4eûcmaun no npoóJleMuM WU{OOIU1 na MeCmUOM u MUUUflüJLbUOM ypoeue IPr 9i I )911J 9e00XPO. EBP0f1A PerHoxaAbxbie Hy6.7u4xauHH B03 EsporreKcxax cepHx Ns 63 CepHa ny6.nHxaunii no Espone>FicxoMy n.Aa1l:y ,ae%icTBHi-1 no 6opb6e c noTpe6.AeHHeM a.AKOrO.AH Ouenxa u xoumponb ôeûcmeuû no anxozonlo, Peter Anderson H Juhani Lehto. IlOdxoÔbi K nonumuxe xoumponst uaâ an.xozoneM, Juhani Lehto. axouOMuxa anxo2o>tbnoû nonumuxu, Juhani Lehto. Altx020nb U cpedcmea Maccoeoû uucf opMauuu, Marjatta Montonen. Jeûcmeust no npo6neMaM anxozonst na MecmnoM u MynuuunanbnoM ypoene, Bruce Ritson. AnxO20nb u nepeunnast Meôuxo-canumapnast noMOU4b, Peter Anderson. Tepaneemunecxue no0xodb2 x anxozOJtbnb1.M npo6neMaM, Nick Heather. MOnoàbie nlOôu u anxozonb, napxomuKu u ma6ax, Kellie Anderson. Anxo2Onb u pa6ouee Mecmo, Marion Henderson, Graeme Hutcheson H John Davies. BceMHpnaR opraHH3anHR 3,qpaBOOxpaneHHR - crienHaAH3HpoBaanoe yvpexcReHHe C1praHH3aLtHH 06'be,QHHeHHbIX HauHH, OCHOBHaR (PyHKLjHR KOTOpOrO COCLOHT B peLneHHH Me?K,QyHapO,QHbIX np06AeM 34paBOOXpaHeHHR H OXpaHbl 3/1OpOBbR HaCeAeHHR. C nOMOnrbIO 9TOH CfpraHH3anHH, KOTOpaR 6b1Aa CO3,4aHa B 1948 r, pa60THHK4 34paBOOXpaHeHHR 60Aee 180 cTpaH 06MeHnBaIOTCH 3HaHH3IMH H OnbITOM ,QAR TOrO, zITO6bI C4eAaTb BO3M0>KHbIM ,gOCTL1?KeHHe BceMH ?KHTeARMH 3eMAH TaKOrO ypOBHSI 3,11op0BbA, KOTOpbIH IIO3BOAHT 14M BeCTH >KH311b, nOAHOL[eHHyrO B COLTHaAbHOM H 9KOHOM144eCKOM OTHOHIeHHH. EBpOneHCKOe perHOHaAbHOe 61op0 B03 RBAReTCR O,QHHM 143 IHeCTH peTHOHaAbHbIX 6K/p0, Ka>K,QOe 143 KOTOpbIX HpOBO,c);HT CO6CTBeHHyIO nporpaMMy, HaripaBAeHHyK) Ha peLneHHe KOHKpeTHbIX np06AeM 34paBOOXpaHeHHR 06CAy?KHBaeMbIX HM CTpaH. EBponeHCKHH perHOH C HaCeAeHHeM B 850 MAH. '-IeAOBeK npOCrHpaeTCA OT I,peHAaH,I{HH Ha cesepe H Cpe4H3eMHOro mops Ha IOre 40 THXOOKeaHCKHX 6eperoB POCCHH. Ho9TOMy npOrpaMMa EBpolleliCKOrO perHOHa B03 1AasHOe BHHMaHHe yQeAReT KaK rip06AeMaM, XapaKTepHbIM ,QAR HH,L[yCTpHâAbHOTO H HOCTHHRyCTpHaAbHOTO o61IreCTBa, TaK H np06AeMaM HaXO,aRILtHXCR B 11pOL[ecce CTaHOBAeHHR 4,eMOKpaTHH cTpaH L1eHTpaAbHOH 14 BOCTO'IHOH EBpOnbr H 6bIB1Hero COBeTCKOro Cor03a. B CBOeH CTpaTerHH ,QOCTH>KeHHR 3/k0p0sb51 AAR BCeX PerHoHaAbHoe 61op0 OCymeCTBAReT ,QeRTeAbHOCTb IIO TpeM OCHOBHbIM Ha1IpaBAeHHRM: 06ecnetleHHe o6pa3a )KH3HH, CHOCO6CTBy10LL[er0 COXpaHeHnro H yKpelTAeHH10 34opoBb51, 34OpOBOH OKpy)KaIOLI);eH cpe,ab1 H COOTBeTCTBy1011114X CAy?K6 np0(HAaKTHKn, Ae'ieHnn H yXOaa. 4AR EBpOneHCKOrO pernOHa XapaKTepHb1 TaK?Ke HaAH'1He 60AbLnOrO 9HCAa 313bIKOB, Ha KOTOpbIX roBOpRT HaCeARIOL1ine ero HapO4b1, H CBR3aiIllble C 9THM TpyQHOCTH pacnpoCTpaHeHnR HH(GOpMaLmH Cpe,QH TeX, KTO B HeH Hy)K,a,aeTCR. PerHOHaAbHoe 61Opo OXOTHO yQOBAeTBOpReT npocb6bl O npeaOCTaBAeHHH ripas Ha nepeBOR CBOHX KHHT Ha RpyrHe 313bIK14. BceMHpxaA opraxH3auHA 3,ApasooxpanexHA EBponercxoe perHOxanbHOe 6FOpo KoneHrareH ßecTBH5I HO npo6neMaM âJIKOI'OJISI Hâ McCTHOM H MyHHIIIIIIâJIbHOM ypOBHe Bruce Ritson Omd enexue ncuxuampuu 3aux6yp2cxuû yxeepcumem KoponeecxaR 6011b11uzla 36ux6yp2a Cocain-lei-woe Koponeecmeo I1y6nHxauH4 Perxoxanbnoro 6topo B03, Esponacxax cepHA Ns 63 ISBN 92 892 4327 X ISSN 0258 -4972 Esponelicxoe perxoxanbxoe 61opo BceMHpxoli opraHH3auHH 3jlpaso- OXpaHeHHA OXOTHO yAOBneTBOpAeT o6pau.[eHHA C rlp0Cb6oii pa3peluHTb nepeneLraTKy nH6o nepeBou ny6nxxauHH tiaCTHYHO HnH nOnHOCTbro. 3aABneHHA H 3anpOCbl cnej(yeT HanpaBJIHTb B Bropo ny6nnxauHl3 Esponel3cxoro perxoxanbxoro 61opo B03 no ajtpecy: Sherfigsvej 8, DK- 2100 Copenhagen, Denmark. Fropo OXOTHO npeuocTasHT nocnejzHlolo HH(l)OpMaLjHIO O KaKHX-.11H60 H3MeHeHHAX B TeKCTe, O rIJIaHaX HOBbIX H3,uaHHlï, a TaK)rCe o6 y)rce HMeiou;HXCA nepeneiraTKaX H nepeBojlax. BCeMHpHaH OpraH{I3amHH 3jjpaBOOXpaHeHHSI, 1998 r. Ha rry6nllxauHH BCeMHpHOi opraHH3auHH 3JlpasooxpaxeHHA pacnpo- cTpaHAiOTCA, C c0xpaxeHHeM 3a Heil Bcex npas, nOJIO)KeHHA IIpOTOKOna 2 BceMHpxoti KOHBexuHH no oxpalte aBTOpcKHx npas. O603HaireHHA, HCrIOnb3yeMbre B HaCTOAIIjeri ny6nHKauHH, H npHBejleHHbre B Her3 MaTepHanbl He OTpa)KaroT MHeHHe ' CeKpeTapHaTa BCeMHpHOti opraHH3auHH 3j(paBOOxpaneHHA O IOpxj(IiLrecxoM cTaryce Kaxol3-nH60 CTpanbI, TeppliTopHH, ropoAa nH6o par3oxa H I-17C opraxos BnacTH n1460 B3rJIA,ijbl O jjenHMHTauHH FIX rpaHHu. Ha3BaHH51 CTpaH HRH TeppHTOpHr3, HCIIOnb3yeMbre B HaCTOAlueri rly6nHKaI.iHH, COOTBeTCTByrOT Ha3BaHHAM, H3BeCTHbIM B neprlou nOjIrOTOBKH H3j1aHHA ,IxaHH0r3 KHHrH Ha 313bIKe OpHrHHana. YnOMHHaHHe KOHKpeTHbIX KOMnaHHti HRH npOj[yKuHH oTjZenbHblX H3rOTOBHTenel3 He 03HaLraeT, YTO BCeMHpHâA OpraHH3auHA 3jtpa- BoOXpaHeHHA nOjI,IZepxCHBaeT NJIH peKOMeHj(yeT FIX HJIH OTjZaCT HM npejjnOirTeHHe nepejl jjpyrHMH KOMnaHHAMH HnH 143rOTOBHTeJIAMH, He ynOMAHyTbIMH B TeKCTe. 3a HCKnIOYeHHeM OIIIH6OK H nponyCKOB, Hä3BaHHA naTeHTOBaHHbIX npOj[yKTOB Bblj(eJUÜOTCSI HaLlanbHbIMH HpOHHCHbIMH 6yxsaMH. B3rJI51,gbI, BbIpaNCeHHble B HaCTOAIUe13 ny6nHKauHH, ABJISIiOTCA B3r1151,i[aMH aBTOpa H He 06513aTenbHO OTpaxCâlOT peIIIeHHA HRH O(iIHIIHanbHyrO nOnHTHKy BCeMHpH033 OpraHH3aIl,H4 3jIpaBOOXpaHeHHA. HAIIELiATAHO B gAHIiIi C epwaHHe Cmp. BBeReHHe 1 1. geIiCTBHSI Ha McCTHOM H MyHHL[HnanbHOM ypOBHe 3 IIOgeMy anKOrOnb? 5 OCHOBHble HCXOZjHble nOJIONKeHHSI 6 KTO ZjOnDICeH 6bITb BOBneLIeH B pa60Ty? 8 rlpeBeHTHBHble CTpaTerHH - cOKpameHHe HaHOCHMOrO anKOroneM yluep6a 11 BcecTopoxxHil noRxoA 13 2. cDopMHpoBaHHe rpynnbl AeHCTBHiI no anxoronIO 21 IIpouecc 21 B3aHMOCB5I3b C HaHHOHânbHbIMHnnaHaMH 25 bonee ulHpoKai cl)opyM 25 3a,qaiIH 27 npHOpHTeTOB 29 I'paHHubt 29 IIonHTHHecxau noggep>KKa 30 IIHTeHHax KynbTypa 30 3. POnb CeKTOpa nepBH=iHOi3 MegHKO-caHHTapHOIi nOMOnm 35 AKTHBH3aLIH5I CeKTOpa IIepBHLIHOÎi MegHKO-CaHHTapHOIi noMOIuH 38 KO M neTe HTHOCTb 39 CKPHHHHr 42 14HTepBeHLjHSi 48 BBe,geHHe CHCTeMbI Ha MyHHLAHnanbHOM ypOBHe 48 CneljHâIIH3HpoBaHHble Cny>IC6bI 54 4. AJIKOrOnb H NCH3HeHHbII%I LjHKn 57 AeTCTBO 57 IIO,IjpOCTKOBbIIi nepHOg 58 B3pOCna51 )ICH3Hb 58 IIpocBemeHHe 60 iii ,E(etiCTSHSI 63 3a,gavH 66 5. Anxoronb H npoH3BOACTBO 67 3aLieM HMeTb 11pOH3BOACTBeHHy1O nonHTHKy? 67 XapaKTep nOnHTHKH Ha pa6o4Hx MecTaX 68 I'pynnbl c oco6blMH nOTpe6HOCTAMH 70 He6onbulHe npennpHaTHSi 71 be3pa60THble 71 14HHI.jHHpOBaHHe nporpaMM nOMOHnH pa6OTHHKaM KaK TiaCTb nnaHa AeiiCTBHN n0 npo6neMaM anKOrOnsl 72 KOMnOHeHTbI nonHTHKH 73 r1OnHTHKa KOMnaHHH B OTHOn1eHHH 3AOpOBb51 75 IIpocBeuteHHe 75 BbISIBneHHe 76 1ZocneAyioulasi pea6HnHTanHSI 78 BoBnegeHHe MecTHOro HaceneHHSI 79 OnpeAeneHHe 3aAaLI, KOHTponb H ouellKa 80 6. Z[OCTynxoCTb anxoronsi 81 .Ï1HI1eH3HOHHble 3aKOHbI 81 1ITIOTHOCTb TOLIeK npOnaxcH 83 TapHCloHble OrpaHH4eHHSI 83 goMaülHee 11pOH3B0ACTBO 83 XapaKTep H pa6oTa nHL[eH3HOHHbIX 3aBeAeHHli 84 MHHHMâJIbHbIIi AOnyCTHMbIii BO3paCT nOTpe6neHHsl 86 geIiCTBHSI H npOCBeLneHHe 86 MOHHTOpHHr 87 be3anKOronbHble 30Hbl 88 AnbTepHaTHBbI 88 3aAatIH 89 7. IlpaBOOxpaHHTenbxasl CHCTM 91 geiiCTBHSI 93 I'ny6HHa npo6neMbl 93 IIOBbiLIIOHHe HH41OpMHpOBaHHOCTH 94 MecTHble AeiiCTBHSi no CHHmeHH10 yI1[ep6a 95 3a,izaHH 100 8. PexnaMa H nponaraHAa anxoronsi 103 KOHTponb 104 iv Mecums' peK.naMa 105 IIponaraHAa/cnoxcHpoBaHHe 106 CpeAcTBa Maccosoil HHCiIOpMauHH 106 9. AnKOronb H HeCYaCTHble cnyLIaH 109 i'ny6HHa npo6neMbl 109 IIpoc1)11naKTHKa 110 Ouexxa 111 TpaBMaTHVecxoe oTAenexxe H oTAeneHHe HeoTnoxcxo%I nOMOLqH 1 1 1 IIporpaMMa CTOxronbMCxoro oxpyra 112 1ZnaH AeI%ICTBHH 113 10. 3axnlomeHHe 114 OueHKa 115 PacnHCaHHe 116 CeTb cOTpyAHH1IecTSa 116 KOM6HHHpoBaHHble noAXOAbI 117 JIHTepaTypa 119 v BBe,qeHme IbcyAapcTSa-Luiexbl EsponeHCxoro perHOxa BCeMepxo noA- AepxcanH EBponeticKHH nnaH Aei3CTBHH no 6opb6e c noTpe6neHHeM anKOrOJLH, KaK 1103HTHBHOe pyKOBOACTBO K AeIiCTBHIO, KOTOpOMy AOn)KIibI CneAOBaTb esponeilcKHe rocyAapcTBa. B LIaCTHOCTH, rOCyAapCTBa-LLTIeHbI AOnxcHbI nepeCMOTpeTb H, B cnyLlae Heo6xoAH- MOCTH, nepepa60TaTb CBOIO nonHTHKy B OTHOLIIeHHH nOTpC6neHHSI anKOrOnSI AnSI 06eCneLIeHHSi TOrO, LiT06bI HX nOnHTHKa B AaHHOii 06naCTH HOCHna BceofteMnK)uxHil xapaKTep H COOTBeTCTBOBana npHHuHnaM, H3nO)KeHHbIM B 1jnaHe AeiicTBHIi. CTpaHaM TaKxce He06XOAHMO 06eCneLIHTb 34:1c13eKTHBHOe BbI1IOJIHCHHe TaKOH nOnHTHKH C TeM, LITO6bI npeAynpeAHTb OnaCHOCTb AJISI 3AOpOBb5I HaCeneHHSI H COLjHanbH0-3KOHOMHLIeCKHe np06neMbI, LiaCTO CBSI3aH- Hble C nOTpe6neHHeM anKOrOnSi, npH3HaBäSI Ba>KHOCTb MHOrOCeKTO- panbHblX Aei%ICTBHiï H CyIIjeCTBeHHyiO ponb MeCTHbIX C0o6u(eCTB. McCTHble npOrpaMMbI H AeiiCTBHSI sceX HanpaBneHHH SIBnSIIOTCSi Bâ)KHbIM IIyTëM nOAjjep)KKH 3AOpOBOTO o6pa3a xcH3HH, a TaK)Ke 06ec- neLIeHHSi O6LIIeCTBOHHOIï H nonHTHLIeCKO1i noAAepxcKH 143MeHeHHSi CHCTeM npOAaxcH H nOTpe6neHHSI anKOrOnSi. HOMHMO pa3BHTHSI LIHCTO McCTHal nOnHTHKH, MeCTHble AeiiCTBHSI MOryT OKa3aTb MOLLjHOe BnHSIHHe Ha rOCyAapCTBeHHylO H Aaxce MexKAyHapOAHyio nonHTHKy B 3TOi3 06naCTH. Ka)KAbiii ropOA HnH paNOH HMeeT nOTeHLjHanbHbMe BO3MO)KHOCTH Ansi npod)HnaKTHLIecKHx AeHCTBHri H 11O3TOMy Hy)KHO BCSILIeCKH nOOLLjpSITb, yCHnHBaTb H nOAAep)KHBaTb AeiïCTBHSI Ha McCTHOM ypOBHe. gOM, LIIKOna, pa6oLiee MeCTO, MeAHuHHCKHe yLIpexcAeHHSI AOnxcHbl npeAOCTasnSlTb yCJIOBHSI, Cn0006CTByIOÜjHe 3AOpOBOMy nOBeAeHHiO, yCHnHBaTb COIZHanbHylO noAAepxcxy H yKpennSlTb nOJIOxCHTenbHOe OTHOÜIeHHe K CHHxceHHIO nOTpe6neHHSI anKOronSi. gCi3CTB1351 no npo6neMaM anKOrOnSI Ha McCTHOM ypOBHe AOJUKHbI CTaTb LIâCTblO nOKanbHbIX ACiiCTBHI%I no yKperUIeHHiO 3AOp0Bb5I H, rAe 3T0 Hy)KHO H BbIIIOJIHHMO, OHH AOnxQ-IbI KOOpAHHHpOBaTbCSi H KOM6HHHpOBaTbC5I C ACIiCTBHSiMH no ApyrHM BbI3bIBa10111HM 3aBHCH- MOCTb Beu[eCTBâM, BKnIOLIâSI HeneranbHble HapKOTHKH H Ta6aK. 1 OnHpaSicb Ha BbIBOgbI i3CCne,ij0BaHHN, nOCB5I1IjëHHbIX pearH- pOBaHHIO Ha npo6neMbI, BbI3BaHHble nOTpe6neHHeM anKOronSI Ha McCTHOM ypoBHe, EBponeiiCKOe perHOHanbHOe 6K)p0 B03 SIBHJIOCb HHHuHaTOpoM cne,AylouzHx AByx npoeKTos no noggepxcxe AeIicTBHIi Ha McCTHOM ypOBHe. IlepBbIii - 3T0 peanH3auHSi geMOHCTpaIjHOHHOrO H oueHO'-IHOrO npoelcTa BCeCTOpOHHCIi npOrpaMMbi no npegoTSpa- LueHHIO Bpega, HâHOCHMOrO nOTpe6neHHeM ânKOrOnSI Ha 6a3e ropoga JIaxTH, cDHHnSiHAHSI. BTopoH nposogHTCSt *3epe3 npoeKT I'opoga 3gOpOBb3I, KOTOpbIii BKniOLIaeT B ce6Si MexKrOpOACKOii nJIaH AeHCTBHIi no anKOrOniO, B paMKaX KOTOpOrO 15 ropOAOB, BKnIOLIëHHble B CeTb npoelcTa B03, COBMeCTHO pa6oTaiOT Hag pa3BHTHeM nonHTHKH H nporpaMM no npo6neMaM anKoronsi. OnHpaSlCb Ha OnbIT, npHO6peTëHHbIIi B pe3ynbTaTe paGOTM npoeKTOB H ApyrHx HHHLIHaTHB B03, 6bIn pa3pa6oTaH gaHHbIIi 6yKneT C TeM, LITO6bI nOAAepwaTb yCTOIiLIHByIO ACSITCnbHOCTb Ha McCTHOM ypOBHe, HanpaBneHHyIO HpOTHB HaHOCHMOrO nOTpe6neHHeM aJIKOronsl yulep6a. 2 1)ecTBI15 Ha M @CTHOM N MyHNy,VIf1âJ16HOM )/pOBH@ B03 onpeAenl-uIa 3aAatiH no AOCTHxceHHIO 3,gOp0sb51 AnA sceX (1) B EBponeHCKOM perHOHe. OTBeTCTBeHHOCTb 3a nOCTH)KeHHe naHHbIX 3anaii nO)ICHTCSI He TOnbKO Ha npaBHTenbCTBa, HO TaK)Ke Ha C006nleCTBa H Kc1)KAOrO OTAenbHOTO )KHTenSi EBpOnbl. 3aAaLIa 17 nonHTHKH 110 AOCTH)KeHHiO 3nOpOBbSI Will BCeX OnpeAenSIeT cpenH Bcero npoLiero, Heo6x0nHMOCTb nOCTH)KeHHSI 3HaL1HTenbx0rO CHIDKeHHSI ypoBHSI noTpe6nexHSi anKoronSI cpenH HaceneHHSI: K 2000 r. BO Bcex rocynapcTBax-=iJlexax AOnxcIIO 6bITb 3HaLIHTenbHO COKpaLL[eH0 nOTpe6neHHe TaKHX npHLIHHSIiOIIjHX ynjep6 3n0pOBbIO H BbI3bIBa10II1HX 3aBHCHMOCTb BeIIleCTB, KaK anxoronb, Ta6aK H nCHXOTponxbie CpenCTBa. ,EtaJlee B TeKCTe rOBOpHTCSI, LITO 3aAaLia MO)KeT 6bITb BbIIIOnHeHa, ecru{ Ha BCex yposHSix H B pâ311H11HbIX CeKTopaX 6ynyT BHeA1)51TbC5I C6âJIaHCHpOBaHHble nporpaMMbI H nonHTHTieCKHe Mepbl B OTHOIIIeHHH noTpe6neHHSi H npOH3BOACTBa AnSI CHH)KeHHSI nOTpe6neHHSi anKOronSI Ha 25%, 06paLuasi oco6oe BHHMaHHe Ha yMeHbnleHHe nOTpe6neHH51, Benyulero K HaH6onbuleMy ymep6y. EBponeHCKHH nnaH AerICTBHH no 6opb6e c noTpe6nexxeM anxoronSI (2) SIBnSIeTCSI rnaBHOii HHHIjHaTHBOii Ha IIyTH AOCTH)KeHHSi 3TOi4 3anaLIH. Onxa 113 cTpaTerHLiecKHX 3anaii Rama COCTOHT B HHHuHHpOBaHHH H yCHJIeHHH AeIiCTBHii no npoCpHnaKTHKe H CHH)KCHHiO Bpena, HaHOCHMOTO noTpe6neHHeM anKOronS1, Ha McCTHOM H MyHHL1HnanbHOM ypOBHe (3). 11OnHTHKa no AOCTH)KCHHiO 3AOpOBbSI Will BCeX npH3HaCT BaxCHOCTb yJIyLIIneHHSi KatiecTBa )ICFi3HH 3 '17 1H17HflX OH XH `Ha,LOOHxCOW£Oa XI4H9I10.LHHIfOUO1t HHmiCIrIH OH `xagOlrah a111 `WEL HxH1.)IEIro:DOdu KHHailaflodu H1OOHxCOW£Og 91.a11Hfl 19901h `4100aHhiloXEH H H)II4aEH K0101rC90d1 '20100duaH oLr017 aHaodiC WOH,LOaW EH H1fl1014011 KI!'17 Ea,L017oaoxiCd aHHaIfaEZOODu :(9) Walrgodu H ao.Lal.Hdolldu XI4H1.OaW 10 4100HaE£ `OHhaHOx `H.LOOH4LCa.LKa11 I4101Hd0Hdu H I41.HaiDId 'HxH,LHIfOU H0H4If01oxIlE i30HâH.L)ia(146 IfH1.Ha£Ed I4a11.L)1aUOdau aHlrlodox .LOIXa.LOamiCo a171 `KHHalraoEH HH£HxC WK,L -0EI190 WI9H4If01110 0I9HH2mKflOOU `I9flElr1 .LK11oXa .LalrxX9 ,Lo.L6 g 'aHfiodiC WOH1.OaW EH HHfl,LOHail EHEIfu O.IOH4IfE.La11 OIHHEII£oO 41.Eaoa.L0g000u0 H XE1OaW EH Oada.LHH 411111iCgodU I4901.h `O.IO.L KIfi1 I4HE.LO9Ed£Ed HHO 'KHHauaOEH OIOHHEi1 Ku11 OJOHdOINEdEX `E.LI9u0 KHHa1fLIOxEH H a0170101,41 Hx.LO9Ed£ed KIf17 I9fi0H00 afl.LOahEx a 41HxGCIfo .LaxCOW OHO 'WKHaOIfOX 1,41I4HhHIf£Ed x I4HEflodH.LUETIE 91X99 .LÂ1oW 0I9d0,L031 `I$1oXilou ixxcdalloo H da.LxEdEx HHxaahH.LxEdU og,C.IXa 100141H oaiottoflox,Cd o.LE 'ISHH0If9ad.LOU HHfl1,OT1311-O0U XI9HâH1.E1aH KHHamEdxoO Ha.LCLI X14HxCOW£Ofl HHHEaO11au00H a axCxE.L E KHHalr9ad.LOI1 a.LaamiCWHadu H 1.Ed,LE£ KHHauaE.LOOUOO KuV XI4HHE1O9Ed£Ed `aOW£HHEXaW XI4H4IfEWdOLI)aH H XI4H9IrEWd01t XI4HhHIf£Ed HHHEWHHOU fl WOIEUI WI4HxCEfl WHmOiiCl7aIfO KOIrHaK `KIfO.IOxIfB WaHHaugad.LOU aI4WaEflI4£I4a `I4Walf9odU EH axaodiC WOH10aW EH OIHxEaodHlEad Ou Odo19 O.IOH9IfEHOH1ad ,Lxaodu 'axaodX WOH4IIBUH11HHiCW EH Ei1Od O1OxE.L HHfl1013317 KHH2HLCOUI4fl HaIfailOW XI9HflH1.H£OU £H HOH11O H aHaOdX WOH.LOaW EH XaOfl KLfi1 K4flod011£ OIHHaxc1110011 OU HH.Ia.LEd.LO KHHaLfa.LOamiCOO 11100H9IfEad W0a109Ua.LaûHa0 WHxdK K010KIfflK K4a0dOi1£ E1t0d0j £Og axxaxCHat 'diC.Lx,Cd.LO XI9HHaa,LOamgO aodo.Lxao xI9HhHIf£Ed HHa.LaHa17 x19H.LOaWaoO H K4fiOdOTt£ WE00duoa OU HxH,LHIfOU HOHHaa.L0dE11X001 41O01xCEfl K01,aiCdH.LHa11xE an `(fr) K9aodoll£ KHHauuadx,C HH.LdEx HoxOaE.LLO HWEUH11HHdu Ka1.aKUUadxE£ mom', KH1a.LEd.La E.LE 1911ado HamolExcXdxo H IlO4EMY A11KOrO11b? EBpona SIBnxeTCx KpynHblM npoH3BOnI-ITeneM H nOTpe6HTeneM ânKOrOnSI, H CBSI3aHHble C BnKOTOneM np06neMbl OKa3bIBaK)T 6o11131E0e BnHSIHHe Ha 3jÿOpOBbe, COuHBnbHOe 6narOCOCTOSIHHe H 3KOHOMI3Ky. 3KOHOMHL'eCKHIi yuÿep6 ouexxaaeTCSi B 2-3% OT BBnOBOrO HauHOHBnbHOrO npOjÿyKTa. HeCMOTpSi Ha 3TH 3aTpaTbI, MHOrHe npOjÿOJDKaIOT CLIHTaTb, LITO CB513aHHble C ânKOrOneM npO6neMbl - 3T0 BOnpOC MejÿHuHHbI HnH jÿaxce L'HECTO nCHxHaTpnH. EcnH MbI XOTHM pa36yjÿHTb HHTepeC H nOHHMBHHe 061I1eCTBeHHOCTH, TO Heo6XOjÿHM 6onee IIIHpOKH'i B31-n51,4 Ha 3Ty npO6neMy. H3MeHeHHe HauJerO nOHHMBHHS' CB513aHHbIX C BnKOrOneM npO6neM SIBnSIeTCSI OjÿHOI3 H3 KnK)LIeBbIX 3T0'i cTpaTerHH. 3-ra uenb MO)KeT 6bITb jÿOCTHrHyTa IIÿTëM npe,gOCTaBneH'ESI HaCeneHH'O TOLIHO'i HH(liopMauHH o nOTpe6neHHH âJIKOrOnSI H ero B03jÿeiICTBHH, a TamICe MeCTHOIi CTaTHCTHLIeCKO'%I HH(liOpMauIIH TaK, LIT06bI COO6LueCTBa CBMIE MOrnH OnpejÿenHTb COUHanbHb'e 3aTpaTbI, BbI3bIBaeMble nOTpe6neHHeM ânKOrOnS', H CaMH MOrnH Bb16paTb COOTBeTCTBy'OID;He OTBeTHble MepbI. 3aTpaTbI o6üjecTBa, BbI3bIBaeMble nOTpe6neHHeM anKOronSl (2), Mo)Kxo onpejÿenHTb cneAy'o'uIIM o6pa3oM: HOTpe6neHHe anxoronSI BbI3bIBaeT 3HaLIHTenbxb'e pacxOnbI jÿnsl 061uecTBa B pe3ynbTaTe CHH)KeHHSi npOH3BOjÿ1ITenbHOCTH Tpyjÿa H H3nep)KeK, KOTOpble npHXOAiETCSi HeCTH B cdiepax 3jÿpaBOOXpaHeHHS', cOl.jHanbHOrO 06eCneLIeHHSI, TpaHCnOpTa H OXpaHbl 061ueCTBeHHOrO nopsijÿKa. HoTpe6neHHe anKOrOnSi no)KHTCS' TSInCënbIM 6peMexeM Ha CHCTeMbI 3jÿpaBOOXpaHeHHSI. no OueHKaM CneuHanHCTOB, 6% BceX CMepTeI4 n'one' B BO3paCTe no 75 neT H OJjHa nSITâSI BCeX OCTpbIX CJIyLiaeB rOCnHTânH3auHH o6yCJIOBneHbI nOTpe6neHHeM anKOrOJiSI. K l'HCJIy 3HaLIHTenbHbIX npo6neM, CB5I3aHHbIX C nOTpe6neHHeM anKoronSl, OTHOCSITCSI: nOBbIIIIeHHOe KpOBSIHOe jÿaBneHHe H Cepjÿei'HO-COcyjÿHCTble 3a60neBaHHSI, pa3nHLIHb'e BHjÿbl paKa (B l'aCTHOCTH, BepxHHX jÿblXaTenbHbIX nyTeH H nxuÿesoro TpaKTa), uxppo3 nellexH H yuÿep6 Ani{ ncHxH*lecxoro 3jÿOpOBb51, BKn'OLIaSI 3asxcHMOCTb H jÿpyrHe npo6neMbl noBejÿeHHS'. 5 IloTpe6nexxe anxoronsi o6ycnasnHBaeT 6onee TpeTH AopoXcHbix npOHCIIIeCTBHii H CMepTei3 H HBnSIeTCSi BâaCiiblM (1)aKTOpOM H npHtiHHOii HCCtIaCTHbIX CnytIaeB B 6bITy, Ha OTAbIXe H Ha pa6oTe. I10Tpe6neHHe anKOTOnâ CB5l3aHO CO MHOrHMH np06neMaMH OXpaHbi O6njeCTBeHHOrO nopSl,gKa, BKniOtIâSi npeCTynJieHHSI, HaCHnHSI H CaMOy6Hi%ICTBa. IIOTpe6neHHe anxoronsl SlBnsieTCSi Bâ)KHOii npHiIHHOii pacnana CeMeH, HacHnHSI B jjoMaIIIHHx yCJIOBHSiX, )KeCTOxoro OTHOIIIeHHSi K ACTSIM H nO)KIiTCSi TSUKënbIM 6peMeHeM Ha CHCTeMy COnHanbHOTO 06eCnetieHHSI. II0Tpe6neHHe anKOrOnsi CHH)KaeT npOH3BOAHTenbHOCTb Tpy,aa H3-3a nporynoB, HeCtiaCTHbIX cnytiaes H yxyAIIIeHHx HaBbIKOB BbInOJIHeHHSi pa6oTbl. IIOTpe6neHHe anKOronSi CBSI3aHO C nOTpe6neHHeM ApyrHX Hap- KOTHtIeCKHX BelIjecTß, COBMeCTHOe AetiicTBHe KOTOpbIX B Cotie- TaHHH C ApyrHMH (iaKTOpaMH pHCKa nOBbILLIaCT 3a60neBaeMOCTb H CMepTHOCTb. OCHOBHbIE MCXO,gHbIE IlO11O)KEHVIA 3-ro pyKOBOACTBO OnpeAenSieT OCHOBHble HanpaBneHHSi pa6OTbI AnSI peanH3aL[HH nOTeHL[Hana npeBCHTHBHOIi ACSITCnbHOCTH C006LIje- CTBa B aKTHBHyIO nonHTHKy. OHH pa3pa60TâHbl AnSI HCIIOnb3OBaH115I Ha McCTHOM ypOBHe B pa3HOO6pa3HbIX cenbCKHx HRH ropoACKHx C006LL[eCTBaX C pa3HOI%I COLjHanbH0- nOnHTHtieCKOH CTpyKTypOIï. BOT HeCKOnbKO HCXOAHbIX nOJIO)KeHHH ne)KaLLjHX B OCHOBe 3TOrO pyKOBOACTBa. IlpeAnOnaraeTCSi, trr0 nOTpe6neHHe anKOTOnSi HeCëT C C060ii KaK npeHMyLL(eCTBa, TaK H BpeAHble nOCneACTBHSI, H COO6njeCTBO XcenaeT yBenHtieHHA nepBbIX H yMeHbLIIeHHSI nOCneAHHX. IIpeAnonaraeTCSI, tiTO HeKOTOpaSi tIaCTb HaCeneHHSi B nlo6oM CO- o6LnecTBe noTpe6JISIeT anxoronb B Onacxbix HnH BpeAHbix KonHtieC- TBax. Yposexb Taxoro noTpe6neHHSI B3aHMOCB5I3aH C noTpe6neHHeM 6 Ha jjyIIIy HaceneHHA Ha 3TO11 TeppHTOpHH, a TaIOKe 3asxcHT OT npeBanHpyloluerO THna noTpe6neHHA anxoronA H xapaKTepHCTHK coo6luecTBa. McCTHble BnacTH oTBe*ialOT 3a co3%jaHHe 6naronpHATHoIi o6utecTBeHHOH cpe,abl, cnej[osaTenbxo, OHH 3aHHTepecosaxbl B pa3BHTHH nORHTHKH no BOnpOCaM 3JAOpOBb51 Ha Hx TeppHTOpHH. [aHHbIIi npoelcT MOxcHO CB5I3aTb c npoeiCTaMH B03: I'opoAa 3A0pOBbA, LIIKOnbI yKpenneHHA 3A0pOBb5I, bOnbHHLjbI yKpenneHHA 3AOpOBbA H C O6meHaL[HOHanbHOii npOrpaMMOii HHTerpHpOBaHHOI%I npO(tHnaKTHKH HeHHII)eKLjHOHHbIX 3a6OneBaHHAM (CINDI). 3r0 pyKOBOACTBO npHMeHHMO B paBHOPI CTeneHH KaK AJIA CenbCKHX, TaK H AnA ropOACKHX pai%IOHOB, XOTA B Ka)KAOiï McCTHOCTH 6yAyT H CBOH 0006ble Tpe60BaHH2. rIOnHTHKa no AOCTIDKeHHIO 3AOpOBb51 ARA BCeX OnpeAenAeT OCHOBHble npHHLHHnbI, KyAa BXOAHT paBHblÎd AOCTyn K Cny-Ac6aM 3ApaBOOXpaHeHHA, OCHOBHOii aKLjeHT Ha yKpeIUIeHHe 3AOpOBbA, nOATiëpKHBaeTCA HeO6XOAHMOCTb yYaCTHA B 3TOM HaCeneHHA H nOTpe6HOCTb B Me>KCeKTOpanbHOM COTpyA- HHTIeCTBe. Oco6oe 3HaT-IeHHe TaK) Ke npHAaëTCA pa60Te n0 np06neMaM yKpenneHHA 3AOpOBb5I Ha ypOBHe nepBHTIHOI-I McAHKO-CaHHTapHOÎ-I nOMOÜ.jH. B HAeane, AeHCTBHA Ha MCCTHOM ypOBHe AOJDKHbI COOT- BCTCTBOBaTb HaL(HOHanbHbIM IIJIaHaM B COLIeTaHHH C OIITHMânbHblM BapHaHTOM MexKAyHapOAHOrO cOTpyAHHTieCTSa. Ho 6b1n0 6bl HenpaBHnbHbIM, TeM He McHee, O)KHAaTb pa3pa6oTKH HaLjHOHâJIbHOH nonHTHKH npexcAe LIeM HaiiHHaTb AeiïCTBOBaTb Ha MCCTHOM ypOBHe. .lIyT3Lne BCerO OnpeAenHTb 3aAaTLH, HanpHMep, B 3KOHOMHtiecKOM, MeAHLjHHCKOM H COLjHanbHOM nnaHe, a 3aTeM Ha HX OCHOBe C(i:lOpMynHpOBaTb 60nee KOHKpeTHble 3aAaT-IH AeHCTBHH Ha McCTHOM yposxe (cM. I'naBy 2). 7 KTO ,qOJ1)KEH 6bITb BOBJIE4ËH B PABOTY? Pa3pa6oTKa nnaHa: rpynna peHCTBHH no anKoronto 11p06neMbI, CB5I3aHHble C nOTpe6neHlieM aJIKOrOnSi npOSIBJLSIK)TCSI B pa3nHLiHbIX cctlepax )IC143H14 coo6uxecTSa. Pa3MaX 3THX npo6neM SICHO nOKa3bIBaeT, LTTO MHOrIIe CeKTOpa, CO3HaTenbHO Hnli HeT, yxce pa60TalOT Hait 3THM14 np06neMâMMH. OitHa l33 nepB131iHbIX 3aitaii, TaKHM O6pa3OM, COCTOHT B OnpeiteneHill3 CeKTOpOB COO6üjeCTBa, rTe yxce BeiteTCSI pa6oTa C npO6neMHbIMIi nbIOIIjHMH HJIIi )Ke eCTb COL[IianbHble HnH 3KOHOMIILIeCKIIe noTepH, BbI3BaHHble nOTpe6neHi3eM anKOronSi, a 3TM B OKâ3aHHH HM nOMOLIjH B COBMeCTHOM COCTaBneHH13 cornaCOBaHHOrO rUIaHa itel%ICTBi3li. B HeKOTOpbIX MeCTHOCTSIX, BO3M0)KHO, BO3HI4KHeT )KenaHi3e O6,IjyMaTb KOM6HHHp0BaHHblii 11O,IjX0,4 iteNCTBHH Ha MCCTHOM yposxe no anKOronIO, Ta6aKy H HapKOTHKaM. nepBblM LLIarOM no npOitBH)KeHHiO rulaHa iteiiCTBiIH SiBnSIeTCSI ctiOpMiIpOBâHHe rpynnbI iteliCTBHH n0 anKOronIO, KOTOpaSI 6yiteT pa3pa6aTblBaTb cTpaTerHK) OTHOCHTenbHO anKOTOnSi itnSI acero HaCeneHHSI 3TOii MeCTHOCTii, yiii3TbIBaSI HHTepeCbl H 06SI3aTenbCTBa pa3nliLIHbIX ceKTOpOB, BKnIOLIaSI 3itpaBOOXpaHeHi3e, COL[HanbHOe 06ecneLleHHe, o6pa3oBaHHe, ceKTop CJryxc6 no pa6oTe C MOnO,TZë)KbIO, cpe,gCTBa MaCCOBOH iIHCpOpMauiIH, noni-ILjlilo, Cyite6Hble OpraHbl, naTeHTHyHJ CnyxC6y, TOprOBnlo, cJry)K6y itocyra, TypH3Ma, 06LgecTBeHHble OpraHH3agHii, rpynnbI pa60TOZjaTeneli H pa60TaloII(Hx no Hai%IMy. rpynnbI j(eiiCTBIiH itOJDKHbI 6yityT KOOpAi3HHpOBaTb CBOiO iteSITenbHOCTb C itel%ICTBHSIMi3 COO6LLjeCTSa n0 Ta6aKy H HapKOTHKaM. OHH JZOJDKHbI nOititep)KHBâTb CB5I3b C LLIIIpOKHM KpyrOM HHbIX 3aHHTepeCOBaHHbIX rpynn H CeKTOpOB C006üJecTSa. rJepBOHaLIanbHO, OitHOH 143 lIX OCHOBHbIX 3aitaLl 6yiteT nOBbILUeHi3e nOHiiMaHHSI ponH, KOTOpyIO HrpaeT anKOTOnb B xcH3HH HaCeneHHSI H JjOCTI3)ICeHHe B3alIMOIIOHHMaHHSI Me)ICity rpynnaMH H OTitenbHbIMH nHL(aMII, pa6oTaiOUjFiMH no HAM 3aHHTepeCOBaHHbIMH B nOnHTHKe OTHOCHTenbH0 anKOTOnx Ha McCTHOM ypOBHe. Arme BCerO, ecnH 3T0 BO3MO)KHO, ;Io CO3itaHHn HOBOl3 CIICTeMbI B3aHMOCB5I3eH HCIIOnb3OBaTb rice CyujeCTSylou[He CTpyKTypbI H OnpeitenHTb nOTeHLHianbHbIX COIO3HHKOB. 3T0 MOryT 6bITb He TOnbKO OTitenbHble niltiHOCTH, HO TalCxCe OpraHi33auHH H iiHCTHTyTbI. 8 B 60nbnIiiHCTBe Cnyiiaes, MeCTHble BnaCTrl, *-IaCro 3apyilHBlili3Cb nO,Ij,gepxKKOii npaBnTenbCTBa CTpaHbl, nopyilaloT I'pynne geHCTBHH pa3pa6oTKy nnaxa AeIiCTBH1i no npo6neMaM anxoronA. r1OnHTHileCKaA nOAAepxcKa Ba)KI-la, H rAe MONCHO, eë Heo6xoAHMo 3aKpenHTb C nOMOLLI;biO MyHHLIHnanbHbIX n0CTaHOBneHH1i, 065I3bIBa- iOLL[HX McCTHble BnaCTH BHe,Ijp5ITb B NCH3Hb H OLjeHHBaTb nnaH Aeli- CTBHIi. KaKOIi-111160 OTAenbHblli OTAen, HanpHMep, 3ApaBOOXpaHeHHSI HJIIi 06pa30BaHHA MO)KCT 6bITb Ha3HaiieH OTBeTCTBeHHbIM 3a pa3pa6oTKy MeCTHOrO IUIaHa H KOOpAHHawIO AeATenbHOCTH no ero BbInOJIHeHHK). TaKNCe He06XOAHMO, no i3CTeiieHi3I0 3apaHee OnpeAe- nëHHOrO nepHoAa, OTiiHTbIBaTbCH O AOCTH)KeHIiAX OTHOCHTenbHO HaMeiieHHbIX Ljeneli. XOTA 3TOT nOAXOA iiaCTO 31Bn5IeTCA OHTHManbHbIM, 5ICHO, iiTO MIIOrO 3(1)(1)eKTHBHbIX H HOBâTOpCKHX rUIaHOB 3apO)iCAaIOTCA BHC CTCH npaBHTenbCTBeHHbIX H MyHHr(IiIIanbHbIX OTAenOB. 34)(1)eKTHBHOCTb rpynn nOTpe6HTeneN H A06p0BOnbHbIX OpraHH3aLjHli HHOrAa COCTOHT B HX CII0C06HOCTH AeiCTBOBaTb He3aBHCHMO, BHC paMOK aAMHHH- CTpaTHBHbIX CTpyKTyp, KOTOpble MOryT HHOrAa TOpMO3HTb npasH- TenbCTBeHHble AeIiCTBIiA. BO3MONCHO, iITO nHAHpÿIOLLjyIO p0nb BO3bMyT Ha ce6A HenpaBHTenbCTBeHHble OpraHH3au,HH, HO OHii AOnNCHbI 6bITb AOCTaT0iiHO MyApbIMH H nonblTaTbCA A061ITbCSI cOTpyAHHiieCTBa C McCTHbIMH OpraHaMH BnaCTH Ha HaiianbHOli CTaAHH pa60TbI. BcenpoHHKaIOLi[aA nplipo.i[a noTpe6neHHA ânKOTOnA H BbI3bIBaeMbIX HM npO6neM Tpe6yeT TeCHOrO cOTpyAHHiICCTBa MHOFHX yilpeNCAeHH1i H OpraHH3aL(Hli, npeACTaBnAfOLL(HX HHTepeCbl pa3nHV- HbIX CJIOëB HaCeneHHA (CM. Ta6nHily 1). Ta6nHua 1. rpynnbl, 3a14HTepeCOBaHHble B pa3pa6OTKe nnaHa ,4eNCTBH0 no npo6neMaM anKoronA Ha MecTHOM ypOBHe MyHNylinanbHble N perNoHanbHble rpynnbi nOTpe6NTeneL1 COBerbl 11 opraHbl BnaCTN OpraHbl 3,4paBOOXpaHeHNA: CneLtNanbHble cny5K6b1, CnyNC6b1 nepB44HOL1 Me,f1,NK0-CâHNTapHON nOMOLuN, yKpenneHtlA 3,11OpOBbA f1ontIL{mSI rpynnbl 3THN4eCKNX MeHbWNHCTB OpfaHN3a141,111 np0113BO,qCTBeHHOl1 CaHNTapNN N rNfNeHbl OKpyNCaK)LI{eLl cpe,qbl lipoN3B0,[;NTenN anKOfOnbHbIX L1 6e3anKOrOnbHbIX HanNTKOB N 9 flpaBoBble opraHbl (nNHeH3NOHHaA cnyN<6a) Y4peNC,D,eHNA npOCBeLL4eHNA (Ha4anbHOrO, Cpe,IjHerO N BbICWerO): CnyN<6bl no pa6OTe c Mono,gëN<blo ,g06pOBOnbHble opraHN3aL;NN, rpynnbl caMOnOMOLLtN iifeHCKNe rpynnbl mirjyCTpINA ,IjOcyra flpOCpcolO3bl N OpraHN3aL{NN pa60TO,C(aTenetl OpraH143aL1,NN, CO3,ga101JtNe yCJIOBNA ljf1A OT,qbIXa N MyHNL{NnanbHble cny- NC6bI: OTAbIX, pa3Bne4eHNA, Typw3M ,qOpON<Hble N TpaHCnOpTHble CnyN<6b1 311C1IeKTHBHble npHHljHnbI H HanpaBJIeHHSi AeSITeJIbHOCTH, 0603HaTieHHble B HaLjHOHâJIbHOM nJIaHe, Heo6XOAHMO AOHOJIHHTb 065I3aTeJIbCTBaMH H MCpOnpHSiTHAMH MCCTHOro ypOBHSi. BaxcHO, TiT06bI HaCeJIeHHe üyBCTBOBaJIO, TITO 3TO FIX nJIaH. O6njeCTBO COCTOHT H3 nOJIb30BaTeJIeii I3JI4 nOTpe6HTeJIeii, KOTOpble 3HaIOT 06 3TOiI np06JIeMe H MOryT CaMH OnpeAeJIHTb nyTH eë peIHeHHSI - KOTOpble AOJDKHbI CTaTb "FIX" peHIeHHSIMH. ArIA rpynnbl AeiICTBHiI HO aJIKOI'OJIIO nOJIe3H0 3apyTIIITbC51 nOAAep)KKON KOHCyJIbTaTHBHOrO C06paHHA, cOCTOS1IIjero H3 npeACTaBHTeJIeii 3aHHTepeCOBaHHbIX CTOpOH, KOTOpble CMOryT 06Cy)KAaTb H HaHpaBJISITb nOJIHTHKy HO Mepe eë pa3BHTHA. Co6paHHe TaloKe AOJI)i<HO 06AyMaTb )KeJIaTeJIb- HOCTb KOM6HHHpOBaHHOrO noAxo,ga K aJIKOrOJIIO, Ta6aKy H HapKOTHKaM. KoHcyn6TaTHeHoe co6paHHe Me)KceKTopaJlbxoe CoTpy,IIHHTiecTBO HpH pa3pa6oTKe CTpaTerHH cOxpal jeHHSi Bpe,Ija HecëT C C060171 MHOro npeHMyn(ecTB. EJIarOAapsi eMy MO)KHO 6bITb yBepeHHbIM, TITO HOJIHTHKa C(I)OpMHpOBaHHaSI B O,IjHOii cctlepe, He HAëT Bpa3pe3, HRH ewe xy)Ke, He npoTHBOpeLIHT nOJIHTHKe Apyroro CeKTOpa. OHO TaK)ICe cnoco6cTByeT 6oJIbIIIeMy yBa)KeHHIO TOTIKH 3pexH5l Ka)KAoro yTIpe)KAeHHSI, ero npiiopHTeTaM H OrpaHHTieHHSIM, KOTOpble MOI'y'r BJIHSITb Ha COTpyAHHTIeCTBO. 111HpOKO HpeACTaBJIeHHOe Co6paHHe 06eCneTlHBaeT npaBHJIbHOe HanpaBJIeHHe AHCKyCCHH H npHeMJIeMyIO aTMOC(l)epy, rAe MO)KeT 3ByTiaTb KpHTHKa H MHCHHe pâ3HbIX CeKTOpOB. 3T0 TaK)Ke y3aKOHHBaeT npeBeHTHBHyK) pa6oTe, KOTOpaSi BO MHOrHx yTipeXCAeHI-ISIx TIaCTO cTiHTaeTCx 10 iT H aâ.LOatngo a Hatton/ HHHamOHIAONIHE£â xI4HiISIIduo IEUg aiEi4u,C£ad I.aENHH£Oâ O.LOEh IfHIvC/ouo.IE/g H if4âodott£ axxamAltO d9d3111A W31lOJONIld OJOWNOOHdH 314H3fit/dNOO - V1V1J31Vd10 3I9H8VI1H383d1J Z aâE/,I â Ifol.aEtiNCXogO on/o.IONIre OU HHâ.LOHatt I4uuXd1 IsHHEâodHllldo4) ooariodu EHEIfU ExauoX Islrtt aHHahEH£ aamolEmad 4.I.aNIIi .I.tiIOIH IfHHEâ0dHlAIdo4i aa g000LI0 H HHâioHatt EuuXd,I 1HI1IIfI.ÂII HIIII4HhH/£Ed OHNCOIII 0I.6 4,LE/att0 If.LOX `aHHOdX i1lOH100Y1I EH HHHaNCO/â £ag Ettadâ HHHamEdxOO â HHH -aNCH.L00tt XI4H4/aI.HhEH6 4.LEttH)I00 0H4IfE0d0H 'âoNHHhO.LOH XI4H10011I HIfH XI4H4IfEHOHtIEH £H I5041If1fâ.LOatmiC00 .LONCOII noie aHHEflOdHOHEHH0 'HHâ.LOHatt XHEIIII OU iC.LOgEd O,IatTIOiiCdHd.LOHHHNIttE 14190E H HHâ.LOHati o.IatuolEâHxcdamtou `EIfEHOOdau £H 41Ifo1303 .LatiXg IfEdol.oN `ÄttHEWOx oaHOH(13o 01/CIII4/O9aH 4I.H/attaduo OHttoxgOaH â.LOatng000 aâ.LOxxm4/o9 g XI4HHEtt XI4H.L0arN H XI4H4IfEHOHtIEH xHirionXâ.LO.Laâ,LOOO 4.LOOxUX10011 H dogo 4.LEâod1,11fed1l-ION H IfHHahXgo O.tOHNC/Ott ocHHattaâodu 41Eâoâ13g000uo `If/O.IONIfE IfHHa/gad.LOU O.IOHIa£Ed aa/Og ,CNH.LNEdu 4,LEâHâ£Ed `Egdatu/C INa/O.IONIrE O.IOI1IaIfHHhxdu HH11E£HNIHHHIII HH.Ia.LEd.Lo 4,LE.LOgEd£Ed axHEâogad.L `dai-vHduEH `4,LHtioxâ I.iC.tONi EttolO 'H,LOOH4/al.Ifatt xEttHâ H xif/atI xxoâo O axxa/âE.LOttadu aoNiah H/ai1IH aHHEd900 00HâH.LE.L4/XOHOx H HHâ.LOHat EIIIIÂd I490.Lh `OHNCEg '.LOIENHH£Oâ HHO attl `I1IEL H.LOOHNCOIII£Oâ If,C£Hlread `Ifxxamad aHNOahH,LNEdII LCttHEH xaoâ Eâ.LOamg000 o.IOH.LOaIi I-nIHH.LOgEd `rllatngo g 'E.aoott HHd.LO&IiH H H.LOOHHa/ -mI4I1IOdII HOHO/O.IONIfE â XHmOIE.LOgEd `ENOHd O.IOHHamI4âOu HHOOactIOdu Ha17oI/ Httado K/O.ION/E aHHa/gad.LOU 4.LHHaPI£H 4.LOOI-13KOIII£oâ .LaEtt axcNE.L E `IfHHamoHio IsIaxxaxalAI£H H HaxHEUI1IEN H0N04/a.LH.Laâ00dII O OHEEIfâO 4.LI49 ,LaNCOi1I IiHHEâodH£HatIHIf EHONEE OJOHOH axxattaââ `dainlHdUEH 'oxxaH£od£Ed ifoiHtloâodU OH axâ.LOxati 00t7NCEN E`I1IH.IXdtt I,aEâH/HOX H HE£Ifâ00NiHE£â H.LOOH4/a.LKatt t7Hâ HHttO 01h NE,L `I1114HHEgOdHOHEIfE90 OmOdOX KoI.aEha-ou If/o.IONIfE I1IEi1[a/90dU OU HHâ.LOxatt HEIM OI.h `OHNCEg HOH.LaI.HdoHduaH HX LlM3HLieCKOTO, ColjNanbnoro H nonNTHLlecxoro oxpy)KeHHSI. AJIKOTOnb SIBnSIeTCSI Ba)KHOH LIaCTbIO 3TOTO OKpy)KeHHSI H J(On)ICeH NCIIOn1330BaTbC51 pa3yMH0. CaHHTapHOe npOCBeLueHHe rlOolupSIeT 3T0 H Jj06HBaeTCSI TOrO, LTT06bI HaCeneHHiO npej[OCTaBnSlnacb nOHSiTHâSi H uoCTOBepHaSI HHCtlOpMauHSt o6 anKOrone TaK, *iT06bI OHH MOrnH CuenaTb OCO3HaHHbII3 H, 6y4eM HaueSITbCSI, 3JjOpOBbIH Bb16op o6pa3a )KH3HH. O6bILiHO MbI rOBOpHM O nepBHLIHOH npOciMnaKTHKe, KOTOpaSI 3aHHMaeTC5I npe,1ZOTBpaIIieHHeM BO3HMKHOBeHHâ npo6neM, H BTOpHLIHOIï npOciHnaKTHKe, HaueneHHOii Ha paHHee BbISiBneHHe H CHH)ICeHHe yruep6a. HaKOHeu, TpeTHLIHasI np0(pNnaKTHKa 3aHHMaeTCSI 011THMBJIbHOH pea6NJINTaLjHeii. XOTSI, eCJIH rOBOpNTb o npOIiH- naKTHKe CBSI3aHHbIX C ânKOrOneM npo6neM, KOHuenuHSi 3TOii MOJIenH SIBnSIeTCSI SIBHO Me,uHLjHHCKON, a Ha npaKTNKe CyLueCTByeT 3HaLIHTenbHOe nepeceLieHi7e Me)K,uy 3THMM KaTCTOpHSiMH npH rIJIaHHpOBâHHH Ha McCTHOM ypoBHe. pyrasi Mouenb KnaccH- ciIHuNpyeT npeBeHTHBHble CTpaTerHH no }IX OCHOBHOFi HanpaBneH- HOCTH: Ha HHJjHBHJjyaJIbHOTO nb101uero, Ha COuHanbHble yCJIOBHSI BbInHBKH, Ha HaH60nee pacnpOCTpaHeHHbIFi THn noTpe6neHHSI H, HaKOHeu, Ha C06CTBeHHO aJiKOTOnb H ero J[OCTyrIHOCTb. OnSiTb )ICe, OnpeJjeneHHSI MOryT 6bITb He COBCCM TOLIHbIMH H nepeceKaTbcSI Ha npaKTHKe. Ilapa,goKC npociHnaicTHKH 143BeCTHO, LrTO nOTpe6neHHe aJIKOTOnSi H CB5I3aHHble C aJIKO- rOneM np06neMbI MO)xHO H306pa3HTb B(l)OpMe IüKâJIbI. YLiHTbIBaSI Bâ)iCHOCTb CTpyKTypbI H yCnOBHii nOTpe6JIeHHSi, B 061ueM BepHO, LTTO Te, KTO nbëT 60nbLLle, C 60nbLIIeH BepOSITHOCTbiO CTOJIKHëTCSI C KpyrOM CB513aHHbIX C aJIKOrOneM npo6neM. 3aJiaLia no COKpameHNIO HaHOCHMOTO aJIKOrOneM BpeJla MO)KeT 6bITb JJOCTHrIiyTa IIyTëM Mep no CHH)KeHHIO o6Luero ypOBHSI noTpe6neHHx nOJXOJ, OpHeHTHpO- BaHHblii Ha Hâ.CeneHHe) H IIyTëM Mep, HanpaBneHHbIX Ha OTJjenbHble THnbI nOBe,ueHNSI nOBbILLIeHHOTO pHCKa (nOuXOJ( OpHeHTHpOBâHHbliï Ha rpynnbl pHCKa). CTpaTerHSI rpynn nOBbInleHHOTO pHCKa, KOTOpasl nOCBSIIueHa HCKJIiOLiHTenbHO T6M, KTO nbeT MHOrO, He ,uaeT MHOTO BbITO,u C006LueCTBy. Tax KaK yMepeHHO m'ouille B nI06bIX 06CTOSITenbCTBaX SIBnSiIOTCSi HâH60nbLLleii rpynnOil, OHM SIBnsIIOTCSI npHLiNHOIi HâH60nbLUerO LiHCna CB5i3aHHbIX C anKOrOneM npo6neM. L1aCT0 3T0 TIp06neMbl, CBSI3aHHble C OnbSIHeHHeM. 3TOT napaJ[OKC 12 npOdxJIaKTi3KH (7) nOKa3bIBaeT, nOLIeMy IUIaH ,IZeI3CTBHI%I Ha McCTHOM yposxe AOn)KeH OXBaTbIBaTb BCë nbiOLL[ee Hacenexxe, a He TOJIbKO rpynnbI nOBbIIIICHHOrO pHCKa. CTpaTerHx rpynn nOBbILIIeHHOrO pHcKa O6bILIHO SIBnSIiOTCSI 60nee npHeMneMbIMH AJIâ ny6nMKH, nOTOMy MTO OHM He 3aTparMBaiOT nOBegeHHSI 601IbLIIHHCTBa. KOHeLIHO, OHH MOryT COCTaBnSITb LiaCTb LUIaHa, HO CaMH no Ce6e OHM HeilOCTaTOLIHbI. Pa3JIHLIHbie nO,I(XOJTbI 6yuyr 60nee npHeMneMbl B pa3HbIX CeKTOpaX. BCECTOPOHHNI IIO,qXOA OLIeHb Ba)KiiO, LITO6bI MecTHbiii nnaH ,IZei%ICTBMi4 HMen IIIHpOKyiO OCHOBy H B HeM noxiëpKHBanxcb 3neMeHTbI, rice AOKa3aBLÜHe CBOK) 34:14)eKTHBHOCTb (8), 'ramie KaK: KpynHOMaCIHTa6Hble Bb160pOLIHble npOBepK13 JjbIXâHHSI ARA BbISIBneHMSI CnyLIaeB BO)K,TIeHHSI B HeTpc3BOM BliJje; npeHMymeCTBa OTKpbITOrO H BHJjMMOrO Ha6nIOgeHHSI 3a 06LLjeCT- BeHHbIM nOpSimKOM B H BOKpyr McCT nOTpe6neHHSI anKOrOnsi; 3(1)clieKTHBHOCTb KpaTKHX, HeneHanpaBneHHbIX KOHCynbTaIjHM A nlOi(eii, nOTpe6nSlloHzHx aJIKOPOnb OnaCHbIM 06pa30M, KOTO- pbie 6binx BbISIBneHbl Llepe3 OpraHbI nepBHLIHOSi Me,ImKO- CaHHTapHOI%I nOMOIIjH H 6OnbHHLAbI; BnHSiHHe HanHLIMSI aJIKOrOJISI Ha CHOpTHBHbIX MepOnpH5ITH5IX Ha XynHraHCTBO; npOCBeIIjeHHe n0 BOnpOCaM nOTpe6neHMA aJIKOrOJISI C aKIjeHTOM Ha 6epeMeHHbIX )KeHLLjHH; H 3KOHOMHLIeCKHe npeHMyLLjeCTBa 3434)eKTHBHbIX npOrpaMM HOMO- ux TpyJoILL[xMCSi Ha pa6oLixx MecTax. YCnoBHSI noTpe6nexxSi anxoronsl oLiexb Ba)KIibI. r1OTpe6neHMe aJIKOronsf MO)KeT 6bITb npaKTHLieCKH 6e3BpeoTAHbIM B OAHOIi CHTyamH, OLieHb OnaCHbIM B Jjpyroii; SIpKHIï npHMep - OnaCHOCTb BOXAeHHSi B HeTpe3BOM BHJ[e, KOTOpaSi nposisnsieTCSI npH ypoBHe noTpe6neHHSI, KOTOpbIi4 B ApyrOri CHTyaLmH 6bin 61,I npHeMneMbIM. 13 Fpynna AeHCTBHii no anKOroniO AOJDKHa 6y,aeT BbIpa60TaTb KOH- LlenLjHIO yKpeIUIeHHA 3AOpOBb51, OCHOBaHHyK) Ha HMeK)IImXCA AâHHbIX HayiiHbIX HCCneAOBaHHIi o npHpoAe CBA3aHHbIX C anKOrOneM npo6neM, H yiiHTblBalOnjylo McCTHble TpaAxuHH H npO6neMbl. gaH- Hble, OCHOBaHHble Ha McCTHOM OnblTe ABniiOTCA HaH60nee HaAë)KHbIMH. C6op 6a30BON NHCpOpMa1..4NN Ba]iClio nony*iHTb nonHOe npeACTasneHl3e o BenHLIHHe H THne noTpe6neHHA anxoronA cpeAH HaceneHHA, a Taxxce noTepb H npe- HMyLLjeCTB 3TO1'O. gaHHble B MaCIIITa6e CTpaHbl none3HbI, HO HM He XBaTaeT OnpeAenëHHOCTH H CB5I3H KOHKpeTHO C AaHHOIi MeCTHOCTbK), LITO OLIeHb Bâ)KHO AnA TOrO, LITO6bI BbI3saTb HHTepeC y Hacenexl-IA. ECJIH BO3MO)KHO, HaMHOrO JIyLILIIe BbIAenHTb MeCTHble AaHHble H3 HaLjHOHanbHOli CTaTHCTHKH H CpaBHHTb HX C AaHHbIMH n0 CTpaHe. HCCneAOBaHHe McCTHbIX nHTeiiHblX npHBbILIeK MO)KeT 6bITb AOporO- CTOAIIjHM H 3aiiMëT MHOro BpeMeHH; He06XOAHMOCTb npoBeAeHHA HayLIHbIX HCCneAOBâHHIi He AOJLXCHa CTaTb npHLIHHOIi 6e3AeiiCTB1451. rpynna AeIiCTBHH no anKOTOniO 6yAeT OTBeLiaTb 3a ConOCTaBne- HHe HHIPOpMaHHH, C06paHH0ii H3 pa3nHLIHbIX O631aCTeii H HCTOLIHH- KOB. HMeK)LLjHeCA B HânHLIHH AâHHble 6yAyT pa3nHLIHbIMH B pa3HbIX c006LL[eCTBâX. HpOL(ecC c6opa AaHHbIX H3 pa3HbIX HCTOLIHHKOB LIacTO CTaHOBHTCA nepBblM LnarOM K 3apo)KAeHHIO HHTepeca H COTpyAHH- LieCTBa, a TaK)ICe K HânâNCHBaHHK) COBMeCTHOIi pa60TbI MeACAy pa3nHLIHbIMH ceKTOpaMH C0061ijeCTBa. gaHHble noMOryT yLlpexclxe- HHAM OnpeAenHTb H OLjeHHTb AO KaKOIi CTeneHH ânKOrOnb rice ABnieTCA npHLIHHOii AOnOJIHHTenbHOÎi pa6OTbI AnA HHX. HHII/OpMa- LIHiO MO)KHO HCIIOnb3OBaTb, LIT06bI CIIOCO6CTBOBaTb npHHATHK) OCO3HaHHOr0 Bb160pa H HHHLjHHpOBâHHK) AeIiCTBHii. CO6paHHble AaHHble TaK)Ke MO)KHO HCIIO1Ib30BaTb, KaK OCHOBy Ani MOHHTOpHHra H3MCHCHHii H BO3ACIiCTBH31 HOBOBBeAeHHH. Thorensen H Pedersen (9) npeAcTaBnAIOT OTnHLIHbIIi npHMep HCnOnb3OBaHHA AaHHbIX, KOTOpble 6bInH Co6paHbI H npeACTaBneHbi Konexrarel-ly s paMxax npoeKTa "ropOAa 3Aop0sb5I". Tam npHBOAH- nHCb Aaxxble no nOTpe6neHHlo, no o6bëMy neLieHHA, no cBA3axxOIï c anKOTOJIeM CMepTHOCTH, no npaBOHapylneHHAM, COBepLHëHHbIM B nbAHOM BHAe, no AOCTynHOCTH nHLjeH3HH H no KOJIHLIeCTBy LIaCOB 14 npOAa)KH. 3'ro nOCJIy)KHnO 3aMetiaTenbxoii OCHOBOIi AR51 AHanora C McCTHbIM HaCeneHHeM H AnSI MOHHTOpHHra H3MeHeHHii. HpocTble OnpOCbl no McCTHbIM nHTeiiHbIM npHBbILIKâM MO)iCHo HHOrAa npOBeCTH OLIeHb 6bICTpO C nOMOII;bio MCCTHbIX areHTCTB, npOBOASILLjHX COLalambHble OnpOCbI ( XOTB LIâCTO 3T0 AOpOrO CTOHT) HRH 06paTHBIIIHCb 3a nOMOmbio K HayLIHbIM yiipe)KAeHHSIM, TaKHM KaK yLie6Hble 3aBeAeHHSI, rOTOBSIIgHe MeACecTëp HJIH nCHXOROrOB. C nOMOLLjbK) onpocos LIepe3 nOLITy TaK)Ke MOxCHO 6bICTpO c06paTb HHCbOpMaL[HIO, XOTSI AaHHble 06bILIHO npOTHBOpeLIHBbI. TeneIIJOHHbIIi OnpOC TaK)Ke MO)KHO npOBeCTH AOBOnbHO nerKO, HO Kpyr peCIIOHACHTOS LIaCTO SIBRSieTCSI He nORHbIM, yITyCKaIOTCSI 6e4Hble CROH HaCeneHHSI, 6e3AOMHble H Te, KOro LIaCTO HeT AOMa. Raxce eCnH MeCTHbIIi OnpOC O nHTei3HbIX npHBbILIKaX He npOBOAHRCSt H ero Henerxo nposecTH, BCë paBHO MOmKHO nonyLlp'Tb HHCliOpMaL[Hio O pomp' anKOrOmSi B o6n(eCTBe. B HeKOTOpbIX CTpaHaX e)KerOAHO C06HpaeTCSI HHCliOpManHSI O npOAaxce BnKOrOmSI H CyMMe MeCTHbIX HanOrOB OT ero npOAaxcH. 3-rH AaHHble 0006eHHO HOne3HbI ARSf aHanH3a TeHAeHlÿHii. OnpOCbi nOTpe6HTeneii H OnpOCbl AOManIHHX X035I1ICTB LIaCTO COAep)KaT BOnpOCbl no nOTpe6neHHlO anKOrORSI H AaIOT nOne3HyK) HHIliOpManHiO. 1104TH B KaxCAOM HaCenëHHOM IIyHKTe MO)KHO nOJIyLiHTb HeKOTOpyK) HHCliOpMaLjHK) O BpeAe, KOTOpbIii npHLIHHSIeT anKOrOnb. B Ta6nHL[e 2 npeACTâBneHbl HeKOTOpble o6LLjHe noxa3aTenH. HeKOTOpble H3 HHX HMeIOTCSI TOnbKO B cpopMe HaLjHOHanbHOli CTaTHCTHKH, HO AaHHble o6 ypOBHSIX CMepTHOCTH H 3a60nesaeMOCTH, AaHHble O KOJIHLIeCTBe apeCTOB H AOpo)KHbIX asapHH MO)KHO nOJIyLIHTb Ha O6naCTHOM p'RH MyHHLjp'nânbHOM ypOBHe (CM. O[f2HKCI ll KOHII[rUOJIb 62ZICIYlBllll no QJIK020J13o, nepBbni 6yKJIeT B 3TOii cepHH). 15 3,gopoBbe: Ta6nNL{a 2. FieKOTOpble nOKa3aTenN HâHOCNMOfO nOTpe6neHNeM anKOfOnA ywep6a CMepTHOCTb B pe3ynbTaTe, HanpNMep: L1Npp03a, naH- KpeaTNTa, HBCNnbCTBeHHaA CMepTb (HeC4aCTHble Cny4aN, CaMOy6NNCTBa, y6Nl%1CTBa), B pe3ynbTaTe paxa (ry6, p0T0- BOC:I 110110CTN, fnOTKN, nNLueBO,ga, fOpTaHN), anK01-0n113- Ma, anKOfOnbHON 3aBNCNMOCT14, anKOfOnbHOfO nCNX03a. 3a60neBaeMOCTb, HanpNMep: ne4eHN, nonblTKN CaMO- y6N11CTBa, fNnepTOHN4eCKaA 60ne3Hb, TpaBMbl fOnOBbI N ,gpyfNe HeC4aCTHble Cny4aN, anKOfonbHaA 3aBNCNMOCTb, anK01-011113M, anKOfOnbHbIN nCNX03. ,qaHHble y4pe)KgeHNN 3,gpaBOOXpaHeHNA no OqeHKe KOnN- 4eCTBa aJ1KOfOnbHbIX np06neM Cpe,O,N KnNeHTOB: Cny)IC6 nepBN4HON Me,gNKO-CaHNTapHON nOMOLL4N, TpaBMaTOnO- fN4eCKNX OTJ.),eneHNN, 6onbHNLt 06L.L4efO npOCloNnA, nCN- XNaTpN4eCKNX KnNHNK. COLManbHble COL4NanbHble BbInnaTbl, nec no NHBanN,gHOCTN cpaKTOpbI: (KOnN4eCTB0 ynOMNHBHNi1 06 anKOf'one B 3a5,1BneHNAX nOKa3bIBaeT OTHOWeHNe K HeMy), 6e3,gOMHOCTb. Pa60Ta: YXy,ruWeHNe BbInOnHeHNA pa6OTbl, HeC4aCTHble Cny4aN, npOfynbl N OTCyTCTBNe no 60ne3HN, 6e3pa60TNlAa. flpaBoHapy- npaBOHapyWeHNA, COBepWëHHble B HeTpe3BOM COCTO- WeHNA: AHNN, ,gOpON(Hble aBapl4N, noTpe6neHNe anKOfonA He- COBepWeHHO neTHNMN, XynNfaHCTBO, HaCNJ1Ne N CCOpbI B CeMbe N BpeMA, KOTOpoe TpaTNT nOJ1NHNA Ha pewee npo6neM, CBA3aHHbIX C anKOfoneM n0JII3111i5I, Cy,a, 6oJIbHHI110I H CJIy0IC6bI nepBHLIHOH MeAFIKO- CaHHTapHOii nOMOLL[H LIaCTO He CHCTeMaTH'iCCKH COO6LI[âIOT O ponH âJIKOfoJISi B i3HIi,Fi,IjeHTâX, KOTOpble OHIi (i)HKCHpyIOT. C He6OJIbLIION AOJIet4 AOIIOJIHHTeJIbHbIX yCHJIFiii OHH MOTÿT BBeCTH npocTylo CHCTMY (IHKCHpoBaHHSI HâJIH111I5I HJIH OTCyTCTBHSI aJIKOI'oJISI, KaK (baKTOpa B JlaHHOM HHuHACHTe. 3TOT BHA 3anHCeFi MO)KeT CTaTb 6eCIjeHHbIM HCTO'IHHKOM McCTHbIX ,aaHHbIX, KOTOpble MOKCHO HCIIOJIb30BaTb IiJA HJIJIEOCTpauIiH npHpoJjbl npo6JieM, B Kâ'-IeCTBe CTHMyJIa HHTepeca MCCTHbIX CpeACTB MaCCOBOÎ-i HH(l)opMaIJ;HH H KaK 16 nOBOA AJISI Ae6aTOB. TaK)Ke HX MO>KHO HCHOJIb3OBaTb KaK CTapTOBblii nOKâ3aTeJIb ,ijJIA nOCJIevioüjer0 KOHTpOJISi H OLjeHKH. Ba)KHO TamiCe CO6HpaTb HHIbOpMa11HK) o ApyrHx acneKTax AeS1TeJIbHOCTH n0 BOnpOCaM aJIKOrOJISi B 06HjeCTBe, BKJIIolIâ51: iiaCbi npoAaxcH aJIKOrOJni, KOJIH'1eCTBO 3aseAeHHii, HMeiolljliX JIHIjeH3HI0, HCKJIIOLIeHHSI H3 HOpMâJIbHOiï npaKTHKH H TeHAeHIjHH B JIHueH3HpOBaHHH; paCnpOCTpaHeHHOCTb H pacnono)KeHHe TO'-IeK npoAaxcH aJIKO- rOJISI, IbaKTOpbI, BJIHSIIOII(He Ha HX H3MeHeHHe H HOJIHTHKa peaJIH3a1[HH âJIKorOJISI; nOJIHTHKa OTHOCHTeJIbHO o6pa30BaHH51 HO aJIKOrOJIbHbIM BOnpOCaM B IIIKOJ1aX, BbICHIHX yLie6HbIX 3aBeAeHHSIX, o6bëM H THn o6pa3oBaHHSI HO BOnpOCaM aJIKOr0JI51; BO3M0)KHOCTb AJIS1 cneuHanHCTOB npoNTH 06y4eHHe Ha HaL(HO- HâJ16HOM H JIOKâJIbHOM ypOBHSIX no BbISiBJIeHHK) H JIe'-IeHHIO aJIKOrOJIbHbIX np06JIeM; npHMepbi npOH3BOACTBCHHbIX MCp B OTHOHICHHH aJiKOrOJISi, BKJIfOL1a5i pacnpOCTpaHeHHOCTb TaKOBbIX H MX BbInOJIHeHHe; r{aCTHe aJIKOrOJIbHON npOMbIHIJIeHHOCTH H HHAyCTpHH AOCyra B np0(kJ1aKTHKe H O6pa3OBaHHH, OCO6CHHO FIX nOJIHTHKa B OTHOÜIeHHH 06yLIeHHSi cBOerO nepCOHâJIa; KaK aJIKOrOJIbHble npo6JleMbI OT06pa)KaioTCSi CpeACTBaMH MaCCO- BON HHcbOpMa1aH, 03a604eHHOCTb aJIKOrOJIbHbIMH npO6JIeMaMH H Ae6aTbl O HHX Ha AaHHbIIi MOMeHT, KOHTpOJIb peKJIaMbI Ha McCTHOM ypOBHe; H OTHOHIeHHe K HâJIHtIHK) aJIKOrOJISI B CHOpTHBHbIX KJIy6ax H Ha CHOpTHBHbIX MepOnpHSITHSiX, pacnpOCTpaHeHHOCTb TO'IeK npOAa- )KH, CIIOHCOpCTBO H T.A. C6op AaHHbIX TaKOI'O pOAa He AOJDKeH 6bITb CaMOIZeJIbIO, OH npeACTaBJISieT L(eHHOCTb TOJIbKO TorAa, KorAa SIBJISIeTCSI HaCTbIO CTpaTerHH maim AeNCTBHÎ3. Ba)KHO CKOHueHTpHpOBaTbCSI Ha AaHHbIX, 17 KOTOpble yxce eCTb B HanHLIHH H KOTOpble nerKO C06paTb TOrO, KaK OpraHH3OBbIBaTb HOBble HariHble npoeKTbI. r10HCK HH(l70pMauHH LiaCTO noMoraeT npoueccy CO3,aaHH51 B3aHMOCBM3eFi H nOBbILIIeHHK) HHTepeca B C006LueCTBe. HHOrna ero MO)KHO CKOM6HHHpOBaTb C HCCnejjOBaHHeM, KOrna OCHOBHbIX npeA- CTaBHTeneli OpraHH3auHii onpaLHHBaK)T C nOMOIubIO aHKeTbI H ZjanbHeFiLneli 6eceAbI o6 HX B3rnMukaX Ha anKOrOnb H CB5I3aHHble C HIIM npo6neMbI. 3TH B31-n5I,abI, XOTSI He O65I3aTenbHO npe,gCTasnMIOT B31-115I,,abI O6LueCTBa B uenOM, LiaCTo 1-10ne3Hbl j11151 nOHHMaHHM OTHOI11eHH5I H npej.[CTaBneHHii, KaCaK)LuHXCM AeMTenbHOCTH 110 BOnpOCaM anKOrOnSI. I7poeKm 17axmu 1-1poeKT .lIaXTH SiBnSIeTC5I r-IaCTbIO Esponelicxoro nnaxa ,iZeIiCTBHUi B03 no 6opb6e c noTpe6neHHeM anxoronx H HaueneH Ha COKpaLueHHe CBSI3anxbtx C anxoroneM H HapxoTHKaMH npo6neM B paMKaX He6onbLnoro ropOAa. gBOe yifënblx, B3MB Ha Ce6M ,EkBOIiHyIO (1:IyxKuHIO nposeneHHM HCCnejjosaHHSI H OL[exxH ero pe3ynbTaToB, nocTaBHnH ce6e 3aAatIy: co6paTb ocxoBHylO HHCpopMauHlo, OpraHH3oBaTb BCTpeLIy Bcex 3aHHTepecoBannblx rpynn H CH0006CTBOBaTb (tlopMHpOBaHHIO COTpynHHLICCTSa Ha paHHHX CTaJjHMX npoeKTa. B pe3ynbTaTe 3T0r0 McCTHble BnaCTH H OT,IS;enbI 3,IjpaBOOXpaHeHHM, COLIHanbHOH pa60TbI H o6pa30BaHHM y3HanH o pa6oTe Apyr Apyra no npo6neMaM anKOrOnSI H 6bina pa3pa6oTaHa cepHM coBMeCTHblx MoAyneli pa6oTbl c HaceneHHeM. rlpoeKT pa3pa6aTblBanCM npH yLIaCTHH 3aHHTepeCOBaHHbIX nIOAeN, aJjMHHHCTpaTHBHbIX pa6OTHHKOB H npej[CTaBHTeneN BnaCTH 3TOii McCTHOCTH, a TaloiCe 3aHHMaIOLuHXCM BOnpOCaMH anKOrOnM yLIëHbIX H ,IjeMTeneM 06pa3OBaHHM. Pa6oTa 6bIna OpraHH3OBaHa B ckopMe MO,Ijyneli, Kâ>1C,LIbIii H3 KOTOpbIX 6bina CB513aH C HCCneAOBaHHMMH. Kamçtblli MoJjynb AelicTBOBan B CBOeii OnpeAe- nëHHON C(I)epe, H BCe OHH KOOp):IHHHpOBanHCb Ha BCTpemax pa6oTaloLHx no npoeKTy cneuHanHcToB. Pa6oTy no npoexTy BO3rnaBn5lna rpynna, COCTOMLuaSI H3 McCTHOrO KoopAHHaTopa, KoopAHHaTOpa npoeKTa, KoopAHHaTOpos Monyneli H npenoAaBaTeneli no BonpocaM anKOronM. bbina TaioICe C(i)opMHposaxa rpynna Hay9HOIi noaaepxCKH, COCTOMIuaM H3 CneuHanxCTOB B Raxxoli 06naCTH. 18 61 91HHE130U NUN `H1rCU H11,4,EH H XE,LOaNi EH H1OEIfa fiOHEJdO I9109Ed iHOOOatiodu o 15o9114vvoxEH£o EHxCifot Euu,Cd1 'soifatiio Ea1.ox14m9lrog KIft1 111000du0a Y1II9H310EH KO101WHK 9IfO.IO)IIf6 01.h `91ISHOU vvK.LOEIfa 9h01V011 1990.1h `.LI9u0 H aI9HHEt1 KaaHfiOlavvH aOH 9.LEH0£9If0Ua14 019H11OX900H OIUO.IOxIfe OU H14H1.oHat1 auuXd1 'KHHaHEdxooaEdti£ EI101110 H.LOOH9ua.LKaT! 910E1f90 oax£.0 MEN `a9aodoti£ ,LOIEaHd.LEVVOOEd dou XHO ott HHO NUN xE.L `0.1O.Le xEH.lOatrhClnlHadu H 91141109X oxxdLi atria x11.1Xd17 'HMI KLVads 01 a `09aodott£ EH HxH,114LfOU HHriE.LHOHdo 91O0HxCEH 10IE11HHOU axCX H.LOEIra Hua1.HaEl.ottadu 0I9do1ox0H 'ÂXaLIOX x .1.at7aaHdu HIf tiKdaEH 1414H1,OHatt HUM HI9HHEHOOEI[JOO axCEii H013EIfH XI9H1,OaN[ Hxx(dattttou HOHHH.LxE £ag '11I09fiOdOti£ OO iliairgodU HHHaaOH)IHH£Og s KlroJOxirE Huod 14oHiHOd10 I4101ah.0 a H.LOOHOEUO£ag H 119aodo17£ I9HEdXO `9aEhXIfO XI9H1.OEhOOH HxH1.xErfHCtoOdU 9H0fiodiC Hii)I00I9s KoifEaHxcdamiou xKH.LKHduttadu EH I9901h `iC111o1 9.LEHOS139000UO 014/Hti0X900H IKx '19HLIÂ10017 O)IOdHm HL1I99 EXI91t10 KHHOLfOiC 0I9HflH.LEHda1911E E `wO£EdgO N[HTIIOLCa.LO.La9.L000 19HaxcououaEd 1411199 KHHatlaflE£ vvaif0J0xLfE a14mOliCJd01. 19901.h `91.EEOd14uod.lHOxodU I9H31CI1olt I9iiad3 1,10t1I01ExCAxo HOaOdOtt£ H KHHEaOdHHE11u 191faï1.L0 '01.O0111 I110h09Ed EH KIfO.IOxIfE H141-10m0H10 s 19d0la H wExHH.logEd HtrIOwou I9WVVEdlodu aHmodox 9.LEaodHtiHE.IEuodu I9HxClfOt 14101fEH0OdaU O a109Ed 01I I9I101i10 'KIl0J031IfE oIHHaLf9ad.10u kNIaHmHIf£H HIfBa0a1O9000113 OH `9IfOd.1HOx 9100 XHH ,C 14vv19d01031 ttEH `KrfoJOxifE EIsiEUxad H KHtIE£HlrEad 19901.h `O1. E£ 9.1.00H1-10a -1alasLO .LaOOH 10H00 `0x01E1 `.NIEHaiI YvI9HH03CHHO OU KLfOJOxirE 14310EttodU HUH EJÂOOtt HHd.LO/CtiHH KIfii KIfOJOxIfE xOLIXxE£ XHHmHLf£H Lo 9aHmaE£Ex.10 `dawHduEH `9.LoovaHmad ()Joao 91.ESod14d.loxowatlodu OmaH 000Z x KIfOJOxifE KHHaugad.loU 01HHamEdx0O OU ÂhEtiE£ K900 KIft1 IfKHHdU 10fiO3 19901.h `01vHtt0X900H '09aodott£ O a.1ogE£ 910OHH031CdaaHdU XH 91ExCEd.LO I9HxCIfO11 ExH.1HIfOU H KHH1O1,10tt XH aas 01h `.LaEhEH£O 09a0dOti£ EH aO.laaoa xHxottOdOJ IfHtIE,1HaHd0 11013EL18 X19H13011 ISNti7B1H2Nd0 'KIfOJOxIfE vvaHH0if90d1.0U a OHE£KHO XI9d010x aHHaaOHxHH£OH `Haugodu XI9H9IfEHTIOO H 119sodotl£ ivairgodu axH1.xE1rH4)odU OU aHHOdiC Y1IOHtiodEH/CtixC0141 H Y1IOH9IfEHOHtIEH EH a.LOgEd a `EriodoJ HpiElrattadU EC H Ha£alroU 1.attS9 1I9u0 HI9HHa.LadgoHdu 'H31H1.xEIrHCpodu I9daNt 0I9HaH1.xaCDCD6 H 0I9HhH1,OHifEad 91,E1AgEd£Ed OI1J01110u XI9H2h H H1.XEJr HO1.O14LfEHtIaUa Ofi1O0hHH17ALLOD anKOrOnb H npO(i)i3naKTHKy CB5I3aHHbIX C anKOrOneM np06neM Ha nOBeCTKy J><HSi. Bo MHOrHX CnyLIâSIX McCTHble BnaCTH CaMH CTaHOBSITCSI HHHIAHaTOpOM CO3,aaHHSi rpynnbI ,IleiïCTBHii n0 anKOrOnIO H nOMO- raK)T B CTaHOBneHHH eë am-opinera H BnHSIHHS. TeM He Mexee, rpynna He AOnxcHa 1103BOnHTb C,IjenaTb Ce6x 7-IaCTbIO oTaena 3ApasooxpaxeHHSi HnH couHanbxoro o6ecneneHHSI, Aonxcxa nolttIëp- KHBaTbCSI He06XO,IjHMOCTb yliaCTHSI B pa6oTe ulHpoxoro Kpyra OTjjenOS H 3aHHTepeCOBaHHbIX rpynn. BCeCTOpOHHHk( nOJjXO%j K OXpaHe 3,4OpOBb5f nO.gpa3yMeBaeT, tiro IjJISI rIJIaHHpOBSHHSI 34)(1)eKTHBHbIX OTBCTHbIX Mep ,aOn)KeH 6bITb npHHSIT BO BHHMaHHe LuHpOKHii Kpyr npo6neM. I'pynne AexCTBHH 6yj(eT Hy-Aula nounepxcxa macre, HO Taxx(e OHa 6yueT 06na,aaTb TeCHbIMH CB5I33IMH C HaCeneHHeM H rpynnaMH noTpe6HTeneii, He 6y,Ijy=IH CTeCHëHHOIi TaKHMH yCJIOBHOCTSIMH, KaK nOnHTHLieCKHe H npO(DeCCHOHanbHble OrpaHHiieHHSi. npOnaraHAHCTbI 3gOpOBbSi JZOJUKHbI HayiiHTbCSI aenHTb BnaCTb C nK),IjbMH, a He 6paTb BnaCTb HâJ>( ni0%>;bMH; 3T0 03HaLiaeT: MeHbIIIe jjHpeKTHB H 60nbIIIe 06cyx,aeHHSi peuleHHFi c niOJjbMH. 3T0 Taxxce O3HaLiaeT LITO, XOTSI cTpyKTypa CIIOCO6CTByK)Illaâ Te*ieHHlO npoijecca TaiUKe Ba)I(Ha, 6onbuie BHHMaHHSI jZOJUKHO yaenSiTbCSi npoueccy, a CTpyKType MeHbule. CTpyKTypbl, OCynjeCTBnSnOII(He nOnHTHKy, AOJDI(HbI HMeTb 6onee KonnerHanbHblx, a He HepapxHriecxHH xapalrrep. 3TH CTpyKTypbi H npOljeCCbl jjOJDKHbI yCHnHBaTb COTpyj(HHLIeCTBO, a He KOHKypeHLjHK) (5). 20 2II)opnnlipoBaHme rpynnbi B viv,qe v cT no an Ko ron Fo BeposiTHo, rpynna AdicTBHii no anxOronio 6y,IZeT ccbopMHpoBaxa nH6o cornacxo pacnopSUKeiiHlo HaljxoHanbxoro, o6nacTHoro HIM MecTHOro OpraHa BnacTH, nii60 BO3H13KHeT n0 HHHuHaTHBe Hacene- HHSI. BHe 3aBHCHMOCTH OT 3T0r0, CaMoe Ba)KHOe, LIT0613I HaCeneHHe 6bICTpO npH3HânO npOeKT McCTHOrO nnaHa AeiiCTBHii n0 npO6neMaM anKOrOnSI CBOHM. OCHOBHOii npHHuHn cTpaTerHH B03 no AOCTH- )KeHHIO 3AOpOBb51 AnSf BCeX COCTOHT B TOM, *-ITO OTAenbHble niOAH H ceMbH AOn)ICHbI BHOCHTb CBOi-I BKnaA B CBOë pa3BHTHe H B yKpenneHHe 3AOpOBb5I HaceneHHSI cBOeli McCTHOCTH. TaKaSi (i)HJIOCOci)HSI MO)KeT nOKâ3aTbC5I nyCTOii pHTOpHKOI3 AO TeX nop, nOKa He 6yAeT CAenaHa peuiHTenbHaSi nonbITKa AaTb HH(kOp- MauHIO Ka)iCaOMy O TeKyIuHX np06neMaX H Cn0006CTBOBaTb ymaCTHiO HâCeneHHSI B npouecce rinaHHpOBâHHSI. HAeH rUIaHa AeÎiCTBHii no npO6neMaM anKOronSl nOnDICHbI pacnpocTpaHSITbcSI, KaK p5l6b n0 BOAe, H MeHSITbCSi nOA BO3Aei%ICTBHeM MHeHHH HaCeneHHSi H conpOTHBneHHSi, C KOTOpbIMH OHH CTanKHBaIOTCA. Heo6X0AHMO, iiT06bI OKOHtia- TenbHaH 4)OpMa nnaHa HOCHna Ha ce6e yHHKanbHbII4 OTneiiaTOK MHe- HHSi i3MeHHO 3TOrO HaCeneHHSI. nPOuECc IIpouecc pa3pa6oTKH cTpaTerHH naCTO HMeeT 6onbuiee 3HatIeHHe, HeM cTpyKTypa. Ilpouecc npHBnexaeT 3aHHTepecosanxbiX; B AHCKyCCHH C HacenexxeM po)ICnaiOTcSI HOBble HAeH H noxHMaHHe. 21 HaLianbxoe pa3BHTHe I'pynnbl AeiICTBHH HMeeT peuiaioluee 3HaLieHHe, TaK KaK Te, KTO 6binH npHBneLIëHbI nepBblMH K 3TOIi pa6OTe, B AanbHeHlueM iIacTO OnpeAenSlioT eë nOCneAyK)ujee HanpasneHHe. OpraHH3aIjHSi, nOnyLiHBIIIâH 3aAaHHe C4)OpMHpOBaTb rpynny, AOnxcxa CB5I3aTbC5I C COOTBeTCTByKKI[HMH rpynnaMH H OTAenaMH H npo- cneAHTb, LiT06bI Fpynna AetiCTBHii 6bIna He CnHIUKOM 6OnbiHOr HnH He CnHIHKOM AanëKOH OT npeACTOSiIljeii 3aAaLIH. K pa6oTe B rpynne AOn)KI-IbI 6bITb npHBneileHbI RK)AH C pa3nHLI- HbIMH HaBbIKaMH H MOTHBaMH. 11pOH3BOnbHO, HX MO)KHO KnaCCH- (13HIjHpOBaTb KaK 3HTy3HaCTOB, BRHSITenbHbIX nK)AeI%I, aAMHHHCTpa- THBHbIX pa6oTHHKOB, u3KCnepTOB" H HCcneAOBaTenei4. B HOKOTOpbIX CRyLIaSIX OAHH iienOBeK MO)KeT COLIeTaTb B ce6e BCe HRH, no KpaHHeli Mepe, HeKOTOpble H3 3THX XapaKTepHCTHK. Ka)KAbIIi BHOCHT CBOI%I Bâ)Ki-ibIIi BKnâA, HO OAHH 6e3 ApyrHX MO)KeT TOpMO3HTb HJIH HCKâ)KaTb 34)43eKTHBHyI0 CTpaTerHio. 3HTy341c2CTb1 ManOBepOSITHO, LiTO nnaH 6yAeT OCyL(jeCTBRSITbCSI 6e3 KnIOLieBOi%I rpynnbI RHLIHOCTeii, KOTOpble rJIy60KO o3a60LieHbl COCTOSIHHeM AaHHOro HaCeneHHSI, OKpyx(aloujeH 06CTaHOBKH H CB5I3aHHbIMH C ânKOrOneM npO6neMaMH. OHH 6yAyT OCHOBHOIi ABHraTenbHOii CHROH, LIaCTO OTAaBaH nnaHy HCKniOLIHTenbHOe BpeMH H 3HeprHK1. OHH MOryr, TeM He McHee, npeACTaBnSITb HeKOTOpble CRO)KI-IOCTH B CJryLIae, ecnH 06naAaiOT 3KCTpeMHCTCKHMH HRH KpaiiHHMH HHTepecaMH, KOTOpble MOryr HCKâ3HTb IIIHpOKHii nOAXOA, He06XOAHMbIii AnSI AOnrOCpOLIHbIX HanpHMep, HeKOTOpble npeBeHTHBHble KaMnaHHH OKa3aRHCb McHee 34)(1)eKTHBHbIMH, KOrAa OCHOBHOIi aKIjeHT Aenancsi Ha nORHOH Tpe3BOCTH, Him )Ke KaMnaHHSI, no MHeHHIO 061IjeCTBeHHOCTH, aCCOIjHHpOBanaCb C 3anpeTOM. B ApyrHX cJryLiasiX BeAyujasl ponb anKOrOnbHOii HHAyCTpHH MO)KeT 6bITb HeBepHO HCTOnKOBaHa. np0(beCCHOHanbHOe npoTHBOCTOSIHHe, HanpHMep, Me)i(Ay OTAenaMH 3ApaBOOXpaHeHHH H COI(HanbHOro 06eCneLieHHSI, MO)KeT TaK)I(e CO3AaBaTb CRO)KHOCTH, KorAa OAHH ceKTop, no MHCHHIO Apyroro, 6ep8T Ha ce6si CnHIIIKOM rnaBeHCTByK)njyiO ponb. nepeOljeHHBaHHe pORH oAHOH nonHTHLIeCKOÎi HRH penHrHO3HOI%I rpynnbI I-IJIH OAHOro KâKOro-nH60 yLipe)ICAeHHSI TaK)Ke MO)KeT npHBeCTH K OCRO)KHeHHSIM B IIJIK)panHCTHLIeCKOM 06IIjecTBe. 22 3KcnepTbl rpynne 6y,i(yT Hy)KIibI niOJH, HMeIOnjHe CneL(HanbHble 3HaHHB no aJIKOrOnbHbIM npO6neMaM H McCTHbIM 3aKOHaM, KaCaiOIIjHMCSI aJIKOronSi. T-laCTO K pa6oTe npHBneKaIOTCSI CneLjHanHCTbI 113 cctlep 3ApaBOOXpaHeHHSI, COLjHanbHOro 06ecneLleHHSI H IopxcnpmeHLjHH; cneuxanxcTbl ccbepbl o6pa3osaxxsl, couHOnorH, ncrIxonorH, aHTpo- nOJIOTH H KpHMHHânHCTbI - BOT CneLjHanHCTbI, KOTOpble MoryT BHeCTH CBOH n03HaHH5I, HeOLjeHHMble jjJISI npoABHoKeHHSI nnaHa. B HeKOTOpbIX O6naCTSIX peanbHO He 6yj[eT cnenHanHCTOB BOO6111e, B TO BpeMSi, KaK B jjpyrHx HX MO)KeT OKa3aTbCSI HeCKOnbKO C pa3nHT3HbIMH HRH j(a)ice npOTHBOpeLiaLLjHMH B3rnSIjjaMM B OTHOIIIOHHH Tpe6yeMbIX Mep, H 3TO Heo6XOjZMMO O6CyjZHTb B paMKaX pa60TbI rpynnbI neiicTBHii. A,qMHHNCTpaTHBHble pa60THNKN OLIeHb Ba)KHO, LITO6bI npeACTaBHTenH Oc1)141(ManbHOIï BnaCTH jjaHHOIi McCTHOCTH Hull ropo,Ija 6bInH TeCHO CB5I3aHbI C pa6OTOii rpynnbI j(eIiCTBHIi. BpSIJj nM rnaBbI MeCTHOii agMHHHCTpaIUHH HJIM jZaxce HX 3aM8CTHTenH HaliAyT BpeMSI 3aHHMaTbCSI jZeTanbHblM rUIaHHpOBaHHeM. OHM jjOn]KHbI, TeM He McHee, 6bITb CB5I3aHbI KaKHM- TO o6pa3oM C npOneCCOM nnaxxposaHHx, LITO6bI pa3pa6oTKa npOXoj[Mna C MX cornaCMSi H Ojj06peHMSI. be3 3TOii CBSI3M, max MO)KeT 6bITb pa3pa6OTaH c 601IbrnMM 3HTy3Ha3MOM, HO He HMeTb peanbHOrO BOnJIOLLjeHHSI 113-3a OTCyTCTBHSi O(IIHLIHanbHOrO pa3peLLIeHMSi Ha ero BbInORHeHHe. 3tH nlOjjH 06b01HO OLIeHb XOpOLIIO OCBejjoMneHbl O nonHTHLIeCKHX H (1)MHaHCOBbIX nOCnejZCTBMHX paCCMaTpHBaeMbIX npo6neM. BnNSlrenbHble nlo,4N B 601IbLÜHHCTBe HaCeneHHbIX IIyHKTOB j(OBOnbHO nerKO OnpejZenMTb niOjjeii, KOTOpble 11Onb3yiOTC5I BbICOKHM aBTOpHTCTOM H 06naj(aIOT BnMSIHHeM cpejzH McCTHOI'O HacenexxSl. Baxcxo, LITO6bI HeCKOnbKO LUIeHOB rpynnbl jjeliCTBMii HMenH TKO aBTOpMTeT H MOrnH nOBnMSITb Ha BaHCHble OTj[enbl MeCTHOIi aj;MMHHCTpaIIHH H HaCeneHMe B LjenOM, a TaK)Ice BbICTynHTb B nOartepxcxy rLTIaHa, KOrjta ero 6yjryT KpHTHLIeCKH OI(eHHBaTb. npHMepOM TaKHX nlogeli MOryT 6bITb BejryIIjHe nonHTHKH, pyxosojiMTenH xpynHblx npennpxslTHli, 23 npoctiCOIO3Hble ni3Zjepbl, riexble, npe,gcTaBHTenH rpynn noTpe61I- TeneH H CpeACTB MaCCOBOH HH(DopMaw3H. 1iiccne,qoBarenN OpraHH3aItHOHHOH rpynne He06XaaHMO HMeTb Ha,aë)KHble CpeACTBa OL(eHKH JZOCTOBepHOCTH nocTynalOII.jeH HHCl'opMauxH H KOHTpOnSi BnHSIHHSI BHe,gpMeMbIX Mep. Be3 nOHHMaHHSi 3THX HayliHblX BOnpoCOS, BeCbMa BepOMTHO, IITO l'pynna Rei%ICTBHI%I 6y,aeT OnHpaTbeSl Ha HeCyLLjeCTBeHHble nOTpe6HOCTH Ii AaHHble. B I'pynne AeiiCTBHN TaKxce ,I[On)ICHbI 6bITb npeACTaBneHbl pa3- nHliHble CJIOH HaCeneHIiSI. OHa JjOn)ICHa 6bITb XOpOLUO c6anancH- pOBaHHOii B nnaHe nana, BO3paCTa, COLjHânbHOl'O H 3THHIieCKOrO npOHCXOxCJjeHHM ea yLiaCTHHKOB. OLIeBH,gHO, IiTO 6bIJIO 6b1 HepeanbHbIM O)KHjjaTb, IiTO I'pynna ,geï-rCTBHIi CMO)KeT COOTBeTCTBO- BaTb BCeM 3THM Tpe6OBaHHSIM H He pa3paCTëTCM AO OrpOMHbIX pa3MepOB. Ba)KIibIM BOnpOCOM, TaKHM O6pa3oM, SIBnSIeTCSi TO, IiTO6bI BCE pa3HOO6pa3He HHTepecos McCTHOrO HaceneHHM OTpaxcanOCb H HMeno CBOrI rOJIOC Talc, IITO6bI ace Hy)KAbI TLIjaTenbHO yIIHTbIBanHCb H 6bina HaliJjeHa noJ.jXOjIAÜ.(aSI peKOMeHaauHM. CyLL[eCTByeT MHO)KeCTBO CII00060B CO3J:(aHH5I n0,4X0)1,5ILgei3 CTpyKTypbI no peanH3aLjHH rUIaHa. OAHa MOJjenb - 3T0 COIieTaHHe He6o11bLLIOIi rpynnbl ,aeriCTBHii no anKOroniO, COCTOSImeH 113 6-10 IIenOBeK, H ropa3,go 6onbIIlero KOHCynbTaTHBHOCO C06paHHA, rJ[e 6bInH 6b1 npe,gCTaBneHbI HHTepeCbl BceX CAOës HaCeneHHSt, ynOMMHyTbIX BbILIIe H nepelIHCneHHbIX B Ta6nxqe 1. }COTM CyLiZeCTByiOT Bne9aTnMK)wHe npHMepbi npoeKTOB, KOTOpble 6bIJIH pa3pa6OTaHbI C MHHHManbHbIMH pecypcaMH, peJtKO MOxcHo pa3pa6OTaTb IIJIaH 6e3 BJIOxCeHHSi HCKOTOpbIX Cpe,I[CTB arm OnJIaT6I pa60TbI nepCOHana. KOOpJjHHaTOp H CeKpeTapb - BOT BO3MO)ICHble MHHHManbHble Tpe6OBaHHSi JjJISI 60nbLIIHHCTBa ropOJjOS. B AepesHMx HnH CenbCKOI4 McCTHOCTH C ropa3Ao McHbIIIHM HaceneHHeM 'max MO)KHO pa3pa6oTaTb LjenHKOM Ha ,I[O6p0BOnbHOH OCHOBe, HanaJjHB COTpy,/aHHIieCTBO Me)ICJ[y OCHOBHbIMH aeHCTByIOlI1HMH nHLlaMH. B OTJjanëHHOH nepcneKTHSe, MHOrHe 3artaIIH nnana MOryT 6bITb BbIIIOJIHBHbI uepe3 HCIIOnb30BaHHe yxce CymeCTByIOILjHX CTpyKTyp H nepeopxeHTawHH IOt yCHnHIi HJIIi 3a cliëT ctlopMHposaHHM HOBbIX anbMHCOB. 413yHKLAHH CeKpeTapHaTa MOryT 6bITb HHTerpHpOBaHbI B 24 6onee IuHpOKyIO cTpyxTypy pa60TbI no yKpenneHHlo 3j10pOBbSI sHyTpH coo6mecTBa. B3AVIMOCB593b C HAWOHAJ1bHbIMV1 I1J1AHAMVI B Hneane, I'pynna AeHCTSHH nomma cpyHKuHOHHpoBaTb B paMKaX CKOOpnHHHpOBâHHOIi ânKOrOnbHOI%I nonHTHKH, KOTOpaSI 6bIna npHHSITa Ha HaUHOHânbHOM ypOBHe (10). KaK y)Ke TOBOpHnOCb paHee, OTCyTCTBHe TaKOii nOnHTHKH HnH nnaHa He nOJDKHO OCTaHaBnI-iBaTb neiiCTBHSI Ha McCTHOM ypoBHe, HO B 60nbIIIi3HCTBe cnyT-IaeB )Kena- TeJIbHO TeCHoe B3aHMOneIiCTBHe Me)Kny HauHOHanbHOii, 06naCTHOii H McCTHOii CTpaTerHSIMH. KOHIjeHTpHpOBaHHOCTb Ha HaI.IHOHânbHOM rUlaHe H Ha 3ana4aX, KOTOpble nyjnIIe BCerO MoryT 6bITb BbIIIOJIHeHbI Ha 3TOM ypOBHe, Mo)KeT OTBneTlb BHHMaHHe OT Kpyra npCBCHTHBHbIX Mep, KOTOpble MO)KHO OCyIIjCCTBHTb Ha McCTHOM ypoBHe. B 60nbIIIHHCTBe CnyTlaes TaKHe peIIIeHHSI, KaK B o6nacTH Hanoro- 06JI0)KeHHSI H 3aKOHOnaTenbCTSa npHHHMaIOTCSI B IjeHTpe, HO CyIIleCTByeT MHO)KeCTBO BO3MO)KHOCTeIi nJISI LIHCTO McCTHbIX HHH- IHaTHB. rpynnbl neI-ICTBHii no anKOrOJIiO MOryT TaK)Ke 6bITb CB513yK)ujHM 3BeHOM, KOHTaKTHpySI npyr c npyroM H o6pa3y5l CeTb, KOTOpaSf 6yneT HHIflopMHpOBaTb npaBHTenbCTBO O BnHSIHHH HarjHOHanbHOli nOnHTHKH H CnOCO6CTBOBaTb nOHHMaHHIO McCTHbIX npo6neM. 5011EE WMPOKOE CO6PAHME Fpynna neiicTBHH no anKOrOnIO, B Hneane, nOJDKHa 6bITb He60nblIIOii, KOOpnHHaTOpy nOCTOSIHHO nOn)KCH OIIJIaTiHBäTbCSI nonHbIli pa6otHli neHb, T-ITO6bI OH nponBHran pa6oTy no nnaHy, C06Hpan naHHble, OpraHH3OBbISan BCTpeTiH H pacnpocTpaxslJl pa3pa6aTblBaeMble HneH. Kpyr 3anaTl H KOnHTieCTBO BO3MO)KHbIX yTiaCTHHKOB BbIIIOJIHCHHSi cTpaTerHH MO)KeT nOKâ3aTbCSI yCTpaulalouje 6onbIIIHM. rJOne3H0 pa3nenHTb 3anaLIH no cciepaM nCSlTenbHOCTH H yCTaHOBHTb npHOpHTeTbI, onpenenHB rpynnbl, OTBeTCTBCHHble 3a Kaxcnylo ccbepy. Baxcxo o6nyMaTb, KaK o6ecnetHTb nocTOSCHHOe nposenexxe pa60TbI. CO3naTenH rUIaHa neiiCTBHii nOJDKHbI 06eCneTiHTb TO, iITO6bI BbIIIOJIHCHHe nJlaHa He 3aBHCenO TOnbKO OT CII0006HOCTeIi OnHOTo 25 9Z ao.LE.L91r£ad o.1a aNxaTlo H HHHamolruos oIa INamHaH4IrET! Hdu H IsuO.IONIrE INEINairgodU ou HHa.L0Ha1t EHEIfLI HHHE1t£00 Hdu EO0H£H9 H Ea.LOdETt,Coo.i `H.L0oxxaa.L0at11go I4oadalHH 41,EâI4£EM31411 IfHhONIOHIfOU 4,L01H .La1tX9 O1.0Eh aHHEd903 aOH -aH.LE.L4I1C0HOx 'EIfEHOOdau O.IamOIEflHNCarOgO 0HH0h,C90 H HiNHH10L1 -0HHamdaaoOaH aHHalf9ad.L0U MEN `I^IEOOduos ivHNE.L OU HIfEhHH1t,Cd.L00 E,IÂOOit KHd1.0,07HH H 4.LOOHHaIrmI4INOdu ISEH9I1O.ION1fE `114aodoit£ ÄHEdxo E£ KoaHmoidog o.I.h `0H100a£H `daiNHduEH :,CI,Cd1t I,Cd1t HWI4HNCOIfOIIOaH.LOd1I oi41.00HIfou ISO.IkiCEN al4do.LoM `IluXd.I  axcE17 4113NC,CdEH90 OHNCONI O,LOEh 1430d01HH 0Ht119O '01110011790 NIOHHET! a iCINaI. ,CL6 EH ,LOiiCa.L0a1II,C0 014d010N `I4111fif.I£a H aHHamOHIA 4.LEH£ `a1f010MLCE g0 oiH11EINdOCPHH OIOa 4.LEdH903 K041E1I411 I9HNCI101t HHO `OIHCp0001fHCp iCI-Iito O9HIf-0i,CMEN 4H£HNC â aHmOlEmolruoâ HIfH ua14H4IfO,IONIfEH.LHE MEN `IS04.LEaHd.LE1s100Ed I4HNCIfO1t aH HHaLOHaTI ELILUCd1 H 011HEd9o0 0OHâH.LE.L4Ir,COHOx 'I9Oad01HH 014H.LxHInjMON KO4.LEMCEdI9a I4HNCIfo17 4oa17£ `.aONHHHaifU1I4NIOHHTta I4.LEga1t a 4OOIfH.L -Edaadu 0H 0HHEd900 I4901.h `OHNCEg 'ISHHad£ HxhO.L 0I4HNC0Ir0110a -H.LOdu axaoHE.LOgo HoH4Ira.LHdasott a Ko4,LE1tNC,Co90 H 150.11.ESI9£EN019a ,LrC.IOiN E17.IOHH 40017£ 'I41O9Ed 4.L00HH2H0xE£,C H 4.L0oINaxuaBdU,C .LHhauOago aNCNEI. E`E.LahOIA ÄNhO.L 0IIf0.I0xIrE OU HHa.Loxalt auu,Cd,l L0E17 oaE I a1iHlrgE,L a XI4HH0I1OHh0d0U `uu,Cd.I xa0a Haua.LHaE,L0ltadU K900 a 4,LEh0I1fNa OHNCIfOit aHHEd900 a0HflH.LE.L4If,COHOx ,CM0a01f0h ,CINOH4Ir01710 XINOmICEN H ,Ca1001119000 EaEdu 4.LHaE.Loottadu H100I190001I3 on a 11101000 EIfHO 010 -,CXdasO KO4.LKdltaHa H0MCIf017 aH HEIfjI 'OIHH31faOEH EHEIfLI O,IOHHETt H.LOOHNCaIf17EHHdLI Ea.LOa,Ch aHHalfuadNiC KOS.aKIfaK INaHHEa09ad.L H.LOOHNCEa OU INI4HâEd INHmo1,C1ta1fD ENNCdalmou KEa0OHEHH(I) H KENOahH,I.HIrOU EHEaodH.I.iIEdE.I EuI49 ,CINa H `KH.LHa£Ed HH11E10 HaHHEd EH H.LOEUS HINKIra,LHaE,L0ltadU HiNHm0iÂa.LO.Laa.L0oo H0d9o17o Iri9g HElru I4901.h `OI1IH1t0X90aH KHHahaU0a90 010H4IfEH1100 H 1(13H2HEdX0011Edit£ aoHE.Ido Ho.1.09Ed KHHauaEdu,C axcNE.L E `H.LOEIra soHE.Ido XI4H.L30IN KHHEâOdHOHEHH4) H KHHEaOdHHEIru sOOOaTIOdLI 10 HHIIKICO£H â HIfEZO9Ed aH aHHEdgOO aOHâH.LE.L91f,COHOx H 01IfO.IOMLCE OU HHa10HaT! ELIIlÂd I I4901h `OHNCEg 'KHHEfi0dHHEIfLI O.I0H9ICEUHTIHH,CIN XEMYVEd a O.LOaIN 20ao 's'ego HEM I4g0.I.h `INO.L a 1130130 I4109Ed KHHaltaaodLl O.IOHHKOI.00U KHH0h0UO090 a101t0d0 EH OHO 'HNH.LHIfoLI I410I.I3dOHdU 0I4aOH HLM IfEHOodaU HI4aOH MEN INHNE.L `iNEa.LO41ra.LKO.LO90 K01NHmo1 -K1aIN£H N EHEIfu OIHTIE.LUETlE H o1H11E£Hlread axmolEaxhau0a90 `I9d,CLN,CdLo HIrEa0a100111,C0 I49O1h `oINH110x900H 'ENaaolrah Heo6xo,I[HMo TaIOKe 06AyMaTb B O6njeCTSe WenaTenbxoCTb KOM6HHHpOBaHHbIX AeiiCTBHii no aJIKOrOJIK), Ta6aKy H HapKOTHKaM, KaK aJlbTepHaTHBy Z[eIiCTBHSIM TOJIbKO no aJIKOrOJIiO. KOM6H- HHpOBaHHbIIi nOAXOA MO)KeT 6bITb HenpHeMJIeM HJIH He)KeJIaTeJIeH A)751 HeKOTOpbIX CTpaH HIM KynbTyp, HO AJISI ApyrHX MO)KeT cn0- CO6cTBOBaTb yCHneHHiO 06MeHa OnbITOM H 34)(1)eKTHBHOCTH HCHOJIb- 3OBaHHSi OrpaHH4eHHbIX CpeACTB (11). 3A,qA4 14 Fpynna AeiicTBHii no anxoroJIiO AOJUKHa ycTaxoBHTb 3a4aLIH, KOTOpble 6yAyT OnpeAeJISITb uenH Ka)iCAOH nporpaMMbI, H nomma KOHTpOJIHpOBaTb nporpecc B AOCTH)KeHHH 3THX 3aAa4. CTpaTe- rH4eCKHii nOAXOA K nJIaHHpOBaHHiO B 06naCTH OXpaHbI 3AOpOBb5I Tpe6yeT OnpeAeneHH51 KOHKpeTHbIX ueneli no yJIy4IileHHiO 3AOp0Bb5I HaCeneHHSi, KOTOpble MOryT KaCaTbCSI KaK Ka4eCTBeHHbIX, TaK H KOJIH4eCTBeHHbIX acneKToB )KIi3HH (npeHMyIueCTBa AJISI 3A0p0Bb5I). I-ITO6bI OTCneAHTb nporpecc no AOCTH)KeHHIO 3THX ueneli, 4aCT0 none3HO OnpeAenHTb npOMe)KyTO4Hble 3aAa4H, KaCaiOnjHeCSi He TOnbKO 3A0p0BbSI, HO H Bâ)KHbIX (111aKTOpOB 3AOpOBb31 H npoueccoB, KOTOpble BeAyT K H3MeHeHHiO 3THX (laKTOpOB. HeAOCTaTOK KOJIHÜeCTBCHHbIX 3aAa4 COCTOHT B TOM, LITO OHH MOryT npHAaTb JIO)KHb1ii npHOpHTCT H3MepHMbIM napaMeTpaM. B33ITble B OTAeJIbHOCTH, OHH MOryT CTaTb CnHIIIKOM ynpOIIZeHHbIM OnHCaHHeM nOJIHTHKH. ECJIH KOJIH4eCTBeHHble ypOBHH 3aAa4 Bb16pa- HbI HenpOAyMaHHO, OHH MOryT nOKa3aTbCSI HepeaJIbHbIMH H OT HI3X nerKO OTKa)i(yTCSI, KaK OT HeAOCTH)KHMbIX. OnHCaHHbIii B Lime 1 c6op 6a30BOii HHIlaOpMauHH npeAOCTaBHT AaHHble, KOTOpble MOryT CTaTb OCHOBOIi Arm OnpeAeJIeHHSI 3aAa4. K 0006bIM acneKTaM OnpeAeneHHSI 3aAaLI MbI 06paTHMCSI nO3)Ke B nOcneAyioü.m rJIaBaX, HO ARA FpynnbI AeiiCTBHH BHOJIHe BO3MO)KHO OnpeAenHTb 3aAa4H B HeKOTOpbIX H3 CneAyK)njHX 06naCTei3: MeAHuHHCKHe npo6JIeMbI, TaKHe KaK TpaBMaTH3M, CMepTHOCTb H 3a60neBaeMOCTb, CB5I3aHHb1e C nOTpe6neHHeM aJIKOrOnSi; 27 COL[HanbHbIiï ynep6, Taxie SisneHHS1, KaK HaClulHe B CeMbe, xKeCTOKOe OTHOLHeHHe K AeTSIM, 6e3A0MHble H 6e3pa60THble; np06neMbl 061IjeCTBeHHorO nopSIAKa: nbSIHCTBO B 06LLjeCTBeHHbIX McCTaX, HaCHnHe B nbSIHOM BHAe, BOxv:teHHe B HeTpe3BOM COCTOSIHHH, ,1(OpONKHble aBapHH, Hapyulexxe npaBlln nHLjeH3H- pOBaHHSI H HeneranbHâSI npO113BOACTBO anKOronSl; H HpOH3BOACTBeHHble npo6neMbl, BKnIO*iaSl nporynbl H aBapHH. gpyrHe 3aAaLIH 6yAyT KaCaTbCSI H3MeHeHH5I OTBeTHbIX Mep coo6ujecTBa, TaKHX xaK: AOCTynxoCTb, KaLIecTBO H o6bëM o6pa3osaHHSI o6 anxorone H 06yLIeHHA HaBbIKaM pa6oTbI n0 np06neMaM anKorOJIA; AOCTynHOCTb H aKTHBHOCTb cnyx(6, HaneneHHbIX Ha yxpenneHHe 3A0p0Bb5I, B03AeiiCTBHH Ha paHHeii CTaAHH, AOnSi MeAHLAHHCKOro nepCOHana, 06yLIeHHOro BbISIBnSITb anKOrOnbHble npo6neMbl H npHHHMaTb COOTBeTCTBylOUnHe MepbI, npeAnox(eHHe ycnyr cnyxc6 yxpennexxx 3A0p0Bb51, paBOHCTBO H AOCTyHHOCTb 3THX cnyxc6; Aoxa3aTenbCTSa ynyliuleHHSI cnoco6HOCTH Cnyxc6 ConHanbxoro 06eCneneHHSi BbISIBnSITb H 34)(1:1eKTHBHO pearHpOBaTb Ha CB3I3aH- Hble C anKOrOneM np06neMbI; AOnSI pa60LIHX McCT, rAe nposOAHTCSI 3(1(1/eKTHBHaSI nonHTHKa, cn0006CTByfOIljaSl 3AOpOBOI%I 06CTaHOBKe Ha npOH3BOACTBe H 06ecneLiHBaK)ujaSl COOTBeTCTBÿl0uW10 nOMOUjb; aAeKBaTHOe OCO3HaHHe Hy-AA 3THHLIeCKHX MeHbInHHCTB H 6e3- AOMHbIX H 0006bIX Tpe60BâHHHIi, CB5I3aHHbIX C Bo3paCTOM H nOJIOM. Be3Ae, rAe BO3MO)KHO, McCTHble 3aAaLiH AOn)KHbI COOTBeT- CTBOBaTb 3aAaLIaM, yCTaHOBneHHbIM Ha HaL[HOHanbHOM H MeKAyHa- pOAHOM ypoBHe. 28 OIIPE,qEllEHV1E IlPV1OPVITETOB )KeJIaTeAbHO, 14T06bI Ha KOHCyJIbTaTI3BHOM C06paHHH 6bI1I13 COtJIaCOBaHbI IIpxOpFireTbI neSITeJIbHOCTx H OnpeJjeJIeHbI nOArpynnbl, KOTOpble 6yJryT pa60TaTb B 3THX 06naCTSDC Ha,I[ nOCTFDKeHxeM KOHKpeTHbIX 14M 6y,IjyT AaHbI CpOKH, B TeieHHe KOTOpbIX ,i[OJUiCHbI 6bITb nOCTHrHyTbl OnpeneJICHHble ueJIH. rlepBblM InarOM MO)KeT 6bITb OnpeneJIeHiie KpaTKOCpOtIHbIX LjeJIeii, KOTOpble nOJDICHbI 6bITb jjOCTHrHyTbi 3a 6-12 MeCSILjeB. 3T0 CIDOpMHpyeT OCHOBy nJlaHa peaJlx3aLuxx HJIH KpaTKOCpOtIHbIX npOrpaMM. BTOpbIM IIIarOM MO)KeT 6bITb OnpeneJIeHHe tIëTKHX 3anatI, OTBOTCTBeHHbIX 3a HX BbIIIOJIHCHxe H KOHTpOJIbHble CpOKH, a TpeTbHM InarOM 6yAeT Ha3HatleHHe O,i(HOrO tIJIeHa I'pynnbI eHCTBH1i, KOTOpbII%I 6y%jeT KaxCJ(bie IIIeCTb MeCSiueB rOTOBHTb OTtIeT, KOHTpOJIHpySI nporpecc BbIiIOJIHOHHSi OCHOBHbIX 3aJxati. FPAHV1Ltbi IlpoeKT tIacTO 6yAeT CTäJIKIiBaTbCSI C TpyJjHbIM Bb16OpOM, CB5I3aHH6IM C a,gMFiHHCTpaTHBHbIMH HJI13 reOrpaCpxtieCKFiMH rpaHHuaMx. TepMHH "C006LseCTBO", tiaCTO HCIIOJIb3yeMbII4 B 3TOIi ny6JiHKauHH, HMeeT MHOI'O pa3HbIX 3HatieHHii, HatIHHâSI C JIiOZjeii )KHByLIIxX no COCenCTBy H HMeIOnjHX TeCHble B3aHMOOTHOLLieHF45I or_ to rpynnbl HIM 06-beAxHeHFLSI JIiOneii, HMeloluxX WO-TO o6Luee HIM )KHByIiIFiX B OHO reorpacixnecxoH HRH a,gMHHi3CTpaTHBHOii 30He. COO6II(eCTBO - 3TO, B Onpe,TZeJIëHHOM CMbICJIe, nOHSITHe yCJIOBHOe (12), rpaHHl>;bI ero 60JIbü1e HaXOnSITCSI B yMaX JIiOJjeH, tieM Ha Kapre. PeJIHrHo3HâSI, 3THHt1eCKâS1 HJIH 3KOHOMH14eCKaS1 061I4HOCTb MO)KeT XapaKTepH30BaTb H Onpe,IjeJISITb AMA MHOrHX McCTHOe C0o6n(eCTBO. B ,qaHHOH ny6JIHKagHH, TepMHH "C006LueCTBO" 6yAeT o3HatlaTb TeppHTopH1o, orpaxxtieHHyK) o6LueH MyHHI);HnaJIbHOr1 OTBeTCTBeH- HOCTb1O. À.jjMHHiiCTpaTHBHble rpaHHlibI MOryT He COBnaJjaTb C npejjCTaBJIeHHeM HaCeJIeHHH O TOM, tITO COCTâBJISIeT nF4Xn C0061uecTBO. CcDepbl a,gMHHFiCTpaTHBHOIi OTBeTCTBeHHOCTH OpraHOB 3jjpaBOOXpaHeHF4SI, COL[HâJIbHOrO 06ecnetIeHHS1, HOJIHIAHH H ,I;pyrFlX ytlpe)iCAeHHH MOryT He cOBnanaTb. OAHH CJIy)IC6bI pa60Ta10T n0 06LL[erOpOACKOMy npHHuHny, ,gpyrxe MOryT pa60TaTb Ha McCTaX. 11oJIHOe COBnaneHHe BCTpetlaeTCSI pe,gKO, n03TOMy Ba)KHO, tITO6bI BeJryluee ytlpexcAexxe I'pynnbi j(eHCTBHIi TII1;aTeJIbHO 29 npOKOHCynbTHpOBanOCb no 3TOMy BOnpOCy H Bb16pan0 nOAXOASIUjyfO (pOpMyny. OCHOBHOIi aKIjeHT pa6oTbI I'pynnbI AOnxceH COOTBeTCTBOBaTb 3a6OTaM H LIâSIHHSIM AaHHOTO HaceneHHSI, npH3HaBâA H HC11Onb3y5l npH 3TOM BnHSIHHe H Bâ)KHOCTb HHTepeCOS TeX, KTO HaXOAHTCSi BHe 06o3HaLMeHHbIX rpaHHLj. ffOJ1Y1TV1LfECKAA flO,qUTP>KKA O6ecneLleHHe CHJIbHOH nonHTHLiecKOH nOAAep)KKH SiB1ISIeTC51 BaxcxbIM (iaKTOpoM AonrocpoLIHoro ycnexa npoeKTOS 3T01-O po,r(a (5). 3T0 O3HaLIaeT, LITO noJIHTHLIeCKHe nHAepbl AOnxCHbl nOHHMaTb H npHHHMaTb npHHLZHnbI H CpyHKI(HH npoeKTa. OLIeHb Bâ)KHO nOCTOSIHHO epxcaTb BeAyïIlHX nOnHTHKOB B Kypce pa3BHTH5I nnaxa ,IjeNCTBHI%I 110 npO6neMaM aJIKOrOnSI - HCO6XO,rZHMO, iiTO6bI OHH HMenH AOCTyn K npoueccy cTpaTerHmecxorO nnaHHpoBaHHx B MyHHLjHnanHTeTe. npoeKT, TeM He McHee, He AOn)ICeH 6bITb CB3I3aH C 3HTy3Hâ3MOM TOnbKO OAHOTO nonHTHKa; npeAnOLITHTenbHblM SIBnAeTCSI ulHpoKHii nojjxojj c yLiëTOM ulxpoxoro Kpyra HTrrepecoB. B npoeKTax rZOnxcxa IIOALIëpKHBaTbCSI HX CBSl3b C IJIHpOKHM KpyrOM MyHHL(HnanbHbIX OTAenOB H CO3,IIaBaTbC5I COTpyAHHLICCTBO B 06naCTH 3,i(0p0Bb51. 3T0 6yAeT npOII(e CAenaTb, ecnH 6a3osble AaHHble CMOTyT 110Kâ3aTb BbI3bIBaeMble anKOrOnbHbIMH npO6neMBMH nOTepH CpeJ.(CTB H BpeMeHH, HaIIpHMep, OpraHaMH 3J.(paBOOXpaHeHHSI, cOL(HanbHOTO 06ecneLIeHHSI H nonHL(HeH. HyxcHO noAAep)KIiBaTb pyre McCTHble HHHIAHaTHBbI, KOTOpble ,i(eHCTByiOT B O,i[HOM KniOLIe C HAeSIMH npoeKTa, TaKHe KaK KaMnaHHSI npoTHB BO)iCAeHIiSi B HeTpe3BOM COCTOSIHHH. ffV1TE2HAA KYJ1bTYPA IloTpe6nexxe anxoronsl Ha Ayilly HaceneHHSi H CTHJIb noTpe6neHHx MecTHOro HaceneHHSI 6yAyT BnxslTb Ha xapaKTep H pacnpOCTpaHeHHOCTb nbAHCTBa H Ha TO, LITO nOHHMaeTCSi nog CB5I3aHHbIMH C anKOrOneM npO6neMaMH. IIOTpe6neHHe anKOTOnSI 3aMeTHO OTnHLiaeTCSI B pâ3HbIX perHOHâX EBpOnbl. XapaKTep npOH3BOACTBa anKOTOnbHbIX HanHTKOB Taxxce BapbHpyeT OT 30 I£ -OX903H HwHmOIETlxcdaalTlou `HiKEdarHHdu HwxmoLCTlalto 11o1oi1fIraK fiIOHHI1I4Haw XHx00hHHIC I4T1)KiCH H HHTIEd1H1s1 KHa10T1a1r00H 07I) o1o1C wodawHdu wHxdK 09000 KOIaKIfBK XEHEd.LO XHIOHNI Ofi HHmH3xC xOâHIII98 H100Ht1KIr1EH H KIfHLO 0HH2HaNI£H 00HaET10H 'NIKHHOHaNI£H 11I4dI0I4g K04IE1dagTlOu .IiC1ow HHO XH1ÂdT1 â NMI Kwadâ 01 g`Hial4H4IrH9EI0 K041E£Ex LCTI,(g HLrod HIC XKIOEIr90 xI4dOIOx0H g '(£I) EOOELrx 010H4IILHTI00 10 HIOONIHOHflE£ a KOIOIKHaIN HxhI98HdU 014HHaIHH 'aHH3T1xCOX0HOdu aOxoahHHIC HUH KH1HUad `OÂIEIO HHx03hHwOHOxC-OH4Ir6HT1o0 `KHoo3cpodu `IoEd£oa `Irou `dawxduEH `IoiKiraTiaduo ol,Cdolox `HUod HOH41fEHTI00 HOHH0141IHt1Ed1 EH I4HE80H00 HHO oIOEh `axflH1114a x HHHaUIOH10 H di(.I.4I1*Cx XI4HHaIH11 ,Ltdx H14HHaIraT7aduo 4IEâ0âI00mX0 13114 103141 0âI3HHIU411-09 g 'I9HOdOIO 014H4IfFi0 XH 401411Ee0£41fOUGH H KHH3I100EH 010H103NI I40dX03d H HIOOHHaTI `HH1114T1EdI `H31hl4flHdil 40HIrEâI4IHhiC HHa1oHa17 aHEIfU 8 I4901h `01AIH11ox903H HH10IEdIO H00a0 aHH3H1f0U14fl fl H41,4100 I0E31011a0â HO Ox411Ox0EH â0d101AI00ü `OHxCOYV HHâI0H3T1 EHELfLI 4I00HUI3U3i( 41HH31I0 'aHH3hEH£ 331TIOiEUI3d I331s,1H KLf01OxIrE 3HH3Lr93dI0U a0Hwalrg0du EH H4IN00 KH11xE0d 01h 'NMI O aI9HHET1 axCxEI 101Câ100mAD '14IExhI411HdII wHIC IHhiC axCNEI aHHaxCiCdxo `X.Ia01C x KHHam0HI0 H x0hI48Hd11 XI4HHa1HU ahETiadau â wOHaa£ wHm01EUI3d KOI3KLrâK oIOEh 'EifOU HIrH EI0Ed£0a 010HHET1 KIf11 `dalaHduEH `Y1IHifIKT10XT10L1 KOI3EIHhO xOIHLIEH HOxEx `4IEâ0IxHT1 10xC01A1 KH1IHT1Edi 'EHT1O adE9 g 41EflHUI4â 13xcO1A1 OH EHHmHaxC `.i(11I0HT70 411311 OH ET11OxHH 6.Hx1HUEH 4IE8HUlaw3 OH `HTl0d0h0 OU i(xflHHI4a E£ 4IHIEI1LI ET1100a `.Hx0ÂxE£ £09 4IHU OH ET11OxHH MEN 510hI4âHdu XI4HHa1HU XHxEI HHHaIrU3dxX H HHHETI£00 HdU I0Ââ101;1011 OHTIIOw HI4dOIOx `4IrOdIHOx HI4H4LBwdocpaH IOIETI£00 H10oHUi(x0800 I4dOIxE(I) HIC 'HIa10H1IHT1Ed1 H HNIKHHKiHIfB HNII4H£OH114Irad `H100H10a1a HOIC HaxdOIOH o OHE£Kao OHO01 41149 13xCO1A1 adXI4LrXx HOHHETI â 1SI1O10xLC6 oIHHalr9ad10u x aHHam0H10 'IfiIHE1HU 4IOEh KEHxCEâ NUN `KO1aEaxdlEwooEd OIOEh `dawl-IduEH `OHO XKIOEIr90 OHM XHmKT10s£H0dU g'wEx1H1IEH 141I4H1dOUIaH x H EgIOTIOa£HOdu 01OH13011! wEx1HUEH x KOIKOOHIO i(IaoH£Ed OU HT1oIIr OIOEh 'axaodU 1,410H1301^1 EH HHa1oHaT1 KLfI1 HlroEdlo HOHHETI 4100111HhEH£ H 4I10d EH 4IKHIfâ Iatl4 a)1CxEl 01E 'HwEO0d01HH HwI4H£Ed900H£Ed o HHtlEdoudox XI4HTIOdEHtCTIxCaw XI4H1A10d10 OE' H0113000 H Hawao XHOaO KifT1 OHHa XHmKTIog£HOdu `11odawd04) Z£ (97) I4dX1xXd10 0I41AIOxEH£ WIG( EH KolaEdxuo 3HH3HIrouI4H 010 HItOa `KO.LaENIHHHdII aad.LOI49 HEIfLI 010th 'HHiIE.LO 1,101tmxEx EH KHHaIfaOEH KHI.OEhiC 1iHHadmOOH H XEXaIIO XHH14IfOgaH a 411f01000 EHNKIIOil 4Ifa17 `.4,LEifiaOgO E`41EH0131Hil OH aIIIhiCIf `HH.Ia.LEd.LO KE.IEIftiadu H1AIEdÂ1xXd10 HNIHxoahHlHIrOU H11II4HhHIf£Ed AVOW H HN[KH11E£HHE.Id0 HI4HH0H10dE1tX001 H HNII4HHaa10amg0 XINKaNi `o14100H10aNi HOxOltod0l H H0x04I1'30 ÂiriIC3111 ISHhHlf£Ed Ko4.LE1toIIt9EH .I.X17X9 4oa1tE NlEooduoH xaoa NIHmoIÂHIfoH OU KHHamad Ko1OIENIHHHdII NIO£Edgo NIHxL'x `a.Loamg000 OHEHO£HHE1d0 MEN `EI1H1vC£H HHH10Halt EUU,Cd1 14901h `oHxCÂH xH x 3x01E1 E `aood,Coad H gxalro x Ko41ExalraHdu xKHaodX xaoa aoHloaw gxcXuo XHmOiiCa101aa1000 '(SI ) axH3110 H olllOd.LHOx `NINiEd10dU OIHHEH0£4IIOHOH EH OHxCIfOû aHHaIfaOEH HOxxH.LOgEd Ox4I101 aH E `KHHaIraOEH HaIfa1HHE1oltadLI x141oodu KHHaHNi 0101111011 KHHahXlrou Ku17 ISHIrxOX 41Hx(OIrxdU OInlHlloxgoaH E0Â1E10 XH axHEHOdHNIdoCI) E £ 4100HHaH101afi10 41KHHdu H HxH.I.HIfOII OIHHEaOdHHEIILI H HHilE£HHE1d0 OU XE1a1HNIOx a I410gEd H KH10EhX 11111.14HOMEILIHdU 41I4g I4HxCII0it KHH31100EH 01011103N1 HIra.IHHE.L011adü 01h `XI70HI4a x .I1417o3U4du EHQ 'KHHaIrgad.IOII UH1 1_1I4aod017£ 10KIfHE1000 O.I.h `1AI01 O KHHaLCHElOitadU H I41I3H1AI 4,IHhX£H 13E1EIr173dU 4Ifa,IEaO17aIfOOx 41HhiCIfOH HIf,IOIH HHO olXdOlOx `H110NIOII 0 HIfEH£ O1fEN1 `01016 HHH,LO1t3I100u XI4HHH1E13H 10 aHmOlEitEd10 `H4NIa0 33101E1 E`I4Nlaugodu HIfExHH£OH 01016 EG-CH 010x Â`a1 H`HHHEUNIOx H HUH ENIOit OIfH170XOHOdII KIf01OxLCE aHHalrgadlou o10Eh ISHHauaaEH 0130a Hrlado Wah `0mI411 IfI4g auLIXd1 H016 H KIrO1OxIrE KHHaIrgadlOU 4H3HOdA I4gxCiC110 aH1HoaHloam,Co OIfEHO£41fOHOH all 4oa17s Kaitour OHIOHHII14ItOg `I4uuXd.I Hole 141riICiC1-I aHxOahH4H11au0 I4HaIfaitadll0 HIfI4g EHOl1HOI[ KHH311'30EH O1Ox01OHd -uHx-OxiladkI. H 010x03h0d1 H1t0d0 Elxao(1u a17ox H`daNiHdUEH 'NIExhI4HHdH NII4HHa1HLI H NIExHHLI14H x OIHH3IIIOH10 XH OU 1400d110 H10HHII14H0NI Hllado HlrHtloaodu 0I11-010xIIE OU xHaloHalt I4UUXd1 314do1ox0H xE1xECI) XI4H4IrE3d EH Nlah `HHHaxCOIf011170dH XI4HH3d3a0duaH H HOXXII'O 3H01100 EH aadoxo Ko1olEHI41EgEd£Ed XHH KIfit I4IKNIEd10du HUH `15010IExOiCIIiC 0HhI490 H10HHI114HaNI I4TIxCXH KHH0H3I1I£H EH 41EH0d -H1E3d 10N1 140 I4901h `11I0£Ed9O 1vHxE1 EHEInI 111411311E1E1000 410OIV1417 3KOHOMHLIeCK0e COCTOSIHHe H peCypCbl HaceneHHA 6yAyT BnHSITb Ha XapaKTep IIJIaHa neHCTBHH. B HeKOTOpbIX pariOHâX MO)KHO HaiiTH nOJIHbMe naHHbMe, OnHCbIBaioIIjHe nOTpe6neHHe anKorOnSi H TpanHIjHH HCCnenoBaHHH B 3TOri o6naCTH; B npyrHx rimer-orgasms B HanHLIHH HrstOpMauHSI 6yneT HMeTb 3nH30,aHLIeCKHri xapaKTep, a pecypcbl 6ynyT MHHHMaJIbHbIMH. 3KOHOMH11eCKHe H nonHTHIieCKHe CfiJIbl LiaCTO nHKTyIOT npHOpHTCTbI, KOTOpble rpynna neiicTBHri peanbHO Mo)KeT nOCTHLib. B HeKOTOpbIX IiaCTSiX BOCTOIiHOii EBpOnbI nepeXon OT HeHTpanH3oBaHHOro KOHTpOnâ 3a npOH3BO,IjCTBOM anKOrOnSI K 3KOHOMHIieCKOH (pHJIOCO(pHH, OCHOBaHHOH Ha CBO6onHOii TOprOBne H npennpHHHMâTenbcTBe, CO3nan BaKyyM B nonHTHKe KOHTpOnSI Han anKOrOneM, LITO MO)KeT BbI3BaTb np06neMbl cpe,gH HaCeneHHSI. 3T0 MO)KeT 6bITb 0006eHHO BepHO nJISi TeX MecT, rne npOSiBnHeTCSi nOHSITHOe ConpoTHBneHHe nIO6bIM MepaM, KOTOpble CO3naiOT BH,IIHMOCTb nonnep)KKH BBCneHHSI ÿeHTpanH3OBaHHOrO KOHTpOnSI (17). rpynna nericTBHi4 no anKOronlO nOnxcxa npO,ayMaTb oIITHManbHyK) nOCne,i[OBaTenbHOCTb BbIIIOJIHeHHSI CBOHX IUIaHOB. Ciona BXOJISIT pa3nHllHble BonpOCbI; ECJIH MbI paCCMaTpHBaeM HX KaK paBHOL(eHHbie, TO MO)KHO HaLiaTb C nlo60r0 H npO,i(BHraTbCSI 3TM no Kpyry. Bb160p CnenyfowerO BOnpOCa 6yJ[eT 3aBHCeTb OT ero nOCTynHOCTH, 3HaIiHMOCTH, peanbHOCTH ero BbIIIOJIHeHHSI, BepOSiT- HOCTH ycnexa H 3aTpaT Ha ero BbIIIOJIHeHHe. CKOpOCTb BbIIIOJIHeHHSI SIBnSIeTCSI peLIIafoIIreri. rpynna neriCTBHii Mo)KeT nOCTeneHHO pefIIaTb BOnpOC 3a BOnpOCOM, a KOHCynbTaTHBHOe C06paHHe 6yneT pyKOBO,i(HTb HX Bb160pOM, OpHeHTHpySICb Ha peaKljHiO COO61IjeCTBa. gOn)KeH CyIIjeCTBOBaTb KpaTKOCpOLIHbIIi rural H nOnrOCpOLIHâSi CTpaTerHSI. K BonpOCâM, KOTOpble IFaCTO MeIIIaIoT BbIIIOJIHeHHIO IUIaHa, OTHOCSiTCSi: HcnOCTaTOIiHOe (lHHaHCHpOBaHHe, OIIeHb KpaTKHe CpOKH, CnHIIIKOM aM6HILH03Hble I.enH, npOTHBOIIOJIO)KHbMe O)KHnaHHSI H Heynalia B nOnbITKe ynenHTb nOJUKHOe BHHMaHHe HCTHHHOMy BOBneLIeHHIO HâCeneHHll. 33 3Pomp ceKTopa nepmiyHOii nnegvt H vKo-caTapHov norviou.tvi JI1o,1xH BCë 6onblIle OcO3HaiOT CBOë npaso Ha xopoIIIee 3gopoBbe H CB010 OTBOTCTBeHHOCTb 3a ero cOXpaHeHHe. B pe3ynbTaTe, OHH O)KH,IjaIOT nonyTiHTb COBeT H HH(bOpMaL[HiO O 3Jj0p0BOM o6pa3e )KH3HH OT pa6oTHHKoB CeKTOpa nepBHiiHOii Me,i[HKO-CaHHTapHOii nOMOUjH, KOTOpbIM ilaCTO He06X0,IjHMO yüHTbCA OKâ3bIBaTb COOTBeTCTByK)U.WIO nOMOH(b no yKpeILTIeHHiO 3,IjOpOBb31. HH(1)0pMaIjHSI O pee nOTpe6neHH2 H KOHCynbTauHA nO H3MeHCHHIO nHTei%IHbIX npHBbliieK ,aOn)KIibI CTaTb COCTaBHOii TISCTbIO pa6oTbI CJIy)K6 3gpaBOOXpaHeHHA (CM. "A1[KOZ01Ib u YI3pBZlT1HQR MBÔZlKO-CQHZlrYlapXCiR YlOMOU.p" LUeCTOI-i 6yKneT H3 3TOii CepHH). B BenHKO6pHTaHHH (rAe nOTpe6neHHe Ha Aymy HaceneHHA B 1991 TOJ.jyy COCTaBJIAJIO 9 n iiHCTOI'O aJIKOTOnA) 6bIJI0 Onpe,i(eneHO, TITO Ha yiIaCTKe o6iuei3 Bpage6HoH npaKTHKH, 06CnyxcHBaloLueM 2000 TienOBeK, npH6nH3HTenbHO 55 TienoBeK noTpe6nAloT TaKOe KOnH- TIeCTBO anKOTOnA, TITO 3T0 npegCTaBnAeT BbICOKyIO CTeneHb pHCKa AAA HX 3A0p0Bb51, H 60nee 200 TIenOBeK nO,IjBepraioTCA Cpe,gHeii CTeneHH pHCKa. OT 9 go 11% My)KTIHH H 3-5% )KeHIIAHH, 3aperHCTpnpOBaHHbIX Ha yTIaCTKe, OKa3ânHCb npO6neMHO nbIOIuHMH (18). Jlioj[H C BbICOKHM ypOBHeM noTpe6neHHA noceLualOT CJIy)K6bI nepBHTIHOii MeJ[HKO- CaHliTapHOH nOMOII(H game, 'gem pyre nauHeHTbI. B OgHOM HCCnegOBaHHH 6bIJI0 nOKa3aH0, TITO ypOBCHb nOCenjaeMOCTH npO- 6neMHbIX B JZBa pa3a npeBbILnaeT TaKOBOii B KOHTpOnbHOii rpynne. COUHanbHble H Me)KJIHTIHOCTHble np06neMbl y TaKHX 35 nbIOH[iIX BO3HiIKaIOT B HeTblpe pa3a game, 'IeM B KOHTpORbHO%I rpynne (19). HeT COMHeHHA, 'ITO 311-1 nauHeHTbI npHXOAAT K Bpally, TaK KaK OHH 03a60T-IeHbI COCTOAHHeM CBOerO 34IOpOBb51, XOTA CaMH OHH MOryT H He ynOMAHyTb O CBOëM nOTpe6neHHH anKOrOnA. YBa)ICHTenbHble, HO TO'iHble BOnpOCbI He COCTaBAT 3Ha'iHTenbHOli AOnOJIHHTenbHOii pa60TbI HnH He yBenH'IaT 3Ha'IHTeJIbHO BpeMA KOHCynbTauHH, HO MOryT npeAOTBpaTHTb CneAytOHjee 06paILjeHHe K Bpa'Iy. CyLucCTByIOT y6eAliTenbHble AOKa3aTenbCTBa TOrO, 'ITO perynApHbte BOHpOCbI O nHTeÏiHbIX npHBbIHKaX COBMeCTHO C OTKpOBeHHbIM COBeTOM TeM, KTO, KaK OKa3a11OCb, 3RoynOTpe6RAeT ânKOI'OneM 'iaCTO ABRAIOTCA O'iCHb 34)C1)eKTHBHbIMH (20-22). Pa6OTHHKii nepBn'IHOIi McAHKO-CaHHTapHOIi nOMOLLIH HaCTO He 3aAaiOT BOnpOCbl O nOTpe6neHHH ânKOI'ORA, TaK KaK y6e)KAeHbI, 'ITO HM He XBaTaeT He06XOAHMbIX 3HaHHÎ/ HRH HaBbIKOB npoBeAeHHA TaKOIi KOHCynbTaLjHH HRH nOTOMy, 'ITO OHH neCCiiMHCTHHHO OTHOCATCA K BO3M0)KI-IOCTH nOMOYb TaKHM nIOAAM. HeKOTOpble CTeCHAIOTCA 3aTparHBaTb TaKyK) "CKOnb3Ky10" TeMy. HMeiOHjHeCA AaHHble n0Ka3bIBalOT, 'ITO nOA06HOe He)ICenaHHe ABnAeTCA nWKHbIM, TaK KaK BO MHOrHX CTpaHaX nauHeHTbI O)iCHAaIOT, 'ITO FIX Bpa'I HRH MeACeCTpa 6yAyT 3aAaBaTb BOnpOcbl, KaCatOII]HeCA 3AOpOBOI'O o6pa3a )ICH3Hii (23). KJIHHHKH nepBH'iHOii MeAHKO-CaHHTapHOI3 nOMOILIH ABRAIOTCA OHTHManbHbIM McCTOM AnA BbIABneHHA anKOI'OnbHbIX npo6neM, TaK KaK 60nbLIIHHCTBO McCTHOrO HaCeneHHA nOCeLL[aiOT IIX, no KpaIiHeli Mepe, pa3 B TpH roAa; 3T0 AOCTynHO, 3HaKOMO H He npe,tzocy- AHTenbH0. BpaHH 06bI'iHO nOnb3yIOTC51 aBTOpHTeTOM, H HX COBeTbI BbIIIORHAfOT. KaK TOnbKO onpeAeneHa yCneHIHOCTb nOAXOAa, ero MO)KHO nerKO II 3KOHOMH4H0 BHeApATb 4epe3 MeCTHyK) CFICTMY nepBH'iHOii McAHKO-CaHHTapHOIi nOMOLL[H. 3Aecb TaKxCe MO)ICHO npOBOAHTb nOnyTHOe 06CneAOBaHHe H BbIABneHHe HnH OpraHH- 3OBbIBaTb 6o1Iee CHCTeMaTH'iHble npoueAypbI CKpHHHHra. OpraHH3oBaHHOe B03 MC)KAyHapOAHOe KRHHH'IeCKOe HCCne- AOBaI-IHe, (21) OXBaTbIBano 1655 naLjHeHTOB, HbiOLL[HX MHOFO, HO 6e3 ABHbIX npH3HaKOB 3aBHCHMOCTH, 113 y'ipe)KAeHHIâ nepBHBHOii nOMOLuH pa3HbIX CTpaH. BOCeMb ueHTpOB C 06LuHM KOnH'IeCTBOM 1490 nauHeHTOB npOH3BOnbHO pacnpe,aenAno 3THX nauHeHTOB JI1460 B KOHTpOnbHyIO rpynny, npollleALHylo TOnbKO OL[eHKy ypoBHA 36 noTpe6neHHx, nH6o B rpynny, me 3a ouexxoli cneAosan KpaTKHIi COBeT, nH6o B TpeTbIO rpynny, rAe AOHOJIHHTenbHO nposonHnacb 15- MHHyTHâSI KOHCynbTauHSI H BbIABBanCSI 6yKneT caMOHOMOUjH. 3a nOCneAyK)IuHe 6-9 MeCSIueB My)KLIHHbI H3 BTOpOii rpynnbI COKpaTHnH nOTpe6neHHe Ha 25% 60nbule, LIeM B KOHTpOnbHOli rpynne, npouleA- Lueli TOnbKO OueHKy. Cpe,aH )iceHn[HH cOKpaLueHHe noTpe6neHH2 Ha6n10,I2Ian0Cb BO BCeX TpëX rpynnaX, HO ,aO6aBOLIHOe COKpaLueHHSI B rpynne, nonyLIHBIUeH COBeT, COCTaBnSUIO 10%. HHKaxorO Ao6aBoLI- HOrO 344eKTa He Aana AOHOnHHTenbHaSl paCnIHpeHHâSI KuHCynbTauHSI. 3TH BbIBOAbI BCenSIIOT HaAe)KAy, TaK KaK OHH n0Ka3bIBaIOT, LITO KpaTKHe HHTepBeHuHH MOryT OKâ3bIBaTb 3HaLIHTenbHOe BnHSIHHe BO MHOrHX pa3nHLIHbIX yLlpe)KAeHHSIX. Ana TeX, KTO CKenTifiIeCKH OueHHBaeT paCnpOCTpaHeHHOCTb anKOrOnbHbIX npo6neM cpeAH CBOHX nauxeHTOB Hy)KHo HCIIOnb3OBaTb AOHOJIHHTenbHyiO CTpaTerHK), npeAno)KHB He6onbIIIOMy KOnHLIeCTBy 6pHraA nepBHLIHOH nOMOIIjH npOBeCTH npoCTOe 06cneA0BaHHe cpeAH CBOHX nauHeHTOB B KaLIeCTBe AOMOHCTpauHOHHOro npoeKTa. Be3 COMHeHHii 3TOT npOeKT nOKa)KeT, LITO anKOr0nbHble np06neMbl IIIHpoKO pacnpoCTpaHeHbI. 3Aecb He06XOAFiMO npHHHMaTb Mepbl B CBeTe AaHHbIX O TOM, LITO npOCTâSi HHTepBeHuHSi Ha ypOBHe nepBHLIHOii McAHKo-CaHi3TapHOii nOMOÜjH MO)KeT ynyLIIIIHTb 3AOpOBbe. B BenHKO6pHTaHHH HeCKOnbK0 yLIaCTKOB o6ujeii npaKTxKH Ha6panH nauHeHTOB, Hcnonb3ySI npocTOli onpoc o noTpe6nexHH HMH anxoronSi. MyxcLIHHbI, nOTpe6naloujHe 6onbuIe 35 eAHHHu B HeAenIO, H xcexujHHbI, nOTpe6nslloujHe 6onee 21 eAHHHubI B He,Ijenlo, 6bInH npOH3BOnbxO nOAeneHbl Ha Am rpynnbl. rlauHeHToB nepBoii rpynnbl BpaLI OnpOCHJI H Aan cOBeT H HH(DopMauHlo o CoxpaujeHHH noTpe6neHHSI anKOronSl H AHeBHHK Ansl BeAeHHS1 3anHceIi o noTpe6neHHH. B KOHTpOnbHOii rpynne coseT He AasanCSr, ecnH o6 3TOM CneuHanbHO He npOCHJIH. CIIyCTSI rOA KpaTKâSI HHTepBOHuHSI HpHBena K 20% COKpaüjeHHK) KOnHLICCTBa nauHeHTOB, KaK My)KLIHH, TaK H )KeHUjHH, 3nOynO- Tpe6nSIK)üjHX anKOroneM. ABTOpbI OTMeLIaiOT, LITO npOBeAeHHe TaKHX HHTepBeHuHIi B paMKaX BCeli BenHKO6pHTaHHH MOTJIO 6bI npHBeCTH K TOMy, LITO e)KerOAHO npH6nH3HTenbH0 250000 My)KLIHH H 67500 )KeHnjHH COKpaII[anH CBOë nOTpe6neHHe AO MeHee OnaCHbIX ypOBHeH (20). KOHTpOnbHble HCCne,aoBaHHSi, noxa3aBIIIHe ueHHOCTb KpaTKOH 37 HHTepBeHLjHH cpeRH nbiOLuHx 6e3 npN3HaK0B 3aBHCHMOCTM 6bIJIO npOBejjeHO B MeAHLjHHCKOii npaKTHKe C 60nee Lieh 4000 nanIieHTaMi3 (24). AKTV1B1,13ALVA CEKTOPA IIEPBVI4HO0 ME,gV1KO- CAHVITAPHOVI II0M0LuV1 HecMOTpSI Ha OHTHManbHOCTb TaKHX HHTepBeHImIi, HMeIOTCSI O61IIHpHble AaHHble O TOM, LiTO BpaLIH H MeAcëcTpbi nepsMLlHOH nOMOIIm He XOTSIT paCCnpaIIIHBaTb nanHeHTOB o6 Hx nHTeIiHbIX npHBblLiKâX. HpHLIHHbI 3T0r0 HC)KenaHHSi BKnIOLIaIOT B Ce6SI, KaK yxce ynOMHHânOCb, HeZ[OCTaTOK 3HaHHI%I H HaBbIKOB, HeXBaTKy BpeMeHH H cTpaX, LITO 3aTparHBaHHe TâKOii TeMbI, KOTOpyiO OHH CLIHTaiOT CKOnb3KOii, BbI30BeT 3aMKHyTOCTb naLjHeHTa. COLIeTaHHe 3THX CbaKTO- pOS yKa3blBaeT Ha SIBHyIO npHOpHTCTHOCTb 06yLIeHHSI pa60THHK0s nepBHLIHOIi Me%jHKO-caHHTapHOH nOMOIIiH BbISIBneHHIO H 3C14eKTHB- HOMy B03Ae1%ICTBHI0 Ha OnaCHOe nOTpe6neHHe. He06XOAHMO, 1LIT06bI OHH y6eAHnxcb, LITO CTOHT npOBO,I(HTb Aaxce npocTermHHe HHTep- BeHnHH H nOHSInH, LITO HM 6yAeT OKa3aHa nOAAepxcxa H CO CJIO)KHbIMH CnyLIaSIMH, Tpe6ylolIiHMH 6onblLlHx 3aTpaT BpeMeHH. B3aHM0- AelICTBHe MCnCAy nepBHLIHOIi MeAHKO-caHHTapHOli nOMOIIjbiO H CnenHanH3HpOBaHHbIMH cnyx(6aMH (ecnH OHM eCTb) jjOMICHa 6bITb TLLjaTenbHO Hâna>ICeHa Ha paHHeli CTaj(HH pa6oTbI. 1TTO6bI nOMOLIb BpaLIaM H MCACëCTpaM npH06pecTH Tpe6yeMble HaBbIKH He06XOAHMO pa3pa60TaTb CHCTCMy o6yLIeHHSi. BaxcHO, LiT06bI 3T0 06yLIeHHe COOTBeTCTBOBâno pOJIH H OnbITy pa60THHKOB nepBHLI- HOiï McJjHKO-CaHHTapHOIi nOMOLLjH. JlyLnlIe BCerO, ecnH BpaLIH nep- BHLIHOM nOMOH.[H 6yAyT yLIaCTBOBaTb B pa3pa60TKe npOrpaMMbI o6y- LIeHHSI, xopoluo, Lrro6bl span npOBOAHn o6yttexxe ApyrHx pa6oTHH- KOB KnIiHKH. CneLjHanbHble aHTHânKOrOnbHble Cny)K6bI TaKxCe AOJLXCHbI npHHSITb yLIaCTHe B pa3pa60TKe nporpaMMbI O6yLleHHSI. Pa60THHKH nepBHLIH0i7 MeAHKO-CaHHTapHOii nOMOILjH AOnNCHbI 03HaKOMHTbC5I CO BCeMH BHAaMH nOMOHjH, KOTOpble eCTb B AaHHOI%I McCTHOCTH, BKniOLiaSI o6LLjeCTBeHHble OpraHH3anHH, COL;HanbHble CJIy)IC6bI H rpynnbI caMOnOMOnw, TaKHe KaK AHOHHMHble anKOrO- nHKH. Ba.xcli0 paCnO3HaTb nOTCHLIHanbHble HeAOIIOHHMaHHe H KOH- CDnHKTbI McXCAy BpaLIaMH-cneljHanMCTaMH H pa6oTHHKaMH nepBHLIHOIi 38 anKOronHKH. Ba)KHO paCno3HaTb nOTCHuHanbHble HeJjOnOHHMâHHe H KOHCpnHKTbI Mexcgy BpaLIaMH-CneuHanHCTâMH H pa6oTHHKaMH nepBHLIHOi%I MeJjHKO-CaHHTapHOil nOMOII(H. rlepBble MOryT peulHTb, LITO HX HaBbIKH 06eCueHHBaIOTCSI, HnH xcC MOxcHO CTOnKHÿTbCSi C 3HaLIHTCnbHbIMH pa3nHTi145IMH B nOHHMaHHH KOHuenuHH neTieHHSi. Bce 3TH BOIIpOCbI Hy)KHO TieCTHO paCCMOTpeTb; gaine BCero OHH BO3HHKaIOT 143-3a He1I0HHMaHH5I TOTO, TITO yCHnHSI 3THX CnpiC6 HanpaBneHbI Ha pâ3nHTiH1D1e TOTiKH CneKTpa anKOTOnbHbIX npO6neM. MOTHBa1,1H10 BbIIIOnHeHHSI 3TOI%I pa6oTbl 6pHraAaMH nepBHTixoH IIOMOIIjH MO)KHO Co3gaTb nyTëM MaTep HanbHOro HnH ,Tzpyroro B03HarpaNcAeHHSi gIISI BOBneTieHH51 Hx B pa6oTy 1-10 yxpenneHHio 3Zjop0Bb5I. BaxCHO nO,uTiepKHyTb, TITO 3aJ[alia COCTOHT He B HOXOTe Ha anKOTOnHKa", a B pâ3BHTHH HaBbIKOB npOBeBeHHSI KpaTKOii HHTepBCHuHH C nbiOLuHM, KOTOpbIii BpCBHT CBOeMy 3,aOpOBbIO, HO He 51B115IeTC5I (1)H3HTIeCKH 3aBHCHMbIM HnH Cepbë3HO nOCTpaAaBLnHM OT aJIKOronSI. He06X0j[HM0 nOCBSITHTb AOCTaTOTIHOe KOnHIIeCTBO BpeMeHH O6bSICHeHHIO TOTO, T{TO 60nbIIIHHCTBO CB5I3aHHbIX C aJIKOroneM np06neM CO 3,aOp0BbeM BO3HHKaCT KaK CneJjCTBHe OnbSIHCHHSI HnH perynSIpHOrO 3noynOTpe6neH4H, a He OT (10H3HIIeCKOIi 3aBHCHMOCTH; TITO B03JIeNCTBHe Ha nHTeiiHble npHBbIIiKH yMepeHHO nbIOLuHX OKâ)KeT 60nbIIIee Bo3,ijeI-iCTBHe Ha 3jjOpOBbe HaCeneHHSI, T-IeM KOHL[eHTpauHfl yCHnHii HCKniOTIHTenbHO Ha CHnbHO nOCTpaJjaBIIIHX. KOMIIETEHTHOCTb B03 (25) onpeAenlula CneuyloLuHe 12 cpaKTOpoB KOMneTeHTHOCTH BpaTieli H 6pHra,g nepBHTIHOii MeJ(HKO-CaHHTapHOI%I nOMOnjH Heo6XOxHMbIX HM XISI TOrO, TIT06bI nOMOTib naL[HeHTaM CnpaBHTbCSi CO CBOHMH nOTCHuHanbHblMH HnH CynteCTByiOwiMH np06neMaMH, CBSI3aHHbIMH C nOTpe6neHHeM anKOrOnSI: 1. 3HaHH5I O paCnpOCTpaHeHHOCTH OnaCHOTO H BpeJ[HOrO nOTpe6neHHSi anKOronSi, a TaK)ICe O CBSI3aHHbIX C 3THM 43H3HTieCKHX, nCHXOnOrHTieCKHX H C011HanbHbIX npO6neMaX; 2. 3HaHHe H nOHHMaHHe B03J1eiiCTB14S1 anKOrOnbHbIX np06neM nauHeHTOB Ha HX CynpyrOB H CeMbH; 39 3. 0003HaHHe OTHOIIICHi3A nani3eHTa K anKOronK); 4. yMeHHe BbIABnATb pa3Jli3i-IHble, (lH3HLIecKHe, nCHXOnorHLIecxHe H COLjHânbHble nOKa3aTenH anKOrOnbHOii npo6neMbl; 5. yMeTb AOHeCTH B nOAXOAAIi[eM ARA 3TOrO yCJIOBHAX TOLIHyiO HH(bopManHlo o6 anxorone H CB513aHHbIX C ero noTpe6neHHeM np06neMaX Ao naljHeHTOB HJIH HX pOACTBeHHHKOB; 6. yMeHI-ie npoBOJ.jHTb pa3nHLIHe MexcAy TaxHMH ypoBHAMH noTpe6neHH2 aJIKOronSI, KaK ypOBeHb HH3KOrO pHCKa, ypOBeHb onacxoro/BpeJ(Horo noTpe6neHHA H ypoBexb anxoronbxoÎI 3aBHCHMOCTH; 7. yMeHHe npHHHMaTb He06XoA4Mble Mepbl B cnyLIae (lIoH3HLIeCKHX nOCneACTBHI%I HnH OCJIO)KHCHHiï OCTpOrO OnbSIHeHHA; 8. yMeHHe co6paTb TOLIHbIFI aHaMHe3 ynOTpe6neHHA aJIKOronA; 9. yMeHHe pacIIO3HaTb npH3HaKH O6yCJIOBneHHOrO nOTpe6neHHeM anKOrOnA 3a60neBaHHA; 10. yMeHHe npaBHnbHO HHTeprlpeTiipOBaTb pe3ynbTaTb1 na6opaTopHoro o6cneAoBaHHA; 11. yMeHHe Bb16HpaTb npaBHnbHbIii nnaH BeAeHHA naL[HeHTa, a HMeHHO KpaTKHIi CoBeT/HHTepBeHL[HA HnH HanpaBneHHe naLjHeHTa K COOTBeTCTByIOLqHM CnenHanHCTaM HnH B KJIHHHKy; H 12. yMeHHe OpraHH3OBaTb H npOBeCTH Heo6XOAHMbIIi Kypc ,IkeTOKCHKaIjHH naLjHeHTa Ha AOMy. CTpaTerHA HHTepBeHLjHH 06bILIHO BKnioLlaeT B Ce6A OnpeAeneHHe AaHHOrO cnyLiaA, CKpHHHHr TeX, KOrO Hy)KHO HanpaBHTb B ApyrHe yLlpexcAexHA, TLIjaTenbHylO OueHKy, HHTepBeHuHIO H nocneAyloLuHe KOHCynbTal(HH (CM. Ta6nHLIy 3). 40 Ta6nNua 3. OcHOBHaA crpaTerNA npoBe,geHNA paHHNx NHrepBeHL461 1. Onpe,genNTb Ha paHHeL1 cTa,gNN 2. f1p0BO,gNTb CNCTeMaTN- 4eCKyK) OL{eHKY 3. flpoaecTN KpaTKylo NHTepBeHL4NK) 4. Bbl,gaTb noco6Ne no CaMOnOMOL4N, eCnN OHO eCTb, NJ7N HanNCaTb COrnaCOBaHHbIN nnaH geNCTBNN 5. flepNo,gN4eCKN npOBOJ.1,NTb KOHCynbTa4NN 1110,0,11 CO CTa611nbHbIM nonoN(eHNeM B o6L4eCTBe Ha paHHeN CTa,gNN CBA3aHHbIX C anKoroneM np06neM NMeK)Tny4WNe nepcneKTNBbICnpaBNTbcA c npo6neMoN KOnN4ecTB0 N 4aCTOTa nOTpe6neHNA CTeneHb anKOfOnbHOII 3aBNCNMOCTN COCTOAHNe 3,40pOBbA N ncNXOnOrN4ecKaA yCTO11411BOCTb f1pNCyTCTBNe anKOronA B ,gbIXBHNN flpOaHanN3NpOBaTb pe3ynbTaTb1 OL4eHK14 C na4NeHTOM N ero CeMbëN garb NHCpOpMawNIO O nCNXN4eCKNX N CpN3N4eCKNX nOCne,gCTBNAX nOTpe6neHNA (HanpNMep, nOBbILIJeHHbIN ypOBBHb raMMbl rnyTaMNn TpaHCCpepa3bl, Cpe,gHLlll 06bëM 3pNTpo4NTOB, yrneBO,gO,geCi3614NTHbIL1 TpaHCCpepNH) OnpegenNTb L4enN COKpaLL4 eHNA nOTpe6neHNA (nonHaA Tpe3BOCTb 1,11111 yMepeHHoe nOTpe6neHNe) Onpe,genNTb 4enN B,gpyrNX BaNCHbIX 06naCTAX f10,0,4epKHyTb OTBeTCTBeHHOCTb naL4NeHTa N ero CeMbN 3a ,goCTN)KeHNe 4enell HanpaBNTb (ecnN Hy)KHO) K ApyrNM cneL4NanNCTaM/y4pe)K/1,eHNAM f10npOCNTb na4NeHTa e)KeJ.1HeBHO BeCTN ,gHeBHNKnOTpe6neHNA KOHTponNpOBâTb cloN3N4eCKNe noKa3aTenN 3noynOTpe6neHNA KOHTpOnNpoBaTb nporpeCc,gOCTN)KeHNA genii 41 CKPVIHVIHF CyLueCTByiOT pa3Hble HHCTpyMeHTbI CKpHHHHra. OHH AOJDKHbI 6b1Tb npOCTbIMH H 3ClIItleKTHBHbIMH (BbISIBnSITb 6OnbnIHHCTBO cny4aeB) H TOT-IHbIMH, T.e. TaM J10JDICHO 6bITb HeMHO1-0 n0)I(IibIX BbISIBneHHIi. OHH TaK)ICe AOnNCHbI 6b1Tb HaAë)KHbIMx H KOpOTKHMH. B HAeane, 3T0 AOn)Kiibl 6bITb BonpOCbl, KOTOpble MO)KI'iO BCTaBHTb B 06bIiiHbIi3 onpOC Bpa4a. CKpHHHHr MO)K110 npOBO,gHTb CHCTeMa- TH4eCKH, paccnpaLIIHBaH Kâ)ICAOTO nauHeHTa, 3aperncTpxpoBannoro Ha 3TOM y4aCTKe, KâXCAOrO BHOBb perHCTpHpyioH(erOCS[ naLLHCHTa BO BpeMSI o6bI4HOr0 npH 3TOM o6cneAoBaHIISI, HnH Aaxce 4epe3 0613S1BneHHe B McCTHbIX CpeACTBâX MâcCOBOii HHIllOpMauHH Bo MHOrHX CHTyaIjHSIX npOUie npOBOAHTb CKpHHHHr npH c03AaBLUeilCSl B03M0)KHOCTH, 3aAaBâSi COOTBeTCTByK)LIjHe BOnp0Cbl BO BpeMSi BH3HTa naL[IieHTa K Bpa4y. MeACëCTpbl H Apyrxe McApa60THHKH MOryT BbI17onHSITb OCHOBHyiO 4aCTb 3T0ii npOueAypbl. BOIIj)OCHNKN no KOJ1N4eCTBy N 4aCTOTe B TaKxX BOnpOCHHKdX 06bI4H0 CnpaIIIHBaeTCSI o iiaCTOTe nOTpe6neHHSi 3a KaKOH-TO nepxOA BpeMeHx, HanpHMep, 3a HCAenio H O KOnH4eCTBe BbInHTOrO, OTCiOAa Mo)KHO BbILiHCJIHTb HeAenbHOe nOTpe6neHHe. nOAC4eT yA06H0 BeCTH, HCII0nb3y51 yTBep)ICAëHHble eAHHHubI HJIH rpaMMbl anK01-01131; HanpHMep, B BenHKO6pHTaHHx yTBepxCAeHa eAHHHua, KOTOpaSi pasxa oAHOMy 60Kany BHHa, non- nHHTe nHBa 06bI4H0ii KpCIIOCTH HJIH 0AH0ii Ao3e KpCIIKHX CnHpTHbIX HanHTKOB. Kâ)ICAaSi 143 3THX Mep COAep)KHT npH6nH3HTenbHO 10 r 3Ta110na. XOTSi eAHHHIja AOnDICI-Ia 6bITb aAanTHpOBaHa K pa3HbIM KynbTypaM H McCTaM, caMOe rnaBHOe, LiT06bI Mepa 6bina noHSITHa nauxeHTy H nerKO HCnOnb30BanaCb. ,TAHeBHHKH nOTpe6neHHSI SIBnSIiOTCSI elljë OAHHM CpeACTBOM nOJIy4eHHSI HH(lcsOpMauHH O nHTeiïHbIX IIpHBbIi-IKaX nauHeHTa, 3Aecb 4aCT0 npeACTaanSleT L[eHHOCTb COOTHeCCHHe KOJIHLICCTBa BbIHHT0r0 C CO6bITHSIMH HeAenH. 3T0 MO)KHO HCII0JIb3oBaTb, KaK OCHOBy AnSI COBeTa, KOTOpbIIi AaëTCSi BO BpeMSi HHTepBeHuHH, TaK KaK OnpeAenSieT BpCMSi "nOBbILLIeHHOrO pHCKa", irTO nOMOraeT nauHeHTy 06AyMaTb, KaK n0-ApyrOMy BCCTH ce6sl B AaHHbIX CxTyauHSIX. CyLueCTByeT HeCKOnbK0 BOnpOCHHKOB n0 nCHXO-COuxanbHbIM nOCnCACTBHSiM nOTpe6neHH2 anKOrOnsl. MHOrHe 143 HHX HauenCHbl Ha 42 OTHOCHTenbHO nO3j1HHe CTaJjHH aJIKOrOnbHbIX npo6neM, HanpHMep, BOnpOCHHK CAGE (26), MHIIHraxCKHI4 TeCT Ha BbISIBneHHe anKOronH3Ma (27), MIOHXCHCKHIi TeCT Ha BbISIBneHHe anKOrOnH3Ma (28). OTieHb n0ne3HbIM BOnpOCHHKOM, KOTOpbIIi HCIIOnb3OBanCSI ,TZJISi BbISIBneHHSt OnaCHOrO nOTpe6neHHSI, SIBnSIeTCSI BOnpoCHHK AUDIT (29), 3434)eKTHBHOCTb KOTOporO 6b1na npOAeMOHCTpHpOBaHa B HeCKOnbKHx esponeÎicKHx CTpaxax, B pa3nHTIHbIX yLlpexcAeHFlxx, BKnioLIaSI nepsHtiHyio MenHKO-caxHTapHylo noMOlub (CM. Ta6nHuy 4). B 3aBHCI3MOCTI4 OT uenH nporpaMMbl cxpliHHHra npe,gnaraeTCSI Asa BapxaHTa. CTIëT 8 RUTH 6onee AaëT 6o11ee BbICOKy1O tIyBCTBH- TenbxoCTb, B TO spew' KaK cLIëT 10 HnH 60nee naëT 60nbu1ylo CneuidCHTiHOCTb. B O61ueM, BbICOKHe 6annbI OTBeTOB Ha nepBble TpH BonpOCa npH OTCyTCTBHH nOBbIIneHHbIX 6annOB Ha BCe OCTaJIbHble BOnpOCbI npe,qnonaraioT HanHT3He OYICICH020 rlOTpe6neHHSI anKOronSI. ITOBbIIIIeHHble 6annbl OTBCTOB Ha BOnpOCb1 4-6 nOgpa3yMeBaioT HanHTme HnH BO3HHKHOBeHHe QJ1K0201[bHOÛ 3Q8UCllMOClYIl[. BbICOKHe 6annbI OTBCTOB Ha OCTanbHble BOnpOCbi npeAnonaraloT epednoe nOTpe6neHHe anKOronSI. 43 Ta6nNa 4. Bonpocr+HK AUDIT 06BeRHre 4HCn0, Koropoe HaH6onee TO4HO CoOTBeTCTByeT oTBery naL1HeHTa. 1. KaK Ham Bbl nbeTe HanNTKH, cogepmawHe anKoronb? (0) HVIKOP,gA (1) 1 PA3 B MECSlu (2) 2-4 PA3A B MECSILI (3) 2-3 PA3A B (4) 4 VI 6011EE PA3 L411V1 PE>KE HE,qEJ110 B HE,qEJl1O 2.' KaKOe Kon114eCT8o CORepNCaL11HX anKOronb HanHTKOB Bbl noTpe6nfleTe 06b14HO B ,QeHb, KOrßa nbeTe? (O6o3Ha4bTe KonH4eCTB0 CTaHRapTHbIX R03) (0) 1 14110 2 (1)314f1VI4 (2)5VUlVl6 3. KaK 4acro Bbl Bb1nNBaere wecrb HnH 6onee Ro3 3a oRHH pa3? (0) HV1KOEfJ,A (3) 7 VU114 8 (4) 10 141114 6011EE (1) PE>KE, HEM PA3 B (2) E>KEMECSIHHO (3) E>KEHEREJlbHO (4) E>KEAHEBHO MECSIL.( 141l1/l flOHTVI 4. CKOnbKO pa3 3a npowegwH6 roR Bbl o6HapymHBanH, 4TO He nnomere npeKpaTHTb 1114Tb, ecnH y>ice Ha4anH? (0) HVIKOEAA (1) PE>KE, HEM PA3 B (2) E>KEMECSIHHO (3) E>KEHEAEJlbHO (4) E>KEAHEBHO MECSILt VI11VI fIOHTVi 5. CKOnbKO pa3 3a npowe,QWNN FOR Bbl He M011114 143-3a BbInNBKN BbInO71H14Tb TO 4T0 06b14H0 ROn)KHbI RenaTb? (0) HViKOr,gA (1) PE)KE, HEM PA3 B (2) E)KEMECSIHHO (3) E>KEHEAEJ1bH0 (4) E>KEAHEBHO MECHLI, V1J1V1 fIOHTVI 6. CKOnbKO pa3 3a npOWertWNl1 r0A Bam Hy)KHO 661710 BbInNTb C yTpa, 4TO6b1 3aCTaBNTb Ce6A AenaTb 4TO-TO nocne KpynHON BbI7114BK14? (0) HV1KOF,QA (1) PE>KE, HEM PA3 B (2) E>KEMECSIHHO (3) E)KEHEAEJ1bH0 (4) E)KEAHEBHO MECSIL.( V111V1 IIOHTVI 7. CKOnbKO pa3 3a npOWnbIN FOR Bbl OLLIYLL(anN 4yBCTBO B14Hbl 14f114 yrpb13eH1451 COBeCTN nocrie BbI7114BKl4? (0) HV1KOrAA (1) PE>KE, HEM PA3 B (2) EWEMECSIHHO (3) E)KEHEAEJ1bHO (4) E)KEAHEBHO MECSILI, vinyl fIOHTVI 8. CKOnbKO pa3 3a npOWnbIN r0rt Bbl He MOrnN BCnOMH14Tb, 4TO 6b1n0 BHepa 143-3a TOfO, 4TO Bbl 6bIn0 nbAHbl? (0) HVIKOMA (1) PE>KE, HEM PA3 B (2) E)KEMECSIHHO (3) E)KEHEAEJ1bH0 (4) E>KEAHEBHO MECSIL.( V1J1V1 fIOHTVI 9. Cny4anL4cb mi y Bac Hn1/1 y Koro-TO ,gpyroro TpaBMbl H3-3a Bawero ynorpe6neHI42 cnl4pTHoro? (0) HET (2) AA, HO HE B IIPOWIIOM FOAY (4) AA, B f1POW11OM MAY 10. Bbipawan nN KTO-n116o 143 BawNX pOpCTBeHHNKOB, BOB 4 NnN ppyrNe Meppa60THNKN 03a604eHHOCTb no noBOpy BaweH BbInNBKN Anti npepnaranN nN Bam coKpaTNTb noTpe6neHNe? (0) HET (2) AA, HO HE B f1POWflOM MAY (4) AA, B f1POW11OM MAY aflpH onpeAeneHNN KaTeroplN oreeTa npep,nonaranocb, vro oAHa "Ao3a" coµepcNT 10 r vHCroro anKoronR. B crpaHax, rAe anKoronbHOe coAepwaHHe craHAapTHOH go3bi ornHtiaercH OT 10 r 6onee, veM Ha 25%, KaTeropNH oreera AonmHa 6biTb cooTeercreeHHO nepecMorpeHa. 3pecb 3anNWNTe cyMMy BCeX oTBeroB NcmovHUrc: Babor et al. (29) HpocTO BOnpOC O TOM, CKOnbKO nauNeHT O6bILiHO BbInNBaeT, npNBOANT O6bIi-IHO K HeTOr-IHOMy OTBeTy. JIyiIIUe CIIpOCNTb 6onee KOHKpeTHO: "B CpejjHeM, CKOnbKO pa3 B HeAeJIIO BbI nbëTe aJIKOrOJIb- Hble HarINTKN?" N"CKOnbKO BbI BbIrINBaeTe 06bIi-IHO 3a 3TOT pa3?". 3T0 AacT BaM npAMOi%I OTBeT, 6narOAapA KOTOpOMy MO)KHO no,tZcHH- TaTb B eANHNHaX NnN rpaMMaX BbInNBaeMOe 3a HeAenlo. CymeCTBy- IOT, KOHelIHO, ApyrNe npN3HaKN, KOTOpble yKâ3bIBaIOT pa6OTHNKaM nepBNiiHOI%I Mej[NKO-CaHNTapHOii nOMOLLjN, Ha npNCyTCTBNe anKOrOnA. Le Go (30) pa3pa6oTan NHCTpyMeHT cKpNHNHra, OCHOBaHHbII%I Ha TaKNX npN3HaKaX, KaK BHeLLIHNII BHA JINI(a H TpeMOp. CneAyiOLUNN CnHCOK BKnioiiaeT B ce6A 11One3Hble KnNHNiieCKNe 1-1p143HâKN BO3MO)KHOrO OnacHOrO nOTpe6neHNA: oxcNpeHNe rIOBTOpAIOLI[NeCA TpaBMbl 14 HeCiiacTHble cJIyiiaN )Kan06bl Ha )KeJIyAOTiHo-KNLLIeiiHbili TpaKT 6paiiHble NH 14 CeMeNHble np06neMbl npOrynbl Ha pa6oTe CnyiiaN BO)KAeHNA B HeTpe3BOM BNAe cnyilaN 6ecnoxollcTBa/AenpeccNN npOtiecCNA, CBA3aHHâA C nOBbILNeHHbIM pNCKOM HâJIHi3He KpynHblX npo6neM C anKOrOneM B NCTOpNN CeMbN nnOXOi%I COH Ci-iHApoM nOCTOAHHOi%I yCTanOCTN nOBbILneHHOe KpOBAHOe AaBneHHe CneAbl CTapbIX nepenOMOB Ha peHTreHOBCKOM CHNMKe lla6opaTopHble Tecrbl Hp06bI AbIXaHNA Ha ânKOI'Onb MOryT 6bITb nOJIe3Hbl, TaK)Ke KaK N 6140XIiM1411eCKNe nOKa3aTenN, TâKNe KaK CbIBOpOTKa raMMa rnyTaMNn TpaHCCpepa3bI (FFT) N cpeAHNH o613ëM 3p14Tp0I1HTOB. H3BeCTHO, ilTO FFT nOBbIIIIaeTCA y 60-70% 3aBNCNMbIX np06neMHbIX nbK)LL[HX. JIO)KHble 1103NTNBHble nOKa3aTenN cnymaioTCA npN HâJINiiNN 3a60neBaHNIï neiieHN, He CBA3aHHbIX C nOTpe6neHNeM anKOrOJIA, H npN ApyrNX cl)opMaX noTpe6neHNA HapKOTNileCKNX BeIL[ecTB. He06X0A14M0 OTMeTNTb, LITO nOKâ3aTenb rrT 06bIiiHO BO3BpaIi[aeTCA HOpMy nocne AByX HeAenb HeynoTpe6neH451 anKOronA. H3BeCTHO, CpeAHNÎ-i 061:ëM 3p14TpOL[NTOB nOBblLnaeTCA y 50% npO6neMHbIX 47 nbIOH.[HX. O4eBHAHO, LITO ueneC006pa3H0 KOM61iHIipoBaTb 3TH Aria TeCTa: OAHH HRH 06a nOKâ3aTenA nOBbIIIIaIOTCA B 70% cnyuaeB. YrneBOAOAecliHuHTHbII%I TPaHC(PepHH SIBnSIeTCSI 6onee HOBbIM, HO nOne3HbIM 6HOROrH'-IeCKHM nOKa3aTeneM (31). 3TH noxa3aTenH SIBnSIIOTCSI TaK)Ke OLieHb none3HbIM CpeACTBOM MOHHTOpHHra nporpecca (32). V1HTEPBEHuV151 MIH6iMânbxaSl cTpaTer&ISI nposegeHIiSi HHTepBeHulili BKJIIOLIaeT B Ce6A np5IMOl3 COBeT TeM, KTO, Cornacxo npoH3BeAëHHOl3 oueHKe, nOTpe6nAeT ânKOrOnb B OnaCHbIX HRH Bpe,I(HbIX pa3Mepax. PIHCpopMauHSI O pHCKOBaHHbIX npeAenax noTpe6neHHA BKyne C HHAHBHAyanH3HpOBâHHbIM COBeTOM 06 H3MeHeHHH nHTeFiHbIX npHBbItIeK, nnioc 6yxneT, co,rxepxcaluHri HH4)opMauHlo no CaMOnOMOÜjH, COCTaBRAK)T OCHOBy HHTepBeHuHH. He06X0AHMO, LIT06bI (pOpMa 6yKneTa H COBeTa pa3pa6aTbIBanHCb Ha MeCTBX (21). 1I0Re3H0, LIT06bI naljHeHT BepHynCA tiepe3 2-3 HeAenH ARA KOHTpORA nporpecca H nOBTOpa 6HOXHMHHeCKHX HCCneAOBaHHri. rlpHBneneHHe npoueCCy My)Ka HRH )KeHbI nauHeHTa HRH ice 611143K0r0 Apyra HRH pOACTBeHHHKa 6narOnpHSITCTByeT nepeMeHaM. Bien et aI. (22) Ha3Ban 3TOT npouecc FRAMES (OCHOBHble HanpasneHHsi): npOHHCpOpMHpOBaTb nauNeHTa O pHCKe; nOAHepKHyTb ero nHLIHyiO OTBeTCTBeHHOCTb 3a H3MeHeHHe; AaTb coseT; COCTaBHTb CnHCOK BO3MO)KHbIX anbTepHaTHB AnA H3MeHeHHA, HCHOnb3yA noAXOA, KOTOpbIii SIBnACTCA BbIpa3HTenbH6IM H cnoco6cTByeT 3(1)49eKTHBHOCTH pa60TbI CaMOrO nauHeHTa. BBE,qEHV1E CIi1CTEMbI HA MYHV1U1411A11bHOM YPOBHE rpynna Aei3cTBHi%I no anlCoronio AOn)KHa Hai%ITH3aiiHTepe- COBaHHbIX napTHëpOB B CeKTOpe nepBHLIHOi%I McAHKO-CaHHTapHOii 48 noMO1uH, KoTOpble 6bI npeACTaBHRH HAeK) KonneraM H npIi3BanH HX npHCOeRHHHTbcSI K eë BbInonxeHHiO. XapaKTep H opraHH3auHSI nepBHT-mon nOMOLuH B pa3HbIX CTpaHaX EBpOnbl pa3nHMHbI. B HeKOTOpbIX CTpaHaX Ka.)K,AbIi%I TienOBeK 3aperHCTpHpOBaH y onpeAe- nëHHOrO BpaTia o611.1ell npaKTHKH, B ApyrHx naui3eHT cam peHlaeT, WITH RH eMy K 0611AenpaKTHKyiOLueMy Bpagy HRH K BpaLly Cneuxa- nHCTy, npHHHMaIOLueMy B TIaCTHOiI KnHHHKe. Be3Ae CyLueCTByIOT nOnHKnHHHKH, rqe pSIAOM pa60TaIOT CneuIiaRi3314p0BaHHble BpaTIH, pa6OTHHKH nepBHT3HOÎI McAHKO-CaHHTapH01%I nOMOLuH, MeACëCTpbl H pyre He06XOAHMble CneuHanHCTbI. OHTHManbHaA CTpaTerHSI 6yAeT 3aBHCeTb OT 3HaH1,151 MeCTHbIX yCnOBHI%I. B CyLuHOCTH, 3aAaLia COCTOHT B TOM, 1-IT06bI HHTepBeHuHH H pa60Ta no yKpenneHHK) 3AOpOBb5I npOBOAHRHCb KaK MO)KHO 6n1,17ce K nauHeHTy, TaM, rAe nORyLIHTb KOHCynbTauHK) RerKO H npOCTO. Hyxcno T-IeTKO OnpeAenHTb OCHOBHOi%I nepcoxaR nposeAeHHA 3TOi-I pa6oTbl, BKnI013a5I aAMHHHCTpaTHBHbIIi H KaHueRApCKHi%I, a TaKNCe uenH H npeHMylueCTBa 3TOrO nOAXOAa. Heo6xo44Mo onpeAenHTb XapaKTepHCTHKH nauHeHTOB, KOTOpbIM He06XOAHMa npoCTaSi HHTepseHuHSI, H CHCTeMy Aei-iCTBHii C TeMH nauHeHTaMH, KOTOpble SIBnSIIOTCSI CRHIIIKOM nCHXHTieCKH HRH C1)H3HTieCKH 60nbHbIMH, 4TO6bI npHMCHATb K HHM AaHHyIO HHTepBeHuHIO. V13MEHEHVIE f1PE,gCTABllEHV11;1 O6paLueHHe K cHCTeMe nepsHTiHOi%I McAHKO-CaHHTapxoN noMOIIZH Aaxxoii McCTHOCTH noTpe6yeT BOBneTIeHHSi B pa6oTy OCHOBHbIX McApa6OTHHKOB 3TOi%I CHCTeMbI, BpaTleïi H MeAceCTëp. B 6011bIIIHHCTBe cnyvaeB, 110 Kpal%IHeii Mepe OAHH npeAcTaBHTenb AaHHOÎ-i CHCTeMbI AOnxceH 6bITb TiReHOM rpynnbI AeHCTBHii. 3AeCb MO)KHO CTORKHyTbCA C COnpOTHBReHHeM, 06yCROBneHHbIM He)KenaHHeM A06aBReHH51 CRy)K6aM nepBHtIHOH HOMOIuH AOnOnHHTenbHOi%I pa60TbI, KOTOpOe yCHRCHO y6e7KAeHHeM, LITO aJIKOI'OnbH6Ie np06neMbI - 3T0 3a6OTa TORbKO CneuHanHCTOB. nepBOii 3aAaTIeH rpynnbl AeHCTBHii 6yAeT H3MeHeHHe npeACTaBneHHii O XapaKTepe aJIKOrORbHbIX np06neM. 3T0 MO)KeT 6bITb AOCTHrHyTO nyTëM npOBeAeHHA CeMHHapOB, nOCBALuëHHbIX COBpeMCHHbIM B31-1151AaM Ha anKOrOnbHble np06neMbl. OTIeHb Ba)KHO npHBneiLb CK)Aa OCHOBHbIX CneuHâJIHCTOB, OnHpaACb npexcAe BCero Ha CneuHäRHCTOB 49 6pHraA nepsH4HOH McAHKO-CaHI-iTapHOÏI nOMOIuH. Bo3M0)ICHO, none3HO COeAHHHTb 3TH nporpaMMbl c ApyrHMH BOnpOCaMH 3A0p0Bb51, KaCaiOn[HMHCA o6pa3a )KH3HH, TaKHMH KaK KypeHHe H nHTaHHe. HanH4He McCTHbIX AaHHbIX 3Ha4HTenbHO nOMO)KeT npOABH- )KeHHIO npouecca. HanpHMep, CIoAa Aon)iCHbI 6bITb BKnI04eHbI AaHHble o McCTHOM nOTpe6neHHH anKOronA, BbILIHCneHHble H3 HaIjHOHâJIbHbIX AaHHbIX, nOKa3bIBaIOIltHe paCnpOCTpaHeHHOCTb OnaCHOro nOTpe6neHHA. CiOAa xce Hy)KHO BKn104HTb AaHHble n0 3a6oneBaeMOCTH H CMepTHOCTH, CBA3aHHOIi C aJIKOrOnbHbIMH np06ne- MaMH H, TaKHM O6pa3OM, CBHAeTenbCTByrOr.ImC O npeHMyII(eCTBaX np0(1)HnaKTHKH. byAeT O4eHb nOne3eH MeCTHbIÎ-r onpoc O pacnpOCTpa- HeHHOCTH 3noynOTpe6neHHA aJIKOrOneM. Ero MO)KHO AOBOnbHO memo npOBeCTH, eCnH nepcOHan 6yAeT nOCTOAHHO OTMe4aTb HanH4He aJIKOrOnA, Kai( CtiaKTOp npH nOCCLueHHH KnHHHKH. BbI3BaB HHTepeC cpeAH McApa60THHKOB, MO)rCHO BBOAHTb CHCTeMaTH4eCKHI-r nOAXOA K O6y4eHHIO, nOAAep)KKe, OBnaAeHHIO MeTOAHKaMH CKpHHHHra H HHTepBeHuHH Ha paHHeÎi CTa)3,HH (33, 34). 1MerOTCA AOKa3aTenbCTBa, 4TO Bpa4eri O61ueM npaKTHKH, MeAceCTëp, nCHXOJIOrOB H COuHanbHblX pa6OTHHKOB MO)KHO yCneI.nHO O6y44Tb npOBeAeHHio npoueAyp CKpHHHHra H npOCTOIi HHTepBeHuHH (21). HepBOHa4anbH0, 3aH5ITHA AOn)KHbI 6bITb opraHH3OBaHbI AnA 3aHHTepeCOBaBIIIHXCA MeApa60THHKOB. r103)Ke, CeMHHapbl n0 3TOFr TeXHHKe AOn)KHbI o6pecTH CBOë noCTOAHHOe McCTO B nOCneAHn- nOMHOM o6pa3oBaHHH McACecTëp H 061IjHX npaKTHKOB, a TaKxce 3TOMy AOn)ICHO yAenATbCA AOn)ICHOe BHHMaHHe B McCTHbIX y4pe)ICAeHHAX nocneAHnnOMHOTO 06pa30BaHHA. B HeKOTOpbIX paHoxax OKa3anOCb 11One3HbIM HCnOnb3OBaHHe OpraHH3aTOpOB O6y4eHHA CneuHânbHO HaHATbIX AnA pa6OTbI B y4pe)fCj[eHHAX nepBH4HOIi nOMOIuH, 4TO6bI npOAeMOHCTpHpOBaTb nOTBHIjHan noAxoAa HHTepBexuxH Ha paxeÎI CTaAHH H 4T06bI CTHMynHpOBaTb HHTepeC cpeAH 6pHraR nepBH4HOii MeAHKO- CaHHTapHOr%I noMOIIjH. CaHKr-IleTep6yprcKHH npoeicr B 1994 roAy B CaHKT-HeTep6ypre 6brna npeAnpHHATa HHHuHaTHSa HauenexxaA Ha noAAepACKy pa6oTHHKOB nepBH4HOri 50 Me,IjHKO-caHHTapHOI%I nOMOIIjH B HX )KeJIaHHH "nOMOTIb JIK),I(AM 143MeHHTbC5I". BCë HatiaJIOCb c npeAnOJ10)KeHHSi o TOM, TITO JjJ1A TOPO LITO6bI yJ1yTILiIHTb 3ZjopOBbe H npegoTBpaTHTb 3a6OJIeBaHHSi, Cneulia- JIHCTbI nepBHTIHOii MegHKO-CâHHTapHOi%I nOMOLuH J];OJDICHbI no6y)IC,IZaTb CBOHX nauHeHTOB K nepeMeHaM B HX nOBeJ1;eHHH, TIaCTO KOHueHTpHpyA BHHMaHHe naL(HeHTa Ha H3MeHeHH5IX B nHTaHHH, nOTpe6JIeHHH aJIKOI'OJIA, KypeHHH H (1JH3HTIeCKOÎ-I aKTHBHOCTH. bbIJ1 OpI'aHH3OBaH cneuIiaJlbHbIÎ-I xypc C uenb1O 06yHHTb MeJ[pa60THHKOB: 06151CHATb KOHLjenLjHK) ynpaBJIeHHSI pHCKOM B npouecce yKpenJIeHHA 3,11OpOBbA; O6-bSICHATb npouecc H3MeHeHHrl H COOTBeTCTByIOluHe THnbI HHTepBeHLjHH Ha Ka>IC,IZOI%I CTa,11HH; npHMeHATb Z[aHHble npHHuHnbl JjJ151 npOBegeHHA KpaTKHX 03J(OpOBHTeJ1bHbIX HHTepBeHuHii B OTHOLIIeHHH npo6JleM nOTpe6JIeHHA aJiKOI'OJIA, Ta6aKa, a TaK)iCe nHTaHHA H(1)H3HTIeCKOii aKTHBHOCTH, TOrJIa, KOI'J[a 3TO He06XOJjHMO. B JjaHHOM KypCe npH3HaëTCA, TITO H3MeHeHHe npHBbITIeK JIiOgei-i HHKOI'ga He 6bIJI0 npOCTbIM eJIOM, H Ba)KHO OnpegeJIHTb CTeneHb I'OTOBHOCTH JiHTIHOCTH K H3MeHeHHIO. 3,Ijecb 3aTpal'HBa1OTCA TaKHe TeMbI, KaK TpygHOCTH nOCTaHOBKH npO6JIeMbI o nOTpe6J1eHHH aJIKOI'OJIA, nun,' o6cJIeJjosaHHA 3JI;OpOBb51, McTO,I(HKH nOMOLuH nauHCHTy B 06):[yMbIBaHHH nyTeli BbIHOJIHeHHA H3MeHeHHii, BJIHSIHHA, KOTOpble CnOCO6CTByIOT HJIH MeLnaiOT H3MeHeHHIO, a TaK)Ke 11J1aH JjegCTBHÎ-i. 11pH3HaH0, TITO XOpoIIIH4i nJIâH JjeiiCTBHii gOJDICeH 6bITb TOTIHbIM, H3MepHMbIM, COI'J1aCOBaHHbIM CO BCeMH, KTO pa6oTaeT HaA 3THM, peaJ1HCTHTIHbIM H Onpe,geJlëHHbIM BO BpeMeHH. l'1HHL[HaTHBa 6blJia OTIeHb XOpOIIIO npHHATa pa60THHKaMH nepBHTIHOii nOMOLuH, KOTOpble 3aTeM CMOi'JIH nepeJjaBaTb CBOH BHOBb npH06peTëHHb1e HaBbIKH KOJIJIeI'aM. Tax KaK peTIb LuJIa o TOM, TIT06bI CIIOCO6CTBOBaTb McHee OnaCHOMy nOTpe6JIeHHIO aJIKOI'oJIA, ueJlbiO npenOgaBaTeJIeii 6bIJ1a nOMOLub B COeJjHHeHHH 3HaHHi%I 06 aJIKOI'oJle C HaBbIKaMH npOBeZ[eHHA HHTepBeHuHH. 51 MCTO4HNKN j:AaHHbIX gaHHble Ha ypOBHe nepBH4HOli MeJlHKO-CaHHTapHoli nOMOLuH MOIyT HMeTb (liOpMy HHCkopMauHH H3 OnpOCOB, n0xa3bIBa10Lui3x pacnpOCTpaHeHHOCTb noTpe6neHHS1 anKOronSi cpeAH pa3nH4HbIX rpynn HaCeneHHSi. Taxxce MO>(eT oueHHSaTbCSi smart CB5I3aHHbIX CO 3JTOpOBbeM CO6bITHi%I, TaKHX KaK HeC4aCTHble CJIy4aH, nOCTynneHHe B 60nbHHuy O6LuerO npocpHnx H noceLlZe[-IHe KJII-iHHKH nepBlivHOli MeJ);iiKO-CaHHTapHOIi nOMOLgIi. TaK>iCe MO)KHO IiCIIOnb3OBaTb ,aaHHble OL(eHKH o&bëMa J>;eslTenbHOCTH, HanpnMep, nposepsisi KOnH4CCTBO cny4aes BbISIBneHIiSI H KOHCynbTHpOBaHFISi Ha KaNCJjOM yyaCTKe, RUH KOHTpOnlipyA cnytiaH BbISIB11eHH5I nauHeHTOS C OnaCHbIM ypOBHeM nOTpe6neHHSI nyTëM 06Hapy>KeHH2 H3MeHeHHli B COO6LIjeHHSiX o nlßTei%IH6IX npHBbI4KaX H B 6HOXHMH4eCKHX nOKa3aTen5IX. 3aRa4H 3TH ,TZaHHbie MOryT HCIIOn630BâT6CSI B Ka4eCTBe OCHOBbI Arm OnpeJjeneHHSI 3aJ1a4. 3aJZa4H 6yJryT BKn104aTb B Ce65i COrnaCOBaHHe H yCTaHOBneHHe nOZ[3a,ga4 no: KOnH4eCTBy nauHeHTOB, 06CneJjOBâHHbIX H 110ny4HBLIII-IX KOHCynbTauHiO e>KeMec5I4H0; yBenH4eHHi0 BO3MO>ICHOCTeI-I 06y4eHHSI; H KOnH4eCTBy H3MeHeHHN B C0061IjeHHAX O nHTeiiH6IX npHBbI4KaX, B 3aperl-iCTpNpOBaHH6IX 6i3OXHMH4eCKHX nOKa3aTenSIX H B COCTOHHHH 3J1Op0Bb51. B nepCneKTIiBe MO)KHO KOHTpOnHpOBaTb 143MCHeHH51 ,apyrHx nOKa3aTeneN 3J10pOBb51 CB513aHHbIX C OnpeJZeneHH6IMH BHJtaMH JZeSITenbHOCTH. O1.{eHKa OL[eHKy MO)KHO OCHOBbIBaTb Ha CTeneHH BbInOJIHeHH51 ynOMAHyT6IX BbILne 3a,aa4. TaKxce oHa MO>KCT OCHOBbIBaTbCH Ha KOnH4eCTSe 6pHraJl nepBH4HOii MeJjHKO-CaHHTapHOH nOMOn(H, npoLUe,aLUHx Kypc o6y4eHH5I MCTO,aHKaM nposeJ;eHHa npOCTOH HHTepseHl.(HH, Ha KOnH4ecTSe MaTepHanos no CaMO1IOMOLuH Ha Ka>KJ[OM y4aCTKe H Ha KOnH4eCTBe nauHeHTOB, npOIne,aIIIHX OueHKy H 52 KOHCynbTauHiO. 3auaLIH n0 yKpenneHiiiO 3uOp0Bbs" Cny)K6 nepBHLIHOii MeuHKO-CaHHTapHOii nOMOLuH, KOHeLIHO xce, AOnDKHbI 6bITb B3aHMOCBx3aHbI C 60nee 0611HMH 3auaLIaMH. PacWNp@HN@ OTB@THbIX Mep }KH3Hb LIenOBeKa, 3noynOTpe6ns"lOLuerO anKOroneM, LIaCTo nOJIHa KpH3HCOB H HeCLIaCTHbIX CnyLlaeB, BO3HHKHOBeHHe KOTOpbIX CB513aHO C nOTpe6neHHeM, LITO LIaCTO npHBOAHT er0 B none 3peHHe pa3nHLIHbIX yLlpexcueHHH. B TO BpeMx, KaK Cny)K6bI nepBHLIHOI%I MeuHKO- CaHHTapHOI3 nOMOLuH xBnxiOTCx OCHOBHbIM McCTOM KOHTaKTa H HHTepBeHuHH, upyrHMH 3HaLIHMbIMH H nOUXOUxLuHMH yLIpexCueHHAMH xBnxIOTCx COuHanbHbie Cnyxc6bl, Cnyxc6bI Ha6n10ueHHs" 3a yCJIOBHO OCyxcuëHHbIMH npeCTynHHKaMH, KOHCynbTaul-IOHHble CnyxC6bI, uepKOBb, IOpHCTbl, nOJIHuHx, Cyubl H auMHHHCTpauHx npeunpHxTHil. AJIKOrOnbHble np06neMbl H OnaCHOe nOTpe6neHHe TaKxce paCHpOCTpaHeHbl cpeJZH nauHeHTOB TpaBMaTHLIeCKHX OTueneHHii H OTueneHHÎ7 HeOTJIO>KHOIi nOMOLuH, a TaKxce nauHeHTOB xHpyprH- LIeCKHX, TepaneBTHLIeCKHX H nCHXHaTpHLIeCKHX KJIHHHK. MOuenb CKpHHHHra H HHTepBeHuHH Ha paHHeii CTauHH, OHHCaHHax TIRA CnyxC6 nepBHLIHOii MeuHKO-CaHHTapHOi%I nOMOLuH, MOxCeT, TaKHM o6pa30M, HCHOnb30BaTbC51 HIHpe, XOTx eCTb OTHOCHTenbHO HeMHOi'O npHMepOB eë npHMeHeHHx BHe CTeH yLIpexcueHHI3 3upaBOOXpaHeHHx. geiiCTBeHHOCTb KpaTKOii HHTepBeHuHH uns" npo6neMHbIX nbiOn(HX 6bina npoueMOHCTpHpOBaHa B KJIHHHKe o6LLjerO npOCpHns" B 3uHH6ypre (35). HanHLIHe anxoronbxblx npo6neM onpeuenxna npOlueunlax o6yLieHHe MeuceCTpa C noMOLubIO nouroTOBnexxoro onpoca, unxtuerOCx 10 MHHyT H KaCaloLuerOCx nHTeI%IHblx npHBbILIeK, HaCTOxlueli H npOIIlnol%I HCTOpHH 6one3Hei%[ H Couliânbxoro npoHcxoxcueHHx. Kaxcubli%I pa3 npOBOuHJICx ananH3 KpOBH (ITT H CpeuHHiï O61ëM 3pHTpOuHTOB). ECnH y nauHeHTa o6HapyxcHBani3cb HeOxeHuaHHO BblcoKHe noxa3aTenH axanH3a, a OH oTpHuân HanHLIHe aJIKOronbxbix npo6neM, ero paccnpaHlHBanH eLuë pa3. KpHTepxeM oT6opa uns" yLIaCTHx B HCCneuOBaHHxX 6bInH uaHHble O HâJIHLIHH y nauHeHTa anKOrOnbHbIX npo6neM HnH OnaCHOrO noTpe6neHHx H oTCyTCTBHe KaKOrO-nH60 npeuineCTByIOLuerO neLIeHHx 3THX npo6neM. 1TauHeHTbI, COOTBeTCTByIOLuHe 3TOMy KpHTepHio, 11pOH3BOnbHO OnpeuenxnHCb nH6o B KOHTpOnbHyiO rpynriy, 3a KOTOpOH npOCTo Ha6nlouanH B TeLieHHH nOCneuylonjerO roua, nH6o B rpynny HHTepseHuHH, rue MeucecTpa KOHCynbTHposana Ka>KuorO B 53 npMCyTCTBMM, ecnM BO3MO)KHO, cynpyra. TaKxce nauxeHTy BbIAaBancx 6yxneT, coj[ep)KaluHÎ-[ COBeT no coxpalueHIilo noTpe6neHNx H Tpe3BOCTH. CnycTA ron o6e rpynnbl onpocHna MeAcecTpa, xOTOpaA He 3Hâna, K KaKOIi rpynne OTHOCHJICA KâNCjjblli nauxeHT. bbinM npOBejjeHbl aHanM3bl KpOBH H OnpOC pOjjCTBeHHMKOB. Bcero 6bIJI0 156 LIenOBeK, H3 HMX 6bIJI0 OnpOIIIeHO 85%. bbIJIO 06Hapy)ICeHO S1BHOe ynynlueHHe y 3HaLIi3TenbHO 6onbMleH naCTH (52%) npOKOHCynbTHpOBaHHbIX nauHeHTOB, LIeM B KOHTpOnbHOFi rpynne. Taxxce Ha6nK)AanOCb 3HaLINTenbHOe ynyLIIIIeHHe ypOBHSf I'I'T. )-IeCKOnbKO npOeKTOB npOJjeMOHCTpMpOBanM ,ueiiCTBeHHOCTb npoßejjeHHSI HHTepBeHuHH B yCJIOBMSiX 60nbHHu. CXOjjHble nOIjXOijbl MOryT HCIIOnb3OBaTbC51 H B HeMejjHuHHCKHX yvpexcneHHslx, HeKOTO- pble H3 HHX OnHCaHbI B npoeKTe B03 AUDIT, rAe B HeKOTOpbIX CnyLiaslX HCIIOnb3OBâJIHCb 06pa30BaTenbHble H MyHMuMnanbHble yHpençjeHHSI (21). Bien et al. (22) onHCanH ycneuixoe nposeReHHe HHTepBeHIjHII B pâ3nHi1HbIX HeMeZjHuHHCKHX yTdpexczeHHSIX. CflEl.MAJ1l/13V1POBAHHbIE CJ1Y)K6b1 B 60nblliHHCTBe LIaCTen EBpOnbl CylJ:jeCTByIOT onpejjenëHHble Cny)IC6b1, KOTOpble CneuManbHO CO3AaHbI ,gnSl niOnei3 C anKOrOnbHb1MH np06neMaMH, LiaCTO ,IjnSI TeX, y KOrO OHM HaH60nee Cepbë3HbI. 3T0 MOT 6bITb nCHXHaTpHLieCKHe CTauFiOHapHble HnM aM6ynaTOpHble KnHHHKH, BpaYe6Hble KJIHHHKM B 6OnbHHuaX o6ujero npocMnA, aM6ynaTOpHO KOHCynbTHpyionjMe Cny)K6b1 Ha McCTaX HnH CTaIjMOHapHble yLlpe)ICj[eHHSI, CO3,gaHHble CneuHânbHO nnSI neLieHHSI naIjHeHTOB C anKOrOnbHbIMH np06neMaMM. Bo MHOTHX perMOHaX Ha6nIOnaeTCSI C,IjBHr OT HHTeHCHBHOTO CTauHOHapHOTO neLIeHMSI K yBenMLIeHMIO KOnMLIeCTBa aM6ynaTOpHbIX cny)K6 Ha McCTaX. XOTSI nepBOHaLianbHO OCHOBHOid aKueHT MX pa60Tbl 6bin HanpaBneH Ha nauHeHTOB C Cepbë3HbIMM änKOTOnbHbIMH npo6neMaMH H âJIKOTOnbHOIi 3aBHCHMOCTbI0, cel%Iiiac Ha6nIOnaeTCSI nosblIIIeHHe HHTepeCa K OpraHH3auMH npOBeAeHHSI HHTepBeHuHI%I Ha paHHeli CTajjHM, 4aCT0 Cny)IC6aMH nepBHziHOro 3BeHa ynOMSiHyTbIX Bbllue ygpextueHMï-l. 54 OT-IeBH,gHO, LITO KOnH9eCTBO nloAeil, nOTpe6nAi0II(HX anKOrOnb Ha OnaCHOM ypOBHe CnHLIIKOM BenHKO, IITO6bI OHH 6binH npeAMeTOM 3a6oT nHUib He60nbuIOil rpynnbI cneL(HanHCTOB, H ni060I%I nOAXOA, HaL(eneHHblii Ha COKpaLL(eHHe rpynnbI pHCKa, BepOATHO AOn)KeH BKJIIOLIaTb B Ce6A npOCBeu(eHHe, COL(HanbHble nepeMeHbl H coTpyA- HHLIeCTBO IIIHpOKOTO Kpyra MeApa60THHKOB. PaCLIIHpeHHe BHCIIIHHX H KOMMyHanbH61X cnyxc6 BO MHOFHX cTpaHaX npxseno K cMeHe npHOpHTeTOS CneL(HanH3HpOBaHHbIX cnyxc6. MHOrHe cneitHanH3Hpo- BaHHble Cny)K6b1 nbITaIOTCA COXpaHHTb HHTOHCHBHy10 nporpaMMy CTaL(HOHapHOil npaKTHKH H OAHOBpeMeHHO A06aBn5IIOT K CBOeN AesA- TenbHOCTH pa6oTy C HaceneHHeM. HpH OTCyTCTBHH AOIIOJIHHTenbHblX pecypcos, 3T0 npHBeAëT K nOBbIIIIeHHIO HanpA)KeHHA H AasneHHA CpeAH nepcoxana. Cyu(ecTByeT Hecxonbx0 cnoco6os, KaK CneL(Ha- nH3HpOBBHHble Cny)K6bI MOryT OpraHH30BaTb pa6oTy C HaceneHHeM, nH6o nyTëM CO3AaHHA OTAeJIbHbIX Cny)K6, KaK OnHCaHO y Chick et al (35) BbILIIe, n1460 IIyTëM OpraHH3aL(HH AeTOKCHKaL[HH Ha AOMy (36), .11H60 n}rrëM OpraHH3aHHH KOHCynbTaL(HOHHOTO npoL(ecca Llepe3 6pHra,i(bI Ae1dCTBHi%I no np06neMaM anKOrOnA Ha McCTaX. bpHraAbl AeIiCTBHN no npo6neMaM anK000JIA Ha McCTaX 6bInH CO3AaHbI B BenHKO6pHTaHHH H 06bI4HO COCTOBT 113 MeACeCTpb1, ncHxonora, nCHxliaTpa, KOHCynbTaHTa H COL(HanbHOro pa60THHKa (MHOrHe pa60Tai0T no COBMeCTHTenbCTBy), Ka)iCAbIiI H3 KOTOpbIX npoHlën o6yLIeHHe H 3aHHTepeCOBaH B penleHHH anKOrOnbHbIX np06neM. OHH MOI-31T 6bITb npHKpenneH6l K KaKOMy-n1760 yLIpe)CAeHHK), HO OCHOBHyIO IfaCTb CBoeH pa60TbI npOBOAHTb cpeAH HaCeneHHA, nO,IlAep)KHBaA CBA3b CO Cny)K6aMH nepBH11HOiI nOMOLIjH, npOBOAA o6ylfeHHe H oKa3bIBaA noAAep)KKy H npe,IjnaraA cneL(HanH- 3HpOBäHHyIO nOMOII(b B TANCënbIX AnA nepBHliHOil nOMOL1(H cny9aAX. B OCHOBHOM, MX pa6oTa HaL(eneHa Ha 'Tatien O6u(eFi npaKTHKH, naTpOHa)KHb1X McAceCTëp, McACeCTëp, pa6oTaloLl(Hx Ha 3THX yTIaCTKaX, COIjHâJIbHbIX pa6OTHHKOS H HHCneKTOpOB, BeAyu(Hx Ha6nIOAeHHe 3a yCJIOBHO OCy)KRëHHbIMH npeCTynHHKaMH. Pa60THHKaM CneL(HanH3HpOBaHHbIX cny)K6, KOTOpble cHallana MOryT 6bITb 06eCnOKOeHbI CMeu(eHHeM aKL(eHTa Ha ypOBeHb nepBHLI- HON nOMOIL(H H HHTepBCHI(Hii AnA MeCTHOrO HaCeneHHA, 6yAeT HyNCHa nOMOIIjb B o6yLIeHHH HOBOMy BHAy pa6OTbI cneL(HanH3HpOBaHHON KOHCynbTaL(HH, KOTOpaA 6yAeT BKnIOLIaTb B ce65i pa3pa6OTKy HHCTpy- McHTOB H MâTepHânOB AJIA HCIIOnb3OBaHH51 pa60THHKaMH nepBHLIHOI%I MeAHKO-CaHHTapHOH nOMOu(H. He06XOAHMO TII.(aTenbHO npOAyMaTb 55 3TOT nepeXOJI TaK, LITO6bI yIIeCTb OIIbIT CneIlHanHCTOB H 06eCneIIHTb HM Heo6xoxxMylo nOJUlepxcxy H o6yLieHi-Ie JIJIA ajjanTaLjHx K HoBOMy BH,i(y pa60TbI H /IRA aKTHBHOrO yIIaCTHA B pa3BHTHH CHCTeM neIIeHHA H 11pO431HnaKTHKH. BepOATHO, MHOrHe CneL(HâJIHCTbI npHMyT aKTHBHOe yLIaCTHe B pa6oTe I'pynnbI JIeNCTBHH no anKOrOnK). Ba)icHO npH3HaTb He06X0,rjH- MOCTb COXpaHeHHA ypOBHA nOJIrOTOBKH CneuHanHCTOS H HHTepeca, LITO MO)KeT JlaTb noarkepxKKy uIHpOKOMy Kpyry 1le5ITenbHOCTH Ha McCTHOM ypOBHe, CnOCO6CTBOBaTb 06yLIeHHIO spatial o61lleil npaKTHKH, CnOCO6CTBOBaTb BbIABneHHK) âJIKOI'OJIbHbIX npo6neM Ha paHHeii CTaJIHH Ha ypOBHe nepBHLIHOii nOMOIIjH H 60nee IIIHpOKOMy BOBneIIeHHIO McCTHbIX yllpexcJleHHi3 B pa6oTy no aJIKOTOnbHbIM np06neMaM. CyLI[eCTByIOT OnaceHHA, IITO nOOHIpeHHe npOBeJIeHHA HHTepBeH- IIHH Ha ypOBHe nepBHLIHOI-t nOMOLLjH, MO)KeT npHBeCTH C CHH)KeHHiO CpHHaHCHpOBaHHA CnegHBJIH3HpOBaHHbIX cnyxc6. 3T0 6bIJIO 6bI HenpaBHnbHbIM, TaK KaK 6e3 3HaHHii H pyKOBOJjCTSa TeX, KTO 06naJ(aeT CneL(IiaJIbHbIMH HaBbIKaMH pa6OTbl C âJIKOTOJIbHbIMH np06neMaMH, Ba)KHbIÎd KOMIIOHeHT CHCTeMbI neLIeHHA H 06yLIeHH51 Ha McCTHOM ypOBHe 6y,1),eT yTepAH. Taxxce Ba)KHO npH3HaBaTb LIpe3BbIliaiiHyK) 3HaLIHMOCTb 06ulecTBeHHbIX OpraHH3auHÎ3 H rpynn caMOnOMOHjH, 3aHHTepeCOBaHHbIX B penleHHH 3THX np06neM. TaKHe rpynnbI CaMOIIOMOuIH, KaK AHOHHMHble âJIKOTOnHKH O6eCneLiHBaIOT ,izpyxcecKylo no,q,ilepxcxy H TOBapHIueCTBO JInA TeX, KTO H36aBnAeTC51 OT anKOTOJIH3Ma, HO OHH TaK)Ke npeJjCTaBnAK)T C060i3 HCTOIIHHK OnbITa H npHBep)KeHHOCTH, KOTOpble JlenalOT HeOI.jeHHMbIM HX BKJIaJI B pa3BHTHe 06yIieHHA H 06C1Iy)KHBaHH51. 56 4A11KOI"OJ16 H )I0/13HeHHbIN LA H KJ1 ,gETCTBO B AeTCTBe LienoBeK iIpOXO,IjHT OAHy H3 HaH6onee aKTHBHbIX IIO3HaBaTenbHbIX cl)a.3 ero HRH eë )KH3HH. npe,ijCTaBneHHA 06 aJIKOI'One H 3HaH145I 06 34:1C1)eKTaX ero nOTpe6neHHA, O CB5I3aHHbIX C 3THM IIpeHMymeCTBaX H Hp06neMaX, IDOpMHpyIOTCA B OLIeHb paHHeM BO3paCTe (37). CeMbA ABnAeTCA CaMbIM BaxcxbIM 3BeHOM nepeAainH OnblTa OT oAHOTO nOKOnCHHSi K ApyTOMy. no3TOMy HeyAHBHTenbH0, LITO OTHOLIIeHHe H y6excAeHHA pOAHTeneIï OTHOCHTenbHO aJIKOI'onA H OCO6eHHO Hx CO6CTBeHHOe nOBeAeHHe B nRaHe noTpe6ReH42 anKOTORA OKa3bIBaIOT CHJIbHOe B03AeirCTBHe. bORbIIIHHCTBO AeTeïi, HeKOTOpble B paHHeM B03paCTe, pyre B 6nH)ICe K ABaAIjaTH I'oAaM, BnepBble 3HaKOMATC51 C aRKOTOReM C nOMOLIjbK) pOAHTeReli, Pa3RHT11451 B nHTCIiHbIX npHBbliiKâX H npeACTaBneHHAX TaK)Ke nO3HaIOTCA B AeTCTBe. PenHT1103Hble, COuHaJIbHble, KynbTypHble H McCTHble TpaAHuHH H MHOTHe BHAbI He(DOpManbHOTO KOHTpORA, KOTOpble OTpaHHLIHBaIOT nOTpe6neHHe, TO)Ke nepeAaIOTCA B 3TO BpeMA. CeMbA, TaKHM 06pa30M, AOJLKCHa 6bITb npHOpHTeTHbIM HaHpaBneHHeM AnA 06pa30BaHHA. CeMbA LIaCTO ABRACTCSI TCM MeCTOM, TAe paHbLHe BCeTO BbIABRAIOT H CTapaiOTCA CHpaBHTbCA C nbAHCTBOM. O6pa3OBaHHe, HaLjeneHHOe Ha CCMbIO, AOR)iCHO 06eCneiiHTb eë *IJIeHOB 3HaHHAMH H HaBbIKaMH HeO6XOAHMbIMH ARA nepeAatiH HHCpOpMauHH o MeHee pHCKOBaHHOM noTpC6neHHH H O TOM, KaK CnpaBHTbCA C anKOTOnbHbIMH np06neMaMH. 57 f1OAPOCTKOBbI0 IlEPv1O,q geTH B nojjpOCTKOBOM B03paCTe CTaHOBATCA 60nee He3asH- CHMbIMH OT CeMbH H tinge 6onee nOgBePmeHbI BnHAHHIO CBOHX Apy3eH H HzjeanH3HPOBâHHbIX MOJIOgbIMH nIOAbMH nHLiHOCTeii, non 3Bë3J.L HnH CnopTCMexoB. PeKnaMa H o6pa3 anxoronA, Co3,i[asaeMblii Cpe,IZCTBaMH MaCCOBOii HHCl)opMaHHH, TaKAce 6yAyT OKa3bIBaTb 3HaLiHTenbHOe BnHAHHe B 3TOT nepxoA, XOTA OHM OKa3bIBaIOT CBOë BnHAHHe Ha nloAeH nlo60T0 Bo3pacTa. B nOAPOCTKOBOM BO3paCTe npOHCXOAHT Bb16Op HanHTKOB, MOJIOAble nIOAH HaLIHHaIOT Onpe,genATb CBOH B3aHMOOTHOIIIeHHA C J1KOOJTM H ero 3HaLIHMOCTb AMA HHX. Bo MHOTHX LIaCTAX EBponbI Ha6niOAaK)TCA 3HaLIHTenbHble pa3nH1IHA B CTHne nOTpe6neHHA MOJIOAbIX nIOAeH H HX pOAHTeneH. 3T0 6onee ApKO npOABnSIeTCA B ropoAax, gem B CTa6H1bHbIX CenbCKHX 061gHHaX. npHBbIi3KH H CTHnH noTpe6neHHA 6bICTpO McHAIOTCA, oco6exxo B ropoACKHx ueHTpax, rAe nOAPOCTKH nbiOT BAanH OT pOJjHTenbCKOro KOHTPOnA H BnHAHHA. OYeHb LiaCTO MOJIOAble mom!, 3noynoTpe6n5I0II(He anKOroneM, TaK)Ke yiiaCTByiOT B ApyrHx CpOPMaxX noTpe6neHHA HapKOTHileCKHX BeIueCTB, KypeHHH H ApyrHx THnax onacnoro noBeAeHHA (38). B3POCJ1AS1 )K1,13Hb Bo MHOrHx cTpanax noTpe6neHHe CHH)KaeTCA, KOrAa B3pOCnbIII LIenOBeK 6epëT Ha ce6A OTBeTCTBeHHOCTb 3a ceMblO. AAA MHOTHX CHH)KeHHe nOTpe6neHHA TaK)Ke BbI3bIBaeTCA 3KOHOMHLIeCKHMH (laKTOpaMH, KOrAa CO3AaeTCA HOBOe CeMeiiHOe X03ArICTBO. POAHTenH npHHHMaIOT Ha ce6A OTBeTCTBeHHOCTb 3a BOCnHTaHHe HOBOTO nOKoneHHA, HX npHBbmeK B nOTpe6neHHH, a BOCnHTaHHe HaH60nee ycneLUxo npOBOAHTCA Ha nHiIHOM npHMepe. Kpyr ciaKTOpoB, BnHAIOn.[HX Ha Bb160p OTHOCHTenbHO noTpe6neHHA anxoronA npHBOAHTCA B Ta6nxue 5. LIaCTO BO spew{ 6epeMCHHOCTH )KCHHUHHbI C nOBbIHIeHHbIM HHTepecoM OTHOCATCA K BOnpOCaM 3AOpOBbA H OCO6CHHO nepexcH- BaIOT 3a 6narononytIHe cBoero He po)KAexxoro pe6ëxxa. Hanbl TaIUKe 6onee nOJiHO oco3HalOT CBOIO OTBeTCTBexxoCTb 3a 6yAymee 61aro- COCTOAHHe CeMbH. tlaCTO B 'ramie nepHOAbI nepexoAa H nepeMeH 58 o6pa3osaHHe OKa3bIBaeT oco6o 3Ha'-I13TenbHbII3 3C1CICbeKT. H3BeCTHO, LITO xCeHII(nHbl oco6eHHo BOCnpnnMLinBbl K HHCPOpMaL[nn o6 OnaC- HOCTH KypeHHSI H 3noynOTpe6neHHSI a11KOroneM j(1151 nnoj(a, H COBeT Ha 3Ty TeMy AOn)ICeH CTaTb 4aCTbio pa60TbI Ka)IC,I(OIi, 3aHHMaI01I(ertCSI j(OpOj(OBbIM nepHOAOM KnFIHHKH. B HAeane, HHCtlOpMauHSI o6 anKOrone H 6epeMeHHOCTn j(OnxcHa 6bITb BKniOLIeHa B nporpaMMy 06yLIeHIi5I M01101[bIX 1110j(eii H 6bITb LIaCTbio pa60TbI )KeHCKOIi KOHCynbTaILHH, pa6oTaeT 1114 OHa CpOpMaTIbHO FUIn HeCpOpManbHO. B11HSIHFie 6011b11I0r0 KOnFiLIeCTBa anKOrOnSI Ha My)KCKyiO nOTeHL(nIO H nnojjOBIiTOCTb TaK)Ke j(Qn)KHO BXOj(FiTb B nporpaMMy 063/Helms'. Ta6nNL4a 5. cOaKropbl, BnNAfOUve Ha Bbi6op, KacaIOWNNcA norpe6neHNA anKoronsa KynbTypa n on CeMeNHble Tpa,L1,11L411F1 COLLNanbHO-3KOHOMNVeCK11L1 CTaTyC Bo3pacT nono)ICeH11e B 06LL4eCTBe OTHOweHlle N nOBej(eHNe po,qllreneH reHeTNVecK11il cpaKrop O6pa3oBaHNe PeKnaMa BnNAHl1e ,gpy3e1 11 3HaKOMbIX ,qOCTynHOCTb anKOronA(BKnlovaA CpopManbHblN KOHTpOnb) ueHa anKOfOnbHbIX Hanl1TKOB npoctleccFiA CiaCTb JkOXOLka, KOTOpyK) MO)KHO noTpaTNTb Ha CnNpTHOe 3AopoBbe OTHOWeHl1e cynpyrll (a) 11 ,geTeï-I nl1vHOCTb PO. b H nonoxceHFie nO)icxnbIX 11IOj(eN B pa3HbIx cTpaHax EBponbl 3Haii{iTenbnO OT11Hi-Ia10TCS1. Fie3pa6OTHua H neHCHSI LIaCTO CBSI3bI- BaIOTCSI C ocna6neHHeM HOnoxceHHSi B o6LI[eCTBe. 3KOHOMH1IecKI3e CJIOxcHOCTH, TSIxCËnble yTpaTbl H j(pyrne CO6bITHSI j(OHOJIHSIIOT CnHCOK cTpeCCOB xcn3Hn B nOxcFUIOM Bo3pacTe, OCO6eHHO KOrj(a HCLIe3aeT noj[j(epxcnBaloüjee paHee j(OMaLUHee nnH COCej(CKOe oxpyxcexne. B 3THX o6CTOHTenbCTBaX a11KOrO11b MoxceT CTaTb yTeLlIenneM j[nSI HeKOTOpbIX. HoxCFÜIbIM 1110,i(HIM Heo6XOj(HMO 3HaTb O nOBbILHeHHOM pHCKe yXyj(LHeHHSI 3,12(OpOBb5I H HeCLIaCTHbIX CJIriaSlX, BCnejicTBHe 59 noTpe6nexiiA anKOI'ORA. B L[enoM, nO?KIülOÎi B03pacT CBA3aH C COKpaHjeHHeM nOTpe6neHHA, HO Hy>KHO, i-ITO6bI C006LL[eCTBo onpe,qenAno TO MeHbLHHHCTBO nIOReIi, KOTOpble npoAOn>KaK)T HnH HaLiHHaIOT 3noynoTpe6nSlTb anxoroneM Ha 3TOM 3Tane CBOeIi >KH3HH H nOMOraJlo 3THM nIO1AM. 1IPOCBELüEHU1E MbI He gOJUICHbI BOCnpHHI-IMaTb npOCBeI1ZeHHe, KaK HeLITO, npOHCXOj(Anjee TOnbKO B ,geTCTBe. CyLLIeCTByeT BO3MO>KHOCTb H Heo6X0A1,1MOCTb npOAOn>KaTb 06r-feline BCIO >KH3Hb. LlacTO tIenOBeKy Ha pâ3HbIX 3TanaX ero pâ3BHTHA Hy>KHa OnpeAenëHHaA HH4)OpMaLjHA. flpOCBeI1IeHHe ABnAeTCA ropa3Ao 6onee 34:1(1)eKTHBHbIM, ecru.' npOBOAHTCA B Hy>KHbIIi MOMeHT, KOrAa AeiiCTBHTenbHO He06XOAHMaA H4OpMaIJ;HA BOCnpHHHMaeTCSI c 6onblllHM >KenaHHeM. 06yLIeHHe LIeMy-To HosOMy LIaLL[e BCerO npOHCXOAHT BO BpeMSI KpH313COB. E(pHMepOM MOryT 6bITb TaKlie nepeXOAHble nepHOAbI, KaK nOApOCTKOBbIIi nepHOA, HnH KorAa MOROAble nlOAid CTaHOBATCSi pOAHTenAMH; KpH3HCbI, TaKHC KaK 60ne3Hb, HeCLIaCTHbIFi CnyLIaH, pa3pyLlleHFie CeMbH, npo6neMbI C 3aKOHOM, nOTepA pa6oTbl HnH TA>KënaA yTpaTa. KpH3HC - 3TO BO3MO>KHOCTb H3MeHHTbcSI, LIaCTO Tpe6yK)LuaA HOBOrO o6yLIeHHA H 6onbluero CaMOCO3HaH1431. BCne,IICTBIie 3T0r0 Te, LIbA pa6oTa CBA3axa C o6u(eHlieM C nK)AbMH BO BpeMA HX KpH3HCa, ABnAK)TCA OIITHMâJIbHbIM BapHaHTOM ARA coo6LL(eHHA HH(popMaljHH H CoseTa no noTpe6neHHIo aJlKoronA. 3To oco6exno sepxo B Tex cny9aAx,KorAa OnaCHOe nOTpe6neHHe BHOCHT CBOIi BxJIaA B pa3BHTHe KpH3HCa, Him KOrAa RIOAH oco6enno OTKpbITbI AMA nOnylleHHA HH(tiopManHH no yxpenneHHlo 3AOpOBbA, TaK KaK OHM 03a6oLlenbl CBOHM COCTOAHHeM 3AOpOBb31 HRH COCTOAHHeM 3)2(OpOBb51 ApyrHX. B uIKOnaX cyLLIeCTByeT TeHAeHLjHA BKJIIOLIaTb BOnpOCbi no ânKOrORK7 B pa3nHLlHble LIaCTH IIIKOnbHOA nporpaMMbl, oco6eHHo B o6yLIeHHe COLjHânbHbIM H nHLLHBIM HaBbIKaM. ECTb MHOrO 11O3HTHBHOrO B o6yLieHHH AeTeIi noxHMaHHiO npxpoAbl aRKOrORA, ero nOTCHLjHâJIbHOrO BnHAHHA Ha MHOrHe aCneKTbI HX >KH3HH, HanpHMep, C 6HOROrHLICCKOIi, COL[HäJIbHOii H nOBeAeHLICCKON TOLIKH 3peHHA H ero BRHAHHA Ha B3aHMOOTHOLHCHHA H Cy>ICAeHHA. 60 I'pynna JjeKCTBHH MoxceT o6ecnetI4Tb nepecMoTp y=Ie6HbIx nnaHOB BO Bcex pailoHax C TeM LIT06bI COOTBeTCTByIOIIjaA HHIiOp- MaLjHA o6 anKOrOne npenO,ilaBanacb OT HaLIanbHOii ILIKOnbI *iepe3 JjanbHeiiLnee o6ygCHHe H yHHBepCHTeTbI B BHJje, JjaK)IueM HaH60nb- InHi3 34:14)exT. B HeCKOnbKHX HCCneJjOBaHHAX Bblpa)KanOCb COMHeHHe B CIIOCO6HOCTH TpaJjHuHOHHbIX (pOpM O6yLIeHHA nOBnHATb Ha nOBeJjeHHe OTHOCHTenbHO nOTpe6neHHA ânKOrOnA, XOTA OHM npOAeMOHCTpHpOBanH KpaTKOBpeMeHHOe BnHAHHe Ha 3HaHHA yiieHH- KOB H OTHOHIeHHe K npO6neMe (39). HOBble noJjXOJjbI K O6pa3OBaHHiO n0 BOnpOCaM anKOTOnA B nOCneJjHHe TOJjbI BKnK)LIaIOT B Ce6A MeTOJjbI 06rieHHA LIepe3 CBepCTHHKOB H npMO6peTeHHe COuHaJIbHbIX HaBbIKOB, H npHMCHeHHe MeTOJjMK, pa3BHBaK)ILjHX yMeHHe MOJIOJjbIX nloJjeïl BeCTH ce6A B CMTyauHAX, KorJja BO3HHKaeT npeJUlo)Kexxe BbInHTb. 17pOBeJjëHHOe B LIeTbIpëX CTpaHaX HCCneJjOBaHHe nOKa3bIBaeT, iiTO nporpaMMbl, KOTOpble npOBOJIHn ytlMTenb, 6bInH McHee 3(1(1)eKTMBHbIMH, 'lem Te, KOTOpble npOBOJjHJIH CBepCTHMKH, rJje BnHAHHe npOABHJIOCb B TeT3eHHe JjByX MeCAucB nocne 3aHATHI%I. CynjeCTByIOT orpaHHiieHHA TOTO, LITO MO)KHO O)KHJjaTb OT 6a30B0r0 o6rieHHA; OJjHa H3 rnaBHbIX ueneK COCTOHT B TOM, .1T06bI nocne nonyLleHHA nOJIHOI'O o6pa3osaxMA MOJIOJjble nloJjH BnaAenH (paKTHLieCKHM MaTepHâTIOM H nOHHMaHHeM BOnpOCOB, KaCaiOnjHXCA anKOTOnbHbIX HanHTKOB, KOTOpble B 601IbIIIMHCTBe LIacTei%I EBpOnbI 6yJjyT COCTasnATb 3HatIHTenbHyi0 LIaCTb MX )KH3HH. Bo MHOrHX CTpaHaX IIOJjaBnAloluee 60nbIHHHCTBO HaCeneHHA perynApHO n0Tpe6n5110T anKOrOnb. HepeanbHO CKpbITb HnH 3anpeTHTb HH(pOpMaIjHK) o6 3TOM JjnA MOJIOJjbIX nlOJjeil B rOJjbl MX CTaHOBneHHA. HeO6XOJjHMO TaK)Ke, LITO6bI McCTHOe HaceneHHe yBaNCano TeX nioJjeii, CeMbH, JjoMa H KynbTypy, KTO TpaJjHIjHOHHO BO3Jjep)KHBaeTCA OT noTpe6neHHA aJIKoroJIA. 1IpH 06rIexxH no BonpocaM anxoronA Hy)KHO O6'bACHATb, LITO Tpe3BOCTb ABnAeTCA a6COnIOTHO npHeMneMbIM Bb16OpoM. XOpOIIIHe MeTOJjHKH 06yLIeHHA MOT 6bITb OnHCaHbI JjnA nlo60H 3aHHTepeCOBaHHOii CTpaHbl, H HH(popMauHA MO)KeT pacnpo- CTpaHATbCA B pa3nHiiHbic pal%IoHbI, me ce He06XOJjHMO aJjanTHpOBaTb K McCTHbIM TpaJjHLjMAM, OTHOIIIeHHIO H OnbITy. HCKyCCHA O nOTpe6neHHH anKOronA LIaCTO ABnAeTCA *3aCTbIO LLiKOnbHOI[ npOrpaMMbI, KyJja TaK)Ke BXOJjAT BOnpOCbI n0 JjpyrHM (pOpMaM nOTpe6neHHA HapKOTHT3cCKHX BeIIjeCTB H pa3BHBaeTCA yBepeHHOCTb H HaBbIKH Bb160pa 3JjOpOBOTO o6pa3a )KI-13HH. O6LuHH BbIBOJj HCCneJjOBâHMIi pâ3nHtIHbIX (pOpM npOCBeüjeHHA n0 BOnpOCaM 61 anKOrOnSI roBOpHT B 110nb3y MHOroCTOpoxxero noj[xo,Ija I3Cnonb30Ba- HHSI HecxonbKHx cTpaTerHH. Hansen (41) H3yLiHn Bce CooTBeTCT- BylouiHe HCCneAOBaHHSI, BbIUIeAuIHe Mexgiy 1980 H 1990 ro,gaMH, H o6HappKHJI, LrrO 6onbuIHHCTBO noj(xO,IjOB MomKHO KnaccH(iHInHposaTb Ha 12 THIIOB, o3arnaBnexxblx: unçbopMaz{ux: Hagenexxax Ha 3HaHHx H y6excAeHHx; npunsimue peucenuü: o6y*TeHHe npogeccy npHHSITHSI pagxoxanbxoro peuleHHSI no Bonpocy noTpe6neHHSI; o6eujanue: nposo3rnalueHHe o65I3aTenbcTBa He ynoTpe6nslTb HapKOTwieCKHe BeuleCTBa, LiaCTO B MOpanbHOM KOHTeKCTe; ymOYHenue CuCmeMbi ifenHOCmeü: HCCnenOBaHHe CHCTeMbI nHLiHbIX geHHOCTeH H ,ijeMOHCTpagHâ HeCOBMeCTHMOCTH 3THX IjeHHOCTeIi C noTpe6neHHeM HapKOTHtieCKHX BeujeCTB; Onped eneHue ZjeReü: pa3BHTHe HaBbIKOB OnpeJ3eneHHSI geneii H pâ3BHTHe *iyBCTBa He06X0JjHMOCTH HX jjOCTH)KeHHSi; ynpaBlienue CmpeCCOM: 06yiieHHe HaBbIKaM CHSITHA cTpecca, TaKHM KaK TeXHHKH peJlâKCagHH, H nOnblTKa ynyLuuHTb 3C14eKTHBHOCTb CaMOCTOSiTenbHOl%I %jeSlTenbHOCTH; CGMOOlfeHKa: pâ3BHTHe y y9eHHKa LIyBCTBa CO6CTBeHHOii 3Ha*3HMOCTH; o6ytienue HQBbiKaM npOmuBOCInORHufi: 06yiieHHe TeXHHKe npOTHBOCTOSIHHSi jjaBneHHIO CO CTOpOHbI CBepCTHHKOB H zjpyrHX BO3IjerICTBHI%I, KâCaioujHXCSI nOTpe6neHIiSI anKOrOnsi; o6p[eHue OICU3HeHHbiM Ha8b1KaM: pa3BHTHe IuHpOKOro CneKTpa HaBbIKOB MexUIHLIHOCTHOI'O 061geHHSI H pa3peuleHHSI KOH(InHKTOB; yCmaH061leHUe nOpM: CO3AaHHe CTpOrHX yCJIOBHii ARA yCTaHO- BneHHSI HOpM H HCnpaBneHHe pa3nyTbIX npe,i[CTaBneHHiï O pacnpOCTpaHeHHOCTH H npHeMneMOCTH nOTpe6neHHSIanKOrOnSi CpenH CBepCTHHKOB; 62 IlOMOl[fb: npOBe,aeHHe HHTepBOHuHii H KOHCynbTauHIi, LIT06bI nOMOT-Ib CnpaBHTbCA C npO6neMaMH pa3nHLiHOrO pOAa; H QJIbYYlBpXCIY1YIlBbI: npOrpaMMbl AeiiCTBHii pa3pa6OTaHHble C TeM, LiT06bI BOBneüb pe6AT B ytiaCTHe B,ueATenbHOCTb, HecOBMeCTH- MyIO C nOTpe6neHHeM HapKOTHiieCKHX BeIueCTB. r(EICTBVIA BcecTopoHHAA nporpaMMa o6yLlexHA Tpe6yeT onpeAeneHHA xiëT- xHx H peanbxblx ueneii. B o61ueM, npOCBeLueHHe, KOTOpoe nopo- nCjjaeT CTpaX HJIH ,iLaeT HH(I)opMamHiO 6e3 nO3HTHBHbIX pexOMeHZjauHIi HO npHCMneMbIM HJIH aJlbTepHaTHBHbIM BH,1ÿaM nOBeneHHA, He npeACTaBnAeT ueHHOCTH. LIHTenA LHKOn H ApyrHX npOCBeTHTenbHblX yLlpencneHHli Z[OJDKHbI 6bITb COOTBOTCTBCHHO o6yLIeHbI H nO,urOTOB- neHbl K BbIIIOJIHCHHIO 3astIaHHA H CHa6)KeHbI XOpOIIIHMH MâTepHanaMH. HepeA rpynnoii AeiiCTBHii no alIKOronIO LIaCTO CTOHT 3agaLIa n013bI- IIIeHHIO nOHHMaHHA Ba)KHOCTH aHTHanKO1-011bH0r0 O6pa3OBaHHA B paMxaX LIIKOnbHOii npOrpaMMbI H CBA3H HauHOHânbHblX H MCCTHbIX CTpaTerHli B 3TOii 06naCTH. HOMHMO nooLupeHHA nHTeI3Hblx npHBbILIeK CBA3aHHbIX C MOHbIÜHM pHCKOM, npOCBeLueHHe TaK)Ke ,i[OJDKHO paClüHpATb nOHHMaHHe OCO6bIX OnaCHOCTeN, CBA3aHHbIX C nOTpe6neHHeM aJIKOrOnA B onpeuenëHHblx yCJIOBHAX, TaKHX KaK BO)iC,IjeHHe aBTOM0611JIA, CIIOpT, 6epeMeHHOCTb H TaK Aanee. He06XOnHMO TaK)Ke o6eCneLIHTb nOHHMaHHe O(lHuHanbHblX npaBHn, perynHpyloLuHX noTpe6neHHe, HanpHMep, LIaCbI pa60TbI nHueH3Hp0- BaHHbIX TOLIeK npoAaxcH, yCJIOBHA, He06XO,i[HMble nOKynKH anKOrOnA, B03paCT, B KOTOpOM ,11OnyCTHMO nOKynaTb H/HnH nOTpe6nATb anKOrOnb B o6LueCTBe. HyxcHO, 14106bI 3Ta HH(l)OpMauHA 6bina 06LueJjOCTynHa, a Tau, rAe MO)KHO oHa nomma 6bITb pacneLiaTaHa HnH HMeTbCA B 3anHCH Ha KaCCeTâX. Oco6eHHo HeO6XOnHMO npOJlvÿMaTb o6yilexxe BHOBb npH6blBa101uHx B 3Ty McCTHOCTb, HanpHMep, npHe3)KaIOLuHX pa60TaTb HJIH rOCTH 143 Apyrxx cTpaH. BO3MOGKHOCTb HOJIyLIHTb O6pa3OBaHHe eCTb He TOJIbKO B MOJIO,IjOM Bo3paCTe, a H BO B3pOCJIOLï )KH3HH, HO 3TH BO3MO)KHOCTH CTaHOBATCA McHee OpraHH3OBaHHbIMH, 6onee H36HpaTenbHbIMH H CnyLIaiiHbIMH. HOCne TOrO, KaK C(i)OpMHpyeTCA Fpynna neIiCTBHIi, oHa 63 JIOJUICiia yBenHLIHTb BO3MOXCHOCTH paCnpOCTpaHeHHSI HHCpOpMaLIHH H peKOMeHJIaLIHÎ no nOTpe6neHHiO aJIKOrOnSI MHOrHMH pâ3nHLIHbIMH nyTSIMH. npHMepaMH TaKHX nyTeÎ MOryT 6bITb MOJIOJIë)ICiible Kny6bl, CnOpTHBHble MepOnpHATHA, pa6oLIHe MeCTa, 3aHATH51 Ha OTJIbIXe H BO BpeMA JIOCyra, HHCbOpMaLIHSI O 3JIOpOBbe H 6e3011aCHOCTH, 06LLIecT- BeHHOe npOCBeLgeHHe, CaHHTapHOe npoCBeLL[eHHe H CpeJICTBa MaCCO- BOÎ HHCi3OpMaLIHH. BaxCHo npH3HaBaTb, LITO IHKOnbI H FIX JIeATenb- HOCTb MOryT CTaTb LIeHTpOM npocBeLgeHHA MeCTHOrO HaCeneHHSi, 3HaLIHTenbHO paCLIIHpHB paMKH CBOeÎ TpaJIHLIHOHHOÎ pa60TbI C JIeTbMH. Bo MHOrHX CTpaHaX CaHHTapHOe npOCBeLgeHHA BXOJIHT B KOMneTeHuHIO KaK HaLIHOHanbHblX, TaK H McCTHbIX OTJIenOB. B HeKOTOpbIX CTpaHaX B paMKaX HaL[HOHanbHOro rUIaHa npOBOJZHTCSI KaMnaHHA n0 nOBbILLieHHIO nOHHMaHHSI KâCaIOIIIHXCA nOTpe6neHHA anKOronSi BOnpOCOB. McCTHâA rpynna JIeÎCTBHÎ MO)KeT COJjeHCTBO- BaTb TOMy, LITO6bI MaTepHanbl KaMnaHHH nOJIHOCTbIO HCIIOnb3OBânHCb H HM 6bUIa npHJlaHa 0006aA MeCTHaA HanpaBneHHOCTb, ECnH TaKHe mama HJIH MaTepHanbl He CyLqecTByIOT, TOrJIa McCTHble CneuHBnHCTbI JIOn)ICHbI pa3pa6OTaTb CBOH CO6CTBeHHble H nOnbITaTbCSI KOOpJjHHHpOBaTb pacnpOCTpaHeHHe H HânHLIHe HHCpOpMaLIHH no BOnpOcaM 3JI0pOBbA. HaLIHOHanbHble HHCpOpMaLIHOHHble KaMnaHHH MOryT BbI3BaTb HHTepeC H JIe6aTbl B 06LgeCTSe. rpynnbI JIeÎCTBHÎ Jlonx( Hbl 6bITb rOTOBbI JIO6aBHTb MeCTHyK) HanpaBneHHOCTb B 3TH KaMnaHHH H TeCHO COTpyJ;HHLIaTb C HaLIHOHâJIbHbIMH OpraHH3aTOpaMH H CpeACTBaMH MaCCOBOH HH(loOpMaLIHH (42). 34)41eKTHBHOCTb HHCloOpMaLIHOHHbIX KaMnaHHH TaKOrO poJla elgë He Jloxa3axa, HO OHH 6eCCnopHO 06naJIaK)T npeHMynlecTBOM BbIHeCeHHA KacaIOLIIHXCSI 3JIOpOBb51 sonpocoB Ha nosecTKy JIHA o6LLIeCTSa (43). yKpelVleHHe 3,qOpOBbA Ha MOCTHOM ypOBHe gpaMa, KaK cpe,gcTBO npocseLlleHHA no BonpocaM anxoronA, HCnonb3OBanacb B pa3nHLIHbIX cHTyaLIHAx. B AHrnHH YnpaBnexxe caHHTapxoro npoCBeLÿeHHA BbI1IOJIHHJIO HecxonbxO npoeKTOB, TaKHX KaK, OCHOBaHHaA Ha HCIIOnb3OBaHHH JlpaMbl pa6oTa C MOJIOJIbIMH JIIOJjbMH, KpHTHLIeCKH O6CyHCJjaK)II;HMH pâ3nHLlHble npeJlnonOweHHA B CpeJICTBâX MaCCOBOii HHCl:lOpMaLIHH H H306pa)KeHHe aJIKOrOJIA B peKnaMe. B JlpyrOM npoeKTe MOJIOJIbIM nIOJISIM 3TOÎ McCTHOCTH 6bina 64 noxa3axa nbeca, H306pa)KaioLLraSI nocneACTBHSI BO)Kj(eHH51 B HeTpe3soM BHne, a 3TM nposo,gHnacb ,IjHCxyccHSI. 3TH BOnpocbI TaioKe BXOz[HnH B HIKOnbHyIO nporpaMMy B O,EIHOM paHOHe. ,I[pyrHe rpynnbI ,ÿeiiCTBHiI no anKOronlo B LHKOne nonpoCHnH MOJIOj[bIX nK)geti CAenaTb HnnIOCTpaL[HH, H3o6pa7Kai0IIwe 344eKTbI nOTpe6neHHSi anKOronSl, a 3aT8M Bb16panH HeKOTOpble H3 HHX JZnSi 60nee HIHpOKOI'O nOKa3a H HCHOnb3OBaHHH B pa6oTe no yKpenneHHio 3J1op0Bb5I. CyH[eCTByeT MHOrO MeCT, r,Te MO)KHO pa3MeCTHTb MaTepHanbi no yKpenneHHK) 3,11Op0BbSI. O6yyeHHe cneuHanHCTOB B 6OnbIIIHHCTBe McCT 06yLIeHHe 6y,TIeT HpOBOAHTbCSI C nOMOLIjMiO OCHOBHbIX CneL[HânHCTOS B IIIKOnaX H OTj(enaX CaHHTapHOrO npOCBeLLjeHHSI. OnpejjenëHHbIM yLiHTenSIM gaëTCsi 3aj[aHHe npOBOJjHTb 063/gel-me n0 BOnpOCaM ânKOrOnSi HIM BKnIOLIHTb ,aaHHOe O6yeHHe B yLIe6HbIi%[ nnaH. BanKHO, TiT06bI 3TH yTIHTenSi npoaHanH3HpOBanH CBOë C06CTBeHHOe OTHOIIIeHHe K aJIKOrOnIO, caw,' npOLHnH 06yLIeHHe KaK no BOHpOCaM npHpO,ltbI anKOrOnsi, TaK H n0 CB5I3aHHbIM c ero nOTpe6neHHeM np06neMaM H o6naAanH HaBbIKaMH 06yieHHS1 Z[eTeii no COOTBeTCTByIOIIjHM H nOSej(eHT3eCKHM BOnpOCaM. 06bITiHO nyTiLUe O6yLiHTb yTiHTenSI, gem BHe,apsITb CneL[HanHCTa "H3BHen, OTJIyTëHHOro OT ApyrHX BHAOB LIIKOnbHOii AeslTenbHOCTH H IIIKOnbHOii nporpaMMbI. HOMHMO yliHTeneli, 3HaHI45i 06 anKorone H 34-4eKTaX ero nOTpe6neHHSI jZOn)KeH HMeTb IIIHpOKHi4 Kpyr jjpyrHX CneL[HanHCTOB. CK)j[a, KOHeHHO, BXOj[SIT pa6OTHHKH 3ApaBOOXpaHeHHSI H COLjHanbHOli ClPepbi, a TaK)Ke nOJIHLIHSi, pa6OTHHKH TK)peM, Cny)K6 COnHanbHOrO o6ecneTieHHSi, COTpyjjHHKH nCHXOJIOrHT3eCKHX KOHCynbTalIHId, IopHCTbI, ynpasnsnoHrHe 6apos H 6y4eTTn3KH. 3TH rpynnbI He06XOnHMO 06yLIaTb paCHO3HaBaHHIO npH3HaKOB 3nOynOTpe6neHH51 anKOroneM y CBOHX KnHeHTOB H yMeTb OKâ3aTb HM COOTBeTCTByK)LI(yi0 nOMOIIjb H COSeT, HO TaK)Ke nOHHMaHHIO 60nee IIIHpOKHX COLIHanbHbIX BOnpOCOB, KâCaK)IIjHXCSI anKOrOnSI. He06X0,1111- MO, TiTO6bI OHH nbITânHCb H3bICKaTb nyTH CBeAeHHSi K MHHHMyMy yHjep6a, npHiiHHSieMOro noTpe6neHHeM anKOronSi, HaceneHHlo O,t;HOBpeMeHHO npH3HaBâSI Bâ)KHyfO ponb anKOronsi B )KH3HH 06LLjecTBa. 65 I'pynna lieiiCTBHIi Taxxce JjOn)KI-Ia o6yzIHTb HMeIOLuHXCSI cneuxanHCTOB H HaH6onee BnHSITenbxbIX nlogeH 3TO1-O o6njecTBa. npocTo O6y4enl-le CneJjylOLLjerO nOKOneHHSI He 6y,IjeT HMeTb 3Ha4eHHSI go Tex nop, noxa HaH6onee BnHxTenbxble npeAcTaBHTenH HbIHeLLIHerO nOKOneHHSi He 6y,IjyT nOHHMaTb 3TH Hy)ICJjbI H np06neMbI. TacTb nOBCeJjHeBHOii pa60TbI rpynnbI JjeHCTBH1i 6y,i[eT COCTOHTb B JjeSlTenbHOCTH no nOBbILIIeHHK) nOHHMaHHSI H OCO3HâHH31 3THX npo6neM cpeJjH aJjMHHHCTpaTHBHbIX pa6OTHHKOB, nOnHTHKOB H rpaxcJjaxcxxx cnyxcaüjHX, KOTOpbIX OHH BcTpe4aloT B npoljecce pa3pa6oTKH nnaxa. IIpOLjeCC pa3pa6oTKH mama SIBnSIeTCSI nyLILUHM cnoco6oM cTHMynxposaHHSI HHTepeca H noHHMaHHSï cpe,aH 3Ha4HTenbHbIX rpynn HaCeneHHSI. 3A+qA4 V1 Fpynna JjeHCTBHIi HO anxoronlo J(OnXCHa npOKOHTponHpOBaTb, 4T06bI HX max npOCBeLLteHHSi BKJI104an B ce6si ,IZOCTHDICHMble H H3MepHMble 3aJja4H. CK)Jja MOryT BXOMHTb: nOBbILHeHHe KOJIH4eCTBa o6y4aloujHX nporpaMM n0 BOnpOCaM aJIKOrOnSI Jjnsl OnpeAenëHHbIX KaTerOpHl%I nlKOnbHHKOB H MOnOJjbIX nK)Jjex; 06eCneLieHHe TOrO, 4TO npOBOJjHTCSI OLjeHKa 3THX HHHLjHaTHB, a HX BbIBOJjbI HCIIOnb3y1OTCSI J[nSi yny4LlleHHSl nocneJjylOLIjHX nporpaMM; H KOHTpOnb 3a npOHHKHOBCHHeM H 3(14eKTHBHOCTb1O npOCBeTH- TenbHblX MaTepHâIIOB B pa3nH4Hble CeKTOpa )KH3HH HâCeneHHSi. TaKOii KOHTpOnb MO)KCT OpHeHTHpOBaTbCSi Ha peIIIeHHe TaKHX BOnpOCOB, KaK JjOCTHrnH nH MaTepHanbI HaMe4eHHOIi rpynnbI Hâcene- HHSI, He npOIIyüjeHa nH KâKax-nH60 rpynna, H o6naualoT JIM OCHOBHble CneLjHanHCTbI 3HaHHSIMH 06 HMeiOIIjHXCSI B HanH4HH npOCBeTHTenbHbIX MaTepHanaX. 66 5AnKOronb N npoN3BO,gcTBo 3A4EM MMETb f1POV13BO,qCTBEHHY1O f1O11V1TV1KY? Ho net:" TeppHTOpHH EBpOnbI aJIKOtonbHble npo6neMbl Ha pa6o4eM McCTe ABnAIOTCA rnaBHbIM (taKTOpOM BO3HHKHOBeHHA HeC4aCTHbIX Cnyiiaes, nporynOB H CHH)KeHHSI npOAYKTHBHOCTH Tpy,ga (44). CociTOAHHe nOXMenbA H OnbAHeHHA Ha pa6o4eM McCTe 3HaLIHTenbHO OTpaNCaiOTCA Ha Ka4eCTSe, MOpânbHOM KnHMâTe H CTaH- AapTaX np0H3BOACTBa. 3aTpaTbl BbI3bIBaIOTC5I He TOnbKO CHH)KCHHeM 3(1(1JeKTHBHOCTH H nOTepeH BpeMeHH, HO TaK)Ke 3Ha4HTenbHblMH BJIO)KCHHAMH B O6y4eHHe, KOTOpble TepSnOTCSi, KOrAa pa6OTHHK nOKH- AaeT KOMnaHHIO npexCAeBpeMeHHO HJIH CTâHOBHTCSI HenpHrOAHbIM K TPYAY 110BbIIIIeHHe noHHMaHHA BxnaAa ânKOrOnA B cHH)KeHHe npOAyx- THBHOCTH Tpy,ija npHBeno K pa3BHTHIO nonHTHKH nO anKOronIO Ha npOH3BOACTSe. BJIO)KeHHA B CJIy)IC6bI, HaljencHHble Ha nOMOUZb noCTpaAasiueMy COTpyAHHKy, 6bICTpO BO3MCUtaiOTCA B BHAe nOBbIIIIeHHA npOAyKTHBHOCTH H npH6bInbHOCTH. npOCBeTHTenbHbie npOrpaMMbI AnA McCTHOI'O HaCeneHHA AOn)KHbI O61ACHATb, 4TO anKOI'OnbHbMe np06neMbl uIHpOKO pacnpoCTpanexbl B cpeAe pa6oTaiou'Hx. KoMnaHHA, xoTOpaSI AO- IIycxaeT CyuleCTBOSaHHe nporpaMMbI no arIKOrOnIO Ha CBOHX pa6o411X McCTax, He AOnxcxa 4yBCTBOBaTb, 4TO cosepuIaeT He4To npeAocyAHTenbxoe H3-3a npe,anono)KexHI3, LITO 3Aecb pa6oTaeT uMHOro aTIKOronHKOB" HJIH 4TO y HHX eCTb CJIO3ICHOCTH C nbi011(HMH pa60THHKaMH. BCeM AOJI)ICHO 6bITb AOCTaTO4HO ACHO, 4TO KOMnaHHA, 67 He NMetOIuaA TaKOrO pOAa nOnHTHKIi, pHCKyeT 3,IZOpOBbeM CBOHX pa6oTHHKOB, 6narOHOnyttHeM CBOerO pa6o4ero KOnneKTHBa H Kw-IeCTBOM npOAyKuHH HJIH cepaHca. IIp0143BOACTBO ABJI5IeTCA Bâ)KHbIM McCTOM npHnO)ICeHHA yCHJIHN IZJIA Aei-iCTBi3ii Ha McCTHOM ypOBHe, TaK KaK 601IbHINHCTBO nloReH C anKOrOnbHbIMH npo6neMaMH pa60TaloT. CylijeCTByeT t-IëTKHIi CTHMyn HWIA pa60TORaTenA H ji;JIA pa6oTaloluer0, LiT06bI 3TH np06neMbt BbISIBnAJIHCb Ha paHHeiï CTajjHH, H 3JeCb HaXOAHTCA rnaBHaA BO3MO)KHOCTb 34)CpeKTHBHbIX nepeMeH, nyTeM MOTHBauiiH nbIOHjHX H3MeHHTb CBOH npHBbP-IKH H COXpaHHTb pa6OTy. XAPAKTEP IlOJ1V1TV1KV1 HA PA6O41,1X MECTAX IIOMOIub nOCTpaAaBlneMy pa60THHKy ABnAeTCA OLieBHAHbIM npHOpHTeTOM 5lo60i3 aJIKOrOnbHOti nOnHTHKH, HO CymeCTByeT rOpa3j(O 60nbIllHti Kpyr npHnoxceHHA yCi3JIHIi 34)C1)eKTHBHOH nonH- THKH Ha pa601teM MeCTe. Pa6oT0,gaTenH H pa6OTHHKH OTBeTCTBeHHbI 3a KOHTponb BCeX aCneKTOB npOH3BOuCTBeHHON 06CTaHOBKH, KOTOpble MoryT yKpennATb, nOJIj[ep)KHBaTb COCTOAHHe 3AOpOBbA HRH OTpHuaTenbHO BnHATb Ha Hero. CIoAa BXOuHT TnZaTenbHblI-i aHanH3 pâ351H11HbIX CbaKTOpoB, CKnOHAIOLuHX K nOTpe6neHHIo, BbI3BaHHbIX CTpeCCOBbIMH yCJIOBHAMH pa6OTbI RAH HeHy)KHbIM npHCyTCTBHCM anKOronA (cM. Ta6nHIl,y 6). Ta6nHua 6. cOaKropbl, Cn0006CTByIOulHe BbICOKOMy ypOBHK) anKOronbHblx npo6neM Ha pa6o4eM mec-re ,QOCTynHOCTb CowNanbHOe ,QaBneHHe fIHTb Ha pa6oTe OTCyTCTBHe anbTepHaTHBHbIX BapHâHTOB OT,4bIXa OTCyTCTBHe Ha,Q3Opa NIIN COI4lianbHOfO KOHTPOnSi CfOBOp Me)K,qy KOnnefaMN CTpeccbl H OnaCHOCTII OT4yN(D,eHNe OT pa6orbl npNëM Ha pa6ory nK)geN, npegpaCnOnONCeHHbIX K 3noynOTpe6neHHK)anKOfoneM HcmovuuK: Hore & Plant (45). 68 T06bi 6bITb 34)cpeKTHBHOfi, noJIHTHKa Ha pa6omeM McCTe ,aOJDKHa 6bITb H3BeCTHOii, BCOMm npHHATOIi H OTKpbITOii B paBHOI%I CTeneHH Arm ncex ypOBHeiï pa60TaK)nmX. OHa J[OJDKIia 06JIa,IjaTb OTKpbITOCTbiO H 1103HTHBHbIM BOCnpHATHeM o6pauxeHHA 3a nOMOLLjbiO, 9T06bI npOTHBOCTOATb KJIeI4My, 'iaCTO CB5I3aHHOMy C npH3HaHHeM HâJIH'iHA aJIKOTOJIbHbIX np06JIeM. gOJDKHa TapaHTHpoBaTbCA KOH(DHJ.[eHIIHâIIbHOCTb KOHCyJIbTaIlHH H TO, WO 3a ymaCTByiOLImM B npOTpaMMe 6y,iZeT COXpaHeHO MeCTO, ecru' OH BbInOJIHAOT peKOMeHjtOBaHHOe JIe'ieHme HJIH npoxo,i1HT KOHCyJibTaLIHH. IIpOTpaMMa Ha pa6omeM MecTe ,gonxcxa BKJIiOLiaTb B ce6A CO3JjaHme nOJIHTHKH Cepbë3HOTO OTHOLIIeHHA K 3,aOpOBbIO, Tjje 6bI OnaCHOCTH npHCyTCTBHA aJIKOTOJIA 6bIJIm OmeJIeHbI OT npOH3BOJZCT- BeHHOii 06CTaHOBKH, HanpHMep, 06eCne4eHHe OTCyTCTBHA aJIKOTOJIA Ha TeppHTOpHH H KOHTpOJIb palm aJIKOTOJIA B CTaTbe paCXO,IZOB Ha pa3BJIeLieHmA. Pa6oTOJjaTeJlm JjOJDKHbI C(DOpMyJImpOBaTb no,gpo6HyK) CTpaTermK) yKpeiuIeHmA 3,aOpOBb51 TaK, 'ITO6bI pa6oTHHKH nOCTOAHHO nOJIy'iaJIH mHCpOpMaL1Hi0 o6 aJIKOTOJIe H OnaCHOCTH ero nOTpe6JIeHHA, 0006eHHO B IiX pa6o'ieH )K113HH. CyüIeCTByeT ABHOe COBna,ijeHHe MexcAy JtaHHO3-I nOJIHTHKOIi H XOpOIIIHMH OTHOnIeHHAMH B TpyROBOM KOJIJIeKTHB. AJjMHHHCTpaLIHSi H npo(I)CO103bI B paBHOii CTeneHH J[OJDICiibI 6bITb BOBJIe'IeHbI B cDopMyJlHpoBaHHe 3TOii nOJIHTHKH. OTCIO,TZa BbITeKaeT He06X0J1HMOCTb 06ytieHmA OCHOBHbIX 'IJICHOB KOJIJIeKTHBa paCIIO3HaBaTb yXyZ[uleHHe BbInOJIHOHHA pa6OTbI H HCHOJIb30BaTb KOHCyJIbTHpyiOlIjHe CJIy)K6bI, 'iTO6bI nOMO4b pa6oT- HHKaM O6paTHTbCA 3a nOMOLi(bIO, KOT,aa 3T0 Hy)ICHO. B HeKOTOpbIX CTpaHaX CTâJIH IiIHpOKO paCnpOCTpaHeHHbIMH npOTpaMMbi nOMOLL(H pa60TaIOLImM, KaK CpeJjCTBO noMOUjH nocTpa- ,qaBIIIHM pa60THHKaM. CyIL(eCTByIOT pa3Hble MOReJIH OpraHH3auHH TaKOM nOMOLI.jm. OHa MO)KeT 6bITb, HanpHMep, 'IaCTbIO npOrpaMMbl pa60TOJjaTeJIA no THrmeHe Tpy,r(a Him OT,IjeJIbHOi%I nporpaMMOIi nOMOLLm pa6oTHHKaM B paMKaX ,gaHHOIi KOMnaHHH; 'IaCTO 6onee ycneuIHOH ABJIAeTCA npOrpaMMa, KOTOpâA npOBOAHTCA 060C06JIeHHO OT CTpyKTypbl ynpaBJleHmA KOMnaHHeM, a ycJIyrH OcymeCTBJIAeT He3aBHCHMOe yvpexcAeHHe. KaKâA 61,I MOJjeJIb He 6bIJIa npmHATa, Bâ)iCHO, 'ITO6bI cOXpaHAJlâcb KOH4)I3,aeHLjHâAbHOCTb MeACJ(y KOHCyJIbTaHTOM H Hâ.HHMaiOII(eii OpraHH3aLmeii. 69 OAHOH H3 nepsblx nonHTHKa no anKOronlo Ha pa6oLieM MecTe BO3HHKna BO OpaxgHH. B 1960 rony Ha BcTpezIe Ha TeMy "3nopOBbe, 6e30naCHOCTb H TpC3BOCTb" 6bIJIO npH3HaHO HanHLIHe Ha pa6oLIeM MecTe B03MO)KIiOCTeIi pa3BHBaTb neSiTCnbHOCTb no yKperUIeHHK) 3AOpOBb51 B OTHOnIeHHH anKOrOnSI, a TaK)ICe cTpaTerHK) HHTepBCHLjHH Ha paHHeH cTanHH. B 6bIBLUeM COBeTCKOM Co1o3e 6bIJIii pa3BHTbI LIIHpOKO pacnpOCTpaHeHHble MeAHmHHCKHe H npOCBCTHTenbHble Cny)K6bI ,i);JISi pa6oTaloluHx, rAe HCIIOnb30BanCSi CneL(HanbHO nO,grO- TOBJ1eHHbIH nepCOHân B TeCHOM COTpynHHLICCTSe CO KOHCynbTaHTaMH-HapKOJloraMH (46). Bo MHOrxx LiacTSIX EBponbl cent-me npHHSiTO, LITO anKOrOnbHble npOrpaMMbI B 6onbLlleH Mepe KacaloTCx "pHCxoBaxxoro noTpe6neHHSI", LieM HenocpencTBexxo anKOTOnbHOii 3aBHCHMOCTH. KaK TOnbKO KOMnaHHSI npOSIBnSIeT HHTepec K AâHHOii npo6neMe, eë BHHMäHHe ,IjOJDKHO 6bITb cocpenoTOLlexo He Ha nHarxocTHposaxxH 3a6oneBaHH5I, a Ha BbISIBneHHH H3MeHeHHH B BbIIIOnHeHHH pa60TbI. B npOLLU1OM CymecTBOBâna TCHAeHLiHSi OTO)KAeCTBnnTb BbISIBnCHHe ni060Ii cl)opMbl anKOI'OnbHbIX np06neM C "anKOrOnH3MOM". 3T0 npHBenO K TOMy, LrrO nOBCeMeCTHO nOA06Hble npOrpaMMbI HCIIOnb30BanH TOnbKO pa6oTHHKH C OLIeHb CCpbë3HOH H BCeM H3BCCTHOii CTeneHblO anKOrOnH3Ma. 3Ta TeHAeHIjHSi nOJDKHa 6bITb 3aMeHeHa Ha O6paTHyIO, eCnH MbI XOTHM 113BneLIb Bee BO3MO)KHble npeHMylLjeCTBa 113 3THX CxeM. f PYlillbl C OCO6bIMV1 IIOTPE6HOCTAMN CylllecTByloT npolbeccHH oco6oro pxcxa, Bo3HHKaiOIIiero B pe3ynbTaTe xapaKTepa pa6oTbt HnH AocTyna K anKOTOnIO. CiO,Ita BXOASiT: MOpenJIaBaHHe, BOOpy)KëHHble CJIy)K6bI, anKOTOnbHâSI npOMbILLIneHHOCTb H HHAycTpHSI nOCyra, 60nbHHUbI, TpaHCnOpTHâSI H He(i)TeXHMHLIeCKâSI npOMbILLIneHHOCTb, H nJISI HHX LIacTO Tpe6yK)TCSI CneLiHânbHO pa3pa6OTaHHble nporpaMMbI. MHOrOHanHOHanbHble OpraHH3aLjHH Taxxce HMCiOT 0006ble np06neMbl npH pa3pa6oTKe COOTBeTCTByiOLI(eIi nOnHTHKH Ha MHOTHX pa3nH1IHbIX TCppHTOpHSX. He06XOAHMO yLIHTbIBaTb OCo6yK) CTpeCCOByK) CHTyaLjHlo, B KOTOpOIi OKa3bIBaIOTCSL pa6oTaI0ILwe BnarIH OT AoMaLIIHerO oxpy)KeHHx. O6LqenpHHSITble nporpaMMbI rUIOXo nOAXOnSIT nnSI MHrpHpyK)LLnHX, BpeMeHHbIX pa6oTHHKOS H npenCTaBHTeneli 3THHLIeCKHX McHb- IIIHHCTB, HX cneIjHCiHLIecKSie HyNCnbI AOJUKHbI BbISIBnSiTbCSI Ha McCTaX. 70 HE6OI1bWilE IIPETAI1PV1ATVIA LIeM 6onbuie KonHliecTBO pa6oTaiouwX Ha npeAnpHxTHH, TeM 6onbille BepOSITHOCTb, iiTO OHM nOJIMICHTenbHO BOCnpHMyT np0- I'paMMy nOMOÜZH pa60THHKaM. bbIJIO nOKa3aH0, TITO B COeAMHëHHbIX I.11TaTaX AaHHbie npOrpaMMbI CyweCTByiOT Ha 52% npeAnpHxTHH c pa60nHM KOnneKTHBOM 750 HRH 60nee LIenOBCK, H TOnbKO Ha 15% npeAnpHATMA C pa6oLIHM KOJIJICKTHBOM 50 - 99 IIeJIOBeK (47). Te, KTO pa60TaioT Ha ce6si HJIH ICe B He60nbalHX OpraHH3aIjHSIX, MOryT HaI3TH 06ujee peiueHHe nOCpeACTBOM, HanpHMep, MX npocloCOio3a, peMec- neHHOii rNnbI(HH MJIH np4eCCHOHanbHOrO 06TeJjHHeHH3I, RAH )iCe IIÿTëM HCIIOnb30BaHH5I nporpaMM KOHCynbTalIHI%I HnH HenpH6bInbHbIX He3aBHCHMbIX rIpexcAeHHx. He60nbIIIHM KOMnaHHSIM HJIH pa6oTaioluHM Ha ce6sl JIiOWIM nerlie HCIIOnb3OBaTb ueHTpaJIH3oBaHHOe ripexcAeHHe. TaKxce MOxCeT npOilje OKa3aTbC5I KOM6HHHpOBaTb KOHCynbTHpoBaHHe no BOnpOCaM ânKOrOnSI H nonHTHKy npO(IHJIaKTHKH C ApyrHMH BOnpOCaMH, TaKHMM KaK KypeHHe, nOTpe6neHHe HapKOTHLIeCKHX CpeJjCTB H CTpeCCbI. He- O6XOuHMO Hai3TH CHOCO6bI npHBnetieHHSI pyKOBOJjMTenei3 He60nbuIHX npeJjnpMSlTMii K HCIIOJIb30BaHHIO nporpaMM TaKOro poAa (48). Fpynna geiiCTBHii no anKOTOJIK) AOn)ICHa 06ZjyMaTb M KOHTpOJIHpOBaTb 3TOT BOnpOC. CpeAM pa3HbIX CTpaH Cyü.[eCTByioT 3HaLIHTenbHble pa3nHHH51 B pa3Mepe H pacnonoxceHHH HX npOMbIIIIneHHOCTH. Bo MHOrHX perHOHaX CyHjeCTByeT 6onbuloe KOJIHIieCTBO He6OnbInHX CpHpM HJIH pa60TaI0awX Ha Ce65i nioJjeIi, H 3THM nOCne,uHHM rpynnaM ropa3Jio Tpy,gxee HCIIOnb30BaTb TpaAHuMOHHbie nporpaMMbi nOMOiuH pa6OTHHKaM. McCTHble opra- HH3aI1HH ,IjOnDiC}ibI pa3pa60TaTb ïiyTH, KOTOpble n03BOnSIT TaKHM pa6oTHHKaM HCIIOnb30BaTb IjeHTpanH30BaHHyIo nporpaMMy nOMOUzM pa60Tai0ajHM, He BbI3bIBâSI OCy-ACJjeHHSi HflCeneHHSi. BE3PA5OTHbIE B HeKOTOpbIX IiacTSIX EBponbI 3HaIIHTeJIbHâA LIaCTb pa6oTalowero HaCeneHIiSI CTana 6e3pa60THOI%I H He HMeK)T perynsipxoi-i pa6oTbI. O6bIIiHO 3Ta rpynna HaCeneHHSI He HMeeT ,IjocTyna K HCnonb3oBaxxio nonHTHKH Ha pa6olieM MecTe. B 71 HeKOTOpbIX Ci3TyaI.jliHX 6bIBIIIHii pa60TO,IjaTeJIb tIyBCTByeT ce6si OTBeTCTBeHHbIM 3a OpI'aHIi3aIjHIO 06cJTy)KS4BaHIiSi AAA TeX, KTO paHbIIIe pa6oTâJI B KOMnaHHH. HeKOTOpble KOMnaHHx npH3HaIOT cTpecCOBOe BJIHSIHHe yBOJIbHeHHSI HJIH COKpan[eHxSi H 06eCnetlHBaIOT noaaepxcKy IryTëM KOHCyJIbTaIjHH H COBeTa nepeA npoBe,gexxeM pactieTa. KJIy6bI 6e3pa60THbIX H 6K)pO Tpy.IIOyCTpoiiCTBa MOryT 6bITb IIeHTpOM KOHCyJIbTHpOBâHIiSI no BOnpOcaM nOTpe6JIeHHSI aJIKOPOJISI H no OIIaCHOCTH BbInxBKH, KaK Cpe,ilCTSa Heï3TpaJIH3aIIHH nOCJICACTBHi3 nOTepH pa60TbI. r1pOTpaMMbi nOMOIIIi3, KOTOpble npOBOZISITCSI Ha 6a3e np0(tiCOi030s, TaK)Ke MOIyT nOMOtIb 6e3pa60THbIM. 14HVIL1,V1MPOBAHNE IIPO('PAMM IIOMOLLm PA6OTHVIKAM, KAK YACTb f1J1AHA AEVICTBVIVI no fIPO6J1EMAM AJ1 KOfO11S1 CTHMyJIHpOSaHlie Ha McCTax MO)KeT npoBO,iIHTbcSI LIepe3 3ai3HTepeCOBaHHble OpTâHH3aLIHH, TaKHe KaK 0673eAHHëHHble COBeTbI npe,IZcTaBHTeJIeI-I npeAnpHHHMaTeJIeIi H pa6otlHX, TOpTOBble naJIaTbI, CO103bI HRH npO(lieCCHOHâJIbHbie OpI"aHH3aLjHH, OpI'aHH3aIjxH npeJl;npHHHMaTeJIeH, KpynHblX pa6oTOljaTeJleii, Me.l;xgiiHCKHe cJIy)K6bI H CJTy)K6bI 6e30naCHOCTH H THTHeHbI TpyAa. MyHHIIIinaJlbHble H McCTHble CJIy)K6bI 3,tipaBOOXpaHeHHA MOTyT nOKa3aTb npHMep, o6ecnetIHS HâJIHtiHe TaKOH nOJIHTHKH XIS{ CBOHX pa6OTHHKOB. XOpOIIIO, eCJIH HaIIxOHâJIbHbIH 'man gei3CTBH13 no âJIKOTOJIK) Co3ByTieH H nOOIIIpsIeT 3TH CXeMbI, HanpHMep, o6ecnetIHBaSI 4:1HHâHCOByio MOTHBaL(HK) CO3AaHH5I 3,I(OpOBOIi O6CTaHOBKH Ha pa6ot3eM MeCTe. CaMOe Ba)KHOe B âJIKOTOJIbHO1:1 nOJIHTHKe Ha pa60TIeM MeCTe, 3T0 TO, TTTO OHa j[OJDKHa 6bITb COTJIaCOBaHHOi3 Me)KZ[y pa60TOAâTeJIeM H pa6OTHHKOM H AOJDKHa BHyIIIaTb ysâXCeHHe H BbI3bIBaTb ,llOBepHe BCeX tUIeHOB KOJIJIeKTHBa. nOJIHTHKa, KOTOpasl, no-BHjjHMOMy, JIe}3CTByeT TOJIbKO jjJISI pSIjjOBbIX TUIeHOB KOJUIeKTHBa H HTHOpHpyeTCSI HatiaJIbCTBOM CKOpO nOTepsleT ,ilOBepHe. KOMnaHHSi, Tjle aJIKOTOJIb, 3anpen[ëHHbIN B pa6otleH CTOJIOBO13, noAaëTcsl B Ka6HHeTax pyKOBOZICTSa, 6bICTpO nOTepsleT yBa.xceHHe. 72 KOMf1OHEHTbI IlO11NTV1KV1 110nHTHKa AOJDKHa OCHOBbIBaTbCA Ha CornalneHHH, npH3HaHHOM BCeMH 'IJIeHâMH KOMnaHHH. B KOMnaHHH AOJDKHa 6bITb OnpeAeneHa OCO6aA rpynna, OTBe'ialoIuaA 3a HHHuHHpoBaHHe, npOgBIDKeHi3e, pa3BHTlIe, nozElep)KaHIIe H OueHKy npoeKTa. B HexOTOpbIx CTpaHaX, TaKHX KaK (I3paHuHA, npoBOpüITCSI ycnelII- Hble npoeKTbI C HCIIOnb3OBaHi3eM OTO6paHHbIX H o6yLieHHbIX 'ineHOB KOnneKTnBa BCeX ypOBHe11 B KaLIeCTBe HHcl)OpMaTOpOB 110 BOnpOCaM anKOrOnA. 3TH nio,iZH o6naAaioT 06H114MH 3HaHHSIMH HO np06neMaM anKOrOnSI H HapKOTHKOB, 6a3OBbIM nOHIiMaHHeM nCi3XOJIOrIi'-IeCKOro H COUiianbHOrO BnHSIHHA H MOryT npOBeCTH 6eceAy H COOTBeTCTBeHHO HanpaBHTb, KOrAa 3TO Heo6xoJl;IlMo. B Ta6nHue 7 npHBOJjHTCx npHMep nporpaMMbl HOMOIuH pa6oTaloluHM, OCHOBaHHbni Ha nporpaMMe, npHMeHABIHefiCA B KpynHOii CTpaXOBOIi KOMnaHHH. Ta6JlNua 7. flpNMep nOnNTNKN J1J1A nepCOHana no npO6neMHOMy nOTpe6neHNlo anKOrOnA 1. BBE,gEHV1E 6onbWNHCTBO nFOOeN, nOTpe6nAlOU.1NX anKOronb, ,genaloT 3TO B npe,ge- naX ,4onyCTNMbIX 06LueCTBOM OrpaHN4eHNtN, 6e3 CyLL1eCTBeHHOfO pNCKa gnA 3,3,op0BbA. Te, KTO 3nOynOTpe6nAF0T anKOroneM, MOryT pa3B11Tb B ce6e anKOrOnbHylO 3aBNCNMOCTb, 4TO MO)KeT npNBeCTN K Cepbë3HOMy 3a6oneBaHNlo, yxy,4WeHNFO C4N3N4eCKOrO 11 nCNXN4eCKOrO 3pOpOBbA, nOBbIWeHNK) OTCyTCTBNA Ha pa60Te, CHN)KeHNK) 11pON3BO,gNTenbHOCTN Tpy,qa, HanpA)KëHHbIM OTHOWeHNAM C KOnnefaMN NnN HapyWeHNAM npaBNn 6e3onacHocrN TpyAa. 3Ta nOf7NTNKa Bblpa)KaeT nO3NLwlO KOMnaHNN 110 OTHOWeHNK) K npo6neMHOMy nOTpe6neHNlO anKOrOnA. 2. flPV1MEHEHVIE 3Ta nonNTNKa 14 onpe,genAeMble etc npOLte,gypbl OTHOCATCA KO BceM 4neHaM KonneKrNBa. 3Ta norm-mica He KaCaeTCA n1o6bIX ge41CTBNLI, COBepWëHHbIX nog Bo3AeNCTBNeM anKOrOf151. ,qaHHble ,D,eNCTBNA 6yRyT paCCMarpNBBrbcA cornacHo ,4NCL{NnnNHapHbIM npoye,qypaM KOMnaHNN. 3. I1 O11 V1TV1 KA 3.1 11O1114TNKa KOMnaHNN 3aKnl04aeTCA B TOM, 4TO C nK)6bIM 4neHOM KOnneK- TNBa, NMelOLL1NM anKOrOnbHble np06neMbl 6yAyT O6paLLtaTbCA TaKNCe, KaK C TeM, KTO CTpa,gaeT OT nio6oro TNna 3a60neBaHNA, KOTOpOe BnNAeT Ha ero C110006HOCTb BbInOfIHATb pa60Ty, AIN BbInOflHeHl1A KOTOpoN OH npNHAT. 73 3.2 OmeemcmeeHHOCmb 3.2.1 McHepKep B3aNMooTHoweHNN B KonneKTNBe oTBe4aeT 3a npoaeAeHNe N KOHTPOnb BbInoJ1H@HNA noJ1NTNKN. 3.2.2 MeHeAN<ep B3aNM00THOW2HNN B KOnneKTNBe oTBe4aeT 3a OKa3aHNe ycnyf KOHCynbTNPOBaHNA (flpofpaMMa nOMOLI{N pa60THNKaM), 4TO6b1 nOAAepNCaTb TeX 4neHOB KOnneKTNBa, 4bë noTpe6neHNe anKofonA BbI3bIBaeT nPON3BO,gCTB2HHble np06neMbl; a TaKNCe 3a KOHCynbTNpoBaHNe pyKOBOANTeneN pAAOBOCO 3BeHa, CTOnKHyBWNXCA C np06neMHbIMN nbK)LLINMN. 3.3 1-ineH KonneKTNBa, KOTOPbIN pacnNBaeT CnNpTHble HanNTKN Ha TePPNTOpNN KOMnaHNN, nOMNMO Ha,gne)KaLLte OPfaH1130BaHHbIX N CaHK141,40H1100BaHHbIX CO6bITNN, MON<eT noABepfHyTbCA ANCLtNnnNHapHOMy HaKa3aHNH). 3T0 noBeAeHNe, TeM He McHee, MO)KeT 6bITb CNMnTOMOM CK0bITOl1 np06neMbl. 4. f1PO14E,gYPbI 4.1 J1K)60N 4neH KOnneKTNBa, KOTOpbIN 4yBCTByeT , 4TO y HefO/Heë BO3HNKna CB5,13aHHaA C anKOfOneM npo6neMa MON(eT O6CyA4Tb 3Ty CNTyaL{NIO c fna3y Ha fna3 C ero NnN eë pyKOBOANTeneM, C pa6oTHNKOM OTAena B3aNMO0THOweHL4 B KOnneKTNBe NnN 4epe3 flpOfpaMMy nOMOLLIN pa60THNKaM. 4.2 LineH KOnneKTNBa HanpaBnAeTCA K BHeWHeMy CneqNanNCTy, 4TO6bI nOny4NTb npoCpeCCNOHanbHoe ne4eHNe 14 nOAAepN<Ky. 4.3 PyKOBO,gNTenN pAAOBofo 3BeHa, KOTOpble OCYI1,.1,eCTBJ1AI0T OtNwNanbHble ANCLINnnNHapHble Mepbl KOMnaHNN no OTHOWeHNK) K TeM, 4bë BbInOJ1HeHNe pa6oTbl 1,111N noBeAeHNe Ha pa6oTe AaK)T noBOA Ans o3a604eHHOCTN, MOfyT npI10CTaHOBNTb Ae11CTBNe 3T4X Mep, ecnN 06HapyNCeHO, 4TO np06neMHOe noTpe6neHNe ABI1A@TCA COCTaBHbIM (PaKTOpoM AaHHOfo noBeAeHNA. ECnN B pe3ynbTaTe Ae41CTBNN 4neHa KOnneKTNBa OH CaM 141141 oHa cama, TPeTbA CTOpOHa 111111 n106011 acneKT Aen KOMnaHNN nOABepfafOTCA pNc- Ky, pyKOBOANTenN AnA YpefyJlNpoBâHNA CNTyaLINN MOfyT npNMeHNTb OfpaHN4eHHble ANCuNnnNHapHble Mepbl, 3a NCKnIO4eHNeM yBOnbHeHNA. Tam, fAe o6HapyNCeHo (NnN eCTb noA03peHNA), 4To np06neMHoe n0- Tpe6neHNe ABJ1AeTCA COCTaBHbIM CpaKTopoM, HeO6XOANMO o6paTNTbcA 3a COBeTOM B OTAen B3aNMOOTHOWeHNN B KOnneKTVIBe. ECnN 4neH KOnneKTNBa Bb16NpaeT OTKa3 OT np0(iaeCCNOHanbHON nOMO- LL(N NnN eMy nOCTOAHHO He yAaëTCA npONTN KYPC ne4eHNA, N ero NJ1N eë BbInOnHeHNe pa60Tbl NnN noBeAeHNe BCë eLLle Bbl3bIBaIOT o3a604eH- HOCTb, 06b14HO AonNCHbI 6b1Tb npNMOH@HbI nOnHble ANCLINnnNHapHble CaHKu,N11. 5. PACROCTPAHEHVIE Bce o6naAaTenN c6opHNKa o flonNTNKe no nepcoHany N flpoLye,gypaM. 74 f1OJ1V1TV1KA KOMf1AHV1V1 B OTHOWEHVIVI 3,14OPOBbA MeHeJpiCepbI JIOJDKHbI AyMâTb O BO3MO)KHbIX nOCJIe,IjCTBHSIX JjJISI 3JjOpOBb5I nOJIHTHLieCKHX Mep KOMnaHHH H nOO1111:5SITb Te H3 HHX, KOTOpble yKpenJISIiOT 3,ztOpOBbe. Cora BXOJ(HT nOHHMaHHe OnaCHOCTH CTpeCCOB Ha pa60LIeM McCTe H KOHTpOJIb TOTO, LIT06bI nOJIHTHKa He BbI3bIBâJIa CBSI3H aJIKOTOJISI C pa60TOH. B LIaCTHOCTH, JZOJDKHO yJZeJISiTbCSI npHCTâJIbHOe BHHMaHHe BOnpoCy HâJIHLIHSI aJIKOTOJI5I B CTOJIOBbIX, KOMHaTaX OTJJbIXa, Cy6CH- JjHpyeMblX 6apax H JzpyTHX TOpTOBbIX TOi3KaX Ha npOH3BOACTBeHHOIï TeppHTopHH. ,aOJDKHbI 6bITb BbIJjaHbI LIëTKHe HHCTpyKuHH J(JISI 06CJTy- )KHBaHHSi J;OCyTa KOMnaHHH, Bâ)ICHO npOKOHTpOJIHpOBaTb, LITO6bI Ha scex MepOnpHSITHSIX, TJ(e npeAOCTaBJISieTCSI TaKOe 06CJIy)ICHBaHHe, HMeJIHCb B HâJIHLIHH 6e3aJIKOTOJIbHble HanHTKH. OCHOSnaSi peKOMeH- naL(HSi 3axJIK)LIaeTCSi B TOM, LITO aJIKOTOJIb H pa6oTa He COBMeCTHMbI. Ha npOBOJ(HMbIX xoMnaxi3eii o6LgeCTBeHHbIX MepOnpHSITHAX ABA BCeX pa6oTHHKOB JjOJDKiia 6bITb OpTaHH3oBaHa BO3M0)KHOCTb 6bITb J(OCTâBJICHHbIM AOMOii 6e3 pHCKa BO)K,£[eHHSI B HeTpe3BOM COCTOSIHHH. gOJDICHbI 6bITb yCTaHOBJIeHbI LIëTKHe JjHCuHHJIHHapHbie npaBHJIa OTHOCHTeJIbHO nOTpe6JIeHHSI aJIKOTOJISi, npHXOJZa Ha pa60Ty B nbSIHOM BHJte, BO)KTIeHHSI B HeTpe3BOM COCTOSIHHH H TaK naJIee. KaKOii 61,I McXaHH3M He 6bIJI npHHSIT, OCHOBHble yLIaCTHHKH pa3pa6oTKH npoeKTa Hy)iCJjaK)TCSI B CncL(HâJIbHOM 06yLieHHH n0 nOHHMaHHIO 3aJ(aLIH, no TOTO KaK npoexT BCTynHJI B JIeiiCTBHe. f1POCBELLIEHViE IeJIbio npocsell(eHHSI SIBJI5IeTCS1 TO, LITO6bI sce LIJIeHbI KOJIJIOKTHBa 3HâJIH H nOHHMâJIH J[aHHyK) nOJIHTHKy H 6bIJIH 3HaKOMbI C npaBHJIaMH, OnpeJZeJISIIOLIjHMH nOTpe6JIeHHe aJIKOTOJISI Ha pa6oTe H Bee HaKâ3aHHSi 3a HTHOpHpOBaHHe 3THX npaBHJI. gOJDKHbI 6bITb OpTaHH3oBaHbl BO3M0)ICHOCTH npOBeCTH 06yLieHHe n0 BOnpOCaM aJIKOTOJISi H 3J1OpOBbSI C 000613IM aKIjeHTOM Ha CBSI3aHHble C MX npO(DeCCHeki onacxocTH,. MoxcHO nposoJjHTb 3TO nepHOJjHLIeCKH Llepe3 HHIbOpMaI>;HOHHble JIHCTKH H 3aHSITHSI Ha McCTaX. BHOBb noCTynaioiuHe AOJDKHbI nOJlyLiaTb 3Ty HHtoOpMauHlo KaK LIaCTb HX nepBOHaLIâJIbHOii nOJITOTOBKH; 3T0 1103BOJIHT 6bITb yBepeHHbIM, LITO 75 ypOBeHb nOHHMaHH51 OCTaëTCSI BbICOKHM, HeCMOTpSI Ha TeKyLIeCTb KORneKTHBa. Oco6oe BHHMaHHe AOnXCIiO yAenSITbCSi H3BeCTHbIM OnaCHOCTSIM, CBSI3aHHbIM C 3TOii pa6oTOK, TaKHM KaK AOCTyn K anKOrOnK) (HanpHMep, B anKOrOnbHOI%I HHAyCTpHH), CTpeCCbI, LIaCbI 6e3 06weHHSI, AnHTenbHble nepHOAbI OTpbIBa OT CeMbH, OTCyTCTBHe HaA30pa Ha pa6oTe, AOCTyn K 6eCiUIaTHOMy HRH Cy6CiiJjIipOBaHHOMy aRKOrORIO. BaNKHO TaKxce BbIAenSITb 00060 OnaCHble nOCneACTBHSI nOTpe6neHH5i anKOrOnSI Ha pa6oTe, TâKHe KaK npH pa6oTe Ha CTaHKaX HnH Ha TpaHCnOpTe. BbI1BllEHU1E Ba)iCHbIM KOMnOHeHTOM n1060ii IIpOrpaMMbI SIBn5IeTC5l He06X0AHMOCTb pa3BHTHSi HaBbIKOB BbISiBneHHSi pa6oTHHKOB, Llbë BbIIIORHeHHe pa6oTbl yxyAulaeTcSl B pe3ynbTaTe nOTpe6neHH5I HMH anKOrOnSI. B 3aAaLiy pa60TOAaTenSI CKOpee BXOAHT BbI5IBneHHe CBSI3aHHbIX C pa6OTOFi np06JIeM, LIeM pâ3BHTHe HaBbIKOB OnpeAeneHHSi CHMnTOMOB nOTpe6neHHSI anKOrOnsi. KaK TOnbKO "np06neMa" BbIHBneHa, pa60THiiKy MO)KeT 6bITb npeAROxceHo Bb16paTb nH6o nOABeprHyTbCSi 06bILIHbIM AHCLjHIUIHHapHbIM MepaM, nH60 06paTHTbCSI 3a nOMOII(bio vepe3 nporpaMMy nOMOLLw pa60THI3KaM. ECJIH Bb16paHO nOCneAHee, LlenoBexa HeO6XOAHMO HanpaBHTb K COOTBeTCTByIOLqeMy KOHCynbTaHTy H nOATBepAHTb, LITO pa6o=iee McCTO 6yAeT 3a HIM COXpaHCHO, eCnH OH nORHOCTbIO npOiiAëT BeCb KypC nOMOAw. B HeKOTOpbIX CTpaHaX CyIIjeCTByiOT nporpaMMbI nOMOIIjH pa60THHKaM, KOTOpble 3aHHMaiOTC5I He TOnbKO anKOrOnbHbIMH np06neMaMH, HO TaioKe 6onee IIIHpOKHM KpyrOM COLjxanbHbIX, nCHXOJIOrHLIeCKHX, 3KOHOMi3LIeCKHX H Me)KJIiiLIHOCTHbIX TpyAHOCTeH CpeAH pa60THHKOB. Bo MHOrHX CTpaHaX CyLgeCTByIOT KOM6HHHp0- BâHHble npOrpaMMbl no aJIKOroniO H HapKOTHKaM. B Ta6nHLje 8 npHBOASITCSI HHAHKaTOpbI, KOTOpble nOMOryT pyKOBOAHTenSIM HIM pa6OTHHKaM OXpaHbI TpyAa OnpeAenHTb BO3MO)KHOCTb HanMLIHSi CB5I3aHHbIX C anKOrOneM npo6neM. npOrpaMMbI 06CneAOBaHHSI 3AOpOBbSI TaK)Ke MOryT BbISIBHTb BO3M0)KHOCTb OnaCHOrO HIM BpeAHOrO nOTpe6neHHSI anKOrOnSi. 76 Ta6nNua 8. cDaKTopbi, yKa3bIBaIOL1.,Ne Ha BO3MO)KHOCTb Han1141151 CB513aHHbIx c anKoroneM npo6neM Ha pa6oTe Omcymcmeue Ha pa6ome MHOr04NCneHHble Cny4aN HeCaHmNOHNpOBaHHOfO yXO,ga C pa6oTbl CnNWKOM ,gnNTenbHble OTCyTCTBNA no 6011bHN4HOMy 4aCTble OTCyTCTBNA no nOHegenbHNKaM N/NnN nATHNqaM CnNWKOM MHOro On03,gaHNN, HanpNMep, no yTpaM B nOHe,genbHNK, Bo3BpaLueHNA C 06e,ga, paHHNN yXO,g C pa6oTbl OCo6ble N BCë 6onee HenpaB,gOnO,g06Hble npN4NHbl OTCyTCTBNA He06bl4HO BbICOKNN ypOBeHb OTCyTCTBNA 143-3a pacCTpONCTBa )Keny,gKa, npocTy,gbl, rpNnna, raCTpNTa N T.A. 4aCTble KpaTKocp04Hble, He o6ycnoBneHHble pacnNcaHNeM pa6orbl, OTCyTCTBNA C NnN 6e3 06bACHeHNA BbICOKUU ypOeeHb KOnU4eCmea HeC4acmHblX Cny4aee 4aCTble HeC4aCTHble Cny4aN Ha pa6oTe HeC4aCTHble Cny4aN rJ.),e-nN6o, HanpNMep, gonna, no Aopore Ha pa6oTy CnONCHOCmU c COcpeÔ0m04eHueM eHUMaHUA pa6ora Tpe6yeT 6onbwe yCNnNN BbInOnHeHNe 3a/(aHNA 3aHNMaeT 6onbWe BpeMeHN 3aMewamenbcmeo CnON<HOCTN B 3anOMNHaHNN NHCTpyKLANN, ,geTaneN N T.,g. BC2 CnON(Hee CnpaBNTbCA CO Cn0)KHbIMN 3ap,aHNAMN C10N<HOCTN C 3anOMNHaHNeM CBONX OWN6OK Hecma6unbHblll cmunb pa6ombl 4epe,goBaHNe nepNOAoB BbICOKON N HN3KON npO,gyKTNBHOCTN nOBbIWeHNe 06ü.teN HeHa,g2NCHOCTN N Henpe,gCKa3yeMOCTN nOBTOpAlOL14NeCA OTCyTCTBNA Ha pa604eM McCTe, 6onbWe 4eM 3TOr0 Tpe6yeT pa6oTa 4acrble noxogbl B TyaneT, N T.A. CnNWKOM ,gnNTenbHble nepepb1661 Ha KoCpe COCTOAHNe anKOfonbHOrO NMI HapKOTN4eCKOfO OnbAHeHNA noAeneHue Ha pa6ome npNXO,g Ha pa6oTy B 04eBN,gHO nbAHOM COCTOAHNN 3anaX anKOronA TpeMOp pyK BC2 60nee HeOnpATHaA BHeWHOCTb/He,gOCTaT04Ha9 nN4HaA rNrNeHa 77 Ta6nHna 8 (npoJtonxceHHe) O6u4ee yxydweHUe 3¢)cPeKmueHOCmu pa6ombl Heco6nfO,geHNe KpaNHNx CpOKOB BbInonHeHNA pa6orbl OWN6KN no HeBHNMaTenbHOCTN NnN B pe3ynbTaTe HBBepHbIX Cy)K,LteHNN pacTpaTa MaTepNanOB, CblpbA npNHATNe HeBepHbIX peweHNN HepeanbHble npN4NHbI nnoxoro BbInOnHeHNA pa6oTbl CHN)KeHNe npOAyKTNBHOCTN 17noxue omHOweHUA C KonneaaMU no pa6ome npeyBenN4eHHaA peaKLtNA Ha peanbHylo NnN MHNMyIO KpNTNKy 6ecnpN4NHHOe Bo3MyLLteHNe pa3ApaN(NTenbHOCTb NCan06b1 OT KOnner OAan)KNBaHNe AeHer y KOnner nOnbITKN N36eraTb Ha4anbCTBa NnN Kanner O6cnedoeaHUe 3dopoebsl HeHOpManbHble 6NOnorN4ecKNe noKa3arenN, npeAnOnaraK)LLtlie 3noynoTpe6neHNe. fIOCJ1E,qYFOLLAAS1 PEA6141111TALW1A Bo MHOrHX cHryaitHxx nK)JZH jtOniKHbl HMeTb BO3MO>KHOCTb npOJZOnpKaTb pa6OTaTb BO BpeMSI npoxoxcJtenHSl COOTBeTCTByIOLL[HX KOHCynbTaLtHH. B JtpyrHx CJryLIâSiX, oC06eHHO Koma aJIKOrOnbHble np06neMbl JZOCTHrnH Cepbë3H0Ii CTaJZHH, Jtom KeH npOIiTH Ha3Ha- LIeHHbIIi nepHOA BpeMeHH Jt0 TOFO, KaK LIenOBeK npHCTynHT K pa60Te. B 060HX CHTyaIZHSiX 06bItIHO CyLIjeCTByeT He06X0JZHMOCTb J[nH- TenbHOIi nO,CllZep]KKH B TeLIeHHe JtnHTenbHOrO BpeMeHH nocne BO3BpaIIteHHSI z-IeJIOBeKa K pa6OTe. rJIaBHbIM SIBnSIeTCSI CHOCO6HOCTb LlenoBeKa 3(1:41eKTHBHO TpyJZHTbCSi no Bo3BpaLI.teHHiO Ha pa6oTy. 01II146O1IHO nonaraTb, LITO OnpeJtenëHHbIIi nepHOJt BpeMeHH B KJIHHHKe HIM B JtpyrOM CnCLtHaJIbHOM yLlpexKJteHHH cam no ce6e "BbIneLIHT" LIenOBeKa. Bcë, Lrro Aonxcl-IO HHTepecosaTb pa6oTOJtaTenSl B npoitecce KOHCynbTHpOBaHHSi, 3T0 npOCTO yLIaCTByeT nH pa6oTHHK B 3TOM npOLteCCe. Pa60TOJZaTenlo He JZOnpKHa npe,1ZOCTaBnSITbCSI HHLllOpMaLtHSI O JZeTanSIX np06neMbI HnH eë yperynHpOBaHHSI, B npOTHBHOM CnyLiae 78 6L a.LOaNl I1Iaho9Ed EH xIrO.IOxue 0H41131HOOH.IO HxH.I.HIrOU HHHa17xCadhX g c111-0d OI,41fl0H3O .LOIEd.1H OLOEh `H.IOEirgo Ho.LS a gdatllX ÂNaNIHHIIIH x 41.Htloao Ea.LO4Ira.LE£ISgO H N13If9odu XH16 xHaod,C 010x00I411 E£-£H `E.I,CooV xHdioXlrtHH H 4100HH3I1IIII411I0du ifEH4IfOIOxIrd ?IHH4Ifog Xl4aodoil£ XxH,IHlfoü OIXgOIIf a xHH31193d.IOU O.IOHOEUO iCxH1.xEIfHftiodu 4.IEhOlIfxa `axC OHhaHOx `I4H31CI1o1l 1411HH4Ifog 'um-modal 0.I00a0 Iflf11 HxH1.HIfOLI I,1OH41fOIOxIfB xHH0173fia iCaHZEHtIHHH 1S900 EH 4.Ix£s 14HxCIf017 I4HE.IdO 3I4H4IfEH141114HX1AI H xHH3HEdXO0flEdtl£ 314H311flEdLlA 'H.Looxxados.LaLrsotlX X1i H XHhogEd aNIHEH Hdu NIEa1,oamXNlHadu X 1.Hltoaxdu 01h `xHHaxCXdxo o.IOaodott£ H o.IOH4Lra.LExairaxdu 331109 x4HEtI£00 a.LE.L4ILC£ad a 1AIEfiI4d.tHI4a 4tl3d3ho OioaO a MHO E `HNIxHHELINIOx H1AII4H.I031/sI a00dX0ad xHHairaE1.00tladLl LO 1aEâI4dIHI4â 3HH3If30EH 3OH1031N `H100HH3h09E£O 4.L0OHIIIHE£a 4.LEflHI1flEHE.LOX OHxCONi Eti.1Ox 'Eâ1001119000 H1.00H4Lfa.Lxatl a xXâ.LOEhX `HHHENIHHOLI 1HOxodHm 331f09 a H OH `xifH.LxHduttadu x14 EH xiimoiE.LOgEd H173d0 ox4IfO1 311 xHHxO1000O.IEIrg H x4aodo11£ 3IIxalruadxX E£ 4.L00HHaâ.LO.Laâ.L0 oI0a0 1AIENIHHOII am4irog aoâ H xxxalraoEH 0.I0H1031AI 41.OEh OiÂH4Ifa1HhEH£ 1OIxLfaE1000 H1131E1AIHHHdLltladJl 'NialfgodLl XI4H4II0.IOXIfE xi3HamEdx03 x00,IamoiEOEx `E.Lxaodu xHHamouuoâ KM' xNlada aahogEd a EIfEHoodau o.laoao IsxxarraE.LOOttadu HUH IfHHEâOdHOHEHH1) I1Ia1.ÂII Xâ1O01119000 XNIOH1.031%1 4h011101I IX.ioi11 H `HHdO.tHdda.I HOHHEtI EH N1aHHxllira II4H4irH0 10IEtlEI190 O14hI49O HHHELINIOx 314m4irog HxaoHE.IOgO OIHHamhXir x Eoada.LHH oloxodHm 301r09 xxHEaodHlrXiNH,Lo xLr17 HEâ0£4I10110H 41.I49 .LaxCONI `HHHELINIEx axxE.L .LOIxLfaE,LOOtladu HI4do10x `HxaoHE1O90 HoaodO17£ daNlHdJl 'xHHairaOEH O,IOH,IOaNI Htlado NIalf9odu XI4H4110.I0xuE IfHHENiHHOU 10HHamI4â0u xLrtl HOIfHO HamCxcl-iatl HOH4IfH0 41E10 1331c01A1 axCxE.L xH.LxHdutladu HxH.LHLfOII XExNIEd a xuO.IOxire )1lEO0d11oâ ou 41E109Ed Os.LO4ira.LE£x90 ESV1H3Lf3O`dH O.1OH103W 314H3h3Lf8O8 'HH£HxC ,C£Edgo Xi^IOa£ad.L X .LEda£oa ouxiruadxX H oifxdmoou aHHaxCXdxo aahogEd I490.Ih `4.LEâod1411od1HOx I4HxCIfOtI `aaxaNi aH NMI `HIf31E1101.09Ed EOOatiodu 0IH1Ha£Ed 4.LEmaN1 i317X9 H1.00H4ifBHllHatlH(tHOx xHH3111.CdEH E£OdLLC OIIPE,qEJIEHNE 3A,gA4, KOHTPOlIb 11 OLAEHKA Pa60TOJ(aTenH MOryT KOHTpOnHpOBaTb CTeneHb npOHHKHOBeHHSI H nOHHMâHHSi HH(l'OpMaljHH nyTëM OnpOCOB pâ3nHiIHbIX rpynn pa60TaIOn.jHX. CTeneHb HCnOnb30BaHH51 nporpaMMbi no ânKOrOnIO Ha pa6oT;eM MecTe HnH nporpaMMbi nOMOnjH pa60THHKaM, a TaK]Ke xonHTiecTBa o6paIIZeHHH 143 Bcex *iacTeii xoMnaxxH, npeAocTaBHT xopoHlHe noxa3aTenH pacnpocTpaxeHHSI H npHeMneMOCTH nporpaMMbI. CHHHKeHHe ypoBHx 3a6onesaeMOCTH, nOBbHneHHe 311(I)eKTHB- HOCTH, yMeHbnIeHHe TeKyTieCTH nepcoHana H yBenHTieHHe 06bëMa npOH3BO,11CTBa - BOT BHeIHHHe nOKa3aTenH, KOTOpble MOryT Cny)KHTb HHaHKaTOpaMH 3(1)(11eKTHBHOCTH 3THX nporpaMM. Tam, rAe npOBOJjSITCSI pelynSlpHble O6CneJjOBaHH3I 3,IIOpOB13SI Ha pa6o4eM McCTe, TaioKe MO)KHO KOHTpOnHpOBaTb H3MeHCHH5I B 6H0JI0rHT3eCKHX nOKa3aTenaX cpeAH Bcex LIJIeHOB pa6oTal0luero KOnneKTHBa. ueJIb McCTHbIX cTpyxTyp Mo)KeT COCTOSITb B 'cowl-pone 3a npOueHTHbIM KOJIHT3eCTBOM npennpHSITHÎi, KOTOpble BBenH nporpaMMy Ana pa6oTHHKOB B OTHOIIIeHHH anKOrOnSI. 80 6JOCTynHOCTb an K01'01151 gOCTynHOCTb aJIKOTOnSI 0006eHH0 Bâ)KHa, TaK KaK 3T0 rnaBHbII%I ci)aKTop, onpe,uenslK)umH noTpe6neHHSi anxoronsl Ha Ay1uy HaceneHHSI (8,49). Ha AOCTynHOCTb BnHSIK)T MHOrxe (tiaKTOpbI: IjeHa RO COOTHOLIICHHiO CO CBO6o,nHOii LIâCTbiO jjoXOAa, npOMbIIIIneHHOe H j.jOMaLLIHee 11pOH3BO,TZCTBO H HMROpT, KOnHLIeCTBO HAOCTH)KHMOCTb TOLieK npO,na)Kii, 3aKOHbI, perynHpyiOLL[He noKynRy H npo,Raxcy, 3KOHOMHLIeCKHe yCJIOBHSi, KOHKypeHLjHSi CO CTOpOHbI 6e3anKOTOnbHbIX HanHTKOB H aJlbTepHaTHBHbIX 3aHSITHr1 Ha AOCyre. Fpynna Ae13CTBHIi no anKOronK) MO)KeT nonaraTb, LITO OHH MOryT OKa3bIBaTb nHLLIb He6onbLLlOe B03j(eiiCTBHe Ha nOAo6Hble (l)aKTOpbI, OAHaKO ,Ije1%ICTBH51 Ha McCTHOM ypOBHe MOryT 3HaL1HTenbHO nOBnHSiTb Ha AOCTynHOCTb ai-moral-15i (CM. Jloàxoàbl K nonumuxe xonmponsl nad LUIK02oJleM, BTOpOi{ H3 3TOÎi CepHH 6yKneT0B). 11V1L4EH3V1OHHbIE 3AKOHbi B 60nbI1IHHCTBe CTpaH CyIIjeCTByOT nOCTaHOBneHHSI, KâcaiOH(HeCs! MCCTOpaCROJIO)KeHHSI H THROB TOLIeK Rpo,ga)KH anKOrOnbHbIX HanHTKOB. 3TH ycn0BH51 06bILIH0 BKnIOLIaIOT B ce6si nOnyLieHHe nHReH3HH y rOpOljCKHX HnH pai3OHHbIX BnaCTeiï, pa3peLLIa10ILjeii TOprOBnlo B paMKaX Onpe,i[enëHHbIX OrpaHHLIeHHi%I. TOpTOBble TOLIKH npOZjaIOT anKOTOnb nH60 j(JISi nOTpe6neHHSI B 3TOM 3aBe,i.ZeHHH, nH60 Ha BbIHOC. B cTpaHax, CyIIjeCTByeT rOCyAapCTBeHHâ51 MOHOROnHSI, anKOTOnbHble HanHTKH HaBbIHOC MO)KHO KynHTb TOnbKO B CneuHânH3HpOBaHHbIX Mara3HHâX. B HeKOTOpbIX MeCTâX HaRHTKH C BbICOKHM COAep)KaHHeM anKOTOnH eCTb 81 B npOAaxce TOnbKO B CneLjHâJIH3HpOBaHHbIX Mara3HHaX, B TO BpeMSi KaK HanHTKH C 6onee HH3KHM cojjep>KaHHeM HMeIOTCSI B 6onee IIIHpOKOM Kpyre 3aBeAeHHii. K TOprOBbIM TOLIKaM, nonyIIHBIIIHM nHLIeH3H10 Ha TOprOBnIO anKOroneM AJISI nOTpe6neHHSI B 3TOM 3aBeAeHHH OTHOCSITCSI 6apbl, Ka(be, KJIy6bI H peCTOpaHbl. nHLIeH3HSI 06bILIHO pa3peLUaeT npOAa>ICy anKOrOnSi B OnpeAenëHHble LlâcbI H noKynaTeJISIM, AOCTHTLUHM OupeAenëHHOTO B03paCTa. Cyü(eCTByeT MaCCa OrpaHHLieHHii 3TOTO pOAa, OHH 3HaLIHTenbHO pa3nHLIaIOTCSi KaK Me>KAy CTpaHaMH, TaK H BHyTpH HHX. B HeKOTOpbIX CTpaHaX CyLI(eCTByIOT nHIilb HeKOTOpble OrpaHHIIeHHSi, B TO BpeMSI, KaK B ApyrHX LiaCTSIX EBponbI OHH MHOTOIIHCneHHbI H CJIO>KHbI. aCTO olleHb noyLlHTenbHO npOCneRHTb HCTOpHIO TaKHX McCTHbIX 3aKOHOB, LITO nOMOraeT MHOrOe y3HaTb O McCTHbIX npe,gCTaBneHHSIX, HHTepecax H CHnaX, KacalouiHxcA nOBeneHHSI B OTHOLIICHHH nOTpe6neHHSI anKOTOnSI. nepBOHallanbHâSI 3aAaLIa I'pynnbI AertCTBHri no anKOronK) - 3T0 BbISICHHTb KaKHe nOCTâHOBneHHSt AeiiCTSyIOT B AaHHOIi McCTHOCTH, H nOCMOTpeTb, HaCKOnbKO FIX MO>KHO HCHOnb3OBaTb B HHTepeCaX COKpameHHSi o6wero ypOBHH HaHOCHMOCO aJIKOroneM BpeAa. B pa6oTy n0 3THM BOnpOCâM, BepOSITHO, MO>KeT 6bITb BOSneLIëH HIHpoKHH Kpyr nloAeH, BKJIIOLiaSI snaAenbL[es H o6CnyxcxsaloLlxHii nepCOHan TOLIeK npOAâ>KH anKOTOnSI HaBbIHOC H 6apoB, pa6OTHHKOB, OTBeIiaiOI1(HX 3a rNrHeHy OKpy>KalOÜjeri CpeAbl (3aHHMaIOH.jHXCSI IIHCTOTOH H O6ujeCTBeHH6IM 3ApaBOOXpaHeHHeM), pa6OTHHKOB npaBOOXpaHHTenbHblX OpraHOS, pa3nHliHble 061IjeCTBeHHble rpynnbI, 3aHHMaIOUZHeCSI MOJIOAë>KbK>, CIIOpTOM H OTAbIXOM, npeACTaBHTeneii anKOTOnbHOri HHAyCTpHH, BnaAenbLleB rOCTHHHI(, TypHCTHIIeCKHIi 6H3Hec H pa6OTHHKOB TOprOSnH. H HaKOHeij, CyLgeCTByIOT rpynnbI nOTpe6HTeneH, KOTOpble 3aHHTepecOBaHbI B KaLIeCTBe nHSa, BHHa H T.A., a TaiC>Ke B xapaKTepe H KaLieCTSe o6cTaxosKH noTpe6neHHSI. CymeCTByIOT MHO>KeCTBO MOMeHTOB, Ha KOTOpble I'pynna AeIiCTBHH MO>KeT nOBnHSITb. McCTHble rpynnbl AaBneHHSt H nonHTHKH HIpaK)T OCHOBHyIO pOJIb B BbIAaIIe nHLIeH3Hii H KOHTpOne 3a O61I[cCTBeHHbIM nopSIAKOM. nOnHLjHSi 06bILIHO HrpaeT OnpeAenëHHylo ponb B O6eCneLIeHHH HHCpOpMaLjHeli H yperynHpOSaHHH npo6neM, BO3HHKaIOLgHX B HMeIOIijHX nHLIeH3HIO Ha TOprOBnK> anKOTOneM 3aBeAeHHSIX, H BOKpyr HHX. 82 I1J1OTHOCTb TO4EK IIPO,gA?KVt MecTOpacnonoxcexxe H nJIOTHOCTb TOLIeK nponaxcH MOxceT OKâ3bIBaTb 3HaLIHTenbHOe BRH51Hxe Ha J[OCTynHOCTb anK0rOn51 Ha McCTHOM ypOBHe. B HCKOTOpbIX CTpaHaX IUIOTHOCTb TOLIeK npOnaxCH anKOTOnsI TLuaTenbHO perynHpyeTCSi HRH FIX MecTOrlonoweHHe OrpaHHLiHBaeTCSi 3anpeLueHHeM, HanpHMep, paCIlOnaraTb HX bowie nIKOn HRH IDa6pHK. B JxpyrHX CTpaHaX CLIHTaeTCSI, LITO pacnOnO)KeHHe 6apoB H nOJ[O6HbIX 3aBej[exxi3 nyilme OCTaBHTb Ha npOH3BOJI cBO6oAHOro pb1HKa. Godfrey (50) HceneAosan Raxxble no nponaxce anKOTOnSI H ero JjOCTynHOCTH H nOKa3an, LITO nOBbImeHHaa ILTIOTHOCTb, n0 BCeIi BHAHMOCTH, CBSI3aHa c 6onee BbICOKHM nOTpe6neHHeM nHBa. TAPV1OHbIE OrPAHVI4EHVIA ToprosnSI Llepe3 rpaxxubl H KoHTpa6aHna 5IB1IS1IOTC51 BaxcIIbIMH npo6neMaMH ASIA HCKOTOpbIX LIâCTeii EBponbI, rAe CyLueCTByeT 6onbmasi pa3HHua B uexe H/HRH JIOCTynHOCTH anxOronM B 6nH3nexcaluHx CTpaxax. McCTHOH I'pynne AeicTBHIi Hyxcxo 06J[yMâTb nOCneJ[CTBxSI npHMeHeHHA 110nHTH1IeCKHX Mep, KâCaiOluxXCSi H3MeHeHHSI TapH4)oB H HanHLIHSi 6cCIIOmnxHHbIX Marâ3HHOS B TpaH3HTHbIX 30HaX HRH Ha KOpa6JLfIX. CnyxCaIuHe TaMO)KHIi J[OnxCHbI nOHHMaTb nOCncJ(CTBHSi J1JISI 06LueCTSa H 3,40p0Bb51 HeneranbHOrO npOSO3a anKOrOn31, KOTOpOMy npHnaëTCH 06bILIHO ropa3,g0 MeHbme 3HaLIeHHSI, LIeM JjpyrHM HapKOTHL1eCKHM BeLueCTBaM. ,4OMAWHEE I1PO113BO,gCTBO goMamxee np0H3BOJICTBO anxoronH J(JISI nHL1HOr0 noTpe6neHHSi pa3pemeHO BO MHOrHX CTpaHax, H 3T0 BHOCHT 3HaLIHTenbHbIii BKnaJ[ B J[OCTynHOCTb. B HeKOTOpbIX CTpaHâX 3anpeII[eHa AHCTHnnSIuH51, HO He H3rOTOBneHHe npyrxx anKOTOnbHbIX HaIIHTKOB. goMamxee np0- H3BOJ(CTBO MOxCeT 6bITb LIaCTbiO capo TpaJjHuHH, H H3MCHeHHe OTHOmeHi331 K ânKOTOniO MOxCeT npOHCXOnxTb TOnbKO nOCTeneHHO C yLIëTOM H yBa)KeHHCM MeCTHbIX TpaJjHuHii H ueHHOCTeiï. 83 XAPAKTEP 11 PABOTA 11V111EH3V1OHHbIX 3ABE,gEH111;1 peCTOpaxbl, 6apbl H Apyri3e HMeioiijHe JIHI1eH3H10 3aseAeHIISI, 3aBHC5IT OT AO6pOmCeJIaTeJIbHOrO OTHOIHeHHSI K HHM MeCTHOrO HaCeJIeHHSi B OKpyre H 06bILIHO BHHMaTeJIbHO OTHOCSiTCSI K McCTHbIM BJIHSIHHSIM. Fpynna AeiiCTBHii n0 aJIKOI'OJIIO MOweT npOHHcbOp- MHpOBaTb npeACTaBHTeJIeN OpraHOB, BbIAaIOUnHX JIH1leH3H10, H ynpasnxioHwx 6apos O C01[HâJIbHbIX H MeAHL[HHCKHX npo6neMax, CB5I3aHHbIX C nOBbIIIICHHeM AOCTynHOCTH. B o6ü1;eM, npeAHOLITHTeJIb- Hee yCTaHOBHTb 6aJIaHC Mexc,Ay noJIHOIi AOCTynHOCTbiO H CJIHIIIKOM CTpOrHMH OrpaHHLIeHHSIMH, KOTOpble npHBOASIT K KOHueHTpaIZHH H3JIHHIHero nOTpe6JIeHHSi Ha KOpOTKOM npOMexCyTKe BpeMeHH, LITO LIaCTO BeAëT K OnbSIHeHHIO nOCeTHTeJIeii B 061IZeCTBeHHbIX McCTaX B LlacbI nepeA 3aKpbITHeM. 3TOT 6aJIaHC MO>iCeT CTaTb rJIaBHbIM HpeAMeTOM AJISI O6CywAeHHSI B McCTHOM C0o6meCTBe. McCTHblii 6ap HJIH Kaue IIaCTO SISJISleTCSi ueHTpOM 061i(eCTBeHHOIi )1(H3H11, H 11O3HTHBHble MOMeHTbI 3T0r0 He AOJDKHbI 6bITb yrlyII[eHbl H3-3a KOHLjeHTpaIjHH HCKJIIOLIHTeJIbHO Ha OHaCHOCTSIX 3JIOynOTpe6JIeHHSI. ,E1H3aiiH TOpryK)IImX aJIKOrOJIeM 3aBeAeHHli, KaK OKa3aJIOCb, BJIHSIeT Ha ypOBeHb B03HHKHOBeHHSi 6eCn0pSIAKOB. BpOBeAeHHble B BeJIHKO6pHTaHHH HCCJIeAOBaHHSI HOKa3aJIH, LITO 15-20% HaCHJIHSI B 6apax MO)KHO OTHeCTH Ha CLIeT (1)aKTOpOB AH3aIiHa, TaKHX KaK AHCKOM4lOpT, nnoxoe o(tiopMJIeHHe, nJioxoe OTOnJIeHHe, yposexb CBeTa H 3ByKa H HeraTHBHble LIÿBCTSa, BbI3BaHHble HCAOCTaTOLIHbIM KOJIHIIeCTBOM nepCOHâJIa. CTHJIb 3ByLlauleii My3bIKH, HaJIHLIHe Hrp, TaKHX KaK 6HJIbSIpA H, KOHeLIHO, HâJIHLIHe 3aKyCKH H pa3BJIeLIeHHIi BJIHSIIOT Ha BepOSITHOCTb BO3H14KHOBeHHSI 6eCHOpSiAKOB (51). MHOrO TpaBM B 6apax BeJIHKO6pHTaHHH HpOHCXOAHT H3-3a 6po111eHHbIX Ilepe3 BCë 3aBeAeHHe HRH HCHOJIb3OBaHHbIX B KaIieCTBe opyAHSI HanaAeHHSI CTaKaHOB HJiH 6yTbIJIOK. nepCOHâJI TpaBMaTH- LieCKHX OTAeJIeHHii H CKOpOii nOMOLI(H 3HaIOT O Cepbë3HOCTH TpaBM noAo6HOro poAa (52). 3aslsnslnocb, IiTO HCHOJIb3OBaHHe 3aKa7IëHHOr'O HJIH 60JIee npollHOro cTeKJIa npHBeJIO 6bI K 3HaIIHTeJIbHOMy coxpaHZeHHio noAo6HbIX TpaBM, HAyT aKTHBHble Ae6aTbI no npeHMyI1[ecTSaM 6oJlee LIIHpoxoro HCn0nb3OBaHHSi TaKoro BHAa cTexna. 3TO npHMep Bonpoca, KOTOpbI4[ MoxceT nOAHSITb Fpynna 84 geiiCTBHIi, LITO6bI nOBbICHTb BHHMâHHe H HHTepeC K AâHHbIM np06neMaM B McCTHOM C006LueCTBe. OKpyxceHHe 6apos, xactie H T.A. TaKxce SIBnSIeTCSI Ba)KHbIM BOnpOCOM, KOTOpbII4 MO)KeT yLIHTbIBaTbCH npH nHL(eH3HpOBaHHH H, KOHeLIHO, nOJLgasaTbCSI 6onee o6LueMy BnHSIHHIO MCCTHOrO Hacene- HHSI. B HeKOTOpbIX McCTaX B 6apax 4-iaxTHLIecKH MO)KHO 3aHHMaTbCSI TOnbKO OAHHM AenOM - paCHHBaTb CHHpTHble HanHTKH, B TO BpeMSI KaK B ApyrHX B HanHLIHH HMeeTCSi LuHpOKHii Bb16op nHniH, 6e3aJlKOronbxbIx HanHTKOB H pa3BneLIeHHI%I. flOCneAHHe, "Kall)e- na6bl", cLIHTaiOTCSI 6onee Cnoco6CTByIOÜjHMH CIIOKOHHOMy CTHnIo noTpe6neH45i. B HeKOTOpbIX CTpaHaX ,geTHM 3anpelIjeHO npHCyTCTBOBaTb BO MHOrHX 6apaX, B TO BpeMSI KaK B Z[pyrHX npHCyTCTBHe AeTeli npHBbILIHO. rAyT CnOpbl O TOM, 'ITO npHCyrCTBHe npHJjaëT 06CTaHOBKe 6onee C6anaHCHpOBaHHOe, CeMeNHOe olIjyLueHHe H MO)KeT OKa3bIBaTb nOJIO)KHTenbHblli 34)(peKT Ha pâ3yMHOCTb nOTpe6neHHSI B3pOCnbIX. OnSiTb )Ke, 3TOT CIIOpHbIIi BOnpOC MO)KeT HCnOnb3OBaTbCSI, KaK CpeACTBO nOBbIIIIeHHSI HHTepeca McCTHOrO HaCeneHHSI. COJjep)KaTenH 6apoB 06bILIHO HecyT OTBeTCTBeHHOCTb 3a nOAAep)KaHHe npaBHn nOBeAeHHSI B HX 3aBeAeHHSIX, HanpHMep, IIyTeM OTKâ3a OT O6CJIy)KHBaHHSI nK)Aeii, KOTOpble SIBHO nbSiHbl HJIH He AOCTHrnH MHHHMâJIbHOrO AOIIyCTHMOrO 3aKOHOM Bo3pacTa. BblAaio- ILjHe nHLieH3HiO OpraHbl H nonHuHSI MOryT npOBeCTH 6onee 3HeprHLIHyIO KaMnaHHIO n0 nposepxe BbI1IOJIHeHH5I 3THX npaBHn. OTBCTCTBeHHOCTb nepcoxana SIBnSieTCSI CneJjyioIIjHM BOnpOCOM, rAe CoJjepxcaTenH 6apos HJIH ApyrHe pacnpocTpaHHTenH anKOrOnbHbIX HanHTKOB MOryT npH3HaHbI BHHOBHbIMH 3a 06CJIy)iCIiBaHHe rice nbSIHbIX nOCeTHTeneii, KOTOpble 3TM CaASiTCSi 3a pynb, LITO npHBOAHT K TpaBMaM. CnyLIaH nOAO6HOrO poAa CBHAeTenbCTByiOT 0 HeA00ueHKe Ba)KHOCTH 06yLIeHHSi nepcoxana H KOHTpOnSI 3a TeM, LIT06bI OHIi nOHHManH HMex)LuHecSI npo6neMbl. B OHTapHO, B KaxaAe AeIicTByeT nHueH3HOHHbIH 3aKOH, AaiOLuHii HHCneKTOpaM LuHpOKidii xpyr nOJIHOMOLIHIï ARA o6ecneLIexxsl paccMoTpeHHSI Bcex xcano6 Ha HapyuleHHSI npaBHn, TaKHx KaK o6cny)KHBaHHe HeTpe3Bblx noceTHTeneii, CHH)KeHHe IjeH 85 HnH OTCyTCTBHe 3aKyCKH. Hx eiiCTBHA He paCUeHHBaK)TCA KaK BTOp)KeHHe, a npHBCTCTBYIOTCA MCCTHbIM HaCeneHHeM (53). MNHNMAJIbHbIV1 ,C]<Of1YCTNMbIV1 BO3PACT f1OTPE6JIEHNA B 6OnbIIIHHCTBe cTpaH OnpeAenëH MHHHManbHbIii BO3paCT, npH JjOCTH)KeHHH KOTOPOrO pa3pellIaeTCA nOKynKa HnH nOTpe6neHHe B O61ueCTBe anKOrOnA. 3TH 3aKOHbI LIaCTO nnOXO BbIIIOnHAiOTCA, H McCTHOe HaCeneHHe MO)KeT npeAnpHHATb 60nee 3HeprH9Hble IIIarH, LITO6bI nPOKOHTPOnHPOBâTb BbIIIOJIHeHHe AaHHbIX 3aKOHOB. KOrAa 6bI MHHHMânbHbIH J1OrIYCTHMbIM BO3paCT He CHH)KanCA, HanpHMep, B HeKOTOpbIX aMepHKaHCKHX n1TaTaX H npOBHHuHAX KaHa,IjbI, 3TO BCer,qa COnpOBO)iSljanOCb ysenH4eHHeM KonHiiecTBa ,I[OpO)KHbIX aBapHH Cpe,gH Mono,gbix nlo,qel3 (54). ,qENCTBUTA N f1POCBELLAEHVIE rpynna ,T;eHCTBHIi no anKOronIO Aon)KHa KoHTponxpoBaTb, iiTo McCTHOe Hacenexxe noHHMaeT npaBllna nHueH3HposaxHA H npouecc BbmaiIH HnH aHHYJIHPOBaHHA nHueH3HH. 3TH 3HaHHA n03BOJIAT )KHTCnAM 6Onee aKTHBHO HHTepeCOBaTbCA 3THM npOueccOM H 3HaTb, KaK BO3JIeHCTBOBaTb Ha Hero. 3T0 6yueT OCO6eHHO ueHHO JIJISI TeX, Koro 3a6OTHT Kai-IeCTBO OKpy)KCHHA H CB313aHHOC C anKOrOneM 6ecnoxOHCTBO H yluep6. nOne3HO 6yJ[eT COCTaBHTb MCCTHOe pyKOBOJjCTBO no nHuCH3HOHHbIM 3aKOHaM, KOTOpOe MO)KHO CJjenaTb J[OCTynHbIM JjJIA BCeX 3aHHTepeCOBaHHbIX rpynn H Ha BCeX HMeK)IuHXCA 5I3bIKaX. B HCKOTOpbIX paiiOHaX 3THHiieCKHe MeHbIIIHHCTBa MOryT He nOHHMaTb McCTHbIX npaBHn nHueH3HpOBaHHA. 110JIe3HbI KYPCbI o6rIeHHA cy,Refi, COTPYJ[HHKOB OTj[enOB nHueH3Hp0BaH1151, nonHuHH H 06na,AaTeneM nHueH3HII. COAep)ICaHHe H uenH O6yLIeHHA JjOJDKHbI BbIpa6aTbIBaTbCA Ha MCCTe, a CTeneHb HCIIOnb3OBaHHA nonjnieHHbIX 3HaHHIi MO)KeT KOHTpOnHpOBaTbCA. 86 B HeKOTOpbIX CTpaHaX Tpe6yeTCSI, tn'06b1 BCe BnaJJenbLJbI MMeIOIIJMx nxgeH3HI0 3aBe,ÿeHi3ii, ynpaBnxlounHe 6apoB H o6CnyACMBaI0U4141 nepcoxan npoulnH o6ytieHHe (55) B uenslX o6ecnetIeHHSI npaBHnbxoro noHIiMani33I MMM CBOei-I pOnM He TOnbxO C KOMMeptIeCKOii TOLIKH 3peHMA, HO TaK)Ke B BO3HMKHOBeHHH nOTeHLJManbHbIX nOCneJjCTBHH nOTpe6neHMA anKOrOnA ARA 3j1OpOBbSI 06LLJeCTBa. Tame KypcbI MOryT BKniotlaTb B Ce6A M3ytieHHe cneJJylouJMx BonpocoB: nMLJeH3MOHHbIii 3aKOH (BKnIOtlaA nOTpe6neHHe JJO JJOCTM)KeHMA JZOnyCTi-iMOrO B03paCTa) BnHAHMe âJIKOrOJISi Ha Cy)iCJJeHHSI H nOBeJjeHHe 3aKOHbI, KaCaiowneCSI BO)KJJCHHA B HeTpe3BOM BHJJe OTBeTCTBeHHOCTb nepCOHana yperyJIi3poBaHiie KOH(NIMKTOB H pa6oTa C nbSIHbIMH. B HeKOTOpbIX 3aBeJJeHMAX HaHHMaeTCSI CneLJManbHblii nepCOHan, peryJlHpyloulHH JJOLIyCK B noMeuJexxe. OHM LIaCTO CTaHOBSITCSI LjeHTpOM HaCMnbCTBeHHbIX 6ecnop5JJKOB, H o6ytleHMe, KaK CnpaBnSITbCSi C AaHHbIMH cHTyaIjMSIMH, MO)iCeT npHHeCTH MM nonb3y. MOHVITOPVIHr CyujecTByeT 3HatIMTenbxaSI Heonpe,nenëxxocTb n0 HOBO Toro, KaK ypOBCHb HaHOCHMOrO anKOrOneM BpeJJa B3aHMOCBSI3aH C KOnHtIeCTBOM, XapaKTepOM H paCnOJIO)KeHHeM TOLIeK npoJJaxcH. TüjaTenbHOe HaHeCCHHe Ha KapTy MeCTHOii Teppl-ITOpHH pacnpe- JJeneHHA anKOronbHbIX npo6neM OTHOCHTenbHO TM-MK npOJjâ)KH MO)KeT 6bITb OJjHMM H3 CpeJJCTB HCCneAOBaHHSI H MOHHTOpHHra 3TOii CB5I314. IIOnHL[MA 06bItIHO pacnOJIO)KeHa TaK, LITO613I KOHTpOnMpOBaTb HapyuIeHMA 06u(eCTBeHHoro nopAJJKa B6nH3H HMeiOLLJMX npasO Ha TOprOBnIO anKOrOneM 3aBeJJeHHIi, H TaK)Ke MO)KeT BeCTM 3anHCH o HapyLLIeHHAX, TaKHX KaK nOTpe6neHHe JJO JJOnyCTHMOrO BO3paCTa H B 3anpelIJëHHble LiacbI. OHH TaK)Ke MoryT TIIjaTenbHO OTMetIaTb BpeMA H McCTO HapyLLIeHHH o6LLjeCTBeHHOrO nopAJJKa H McCTO BO3HHKHOBeHH5I 87 CB513aHHbIX C ânKOrOneM HeCYaCTHbIX CJIyiiaes, KOTOpble O6bIÜHo CnymalOTCSI B HIM OKOJIO 6apOB H KaLtle BO BpeMSi 3aKpbITH5I. IIpOCTble MepbI TaKOrO pOAa ,IZa,ayT 6a30Bble AaHHble, no KOTOpbIM MO)KHO OI1eHHBâTb BIHSIHHC McCTHbIX nepeMeH. BE3AJ1KOrOJ1bHbIE 30HbI KorAa CTaJIO OLIeBHAHbIM, iiTO nbSIHCTBO B 06LueCTBeHHbIX MecTax H nocne,aylouiHé HapyuleHHSI o6ulecTSexxoro nopsiAKa 'mule BcTpe9aeTcSl B onpeAenëxxblx paiioxax ropozja, LLeM B ,Z;pyrHx, B HeKOTOpbIX C0061IjeCTBâX 61,I11H yCTaHOBneHbl "6e3anK0r0nbHble 30HbI" (56). npaBHna 3anpeüjaK)T nOTpe6neHHe aIKOr01151 Ha nK),IjSIX B 3THX McCTax. Ha ,T1aHHb1Ii MOMeHT 34)43eKTHBHOCTb 3TOTO He Onpe,geneHa, HO CyLneCTByIOT onaceHHA, iITO 3TH Ae1iCTBM1I npOCTO cMeüna1OT TaKHe npo6neMbl B ApyrOx païlOH rop0na (CM. rnaBy 7). McCTHb1e C006LLlecTSa, B KOTOpbIX aJIKOrOnb H HapKOTHKH nerKOAOCTynHbl, H npOSIBnSieTCSI TepnHMOe oTHOIIIeHHe K nbSIHCTBy, npeACTâBnsleT c060iï OKpy)KeHHe, KOTOpOe 06bILIHO He nO,IIljepXCHBaeT np0(pHnaKTHKy. Bo MHOrHX CTpaHaX 6b1n11 pa3pa60TaHbI "Bble3AHble" nporpaMMbl Ansl MOJIO,aë)KH B 3THX cHTyauMSIx. HanpHMep, HaLjHOHanbHblli gMpeKTOpaT n0 npOcl)HnaKTHKe CBSI3aHHbIX C aJIKOroneM H HapKOTHKaMH npO6neM B HopserxH BbIAenHn CneLlHânbHble Li/OHAbI AnSi COIjHanbHblX pa6OTHHKOB, *ITO6bI OHM yCTaHâBnHBâJIM KOHTaKT C MOJIOAbIMH nloAbMM, KOTOpble yTepslnH CB5I3b C o6LLjeCTBOM H Kâ)KyTCâ OTLIyNC):1ëHHbIMH OT Hero. MOnoAë)KHble Kny6b1 H He3aBHCHMble MOIOAe)KHb1e pa6oTHHKH LIaCTo HrpaiOT OCHOBHyIO p0nb B OCyLI;eCTBneHHH HHHIjHaTHB TaKOTO pOAa. AJ1bTEPHATYIBbI B nOCneAHHe rOAbI BHOBb BO3p0AMJIC5I HHTepeC K CO3AaHMIO BO3MO)KHOCTe1i anbTepHaTHBHOrO OTAbIXa 6e3 yLIacTHSI anKOronSi. B BenHKO6pHTaHMH HeCKOnbKO ropOAOB npOBOAHnH 3KCnepMMeHT c "6e3anKOro11bHblMH 6apaMH" H nponaraHAoH 6e3anKOronbHbIX HaIIHTKOB HJIM nHBa H BHHa C 111,13KHM coAepxcaxxeM HIM 6e3 co,qepxcaxxH anxoronsl. I'pynna AeHCTBH1i MO)KeT KOHTpOnHpOBaTb 88 AOCTynHOCTb 3THX HanHTKOB H LiX neHy OTHOCLiTCnbHO anKOrOnbHbIX HanHTKOB. B HCKOTOpbIX CTpaHaX CymCCTByCT TeCHâSi H BHJ_jliMaH CB5I3b Me)ICAy anKOCOneM H OT,gbIXOM; B CIIOpTHBHbIX LjeHTpaX, Ha nbDICHbIX KypOpTaX, B TâHgeBanbHblX 3anaX, Ha Il)yT6OnbHbIX nnolliaAKâX H TaK Aanee HMeeTCSi B npOAaxce aJIKOTOnb. HHOr,ita npH6bInb 6apa HAëT KTiy6y. Fpynna ACIiCTBHIi MO)KCT HCCneAosaTb BO3MO)KHble IIyTH pa3geneHHSI 3THX BHAOB OTAbIXa H nOTpe6neHHSl anKOrOnSI TaK, LIT06bI )KenaiOlLjHe OTAOXHyTb B 3TOM 3aBeAeHHH He iiyBCTBOBâTIH AaBneHHSI, BbIHy)ICAaIOInerO nOTpe6nSITb anKOrOnb. 3A,gAy V1 I'pynna AeIiCTBHM no anKOronlo MO)KeT AOCTHiib cornaCHSI C McCTHbIM C006wecTBOM no TaKHM 3aAaLIaM: OXBaT 06yLIaIOÜ.jHMH KypCaMH TaKHX nloAeH, KaK o6naAaTenH nldqeH3LIii H npeACTaBHTenH CyAe6HbIX OpraHOB H BnaCTeli, BbIAaiOIInHX nHLjeH3Hi0; COKpaLneHHe KOnHLICCTBa HapynleHHli nHL[CH3HOHHbIX npaBLLTI H CJiyLIaeB nbSIHCTBa B O6njeCTBCHHbIX McCTaX; OfITHManbHaSl HJIOTHOCTb H KOnHLICCTBO 3aBeAeHHi4, TOpryIOHjHX Ana nOTpe6neHHS1 Ha McCTe H Ha BbIHOC; HanHLIHe aJIbTepHaTHB anKOrOnbHbIM HanHTKaM H HX CpaBHH- TCnbHaSl L[eHa; H KOnHLICCTBO BHAOB OTAbIXa, He CB5I3aHHbIX C npHCyTCTBHCM anKOronSi. 89 16 â OH.IOHK4u :.LExciCIro O.IO.Le xNlEdaNlxdlj Exu,(I.00du 0i4,L3OHHUX3 KO,LaKIruK KICO.IOxuE aHHaugad.LOU 317.1 `ISxxalrl/CdEHOSEdu 31 :axmoltilauo KO.IKOOH.LO KHHaIrIMEHOUL'du waUOIOxIrE O I1II4HHE£ISSO x Et7Elrxg 013 H.LOOwHhEH£ aHHEâHxCEIr,IO H KHHa1n/CdEHOUEdu 3HH3II1d311O0 s IfIro,IOxIrL KHHaugad.LOLI 0.IOHHENIX17902H X17EIrx11 Eoau O.I0III4U09 woxIUHUO INaI3HE174I3du ,01.31c31A1 EOHEUL'g O.IOH4IfHgEdu If041I49o17 oxxcEH awaUgOdu HOLE x INaHHaInoH.iO XH H KHHauaOEH 0.101e HaxdO.LOH I3oIrIIIOdu K04115113l73duo OH4Ira.LHhEH£ `wo£Edgo wHxE.L `i317Â9 `HHHaIIIAEHOâEdu XI411411L'HtIOO Ei1Kd aim= HHHaIIIdauOO u KIro.IOxu6 41f od KEIsIaE.IEUOUH13d11 i3HHaInIaOadu XH.IOHNI KHHaIIIdasoO HOHHhxdu K04,LE.LHhO 13t74 KIfO,IOxIfE aH&L0.LX0Hdu `3HHaxOU)130 xEx `KO,LaEfiHHaiIOEd HUH 1A1I410Eh3H IfO.IOKUUK aHHaIrgad,LOu att.I `wE1, KEHHEhÂUO O.LOHh NUN 41f041EHHd.LEIN00Ed .LaxcOw XKHU,L0Ha)7 XI4H4UEHHwHdx u I5110.10xIfE 4uOd `aH.LI4g00 aOHUaHtla0â0U xEx `KO.LaEâHd.I.ENI00Ed KUO.IOxUE aHHaugad.IOÜ aH7,I `wE1, 'KHHaIIIOH.IO H HHtIHt7Ed.L 3I4H.LO0w 4.1KH1f11 ,r.C7C9 XKHHaIIISdEHOEEdu waUO.IOxuE O XI411HE£KU0 O KHH31130EH O.IOH,IOaw KHHaufiE.IOttadu EH 'HH£Hxc E£EdgO XH O114H2Haw£14 OH 41IIOwOU 1411-EflI4£Ex0 wH H `HHHfE.LO 142H11Ed EH 4o14111SUflKI411 I41A131r9odu waHHalrgad.IOU O 3I4HHE£11110 `KHHaUIIX.IOadLI Etlod O.IOxE.L uHlndauoo 01x `Xa.L I490.Ih H `.ISHHaIruÂ.LOadu oIHHaIIIdafioO x ,LKtlouHdu aI4dO.IOx `xahl4uHdU XI4HH3.L1111 KHHaHIIEdxOO XEOada.IHH u 4oEUKUU.L33t11X00 HHHE£ExEH ExH.LxEdU H ExH.LHUOU 14g0.Lh `41ES0dH110d1HOxodu EHxcuot7 ollro.IOx1rE ou HHg.IOHat7 EuuÂdi ewa.l0v10 IseH9Ila1V1 HedX009L'd U L Z6 'at1,Co g KO.LOIEaHd.LEwooEd KHHaIIIMEHOaEdLI HIC MEN `01 EH aHHKHIfa 0OH4I101.11hEH£ 41E1114£EXO .LaXCONi EHO a)K)IE1, 'aHaodX NIOH100Ni EH fiOHOXE£ aHHEaOXIfOI.OH H 0HH2HICOLII411 EH 0111109000 H aHHEXCdatroo EH aHHKHIfa 4.LEHI4£EXO `NIO£Edgo wHXEL `1.03cON1 01If010XIrE ou HHa.LOHaV ELILIÂd 'I4HE1d0 0I4H41faI.Ei10HOXE£ 0I4H41fEH0H1IEH a H1.00xukLOadu H 11I1O.IOXIfE 0114110111001110 ISHHad£ 0i0a0 4.LEtladau ,LaxcONl `OHhaHOX `0X01E1 oal.oamg00j 'IfHH2HL101II4a H1.0010d.LO g H 31E1 `HHHEEOXIfOI.OH XH fi XEX `EOHOXE£ 1403ENI HOHfiOH0O KHHOHLC011I4g XXH,LXEdLI EH 41.EEI4£EXO 14IIIIXd1 a14H.LOaNI aodO.LOX `ISHHKHIfa H.LOOHXCONI£Oa 0I4HdHIIIg0 `aaHaNl OH IH01 `I,OLXaI.00tfIXj 'KlfoloXlre OH4I10.LHOOH1O ÂXH1HIfOLI EH I411KIf1£a aHmol.CdHlrEaadu 4.LEXCEd.LO 14HXCIfotl H NIOal.oamg000 I4.LKHHdu 4.LI4g 1.Â10NI aI4dO.LOX `ELCHaEdu H I4HOXE£ 0I4H.LOONI .LOiiCa.LOamXo 01OEh `Xi'1IO.L6 X axxaHLrouOT1 g 'Oa1.O41ra1.Et10HOXE£ aOH4IfEdatlaSl) HIfH/H 00H4IfEH0H1IEH .LaKICatladLiO 011h1490 aOHOXE£ XH16 EH aH.IOHNi 0g.1001119000 NiOH4Ir01110 g 'axaoxEd.LO O gOXOH ,Ctioaou OU 9XCK1. H HHhEOHauwOX O gag' `aOr[og£Ed HHh14dU EH Hoxtlo IS010Efl14£EH 01OEh 4IfO.IOXLrE :aOHOXE£ XHX3HEtiXCEd1 1SHHaIILCdEH 'KOXOLI ISHHOIILCdEH H NIK.Lat1 X aHHOHIOHIA 0OX01OOXC `XKHHOIfOiC XHHIIIENI017 g aHLCHOEH `YNI£HIfEt1HEa `KHHOIrukLOadU 0I4H41rEiC0X00 `0a1.00hHHXCKt1Od9 `KHHat1ELIEH - O.L6 `t1EIrXa HI4H11EI1.I .LHOOHa OHhI490 KIfO10XIfE aHHalrgad.LOU xI4dO.LOX aHHallldaaoo a `ISHHauI,CdEHOaEdu 'XKHH3t7aaE£ HH£HariHlf XHfiOIaNIH OH g aXC HICH I40Eh aI4HH0maduE£ a aHHEEHXCÂICOgO H HaICa.LH1,aO0H x14fi£0d1aH aXCX axHEaHXCArogo `E1,oEd£oa NIOHOXE£ 01o11[H1,OiCLIOt1 NIHffi1H1.o011 OH `NIEtIHLC KlroloXIfE EXCEt1Odu `daNlHduEH `101O1OXIrE HXCEi1OdLI H KHH0HEd1.00d11OEd KOOHmOIEOEX `I4HOXE£ 0I4HH H a14HHOH£H01IHL1 K01A1Et101Ifg00 OH Et110X `ISHHaffiÂdEHOfiEdU 'Et1£0OI1 1.0HHHIIIENI HIfH 10IfHLIEH11E MEN XHXE.L `xK1400041odu xI4HH01101l0duo HdLI `dawHduEH `HaodX g 0Ha101X010 01a 00HI10U KO.La,Cgad1. Eti1oX K11O10XIrE aHHalrgad.LOU H HHHKO.LOOa NIOa£ad.LaH g axxatlXCOa `aHHatlaaOU 00X0HE1HIfXX H 01110HK4I! `XE100I11 XI4HHaa1.001119O £6 â 4uoJOx11E K010EHHNIOUiC O1.0Eh MEN `41.i31t0110odu I490.Lh `HHHEit00E£ XI4H9017X0 V00H11E£ Ed.LOINOOdu OJO.LOOdu NIa.I.ku 41141iXIro11 OHxCONI aI4HHElt EitJOHH '1400du0a H.Le 1,0EâI4dxOEd OHaH1.x0(DcDe ENI40aa O,LOEh `ahXO HUH HHiIH110u XISHHaIra17.LO XI4H1.0aNI a NIKHHaIfukLOadu NI0110J0x11E O NII4HHE£Ka0 OU 014HHEll IiH11IO1EdHgo0 `1.xaodj_j 'NI0119Odu I1I0uOJOxICE O XI4HHE£Ka0 aHhHIfEH o14011aISl4a XI4d010x X HIfH `ISxxauuX.LOadu HNIH aHHauldaao0 a itEUxa 00Ha 4uOJOx11E XI4dO1Ax X `HHdoJa.LEx Ii09000 HO1hKEx a Haua.LHIII/CdEH 01101t O aHHauaE.L0itadu 41Hh/CIrou 1rCJONI01.1 1400duo XISHHaIhKadhiC XI4HHaual7adu0 a aI4HH073aodu `X11EhÂ110 mu/WV g 'da.LxEdEx HHxOahHitO£HUe O.LOHh 4.LaNIH .LaxCONI `i3HHauuXlAadu XI4HHE0141.100uII411 EJ/Cdx oJOxodHUl 001109 ai3Haffid0ao0 a 11110J0xIfE itElrxa `XKHhEX.Li30 xl4do.LoxaH g 'fiOHOxE£ XI4HHOH£H0TIH11 1SHHauIXdEH H XE103N1 XI4HH0111.0011190 a 0a.L0HK4u `017Ha NIOa£Od.LOH a aHHalhKOa MUM `NIKHHaIII/CdEHOaEdLI NIHxE.L OU 0I4HHElt 0I4H.LOaNI H 0I4H4IfEHOHiIEH 1101O10NIH HHhH1fEH a 0Hh1490 'H1OOH1O0N1 HO.Le a H1.00HLLC100d11 4H0aod,C a K110J0x1fE E1tEInIa HHOLI310 o uuXdJ XI4HHEao00d01HHE£ EJÂdx oJOxodHlfI OJOZe OJaOa HHHEaOdHLVdO(DHH a 411101000 1.01tX9 EhE17E£ KEH4IfEhEHOadOLj I91N3Lf9OdIJ VH149ALfJ 'XE00duoa }CHIC a I400d01HH 0I4HHOxE£ HOaO 10101%IH HHO 00E1 `.XI4HHah0111xE£ H0IK00 031O1E1 E`HOXE£ uHIILCdEH 01.x `Xa.L HHiIE.LUEitE HOHhHdo.La H HHH0h0110u `HH1IIHaxC a.LHhIE£ `a.LdaxC axxcdamtou a 0I4HHEa000da.LHHE£ `I4uu/CdJ 11o4.LEaodHwdocDo .L/CJONI axCxEJL 'XI1017 4.LEaoa109000u0 1,Â.I0NI O3101E1 `IiHHOIrLIX.L00du I417Ha 0I4H411017.10 HIfH 4100HLIÂ130dII 101iCH110a OHH09000 XI4dO.LOx `HEThICEdJ I4uU/Cd1 0I4HH0a100TU90 'OHEaodHNldO(I)HHOdu offiOdOX 011I49 aHHauaOEH I4901h `xEL ao.LE90l7 XI4HHaa10011190 HHiIE£HHEJd0 â HNIExHH£0100 41,EL0 1rCJONI axCxE1. `XKHHaIruX.LOadu I1I011OJOxIfE O XI4HHE£Kâ0 O HxCE.Ldouad H aHHaUIOH.LO XH `HHIIENIdO(i)HH HOfi0O0ENi Ea,LOltadp '14Nia.L0H0 HoH4ua.LI-IHEdxooaEdu HNIEd/fJHcl) HNII4g0hO11fx KO.Lo1KUaK al4do.Lox `HailolIf 4,LHlfailadu0 EHxCICOit EHO '4,L00H411a1.K0it 41.HaEduEH 4hONI0U H KHH01100EH aHHENIHHOu 4LH0I4EOU .LaxCONI O1110JOxIfE OU i3Ha101,1017 11EH1,001N FSM91OV13û KatiecTSe oTSIrLIalowero HnH CMSIrLiaiOLgerO (kaKTopa. CHCTeMbI Haxa3aHHii no-pa3HOMy paccMaTpHBaeT ponb anKOrOJIH B COBepLIIeHHH npecTynneHmi. B HeKOTOpbIX H3 HHX HMeeTCSI OTAenbHâ51 KaTerOpHSi AVIA BCeX HapynleHHii, K KOTOpbIM, BHJjHMO, 6bin npH*iaCTeH anKOrOnb; B JjpyrHX COCTOSIHHe OnbSIHeHH51 CLIHTaeTCSi CMS1r*iaiOn;HM O6CTOSITenbCTBOM. bOnbIHHHCTBO paCCMaTpHBaeT aJIKOrOnb, KaK OTSirLIaIOLIlee 06CTOSITenbCTBO H, KOHeLIHO, He KaK onpasnaxxe npaBOHapyHleHHS1. CTeneHb perHCTpanHH anKOrOnSi B KaLIeCTBe JjOnOJIHHTeJIbHOrO (l)aKTOpa OLIeHb CHJIbHO pa3nHLIaeTCSi, H OLIeHb LIaCTO OKa3bIBaeTÇ51, LTTO ,i(06HTbCS1 COrnaCOBaHHOCTH B OTL1eTâX AOBOnbH0 TpyJZHO. fIOnHi[HIO MOmKiiO nOnpOCHTb BeCTH CHCTeMâTHLieCKHe 3anHCH O COCTOSIHHH OnbSIHeHHSI nioJieH, KOTOpbIX OHH apeCTOBbIBaIoT. r1epCOHâTI TiOpeM MmKHO OnpOCHTb O nHTeHHbIX npHBbILIKaX 3aKJI10LIëHHbIX. r1pOCTble OnpOCbl TaKOrO pOAa LIaCTO 11OKa3bIBaIOT OLieHb BbICOKHii ypOBeHb CB513aHHbIX C anKOrOneM np06neM. COLIHanbHble pa60THHKH HRH HHCneKTOpa, BeJjyII(He Ha6nK),IJeHHe 3a yCROBHO OCy)IUjëHHbIMH npeCTynHHKaMH MOryT npOCnenHTb paCnpOCTpaHeHHOCTb oco6o OnaCHOrO nOTpe6neH451 aTIKOrOnSi CpenH CBOHX nO,IJOneLIHbIX. Tame JjaHHble MOwHO CO6HpaTb CHCTeMaTHL1eCKH. 3Ta HH(DOpMaLjH51 nOBbIIIIaeT nOHHMaHHe MCCTHbIM HaCeneHHeM pORH aJIKOrOnSI B npeCTynHOCTH H B CB5I3H C 3THM 3aTpaT CpeJjcTB; 3T0 TaKwe MO>KeT CJIyAKHTb TOLIKOii OTCLIëTa JZJISI KOHTpOnSI BnHSIHHSI H3MeHeHHii. dT11ëTbI, OCHOBaHHble Ha McCTHbIX ,gaHHbIX, HeCyT B ce6e aKTyanbHOCTb H OCTpOTy, KOTOpble MOryT He BbI3BaTb Ha1jHOHanbHble JjaHHble. McCTHble CpeJjCTBa MaCCOBOIi HH4)OpMânHH LiaCTO MOryT nOMOLIb B paCnpOCTpaHCHHH HH(DOpMaIZHH O B3aHMOCBS13H âJIKOTOnSi H npeCTynHOCTH, TeM CaMbIM nOBbIILIâSi OCO3HaHHe H nOHHMaHHe B 061LjeCTBe AaHHbIX npo6neM. IIOBbIWEHNE VIHOOPMVIPOBAHHOCTUI XOTSI HeKOTOpble n10AH, 3aHHMa1O1IjHeCS1 OXpaHOii 06n.[eCTBeHHOTO nOpSIJjKa, OLIeHb 3aHHTepeCOBaHbI 3TOii np06neM0H H 6yJlyr pa3AenSlTb B31715IJ1bI rpynnbI ,i;eHCTBHII, B JjpyrHX cHTyatjHSIX arm TOrO, LIT06bI Jj0614TbC5I no,u,lepxcKH He06XOnHMO 6y,AeT nposoJiHTb o6yilexxe H no6y-AcAeHHe. 94 IlporpaMMbl o6yLIeHHA MOnKHO npOBOnHTb nnSI pa6OTHHKOB Cy,ROB, nOnHIjHH, COLjHânbHbIX pa6oTHHKOS, HHCneKTOpOB Ha6niOZjeHHSI 3a yCJIOBHO OCynKJ[ëHHbIMH npeCTynHHKaMH, pa6oT- HHKOB Topem H nepCOHana pea6HnHTamH. KOnHiieCTBO TaKHX npOrpaMM H/HnH HX BnHAHHe Ha 3HaHHSi, OTHOIIIeHHe H nOBeJjeHHe MOnKeT H3MepATbCS1 H KOHTpOnHpOBâTbCA. MECTHbiE REVICTBUISI no CHMEHVIFO YI1IEP6A CyuiecTByeT onpe,genëxxblli Ha6op nposepeHHbix Mep, BBeAeHHe KOTOpbIX, KaK CBHAeTenbCTByIOT (PaKTbI, MOweT CHH3HTb ypOBCHb CBA3aHHbIX C ânKOrOneM npaBOHapyuieHHN B COO6wecTBe. BO)K,qeHNe B H@Tpe3BOM COCTOAHNN BOxKjjeHHe B HeTpe3BOM COCTOAHHH npe,gCTaBJIAeT C060ii XOpOLUHIi npHMep BnHAHHA j[eiiCTBHFi COO6u[eCTBa Ha COKpaLL[eHHe yinep6a. XopoLIIO H3BecTHO, TITO noTpe6neHHe anKOronA nepeJj BONCJ;eHHeM nOBbILIIaeT BepOATHOCTb BO3HHKHOBeHHA .I1OpONKHbIX asapHli (CM. I'nasy 9). Bo Bcex esponeiicKHX CTpaxax Boxc,AeHHe B HeTpe3BOM BHZ[e ceI9aC ABnACTCA npasoxapyHIeHHeM, XOTA yposexb ânKOrOJIA B KpOBH, npH KOTOpOM npH3HaëTCA HanHLIHe npaBOHapyuleHHA, 3HaLIHTenbHO oTnHnaeTCA. TaKxce CyLLleCTByeT OrpOMHâA pa3HHL(a B cTeneHH Co6niO,lZexHA 3THX nocTaxoBnexHli nonHL(Heii. O+THoüieHNe K HX c06niOneHHiO *iaCTO BeCbMa ycneLIIHO nOnAaëTCA McCTHOMy BnHAHHK). IlpeBeHTHBHble CTpaTerHH MOIyr KOHLIeHTpHpOBaTbCA Ha npOCBeLLIeHHH. HaijHOHanbHbie H/HJIH MeCTHble KaMnaHHH MOryT nOKâ3bIBaTb OnaCHOCTH BO)K,LIeHHA B HeTpe3BOM COCTOAHHH, LIaCTO nonLiëpKHBaA 60nb H CTpanaHHA >KepTB HJIH 06paüjaSi BHHMaHHe Ha HaKâ3aHHA 3a BOmmeHHe B HeTpe3BOM COCTOAHHH. B HeKOTOpbIX KaMnaHHAX Jjenanacb nonbTKa CBA3bIBaTb CBeJjeHHM O BOnvieHHH B HeTpe3BOM COCTOAHHH C nponaraH,nOIi 6e3anKOronbHblX HJIH Cna6oanKOl'OnbHbIX HanHTKOB. 95 Heo6xoA14M0, LiTO6bI B KiUKAOM coo6tljecTBe JIioAH o6paTIUIH BHHMaHHe Ha CBOiiCTBeHHblii HaM napaAOKC nOOmpeHHSI KaK BO)KJ[eHHSi, TBK H nOTpe6JIeHHSi aJIKOTOJISi. Hy)KHO, LITO6bI 3TH ABa nOITyJISIpHbIX BHAa AeSITeJIbHOCTH 6bIJIH pa3AeJIeHbI (57). npOCTO npOCBeLLjeHHSi HeAOCTaTOiiHO, ero He06XOAi3M0 KOM6HHHp0BaTb CO CTpaTeTHAMH, KOTOpble Cn0006CTByfOT 3TOMy pa3AeJIeHHK) H yCHJIHBaIOT eTO. BbIJIO nOKa3aH0, LiTO Bb16opOTiHâSI npOBepKa AbIXaHHSI S1BJIS1eTC5I OTIeHb 34(peKTHBHbIM CTI00060M cOKpaLLjeHHSi ypoBH31 BO)ICAeH1431 B HeTpe3BOM COCTOSIHHH CpeAH HaCeJICHHS, HO Hy)KHO, iiTO6bI OHH BbInOJIHSIJIHCb OpTaHH3oBaHHO H peTyJISIpHO, a HX npOBeAeHHe 6bIJI0 T3aCTbIM H HaTJISIAHbIM TaK, LITO6bI BepOSITHOCTb 06Hapy)KeHHSI B C0061IjecTBe 6bIJIa BbICOKOH (58). rpynnbI CTOpOHHHKOB ycHJiexxsl HaKa3aHHii 3a BO)K,IjeHHe B HeTpe3BOM COCTOSIHHH MOT 06Hapy)KHTb, TO OHH OKa3bIBaiOT JIHLIIb He60JIbLUOe AeïICTBHTeJIbHOe BJIHSIHHe Ha ypOBeHb yujep6a cpeAH HaCeJIeHHSI. TeM He McHee, CymeCTBy10T amble npeHMyLL[eCTBa B 06eCneTLeHHH TOTO, LITO6bI y BOAHBIIIHX aBTOMO6HJIb B HeTpe3BOM COCTOSiHHH npasa He BOCCTaxasnx6aJIHCb 3HaLIHTeJIbHbIt%[ nepHoA BpeMeHH. Taxxce Ba)KHO, iiT06bI HapyIIIHTeJIH H3MeHHJIH CBOH npHBbILtKH AO TOTO, KaK BepHyTCSi K BONUaeHHIO. ECTb AaHHble, CBHAeTeJIbCTByK)IInHe, LITO 3TOT0 MO)KHO AOCTHTHyTb IIyTëM BBeAeHHSi pea6liJIHTaL[HOHHbIX npOTpaMM Ana HapyLLIHTeJIe1i. 3Ta MOAeJIb XOpoILIO pâ3BHTa B HeCKOJIbKHX EBponeliCKHX CTpaHaX. HH OAHH 113 3THX BHAOB AeSITeJIbHOCTH He 6yAeT 3(i)(tleKTHBHbIM AO TeX nOp, nOKa OH He 6yAeT COnpOBO)KAaTbCSI COOTB6TCTByK)IIjHM ypOBHeM nOHHMaHHSI C006LgeCTBOM 3THX BOnpOCOB. CKOOpAHHHpO- BaHHâSi CTpaTeTHSi n0 BO)iCAeHHK) B HeTpe3BOM COCTOSIHHH SiBJISIeTCSI XOpOLLIeH HJLJI1oCTpaLmeH TOTO, KaK He06XOAHMO COTpyAHHLiaTb MHOI'HM pa3JIHLiHbIM CeKTopaM, TaKHM KaK o6weCTBexxoe npo- CBeLi(eHHe, cpeACTBa MaCCOBOH H4OpMaL(HH, noJIHLjHS1, CyAe6Hble OpTâHbl, pea6HJIHTaLjHOHHble npOTpaMMbI, TpaHCTIOpTHble CJIy)K6bI, a TaK)ICe aJIKOTOJIbHaSI npOMbIIIIJIeHHOCTb H HHAyCTpHSi AOCyTa. 96 06114eCTBeHHbIN 11OpSAROK McCTHble npoeKTbI LIaCTO BO3HHKaIOT B OTBeT Ha KaKOe-nH60 npOHCIIIeCTBHe, KOTOpOe BbI3bIBaeT TpeBOry C006nJeCTSa. 9TH KpH3HCbI MOIyT 6bITb CTHMynaMH K JJeiICTBHK), H rpynna AeHCTBHH n0 âTIKOTOniO MO)KeT CTaTb ueHTpOM OpraHH3auHH COBMCCTHbIX OTBCTHbIX Mep. HapylueHHA o6nJecTSe11Horo nopAJJxa H nOKOA ABnAiOTCA npHMepaMH npecTynne11Hil, KOTOpble O6bILiHO CB313aHbI C anKOTOneM H BbI313IBaiOT TpesOry. MHOrHe H3 3THX HapynIeHHIi npOHCXOJJAT B nHTeiiHblX 3aseJJeHHAX H B03ne HHX. FeCIIOpAJJKH B ueHTpe ropoga LIaCTO CB5I3aHbI C anKOTOneM H CnytlaiOTCA B OCHOBHOM CpeJJH MOJIOJJbIX nK)JJeiI, KOTOpble npHHInH B 3TOT paiiOH B nOHCKe pa3BnetleHHI4 H BOCenbA. CTpyKTypa rUIaHHpOBKH HCKOTOpbIX ropOJjOS MO)KeT CIIOCO6CTBOBaTb (DOpMHpO- BaHHK) nOBeJ[eHHA. B nOCneJ);HHe TOJJbI B rU1aHHpOBaHHH ropOJlOB Ha6nIOJJaeTCA TeHJJeHuHA pâ3JJeneHHA pa3nHtIHbIX BHJJOB JJeATenb- HOCTH, pa3JtenAK)üJaA )KHnb1e KBapTanbl H Mara3HHbI, O4:1HCbI H 3OHbI pa3BnetieHHN. rOpOJjcKHe ueHTpbI CTaHOBATCA pai%IOHaMH 06Cny)Ki-i- BaHHA, KyJja nIOJjH npHXOJJAT JJHëM B Mara3HHbI HnH Ha pa6OTy, H 3Ta 06CTaHOBKa MO)KeT npOBOuHpOBaTb HapylneHHA BetlepOM, KOTJ[a ueHTp BCeMH nOKHHyT H 3JJeCb nOtTTH HeT O(pHuHanbHOTO KOHTpOnA (59). B BenHKO6pHTaHHH CIaKTbI CBHJjeTenbCTByIOT, tITO KOH(pnHKTbI 6onee BepOATHO BO3HHKaIOT B OnpeJ[enëxxbIX MeCTax, rJJe co6HpaeTCA 6onbnloe KOnHtieCTSO HeTpe3Bblx MonoJ[bIX n1oJJeil, TaKHX KaK Ka(te 6bICTpOii cJJbI, CTOAHKH TaKCH H aBTO6yCHb1e cTaHuHH. CKOOpJJHHHpOBâHHbIiI nOJJXOJj K ynpaBneHHIO cHTyauxeil B ropOJJCKOM ueHTpe, BKnlOtialOnjHil B Ce6A JJeiICTBHA nonHLJHH, TpaHCnOpTHbIX Cnyxc6 H JJenOBOrO C006üJeCTSa, MO)KeT ynytIlnHTb O6CTaHOBKy B ropOJje. YnpaBnAK)nJHIi rOpOJJCKHM ueHTpOM JJOJDKeH MO)KeT 6bITb KnIOt1eBOIi (l)HrypOii JJnA HHHuHaTHB B 3TOiï 06naCTH. nOnHTHKa CO3JJaHH51 B ropOJJe 6e3anKOronbHbIX 3011 MO)KeT Taicxce COKpaTHTb KOnHtieCTBO npeCTynneHHl%I H HapynleHHi%I nopAJJKa. B Tpëx LIIOTnaHJ(CKHX ropoJJax 6bina nposeJJe11a oue11Ka BnHAHHA 3anpenJeHHA nOTpe6neHHA anKOTOnA B 06nJeCTBeHHbIX MeCTâX B OnpeJJenëHHbIX 30HaX. B JJByX TaKHX 30HaX Ha6nIoJJanOCb 3HatiHTenbHOe COKpaIueHHe HapylneHHH O6üjeCTBCHHOrO nopAJ[Ka, XOTA B OJJHOi4 H3 HHX np06neMa, nOXO)Ke, nepeulna B JJpyrylo tiacTb ropoJJa. 3TH MepbI 6bInH IIIHpOKO noJJJJepxca11bl o6uJ0CTBOM, H, 97 BH,gHMO, OHH HaH6onee ycneluxo ZjeHCTByIOT B npemoTspaniexxH 6ecnopsljjxoB, cosepulaeMblx rpynnaMH Monojjblx nlojjeH, BbInHBaIOLLjHX B o6LLjeCTBeHHbIX McCTaX (56). CyIueCTByIOT jjpyrHe npHMepbI, KOr,IZa npHCyTCTBHe nOnHLjHH OKa3bIBanO npeBeHTHBHbIN 3clicl)eKT. HanpHMep, npHCyTCTBHe no HOLIaM nonHLjHM B 6apax H BO3ne HHX, OCO6eHHO BO "spew' 3aKpbITHSI, OKâ3âno 3Ha7-IHTenbHOe BJIHSIHHe Ha ypOBeHb npeCTÿnHOCTH B OAHOM 113 HaCeneHHbIX IIyHKTOB B AHrJIHH (60). 3anpeLLIeHHe anKOTOnSI Ha cllyT6OnbHbIX CTajjHOHâX H B03ne HHX COKpaTHJIO KOnHLIeCTBO CJIyLiaes XynHraHCTBa B HeKOTOpbIX ropOjjaX BenHKO6p14TaHHH. B Ta6nHLje 9 nepeiiHcneHbl Mepbl, npejjnpHHSlTble rpynnOH jjeliCTBHii no anKOronio B OjjHOM H3 ropO,gOB AHrnHH, LIT06bI nOnbITaTbCSi peLIIHTb npo6neMy HapyIIIeHHIi 06LIjeCTBeHHOTO nopSljLKa B LjeHTpe ropojja. nbAHCTBO B 061.1.4eCTBeHHbIX MeCTaX nbSIHCTBO B 061IjeCTBeHHbIX McCTaX LiaCTO BbI3bIBaeT TpeBOry. ÏLbSIHble MOryT 6bITb HenpHSITHbI H 3a,TZeBaTb npOXomKiiX, a, Ha 6onee LIenOBeLIHOM ypoBHe, OHM B OCHOBHOM 6e3jjoMHbI H 6poj1,50ICHHLIaIOT H Hy>ifjjaiOTCSI B MejjHLjHHCKOH H COL[HanbHOH nOMOIi[H. IHOrjja o3a60LieHHOCT6 o6LÿeCTBa BblpaxcaeTCS1 TOnbKO TOrjja, KOrjja KTO-nH60 C Cepbë3HbIMH anKOTOJIbHbIMH np06neMaMH yMHpaeT B McCTaX npejjBapHTenbHOrO 3aKnioLIeHHA nOCne apecTa. He06XOJ.jH- MO, LIT06bI ycnyrH no neLIeHMio H yxOjry 6bIJIH jjOCTynHbI ,IjJISI Taxxx nKljjeH, HymKHO pa3pa60TaTb OnpejjenëHHblli McXaHH3M, Lrr06bI nOMOiIb nOnHLjHH BbISIBnSITb TeX, KTO HaXOjjHTCSI B 30He pFiCKa, H OKa3bIBaTb HM COOTBeTCTByIOnjyIO nOMOLLjb. npOTOKOn jjonpoca H o6cnejjoBaHHe ociHljepaMM nonHLjMH BO BpeMSI apecTa MoI'yT noMOLIb ynyLILIIHTb BbIâBneHHe 3noynOTpe6neHHSI anKOrOneM. 3'rH MepbI TaKmKe jjOJLKCHbI CBeCTH K MHHHMyMy BepOSITHOCTb TOrO, LrrO nlOjjH, cTpajjaloLqxe OT CHnbHOrO a6cTxxeHTHoro cHHjjpOMa HJIH jjpyrHx CBSI3aHHbIX C aJIKOroneM (1)M3HLIeCKHX np06neM, OCTaHyrCSI He3aMe- LICHHbIMH B nOnHLjeIiCKMX yiaCTKâX. 98 Ta6nNl.1a 9. nyHKrbl ,geNCTBMN no COKpaLL{eHNIO CB5,13aHHbIX C anKOfoneM 06LL4eCTBeHHbIX 6eCn0p51,11KOB YCNneHNe nOnNTNKN no nML4eH3MpOBaHHbIM 3aBegeHMAM N 6onee aKTMBHaA pOnb B NH(OOpMMpOBaHNN Bna,genbL4eB nNL4eH3NN 06 MX 06513aHHOCTAX BCTpe4M Bna,genbL4eB nML4eH3MN M 411eH0B rpynnbl ,gf1A C0o6L11eHNA NM 06 MX pO11N B 3TOM npoeKTe CO,geNCTBMe B OpraHN3aL4NN Ho4HbIX aBTO6yCOB nepeMeLLIeHMe ,r401-1011HNTenbHbIX CTOAHOK TaKCN, Cn0006CTBylOLL4ee MX paCCpe,gOTO4eHNK) Pa3pa6oTKa cxeMbl Ha6nK),geH40 3a 6apaMN, cnoco6cTByK)LL4aA CBA314 Me)Kp,y non4L44eN N Bna,genbL4aMM nNL4eH3NN O6bABneHNe L{eHTpa fopO,ga 6e3anKoronbHON 30HO11 (r.e. 3anpeLL(eHNe norpe6neHNA B o6LL4ecTBeHHblx Mecrax) no,gp,ep)KKa co3,gaHNA 6e3anKOronbH0rO Ho4H0ro Kny6a Y4aCTNe B pa6ore npo6Horo npoeKra no npo6neMaM anKoronA (npOBO,gNTCA Ha HaL4NOHanbHOM ypOBHe) no KaMnaHMN 06u4eCTBeHHOrO npoCBeü(eHNA "Pa3yMHoe nOTpe6neHNe" Pa3pa6oTKa perNCTpaL44OHHOl1 CXeMbI ,gJ1A nepcOHana npMBpaTHNKOB n11L4eH3NpOBaHHbIX 3aBe,geHMN, 4TO6b1 npOKOHTpOnNpOBaT6, 4TO OHM MMeIOr HBBbIKM yperynNpOBaHMA npOBOKaL4NOHHbIX CMryawNN OpraH43aL4NA 06y4eHMf1 ,n,nA 6yAylyNX BnaAenbL4eB nNL;eH3NN N MeHep(epOB Mara3NHOB, npOrtaK)LL{Mx anKOrOnb Ha BbIHOC, 4epe3 MeCTHbIN TeXHN4eCK4 KOnne,g)K 44CCne,gOBaHNe nyTeN 6onbwero paCCpe,gOTO4eHNA T04eK 6bICTpON e,gbl CO,geNCTBNe yBenN4eHNK) KOnM4eCTBa pa6oTaIOLIvX TaKCN MHrerpaL4NA no,gXOgoB rOpO,gCKOfO COBera N OpraHOB, BbI,gaIOL1ANX nM1.4eH3NK) YCTaHOBneHNe CTaH,gapTOB nony4eHNA M aHHynNpOBaHNA nML4eH3N4 Ha TOprOBnK) anKOroneM PIcrovHHK : Purser, R.M., personal communication, 1993. ara (pOpMa HapyuleHlii3 661JIa ,IjeKpi3MIiHâJIid3IipoBaHa B HeKOTO- pblX cTpaHax, H CJIy)K6bI J.I;eTOKCIiKaulili H pea6HJIHTa1[IiH 3a6HpanH TaKIIX JliOjjer%I 1i3 npaBOOXpaHiiTeJlbHbIX OpraHOB. TaKiIX JIIOACFI MOryT He apeCTOBbIBaTb, iiaCTo HMH rtpOCTO npexe6peraloT. 3To MoxceT OKa3aTbC51 HeyAOBJIeTBOpiiTeJlbHbIM, TaK KaK 3a apeCTOM CneayiOT 99 xpaTxoe 3axJIIOtieHHe H OCB060)KJ[eHHe B To)Ke caMoe oxprKeHHe. OnaCHOCTH HeTpe3BOro COCTOSIHHH H 6e3AoMHOCTH OCO6eHHO CHJIbHbI B CeBepHOM KJIHMaTe, rite CHIIbHâSI j(JISI 6p0,IZ5Ir 06bI1IH0 npegCTaBJISIeT OnaCHOCTb rHnOTepMHA. ,11JISI HHX He06X0,111-1Ma 6e3011aCHâSI 06CTaHOBKa, rJ1;e OHM MOrJIH 6bI nonpasHTbcA H Bb16paTb MeHee OnaCHbli%I 06pa3 )KH3HH. I'pyrina p(eHCTBHIi 110 aJIKOTOJIIO MO)KeT pa6OTaTb C )Ki3JIHIuHbIMH OTAeJIâMH, COuHaJIbHbIMH CJIy)K6aMH, cJlyxc6aMH CKOpOi3 nOMOLuH H nOJIHuHH, C TCM TiTO6bI o6ecneLIHTb Co3,uaHHe a,rkeKBâTHbIX yCJIOBHI%I npo)KHBaHHA B 06L1e)KHTHH H/HJIH KBapTHpe, tITO6bI C110006CTBOBaTb pea6HJIHTauHH. ÎÎpOCBeTNTeJ16Hble I7pOrpaMMbl Hap)/WNT@17eH AJIKOrOJIb MO)KeT paCCMaTpHBaTbCA (1)aKTOpOM coseplueHHA nIHpOKOrO xpyra npaBoxapyHlexHii. CyLueCTByIOT OnpeJjeJIëHHble npOCBeTHTeJIbHble nporpaMMbl, KOTOpble HaL[eJIeHbI Ha nepesocnH- TaHHe HapyLIIHTeJIeii B HanpaBJIeHHH MeHee OnaCHOrO nOTpe6JIeHHA allKOrOJIA (61). OHH LIaCTO npOBOwiTCA COuHaJIbHbIMH cJly)x6aMH, OTJjeJIaMH Ha,u30pa 3a yCJIOBHO OCyAc,IjëHHbIMH HJIH OTZ[eJIaMH npocseLueHHA. MHOrxe 3aKJII0LIëxxble MOryT OHHCaTb CBOIO npOLÜJIyIO HCTOpHIO KpynHblX npo6JleM, CB313aHH13IX C nOTpe6JIeHHeM aIIKOrOJIA. nOJIe3H0 OpraHH3OBaTb npOBeJjeHHe B TlopbMaX pea6HJIHTauHOHHbIX npo- rpaMM, H oco6eHHo Ba)iCHO, TiTO6bI OHM CBA3bIBBJIHCb C aKTHBHOÎi pea6HJIHTauHeli nOCJIe OCB060)KAeHH31. MO)ICHO nOMOiib pa6OTHHKaM TIOpeM y*iaCTBOBaTb B 3THX npOCBeTHTeJIbHbIX nporpaMMaX ,gJIA 3aKJI101IëHHbIX H OnHpaTbCA Ha nOMOLub CyJ3e6HbIX HHCTaHuHii, yLIpe)KJjeHHM, 3aHHMaiOluHXCA JIeiieHHeM aJIKOrOJIH3Ma, H 06LueCTBCHHbIX rpynn, TaKHX KaK AHOHHMHble aJIKOrOJIHKH. 3A,qA4 N I'pynna AeHCTBHil no âJIKOrOJIK) MO)KeT IIy6JI14KOBaTb AaHHble H KOHTpOJIHpOBaTb paCnpOCTpaHOHHOCTb CB513aHHbIX C âJIKOrOJIeM npaBOHapyHIeHHH, TaKHX KaK BoxvIeHHe B HeTpe3BOM BH,Ike, nbAHCTBO, BaH,aaJIH3M H noTpe6JIeHHe BJIKOrOJIA JIK)JjbMH, He 100 AOCTHrüIHMH ,nonycTHMOro Bo3pacTa; a TaKnce cornacoB6lBaTb L[enH no Hx coxpainexHlo. Moxcxo npocnexcxsaTb npoqeHT oxBaTa o6yialounHMH xypcaMH pa6OTHHKOB CyAa, nOnHUHH, aJIK0r0nbH0I3 npOMbTIIIneHHOCTH H HHAyCTpHH AOCyra H H3MepSITb BnHSIHHe 3THX KypCOB Ha 3HaHHSI H noseAexxe. Mo>KHo TaK]Ke npocne)KHBaTb LlHCno npaBoxapyluHTeneii, npoIIIeAIIIHx xypcbl o6yLIeHHSI no BonpocaM anxoronSl H BnHSIHHe Aaxxoro o6ynexxx Ha coBeplueHHe npasoxapylueHHH B nocneAylomeM. 101 £0I axcxEl, Â.IOSad.L OI/Cmgo Ha111oleHl4£I4H `HOwalrgodu Isoiaxlrax `wK170IU wI4170110111 O1I-I09000 H`OIHHaIfaoEH KOZaKIfHE.LOiIadU 4Ir010xIlE NUM `01 `aaHaw aH NMI 'HOHO112H 1101aEl.00 KHHalrgad.LOU waxaod,C H L1IO£Edgo wxxE.L kx(Eilodu 4.LHhHIraâ Hwex.LI4uoU &xaw 4£KHD 'HH11Edoudox OH.LOI1IHHdua1,OO.I H ûHeillOx XI4HHalfaitad11O HOxHHHOIfxOII NIX I40XgOZHE `EHHU HxHHiI'£Edu `I41d011HOx H HIM111L004) `Kii.LKi3duod0 0I4H111141.d0U0 H 0I4Hdi(L41fX31 111170XH E110ID 'Klfod.l.HOx INENido( 111I411hHI1£Ed K310iE1r17011 a14dOZOx KHHeH0dH0HOU0 H I4111He.Ie110dU NId04) O.IOHw 10X111001TIX0 `01HE1fx0d Ho1HKdu X 013110Hlfouol7 g KO.LOIEmaduE£ OHhI490 `HIM! 410dio1A10 .LrCIOw 01a EILION `KwadH OH ATo£HHalra.L ou Ka1AiXdHIr0HEd1. HUH Ha17oIU xI4t7ouow Nut' KO1AIEil£oa al4do.Lox `I4IrliHda.LEiN 3xxal7xCOg xex `H.LooH4Ira.LKa17 HNIEI7HH HwxxE.L a 4I10.I0xIrE 41eHI4£11110 Ko.LaemaduE£ HUH `410oH4IfEX0x00 HIfH A11110 10eâ13hHlraHX ExHHUI4H 01h `HHHamxdaH.LiC KHH.LO,LÂOZO aHHEHOgad.L NUN 011)Ie1 `KIf010xIfE I4wEIfxad I4,LdE1lHE1.a a14HH2Iraiadu0 4100 HEd.LO aH1,OHHm4uOg g KHHaIfHE.LailadU 1lHH H KwadH `axHExcdaTloo Ko.LaXdHIrodl.HOx xH.IXdtl xH,IOHw OH MUM KwadH 01. H`HxcetiOdU XExhO.L H ox4Iro.L EHamad£Ed EwEifxad xH.ad17 H `.Ladue£ HI4HIrOU 1,aXH.LaamXo XHH £H 3I4do10310H g (Z9) K01.0EhHIf10 OH4Ira1.HhEH£ XilHE1ELlOdli H ÂwElrxad 41E110dHIfod.I.Ilox 11O10IE.LI411 I4Hed10 Hodo.LOx H `4H0ua1D EHdOua `axxaugadl,ou aamgo 1AIXdHUXwH1.0 HHO Hodo.LOx H `4110u010 `.axHI4d EH E.LxXTlOdu OJOIC 1111017 XI-IHhHIraH H Ex.LHUEH dOgI4H EH 41.1113IrH0U HHHauwad.La H 11101000 HOx1H11EH XI4114I101oxlfE I417He1EU0dU H I4wEIfxad 4Iran I3LIOJ o?I LIL' ettHemuodu H BwBuDIad S cyLL(ecTByeT MHeHHe, HTO Be3JI,eCyuxasl nponaraHj[a anKOTOnSI Co3RaëT KJIHMaT npHeMneMOOTH, KOTOpblii MO)KeT CKâ3bIBaTbC51 B Z[anbHeliLIIeM npH nOnbITKaX OrpaHHTIHTb ero nOTpe6neHHe. OfteM peKnaMbl H npaBHna eë perynHpyloLuxe 06bITIHO Onpe,aenSIIOT05I Ha HaI.jHOHanbHOM ypoBHe, MO)KeT BO3HHKHyTb LIyBCTBO, TITO McCTHble HHHL[HaTHBbI Mâno TITO MOryT CJ(enaTb B 3T011 0611aCTH. HMeiOTCSI naHHble, TITO 3T0 He TaK, nOTOMy TITO MHeHHe McCTHOTO HaCeneHHSI MO)KeT BnHSITb Ha HaLjHOHanbHyK) nonHTHKy H OKâ3bIBaTb 3HaTIHTenbHOe BnHSIHHe Ha TO, KaK oHa TOnKyeTCSI H npeJaCTaBnSIeTCSI Ha McCTHOM ypOBHe. 14306peTeHHe CnyTHHKOBOTo TeneBHJjeHHSI C,iZenanO pexnaMy anxoronSi McXCgyxapo,IZHOIï, H 3TH npOrpaMMbl, KaK MO)KeT n0Ka3aTbC5I, elIuë MeHbine nOJ1,L1aIOTCSi BnHSIHHIO MHBHHii Ha McCTaX. McCTHble HHHIjHaTHBbI MOryT, TeM He McHee, BnHSITb Ha HaL[HOHanbHylO H, OCO6eHH0, Ha McCTHyIO pexnaMy H nponaraHJZy anKOronSI. Fpynna ,qeHCTBHii no anxOrOnio MO)KeT OnpenenIITb nloReil c OCo6bIMH HHTepeCaMH B 06naCTH peKnaMbI H cnoHCHpOBaHHSI. Pa6OTHHKH CaHHTapHOrO npocaeLueHHSI O65I3aTenbHO BO%IJjyr B 3Ty rpynrry, HO pa6oTHHIfYI ccisep o6pa3oBaHHSI, ccisepbl ,ijocyra, 3JjpaBo- OXpaHeHH31 H 6e3onacxoCTH, Te, KTO 3aHHMaeTCH BonpocaMH cnopTa, ptocyra H OKpyxcalOLgeii CpeJjbI, TaKXCe ,IZOn)KHbI 6bITb BOBneTIeHbI B pa6oTy. KOHTPOl1b MO)KHO CcpOpMHpOBaTb rpynrIy 3HTy3HaCTOB, TITO6bI KOHTpO- nHpOBaTb cOnep)KaHHe, pacnoJIO)KeHHe H BpeMSI peKnaMbI H BbISIBnSITb TeX, KTO HapynlaeT HaLjHOHânbHble npaBHJIa H OrpaHHTIeHHSi. Baxcrl0, TIT06bI McCTHOe HaCeneHHe HMeno TIëTKOe npe,aCTaBneHHe O Tpe60BaHHSIX pyKOBOACTBa peKnaMbI H npOL(eCCa HX pa60TbI H O TOM, KaK MO)KHO nOJtaTb )Kano6y. HHTepeCHblii npHMep naxeTa MaTe- pHânOB PAS{ 1[eiïCTBH1 Ha McCTHOM ypOBHe, HanpaBneHHbIX Ha KOHTponb, a npH Heo6XOj[HMOCTH npOTeCT npOTHB peKnaMbl, 6bin noaroTOSneH uJIA ABCTpanHH Saunders & Shoebridge (63). K BOnpOcaM, KOTOpble MO)KHO KOHTpOnHpOBaTb, OTHOCSITCSI XapaKTep peKnaMbI: HanpHMep, He CBSI3bIBaeT nH OHa nOTpe6neHHe 104 anKOTOnA C OnaCHbIMH BHAaMH cnopTa, oco6exxo c nnaBaHHeM H Bo)KAeHHeM nOAKH, HRH C Bo]KAeHHeM HRH ynpaBneHHeM TexHHKOI%I; HeT nH TaM KOHKpeTHbIX yTBep)iC,rjeHHii, iiTO nOTpe6neHHe anKOI'OnSI yCHRHBaeT CeKCyanbHble HRH ynyinnaeT HaBbIKH o61ueHHA. Oco6oro BHHMaHHSI Tpe6yeT pelcrlaMa, HaueneHHâSI Ha noompeHHe BbInHBOK MOJIO,i[bIX RiOAeii. BpeMA TpaHCnSIuHH peKnaMbl TaK)ICe Bax( HO. HCKRIOLieHa 11H OHa 143 nepHOAOB caMOTO nOnynSlpHOrO BpeMeHH, KOrAa MOJIOAble MOTIF! BepOSITHO CJlyinaioT HRH CMOTpSIT nepeAaLIH? BbICTaBneHa RH OHa B oco6o 6pocaiOluHxcSI B rna3a MecTax, rAe co6HpaeTcSI Mono,r[bKb, TaKHX KaK B031Ie IIIKOn H MOROAUKiibIX KJIy6OB? HapyulaloTCA 11H npaBluia, onpeAensIIOII;HX TO, KaKHe HanHTKH MOryT peKnaMH- poBaTbcsl B CpeACTBax MaccoBOH HH(l)opMauHH HRH spew' noxa3a? MECTHASl PEKIIAMA rpynna AeiiCTBHii n0 anKOI'Onlo 6yAeT HMeTb 60nbnlHii AOCTyn K peKnaMe B MeCTHbIX CpeACTBaX MaCCOBOIï HHCpOpMauHH. B HeKO- TOpbIX McCTaX MyHHuHnanHTeT MOxCeT KOHTpOnHpOBaTb pacxneHBa- HHe peKnaMbl Ha Huffax 067551BReHHii H B ApyrHX McCTaX ropOAa H npOBepSITb, LITO6bI peKnaMa ânKOrOnx He pacnonaranacb B Heno- CpeACTBeHHOii 611H3OCTH IIIKOn H ApyrHX MeCT, rAe CO6HpaIOTCSI AeTH H MOROAë)Kb. PeKRaMy TaK)Ke LiaCTO nOKa3bIBaK)T B KHHOTeaTpaX, H BHOBb MeCTHaA rpynna AeiiCTBHii AOJDICHa npOKOHTpORHpOBaTb, LIT06bI AeTH He nOABepranHCb B03AeiiCTBH1O HeHaAne)ICaluer0 MaTepHana. McCTHble paAHO H Tene- CTaHuHH 6yAyT 6onee noAaTnHBbI MCCTHOMy BnHAHHIO, BepOATHO, MO)KHO 6yAeT A06H1E1CA TOTO, LTr06bI HX peKnaMa oTBeitana Tpe6oBaHHAM, npHCMneMbIM Arm McCTHOTO coo6luecTBa. rpynna AeiicTBHii AOn)ICHa npH3HaBaTb 3axoxxble HHTepeCbl TOprOBnH H pacnpOCTpaHeHHA H He BCTaBaTb B KpaiiHiolO no3HuHK) OTHOCHTenbHO anKOTOnA, KOTOpaA a6COnIOTHO He COOTBeT- CTByeT TOLIKe 3peHH2 6011bIII14HCTBa. B 6OnbnIHHCTBe COO6njecTB 3aAaLIa 6yAeT COCTOATb B AOCTH)ICCHHH 6anaHCa Me)KAy KOHTp011eM H nHueH3HpOBaHHeM. LITO KaCaeTCA AeTeii, uenb 061,I1IHO COCTOHT B TOM, LTT0613I nOMOLIb HM pa3BHTb yMeHHe peanbHO OueHHBaTb yTBep)KAeHHA peKnnaMbl. 105 IIPOIIAFAH,qA/CIIOHCVIPOBAHVIE CnOHCHpOBaHxe HCKyccTB HIM cnopTa anxoronbxOli HHAyCTpHeH CTanO 06bILIHbIM SIBneHHeM, MHOrHe OpraHH3aL(HH paCCLIHTbIBBIOT Ha Hero, LiT06bI npOAOn)ICaTb CBOIO AeSiTenbHOCTb. CyIL(eCTByeT, TM He McHee, IIIHpOKO pacnpOCTpaHeHHâSi 03a60LIeHHOCTb TeM, KaK H306pa)KaeTCSI anKOrOnb, HanpHMep, peKJiaMa nHBa Ha ctlyT60nKaX, KOTOpble HOCSIT AeTH. MecTHasl 03a60LIeHHOCTb MO)KCT BbIpâ)KaTbCH iiepe3 Fpynny J.jeiicTBHii no anKOronIO. He06X0,i(HMO pa315ICHSiTb, LITO LIâCTO CyLI(eCTByiOT ApyrHe HCTOLIHHKH CnOHCHpOBaHHSI, KOTOpble He CBSI3bIBaiOT CnOpT C nOTpe6neHHeM anKOronSt. B TO BpeMSI, KaK B OAHHX paiiOHaX 6yAeT peüleHO nOJIHOCTbIO OTKâ3aTbCSI OT TaKHX HCTOLIHHKOB CnOHCHpOBaHHSi, B Apyrxx noxcenaHHe 6yAeT COCTOSITb TOnbKO B KOHTpOne 3a TeM, *TTO6bI OHO He BBOAHJIO B 3a6JTy)ICAeHHe. BOnpOCbl TaKOrO pOAa, KOHeLIHO, MOryT 6bITb npeAMeTOM McCTHbIX Ae6aTOB. AJIKOCOnbHaSl npOMbIluneHHOCTb H HHAyCTpHSI AOCyra AaHHOiï McCTHOCTH LIâcTO HpOBO,gSIT AeSlTenbHOCTb, KOTOpaSI n06y)ICAaeT niO,qeii nHTb 6Onbuie anxOrOna HIM onpeAenëxxoro aJIKOCOnbHOro HanHTKa. HpHMepbl 3TOr0 BKniOLIaIOT B Ce6A 6ecrUIaTHble pa3Bne- LIexHSi, npeAJiaraeMbie cTyAeHTaM B Hx "HeAenio HosHtiKa", npeAno)icexxe nonpo6oBaTb C L(enbi0 pexnaMbi HosyiO npoAyKlmo B Marâ3HHaX H pecTopaHax, npeAJlo)KeHHSi nHTb "CTOnbKO, CKOnbKo 3aXOTHTe" 3a 4HKCHpOBaHHyK) rinaTy 3a Betiep. "CLiaCTnHBbiii LIaC" - npaKTHKa, KOTO npxulna H3 COeAHHëHHbIX LIITaTOB, H SIBnSIeTCSI nOnbITKOii BnaAenbL(eB nHIjeH3HH CTHMynHpOBaTb TOprOBniO. BCë 3T0 AOnDICHO CTaTb npeAMeTOM BHHMaHHSI rpynn AeHCTBHii, LrTO6bI OpraHH3oBaTb McCTHble Ae6aTbi n0 nOBOAy TOrO, WO SIBJISIeTCSI npHeMneMbIM, a jiTO HeT. CPE,qCTBA MACCOBOVI 14HcDOPMAI.AMI McCTHble CpeACTBa MaCCOBOii HHCl)OpMaL(HH HrpaiOT OLIeHb 3HaLIHTenbHyio pOnb B peKnaMe H OpraHH3aL(HH paCnpOCTpaHeHHSI, HO TaK)ICe OHH BHOCSIT OCHOBHO}i BKnaA B TO, KaK o6LL(eCTBO paCL(eHHBaeT nOTpe6neHHe aJIKOrOJISI. 3T0 BHAHO, HanpHMep, B TOM, KaK KOMMeH- THpyIOTCSI CB5I3aHHble C anKOrOneM HeCLiaCTHble CJIyLIaH; B TOM, KaK OnHCbIBaeTCSI nOBeAeHHe nbiOLL(HX, rAe BHHMaHHe LIaCTO KOHL(eHTpH- 106 pyeTCA TOnbKO Ha nOJIO)KliTenbHblX MOMeHTaX, HJIH OHO paCLteHHBaeT- CA, KaK 06bIiiHbl171 4")0H nOBCeAHeBHOii )KH3HH. HCCne,aOBaHHSI nOKa3a- nH, TITO ypOBeHb nOTpe6neHHSI, H3o6paACaeMbIii B TeJIeBH3HOHHbIX cepHanaX, HaMHOrO npeBbILLIaeT TOT, KOTOpbI13 peanbHO CynteCTByeT B 3TOM 06LIte0TBe. C0I03 C McCTHbIM pa,i[HO H TeneBHAeHHeM MO)KCT 6bITb OlieHb Ba.ACiibIM AnSI H3MeHeHH51 B3rnAAOB nx)Acx Ha nOTpe6neHHe anKOronSI H H306pa)KeHHA ânKOrOnbHbIX npo6neM. OLIeHb 110ne3HO HMeTb npeAcTaBHTendi cpe,acTB HHIDopMaqHH B Fpynne AeiicTBHil no aJlKOronIO H 3apyLIHTbCS1 HX noAAep)KKOIi B nosbllIIexHH o6lLjecTBeH- HOrO nOHIdMâHHA H HH4)0pMHp0BaHHOCT14. CpeACTBa Mâ000BOi4 HH- 41opMaLtHH SIBnAIOTCSi Bâ)KHbIM CpeACTBOM HH(I)OpMHpOBaHHA 06LLteCTBa O pâ3BHTHH Aen, BnHATenbHblM HHCTpyMeHTOM OnpeAeneHHA COLtHanbHOli nOnHTHKH B npeAenaX cOO6nteCTBa. 3(1)43,eKTHBHOCTb KâMnaHHii CpeACTB MaCCOBOii HH(tiOpMaLjHH nOCBAHteHHbIX Hpa3yMHOMy nOTpe6neHHIO" 6bIJI0 CJIO)KHO o6Hapy- )KHTb, 3a HCKJI1011eHHeM cnyLiaeB, xor,ita OHH KaCanHCb CneLtH(l)H- iIeCKHX BOnpOCOB, TaKHX KaK BO)IUteHHe B HeTpe3BOM BHAe. 3(1)431eKTHBHOCTb yBenH'-IHBaIOTCA, KOrAa KaMnaHHA cOeAHHAeTCA C AeiiCTBHAMH Ha McCTHOM ypoBHe, KOTOpaSi yCHnHBaeT C006IIjeHHA CpeACTB HH(tiOpMaL[HH. HaLtHOHânbHble HHHLtHaTHBbI TaKOrO pOAa BCerAa AOJllKHbI 06CyxcAaTbC51 3apaxee c I'pynnaMH AeHCTBHi4 Ha McCTaX, TaK IITO6bI nOAXOAbI MO)KHO 6bIJIO CKOOpAHHHpOBaTb. HanpHMep, noTpe6neHHe, O KOTOpOM COO6HtanH CaMH pecnOl-IAeiiTbI, nOAAanOCb BnHAHHIO KaMnaHHH CpeACTB HH(tiOpMaLtHH, nOCBSiüteHHOii H3MCHeHHio nHTer%[HbIX npHBbliieK TOnbKO TOrAa, KOrAa cOnpOBO)K- AanOCb HHAHBHAyanbHOii BblAaiieH JIHCTOBOK B AOIIOJIHeHHe K c006LItaeMOi4 HH(pOpMaLtHH. KaMnaHHH CpeACTB MaCCOBOi3 HH(tiOpMa- LtHH TaK)Ke 11One3HbI B npeAOCTaBneHHH HHIliOpMaLjHH AnA nO,tirtep)KKH McCTHbIX Ae6aTOB, HanpHMep, o HaCaX pa60TbI, o6 06LLteCTBeHHOM nopSlAKe HnH pâ3yMHbIX ypoBHAX noTpe6neHHA. Casswell et al. (64) noxa3anH, iITO TaM, me npOBOAHnHCb McCTHble KaMnaHHH CpeACTB MaCCOBOii HH(l)OpMaLjHH, OHH nOMOrnH BbI3BaTb nOAAep)KKy nonHTHKe KOHTpOnA HaA anKOrOneM npOTHBOCTOSIIIteii TeHAeHLtHAM nH6epanH3aLtHH, a TaM, rAe HX He 6bUIO, 3THM TeHAeHqHAM He 6bin0 OKâ3aHO COnpOTHBneHHe. 107 9AJ1K0ronb V1 HecyacTHbde cnyyam H01-pe6neHHe aJIxoronx 06bItiHO BHOCHT CBOII BKJIaZj B B03HHKHOBeHHe HeCtiaCTHbIX cnytlaes, BbI3bIBa51 OnbAHeHNe, tITO BnIiSIeT Ha Cy>x,rkeHHA, KOOp,IjI3HaI(iiK) H pyre AsxraTenbxbMe HaBbIKH. CynjeCTByeT TaioICe pHCK BO3HHKHOBeHH5I HeCtiaCTHbIX cnytiaes Bo spew{ nepHo,ga "noxMenbSl", xorAa tienoBex nnoxo ce6si qyscTByeT H pearxpyeT Mej[neHHO. gnHTenbxoe nOTpe6neHHe anKOTOnSi MO>KeT TaK]Ke BpeAHTb ItlyHKIjHOHHpOBaHHIO CO3HaHH51 H BHOCHTb CBOii BKna,a B TO, iiTO 3TOT tienOBeK CTaHeT nOnBepiCeH HeCtiaCTHbIM cnytiaSIM. rJ1Y614HA I1PO611EMbI HanHiiHe anxoronSl B opraxH3Me tienOBeKa, C KOTOpbIM npoH3olllën HeCIiaCTHbIH Cnytiai3, eunë He AOKa3bIBaeT npHtiHHHylo CB5I3b. TeM He McHee, KOHTpOnbHble HCCne,TIOBâHHSI nOKa3anH, tITO BepOSITHOCTb BO3HHKHOBeHHSi HeCtiaCTHbIX cnrIaeB, HanpHMep, y BO,IIHTenei%I H nellIeXO,IZOB 3HatIHTenbHO yBenHtIHBaeTCSI C nOBbIIIIe- HHeM nOTpe6neHHSI anKOTOnSI. Y cpeAHerO BO,IIHTenSI nOBbIHIaeTCSI BepOSITHOCTb BO3HHKHOBeHHSI HectiaCTHOro cnytiaSl npH ypOBHe 50 Mr ânKOTOnSI Ha 100 Mn KpOBH. HpH ypOBHe 60Mr/100Mn BepOSITHOCTb BO3HHKHOBeHHSI HOCtiaCTHbIX CnytiaeB yBenHtiHBaeTCSI B,IZBOe, a npH 8OMr/100Mn - BtieTBepO. HpH6nH3HTenbHO tieTBepTb AOpO)KHbIX aBapHH CO CMepTenbHbIM HCXOAOM cnytlaeTCSi C TeMH, y KOrO ypOBCHb anKOTOnSI B KpOBH COCTaBnSICT 60nee 8OMr/1OOMn. COMHHTenbHO, tiTO CYII(eCTByeT rpaHHlja, HmKe KOTOpOti pHCK npH BOnleHHH He 109 OIT HINEdaINHdU H310I1511HH `HHd.LOXI7HH HOH,LdOLIOHEd.L H OHH39000 `31031N I0h09Ed EH Huo.IOxIrE 3HH101Xoxdu H 311x31193d.LOU 3HmoI,CdH11X.I3d `EIfHflEdu H `3t7HH INOH£ad.LaH H HHH317xc0H HoaHmolEOEx `I4HOxE£ 'INO.Ldouo xHH.LHI-IE£ Hdu H a.1,09Ed EH `IN3HHat7xcoH tl3d3u H110.IOxIfE HHHa119ad.LOU H.LOOHHEHOxOHd HHH3HOH4.90 EH H041,HhO.L -ottad000 EHxclrott H4HOdot7£ olHHalruadxX ou 4.LooH411a.LHajY d)I Vl.11lVLlIeIcDOd lJ '(89) 11IHEhÂIfO IVI4H.LOEh03H 11I11IXdt1 H wHHH3t7EU x H.LOaHHdU Ox,I311 13xcO1%1 aiN£HHE,Ido INoxuXdx H I4.LHaiNExHt7aIN aH.IXdt7 00i1fU 4110,I0xICE 3HHE13hO0 H `4110.I0x11E ,LHOOHadaü 3xCiCX HilOIIf 31411Hxcoll 'VW H HHHat7EU 331109 HIM OH17O 101EHHxc3d31.1 3H1dE10 H 131 çy a.LOEd£oH H Ha170111 X30H 413d.L EHt7o oH411a.LH£H119Hdu HHxE.I.Hdgoxxuag g 'HO.LaBxOiCI1X 010Eh Hat7olu xI411Hxcou xoHd 'XExI4HEH XI4H4113,LE.IHHt1 XI4HH2.L3d9OHdU O.Lh Ox41101 H H H110.IOxIfE HHH31199d.LO1.1 H H E1I4LI0 I1IOx.LE10O113H 0 Âx0Hd x 3HH311IN3d.1O 3930 H .LOIE13h00 HHO 01h X1%I01.011 `HaEhXIf0 XI411.L0Eh0aH IN3110.IOxIfE O XI4HHE£HHO OIHHaHOHxHH£OH x I4INHH£HiC OHH39000 11110111 3I4170110V\I 'INHEd.L XI4HHH1d01I0 %b H H XHHH0110X XHHIIIEINOiI H INHEd.L %ZZ H Edo.LxEcto O,IOxxaH.LOamXO as.LOahEx H HEHOdHd.LOH.IadE£ 11149 4110.I0xIfE (Zy) 141111EE10173110313 IVOxO£kEIHEd(I) OH '(99) I4d3IN 3I4H1IH.u-IaH3du o91111-aHxEx H103HH 09H11 `4.LOOHH3HEd.LOOd1IOEd XH 4.LEH0dH0xHCITE£ 09H11 01.11.1311 0 INHHH1O11311 iNI4H£04d3O INH,IOHIN3H x 4mHIr .L217aH O.LE 'HO.LOadHOxHIp OXOIfU HHO O.LOEh H`aI4HxCa9£H3H H aI4Hh1490 NUN 3XI41710 EH H EIN0û H110,IOx1[E 01-IHH OLI aHHIxHH£OH `HEhiC110 3I4H,LOEhO3H ,L3EHHH3tI0Ed O.LOEh OH.LOam9O 'HHHat7EU H aHH3IfUO,Lrt `aHHa11HEd.LO a0H4110.I0x11E HO1O1H11HH (10317£ Hi1IEdO,LxEII) HI1II4H4110113hEH£ `ExOHd 0.109000 aHO£ H HO1.15170XEH 1311 XHH17ad0 I4HHhxCÂIN H I4HHhxCÂIN aI4t10110w '(S9) HHHa17EU a.LE.L411X£3d H Ha.LdalNO %£t H H (Lau OE-oz a.LOEd£oH a xHInHEt7Ed.Loou %0S) INOt7oxOH INI4H411aLdaiNO OO 311.0E1 EH H3EhXIf0 XI4H.L0EhO3H %SZ H`HOdExCOLI XI4HUE£aHH %0t H`3i09Ed EH HaEhiCIfO XI4H.1.0h0aH %S T H `H3EhiCIfO XI4H.LOEhO3H XHHUIEIA1017 113413d.1 HOHtIO H HEH0H1OH317E£ 4110.IOxLfv 'H0131SHaI1I np0(iHnaKTnKH, He06XOAHMO KOHTpOJIHpOBaTb HHCtiopMHposaH- HOCTb H BbIHOnHSïeMOCTb. OuEHKA PerynâpxbIH KOHTponb HecLIacTHbIX cnriaes Ha pa6oTieM MecTe H Ha AOpOraX SIBnsIeTCSt CpeACTBOM OueHKH BnHSiHHSi pâ3nHLIHBIX MeTOAOB npo(i)HnaKTHKH. O630p HeCTiaCTHbIX cnyT;aeB B 0,T-10ü KOMnaHHH nOKa3an, 'iT0 20% BCeX 3aperHCTpHpOBaHHbIX HeCLiacTHbIX CnyLIaeB 6bInH CBSI3aHbI C anKOrOneM, a spew{ BO3HHKHOBOHHSI FIX Ha pa6oqeM MecTe rpynnHposanocb BOKpyr BpeMeHH npxëMa nHIuH H Co6bITHIi, rAe BepoSITHO noTpe6nexxe anxoronst. TPABMATVI4ECKOE OT,qEJ1EHVIE VI OT,gEJ1EHVIE HEOTJ1O)KHOVI IIOMOütVi TpaBMaTH'iecxoe oT,geneHHe H oTneneHHe HeoTno)Kiioii noMOHjH SIBnSIiOTCSi BâxCHbIM McCTOM BbISIBneHHSI CBSI3aHHbIX C anKOroneM HeC'iaCTHbIX CJIy'iaeB H TpaBM. Bce B3pOCnble H MOJIOAble nIOAH, nocTynaiOHjHe B TpaBMaTHTlecxoe OT,aeneHHe nocne HeC'IaCTHOTO cJIy'iaSI AOJDKHbI OnpaIIIHBaTbCSi, He 6bIJI0 nH BO3HHKHOBeHHe 3TOTO CJIy'iaSI CBSI3aHO C anKOTOneM. ECnH B HanHLIHH eCTb He06XOAHMOe o6opyAoBaH0e, He06XOAHMO nposecTH HCCneAOBaHHe AbIXaHHSI Ha npxcyTCTBHe anKOTOnsi. AIM BbISIBneHHSI oco6o OnaCHOTO noTpe6neHHSI none3eH "TpasMaTwIecKHH BonpocxxK" (Ta6nHua 10). gBa HJIH 60nbnle n03HTHBHbIX OTBeTa paCueHHBaIOTCSI KaK nOJIO- )KHTenbHbIi4 pe3ynbTaT TeCTa. IlyBCTBHTenbHOCTb TeCTa n0 00060 OnaCHOMy nOTpe6neHHIo COCTaBnSIeT 66%, a cneuxciIHtnHOCTb 80% (67). IlepCOHan MO)KiiO 06y'iHTb BbIS(BnxTb CB5I3aHHble C anKOTOneM np06neMbl H ,IjaBaTb ncpBH'iHbiii COBeT TeM, y KOrO anKOTOnb 6bIn 3Ha'iHTenbHbIM (1)aKTOpOM BO3HHKHOBeHH5I HX HeC'iaCTHOTO CJIy'iasI. JT1HXOpaAOLlHbiii XapaKTep AeSITenbHOCTH 6OnbIIIHHCTBa TpaBMa- TH''eCKHX OTAeneHHi-I MO)KeT nOMeIHaTb npOBOAHTb KOHCynbTaHHH BO BpeMSi npe6blBâHHSI TaM, HO He06XOAHMO HaiiTH BO3MO)KHOCTb onpeAenHTb npiicyTCTBHe anxoronSi. 3TO AOJDICHO BHOCneACTBHH 111 o6cyXCjjaTbcx c naIZHeIIToM HnH nauHeHTy Hy)KHO ,aaTb xapTozixy, npHrnauiaiollrylo ero HnH eë o6paTHTbcsi 3a nOMOILjbiO Ha 6onee 1103JIHeI3 CTaJjHH. B OTLICTâXX, KOTOpble BbICbinaIOTCSi ceMei%IHOMy Bpairy H ,gpyroMy McAHuHHCxoMy nepcoxany, JlOJDICHO noALIëpKHBaTbcsl npxcyTCTBHe anKOrOnSl, H, ecnH BO3M0)ICHO, AOn)KeH 6bITb 06o3Ha4eH ypOBeHb anKOronsl B bIXaHHH BO BpeMSI nOCTynneHHSi B TpaBMaTHIieCKOe oTJjeneHHe. K 3TOMy MO)KI-IO BepHyTbCSI, KOr,IZa nauHeHT 6yAeT nocen(aTb Cny)IC6bI nepBHLIHOH MeJ(HKO-CaHHTapHOii nOMOUjH Ha 6onee n03AHei%I CTaJjHH. Ta6nit.la 10. TpâBMâTN4eCKNN BOfIpOCHNK nauxeHTy xeo6xo,uHMo 3ariaTb cneAyioulHe Bonpocbl. cnyvanxcb nn y Bac KaKHe-51146O nepenOM61 KOCfH HMI BbIBHxH cycTaaoB? nOny4anH 3114 BbI TpaBMbl B JIOpO)KHbIX aBapHaX? 6bI1114 11H y Bac TpaBMbl rOnoB6I? nOny4âMH 3114 Bbl TpaBM6i B pe3ynbTaTe Han$.ueHHN HRH ApaKH? nOny4anH RH BbI TpaBMb1 nocne BbInHBKH? Ilcmokxux: Alcohol and accidents (65) tIPOrPAMMA CTOKTOl1bMCKOr0 OKPYrA B CTOKrOnbMe 6bina CnenaHa 11011blTKa COKpaTHTb 3a60neBaeMOCTb H CMepTHOCTb B pe3ynbTaTe CBSI3aHHbIX C anKOroneM HeCLiaCTHbIX cnyLIaeB Llepe3 yLlpexc,i[eHHe OT,IZena npOdoHnaKTHKH HeCtIâCTHbIX cny4aeB. 3Jjecb 6bIJIo H3ÿtieHO BnHSIHHe anKOrOnsi Ha B03HHKHOBeHHe pa3HbIX HeCLIaCTHbIX CnytlaeB H npOBeneHa pa6oTa C CeTbio ytipeHCJjeHHii no pa3pa6oTKe nporpaMMbI J(eriCTBHIi no KOHKpeTHbIM BonpOCaM 6e30naCHOCTH, TaKHM KaK nOpO)KHOe JjBH)KeHHe, pa6oTa, CnOpT, AeTH H nOnpOCTKH, nO)KHJIble nK)JjH, HaCHnHe, KaTaCTpo(tibI H BenOCHnenHble nineMbl. amen 3nHaeMHOJIOrHH TpaBM BBOJjHT CHCTeMy Han3opa 3a TpaBMaMH BO BCei%I cTpaHe, C06HpaSI naHHbie no BCeM TpaBMaM, rRe 6bina OKa3aHa McJjHIjHHCKaSI nOMOnjb, BO BCëM cm-Tope 3,4paBOOXpaHeHHSI. OHH BKJIIOLIaiOT B ce6si OL(eHKy, BHëc nH aJIKOrOnb CBOii BKJIa,a B BO3HHKHOBeHHe 3TOI3 TpaBMbl. 112 1111AH .jEV1CTBV1V1 Fpynna AeHCTBHI%I n0 anxorOnlO MOxKeT nOBbICi3Tb noxi3MaHI3e o6LI[eCTBOM TOTO, HaCKOnbKO anKOTOnb BHOCHT CBOH BKnâA B B03Hi3KHOBeHHe HectiaCTHbIX cnyzlaeB H noxcapoB. IIoArpynna, CCDOpMi3pOBaHHaSI JjJISi pa60TbI n0 3TOMy BOnpOCy, 6yReT BKnIOLiaTb B Ce6si npejZcTasHTeneii nOnHLji3id, TpaBMaTOnorHTiecKHX cny)K6 H Cny)K6 HeOTJIO]KHOii nOMOLLw, pa6oTHHKOB yKpeLLIIeHHSI 3,aOpOBb51, pa6oTHI-SKOB IiIKOn H yLIe6HbIX MOJIOAe)KHbIX 3aBe,i(eHIiH, aBTOM06Hnb- Hble OpraHi33aÿHIi, pa6oTHHxos npOTiiBOIIOmKapHOi3 6e3onacHocTH, nepCOHan 3j[paBOOXpaHeHHSI H 6e30naCHOCTIi, OpraHH3aTOpOS Aocyra H O6IIjeCTBCHHble rpynnbI, 3aHHTepeCOBaHHble B yCHneHHH Z[OpO)iCHOI3 6e30naCHOCTH ii npOCiIHJIaKTi3Ke HOCLIaCTHbIX CJIytiaes. OHH MOryT Co6iipaTb MCCTHyIO i3HIFlOpMaui3io, roTOBi3Tb COOTBeTCTByfOI.Iwe AaHHble H npCJjCTaBnSITb HX pyKOBOAHTenSIM cOO6LLjeCTSa. OHH MOryT TaloICe paTbaCHi3Tb npOCpeCCHOHanbHblM rpynnaM He06X0,2113MOCTb o6ytieHHSI n0 BOnpOCaM aJIKOTOnSi H HCCLIaCTHbIX cny*mes, H CrIOCO6CTBOBaTb BBe,iZeHIiIO npOrpaMM paHHerO BbISIBneHHSi H HanpaBneHHOii nOMOLIjH TeM, KTO nOTpe6nSleT anKOTOJIb B oco6o OnaCHbIX KOnFrieCTBaX. 113 10 3aKnFoyeHNe OAHa uenb rUIaxa jjeiiCTBHii no npo6neMaM anxOrOnSi Ha MCCTHOM yposxe COCTOHT B HanpasneHI3H o6luecTBa K SICHOMy nOHHMaHIiiO npHpoAbl anKoronSi, OnaCHOCTeii H npeHMyLuecTB, C HHM CB5I3aHHbIX. nJIaH AOnXCeH, no KpaiiHeri Mepe, npOBepSiTb, LITO niO,TZH 06na,LkaioT HâAëxCHOii HH(loOpMauHeri, Ha 6a3e KOTOpO)i OHH MOryT npHHHMaTb pelneHHSi OTHOCHTCnbHO HX 3AOp0BbSI H o6pa3a )KI13HH. 3AeCb TaK)ICe He06XOAHMO npOKOHTpOnHpOBâTb, iITO6bI MyHHuH- nânbHble OTAenbI 6bIJIH XOpOLLIO HH4)OpMHpOBaHbI H COTpyAHiiLIanH B CO3,aaHiiH eAIiHOTO nnaHa, HaueneHHOro Ha CBCAeHHe K MHHi3MyMy BpeAHbIX nOCneACTBHri nOTpe6neHHSt ânKOrOnSI OTAenbHOrO LlenoBeKa, CeMbH H OKpy)KeHHSI. PeanbHOli LjenbK) AOnDKHbI 6bITb roCyAapCTBeHHâSI nonHTHKa, opxeHTHpoBaxxax Ha 321OpoBbe H Cn0C06CTByIOLuee 3TOMy oKpy)ICeHHe. AJIKOrOnb BTOpraeTCSi nOLITH B Ka)KAbIIi aCneKT )KH3HH ropoAa, H B npe.ubIAyluHX rnaBaX paCCMaTpH- BanHCb HeKOTOpble 06naCTH, r,ge MO)KHO npe,gnpHHSITb 1103HTidBHble AeIiCTBHSi. HauH0HanbHble H MyHHuHnanbHble rLIIaHbI Aon)ICHbI 6bITb TCCHO B3aHMOCBSI3aHbI. OLIeBiiAHO, LITO n0ne3H0, ecnH ACiïCTBHSi Ha MyHHuH- nanbHOM ypOBHe 6yAyT COOTBeTCTBOBaTb HauHOHanbHOii cTpaTerHH. COTpyAHHLIeCTBo TaKOro pua CnyxcHT ycHneHHIO uenerl nnaxa AeiiCTBHii no npo6neMaM anKOronSl, n03BOnSIeT 3KOHOMHTb CpeACTBa H OIITHManbHO HCIIOnb30BaTb pecypcbi H HaBbIKH. HpCHMynjeCTBa aKueHTa Ha MCCTHble AaHHble Ha (DOHe HauHOHânbHblX TeHAeHuHN ywe ynoMi3HanHCb HecxonbxO pa3 B npeAblAyLuHX rnasax. IlnaH AericTBHii He 6yAeT ycneIIIHbIM, ecnH OH 6y,i[eT paCueHHBaTbCSI, KaK LITO-TO npHBHTOe K )KH3HH o6lljecTSa HAM BHeApSieMOe csepxy HaLiânbCTBOM H CneuHanHCTaMH. 1TT06bI 6bITb 114 yCneLIIHbIM nnaH, j(OmKeH 6bITb "C06CTBeHHOCTbK)" HaCeneHHA 3TOIi MeCTHOCTH H 3aTeM HHTerpHpOBâTbCA B npogecc nnaxxposaHHA MyHHLjHnanHTeTa. TaKxce eMy He06XO,AHMa no,tlAepxcxa COOTBeTCT- BeHHbIM (1)HHaHCHpOBaHHeM, HCCneAOBaHHSIMH H 06yLIeHi3eM TeX, Ha zIbeI%I pa6oTe 6yj[eT CKâ3bIBaTbCSI BBOAHMaSI nonHTHKa. IIoAxoA "csepxy BHH3" peAKO OKâ3bIBaeTCSi ycneLUHbIM, H MOx(eT ;twice oCTasHTb y npencTasHTeneli MecTHOro HaceneHHSI OLLjyLLjeHi3e, LITO OHH elAë MeHbLIIe CTanH KOHTpOni3pOBaTb CBOë OKpyx(eHlie, LieM AO TOTO (69). OLAEHKA He06X0AHMOCTb OniHCbIBâTb H KOHTpOni3pOBaTb Ha6nK)AaeMble i33MeHeHi3SI nOALiëpKHBanaCb BO BCeX MâTepHanaX 3T0T0 6yKneTa. tlacTo ynOMi3HanOCb OnpeAeneHHe 3aAaLI H OL[eHKa pe3ynbTaTOB. geATenbHOCTb rpynnbI AeHCTBHi3 n0 anKOrOnK), KOHCynbTaTHBHOI'O Co6paHII5I H HHAHBHAyanbHbIX npOeKTOB AOnx(Ha TII;aTenbHo Oni3CbIBaTbC5I B (pOpMe AHeBHHKa, TaK LITO6bI npouecc 6b1n nOHSITeH H 3a(pHKCHpOBaH. TaKHM o6pa30M, oAHa rpynna CMOx(eT yLIHTbCSI Ha OnblTe JpyrOli. CnoxfHO COLIeTaTb JjeiiCTBHSI TaKOro pOAa C OLeHOLIHbIMH HCCneJZOBaHHSiMH. l'1CCneAOBâTenb, KOTOpbIiï yLIaCTByeT B Aei-1CTBHAX, npi-IO6peTëT JjeHCTBHTenbHOe nO3HTHBHOe nOHHMaHHe nponecca H 6yAeT npHHAT C006L(jeCTBOM, HO HaKâ3aHHeM 3a 3Ty CTeneHb yLIaCTHSi LIaCTO 6yAeT HeCIIOCO6HOCTb OCTaBaTbCSI 06.beKTHBHbIM Ha6nloAa- TeneM. 14CCneAOBaHHe pe3ynbTaTOB AeilCTBHi3 o6bILIHO npOHCXOAHT B aTMOC(pepe, "HaCbIIIjeHHOH" 3KOHOMHLIeCKHMH H COLjiianbHbIMH BnHAHHSIMH nOBCeAHeBHOH xCH3HH, a TaKxCe CHnbHbIM nOnHTHLIeCKHM BnHAHHeM. IIOA 3THM AaBneHHeM, HeyAHBHTenbHO, LITO nHIIIb HeMHOrHe HCCneAOBâTenbCKHe npOeKTbI 3(13(beKTHBHO H3yLIanH BnHAHHe MHOrOKOMnOHeHTHbIX HHHHHaTHB Ha McCTHOM ypOBHe (70). Hai46onee 3(i(beKTHBHb1e nOKâ3aTenH 6binH npOAeMOHCTpHpOBaHbI B o6naCTH npo4)14naKTHKH CepAeLlHo-CocyAHCTbix 3a6onesaHHrt, H nHLIIb B He60nbLÜOM KOnHLieCTBe npoeKTOS 6binH nOKa3aHb1 CKpOMHble AOCTHxCeHHA B o6naCTH anKOTOnA H HapKOTHKOB (71, 72). OAHH H3 KOMnOHeHTOB EBponeHCKOrO nnaHa AeHCTSHK n0 60pb6e C nOTpe6neHHeM BnKOTOJIA COCTOHT B OLjeHKe BnIiAHHSI 115 MHOrOCTOpOHHeIi CTpaTerHH AeHCTBH1i Ha MBCTHOM yposHe no nOTpe6neHHK) aJIKOrOnSI B J1aXTH, B (1)HHJIMHAHH (3). OueHKa pe3ynbTaTOB H AeMOHCTpauHM H3MeHeHHi7I BO BpeMCHH SIBnSIeTCSI OAHHM H3 aCneKTOB HCCne,£jOBaH1351 AeIiCTBI3ii. OueHKa npouecca H CHCTeMbI KOHTpOnSI - ,gpyrHM. r10ne3H0, ecnH Fpynna AeHCTBHI%I no anKOrOn10 Bcerga 6yZjeT onpeAenâTb 3a,lÿaLIH AJISI Ka>KaOrO 3aAâHHM, npOBOAxTb OCHOBHble MeponpHSITHM, ri;e 6bI 3T0 HH 6b1n0 BO3MO)KliO, H 3aTeM ttHKCHpOBaTb H3MeHeHH5I BO BpeMeHH. KOHTponb TaKOrO pOAa OLIeHb BaxceH H He 3a6HpaeT MHOrO BpeMeHH HnII CpeACTB. Ba>KHO, iiTO6bI TIIjaTenbHaM OLjeHKa 3THX npOrpaMM npoAon- xKâJIaCb TaK, LITO6bI MbI MOrnH onpeAenHTb, KaKHe KOMIIOHCHTbI MBnMiOTCM 341(1JeKTHBHbIMH, a 'calme OKa3bIBaIOT nHIIIb He6onbuloe BnHMHHe. PACIIVICAHIVIE 1-Max AeHcTBHH no npo6neMaM anxoronsl 6yAeT xaH6onee 3(lI(tieKTHBHbIM, ecnH 3aAaHHM 6yAyT pacnonoxceHbl B peanbxoH BpeMeHHOI3 IIIKane, COCTOSiIIje1 H3 cepHH LL1aroB, H 3aAa1IH 6yAyT BbI1IO11HMTbC51 no XOAy. Heo6XOAHMO, LIT06bI npOBOAHJICM 0630p CTpaTerHFi, no KpaNHeli Mepe, exceroAHo, H I'pynna AexcTBHx no anKOrOn10 Aenana AoKJIaA o npoABllxceHHH B HanpasnexxH AOCTH)KeHHM OCHOBHbIX nOKa3aTenel4, HaMeLIeHHbIX B nnaHe AeiiCTBHIi Ha 3T0 BpeMM. 1-1OA06Hble 0630pbI CnymKaT TaK)iCe, LIT06bI nOAAep]KaTb ny6nHLiHbII4 xapazrrep nnaxa, nOAHMTb BO3HHKIIIHe BOnpOCbI H OTMeTHTb AOCTH)KeHHM H HeAOCTaTKH. CTpaTerHM Tpe6yeT pelynMpHbIX yCHnHii H BHHMaHHM, ecnH BbI XOTHTe, LTT06bI oHa OCyLLjeCTBnMnaCb yCnenlHO B TeLIeHHe HOCKOnbKHX neT. MOxcHO OnpeAenHTb npHopHTeTbI H IUIaH HX BbIIIOJIHOHHM BO BpeMeHH. CETb COTPY,gHV14ECTBA Co3AaHHe rlJiaHOB AeIicTBH1i no npo6neMaM anxoronM B ropoJ.jax npHBeAëT K BO3HHKHOBCHHiO CeTH OCHOBHbIX pa6OTHHKOB H rpynn, 116 KOTOpble 3aTeM MOryT AenHTbCSi 3HaHHSIMH C ApyrHMH rpynnaMH eAHHOMbIILineHHHKOB H COO61ueCTBaMH. 110ne3H0, ecnH McCTHble COTpyAHHKH KOHCynbTaTHBHOI'O co6paHH2 H rpynnbl AexCTBHH yCTaHOBSIT CB5I3H C ApyrHMH rpynnaMH 3TOrO perHoxa. FnaroAapa 3TOMy OHH CMOryT AenHTbCSi MâTepHanaMH, OnbITOM HCCneAOBaHHI%I H CpaKTaMH 06 34)(1)eKTHBHOCTH H yCneIIIHOCTH CTpaTeril ii. byAeT nOne3H0, eCnH HauHOHanbHOe npaBHTenbCTBO CMO)KeT nOOLupHTb nOA06HOe pa3BHTHe npouecca H Cn0006CTBOBaTb nepeAaTle OnblTa nyTëM OpraHH3auHH KOHI13epeHuHii H 06yTieHHSI. KOM6V1HV1POBAHHbIE IlO,4XO,gbI B 3TOI%I rly6nHKaLjHH BHHMaHHe 6bIJI0 COCpeAOTOileHo HCKJIIOtIHTenbHO Ha nOAXOAaX, cOKpaLuaiOIuHX HaHOCHMbIii aJIKOrOneM yLuep6. IIoTpe6neHHe anxorOJlSi slBnxeTCSI COCTaBHOi3 4aCTbiO 06LueCTBeHHOki )K143H14 H OTAbIXa MHOrHX niOAeH. HeKOTopble MOryT n0AyMäTb, TITO OTAeneHHe 3TOrO oco6oro acneKTa nOBeAeHHSI OT ApyrHX SIBnSICTCSi HCKyCCTBeHHbIM. B EBpOneiiCKOM Malle AeiiCTBHÎd no 6opb6e c noTpe6neHHeM anKOronSi SICHO cKa3aHo, TITO BHHMaHHe (boKyCHpyeTCSI Ha anKOrOne H3-3a ero nOTeHuHana HaHOCHTb yluep6 3A0pOBbIO H o6iueCTBeHHbIM B3aHMOOTHOIUeHHSIM. 11pH3HaHO, TITO 06yTieHHe H Mepbi n0 nOBOAy anKOTOnSI MOryT 6bITb B3aHMOCBSI3aHbI C 60nee 061uei1 nporpaMMOH yxpenneHHSi 3A0p0Bb5I H CO3AaHHSI 3A0p0B0r0 OKpy)KeHHSI. OnaCHOCTb KypeHHSI SIBnSIeTCSI 061uenpH3HaHHOIi, H McAHuHHCKHe BnaCTH n0 BCeiï EBpone BbICTynaIOT 3a npeKpaLueHHe xypeHHSi. KpynHyio 03a6oT{eHHOCTb BbI3bIBaIOT np06neMbl, B03HHKaIOIuHe B CB3I3H C nOTpe6neHHeM ApyrHX HapKOTHTIeCKHX BeII.jecTB, B TIaCTHOCTH HenerânbHblX HapKOTHKOB, XOTSI OHH HMeIOT 3HaTIHTenbHO MeHbIIIHe MaCLÜTa6bI, TIeM Te, KOTOpble CB5i3aHbI C nOTpe6neHHeM aJIKOTOnSi. HOnHTHKa 3AOpOBOrO nHTaHHSi H noolupeHHSi (13H3HTIeCKOH aKTHBHOCTH SIBnSIIOTCSI CneAyiOLLjHMH npHMepaMH HHHuHaTHB no yKpenJIeHHIO 3A0p0Bb5I. OnTHManbHbluâ BapHaHT pa3pa6oTKH IUIaHOB n0 BCeM 3THM BHAaM nOBeAeHHSI eluë HeSiCeH. BaxcHO, TeM He McHee, y6eAHTbCSI, TITO BOCnpHSITHe anKOTOnSi, KaK HapKOTHKa He CTHpaeTCSi B pe3ynbTaTe npHSneTIeHHSI BHHMaHHSi K noTpe6nexHlo HeneranbHblX HapKOTHKOB, HnH TiTO KaMnaHHH 3anpeLueHHSi KypeHHSi He OTBneKaIOT BHHMaHHSI OT ropa3Ao 6onee CKpOMHbIX pexoMeHAauHii OTHOCHTenbHO anKOrOnSi. B HeKOTOpbIX MOCTâX anKOronbHâSt 117 nOnHTHKa MO)KeT 6bITb coejjHHeHa C nOnHTHKOIi no ApyrHM HapKOTHLIeCKHM BeII[ecTBaM, H KOHeLIHO, 6yAeT HMeTb CB5I3b C npOBeAeHHeM AeSITeJIbHOCTH 110 npo(i)HJIaKTHKe KypeHHSI H Apyroii pa6oToii no yxpenneHHlo 3AOpOBbSI. CynjeCTByeT MHOI'O BO3MO)KFiOCTeIi HRH COTpyAHHLIOCTBa 3THX 3aHHTepeCOBaHHbIX rpynn B COBMeCTHbIX npOeKTâX H AJISi HX yLIë6bI Apyr y Apyra. BecbMa xcenaTenbHa Taxxce CBSI3b C genSiMH ABH)KeHHSI "3AopoBble ropoAa". MyHHLjHnanbHbIIi naafi AeiiCTBHiï n0 npO6JIeMaM ânKOrOJISI SIBJISieTCSI OAHOiï H3 HCCKOnbKHX HHHLjHâTHB, coAepxcaujHXCA B EBponeiiCKOM rUlaHe AeiiCTBHIi no 6opb6e C nOTpe6JIeHHeM anKOrOJISI. OLIeBHAHa ero CB5I3b C nOnHTHKOIi, 3aHHMaiOUjeI4CSt yBenHiieHHeM BO3MO)KHOCTeii nepBHLIHOH McAHKO-CaHHTapHOii nOMOUjH B BbISIBJIeHHH H npHHSITHH OTBeTHbrX Mep n0 CB5I3aHHbIM C anKOrOneM np06neMaM (3). KOMnOHeHTbI, CnOCO6CTByioujHe Me]KAynapoAxoMy H eBpOneiiCKOMy cOTpyAHHLIecTBy AOnXCHbI TaK)Ke B3aHM0AeIiCTBO- BaTb C MyHHLjHnânbHblMH nnaHaMH. B HAeane, Bee KOMIIOHeHTbi AOn)KI-IbI KOM6HHHpOBaTbC11, LTT06bI CTaTb eAHHbIM esponeHcKHM ABH)KCHHeM BeAyujHM K 60nee npOCBenjëHHOMy nOAXOAy K nOTpe6neHHio anKOrOnSI. 118 Jl VlTEPATYPA 1. Health for all targets. The health policy for Europe. Copenhagen, WHO Regional Office for Europe, 1993 (European Health for All Series, No. 4). 2. European Alcohol Action Plan. Copenhagen, WHO Regional Office for Europe, 1993 (document EUR/ICP /ADA 035). 3. Community and municipal action on alcohol. Report on a WHO working group. Copenhagen, WHO Regional Office for Europe, 1993 (document EUR/ICP /ADA 039). 4. Ottawa Charter for Health Promotion. Health promotion, 1(4): iii -v (1986). 5. TSOUROS, A., ED. Healthy Cities project: a project becomes a movement. Milan, SOGESS, 1992. 6. ROBINSON, D. & TETHER, P. Preventing alcohol problems: local prevention activity and the compilation of "guides to local action ". Geneva, World Health Organization, 1990. 7. KREITMAN, N. Alcohol consumption and the preventive paradox. British journal of addiction, 81: 353 (1986). 8. EDWARDS, G. ET AL. Alcohol policy and the public good. Oxford, Oxford University Press, 1994. 9. THORSEN, T. & PEDERSEN, D.S. Alcohol profile of the City of Copenhagen. Copenhagen, Copenhagen Health Services, 1994. 10. GRANT, M., ED. Alcohol policies. Copenhagen, WHO Regional Office for Europe, 1985 (WHO Regional Publications, European Series, No.18). 11. WEST, R. & GOSSOP, M., ED. Comparing drugs of dependence. Addiction, 89: 1355 -1569 (1994). 12. COHEN, D. The symbolic construction of community. London, Tavistock, 1985. 13. HUNT, G. The middle class revisited: eating and drinking in an English village. Western folklore, 50: 401-419 (1991). 14. GEFOU -MADIANOU, D. Alcohol, gender and culture. London, Routledge, 1992. 15. THEODOROU, Z. Alcohol and the invisible communities. London, Harringay Advisory Group on Alcohol, 1993. 16. GRANT, M. & HODGSON, R. Responding to alcohol -related prob- lems in the community. Geneva, World Health Organization, 1991. 17. WHO Expert Committee on Drug Dependence. Twenty- eighth report. Geneva, World Health Organization, 1993 (WHO Techni- cal Report Series, No. 836). 18. CUNNINGHAM, J.C. ET AL. Use of questionnaire in general prac- tice to increase recognition of patients with excessive alcohol consumption. British medical journal, 291: 412 -413 (1985). 19. BUCHAN, I.C. ET AL. Problem drinkers and their problems. Jour- nal of the Royal College of General Practitioners, 31: 151 -153 (1981). 20. WALLACE, P. ET AL. Randomised controlled trial of general practitioners' intervention in patients with excessive alcohol con- sumption. British medical journal, 297: 663 -668 (1988). 21. BABOR, T.F. & GRANT, M. Project on identification and man- agement of alcohol- related problems. Report on Phase II. Geneva, World Health Organization, 1992 (document WHO/PSA/91.5). 22. BIEN, T.H. ET AL. Brief intervention for alcohol problems. Addic- tion, 88: 315 -336 (1993). 23. WALLACE, P.G. ET AL. Are general practitioners doing enough to promote healthy lifestyles? British medical journal, 294: 940 -942 (1987). 24. CHICK, J. Brief interventions for alcohol misuse. British medical journal, 307: 1374 (1993). 25. The role of general practice setting in the prevention and man- agement of the harm done by alcohol use. Copenhagen, WHO Regional Office for Europe, 1992 (document EUR/ICP /ADA 038). 26. MAYFIELD, D. ET AL. The CAGE questionnaire: validation of a new alcoholism screening instrument. American journal of psy- chiatry, 131: 1121 -1123 (1974). 27. SELZER, M.L. The Michigan alcoholism screening test. American journal of psychiatry, 127: 1653 -1658 (1971). 28. FEURELEIN, W. ET AL. Diagnosis of alcoholism: the Munich alco- holism test. Currents in alcoholism, 3: 137 -147 (1980). 29. BABOR, T.F. ET AL. The alcohol use disorders identification test: guidelines for use in primary health care. Geneva, World Health Organization, 1989 (document WHO/PSA/92.4). 30. LE Go, P.M. Le Düpistage prücoce et systematique du buveur. Riom Laboratories, 1976. 31. STIBLER, H. Carbohydrate deficient transferrin in serum: a new marker of potentially harmful alcohol consumption. Clinical chemistry, 37: 2029 -2037 (1991). 32. ANDERSON, P. Management of drinking problems, Copenhagen, WHO Regional Office for Europe, 1990 (WHO Regional Publi- cations, European Series, No. 32). 33. GASK, L. & THOMSON, D. DRAMS scheme. Skills for the general practitioner. Edinburgh, Scottish Health Education Group, 1990. 34. Cut down on drinking pack. London, Health Education Authority, 1991. 35. CHICK, J. ET AL. Counselling problem drinkers in medical wards: a controlled study. British medical journal, 290: 965 -967 (1983). 36. STOCKWELL, T. The Exeter home detoxification project. In: Stockwell, T. & Clements, S., ed. Helping the problem drinker. London, Croom Helm, 1987. 37. FOSSEY, E. Growing up with alcohol. London, Routledge, 1994. 38. PLANT, M.A. & PLANT, M.L. Risk takers. Alcohol, drugs, sex and youth. London, Routledge, 1992. 39. MOSKOWITZ, J. The primary prevention of alcohol problems; a critical review of the research literature. Journal of studies on alcohol, 50: 54-88 (1989). 40. PERRY C. ET AL. WHO collaborative study on alcohol education and young people. International journal of addiction, 24: 1145- 1171 (1989). 41. HANSEN, W.B. School based substance abuse prevention: a re- view of the state of the art in curriculum 1980 -1990. Health education research, 7: 404-430 (1992). 42. Major improvements in unit awareness after Drinkwise Day. Lon- don, Health Education Authority, 1992. 43. BEAUCHAMP, D.E. Alcohol and tobacco as public health chal- lenges in a democracy. British journal of addiction, 85: 252 -254 (1990). 44. MORAWSKI, J. ET AL. Economic costs of alcohol abuse in the negative social consequences of alcohol use. Oslo, Norwegian Ministry of Health and Social Affairs, 1991. 45. HORE, B.D & PLANT, M.A., ED. Alcohol problems in employment. London, Croom Helm, 1980. 46. Health promotion in the workplace: alcohol and drug abuse. Geneva, World Health Organization, 1993 (WHO Technical Report Series, No. 833). 47. National survey of worksite health promotion activities. Silver Spring, MD, Office of Disease Prevention and Health Promotion, 1987. 48. PLAGGENBORG, J. & THRAN, M. Shauplatz arbeitswelt: Sucht - prAvention ist Moderne Sozialpolitik. Partner magazin, 1: 6-15 (1992). 49. BRUUN, K. ET AL. Alcohol control policies in a public health per- spective. Helsinki, Finnish Foundation for Alcohol Studies, 1975. 50. GODFREY, C. Licensing and the demand for alcohol. Applied eco- nomics, 20: 1341 -1558 (1988). 51. Conflict and violence in pubs - design considerations. Oxford, M.C.M. Research Ltd, 1992. 52. SHEPHERD, J.P. ET AL. Glass abuse and urban licensed premises. Journal of the Royal Society of Medicine, 83: 176 -177 (1990). 53. SINGLE, E. & TOCHER, B. Legislating responsible alcohol service. British journal of addiction, 87: 1433 -1444 (1992). 54. WHITEHEAD, P. ET AL. Collision behaviour of young drivers: im- pact of change in the age of majority. Journal of studies on alco- hol, 36: 1208 -1223 (1975). 55. SALTZ, R.F. The introduction of DRAM shop legislation in the United States and the advent of server training. Addiction, 88(Suppl.): 95 -103 (1993). 56. RUIz, E. Prohibiting the consumption of alcohol in designated areas. Edinburgh, Scottish Office, 1993. 57. ROSS, H.L. Confronting drunk driving. New Haven, Yale Uni- versity Press, 1992. 58. HOWELL, R. The impact of random breath tests in New South Wales. Medical journal of Australia, 1: 616 -621 (1983). 59. HOPE, T. Implementing crime prevention measures. London, H.M. Stationery Office, 1985. 60. JEFFS, B. & SAUNDERS, W. Minimising alcohol related offences by enforcement of existing legislation. British journal of addic- tion, 78: 67 -77 (1983). 61. BALDWIN, S. Alcohol education and offenders. London, Batsford Academic, 1990. 62. PARTANEN, J. & MONTONEN, M. Alcohol and the mass media. Copenhagen, WHO Regional Office for Europe, 1988 (EURO Reports and Studies, No. 108). 63. SAUNDERS, W. & SHOEBRIDGE, A. Combating alcohol promo- tions. Perth, Curtin University, 1992. 64. CASSWELL, S. ET AL. Changes in public support for alcohol poli- cies: a community based campaign. British journal of addiction, 84: 515 -522 (1989). 65. Alcohol and accidents. London, British Medical Association, 1989. 66. HONKANEN, R. Alcohol in home and leisure injuries. Addiction, 88: 939 -944 (1993). 67. Haut comitii d'etude et d'information sur l'alcoolisme. Alcool et accidents. Paris, La Documentation fran3aise, 1985. 68. DUNNE, F.J. Misuse of alcohol or drugs by elderly people. British medical journal, 308: 608 -609 (1994). 69. HUNT, S. Building alliances - professional and political issues in community participation. Health promotion international, 5: 179- 185 (1990). 70. GIESBRECHT, N. ET AL., ED. Research, action, and the community. Rockville, MD, Office of Substance Abuse Prevention, 1990 (DHHS Publication 89.1651). 71. CASSWELL, S. & GILMORE, L. An evaluated community action project on alcohol. Journal of studies on alcohol, 50: 339 -346 (1989). 72. WALLACE, L. & BARROWS, D.C. Evaluating primary prevention: the California "winners" alcohol programme. International jour- nal of community health education, 3: 307 -336 (1983). EBPOiINCION 111IAH AENCTBNN I10 60Pb6E C 110TPE6lIEHI+IEM AIIKOOnA EBpOna RBAReTCR KpynHblM npOH3BOAHTeAeM H nOTpe6HTeAeM aAKOTOAR, H CB313aHHble C aAKOTOAeM np06AeMbI OK93bIB3.IOT 60AbIII0e BAHRHHe Ha 34OpoBbe, GOHHaAbHOe 6AarOCOCTORHHe H 9KOHOMHKy. IeCMOTpH Ha 9TH 3aTpaTbl, MHOTHe npOAOA)KaIOT CiIHTaTb, iITO CBR33HHble C aAKOTOAeM np06AeMbI - 9TO BonpOC Me,4HÿHHbI HAH Aaxce iIHCTO nCHXHaTpHH. IZpOrpaMMbl Ha McCTHOM ypOBHe H MCCTHble ,4eI3CTBI3R scex pa3HOBH4HOCTeii RBARK)TCR oAHHM 1,13 Ba?I(HbIX nyTeYÎ nOAAep)KKH 6oAee 3,4OpOBOTO o6pa3a ?KH31111, a TaK)Ke 06ecneileHHR 06njecTBeHHOï H nOAHTIVIeCKOÎ3 nOAAep)KKH H3MeHeHHÎI B npOAaxce H noTpe6AeHHH aAKOTOAR. IIOMHMO pa3B14THR MeCTHOH nOAHTHKH, AeHCTBHR Ha MeCTHOM ypoBHe MOryT OKa3bIBaTb MOIICHOe BAHRHHe Ha HanHOHâAbHyK) H Aaace Ha Me?K,zryHapO,QHyK) nOAHTHKy. Ka)KAbii3 HaCeAeHHbIIi nyHKT o6AaAaeT noTeHL{HâAOM AmR npO4HAaKTH*ieCKHX AeicTBHIÎ. AOMa, nIKOAbI, pa6oeIHe MeCTa H Me4HLjHHCKHe yiipexcAeHYIR 40A?KHbI npC,4OCT3aARTb yCAOBHR, CnOCO6CTByK)nwe 3,4opoBOMy nose,QexHIO, yAyiIIIIaTb COL[HâAbHyIO nO,a,Qep)KKy H yKpenARTb OTHOIHeHHR, BeAyIIwe K CHH?KeHHK) noTpe6AeHHR aAKOTOAR. 9T0 pyKOBOACTBO RBAReTCR IjeAHKOM npaKTHiIHbIM H COAep)KHT nOAXO,w, KOTOpbIC MOryT 6bITb aAanTHpOBaHbI K pa3AHTIHbIM yCAOBHRM. ÜHH MOryT CAy?KHTb O6pa3HOM, Ha OCHOBe KOTOpOTO MONCHO pa3pa6aTbIBaTb McTO,RbI H HaKanAHSaTb OMIT, ynHKaAbHble AAR p(aHHoro coo6rClecT]äa. OHO pa3pa60Tad-IO C HeAbIO CTHMyAHpOBaTb HHTepeC Ha MeCTax H CnoCo6CTBOBaTb C034âHHK) AeTaAbHOTO 'mana AeIicTBHiÎ Ha MeCTHOM ypoBHe. TOT 6yKAeT COCTaBARIOT rmasbl, rite paccMaTpHsaiOTCR pa3AHHHble o6AacTH ?KH31114 COO6n{eCTBa, rAe eCTb XOpOIIIHe nepcneKTHBbI pa3pa6oTKH 9lxpeKTHBHOI3 aHTHaAKOTOAbHOkI nOAHTHKH. ISBN 92 890 4327 X llIBeiu. p.23.-
Organisation mondiale de la santé (OMS) · Publications
Действия по проблемам алкоголя на местном и муниципальном уровне
Voir le document original
Le texte intégral est hébergé par l’organisation qui le publie. lawenc.com indexe les métadonnées et renvoie vers la source officielle.
Texte intégral
Informations clés
Organisation
Organisation mondiale de la santé (OMS)
Type de document
Publications
Source
Organisation mondiale de la santé