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Introduction

According to the WHO, the health of adolescents is one of the most pressing problems in the world.

The health state of the younger generation is the most important indicator of the well-being of society and the state, not only reflecting the present situation, but also giving a forecast for the future. The country's labor resources, its security, political stability, economic well-being and the moral and moral level of the population are directly related to the state of health of children, adolescents, and youth.

At the beginning of the third millennium, human society faced a number of global problems caused by a change in the rhythm and way of life of a modern person, informational and psycho-emotional overload, the destruction of the harmonious connection between man and nature, an increase in environmental pollution, a change in the nature of nutrition, etc.

An analysis of the health status of the Russian population according to official statistics and the results of epidemiological studies shows that it is much worse than in most industrialized countries, and its further deterioration should be expected if conditions affecting health are not significantly changed in a favorable direction. The health of the future generation is in our hands, if we do not bring up a culture of a healthy lifestyle in our children, then this can have a detrimental effect on our nation and on the health of future generations.

Our physical condition directly affects the condition of our future or already born children. This is a very global problem that affects common cultural values ​​and norms, it is so big that it has a huge number of problems that we have to solve. In our thesis, we touched on only a part of the problem of valeological education of adolescents of their culture, and in particular such well-known problems as drug addiction and adolescent alcoholism, mental illness of adolescents and low physical activity. Based on numerous sources, it is possible to identify ways of possible prevention and prevention of these problems.

In the 19th century in Europe, according to Philippe Aries, there was no concept of adolescence.

The reason for the emergence of adolescence was the need for a stage of preparation for adulthood.

The society became more complicated and for a successful entry into the world of adults one more age period is required.

Adolescence is the age of the beginning of the formation of a worldview, moral convictions, principles and ideals, a system of value judgments, which a teenager begins to be guided by in his behavior.

Adolescence is the period between childhood and adulthood.

According to the UN, as of 2011, there were over a billion adolescents in the world.

According to UNFPA(United Nations Population Fund) teenagers- persons aged 10-19 years:

Early adolescence - 10-14 years;

Late adolescence - 15-19 years

Currently teenageperiod covers the age from 10-11 to 15-17 years.

1. Health of the younger generation

1.1 WITHhealth status of adolescents

Adolescence is associated with puberty, determined by endocrine changes in the body. Under the influence of sex hormones, the level of metabolism increases, which intensifies growth, development, the length of bones increases rapidly, muscle mass grows, and secondary sexual characteristics appear. The time of the onset and the rate of the noted changes is not the same for boys and girls. In addition, different physiological systems in the same adolescent do not develop simultaneously, therefore, for example, the blood supply to the brain may be reduced, which leads to increased inhibition processes, rapid fatigue, mood swings, emotional instability, and sleep disorders.

The health status of adolescents is particularly affected by alcohol and drug use, sexual intercourse and trauma. Mental disorders, conditions of the musculoskeletal system and genitals, as well as the state of the gastrointestinal tract also play a significant role.

The health status of young people is determined by many factors - both objective: ecology, health care, the quality of living conditions, and subjective. It is believed that at a young age, subjective reasons are of decisive importance. And this is an awareness of the value of a healthy lifestyle, physical education and sports, the absence of habits such as alcohol abuse and smoking.

According to specialists from the Research Institute of Hygiene and Health Protection of Children and Adolescents, the following negative trends have emerged in recent years:

1. A significant decrease in the number of absolutely healthy children (there are no more than 10-12% of them);

2. A rapid increase in the number of functional disorders and chronic diseases, which are registered in more than 50-60% of schoolchildren;

3. A sharp increase in the proportion of pathology of the digestive system, musculoskeletal system, kidneys and urinary tract;

4. Increase in the number of schoolchildren with multiple diagnoses.

1.2 Smoking and alcoholism

It would seem that a person should realize the need to protect himself from additional intake of substances alien to the body. In life, often, a person commits actions that worsen his health, lead to a disease of the main organs: heart, lungs, liver, kidneys. Addiction to such activities is often called bad habits. The most common of these are smoking, alcohol and drug use. The nicotine contained in tobacco is very toxic. This is especially acute for those who are just trying to smoke. They develop nausea, dizziness, and abnormal agitation. The insidiousness of nicotine is that over time the body gets used to it. The symptoms of poisoning disappear, and only pleasant excitement remains. But the harmful effect of nicotine on the body does not disappear, but, on the contrary, increases. At the same time, more than 30 substances harmful to health have been found in tobacco smoke. The lethal dose of nicotine for a person is 1-2 mg per day. When smoking 20-25 cigarettes per day, 1 mg of nicotine is supplied to the body. However, death does not occur, because the poison is introduced gradually. Smoking reduces performance, memory, attention, because nicotine disrupts the central nervous system. Substances contained in tobacco smoke make a person irritable and often cause headaches. Nicotine is very harmful for the heart and blood vessels. Long-term smoking leads to disruption of blood vessel walls. Smokers are many times more likely to have diseases associated with spasm and damage to the vessels of the heart and legs. All this leads to a heart attack over the years. Smokers are 5-10 times more likely to develop bronchial asthma, inflammation and lung cancer. This is why smoking is incompatible with health. Unfortunately, some schoolchildren start smoking in adolescence. They acquire this habit mainly because of the desire to seem more mature, independent. But at the same time, they do not realize what great harm smoking can bring them. At the same time, adolescents do not take into account the fact that courage, independence and confidence will help them acquire regular physical education and sports, and not smoking. The effect of nicotine on the sex glands has been proven. According to the observations of specialists, smoking is the cause of sexual impotence in at least 10% of cases. And the cessation of nicotine intoxication leads to the restoration of sexual function. Women who smoke tend to age quickly and experience premature sexual wilting. In women who smoke, miscarriages and stillbirths occur 2-3 times more often than in non-smokers. Girls who started smoking early, develop worse physically, more often get bronchitis than their nonsmoking peers. The use of tobacco by women has always been considered a sign of bad taste and frowned upon.

The harm of alcohol. One of the harmful habits that destroy health is the use of alcoholic beverages. They usually start drinking alcohol in connection with some event - a birthday, a holiday. And although this happens, sometimes, with the consent of the parents, in the bosom of the family, still such an introduction to wine is dangerous. Alcoholism is a serious chronic disease, mostly intractable. It develops on the basis of regular and long-term alcohol consumption and is characterized by a special pathological state of the body: an irrepressible craving for alcohol, a change in the degree of its tolerance and personality degradation. The alcoholic directs all his energy, funds and thoughts to get alcohol at any cost. Once he has drunk, he strives to get drunk to the point of complete intoxication, to unconsciousness. It destroys the human body, his brain, deprives him of the mind. This evil has acquired a social danger. Statistics show that more than 2/3 of malicious hooligans and over half of serious crimes are committed in a state of intoxication. The social danger of alcoholism increases in the absence of an organized fight against it. The systematic use of alcoholic beverages is noted primarily among uncultured, morally dissolute people who have lost a sense of responsibility to their family and their conscience. Very often alcohol abuse is the result of poor upbringing. For weak-willed and dissolute people, any excuse to drink is enough. Alcohol is a universal poison. Alcohol abuse lowers the body's resistance to external factors, in particular to infections, disrupts metabolic processes, and accelerates senility. Statistics show that mortality among systematic drinkers is 1.5 times higher than among non-drinkers. Alcohol primarily has a detrimental effect on brain cells. Being in a state of intoxication, a person loses a critical attitude to his actions. He tends to overestimate his abilities and capabilities. Movement coordination is impaired. The alcoholic has disturbed sleep, neuritis develops, sexual function weakens, heart function is disturbed, and diseases of the digestive system appear. Absolutely all "lovers" of alcohol have liver damage. One of the reasons teenagers drink alcohol is the misconception about it as a pleasant and even healthy drink, that alcohol adds strength and reduces fatigue. It is necessary to conduct explanatory work with adolescents.

1. 3 Physiology of adolescents

In adolescents at the age of 12-17, secondary sexual characteristics increase:

Girls start menstruating, eggs begin to mature and develop in the ovaries.

In boys, by the age of 12-15, hair begins to grow on the body and face, and emissions appear.

Adolescence is a transitional age and is called:

Pubertal or pubertal,

Transitional or adolescence,

· Puberty.

Teenagers look for themselves, define goals in life. At puberty, the child becomes lost. The teenager feels that something has changed, but what is not clear, interests are changing. The teenager is not a child, but has not fully developed as a person. However, the desire to be an adult causes resistance from others. He no longer feels himself to be a child, and so far he cannot become an adult either.

During this period, a conscious attitude to their needs, abilities, drives and motives of behavior, experiences and thoughts is formed. Self-awareness is also expressed in the emotional and semantic assessment of their subjective capabilities, which, in turn, serves as a justification for the expediency of actions and deeds. Attention to appearance. Comparing themselves to the "standard", adolescents find "flaws" in their appearance, which causes anxiety and self-doubt. At the same time, along with a sense of pleasure, vague anxiety and anxiety appear. Unresolved for various reasons, the tasks of growing up have an impact on the further influence of the personality and block the possibilities of self-disclosure and personal growth. How to help the adolescent to set these tasks for himself, how to show that "a solution exists", how to include the adolescent in the conscious process of finding solutions. Today, no one is specifically and purposefully engaged in this in our country. Of course, the tasks of growing up can be solved spontaneously, most often this happens, or not at all. Unfortunately, such a path contributes to the transformation of problems that are solvable in adolescence into insoluble problems of the whole future life. Many inferiority complexes experienced by adults are nothing more than the tasks of growing up unresolved in childhood.

Physical development of boys and girls happens in different ways.

At the age of 12-13, girls are ahead of boys, because two years earlier they enter the pubertal growth spurt, they begin to menstruate at this age.

At the age of 14-15, the physical indicators of boys become higher, their activity of the endocrine glands and genitals increases, and emissions appear. In adolescents, the nervous system develops, muscle strength grows.

Adolescence or puberty - ending:

For girls by 16-17;

· For young men - by the age of 18-19.

In adolescence, the cardiovascular system develops rapidly, the heart grows, the weight of which doubles. This process does not keep pace with the rapidly growing body, so children complain of weakness, fatigue, palpitations, they may have a tendency to faint. A teenager needs systematic physical exercise, proper nutrition, a clear regime of work and rest.

The problem is lack of exercise, therefore, their working capacity is sharply reduced, and their health deteriorates.

Another problem of the modern generation is acceleration, that is, the acceleration of the development and growth of adolescents in comparison with previous generations.

Modern boys are 16.2 cm taller than their peers at the beginning of the last century, and girls - by 14.2 cm, respectively, their weight has increased, and puberty begins earlier.

Large and developed, they are not inferior in weight and height to adults, but their nervous and endocrine, respiratory and cardiovascular systems are in the stage of development.

The acceleration process causes some problems in the upbringing of adolescents and young men. If earlier the onset of puberty coincided with the beginning of labor activity, now the situation has changed: girls and boys are in the position of children.

Learning is required to master the profession, which shifts the terms of independence.

Teenagers continue to be overprotected, they do not feel responsibility for their actions.

1.4 The condition of the digestive system in adolescents

The digestive system of adolescence has increased demands. The rapid growth of a child, intense mental and mental activity, puberty require additional energy, enhanced assimilation of a variety of proteins, vitamins, trace elements and other biologically active substances. This leads to an increase in appetite and an increase in the amount of food consumed.

The most common pathology of the digestive system in adolescents is dysfunction of the gastrointestinal tract, manifested in impaired motor-evacuation activity (dyskinesia) of the stomach, small or large intestine, gallbladder, gastritis, peptic ulcer, which often becomes chronic.

Gastritis- these are inflammatory or inflammatory-dystrophic changes in the mucous membrane.

The main cause of gastritis in adolescents is unhealthy diet.

Teens eat instant food on the street, buy themselves chips, crackers, chewing gum, chocolates, sodas, and start smoking and drinking alcohol at an early age - all these reasons give rise to the development of gastritis.

As a result of inflammation of the digestive system, ulcers may appear.

Gastritis in adolescents is manifested:

Sharp pain in the upper abdomen - pain in the stomach;

Heartburn, often noted during physical exertion;

Great heaviness in the stomach after eating;

Belching, which is accompanied by an unpleasant odor from the oral cavity;

W nausea and profuse vomiting;

High salivation, or vice versa, dry mouth;

Constipation or indigestion is common;

Pallor of the skin, light coating on the tongue, etc.

Lack of appetite;

General weakness of the body, frequent dizziness, fever, low blood pressure, sometimes headache.

Treatment of gastritis in adolescents

To get rid of the symptoms, the cause of its appearance should be eliminated, which means that it is necessary to pay attention to the diet of children.

Healthy nutrition rules:

First:

Sh fractionality,

Portions

The regularity of meals.

Portions should be small, you need to eat five times a day at the same time. This will activate the work of the digestive tract.

Second- products must be

High quality,

W fresh

W useful.

When treating gastritis, you can not use spicy, salty, fatty, smoked foods and flour products.

Third- heat treatment. All meals must be in the following form:

Mushy,

· Mild form.

Fourth- the menu for a teenager should be varied. A growing organism needs protein food, fiber, various vitamins and microelements.

Fifth- diligently and strictly follow the diet in the first two weeks of illness.

Medicines for gastritis:

Sorbents: activated carbon, Smecta, Enterosgel, etc.

Enzyme medicines: Mezim, Festal, etc.

Gastrocytoprotective drugs: Almagel, Fosfalugel, etc.

Dyskinesia of the biliary tract and gallbladder

Word " dyskinesia"Means - movement disturbance... This is a functional disorder of the motor function of the gallbladder.

The coordinated contraction of the gallbladder and sphincters, which allow bile to exit from the gallbladder into the duodenum, is violated.

Normally, bile is synthesized by the liver, from where it enters the gallbladder. In the bladder, bile is waiting - when the eaten food from the stomach enters the duodenum. As soon as this happens, the gallbladder, contracting, secretes a portion of bile into the intestinal lumen.

Bile plays an important role in the digestion of fats. Thanks to bile acids, fat is emulsified and broken down into fatty acids.

The mechanism of development of biliary dyskinesia

· vegetoneurosis- discoordination of contractions of the gallbladder and the sphincter apparatus.

· hormone- intestinal hormones play an important role in the regulation of bile secretion - stimulating - cholecystokinin, suppressing - glucagon

Under physiological conditions, the processes of inhibition and excitation are self-regulating.

Unfavorable factors, affecting the autonomic nervous system and hormonal regulation, lead to motility disorders and changes in the physicochemical and bacteriostatic properties of bile.

Another reason is the lack of normal bile secretion into the gallbladder. Anomalies in the development of the gallbladder and bile ducts, constrictions, constrictions, valves

Biliary dyskinesia is more common in adolescents. Almost 90% experience sudden contractions or dull pain in the right hypochondrium, a feeling of bitterness in the mouth, nausea, the tongue is often coated with a gray-yellow coating.

Adolescents note pain in the right hypochondrium, aching, stitching or cramping, radiating to the right scapula, shoulder, back; which often happens after eating, especially fatty, belching, bitterness in the mouth, loss of appetite. There may be an increase in stool frequency, bloating. Constant stagnation of bile can cause the deposition of stones in the gallbladder, the development of inflammation of its wall. Sometimes short-term jaundice.

Treatment of dyskinesia of the biliary tract and gallbladder.

Compliance with the diet, treatment of the underlying disease that caused dyskinesia, elimination of nervous tension.

An important role in the development of primary dyskinesia of the biliary tract and gallbladder is played by a violation of the diet:

Long intervals between meals,

· binge eating,

Force-feeding,

· Abuse of fatty or spicy foods.

Compliance with a diet restricting animal and vegetable fats, eggs, meat and fish broths.

Sample menu table number 5:

1st breakfast: milk porridge, soft-boiled egg, tea with sugar, bread with butter and cheese.

2nd breakfast: fruits.

Dinner: vegetarian soup made from mixed vegetables, boiled fish with mashed potatoes, fresh cucumber or cabbage salad with vegetable oil, dried fruit compote.

Afternoon snack: a glass of milk or kefir, marshmallows - 1-2 pieces.

Dinner: steamed meatballs with noodles, sweet tea, bread with butter.

Before bedtime: a glass of kefir.

Depending on the type of dyskinesia, the following are prescribed: drugs that relieve spasm, choleretic drugs.

1.5 Teenage acne

Teenage acne is experienced by almost all young adults, which usually occurs between the ages of 10 and 18. According to some medical estimates, every year around the world, about 80% of minors are exposed to skin rashes. Moreover, more often teenage acne is taken by surprise by the youngest individuals (12-15 years old), that is, at the very beginning of hormonal changes.

Acne causes:

1) Imbalance in the body. Hormonal disorders are the first cause of acne in adolescents. Also, acne on the neck may appear due to thyroid disease.

2) Improper nutrition. Consuming spicy foods with a high content of carcinogens will lead to clogging of the body, which will not have the best effect on the condition of the skin. Eat oatmeal in the morning and drink plenty of plain water.

3) Sweat. With an active lifestyle, the body sweats and the skin becomes more dirty. If you don't want to wait for acne to appear, take a shower on time;

4) Hormonal surge. Age-related hormonal imbalances are often the cause of acne.

5) Oily cosmetics. Pimples appear due to clogging of the skin channels that occurs from the frequent use of oily cosmetics and oil products for the skin.

Some proven remedies can be used to treat teenage acne:

1. Salicylic acid is rightfully considered the most popular remedy. It is necessary to wipe cleansed face skin with a cotton swab moistened with the solution. It is best to use 1%, 2% or 3% solutions;

2. Tar soap is another effective remedy for acne. It is recommended to wash your face with this soap at night, as it dries the skin too much;

3. Talker is an old effective drug in the treatment of acne. Unfortunately, now it cannot be bought cooked. It must be applied on the face with a moistened cotton swab and preferably in the evening.

At the same time, the teenager should follow a diet. It is recommended to stop taking fatty, smoked and spicy foods, artificial colors and preservatives, as well as sweets and soda water.

1.6 Increased sweating in adolescents

Increased sweating or hyperhidrosis of adolescents is a fairly common phenomenon, since it is at this age that the endocrine system develops, which provokes an increase in the secretion of sweat glands several times.

Excessive sweating in young people gives them a lot of trouble. Vulnerable teenagers are ashamed of the smell from armpits, and stains from sweat on their clothes, and their sweaty cold hands.

There are two types of adolescent hyperhidrosis:

Primary- excessive sweating is localized in the armpits, arms, face and legs. The patient's condition worsens during puberty.

Secondary - common. In hyperhidrosis, excessive sweating is caused by the influence of another disease and is usually observed throughout the body, without a specific location. Diseases that can provoke secondary hyperhidrosis can be heart disease, obesity, infections, hyperthyroidism, mental disorders, diabetes mellitus, tuberculosis, etc.

1.daily bathing to reduce underarm bacteria;

2. the use of comfortable clothes made of natural fabrics that do not hinder movements, which easily absorb moisture;

3. Frequent dressing in fresh clothes;

4. use of aluminum chloride antiperspirants before bedtime.

7.balanced nutrition for adolescents

Also, the reasons for profuse sweating can lie in human genetics. In 25-40% of cases, hyperhidrosis is a genetic problem and is transmitted “from generation to generation”.

1.7 Vegetovascular dystonia in adolescents

Vegetovascular dystonia is a multisymptomatic syndrome that affects various systems and organs of the human body. The main effect of the autonomic nervous system is on the peripheral nerves. The cardiovascular system also suffers. adolescent health gastritis hyperhidrosis

The teenage years are transitional not only in the process of the transformation of a child into an adult, but also in the neurophysiological one. Conflict situations, emotional stress, chronic diseases, endocrine disorders, lack of movement and other factors are in many ways provocateurs of the development of vegetative vascular dystonia in adolescents. The increased mental load, having a hereditary component under it, leads to the emergence of a certain imbalance in the body, which leads to the appearance and development of vegetative vascular dystonia.

Treatment

In order to cope with any problem, you must first of all determine the causes of its occurrence. This is due to the increased psycho-emotional stress, with which the fragile nervous system is not able to cope. That is why adolescents with a fine mental organization, excitable and prone to worries most often suffer from vegetative-vascular dystonia.

Everything is aggravated by non-compliance with the regime, midnight vigils at the computer, excessive physical activity and craving for adulthood in the form of cigarettes and booze.

To cope with vegetative dystonia in adolescents, adherence to the following rules will help:

1. The teenager needs to establish a daily routine;

2. Proper nutrition; vascular's best friends are foods that contain potassium and magnesium:

· buckwheat;

· oatmeal;

Legumes (peas, beans);

· rose hip;

· Apricots;

· Dried fruits (raisins, dried apricots, prunes), nuts;

Vegetables (parsley, onion, eggplant).

3. A good way to save a teenager from vegetative-vascular dystonia is also therapeutic massage and physiotherapy.

4. The life of a teenager is full of various stresses. These are study loads, and relationships with peers, and changes that occur with his body. Therefore, you should not further complicate his life with exorbitant demands.

5. In especially severe cases, when vegetative-vascular dystonia in adolescents literally poisons their lives, it is worth resorting to drug therapy. Drugs for the treatment of vegetative-vascular dystonia are selected by a neuropathologist, taking into account all the features of the disease. Most often, the composition of therapy includes antidepressants, sedatives and general tonics.

1.8 Scoliosis in adolescents

Scoliosis is a disease of the spine in which there is a lateral deformity of the spinal column. Most often, scoliosis occurs in adolescents, that is, during the period of active growth of a person. Indeed, at this age, the skeleton is formed faster than skeletal musculature develops, and the spine is at great risk of deformity. In medicine, this disease is called juvenile idiopathic scoliosis. Of all the reasons for its development, the main ones are still considered to be inactivity and improper long-term sitting on a chair, which causes an overload of the spine and its curvature. That is why the treatment of scoliosis in adolescents begins with finding out the causes of the disease and eliminating them. And after that, an individual course of treatment is selected.

Therapeutic regimen for scoliosis

Another important and integral moment in the treatment of adolescent scoliosis is a special treatment regimen. It consists of the following activities:

§ taking vitamins, balanced nutrition;

§ morning exercises, including special exercises, swimming;

§ sleeping on an orthopedic mattress, as recommended by a doctor;

§ use of ergonomic furniture: orthopedic chair table;

§ cancellation of sports training associated with increased stress on the spine and asymmetric muscle development. That is, you cannot play football, rhythmic gymnastics, artistic gymnastics, tennis, as well as weightlifting.

2. Research work

Our practical part about the health status of adolescents in the city of Baikonur is also connected with the theoretical part. From the journal of the pediatric department of the hospital No. 1 "Book of registration of patients in inpatient treatment", diseases that are common among adolescents for 2013-2015 were studied.

The aim of the study is to identify the influence of factors on the health status of adolescents.

The following hypothesis was put forward: among the many reasons affecting the health of adolescents, an important role is played by chronic diseases, mental disorders, significant deviations in the formation of reproductive health, an increase in sexually transmitted diseases, an increase in deviant forms of behavior, juvenile delinquency, prostitution, vagrancy. , social loneliness, young motherhood, an increase in alcoholism, drug addiction, toxic dependence, a significant degree of restriction of opportunities for social integration.

In accordance with the goal and the above hypothesis, the study set the following tasks:

1. Select psychodiagnostic diagnostic techniques in order to identify diseases among the surveyed.

2. Identify the relationship between organizational factors and adolescents.

2.1 Techniques used

The study used:

Observation from practice

A 13-year-old patient is hospitalized in the pediatric department with a diagnosis of acute gastritis.

Complaints of pain in the epigastric region,

In the third paragraph of the experimental part - research results the data obtained are presented. It is advisable to present them in the form of tables, graphs, diagrams, diagrams, which should be numbered and have an exact name. To tables, charts, etc. there should be textual explanations. It is necessary to indicate what exactly in the presented table to pay attention to. It is not yet necessary to give a detailed assessment, to draw conclusions, only an impartial statement of the data obtained is required.

The fourth paragraph is discussion of the data obtained. It is advisable to start it with an answer to the question of confirming or not confirming a hypothesis. Our own discussion of the results can be carried out in two directions. On the one hand, it consists in comparing the data obtained with the results of earlier studies on this topic, which have already been reflected in the first, overview chapter of the thesis. Another line of discussion of the results is their explanation (interpretation).

It is necessary to adhere to a certain logic of presentation of the material: consider the results obtained using the methodology ...; they are presented in table 3 ...; as can be seen from table 3, the subjects ... are different (characterized) ...; thus, we can conclude that ... ”.

In the conclusion, the results of the study are presented. On the basis of the scientific-theoretical and experimental-practical study of the problem posed, its relevance is emphasized, the degree of fulfillment of the goal and objectives of the study is noted, the hypothesis is confirmed or refuted, the practical significance of the work is assessed (the contribution of its author to the solution of the problem). If necessary, a range of issues requiring deeper development is determined, and prospects for further study of the problem are outlined. In the conclusion, repeating the content of the introduction or the main part is not allowed. The approximate volume of the conclusion is 5-7 pages.

Istage- nursing examination

Objective symptoms are clarified: skin color, eye expression, oral cavity, assessment of body weight, shape of the abdomen, pain on palpation of the abdomen in the epigastric region. A connection is established between abdominal pain and food intake.

IIstage - nursing identification of patient problems

The real problem is epigastric pain, decreased appetite

Potential problem - stomach ulcer

Priority issue - epigastric pain

IIIstage - planning of nursing interventions

Short term goals - reduce pain throughout the day

Long term goals- prevent the development of complications

IVstage - implementation of nursing interventions

Dependent interventions fulfillment of doctor's prescription

Independent interventions - to conduct a conversation with the patient about the peculiarities of nutrition, about the need to follow a diet; control over appetite, sleep; identification of complaints; measurement of blood pressure, body temperature, control of physiological functions.

Vstage- efficiency mark

The goal is achieved- epigastric pain is eliminated.

Conclusion

The health status of adolescents in the last decade is characterized by:

The steady rise in chronic diseases

Increased levels of mental disorders

Significant deviations in the formation of reproductive health

The rise in sexually transmitted diseases

Increase in deviant behaviors, juvenile delinquency, prostitution, vagrancy, social loneliness, young motherhood

Increased alcoholism, drug addiction, toxic dependence

Significantly limited opportunities for social integration

Resolving these problems requires:

1. Optimization and acceleration of the processes of reforming health care for adolescents.

2. Interdepartmental approach (cooperation of doctors, teachers, medical psychologists, social workers, etc.).

3. Creation of a sustainable adolescent health management system based on the management of risk factors and the use of the principles of hygienic education and upbringing.

4. Involvement of educational and sports and recreation institutions in the formation of a healthy, socially effective lifestyle of adolescents.

5. Creation of a multilevel health education system for adolescents.

On the practical part of this diploma work in pre-graduation practice, we will conduct research on the health of adolescents, the statistics of the health group of adolescents in the city of Baikonur will be analyzed.

List of sources used

1. Adolescence: a historical approach / Kle M. Psychology of a teenager // Psychology of a teenager. Reader / Comp. Frolov Yu. I. - Moscow: Russian Pedagogical Agency, 1997. - pp. 103-140.

2. Bezukh Ksenia Evgenievna Methodical development of a special course for students "Teenager and his health"

3. Karabanova O.A. Age psychology. Lecture notes .. - Moscow: Airiss-press, 2005. - 238 p.

4. Seventh annual demographic report POPULATION OF RUSSIA 1999

5. 17. www.bigpi.biysk.ru/encicl/articles/39/1003905/1003905A.htm

6. 1.window.edu.ru/window_catalog/pdf2txt?p_id=27758&p_page=4

7. Zhdanova LA, Salova MN, Runova OS Neurosomatic approach to the rehabilitation of adolescents with diseases of the digestive tract // Vestn. Ivanovo Medical Academy.-2009.-T. 1

8. Isaev D.N.Psychosomatic medicine of children. - SPb. : Special literature, 1996.-454 p.

9. Kuchma V.R.Medical and preventive foundations of teaching and upbringing of children: a manual for medical and pedagogical workers of educational and treatment-and-prophylactic institutions. - M.: GEO-TAR-Media, 2005 .-- 528 p.

10. Kushnir SM, Antonova LK Vegetative dysfunction and vegetative dystonia. - Tver, 2007 .-- 216 p.

11. Medical, social and demographic parameters of the maternal and child health service: inform. mater. Ministry of Health and Social Development of the Russian Federation. - M., 2007 .-- 128 p.

12. Mendelevich VD, Solovieva S. L. Neurosology and psychosomatic medicine. - M .: MEDpress-inform, 2002 .-- 608

13. Belousov A.S., Vodolagin V.D., Zhakov V. P. Diagnostics, differential diagnosis and treatment of diseases of the digestive system / M .: "Medicine", 2002. AA Rean. Human Psychology: From Birth to Death. - SPb .: Prime-EVROZNAK, 2002 .-- S. 319-396. - 656 p.

14. International Classification of Diseases (10th revision). Classification of mental and behavioral disorders. - St. Petersburg: "Adis", 1994.

15. Gurieva V.A., Semke V.Ya., Gindikin V.Ya. Psychopathology of adolescence (theoretical, clinical and forensic psychiatric aspects). - Tomsk: Publishing house of Tom.un-ta, 1994.

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Types of biliary dyskinesia. Causes and risk factors for its development. Clinical and dyspeptic manifestations, the main symptoms of the disease, complications and consequences. Diagnostic and treatment methods. Basic principles of nursing care for vein dysplasia.

term paper added 03/19/2016


Characteristics of the dynamics of the health status of adolescents in the Russian Federation in recent years. The health of the population as a kind of mirror of the socio-economic, ecological, demographic and sanitary and hygienic well-being of the country.

term paper added 01/23/2016


Psychophysiological characteristics and health status of adolescents, health problems of adolescents: statistics. The Ministry of Health warns ... The spread of drug addiction among adolescents. Behavioral signs suggestive of drug use.

term paper, added 01/27/2004


Causes and clinical symptoms of inflammatory processes in diseases of the liver, gallbladder and bile ducts. The principles of herbal medicine, classification and characteristics of plants. Treatment of biliary dyskinesia, chronic cholecystitis.

term paper, added 04/03/2016


Public health and the environment. Fundamentals of Human Ecology. Nutrition as a factor in maintaining and strengthening health. Occupational hygiene and health protection of workers, medical institutions, children and adolescents. Hardening of children and adolescents.

test, added 04/09/2016


Definition of the concept of reproductive health; the basics of its preservation. Features of maternal and child health protection in Kazakhstan. Consideration of factors affecting the ability to conceive, bear and give birth to a healthy child. Problematic behavior of adolescents.

The health of children and adolescents in any society and in any socio-economic and political situations is the most pressing problem and a subject of primary importance, since it determines the future of the country, the gene pool of the nation, the scientific and economic potential of society and, along with other demographic indicators, is a sensitive barometer socio-economic development of the country.

In accordance with the Law of the Russian Federation “On Education,” the health of schoolchildren is one of the priority areas of state policy in the field of education. In modern conditions, the school is called upon to perform not only an educational function, but also to take care of the preservation and strengthening of the health of children, since everyone passes through the school and the problem of preserving and strengthening health must be solved here.

However, dynamic monitoring of the health status of the child population, especially schoolchildren, reveals a persistent trend of deterioration in health indicators; the proportion of healthy schoolchildren decreases with a simultaneous increase in chronic forms of diseases during the transition from class to class in the learning process, and the health index decreases.

Despite close attention to the health improvement of the younger generation and existing laws, the number of healthy children, according to the Research Institute of Hygiene and Health Protection of Children and Adolescents of the Scientific Center for Children's Health of the Russian Academy of Medical Sciences, has decreased three times. Statistics show that the prevalence of pathology and morbidity among children aged three to 17 years is increasing by four to five percent annually.

Only ten percent of the total number of students can be called healthy, and the remaining 90 percent have problems and deviations in physical, psychological, and nervous development. According to statistics in our country, from year to year, the health index decreases and the overall morbidity of children and adolescents increases. Of particular concern in this regard is the very nature of the disease, which is changing towards chronic non-infectious: allergic, cardiovascular, oncological, neuropsychic, respiratory diseases, vision, hearing, etc.

In the structure of chronic diseases of modern adolescents, diseases of the digestive system began to occupy the first place. Their share has doubled (from 10.8 percent to 20.3 percent). The share of chronic diseases of the nervous system increased 4.5 times (from 3.8 percent to 17.3 percent). Diseases of the musculoskeletal system are still in third place, while the proportion of chronic diseases of the ENT organs has halved, moving from first to fourth rank. Gynecological pathology in high school girls began to occupy the sixth rank place.

Among functional disorders, disorders of the circulatory system are “in the lead” (25 percent), followed by disorders of the musculoskeletal system (17 percent). In third place are endocrine metabolic disorders (up to 14 percent). The indicators characterizing physical performance and physical fitness in modern adolescents are significantly (by 20-25 percent) lower than those of their peers in the 80s and 90s, as a result of which about half of 11 grade boys' graduates and up to 75 percent of girls are unable to meet the standards physical fitness.

Official statistics continue to indicate alarmingly the deteriorating health of students in schools.

The Research Institute of Hygiene and Health Protection of Children and Adolescents, SCDH RAMS notes that the features of negative changes in the health of children in recent years are as follows:

1. A significant decrease in the number of perfectly healthy children. So, among students, their number does not exceed 10-12%.
2. The rapid growth in the number of functional disorders and chronic diseases. Over the past 10 years, in all age groups, the frequency of functional disorders has increased 1.5 times, chronic diseases - 2 times. Half of schoolchildren aged 7–9 and more than 60% of high school students have chronic diseases.
3. Changes in the structure of chronic pathology. The share of diseases of the digestive system has doubled, the proportion of the musculoskeletal system (scoliosis, osteochondrosis, complicated forms of flat feet) has increased by 4 times, and diseases of the kidneys and urinary tract have tripled.
4. An increase in the number of schoolchildren with multiple diagnoses. Schoolchildren 7–8 years old have on average 2 diagnoses, 10–11 years old - 3 diagnoses, 16–17 years old - 3-4 diagnoses, and 20% of high school teenagers have a history of 5 or more functional disorders and chronic diseases

There are several reasons for this situation, and many of them are associated with the school. The main school-related risk factors for the formation of the health of schoolchildren, first of all, include non-observance of sanitary and epidemiological well-being in educational institutions, malnutrition, non-observance of hygienic standards for study and rest, sleep and stay in the air. The volume of curricula, their informative richness often do not correspond to the functional and age-related capabilities of schoolchildren. Up to 80% of students are constantly or intermittently experiencing educational stress. All this, combined with a decrease in the duration of sleep and walking, a decrease in physical activity, has a negative effect on the developing body. Also, low physical activity has a detrimental effect on health. Its deficit already in the lower grades is 35–40 percent, and among high school students - 75–85 percent.

To a large extent, the ill health of schoolchildren arises from an insufficient level of literacy in matters of preserving and strengthening the health of students themselves and their parents. In addition, harmful factors such as smoking, alcohol and earlier onset of sexual activity are a significant cause of deterioration in the health status of schoolchildren (senior grades).

Meanwhile, the main criterion for the effectiveness of the work of any school is the health of students.

Of course, it is inappropriate to blame only the school for the deteriorating health of children and adolescents. For 9 - 11 years of study, many factors that are not directly related to the school and the learning process have an impact on the body and psyche of a student. But, firstly, the school's contribution to this complex negative impact is very large. Secondly, the existing problems of preserving and strengthening the health of modern schoolchildren can and should be solved directly in an educational institution for one simple reason that children are on the territory of an educational institution most of their time.

From the very beginning, I would like to express my gratitude to the school administration, to all teaching staff for their understanding and cooperation in our common cause. In 2007, the idea of ​​a comprehensive program for the preservation and strengthening of the health of primary schoolchildren arose, which included both school teachers and medical staff. Class 1 “B” was chosen. There are 14 girls and 11 boys in the class. All children are the same age. In September, a comprehensive medical examination of students was carried out by all medical specialists available at the CRH. During the medical examination, the existing medical deviations in the state of health of children were identified and it was found that only 7 of them can be attributed to the 1st health group and 18 to the 2nd group. The main directions of work were outlined. Physical health monitoring is done regularly at the beginning and end of the year. Depending on the results, the work to preserve and improve the health of students was also adjusted.

I believe that one of the main factors in the health problems of schoolchildren is the insufficient level of literacy in matters of preserving and strengthening the health of the students themselves and their parents. It is necessary to form in the child the need to be healthy, to teach him this, to help in an organized way in the maintenance and formation of health. It was to address these issues that the first block of our program was directed. It was decided to devote one class hour a month to valeological topics. Hospital medical workers, pediatrician, dentist, ophthalmologist, dermatologist, etc., conducted conversations with the children in a playful, entertaining manner that corresponds to the age characteristics of the children. The topics of the conversations are varied: “Cleanliness is a guarantee of health”, “I will take care of my teeth ...”, “Soap, brush and water are our faithful friends”, “Do not put off until tomorrow what you can do today (about the daily routine)”, “ My eyes are my wealth ”,“ I am not afraid of injections ... ”,“ Food is a friend, food is an enemy ”, etc. The school psychologist O.A. Kuznetsova rendered great assistance in the work. For example, during the training “Why be healthy?” the children themselves deduced the rules of the inhabitants of the Healthy City. As part of the work of the school government, the Ministry of Health was active in the classroom under our leadership. The issue of the medical leaflet "Advice of Dr. Pilyulkin" has become a constant issue in the class. There is a Flower of Health in the class, each petal of which corresponds to one of the directions of our program.

In order to preserve the health of children, close cooperation with parents is necessary in this matter. To this end, a school of like-minded parents was organized for parents, which worked under the motto: "The health of our children is in our hands." At the very first parent meeting, the parents were informed about the results of the medical examination of children and the disappointing average Russian statistical data on the dynamics of the health of schoolchildren during their studies at school. All this caused anxiety among the parents and we received great support from them in the implementation of our program. At parents' meetings, medical workers spoke on topical issues of preserving the health of children, a school psychologist and other pedagogical workers. Attendance at such parent-teacher meetings has always been almost 100%. Representatives of the parental community more than once monitored the observance of the sanitary and hygienic regime of the school, the correct distribution of the teaching load. These issues were discussed together with representatives of the school administration at meetings of the Governing Council of the school, Council of Fathers, etc.

At one of the first parents' meetings, the issue was discussed that the quality of nutrition has a significant impact on the health of children. Rational nutrition creates conditions for the normal physical and mental development of the child's body, maintains high performance, contributes to the prevention of diseases and has a significant impact on the ability to withstand the effects of adverse environmental factors. As a result, 23 people in the classroom during their studies at the primary school level are covered with hot meals (2 people do not eat in the school cafeteria due to adherence to a diet for medical reasons). At the regional scientific-practical conference "Start in Science", a research work of a student of the class R. Galkin "Drink milk, you will be healthy," which became a prize-winner in the nomination "First Step into Science", was presented.

In many respects, the deterioration in the health of schoolchildren is associated with a deficit in physical activity. From the first years of study, it decreases by 50% and continues to decline steadily in the future. TV, computer, static loads at school, daily “jail time” for homework - this is the day of most modern schoolchildren. How to form a solid “health frame” with such a lifestyle? This issue was also brought up for discussion by the parental community. Before lessons, students do exercises every day, realizing the direction "Health is OK - Thanks to Exercise." Morning exercise instructors were trained in the class. A set of exercises for all muscle groups was developed jointly with S.V. Rodina, a nurse from the physiotherapy room. The schedule includes 3 physical education lessons. Each child keeps a diary of sports achievements, in which the child, together with the teacher, outlines an individual route of physical development.

Joint sports events with the participation of children and parents at the Yunost sports complex, sports relay races, and competitions have become traditional in the classroom. During the summer holidays, once a month, the class, together with the parents, passes the Health Path, where adults teach children to put up tents, help each other, clear springs, relax and compete together. From the reviews of MP Efremova's parent: “At first, I was very reluctant to go to great sports competitions - they are held on weekends, and I had somehow lost the habit of sports for a long time. I went so that the child was comfortable that his parents were next to him. And now I look forward to these events no less than my daughter. This is an extra opportunity to be with your child, regain your physical shape and show the child that I am no worse than other parents, and together we can do a lot ”

In order to increase physical activity, children and parents were offered circles and sports sections that are part of the system of additional education. As a result, 5 boys are engaged in the football section (participants in zonal football competitions in the junior group), 2 people - in the chess section (A. Zheleznyakov - prize-winner of regional competitions, participant in regional), 3 people - in the volleyball section, 2 people became interested in judo ( A. Beshnov is a multiple winner of regional competitions). More than half of the girls in the class attend a rhythmic dance club. Not a single event on the regional stage is complete without their participation. And in 2011 the class took 2nd place in the regional competition within the framework of the “Dancing School” project, 1st place in the school leaflet competition “We choose health!”, 2nd place in the booklet competition “Being healthy is fashionable”.

According to the results of the school competition (2010-2011 academic year), the class was awarded the title “The Healthiest Class”.

According to the results of a comprehensive medical examination at the end of primary school, not a single child was found to have any deterioration in the state of health in comparison with the state upon admission to school. And 8 students in 4 years were transferred according to indicators from the second to the first group of health. And this is a significant result.

Our forms of work do not claim to be universal. This is just a small attempt to solve the problem of maintaining and improving the health of children within the framework of one class during primary school. But these are real steps, which, according to the estimates of the parents and the school administration, turned out to be effective and efficient.

We all need to remember that the state of health of the younger generation is the most important indicator of the well-being of society and the state, reflecting the present situation and giving a forecast for the future.

Z and the last decade, the incidence of children has been catastrophically increasing. There was a high growth rate of the number of such diseases among children under 14 years of age, such as anemia (1.3 times), diseases of the endocrine (1.5 times) and musculoskeletal system (1.5 times), allergic diseases (1 , 3 times), diseases of the circulatory system (1.3 times), neoplasms (1.3 times).

The most serious situation is registered among adolescents. There is an increase in anemias by 1.8 times, diseases of the endocrine system by 1.9 times, allergic diseases by 1.6 times, diseases of the circulatory system by 1.5 times, neoplasms by 1.8 times, diseases of the genitourinary system by 1.5 times , the musculoskeletal system 1.9 times.

Due to the increase in the proportion of long-term current somatic diseases, psychosomatic pathology doubled during this period. As a response to the impact of negative environmental factors, the number of reactive states and psychopathies increased by a third.

The number of drug addiction disorders in the 90s increased by 3.7 times, drug addiction - 15 times, alcoholic psychoses - 15.5 times, chronic alcoholism - 2 times. According to special studies, the real number of adolescents with alcoholism has increased 2-3 times, those suffering from drug addiction and substance abuse - 6-10 times, substance abusers - 5.6 times.

There is convincing evidence of a slowdown in the previously observed accelerated physical development of children and adolescents and even of their deceleration.

The indicator of disability can be considered a concentrated reflection of the level and quality of health of the younger generation. It most clearly illustrates the sharp decline in children and adolescents in the functional capabilities of the body, adaptation and defense reactions. Over the past 10 years, the number of disabled children has quadrupled and reached 600 thousand. According to expert estimates, the number of disabled children will double in the next 5 years. The number of healthy children, according to various studies, currently does not exceed 4-9%.

In general, in Russia, the health status of the younger generation is characterized by the following features:

Increased chronic morbidity

The increasing level of disability

Violation of the formation of the reproductive system

Mental health abnormalities

An increase in the number of maladjusted children

Decrease in indicators of physical development.

The listed trends in the health status of children are associated with a complex of factors that adversely affect the growing body.

Deterioration of the social status of most children

Changes in nutritional quality

Impact of environmental factors

Increasing severity of goiter endemic

Medication "aggression"

Introduction of new forms of education.

The deterioration of the social status of the majority of children is evidenced by the increase in the number of socially disadvantaged children. Thus, 600 thousand children have no parents, 500 thousand annually “lose” one of their parents, 300 thousand children are born annually out of wedlock. 160 thousand children - refugees and displaced persons, 12 million children live in families with incomes below the subsistence level, 10 million - in poor families, 2 million - homeless. With this state of affairs in the country, the social background can be a serious prerequisite for the formation of diseases and their progression.

Changes in nutritional quality

According to numerous studies, in recent years, children not only receive less protein, fats and food sufficient to replenish energy, but also experience a deep deficiency of vitamins, minerals and trace elements. So, experts from the Research Institute of Nutrition of the Russian Academy of Medical Sciences, who examined schoolchildren in Moscow, found that the concentration of ascorbic acid in the blood was below normal in 40%, vitamin E - in 33%, vitamin A - in 28% of schoolchildren. In Orenburg, 95% of the children were provided with vitamin C significantly below the norm, including 10% with a deep deficiency. Similar indicators were noted in other regions of Russia.

A sharp decline in the consumption of milk and dairy products, meat, vegetables and fruits has created a new problem - the body of a modern child is forced to work in a mode of insufficient supply of calcium, iron, and many other macro- and micronutrients. The greatest attention is currently required by calcium provision, which is associated with an increase in the number of children and adolescents with osteoporosis, the prevalence of which has reached, according to our data, 44%.

It should be taken into account that in a number of regions of Russia, not only children, but also 40-90% of pregnant women experience varying degrees of deficiency of one or another macro- or micronutrient.

Disorders arising in the state of health due to malnutrition come to one of the first places. These primarily include: an increase in the number of low birth weight children, starting from birth, a decrease in resistance to environmental factors, repeated respiratory diseases, an increase in diseases of the digestive system, a deterioration in physical endurance, rapid fatigue, a weakening of cognitive and physical activity, delayed puberty, an increase in the proportion of children with decreased visual acuity.

Impact of environmental factors

The role of ecopathogenic factors in the deterioration of the state of health of modern children is indisputable. This is due to the constantly increasing technogenic load on the growing organism. Industrial pollution of places of residence increases the level of chronic pathology by 60%, including diseases of the respiratory system - by 67%, digestion - by 77.6%, the musculoskeletal system - by 21%, and neoplasms - by 15%.

Increasing severity of goiter endemic

The termination of iodine prophylaxis in Russia led not only to the prevalence of endemic goiter, but also to an increase of up to 9-12% of the number of children with stunted growth, up to 14% of schoolchildren with learning difficulties, and up to 5-12% of the proportion of adolescents with puberty disorders.

Medication "aggression"

The still widespread practice of unreasonable inclusion of potent antibiotics in therapy and a high drug load on children leads to many negative changes in the child's body, primarily to a decrease in natural defense mechanisms and the development of multiple organ pathology.

Introduction of new forms of education

Reforming school education without taking into account the health status of children has significantly increased the incidence. With the introduction of new forms of education, when hundreds of new programs literally fell on students, the daily school hours exceeded the permissible norms by 3-5 hours in duration. With this “anti-child” reform, the school has become a factor that destroys health. This is evidenced by the fact that the number of healthy children in modern educational institutions from the first to the eleventh grade of school decreases by at least a third.

Already today, the quality of health of children and adolescents has significantly reduced the social opportunities of adolescents and youth. 30% of them have limitations in obtaining a decent education, 26% - to service in the Armed Forces. One in four has a high risk of reproductive dysfunction.

Problems and solutions

It is quite obvious that the preservation and restoration of children's health in modern conditions requires the widespread introduction of mass preventive programs, the creation of optimal conditions for education and training, on the one hand, and the optimization of nutritional support, harmonious development and competent treatment of diseases, on the other. Pediatric science and practice has extensive experience in addressing these problems. The importance of assessing the importance of prevention in maintaining the health of children can be judged by the results that the implementation of some of these programs promises to bring.

The introduction of mass iodine prophylaxis provides:

A 10-20% decrease in the number of preschool children with disharmonious physical development

A 30% decrease in the number of children with chronic diseases

Reduction by 20-25% in the number of children who do not master the basic curriculum

15% decrease in the number of children at risk of antisocial behavior

Prevention of severe forms of mental retardation for up to 1000 children annually

Reducing the incidence of thyroid cancer by 3 times.

Prevention of calcium deficiency in children and adolescents, it can reduce the frequency of diseases of the musculoskeletal system in people of working age to 40-45%.

Improving medical care for adolescents 15-18 years old can:

Reduce by one third the incidence of adverse outcomes of chronic diseases

Increase the detection rate of functional disorders and chronic diseases by 5 times, especially of the cardiovascular system, digestive organs and musculoskeletal system

Reduce the incidence of disability at working age by 18-20%.

Organization of children's health improvement directly at school will allow:

Reduce by 2 times the number of underweight children

Reduce the incidence of ARVI by 2.2 times

Reduce by 22% the number of relapses of chronic diseases

Reduce by 2 times the frequency of ENT pathology

Improve the performance of schoolchildren by 15%.

Nowadays it is more urgent than ever to intensify scientific research in pediatrics. The child is dynamic, he is distinguished by the ability to react sharply to all changes in the environment. Therefore, pediatrics at every stage of the development of society face new scientific challenges, on the solution of which the effectiveness of preventive and organizational technologies depends.

Among the priority scientific tasks are:

Assessment of the adaptive capabilities of children of different ages to the effects of environmental factors: feeding characteristics, micronutrient provision, inadequate physical activity, xenobiotics, stress, increased school loads, etc.

Development of new technologies for maintaining and strengthening health based on the age-specific forecast of adaptation, increasing the functional reserves of the body against the impact of risk factors.

Justification and assessment of the quality of children's health.

Development of new algorithms for the treatment of various diseases of the neonatal period, providing for a decrease in the drug load on immature (premature) children.

Study of the modern etiological structure of infectious pathology in newborns and the development of effective methods for their prevention and treatment.

To successfully implement the results of scientific research and effective preventive technologies, little is needed: to make the health of children and adolescents a national priority of the state.

Creation date: 2015/04/27

How often do we hear: adolescence and adolescence. But does everyone know what this period is? How is it characterized? What changes are taking place? I will try to answer these questions. Puberty is the most difficult and difficult of all childhood ages, which is a period of personality formation. The main new feature that manifests itself in the psychology of adolescents in comparison with a child of primary school age is a higher level of self-awareness. At this age, children become especially sensitive to the opinion of their peers and adults, for the first time they face acute problems of a moral and ethical nature, associated, in particular, with human relationships. Adolescence - as adolescence is sometimes called - is the time of the formation of a true individuality, independence in learning and in work. Children of this age are distinguished by increased cognitive and creative activity, they always strive to learn something new, to learn something.

Adolescence is associated with the restructuring of mental processes. This age is considered the most difficult in educational terms. Currently, this period of development covers approximately the age from 10-11 to 14-15 years. Teenagers in the last 20-30 years are developing at an accelerated pace, they have become larger, taller, stronger than their peers 30 years ago. There is an age-related discrepancy in the development of the cardiovascular system. At this time, the heart significantly increases in volume, it becomes stronger, works more powerfully, and the diameter of the blood vessels lags behind in development. This often leads to some temporary circulatory disorders, increased blood pressure, tension of the heart system, the consequence of this is dizziness, palpitations, headaches, temporary weakness, and fatigue. The transition to adolescence is associated with a significant restructuring of the educational activity of the adolescent. For him, the meaning of educational activity as a self-education activity aimed at satisfying cognitive needs is gradually revealed. In adolescents, a conscious attitude towards learning is noticeably enhanced. At this age, all sorts of pathological reactions associated with the development of mental illnesses may also appear for the first time or noticeably exacerbate. Mental disorders in adolescence have become a very urgent problem. As a result, there are so-called> children at this age. But even perfectly healthy adolescents are characterized by extreme instability of moods, behavior, constant fluctuations in self-esteem, a sharp change in physical condition and well-being, vulnerability, and inadequacy of reactions. The most important psychological characteristic of adolescence is the intensive moral formation of the personality, the formation of moral consciousness, the mastery of moral and ethical norms of behavior. Adolescence is the age of the beginning of the formation of a worldview, moral convictions, principles and ideals, a system of value judgments, which a teenager begins to be guided by in his behavior.

The health status of adolescents in Russia

The health status of adolescents in Russia has been a cause for concern for a long time, and various studies confirm the validity of such anxiety. It also penetrates into the highest echelons of state power.

The problem of adolescent health is always a key issue for any country, and the words of F.I. Dostoevsky's "for generations are created from adolescents" are a vivid illustration of this statement. For Russia, the problem of potential opportunities for preserving the health of adolescents is especially relevant due to the fact that the country still cannot get out of an unprecedented demographic crisis, and a noticeable deterioration in the health of the last generations of the population is viewed as a national tragedy, a threat to the security of the individual, society and the state. The health of older children and adolescents can be improved if health policies for this age group are comprehensive, combining elements of public health, and are aimed at promoting health and comprehensive treatment of diseases affecting young people.

Adolescence is the stage of life with the highest potential for intellectual and physical development, during which the development of lifelong social skills, including those related to health, continues. Until now, the state, society, and the population have not been able to radically change in a positive direction the processes of formation of many indicators of the health of the population, children, adolescents, and youth in Russia. The current state policy that directly affects the protection of the health of adolescents does not bring the desired effect, and the social portraits of young people look unattractive.

A decrease in the functional capabilities of the body, the occurrence of many diseases even in a healthy born, having proper material and living conditions of a person is associated with the action of not only social, but also genetic, environmental, behavioral factors, the formation of healthy lifestyle habits, etc. The data of special scientific clinical studies indicate a qualitative deterioration in the health of adolescents: in Russia, only 10% of school graduates can be considered healthy, half have morphofunctional deviations, 40% have chronic pathology. General morbidity rates in children and adolescents are increasing.

In the report on the state of health of children in the Russian Federation (based on the results of the All-Russian clinical examination in 2002), it is noted that in the last 10 years, due to the increase in the prevalence of chronic diseases in children, the contingent of children undergoing dispensary observation has increased accordingly. The incidence of children aged 15-17 years is lower than that of children aged 0-14 years and in 2002 amounted to 100469.1 per 100 thousand children of the corresponding age.

It should be noted that with different methods of assessing and registering the disease among different age groups, adolescents are the most vulnerable group.

Health problems of adolescents in the Far North

The health problem of adolescents living in the Far North and forming the basis of its future potential is extremely urgent today. On the one hand, the health and development of the younger generation is affected by uncontrollable climatogeographic and bio-social factors that have a special harmful effect on the child's body and contribute to the formation of pathology from the cardiovascular, respiratory, endocrine and other systems. This is happening against the background of deteriorating conditions for the education and upbringing of children, and a decline in physical education and sports.

The peculiarities of the climate of the Far North cause the appearance of other risk factors that have an extremely negative effect on the child's body and in the future can lead to the development of any pathological disorders. This is, first of all, low physical activity, dietary habits (consumption of canned foods, excess of fats and carbohydrates in food), decreased efficiency.

An important role in the adaptive rearrangements of the organism in the Far North is played by the cardiovascular and respiratory systems, which are responsible for the oxygen regime of the organism. The activity of these systems most often becomes a factor limiting the development of the organism's adaptive reactions in the process of its adaptation to various environmental conditions.

The intense oxygen regime is one of the main features of the Far North, which is due to increased energy consumption, the effect of low temperatures on the respiratory system and the activation of metabolic processes. The climatic and ecological conditions of the Far North increase the body's need for oxygen, cause a more frequent increase in the activity of the external respiration apparatus in children.

One of the factors reducing the level of health of children in the Far North is sharply limited natural physical activity, that is, in the Far North, pronounced hypodynamia can be traced. The conditions of the Far North artificially limit the daily physical activity of schoolchildren, increasing the risk of childhood morbidity, which is largely predetermined by a high degree of hereditary risk. The research data showed that almost all children with chronic diseases were born and born in the Far North from parents with different periods of residence in high latitudes and mostly with poor health.

There are several reasons for the continuing deterioration in adolescent health:

• inadequate nutritional balance (lack of animal proteins and vitamins)
• insufficient work of the health care system (not provided with medical personnel, appropriate equipment, medicines)
• impossibility of full recovery of forces (not everyone can afford annual leave, rise in the cost of transport)

1

The analysis of foreign and domestic studies devoted to the state of health of the child population in different age groups is carried out. General trends in the incidence of children and leading nosologies (diseases of the musculoskeletal system, respiratory and digestive organs, diseases of the nervous system, ENT pathology) have been identified. In many studies, there is a decrease in the number of healthy children to 7.0-10.0% and an increase in functional disorders among children already in the early stages of development. The WHO European Office has developed a prevention strategy that experts say is the most effective investment in the health of children and society at large. A review of domestic studies has shown that in modern conditions an interdisciplinary and integrative approach is needed with the introduction of new disciplines into the educational process in preventive pediatrics.

health

health group

morbidity

prevention.

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According to the European Community, prevention at all stages of life is the most effective approach (from an economic and medical point of view) to investing in health and the development of a harmonious society. Of course, the individual characteristics of a child largely determine the degree of exposure to risk factors (gender and ethnicity; genetic predisposition; emotional stability), in the first place among which social, economic and environmental determinants (level of income and family education, living conditions and labor).

It is social determinants, according to WHO experts, that play a leading role in the formation of population health. With a decrease in the adaptive and compensatory capabilities of the body against the background of a high aggressiveness of environmental factors and an unfavorable social portrait of the mother (alcoholism, tobacco smoking, poverty), social predictors contribute to an increase in the incidence and disability of children during critical periods of growth and development.

In the perinatal period, the foundation of the health of the adult population is laid, determining the further development of the body. According to WHO studies, young mothers with disadvantaged social status are more likely to have children with low body weight, which, in turn, is a predictor of many age-related pathologies and is directly associated with an increased risk of coronary heart disease, stroke, arterial hypertension and insulin-dependent diabetes mellitus. In the earliest stages of life, the family plays an important role in shaping the physical and mental health of the child. For example, according to the European Community, those who experienced childhood abuse in later life have a higher risk of smoking, abdominal obesity and alcoholism later in life.

The current state of child health in the European Region is characterized by high infant mortality under the age of five, especially in the first month of life, which accounts for 50.0% of cases. The leading causes are neonatal pathological conditions (prematurity, sepsis, birth asphyxia), trauma, pneumonia and diarrhea. At the age of 5-19, road traffic injuries take the first place. In the structure of unintentional injuries, road accidents account for 39.0%, drowning - 14.0%, poisoning - 7.0%, fires and falls - 4.0% each. Unintentional injuries are responsible for 42,000 deaths between the ages of 0 and 19 years. Along with this, more than 10.0% of adolescents have mental disorders, neuropsychiatric disorders are the dominant cause of disability among this age group. Severe depressive disorders rank first in terms of prevalence among children 0-17 years old, followed by anxiety disorders, behavioral disorders and disorders associated with the use of psychoactive substances.

The study showed that every third child aged 6-9 years old suffers from overweight or obesity. In the group of 11-13-year-old children, similar indicators range from 5.0 to 25.0%. According to forecasts, more than 60.0% of children who are overweight before puberty maintain a similar trend at an early working age, which contributes to the development of mediated interdependent pathologies - cardiovascular diseases and insulin-dependent diabetes mellitus.

The state of health of children of different age groups and the factors that determine it are the subject of study by domestic authors. So, V.S. Merenkova et al. 50 pairs "mother-child of the first year of life" with an average age of the mother of 24.46 ± 5.57 years and 50 pairs of "mother-child of the second year of life" with an average age of the mother of 25.54 ± 4.9 years were studied. In the course of the work, it was revealed that the deterioration in the health of children is directly related to maternal factors: in the first year of life - with fetoplacental insufficiency, the threat of termination of pregnancy and the presence of preeclampsia (r = 0.44; 0.38 and 0.35 at p<0,01, соответственно); на первом-втором годе - с преждевременными родами (r = 00,63 при p<0,001), и на 2 году жизни - с анемией, венозными осложнениями и болезнями почек у матери (r = 0,51 при p<0,01; 0,48 при p<0,01, соответственно) .

Study of the health of children in the first year of life in Samara for the period 2012-2014. showed that diseases of the respiratory system are leading in the structure of morbidity, there is a high level of spread of intestinal infections, diseases of the nervous system and alimentary-dependent pathologies (anemia, rickets).

An expert assessment of the health status of children aged 3-7 years attending a preschool educational institution in Yekaterinburg (n = 322) revealed that none of them belonged to group I, 58.7 ± 2 were assigned to group II, 7%, and in group III there were 41.3 ± 2.7%. In general, the incidence of this age group was characterized by multimorbidity, with respiratory diseases in the first rank, in the second - in the musculoskeletal system and in the third - in diseases of the digestive system. A fairly high percentage were children with chronic diseases - 41.3 ± 2.7%, of which the share of multisystem lesions accounted for 52.8 ± 4.3%.

Monitoring of the health of children 5-9 years old (n = 738, of which 418 are boys and 320 are girls) found that already at the preschool stage there are no more than 10.0% of healthy children; 70.0% of the surveyed have multiple functional disorders. Among nosologies, diseases of the musculoskeletal system prevail (46.1%); diseases of the digestive system and circulatory system (16.7%); ENT pathology (17.8%).

Similar data were obtained in a two-stage study of the health of children and the health of interdependent sequential groups in Primorsky Krai and Vladivostok. The study involved 626 children 4-17 years old; 226 children 4-6 years old; 224 students in grade 5 and 176 high school students. At the same time, families expecting a child (n = 54), infants (n = 60), preschoolers (n = 126) and adolescents (n = 123) were analyzed. The results of the study made it possible to develop effective preventive measures at each stage of ontogenesis: family-newborn-preschooler-schoolchild-teenager-family. The result of this work was an increase in the number of physiologically occurring pregnancies from 38 to 90.0%; less often acute respiratory diseases were recorded among children of the first year of life - from 50 to 75.0%; there was an improvement in the health status of children in all age groups.

As noted above, the course of the perinatal period largely determines the resources of health. Catamnesis of 136 children aged 4 years (n = 48; for children born in 1994) and 11 years old (n = 88; children born in 1991), who are at the initial stage of life in intensive care and intensive care units, revealed a close relationship between the severity of the newborn's illness and health in general, as measured by the NTISS (Neonatal Therapeutic Intervention Scoring System, Gray JE et al., 1992). It was also found that the degree of functional disintegration during the neonatal period and in the follow-up period directly correlates with each other. Consequently, the cross-interaction of a set of parameters of the state of health and perinatal factors on the individual characteristics of the constitution and reactivity determine the features of the course of pathology in the perinatal and subsequent periods of ontogenesis.

A large study based on preventive examinations was carried out by the Research Institute of GiOZDiP "SCCH" RAMS in 6 preschool institutions in Moscow (n = 383 children, of which 200 are boys and 183 girls) and in schools among students from grades 1 to 9 (n = 426 children; 216 boys and 210 girls). The final data showed that 5.0-7.0% of children belong to health group I, 40.0-45.0% to group II, and 50.0-55.0% of preschoolers to group III. In this age group, functional disorders of the musculoskeletal system, oropharyngeal pathology, and functional mental and behavioral disorders are recorded. Among schoolchildren, there is a progressive deterioration in health: in grade 1, group I health is 4.3%, and in grade 9 only 0.7%. In terms of gender distribution, boys are more susceptible to functional disorders and diseases. Chronization of diseases occurs already by the 7-9 grade. The leading positions among functional disorders are occupied by cardiovascular, bronchopulmonary pathology and disorders of the digestive tract.

The health of adolescents, ensuring their normal growth and development determines the level of well-being and regional stability of the country for decades to come. A multifaceted study by A.A. Baranova et al. states that over a 20-year period, the trend towards an increase in the incidence rate in terms of referral among the pediatric population by 2.0-4.0% per year persists, an increase in chronic pathology is recorded, the number of healthy children in all gender-age groups is decreasing. As the authors note, according to state statistics, the total morbidity in children aged 0 to 15 years exceeds 2400 ‰, and the total morbidity in children 15-17 years old is close to 2000 ‰. There is an increase in primary morbidity among children 15-17 years old for all classes of diseases by 66.0-64.6%. At the same time, the most significant increase in the indicator was found in neoplasms (+ 97.7%), blood diseases (+ 99.2%), circulatory system (+ 103.1%), digestive organs (+ 80.7%), musculoskeletal systems and connective tissue (+ 96.9%), the genitourinary system (+ 77.2%), the effects of external causes (+ 71.8%). As the authors note, an unfavorable trend is the deterioration in the reproductive health of children, especially in older age groups. Thus, more than 30.0% of boys and girls have a delay in puberty, the frequency of menstrual dysfunctions in girls aged 15-17 is increasing (+ 96.5% for the period 2001-2008); inflammatory diseases of the genital organs (+ 46.2%); about 40.0% of boys and young men 15-17 years old suffer from diseases that can disrupt the implementation of reproductive function. Another alarming point, according to the authors, is that one of the leading ranking places in the structure of adolescent morbidity is occupied by mental and behavioral disorders, the indicator of which for the period 2001-2008. increased by 43.4% and 25.3% (respectively, total and newly diagnosed morbidity). Their structure is dominated by behavioral syndromes, non-psychotic and neurotic disorders associated with stress; somatoform dysfunction of the autonomic nervous system. Against this background, there is no tendency to reduce the incidence of children with mental disorders of organic genesis and mental retardation.

Preserving and improving the health of children is a multifaceted problem. According to the 2006 WHO Regional Office for Europe Prevention Principles, spending on the prevention of childhood illnesses is an investment in the health and development of a country. To achieve these goals, it is necessary to create a favorable environment for the health of children with the education of the need for a healthy lifestyle; ensure universal access to health services and government support in the implementation of preventive programs. Exposure to behavioral, social and environmental risks of children should also be monitored in order to use this data to determine the social determinants of children's health and interventions.

According to a number of domestic authors, first of all, it is necessary to strengthen the legislative framework in relation to the protection of children's health; to carry out prevention and monitoring of infant mortality, child morbidity and disability; create protocols for the preventive activities of medical organizations at all levels with an interdisciplinary and integrative approach; resolve personnel issues with the introduction of the specialty "social pediatrician"; introduce new forms of rehabilitation; involve the media to inform the population about the main elements of a healthy lifestyle.

In addition, the improvement of education is required, for which an additional professional training program for pediatricians and health care organizers "Actual issues of preventive and social pediatrics" is envisaged; introduction to the educational process of the section "Fundamentals of the formation of children's health" (where basic knowledge is given on preventive medicine, including the concept of healthy lifestyle, and on the prevention of addictive behavior; recommendations for maintaining the health of preschoolers and schoolchildren; children involved in sports; concepts of mental health) and the discipline " Fundamentals of medical knowledge and health protection of children ”, carried out in accordance with the Concept of medical education of teachers on the basis of curricula for students.

Thus, the analysis of domestic and foreign studies showed that at the moment there are unfavorable trends in the state of children's health. The solution to this problem requires an interdisciplinary approach aimed at introducing a set of preventive measures throughout ontogenesis, but specific for each age group and taking into account the existing functional reserves of the child's body. An important role in achieving this goal is also played by the introduction of new professional training programs for pediatricians in the basics of child health protection from the standpoint of preventive and social pediatrics.

Bibliographic reference

Sokolovskaya T.A. CHILDREN'S HEALTH: MAIN TRENDS AND POSSIBLE WAYS OF ITS PRESERVATION // Modern problems of science and education. - 2017. - No. 4 .;
URL: http: // site / ru / article / view? Id = 26572 (date accessed: 15.06.2019).

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