Theme: the complex assesment of individual health of children and adolescents icon

Theme: the complex assesment of individual health of children and adolescents




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1. /Module1. General questions of Hygiene and Ecology/Lectures/Children and adolescent hygiene.rtf
2. /Module1. General questions of Hygiene and Ecology/Lectures/Health and Environment.rtf
3. /Module1. General questions of Hygiene and Ecology/Lectures/Introduction to hygine.rtf
4. /Module1. General questions of Hygiene and Ecology/Lectures/Nutrition and health. Bolonian..rtf
5. /Module1. General questions of Hygiene and Ecology/Lectures/Occupation and health Bolonian.rtf
6. /Module1. General questions of Hygiene and Ecology/Lectures/Water and health.rtf
7. /Module1. General questions of Hygiene and Ecology/Practical studies/Compl. infl. of microclimate/Complex microclimate assessment. doc.doc
8. /Module1. General questions of Hygiene and Ecology/Practical studies/Compl. infl. of microclimate/Topic 08.doc
9. /Module1. General questions of Hygiene and Ecology/Practical studies/Dust and chemic.admix/Dust. doc.doc
10. /Module1. General questions of Hygiene and Ecology/Practical studies/Dust and chemic.admix/The methods of air sampling.doc
11. /Module1. General questions of Hygiene and Ecology/Practical studies/Dust and chemic.admix/Topic 12.doc
12. /Module1. General questions of Hygiene and Ecology/Practical studies/Food poisoning/Food pois.doc
13. /Module1. General questions of Hygiene and Ecology/Practical studies/Hygiene of children/mannual 1.doc
14. /Module1. General questions of Hygiene and Ecology/Practical studies/Hygiene of children/mannual 2.doc
15. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/Hygienic estimate of insolation regimen.doc
16. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/Natur. ill. doc.doc
17. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/SOLAR RADIATION AND ITS HYGIENIC IMPORTANCE.doc
18. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/Topic 04.doc
19. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/Topic 05.doc
20. /Module1. General questions of Hygiene and Ecology/Practical studies/Illumination/illuminatiom artif. doc.doc
21. /Module1. General questions of Hygiene and Ecology/Practical studies/Menu apportion ass/Menu-raskl. doc.doc
22. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/Air movement. doc.doc
23. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/Determination of atmospheric pressure.doc
24. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/RESEARCH OF THE FACTOR OF INFRA-RED RADIATION.doc
25. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/Topic 06.doc
26. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/Topic 07.doc
27. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/Topic 11.doc
28. /Module1. General questions of Hygiene and Ecology/Practical studies/Microclimate ass/temperature. doc.doc
29. /Module1. General questions of Hygiene and Ecology/Practical studies/Nois ass/noise and vibration.rtf
30. /Module1. General questions of Hygiene and Ecology/Practical studies/Soil.ass/Topic 18.doc
31. /Module1. General questions of Hygiene and Ecology/Practical studies/Water ass/Mannual 1.doc
32. /Module1. General questions of Hygiene and Ecology/Practical studies/Water ass/Mannual 2.doc
33. /Module1. General questions of Hygiene and Ecology/Practical studies/Work hardness/hardness and intencity 2.rtf
34. /Module1. General questions of Hygiene and Ecology/Practical studies/ultraviolate/manual.rtf
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Theme: THE COMPLEX ASSESMENT OF INDIVIDUAL

HEALTH OF CHILDREN AND ADOLESCENTS


Topicality of the theme

Development and strengthening of the health of children and adolescents is one of the major problem of the present comprehensive school. This problem is solved by parents, teaches, public health workers and also by the local authorities.

The complex assesment of individual and collective health of children and adolescents is the main criterion of the sanitation efficacy in case of children and adolescents. Children having the functional or morphological deviations should undergo for a mandatory medical follow up and sanitation. The individual assessment lead to the results and interpretation of the sanitarium statistics, reflecting the health level of children‘s collective, which will become subject of students their departments quit. Taking into account the inadequate environment in Ukraine, the health level of the population is considered to be one of the major criterion of the efficacy of the environment preservation measures.

The purpose (general): to know how to determine a health group of schoolstudents for the substantiation of individual preventive measures.

Specific goals

TO KNOW HOW:

  1. To justify the selection of the complex of parameters reflecting the health level of schoolstudents .

  2. To determine the harmonicity of physical development of the schoolstudents according to the regression scales.

  3. To evaluate schoolstudent’s biological age.

  4. To interpret results schoolstudent’s medical examination for determining her/his health group.

  5. To assess children’s “ school maturity ”.

For detailed information concerning knowledge- skills formation see the following literature:
ACADEMIC CONTENT

On mastering required knowledge start to study the following literature :


Basically:

  1. Даценко І.І., Габович Р.Д. Профілактична медицина. Загальна гігієна з основами екології: Навчальний посібник.- К: Здоров’я. - 1999.- С. 568-578, 603-.607.

  2. Даценко І.І., Денисюк О.Б., Долошицька С.А. та інші. Загальна гігієна: Посібник для практичних занять. – Львів: Світ. - 2001.- С. 221-241.

  3. Лекция по теме.

  4. Граф логической структуры темы (Приложение 1).

  5. Методические указания по теме с приложениями.



Supplementary:

  1. Габович Р. Д., Познанский С.С., Шахбазян Г.Х. Гигиена: Учебник. – Киев: Вища школа. – 1983. – С. 243-252.

  2. Гигиена детей и подростков / Под ред. Кардашенко В.Н.: Учебник. – М.: Медицина. – 1988. – С. 41-115.

  3. Пивоваров Ю.П., Гоева О.Э., Величко А.А. Руководство к лабораторным занятиям по гигиене. – М.: Медицина. - 1983. – С. 186-198.

  4. Сердюковская Г.Н., Сухарев А.Г. Гигиена детей и подростков. Руководство для санитарных врачей. – М.: Медицина, 1986. – С. 60-95.

  5. Гурова А.Н., Горлова О.Е. Практикум по общей гигиене. – М.: Ун-т дружбы народов, 1991. – С. 116-128.

  6. Філімонов В. І. Нормальна фізіологія. - Запоріжжя.-1995. - С. 36-37, 336-340.

  7. Нормальна фізіологія / Під ред. Філімонова В. І.: Підручник. - Київ: Здоров’я, 1994. - С. 566-586.

  8. Емчик Л., Кміт Я. Медична біофізика – Львів; 1998.-С.167-177.

  9. Морозов Ю.В. Основы высшей математики и статистики: Учебник-М.: Медицина.- С. 104-128.

  10. Ремизов А.Н. Медицинская и биологическая физика: Учебник.- М.: Высшая школа, 1999.-С.17-49.

  11. Анатомия человека / Под. ред. Сапина М.Р. М.: Медицина, 1996. Т.1: С.18-21.

  12. Свірідов О.І. Анатомія людини: Підручник.- Київ: Вища школа. 2000.- С.19-30.



Theoretical questions underlining the implementation of purpose full activities:

  1. Health of schoolstudents as a socio - biological category.

  2. The factors influencing on the level of health of children and adolescents (positive and negative).

  3. The criteria for distribution of school students into health groups .

  4. The notion of physical development. Criteria of determining harmonic physical development of school students according to regression scales.

  5. The notion of the biological age. Criteria for determining. Hygienic importance.

  6. The notion of “ school maturity ”. Criteria for determining. Hygienic importance.

  7. The methods used to determine school students health group of the Applied value. Fitness group.


Oriented bases for activities

After mastering the above problems acquaint yourself with algorithms which will allow you to muster professional skills in a more successful ( suppl. 2, 3).

To check knowledge of the given material do the following tasks.

Teaching type tasks:


The task 1.

Most accurate characteristic of the schoolstudents ‘ health level is:

  1. Harmonicity of physical development.

  2. Biological age.

  3. The presence or absence of chronic diseases.

  4. Immunological resistance.

  5. Chronological age.


The task 2.

On physical examination at school of a body weight is measured by:

  1. Back muscles dynamometer .

  2. Foot-stand weights.

  3. The medical balance.

  4. The dynamometer.

  5. Counter balance.


The task 3.

A girl 12 years of age has + 0,6 σR height, mass of a body is+ 1,5 σR at the expense of an adipopexis, a thoracic circumference is + 1,3 σR. Determine a harmonicity of her physical development as:

  1. Harmonic.

  2. Disharmonious.

  3. Sharply disharmonious.

  4. Nonharmonic.

  5. Unproportional.


The task 4.

The biological age of the child outruns chronological for 10 months. Which is the correct variant of assessing his biological age:

1.Outruns chronological.

2.Does not correspond chronological.

3.Corresponds chronological.

4.Within the limits of the age norm.

5.Exuberant.


The task 5.

The in-depth medical examination of a child determined in: harmonic physical development, his biological age corresponds to chronological one, chronic diseases absent, during the year 5 respiratory diseases. Determine the health group as:

  1. First.

  2. Second.

  3. Third.

  4. Fourth.

  5. Fifth.

The task 6

The medical examination of the child 6 age determined in the tonsil hypertrophy grade III. Ready go to the school since :

1. 6 year

2. 7 years

3. 8 years

4. Doesn’t ready go to the school.

5. He is needed by hospitalized

Keys:

1 - 3; 2 - 3.


Concise methodical recommendations for a lesson


Each student is given situation of task containing minimal information about the schoolstudents general health according to results of in-depth medical examination. On the bases of algorithmic steps the student master professional skills relating to the objectives of the lesson they learn to form doctor conclusion.

In according with the first algorithmic step the harmonicity of schoolstudents physical development by regression scales (Suppl. 2) begins with the general body inspection determination of acsessive adipopexis or pronounce muscular mass..

The second step of envisages the measurement of anthropometric endices by the method of health ministry (HM). It is advisable to do all this measurement in the morning.. Since during the day the height and body mass can fluctuate significantly.

The third step requires some elementary calculation determining the difference between the endices measured and the standard ones. In this case the child ‘s height is compared with average height of children according to the age-sex group, while their bogy weight and thoracic circumference is determined by the line of the regression scales table corresponding to the given height. In calculating the difference a great attention should be paid to the sign: minus below – the standard plus the standard.

The fourth step –the resulted difference is divided by σR ( usualy in the tables regression scales it is the last figure in columns ). Depending on the sign and values of the figure obtained the level of the antropometrical sign development may be low (<-2 σR), below the average (from-1 σR to-2 σR), average (in the limits ± 1 σR), above the average (from +1 σR up to +2 σR), high (> 2 σR).

The fifth step of the algorithm is the analyses of the date obtained the combination of which allows as to enter a schoolstudent into one of the three groups of the harmonicity of physical development (see criteria in the algorithms).

Practical classes this algorithm is used to asses the physical development mail adolescents aged 17 years (Suppl. 6) .

Suppl. 3 gives the algorithm of determining the group of the schoolstudents’ health.

The first step is a complex medical examination including anthropometric, laboratory, instrumental studies and doctor’s conclusion.

The second step envisages the assesment of the biologic age which can correspond to or been ahead of the chronological one or lagging behind of it by more the one year. In this case this lagging behind belongs to the third while been head to the second health group.

The third step consist of assesment of schoolstudents harmonicity of physical development using an individual algorithm ( see Suppl. 2).

The fourth step is determining the presence or absence of functional deviations or chronic diseases in the child. If during a year schoolstudent falls ill for and more for time with acute diseases he shown be included to the group frequently and durablu sick (DLS). It been considered a sign of decreased body resistance (functional deviation)

The fifth step should establish the level disease compensation for the children with diagnosed chronic diseases or pathological conditions (E.G. posttraumatic syndrom) . For this purpose one should use special methodical recommendations HM of Ukraine .

In the last, the sixth step of algorithm, a doctor should make a decision about entering of the given child into one of the 5 health ( the criteria result from the analyses of functional bonds of the given algorithm and Suppl. 7).


Technological chart of the practical lesson





Stages

Time (min).

Teaching aids used at classes , location and characteristic of classes

A site of negotiations and character of occupation


1.

Checking and correction base line level

15

Tests, graph of logical of structure


Classroom.

Of the dpt

2.

Independence-work

Doing situational models to asses professional problems of physical development and determining health group.


225

Tables


3.

Analysis and correction of conclusions


15







4.

Final test control and determining the assessment of classes outcome.

15









Sup. 1

Graph of logical structure of the theme

“The complex assessment of individual health of children and adolescents”


Vocational guidance

Fitness groups

“School maturity”

Improving from a health point of view

Observation

Applied value

Health ‘ groups

The harmonicity of physical development

Biological age

Body resistance

Functional state’s indeces

Presence or absence chronic diseases

The harmonicity of physical development

Health criteria

The factor influencing on the level of health of children and adolescents

The level of treatment and preventive aid

Genetic factors

The quality of the environment

Life style

Social conditions

Health of the human being


Sup. 2

ALGORITHM

Of the determining physical development’s group on regression scales

Sharp disharmonic physical development

Disharmonic physical development

Harmonic physical development

Any height. The weight and the thoracys circumference are low r or high caused by acsessive adipopexis


Any height. The weight and the thoracys circumference are under or above the average caused by acsessive adipopexis


Analysis of the combinations

High

> 2 бR

Above the average

От + 1 бR до +2бR

Average

± 1 бR

Under the average

От - 1 бR до -2 бR

Low

< 2 бR

Determining the level of the antropometrical sign development

calculation determining the difference between the endices measured and the standard ones

the measurement of anthropometric endices

general body inspection determination of acsessive adipopexis or pronounce mascular mass


Any height. The weight and the thoracys circumference are average, above the average or high caused by pronounce muscular mass


Sup.3


ALGORITHM

Of determining the group of the schoolstudents’ health

A complex medical examination


Methods of examinations


phisiometric

clinical

somatoscopic

antropometric


Health ‘ level, biological age


All indecis in limits of age norm


1 health’ group


Harmonic physical development


One or more endices are out of age norm


2 health’ group


Disharmonic physical development


Chronic diseases are in countervailed stage stage


3 health’ group


Chronic diseases are in subcountervailed stage

4 health’ group


Sharp disharmonic physical development


Chronic diseases are in decompansation stage


5 health’ group


Conclusions and recomendations for

‘Schoolmaturity” . Ready attends the school

Featness group


Since 7 age

Must not attends the school

Since 6 age

Preparatory

special

basic


Sup. 4
MEDICAL INDICATIONS

To delay of receipt in school of children of six-year age

(extraction from СанПиН 42-125-4216-86)



1. Following diseases occured during the last year:

  1. Infections hepatitis;

  2. Pyelonephritis, diffuse glomerulonephritis;

  3. Non rheumatic myocarditis;

  4. Rheumatic disease in the active phase;

  5. Epidemic meningitis, a meningocephalitis;

  6. Acute repeated and durablu respiratory diseases;

  7. Tuberculosis (all forms, including on turn of a tuberculin test);

  8. CNS traumata;

  9. Diseases of blood;

  10. Severe pediatric infection deseases.

2. Following chronic conditions:

  1. Retarded psuhic development.

  2. Retardation of physical development one year and more (the height is low M-2 σ of the mean, stationary values teeth miss);

  3. The residual phenomena of CNS organic disoders with the pronounce disturbance of motor<, trophic and sensing functions.

  4. Epilepsy, epileptiform set of symptoms;

  5. Neuroses, neuroses-like disoders (a logoneurosis, an enuresis, etc.);

  6. Endocrine diseases (a crop, diabet mellitus, etc.);

  7. Myopia with a tendency to progression (more - 2,0 Д);

  8. Tonsil hypertrophy grade III ;

  9. Adenoid vegetation of grade III, chronic adenoiditis;

  10. Chronic tonsillitis ( decompensation form);

  11. Vegetovascular dystonia on hypotonic(the AP below 80 mm mercury ) or hypertonic type ( the AP 115 mm mercury or above );

  12. Rheumatic or congenital heart defects;

  13. Exacerbation with no stable remission chronic bronchitis, bronchial asthma, chronic pneumonia (at an exacerbation or absence of proof remission in the course of the year.);

  14. Peptic ulcer of a stomach or duodeni, chronic gastroduodenytis, a chronic cholecystitis (in the stage of incomplete remission frigement relapsis);

  15. Eczema, neurodermite (at the widespread dermal changes);

  16. Anaemia (at a haemoglobin content in blood of 107 mg / ½ and less);

  17. Other chronic diseases in a stage of incomplete remission and crowded relapses.




Sup. 5

Regional standards

anthropometric parameters of adolescents 17 flying

(scales of regression)

Limits of standart deviations

Height, cm

Weith, kg

Thoracys circumference , cm

– 1 σ




+ 1 σ

– 1 σ




+ 1 σ

Low (from М –2 σ and lower )

159

50,7

55,6

60,5

76,6

81,5

83,4

160

51,2

56,1

61,0

77,0

81,9

83,8

161

51,7

56,6

61,5

77,4

82,3

84,2

Under the average

(from М –1 σ to М –2 σ)

162

52,3

57,2

62,1

77,8

82,7

84,6

163

52,8

57,7

62,6

78,2

83,1

85,0

164

53,3

58,2

63,1

78,6

83,5

85,4

165

53,8

58,7

63,6

79,0

83,9

85,8

166

54,3

59,2

64,1

79,4

84,3

86,2

167

54,9

59,8

64,7

79,8

84,7

86,6

Average (from М –1 σ to М +1 σ)

168

55,4

60,3

65,2

80,2

85,1

90,0

169

55,9

60,9

65,7

80,6

85,5

90,4

170

56,4

61,3

66,2

81,0

85,9

90,8

171

56,9

61,8

66,7

81,4

86,3

91,2

172

57,5

62,4

67,3

81,8

86,7

91,6

173

58,0

62,9

67,8

82,2

87,1

92,0

174

58,5

63,4

68,3

82,6

87,5

92,4

175

59,0

63,9

68,8

83,0

87,9

92,8

176

59,5

64,4

69,3

83,4

88,3

93,2

177

60,1

65,0

69,9

83,8

88,7

93,6

178

60,6

65,5

70,4

84,2

89,1

94,1

179

61,1

66,0

70,9

84,6

89,5

94,4

180

61,6

66,5

71,4

85,0

89,9

94,8

181

62,1

67,0

71,9

85,4

90,3

95,2

Above the average( М +2 σ)

182

62,7

67,6

72,5

85,8

90,7

95,6

183

63,2

68,1

73,0

86,2

91,1

96,0

184

63,7

68,6

73,5

86,6

91,5

96,4

185

64,2

69,1

74,0

87,0

91,9

96,8

186

64,7

69,6

74,5

87,4

92,3

97,2

187

65,3

70,2

75,1

87,8

92,7

97,6

High

(from М +2 σ and higher)

188

65,8

70,7

75,6

88,2

93,1

98,0

189

66,3

71,2

76,1

88,6

93,5

98,4

190

66,8

71,7

76,6

89,0

93,9

98,8



174,45

63,38

87,54

± σ

6,48

5,86

3,8

R




0,52

0,40

± σ R




4,86

4,94



Sup.6


Determining of the harmonicity of physical development

The schoolstudent 17 flying on scales of regression

(Example)


Parameter

Height, cm

weight, kg

Thoracys circumference , cm


Measured attributes, Х


164, 0


70,6


81,3

The standards of attributes on scales of regress (mean),



174, 5


58,2


83,5

Deviation of the measured attributes from standard by module

ΔΥ = Х


- 10, 5


12,4


- 2,2

Mean standard deviation of attributes regression


± σ Ŕ


6, 5


4,9


4,9

Deviation of measured attributes from standard in lobes σ Ŕ

ΔΥ

------------

± σ Ŕ



- 1, 6



2,6



- 0,5

The level of the development endices

Under the average

High

High



Harmonicity of the physical development

Sharp

disharmonic






Sup.7


Derivation of children and adolescents on groups of health


Parameters

Groups of health

I

II

III

IV

V

Chronic disease or inborn heart disease:

One

More than two








+


+

+


+

+

Stage of disease:

Countervailed

Subcountervailed

Decompensation








+



+



+

Morphological or functional deviations




+










Harmonicity of physical development:

Harmonic

Disharmonious

Sharply disharmonious


+



+

+










Back log of a biological age > 1 года







+







Frequent deseases (> 4 per year)




+










Exacerbations of chronic disease

1-2 per year

3 and more per year








+



+




Health disturbance and state of health after an exacerbation of chronic disease










+




The term of a reconvalescence:

After a contagion

Short after an exacerbation of chronic disease

Lingering after an exacerbation of chronic disease





+



+



+




Caries of teeth:

Countervailed

Decompensation





+



+







Resistance (immunological):

Normal

Reduced


+



+










Burdened biological and social hystorys (for 1-st year of life)




+










Harmful habits




+










Developmental abnormalities:

Not requiring corrections

Requiring corrections


+



+












Sup.8

Organization of occupations by physical training and sport

Pupils of miscellaneous medical groups



The medical characteristics of group

Mandatory kinds of occupations

Facultatives and recommendations.

Subjects with no health disorders as well as with in significant morfofunctional of sufficiently physicaly fit ones (basic group)

Physical culture classes according to the syllabus. Taking control normatives. Participation in physical culture and sanitation programs.

Regular trainings in one of sportschoolsections or in extraschoolinstitutions. Participation in sportevents of different levels.Hiches and sport events at the extracurriculum time. Participation in the work of physical fitness section.

Subjects with significant health disorders, insuffycyently physical fit (preparatory group)


Lessons of physical culture according to the curriculum providing more gradual mustering motor abilities and as well as excluding exercises proposing higher demands to the body. Taking some control normatives. Participation in sport and sanitation activities.

Lessons of physical culture according to the educational program under condition of more gradual development of impellent skills and skills, and also exception of exercises showing increased requirement to organism. Delivery some

The control specifications. Participation in exercises improving measures.

Subjects with significant health disordersof permanent or transient character aloud to perform academic and labour activities (special group).

Lessons according to a special program with an account of the disease’s character and severity...

Participation in sport activities


Walks, active games, sport events and social useful work with under self-control rules individual physical exercises includes into days regiment according to medical recommendations. Medical control over circadian amount of motor activity and health conditions dynamic.


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