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    ΠŸΠ°Ρ€Π°Π΄ΠΈΠ³ΠΌΠ° ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π½ΠΎΠ³ΠΎ Ρ€ΠΈΠ·ΠΈΠΊΡƒ Π² систСмі Π½Π°Ρ†Ρ–ΠΎΠ½Π°Π»ΡŒΠ½ΠΎΡ— Π±Π΅Π·ΠΏΠ΅ΠΊΠΈ Π£ΠΊΡ€Π°Ρ—Π½ΠΈ (ΠΏΡ€ΠΈΠΊΠ»Π°Π΄Π½ΠΈΠΉ аспСкт)

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    Π ΠΎΠ·Π³Π»ΡΠ΄Π°Ρ”Ρ‚ΡŒΡΡ загальна модСль систСми Π½Π°Ρ†Ρ–ΠΎΠ½Π°Π»ΡŒΠ½ΠΎΡ— Π±Π΅Π·ΠΏΠ΅ΠΊΠΈ. Π’ΠΈΠ·Π½Π°Ρ‡Π°ΡŽΡ‚ΡŒΡΡ місцС Ρ‚Π° Ρ€ΠΎΠ»ΡŒ ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π½ΠΎΠ³ΠΎ Ρ€ΠΈΠ·ΠΈΠΊΡƒ Π² Ρ„ΡƒΠ½ΠΊΡ†Ρ–ΠΎΠ½ΡƒΠ²Π°Π½Π½Ρ– систСми Π½Π°Ρ†Ρ–ΠΎΠ½Π°Π»ΡŒΠ½ΠΎΡ— Π±Π΅Π·ΠΏΠ΅ΠΊΠΈ. ΠΠ½Π°Π»Ρ–Π·ΡƒΡ”Ρ‚ΡŒΡΡ катСгорія Β«ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π½ΠΈΠΉ Ρ€ΠΈΠ·ΠΈΠΊΒ» Ρ‚Π° ΠΉΠΎΠ³ΠΎ основні складові, ΡƒΠΌΠΎΠ²ΠΈ виникнСння Ρ‚Π° функціонування. ΠŸΡ€ΠΎΠΏΠΎΠ½ΡƒΡŽΡ‚ΡŒΡΡ ΡƒΠΌΠΎΠ²ΠΈ ΠΏΡ€ΠΎΡ‚ΠΈΠ΄Ρ–Ρ— Ρ€ΠΈΠ·ΠΈΠΊΠ°ΠΌ Ρ‚Π° ΠΏΠΎΠ΄Π°Ρ”Ρ‚ΡŒΡΡ модСль зниТСння ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π½ΠΈΡ… Ρ€ΠΈΠ·ΠΈΠΊΡ–Π² Ρƒ систСмі Π½Π°Ρ†Ρ–ΠΎΠ½Π°Π»ΡŒΠ½ΠΎΡ— Π±Π΅Π·ΠΏΠ΅ΠΊΠΈ . ΠšΠ»ΡŽΡ‡ΠΎΠ²Ρ– слова: Π½Π°Ρ†Ρ–ΠΎΠ½Π°Π»ΡŒΠ½Π° Π±Π΅Π·ΠΏΠ΅ΠΊΠ°, ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π½ΠΈΠΉ Ρ€ΠΈΠ·ΠΈΠΊ.РассматриваСтся общая модСль систСмы Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ бСзопасности. ΠžΠΏΡ€Π΅Π΄Π΅Π»ΡΠ΅Ρ‚ΡΡ мСсто ΠΈ Ρ€ΠΎΠ»ΡŒ ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π΅ΡΠΊΠΎΠ³ΠΎ риска ΠΏΡ€ΠΈ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠΈ систСмы Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ бСзопасности. АнализируСтся катСгория Β«ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π΅ΡΠΊΠΈΠΉ риск» ΠΈ Π΅Π³ΠΎ основныС ΡΠΎΡΡ‚Π°Π²Π»ΡΡŽΡ‰ΠΈΠ΅, условия возникновСния ΠΈ функционирования. ΠŸΡ€Π΅Π΄Π»Π°Π³Π°ΡŽΡ‚ΡΡ условия противодСйствия рискам ΠΈ подаСтся модСль сниТСния ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π΅ΡΠΊΠΈΡ… рисков Π² систСмС Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ бСзопасности ΠšΠ»ΡŽΡ‡Π΅Π²Ρ‹Π΅ слова: Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Π°Ρ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ, ΡŽΡ€ΠΈΠ΄ΠΈΡ‡Π΅ΡΠΊΠΈΠΉ риск.The problems of forming and development of the system of national safety are examined in the article. The general model of the system of national safety is offered and the role of legal risk is determined in this system. The location and role of legal risk is determined at functioning of the system of national safety. A category is analysed Β«legal riskΒ» and his basic component elements, terms of origin and functioning. The terms of counteraction risks are offered and the model of decline of legal risks is given in the system of national safety. Key words: national safety, legal risk

    Antidepressantuse and the risk of hip fracture: A self-controlled case series approach in two primary care databases

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    Background: The use of antidepressants(AD,selective serotonin reuptake inhibitors,SSRI, or tricyclic antidepressants,TCA) has been associated with hip fractures(HF) in observational studies.However, it has been suggested that such results may be confounded by unmeasured patient characteristics. Objectives: To assess the effect of AD use on the risk of HF using self-controlled case series design. Methods: A self-controlled case series study was conducted in two primary care databases among patients with a first HF and a prescription for AD at any time during observation.Data were extracted from the UK THIN and the Dutch Mondriaan GP databases of the period 2001-2009.The incidence rate ratio(IRR) of HF for periods of AD use versus no AD use was estimated using conditional Poisson regression. Results: There were 6,632 and 136 HF patients for analysis in THIN and Mondriaan, respectively.After adjustment for age, an increased risk of HF was observed during the 30 day period after AD initiation: IRR 1.57 (95% CI, 1.39-1.78) in THIN and 3.22 (1.51-6.84) in Mondriaan.The increased risk was also observed during the next six months of AD use: IRR 1.52(1.39-1.65) in THIN and 2.76 (1.69-4.50) in Mondriaan.In the period after six months, the risk remained higher in THIN (IRR: 1.47; 1.31-1.65) but not significant in Mondriaan (IRR 1.94; 0.84-4.47). Furthermore, an increased risk of HF was observed during the 30 day period prior to AD initiation (IRR 1.22; 1.06-1.41) in THIN and (IRR 2.51; 1.00-6.33) in Mondriaan.In both THIN and Mondriaan, when cases were censored at the event times (HF) there appeared to be a substantial bias in IRR in all the periods: IRR during the 30 day period after AD initiation: 3.07 (2.66-3.54) in THIN and 12.34 (2.13-71.54) in Mondriaan.The risk of HF was higher in SSRI users than TCA users (4.39; 2.42-7.99 vs. 1.39; 0.58-2.41) in Mondriaan but was similar in THIN (1.49; 1.36- 1.63 vs. 1.49; 1.33-1.66). Conclusions: The incidence rate of hip fractures was higher in the periods both immediately after the start of AD use and during the first six months of AD use compared to periods of no use, although the magnitude of the risk varied between databases

    Antidepressant Use and the Risk of Hip Fracture : A Self-Controlled Case Series Approach in Two Primary Care Databases

    No full text
    Background: The use of antidepressants(AD,selective serotonin reuptake inhibitors,SSRI, or tricyclic antidepressants,TCA) has been associated with hip fractures(HF) in observational studies.However, it has been suggested that such results may be confounded by unmeasured patient characteristics. Objectives: To assess the effect of AD use on the risk of HF using self-controlled case series design. Methods: A self-controlled case series study was conducted in two primary care databases among patients with a first HF and a prescription for AD at any time during observation.Data were extracted from the UK THIN and the Dutch Mondriaan GP databases of the period 2001-2009.The incidence rate ratio(IRR) of HF for periods of AD use versus no AD use was estimated using conditional Poisson regression. Results: There were 6,632 and 136 HF patients for analysis in THIN and Mondriaan, respectively.After adjustment for age, an increased risk of HF was observed during the 30 day period after AD initiation: IRR 1.57 (95% CI, 1.39-1.78) in THIN and 3.22 (1.51-6.84) in Mondriaan.The increased risk was also observed during the next six months of AD use: IRR 1.52(1.39-1.65) in THIN and 2.76 (1.69-4.50) in Mondriaan.In the period after six months, the risk remained higher in THIN (IRR: 1.47; 1.31-1.65) but not significant in Mondriaan (IRR 1.94; 0.84-4.47). Furthermore, an increased risk of HF was observed during the 30 day period prior to AD initiation (IRR 1.22; 1.06-1.41) in THIN and (IRR 2.51; 1.00-6.33) in Mondriaan.In both THIN and Mondriaan, when cases were censored at the event times (HF) there appeared to be a substantial bias in IRR in all the periods: IRR during the 30 day period after AD initiation: 3.07 (2.66-3.54) in THIN and 12.34 (2.13-71.54) in Mondriaan.The risk of HF was higher in SSRI users than TCA users (4.39; 2.42-7.99 vs. 1.39; 0.58-2.41) in Mondriaan but was similar in THIN (1.49; 1.36- 1.63 vs. 1.49; 1.33-1.66). Conclusions: The incidence rate of hip fractures was higher in the periods both immediately after the start of AD use and during the first six months of AD use compared to periods of no use, although the magnitude of the risk varied between databases

    Antidepressant Use and the Risk of Hip Fracture: A Self-Controlled Case Series Approach in Two Primary Care Databases

    No full text
    Background: The use of antidepressants(AD,selective serotonin reuptake inhibitors,SSRI, or tricyclic antidepressants,TCA) has been associated with hip fractures(HF) in observational studies.However, it has been suggested that such results may be confounded by unmeasured patient characteristics. Objectives: To assess the effect of AD use on the risk of HF using self-controlled case series design. Methods: A self-controlled case series study was conducted in two primary care databases among patients with a first HF and a prescription for AD at any time during observation.Data were extracted from the UK THIN and the Dutch Mondriaan GP databases of the period 2001-2009.The incidence rate ratio(IRR) of HF for periods of AD use versus no AD use was estimated using conditional Poisson regression. Results: There were 6,632 and 136 HF patients for analysis in THIN and Mondriaan, respectively.After adjustment for age, an increased risk of HF was observed during the 30 day period after AD initiation: IRR 1.57 (95% CI, 1.39-1.78) in THIN and 3.22 (1.51-6.84) in Mondriaan.The increased risk was also observed during the next six months of AD use: IRR 1.52(1.39-1.65) in THIN and 2.76 (1.69-4.50) in Mondriaan.In the period after six months, the risk remained higher in THIN (IRR: 1.47; 1.31-1.65) but not significant in Mondriaan (IRR 1.94; 0.84-4.47). Furthermore, an increased risk of HF was observed during the 30 day period prior to AD initiation (IRR 1.22; 1.06-1.41) in THIN and (IRR 2.51; 1.00-6.33) in Mondriaan.In both THIN and Mondriaan, when cases were censored at the event times (HF) there appeared to be a substantial bias in IRR in all the periods: IRR during the 30 day period after AD initiation: 3.07 (2.66-3.54) in THIN and 12.34 (2.13-71.54) in Mondriaan.The risk of HF was higher in SSRI users than TCA users (4.39; 2.42-7.99 vs. 1.39; 0.58-2.41) in Mondriaan but was similar in THIN (1.49; 1.36- 1.63 vs. 1.49; 1.33-1.66). Conclusions: The incidence rate of hip fractures was higher in the periods both immediately after the start of AD use and during the first six months of AD use compared to periods of no use, although the magnitude of the risk varied between databases
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