2022, volume 18

Abstract. Objective: quantitative assessment of health risk changes for the fifth grades students caused by functional disorders and chronic eye diseases (myopia) during primary school education. Material and methods. The assessment of myopia prevalence and a quantitative assessment of the risk change caused by the pathology of the visual organ were calculated according to the data of the child's medical records (before entering school, after the first grade and after the fifth grade) in one of the educational organizations of a large industrial city (for example, Perm). The number of the observation group was 136 children aged 11-12 years (including 56% of boys). To characterize the risk, additional probabilities of pathological lesions to the fifth class were determined and severity coefficients. Results. With an increase in the educational load from the first to the fifth grades by 1.5 times (from 23.1 ± 1.04 to 35.6 ± 1.9 points of subjects difficulty), the prevalence of myopia in school ontogenesis increases by 2.3 times (p<0.001). The risk level increases from acceptable (3.7x10-5 in the first grades) to high (1.1x10~3 in functional disorders and 1.9x10~2 in chronic conditions), which is not acceptable. Conclusion. Using a quantitative risk assessment approach, it was possible to identify a transition from an acceptable to a high risk of developing eye diseases (myopia) among children in primary school. To prevent such changes, the implementation of effective medical and preventive measures is required.

Abstract. Objective: on the basis of a study of the health, organization of the daily routine and activities of adolescent schoolchildren to substantiate preventive measures aimed at strengthening their health. Material and methods. A cross-sectional study of health, daily regime and activities of schoolchildren by questionnaire survey was carried out. The research group included 218 students of 8-10 classes (14-17 years old) of Ekaterinburg comprehensive schools, including 34.9% boys and 65.1% girls. The relative scores in percentages, confidence intervals, chi-square test, and odds ratio (OR) with 95% confidence interval were calculated. Results. Schoolchildren do not follow the regime and have low night sleep (67.3%), use electronic devices for a long time (up to 90.4% at weekends), have low physical activity (63.3%), do not follow the diet (28.4%), do not walk (29.6%). Low self-assessment of health have 42.7% of students (girls more often than boys), report various complaints from 20 to 81.2% (more often from the central nervous system). The most significant factors for the health of schoolchildren were the diet, the duration of night sleep, the duration of self-preparation and the use of electronic devices (OR — 2.1-2.7). Conclusion. It is necessary to train the skills of rational organization of the daily routine and time budget, increase physical activity among teenage schoolchildren.

Abstract. Objective: determination of the importance of compliance with various requirements for the prevention of acute respiratory viral infection (ARVI), including COVID-19, by schoolchildren in the formation of their health condition and morbidity. Material and methods. A survey of 752 urban schoolchildren aged 14-17 years was carried out on issues characterizing compliance with the requirements for the prevention of ARVI, including COVID-19. The list of symptoms of deterioration of health condition is compiled on the basis of literature data. Results. Using the chi-square method, the connection between non-compliance with social distance and manifestations of symptoms was proved in schoolchildren: significant fatigue — x2=15-075 (P=0.005), cough —x2=14-724 (df=4, p=0.005) and general malaise — x2=11-421 (df=4, p=0.002). It has been confirmed that non — compliance with anti-epidemic requirements on the prohibition of touching the mouth, nose, eyes and other parts of the face with unwashed hands is a risk factor for the formation of symptoms of general malaise — x2=24.120 (df=4, p<0.001), significant fatigue — x2=9-621 (df=4, p=0.047), difficulty respiration — %2=16.504 (df=4, p=0.022), as well as cough. Often practiced among schoolchildren, the refusal to constantly use personal respiratory protection equipment in public places during the ARVI epidemic, including COVID-19, causes the risk of a symptom of difficulty breathing in adolescents. The effect of non-compliance by schoolchildren with the requirements for preventing the spread of ARVI, including COVID-19, on the frequency and duration of all diseases and respiratory diseases separately has not been established. Conclusion. Failure to comply with anti-epidemic requirements is a risk factor for the formation of various symptoms of deterioration in health condition in adolescents. Based on comparative data on the results of self-assessment of schoolchildren and objectively according to medical documentation, it is confirmed that non-compliance with the recommended anti-epidemic requirements is a risk factor for the formation of various symptoms of deterioration of health condition in adolescents.

Abstract. Objective: based on the assessment of the activities of medical organizations providing primary health care, to determine the best practice for organizing preventive medical examinations of school-age children. Material and methods. Based on the data of Rosstat, FRIHOI of MoH of the RF, the Ministry of Health of the Sverdlovsk Region, the Territorial Fund of Compulsory Medical Insurance of the Sverdlovsk Region, an assessment was made of indicators characterizing the organization of the provision of primary health care for children's population. Results. An assessment of the activities of the departments of medical organizations providing assistance to the children's population was carried out, a shortage of personnel, an excess of the number of attached population in pediatric areas, insufficient coverage of preventive measures were revealed. The best practice on the organization of preventive examination of school-age minors based on the use of lean technologies is highlighted and described. As a result, the time of passing the preventive examination of organized groups of minors was reduced by 2.2 times, the intersection of the flows of children undergoing preventive and diagnostic examinations was excluded, the level of satisfaction with the services provided was 87.5%. Conclusion. Lean technologies show high efficiency in optimizing the processes of providing medical care to the children's population, but they do not solve the problem of a shortage of specialists.

Abstract. Objective: based on an assessment of the inhalation risk to the health of children involved in sports, to substantiate the need to improve the control of chemical air pollution in sports halls. Material and methods. The quality of the air environment of open and closed sports facilities was evaluated in comparison with 0.8 of the current one-time maximum permissible concentrations (MPC). The routes of exposure to pollutants from atmospheric air and the air environment of sports, residential and school premises are considered. The assessment of the general toxic risk was carried out in accordance with R 2.1.10.1920-04. Results. In the air of outdoor sports grounds there were registered contents exceeding maximum single MPC: within the city limits — N02, NO, S02, suspended substances, formaldehyde; outside the city— N02. In the air of the indoor ice arena, an excess 0.8 maximum single MPC of formaldehyde. In the martial arts halls the content of C02 was 1500.5±444.9 ppm. Taking into account the daily route of children engaged in sports in the halls of children's and youth sports school, the value of the hazard index (Hlch) =4.9, and for those who are engaged in ice arenas Hlch=5.7. It is possible to develop negative effects of the respiratory system and immunity. Conclusion. High breathing rate during sports can lead to health risks, even if the maximum concentration limit is observed. The current documents do not reflect the criteria that regulate the impact of air pollution in the training process. It is necessary to revise the system of hygienic regulation of sports environment factors for children involved in physical culture and sports.

Abstract. Objective: analysis of forms of learning in conjunction with the factors and conditions of the educational environment that can affect the health of children with disabilities and persons with disabilities. We analyzed 48 scientific papers (2005 to 2022) using databases eLibrary, PubMed, with the formulation of queries: "peculiarities of teaching disabled children", "inclusive education", "education of children with disabilities", "peculiarities of the influence of the technical condition of school buildings on the health of students in general educational institutions". Based on the analysis, the conclusion was made that children with disabilities represent a particular social group of children whose education is implemented with the use of special educational, remedial and health-saving technologies, which determines the success of achieving the educational goals and social adaptation of children in the peer group, and in case of non-compliance with medical and social regulations and sanitary and hygiene standards in the implementation of the educational process leads to deterioration of physical and mental health of the school.

Abstract. Objective: determine the need for medical professional psychological counseling (MPPC) for patients with bronchial asthma (BA) and informing them and their parents about the peculiarities of choosing a future profession in this disease. Material and methods. 40 patients aged 11-17 years old with a verified diagnosis of "Bronchial asthma" underwent a MPPC in order to determine the choice of a future profession. A questionnaire was developed, 2 psychological tests were used: "Map of Interests" and "Differential Diagnostic Questionnaire of Interests". Results. 9 adolescents (22.5%), including 4 patients (10%) with disabilities, had not thought about occupational determination or had not yet decided on the choice of profession. 5 patients (16.1 %) chose professions that could certainly cause an exacerbation of BA, and 22 people (70.7%) chose professions that were not contraindicated to them due to their health condition (lawyer, psychologist, programmer, etc.). The desire to learn a particular profession did not coincide with the actual test results (the "Map of Interests" test) in 6 patients (15%) and according to the results of the "Differential Diagnostic Questionnaire of Interests" test in 7 patients (17.5%). Psychological pressure from the mother on the child's choice of future profession was established. Conclusion. MPPC should become a necessary part of the work of a pediatrician, allergist, pulmonologist with a patient with BA. It is required to develop a List of professions at the legislative level, the choice of which is impossible with BA, and bring this document to the attention of interested persons. It is necessary to create Centers for MPPC with the participation of a clinical psychologist on the bases of children's district polyclinics, allergy centers for patients with BA starting from the younger adolescence (11 years).

Abstract. Objective: to assess the prevalence of depressive states and the level of knowledge about them among schoolchildren for the development of preventive educational programs. Material and methods. An anonymous voluntary survey was conducted in two stages with an interval of 4 years among students of grades 8-11 of general education institutions: a total of 575 teenagers were interviewed. The severity of depressive states was assessed using the Hospital Anxiety and Depression Scale — HADS, the level of knowledge by questionnaire. Results. The prevalence of depressive states among schoolchildren in 2014 was 204 per 1000 examined, in 2018 - 211. During the observation period, the number of students who know nothing about depression significantly decreased to 37%, and to 56.2% who believe that nothing should be done in case of depression. The number of schoolchildren ready to see a doctor remains low (6.1%), the number of teenagers who consider self-medication possible has not changed (7.2%). The Internet remains the main source of information about depression. Discussing mood problems with others and using physical activity proved to be effective ways of self-correction of depressive states. Taking into account the results obtained, a conversation plan for students has been developed. Conclusion. The high prevalence of depressive manifestations, insufficient knowledge of students in this area has been revealed, which requires correction of educational programs for schoolchildren and regular monitoring of their awareness.

Abstract. Objective: to substantiate the system of preventive measures in a sports school. Material and methods. A prospective three-year observation of the health status of 1,293 athletes involved in mass sports was carried out. The lifestyle of 901 athletes was studied by simultaneous anonymous questionnaire. The results we obtained were compared with the results in children who do not play sports. The assessment of the sanitary and hygienic condition of 14 sports schools was carried out. 17 medical and pedagogical observations were carried out. Results. Children who play sports have lower levels of pathological lesions (94.5 vs. 130.6 cases per 100 people) and its growth rate in relation to peers who do not play sports. They were more likely to have body weight corresponding to height (70.8 vs. 54.8%), average, above average or high values of lung capacity (94.5 vs. 65.5%), arm muscle strength (89.7 vs. 80.5%), somatic health (53.9 vs. 21.0%). Children-athletes are quite satisfied with the organization of the training process and the psychological microclimate in the sports section. A sufficient level of physical activity was established in 92% of athletes, they are less involved in the consumption of psychoactive substances. Insufficiently good sanitary and hygienic conditions in sports schools were revealed. Conclusion. The necessity of developing a network of sports schools, improving their sanitary and hygienic condition and medical support of the training process is substantiated.

Abstract. Objective: analysis of the state of health and defects in the provision of pediatric care for the development of management decisions. Material and methods. The article presents the dynamics of morbidity for the period 2019-2021 based on the results of preventive medical examinations according to official statistical reports (form №030-PO/o-17). 102 curatorial visits were conducted in order to assess the quality of preventive examinations in health care institutions that provide assistance to children. Results. In the dynamics of the health status of children in the Sverdlovsk region, there have been positive trends in the form of a decrease in the prevalence of morbidity by class: diseases of the digestive system, diseases of the musculoskeletal system. However, in 2019-2021, there is an increase in the prevalence of general morbidity, and by classes: diseases of the eye and its accessory apparatus and the endocrine system. 89.3% of children have normal physical development, and up to 22.9% of children aged 10-14 years are overweight (as of 2021). In the course of conducting audits of health care institutions that provide assistance to the children's population in terms of preventive medical examinations, insufficient quality control of preventive examinations is more common. Conclusion. Trends in children's health require the development of a set of measures aimed at increasing the competence and commitment of medical personnel to medical prevention issues, as well as the introduction of health-saving technologies in the educational process.