki samrakshakulu srushtinchabaddaaru.
17va sataabdamloo, thamus vilis medho vaikalyam gurinchi oka vyadhiga modati vivarananu andinchaaru. medadulooni nirmaanaatmaka samasyala valla idhi sambhavinchindani ayana viswasinchaadu. villis prakaram, shareera nirmaana samasyalu puttukatho vacchina paristhiti kaavacchu ledhaa taruvaata jeevitamlo pondavacchu.
18va mariyu 19va sataabdaalaloo, gruhanirmaanam mariyu samrakshana kutumbaala nundi dhooramgaa, aasrayam namuunaa vaipu maarindi. prajalanu vaari kutumbaala dwara (saadhaaranamgaa baalyamlo) unchaaru ledhaa vaari nundi tolaginchaaru mariyu pedda vruttiparamaina samsthalalo unchaaru, veetilo chaalaa varaku nivaasitula shrama dwara swayam samruddhiga undevi. eee samsthalalo konni chaalaa praathamika sthaayi vidyanu andinchaayi (rangulu mariyu praathamika padha gurtimpu mariyu sankhyaasaastram madhya vyatyaasam vantivi), conny chaalaa varaku aaharam, dustulu mariyu aasrayam vanti praathamika avasaralanu teerchadampai matrame drushti pettadam konasaginchayi. atuvanti samsthalalo paristhitulu vistrutamgaa maarutuu undevi, conny andinchina maddatu saadhaaranamgaa vyaktigatam kaanidi, asaadhaarana pravartana mariyu takkuva sthaayi aardhika utpaadakata samaajaaniki bhaaramgaa pariganinchabadutundi. adhika sampada kaligina vyaktulu tarachugaa gruha samrakshana ledhaa private aasrayaala vanti adhika sthaayi samrakshananu pondagaligevaaru. bhaarii prasaantata mariyu assembly-line maddatu paddhatulu pramaanamgaa undevi, mariyu vaikalyam yokka vaidya namuunaa prabalamgaa undedi. sevalu providerku saapeksha soulabhyam aadhaaramgaa andinchabaddaayi, vyakti yokka avasaraalapai aadharapadi kaadu. 1891loe dakshinaafrikaalooni cape townloo nirvahinchina oka survey vividha soukaryaala madhya pampineeni choopistundi. survey chesina 2046 mandhi vyaktulalo 1,281 mandhi private nivasalalo, 120 mandhi jaillalo mariyu 645 mandhi aasrayaalalo unnaaru, survey chesina vaarilo daadaapu moodinta rendu vantula mandhi purushulu unnaaru. vasati korata paristhitulalo, tellajati purushulu mariyu nallajati purushulaku praadhaanyata ivvabadindi (vaari picchitanam upaadhi sambandhaalaku antaraayam kaliginchadam dwara tellajati samajanni bedirinchindi mariyu tellajati mahilalatho nishiddha laingika sambandhaanni debbateesindi).
19va sataabdam chivaralo, charless darwin yokka "jaatula moolampai" pratispandanagaa, frances galton medho vaikalyanni tagginchadaaniki maanavula empika chesina pempakaanni pratipaadinchaaru. 20va sataabdam praarambhamlo, sujanana udyamam prapanchavyaaptamgaa prachuryam pondindi. idhi chaalaa abhivruddhi chendina deshaalalo balavantamgaa sterilization mariyu vivaha nishedhaaniki daariteesindi, taruvaata holocast samayamlo medho vaikalyam unna vyaktula saamuuhika hatyaku adolph hitler dheenini hetubaddhamgaa upayoginchaadu. sujanana shaastram taruvaata maanava hakkula ullanghanagaa vadiliveyabadindi, mariyu 20va sataabdam madhya natiki chaalaa abhivruddhi chendina deshaalu balavantamgaa sterilization mariyu vivaha nishedham yokka abhyasanni nilipivesaayi.
1905loe, alfred binnet pillalalo medhassunu kolavadaniki modati praamaanika pareekshanu roopondinchaadu.
praacheena roman chattam medho vaikalyam unna vyaktulu oka vyakti neram cheyadaaniki avasaramaina haani cheyalane uddesamto asamarthulani prakatinchinappatikii, 1920laloe, paaschaatya samajam vaaru naitikamgaa ksheeninchaarani nammadu.
prastuta vaikharini vismarinchi, 1952loe pourasatvavettalu abhivruddhi vaikalyalunna vyaktula sevanu pradhana samsthaagata pradhaanyatagaa sweekarinchaaru. vaari prarambha prayatnaalalo pratyeka vidya upaadhyaayula kosam varkshaaplu mariyu vikalanga pillala kosam day camplu unnaayi, ivanni atuvanti sikshana mariyu karyakramalu dadapuga lenappudu. abhivruddhi vaikalyalunna vyaktula vibajananu 1969loe wolf wolfensberger yokka "mana samsthaagata namuunaala muulam mariyu swabhaavam" anae praathamika rachana prachurana varaku vidyaavaettalu ledhaa vidhana nirnetalu vistrutamgaa prasninchaledu, idhi S. zii. 100 samvatsaraala kritam elaa. eee pustakam vikalaangulanu samajam vichakshana, upa-maanava mariyu daatrutva bharaluga vargeekaristundani, phalitamgaa aaa "vichakshana" paatranu sweekarinchindani perkondi. eee amaanaveekarana, daani phalitamgaa erpadina verucheyabadina samsthalu, prajalandaruu samaajaaniki cheyagala sambhaavya utpaadaka sahakaranni vismarinchaayani wolfensberger vaadinchaaru. medho vaikalyam unnavaari maanava avasaralanu gurtinchi, migilina janaabhaaku samaanamaina praathamika maanava hakkulanu andinche vidhanam mariyu aacharanalo maarpuku ayana munduku vacchaaru.
eee rakamaina vaikalyalaku sambandhinchi vaikalyam yokka saamaajika namuunaanu vistrutamgaa sweekarinche disagaa eee pustakam prachurana modati charyaga pariganhinchabadavacchu mariyu vargeekarana kosam prabhutva vyuuhaala abhivruddhiki preranagaa pariganinchabadutundi. prabhutvaalapai vijayavantamaina vyajyalu mariyu maanava hakkulu mariyu sweeya-nyaayavaadampai avagahana penchadam kooda eee prakriyaku dohadapaddayi, phalitamgaa yuu. ess loe aamodam pondindi.ess. 1980loe samsthaagata vyaktula poura hakkula chattam.
1960la nundi ippati varaku chaalaa rashtraalu verucheyabadina samsthalanu nirmoolinche disagaa payaninchaayi. saadhaaraneekarana mariyu samsthaagatheekarana prabalamgaa unnaayi. wolfensberger mariyu gunnar mariyu rosemary dibwadto sahaa itarula panitho paatu, rashtra samsthalalo bhayankaramaina paristhitula chuttoo aneka apakeerti velladi praja agrahanni srushtinchindi, idhi sevalanu andinche marinta samaja aadhaarita paddhatiki maaradaaniki daariteesindi.
1970la madhya natiki, chaalaa prabhutvaalu samsthaagatheekaranaku kattubadi unnaayi mariyu saadhaaraneekarana suutraalaku anugunamgaa saadhaarana samaajamloki prajala toku kadalikaku sannahalu cheyadam praarambhinchaayi. chaalaa deshaalalo, idhi 1990la chivari natiki puurtayimdi, ayithe masachusetsto sahaa konni rashtraallo samsthalanu musiveyala vadda anae charcha konasagutondi.
gatamlo, led poisoning mariyu antu vyaadhulu medho vaikalyaaniki mukhyamaina kaaranaalu. teaca vanti vaidya purogati peragadamtho medho vaikalyaaniki konni kaaranaalu taggutunnaayi. itara kaaranaalu kesula nishpattilo perugutunnaayi, bahusha perugutunna talli vayassu kaaranamgaa, idhi aneka rakaala medho vaikalyaalato mudipadi untundi.
paribhaashalo maarpulatoe paatu, paatha padaala aamodayogyatalo diguvaku taggadamtho, anni rakaala samsthalu padepade tama paerlanu marchukovalasi vachindi. idhi paatasaalalu, aasupatrulu, sanghaalu, prabhutva vibhagalu mariyu vidya patrikala paerlanu prabhaavitam chestundi. udaaharanaku, midlands institute off mental sub-normality british institute off mental handicapga maarindi mariyu ippudu british institute off learning disabilityga maarindi. eee drugvishayam manasika aarogyam mariyu chalana vaikalyaalato panchukoobadutundi, mariyu indriya vaikalyalalo takkuva sthaayilo kanipistundi.
paribhasha.
gatha rendu dasabdaluga, chaalaa aanglam matlade deshaalalo chaalaa mandhi nyaayavaadulu mariyu parisoedhakulu "medho vaikalyam" anae padaanni ishtapadutunnaru. 101 mandhi kenadian aarogya samrakshana nipunulapai 2012loe nirvahinchina sarvelo, 78 saatam mandhi "medho vaikalyam" (8 saatam) paie thallidandrulatho "abhivruddhi alasyam" anae padaanni upayogistaamani chepparu. abhivruddhi vikalaangulu", "pratyeka", "pratyeka avasaralu" ledhaa "savaalu cheyabadina" vanti vyakteekaranalu konnisaarlu upayoginchabadataayi, conny "prajalu tama vaikalyaalato nijaayiteegaa vyavaharinchaleru anae aalochananu balopetam chesinanduku" vimarsinchabaddaayi.
pillala sahaja abhivruddhi yokka alasyam ledhaa "mandaginchadam" phalitamgaa ituvanti paristhitulu talettayane avagahana nundi udbhavinchina "mental retardation" anae padam, american psychiatric association yokka dsm-aivi (1994) mariyu prapancha aarogya samstha yokka icd-10 (kodlu eff 70-eff79) loe upayoginchabadindi. tadupari punarvimarsalo, icd-11, daani sthaanamlo "medho abhivruddhi rugmatalu" anae padam (sankethaalu 6a 00-6 a04; "paerkonabadani" roganirdhaarana sanketaaniki 6a00.z) vachindi. medho vaikalyam (medho abhivruddhi rugmata)" anae padaanni dsm-5 (2013) loe upayogistaaru. manasika mandagamanam" anae padaanni ippatikee prabhutva sahaya karyakramalu ledhaa aarogya beema patraalu vanti konni vruttiparamaina amarikalalo upayogistaaru, ikkada "manasika mandagamanam" pratyaekamgaa cover cheyabadutundi conny "medho vaikalyam" kaadu.
medho vaikalyaaniki chaaritraka padaalu chivariki avamanamga bhaavinchabadataayi, saadhaaranamgaa sabhyokti treadmill anie piluvabade prakriyaloo. manasika mandagamanam" mariyu "manasika mandagamanam" anae padaalu 20va sataabdam madhyalo "moorkhatvam", "moorkhatvam", "balaheenamaina manassu" mariyu "moorkhatvam" vanti munupati padaala sthaanamlo prachuryam pondaayi, mariyu ippudu abhyantarakaramgaa pariganhinchabadutunnaayi. 20va sataabdam chivari natiki, "mandaginchadam" mariyu "mandaginchadam" vistrutamgaa avamanakaramainaviga, rajakeeyamgaa tappugaa mariyu pratyaamnaaya avasaram unnavigaa pariganhinchabadutunnaayi.
samvatsaraalugaa vadakam maarindi mariyu desham nundi deshaaniki bhinnamgaa undhi. udaaharanaku, konni sandarbhaallo "manasika mandagamanam" mottam rangaanni cover chestundi, conny idhi gatamlo telikapati balaheenatalu unnavaariki vartistundi. "balaheenamaina manassu" antey UKloe telikapati balaheenatalu anie ardham, mariyu okasari USloe mottam kshetraaniki vartimpajeyabadindi. "sarihaddu medho paniteeru" prastutam nirvachinchabadaledu, conny eee padaanni 70laloe iques unnavaariki vartimpajeyadaaniki upayoginchavacchu. 70 nundi 85 varaku iqu unna vyaktulu medho vaikalyam kaaranamgaa us prabhutva vidya vyavasthalo pratyeka pariseelanaku arhulu.
united states.
american association aann mental retardation 2007loe daani paerunu american association aann intellectual und developmental disabilities (aid) gaa maarchindi, aaa taruvaata ventane "medho vaikalyam" anae padaanni pratibimbimchaelaa daani panditula patrikala paerlanu maarchindi. 2010loe, aid thana padajaalam mariyu vargeekarana manueval yokka 11va editionnu vidudala chesindi, idhi "medho vaikalyam" anae padaanni kooda upayoginchindi.
united kingdom.
1995 nundi 1997 varaku united kingdom aarogya karyadarshi stephen dorrell enhetchs hodaanu "abhyasa vaikalyam" gaa marchentha varaku, scatlandlo "manasika asaadhaaranata" mariyu ingland mariyu vaelsloo "manasika lopam" sthaanamlo "manasika vaikalyam" anae padam saadhaarana vaidya padamgaa maarindi."kotta padam inca vistrutamgaa ardham kaaledu, mariyu tarachugaa paatasaala panini (american vadakam) prabhaavitam chese samasyalanu suuchimchadaaniki teesukobadutundi, veetini UKloe" "abhyasa ibbandulu" "anie pilustaaru". british saamaajika kaaryakartalu medho vaikalyam unna vyaktulu mariyu dyslexia vanti paristhitulu unnavaarini suuchimchadaaniki "neerchukoevadamloo ibbandi" nii upayoginchavacchu. vidyalo, "abhyasa ibbandulu" vistruta shreni paristhitulaku vartinchabadataayih "nirdishta abhyasa kashtam" anedi dyslexia, diascalculia ledhaa abhivruddhi samanvaya rugmatanu suuchimchavachchu, ayithe "mitamaina abhyasa ibbandulu", "teevramaina abhyasa ibbandulu" mariyu "lothaina abhyasa ibbandulu" marinta mukhyamaina balaheenatalanu suuchistaayi.
1983 mariyu 2008 madhya ingland mariyu vaelsloo, manasika aarogya chattam 1983 "manasika balaheenata" mariyu "teevramaina manasika balaheenata" nuu "gurtinchaleni ledhaa asampoornamaina manassu abhivruddhi yokka sthithigaa nirvachinchindi, indulo gananeeyamaina/teevramaina medhassu mariyu saamaajika paniteeru balaheenata untundi mariyu idhi sambandham kaligi untundi."pravartana prameyam unnanduna, ivi tappanisarigaa shaashwata paristhitulu kavuh avi aasupatrilo nirbandham ledhaa samrakshakatvaaniki adhikaram ichhe uddesyamto nirvachinchabaddaayi. 2008 navambarulo "manasika balaheenata" anae padaanni chattam nundi tolaginchaaru, conny nirbandham kosam aadharalu migili unnaayi. ayithe, aangla saasana chattam "manasika balaheenata" nuu vaerae chota takkuva nirvachinchabadina paddhatiloo upayogistundi-udhaa.zii. pannula nundi minahaayimpunu anumatinchadam-etuvanti pravartanaa samasyalu lekunda medho vaikalyam anie soochinchadam antey.
united kingdamlo nirvahinchina oka bbc pole 'retard' anedi atyanta abhyantarakaramaina vaikalyaaniki sambandhinchina padam anie nirdhaaranaku vachindi. daaniki edurugaa, "pramukha pedda sodarudu" pratyaksha prasaaramlo oka pootiidaarudu "mandakodigaa nadavadam" anae padabandhaanni upayoginchinappudu, prajalu mariyu swachchanda samsthala nundi firyadulu unnappatikee, communications regulator off com firyadunu samarthinchaledu, "idhi abhyantarakaramaina sandarbhamlo upayoginchabadaledu [...] mariyu telikapati hrudayamtho upayoginchabadindi ". ayithe, itara pradarsanala nundi munupati rendu saaruupya firyadulu samarthinchabaddaayi.
australia.
gatamlo, australia "manasika mandagamanam" mariyu "manasika vaikalyam" thoo sahaa british mariyu american padaalanu parasparam maarchukundi. nedu, "medho vaikalyam" anedi praadhaanyata mariyu saadhaaranamgaa upayoginche vivaranaatmakamainadi.
samajam mariyu samskruti.
medho vaikalyalunna vyaktulanu tarachugaa samaajamlo puurti pourulugaa chudaru. vyakti-kendrikruta pranaalika mariyu vidhaanaalanu vikalaangula vanti samajikamga viluva taggina vyaktula nirantara labeling mariyu minahaayimpunu parishkarinche paddhatulugaa chuustaaru, saamarthyaalu mariyu bahumatulu alaage maddatu avasaralu unna vyaktigaa vyaktini drushti pettadanni prothsahistaaru. sweeya-nyaayavaada udyamam medho vaikalyalunna vyaktula sweeya-nirnayam mariyu sweeya-dhisha hakkunu prothsahistundi, antey vaari swantha jeevitaala gurinchi nirnayaalu teesukoovadaaniki veelu kalpistundi.
20va sataabdam madhyakaalam varaku, medho vaikalyalunna vyaktulu mamuluga prabhutva vidya nundi minahayinchabaddaru ledhaa itara saadhaaranamgaa abhivruddhi chendutunna pillala nundi dhooramgaa chaduvukunnaru. pratyeka paatasaalallo vaeru cheyabadina thoti vidyaarthulatho poliste, pradhana prasaram cheyabadina ledhaa saadhaarana taragati gadulalo cherchabadina vidyaarthulu ilanti sthaayila kalankam mariyu saamaajika sweeya-bhavananu nivedistaaru, conny upaadhi kosam marinta pratishtaatmakamaina pranaalikalanu kaligi untaaru. peddalugaa, vaaru swatantramgaa, kutumba sabhyulatho ledhaa vikalaangulaku maddatugaa erpaatu cheyabadina vividha rakaala samsthalalo jeevinchavachhu. prastutam sumaru 8 saatam mandhi oka samsthalo ledhaa samuuha gruhamlo nivasistunnaaru.
united stateslo, medho vaikalyam unna vyakti yokka sagatu jeevitakaala vyayam vaidya mariyu vidya kharchulu vanti pratyaksha kharchula kosam 2003loe prati vyaktiki $223,000, US dollarlu. takkuva jeevitakaalam mariyu sagatu aardhika utpaadakata kante takkuva kaaranamgaa paroksha kharchulu $771,000 gaa anchanaa veyabaddaayi. mottam pratyaksha mariyu paroksha kharchulu, oka million dollarla kante konchem ekkuva, cerebral paalseeki sambandhinchina aardhika kharchula kante konchem ekkuva, mariyu teevramaina drushti ledhaa vinikidi lopalatho sambandham unna vaati kante rettimpu. kharchulalo, sumaru 14 saatam vaidya kharchulu peragadam valla (saadhaaranamgaa vyakti chese kharchulatho sahaa), mariyu 10 saatam praamaanika paatasaala vidyatho poliste pratyeka vidya yokka adanapu kharchu vanti pratyaksha vaidyetara kharchula valla. atipedda mottam, 76 saatam, paroksha kharchulu, utpaadakata taggadam mariyu jeevitakaalam taggadam. kutumba samrakshakulaku konasagutunna kharchulu ledhaa samuuha gruhamlo nivasinchadaaniki sambandhinchina adanapu kharchulu vanti konni kharchulu eee ganana nundi minahayinchabaddayi.
maanava hakkulu mariyu chattaparamaina hodha.
medho vaikalyalu unna vyaktulanu medho vaikalyalu laeni vyaktula kante bhinnamgaa chattam pariganistundi. ootu hakku, vyaparam nirvahinche hakku, oppandam kudurchukovadam, vivaham chesukovadam, vidya hakku vanti vaari maanava hakkulu mariyu swechhalu tarachugaa parimitam cheyabadataayi. nyaayasthaanaalu eee parimitulalo konnintini samarthinchaayi mariyu itarulalo vivakshanu kanugonnayi. vikalaangula hakkulapai aikyaraajyasamiti samavesam, vikalaangula hakkulaku kaneesa pramaanaalanu nirdesistundi, dheenini 180 kii paiga deshaalu aamodinchaayi. aneka U.ess. rashtraalu, mariyu aneka european union rashtraalu, medho vaikalyalunna vyaktulaku ootu hakku ledhu. european maanava hakkula nyayasthaanam alazos kiss v loe teerpu ichindi. hangari "(2010) manasika saamaajika vaikalyam kaaranamgaa samrakshakatvam aadhaaramgaa matrame oating hakkulanu parimitam cheyalemu.
aarogya asamaanatalu.
medho vaikalyalunna vyaktulu saadhaaranamgaa muurcha mariyu naraala rugmatalu, jeernasayaantara rugmatalu mariyu pravartanaa mariyu manasika samasyalu vanti sanklishta aarogya paristhithulatho jeevinche pramaadam vaikalyalu laeni vyaktulatoe poliste ekkuvagaa untundi. medho vaikalyam laeni peddala kante peddalu aarogyam, pravartanaa pramaada karakalu, niraasa, madhumeham mariyu paelavamaina ledhaa nyaayamaina aarogya sthithi yokka paelavamaina saamaajika nirnayaadhikaarula praabalyam kooda ekkuvagaa untundi.
united kingdamlo medho vaikalyam unna prajalu saadhaarana janabha kante sagatuna 16 samvatsaraalu takkuva jeevistunnaru. naanhyamaina aarogya samrakshananu pondadaaniki gurtimpu unna vyaktulaku unna konni addankulu communication savaallu, seva arhata, aarogya samrakshana pradaatalaku sikshana lekapovadam, roganirdhaarana kappiveyadam mariyu lakshya aarogya prothsaahaka sevalu lekapovadam. medho vaikalyalunna vyaktula aarogya sthithini meruguparachadaaniki sidisi nundi mukhya sifaarsulu aarogya samrakshananu meruguparachadam, dayta sekarananu meruguparachadam, sraamika saktini balopetam cheyadam, prajaarogya karyakramalalo gurtimpu unna vyaktulanu cherchadam mariyu vikalaangulanu drushtilo unchukuni atyavasara paristhitulaku siddham cheyadam.

