Chapter 1 the literature Review

Studying of a state of health, its factors defining, is odyonoj from actual problems of some specialities - both pediatrics, and social giyogieny, and physiology. For today to give unequivocal semantic znacheyonie to the term "health" it is difficult.

Exists more than 100 definitions. And it poyonjatno: being the basic universal value, "health" involved and involves in itself minds of people of various specialities: philosophers, poets, writers, sociologists, politicians, doctors, ecologists, hygienists, etc. In the charter of the World organisation of public health services (Geneva, 1958) "zdoroyove" is treated as a condition of full physical, sincere, social well-being, and not just absence of illnesses or physical defects ". In 1968г. The CART has accepted the following formulation:" Health - property of the person to carry out the biosocial functions in the changing medium, with overloads and lost-free, under condition of absence of illness or defects. Health happens physical, mental and moral ".

With reference to the childhood, with the account of constant growth and development detyoskogo an organism, the basic value of concept "health" consists in posleyodujushchej adequate realisation of the put in pawn potential. The predominating role in this question belongs "sredovomu" to the factor, i.e. the characteristic of a family, an environment and education of the child. Socially-biological, sotsialnoyogigienicheskie factors, living conditions and a way of life of the child become
Risk factors for its health both in the childhood period, and in kept away buyodushchem.

In Russia M.V.Lomonosova's letter-treatise column I.I.Shuvalovu "About reproduction and conservation of the Russian people" (1761) was one of the first works devoted to a case rate and smertyonosti of children. In it Michael VasileYovich offered a number of measures on depression of a children's mortality, and the majority of them had social character. In the subsequent in works of front lines deyojatelej zemskoj the sanitary statistics and doctors-pediatrists - data about a case rate and a mortality of children in a number of provinces of Russia were S.G.Zybelina, S.F.Ho - tovitskogo, N.I.Bystrova, N.P.Gundobina, N.F.Filatova, K.A.Rauhfusa proanaliziyorovany. These researches have allowed to make a health general characteristic detskoyogo the population, to put in pawn bases of modern preventive and clinical pediatrics. Certainly, from present positions these works are far from perfect. But it is necessary to give due to persistence and kropotlivosti in spent isyosledovanijah those years when, not owning systematic methods of a set and statiyosticheskoj data processing, researchers tried to establish the basic zayokonomernosti organism formations, many of which we is wide polyozuemsja and until now.

From first years of existence of the Soviet power in our country was proyovozglashen a principle of "preventive medicine", and in the twentieth years there were detailed researches about a children's case rate and its structure among the population of Petrograd, Moscow provinces. In 1929 V.V.Paevskim,
The large theorist in the field of sanitary statistics and a demography, was doyokazano advantage of application of a selective method of studying zabolevaemoyosti, that considerably simplified research carrying out at conservation dostoyovernosti received results.

Unfortunately, this method has received a wide circulation a little bit later.

In post-war years along with remaining researches on hayorakteru and case rate structure in separate regions of Soviet Union the researches, concerning studying separate neblagopriyojatnyh the factors forming a pathology have been undertaken. Among works of those years it is possible otmeyotit S.M.Levitinoj's work (1948). It was the first experience of statistical studying of a case rate of children at the age from 5 days till 3th years, with separation into two age groups with use of the simplified method of calculation of the children's mortality offered by V.V.Paevskim.

In 50-60th years in our country variety of the special researches devoted to studying of a case rate of the children's population has been executed. SreYOdi these works it is possible to note S.J.Levinoj's (1963) research, R.B.Kogana (1964), A.A.Perelyginoj (1962), A.A.Perelyginoj (1968). During this period the method of selective research by vykopirovki data from development histories is activly introduced. The high role in formation of a case rate social faktoyorov in comparison with industrial (Notkin E.L is confirmed., 1961). Are undertaken popytyoki numerical ranging of influence of some socially-hygienic fakyotorov on case rate level (Shlehovsky E.V., 1967). Are analysed uroyo
ven and case rate structure, physical development of children various vozrasyotnyh groups with definition of influence on these indicators of separate social factors.

Since 60th years with introduction in practice of researches powerful vychisliyotelnoj technicians have considerably extended methods of mathematical data processing. Such traditional ways statistiyocheskoj processings, as factorial, disperse, consecutive, cluster analyses began to be used widely. There was an allocation of social pediatrics in separate scientific discipline. A main objective of this branch of pediatrics is studying zdoroyovja children, and also a complex of factors, its defining, with working out efyofektivnyh methods of preventive maintenance and medical aid rendering to the children's population. On the basis of chair of social hygiene II MOLGMI of N.I.Pirogova under the guidance of J.P.Lisitsina the methodical basis soyotsialnyh researches has been developed. The complex estimation of a state of health of the population is proved at carrying out socially-hygienic, clinico-social isyosledovany. It is offered to consider at an estimation of a state of health following criteria (Grombah M. S, 1967):

♦ a functional condition of organs and systems,

♦ resistance and reactance of an organism,

♦ level and a harmony of physical and psychological development,

♦ presence chronic (including congenital) pathologies.

In 1966 the program mediko-social obyosledovanija the families (Grinina O. V), covering practically all parties semejyonoj lives and their influence on health of members of a family has been introduced. As object nabljudeyonija it was offered to use a family. Following parametres of the soyotsialno-hygienic characteristic are allocated: demographic, social, poveyodencheskie, medicobiological, sredovye.

Under the program complex socially-gigenicheskih researches vyyopolneny N.V.Poluninoj's works (1973); E.A.Koshkinoj (1975), E.A.Ivanovoj (1977); N.N.Stepanovoj (1977); G.G.Beljaevoj (1978) and others.

The scheme of studying of risk factors at their revealing (is offered Bushtueva K.A., Sluchanko I.K., 1979):

♦ definition of frequency of prevalence of this factor among certain group of the population,

♦ an establishment of influence of this factor on augmentation of risk of occurrence of studied disease,

♦ studying of possibility of influence on a risk factor,

♦ studying of efficiency of influence on a risk factor,

♦ studying of possibility of influence on population at influence on a risk factor.

Risk groups on disease by allergic dermatoses (Ravinsky I.N are allocated., 1976; Cogavel Y.Y., Halliday D.F., Alexander Y.R., 1982). Are defined nekotoyorye the factors influencing an outcome of a bronchial asthma at children (Bolshakova G. S and
Co-workers., 1977). Occurrence risk factors bronholegochnoj patoyologii (by Bolshakova G. S, Onoprienko A.V., Hodareva R. B, 1981) are established. Attempt vyyojavlenija children with immunologic disturbances on a complex of signs, soyoputstvujushchih to disorder of immune system, including by data obychyonogo clinico-laboratory research is undertaken at prophylactic medical examination (Podosinnikov I.S., Gubler E.V., 1979). Influence of risk factors on development in children zayobolevany digestion organs (Baranov A.A. and co-workers is studied., 1980).

In 1980 I.I.Brehman has entered for the first time into the scientific literature the term "valueology" as a designation of that direction which studying of health and methods of its active formation sets as the purpose. Complex issleyodovanija states of health were enriched with introduction of definition of influence fakyotorov environment. It is established, that health of the person and population javyoljaetsja the indicator of quality of environment. Thereupon it is necessary to note K.V.Orehova's works (1984); V.P.Kaznacheeva (1986); N.A.Agadzhanjana (1988); F.A.Kaufmana (1989); N.J.Madge (1982); L.Pelech (1985). It is calculated, that health more than on 50 % is caused by conditions and a way of life, on 20-25 % - an environment condition. Are definitively introduced in practice of the program complex sotsialnoyogigienicheskih researches of health of children taking into account conditions and a way of life (Veselov N.G., 1981; Albitsky Century JU, 1987; Barber Y.H., 1982; Baldwin S., 1983; Bircheva E, 1984).

The objective and subjective factors affecting soyotsialno-economic and cultural development of our country, shown in 70, 80th years and taking place now, render negative a cart
Action as on population health (especially sharply being shown in children's and poyozhilom age), and on activity of establishments of public health services in whole, quality of rendering of medical aid. Population health progressively worsens. Position of the children's population (annual goyosudarstvennyj the report "About position of children in the Russian Federation", 1993) has especially worsened. Thereupon a problem of an estimation of a state of health, allocation of its factors defining last years the increasing and larger attention (Avtsyna A.P is paid., 1985; VoYOrontsov I.M., 1985; Sedov K.R., 1988; Seamy side A.D., 1992; Gun G. E, 1994). Similar raboyoty are conducted and in foreign countries (Grodin, 1988; Hartmman 1988; Paeters, 1988; Zikmund, 1989; Betz C.L., 1994; Bloomberg L., 1994; Wehr E., 1994). In some of them (VoYOrontsov I.M., 1985; Treasurers S.P., 1988; Bug E.G., 1990; Eiben O.G., 1986; Pechstein I., 1990; Hellbrugge Th., 1991; Harris P., 1994) the concept of health is treated not only as statiyocheskoe a condition, but also as adaptability process to environment in performance of biological and social functions. Dynamic process foryomirovanija health against continuous morphological and funktsionalyonogo developments makes essence of children's age. Therefore allocation of separate concept - "health of the child" is expedient. Being based on opredeleyonii the CART, the standard definitions of health, I.M.Vorontsov (1989) has given opredeyolenie to concept "health of the child" as to set of properties of its organism, seyomi, an environment and education which provide:

♦ absence of chronic diseases and significant anomalies of development;

♦ a relative rarity and ease of a current of acute diseases;

♦ absence donozologicheskih syndromes, reactions and risk conditions;

♦ adequacy of psychological support and measures of stimulation of development;

♦ eliminatsiju and (or) correction of risk factors for the subsequent periods of a life;

♦ optimum type of an ontogenesis.

At each stage of an ontogenesis it is traced defined zayokonomernost in the interconnected balance hereditary and sredovyh faktoyorov (Gavalov S.M. and co-workers., 1985; Berezhkov L.F. and co-workers., 1986; Ivanov V. P, 1987; Jugaj G. A, 1989; Karelin, 1994; Alexeys S.V., 1994; Horwitz, 1989; Lee A.I., Dressler W.W., 1994).

The factors influencing a state of health, can be klasyosifitsirovany variously. M.M.Brzhezovsky (1990) has offered separation on sleyodujushchim to signs: universality, character and influence level, znachiyomost, action time, stability, management level, degree of a level of scrutiny. Often enough make division of risk factors on the childhood periods: fakyotory, the conceptions of the child operating in antenatalnyj influencing till the period, inyotranatalnyj, postnatalnyj the periods, and also the factors defining usloyovija and a way of life of the child. In practical socially-hygienic issledoyovanijah separation of the factors influencing health, on following groups is most standard: demographic, prirodno-climatic, sotsialnoyoekonomicheskie, socially-biological, socially-gigenicheskie, meditsinyoskie (Jurev V. K, 1993).

For last years variety of the researches referred on studying of influence of separate groups of factors in formation and formation of health (Baleeva L.S is undertaken., 1987; Grishchenko Etc. and co-workers, 1989; Balygin M. M, Dmitriev V. I, 1990; Ashabova L.M., 1994; Beglay L.E. et al., 1994; Carole L.M. et al., 1994; Fuchs G.J. et al., 1994; Michels R., 1994; Telahun M., 1994; Severson H.H. et al., 1995). E.G.Zhurkovym and E.K.Vlasovoj (1988) studies influence of medicobiological factors on formiroyovanie groups often and is long ill children. I.P.Katkovoj and S.N.Safarovoj (1988) proves serious consequences for health of children of such factors as divorce of spouses, education of children in the conditions of serious disputed situayotsy. L.L.Maksimenko (1991) carries out research by force definition vozdejyostvija of some socio-economic factors on health of teenagers of Stavroyopolsky edge. The forecast of development of a chronic pathology in zaviyosimosti from various factors of conditions of a life is made. T.M.Maksimovoj (1991) taps features in conditions and education of children in the families belonging to razlichyonym to social groups of the population (the workers serving, invalids of work, inyovalidy since the childhood, pupils, housewives). It is confirmed negative vliyojanie bad habits of fathers (Bezrukov L.A. and co-workers., 1988), the social status of a family (Nolte A.E., Smith B.J., O'Rouk T., 1983; Douglas I., 1991), stressful situations in seyome (Isaev D.N., 1994; Haggerty R.J., 1986) on health of children. It is expressed in more frequent formation at children of the premorbidal conditions, raised sklonnosyoti to diseases, development dysfunction. Adaptive possibilities of such children are lowered, in the course of training quite often there are difficulties in development navyyo
kov and abilities, disturbances of processes of thinking, knowledge, mezhlichyonostnogo dialogue become perceptible. Influence of conditions and a way of life in formation of a pathology at children of various age groups is studied by V.D.Sokolovym (1985). P.H. Thomsen (1994) has defined influence of socially-demographic indicators on razviyotie pathologies of nervous system at children and teenagers.

With reference to the preschool period it is necessary to note big znayochimost factors of the socially-biological plan (Albitsky Century JU, Rams A.A., 1985; Borisenko N.F., Bevz R. G, 1985; Veselov N.G., 1986; Bodzsar B.E., 1985; Yrko G.P., 1988; Horwitz F.D., 1989).

It is necessary to underline especially, that the environment can act not only in a negative role of change of level of health, but also as blagoprijatyonyj a source of optimum realisation of hereditary factors. On occasion vneshnesredovye factors can level "nature errors" substantially. Some researchers in the works specify on poyolozhitelnuju a role of physical training and methods of physical influence in the child in strengthening of health and a development harmony (it is brisk P, 1985; BeYorezhkov L.F. and co-workers., 1986; Veselov N.G., 1987; Vajtrub E.M., 1989; CHehoeva N.B., 1992; Saris H.M., 1986; Ettrich, 1989; Dzewaltowski D.A., 1994).

Along with studying of a social environment in a number of works studying of changes of a state of health depending on ecological okruyozhenija (Gusev M. I, 1986 is undertaken; Goremykin V. I and co-workers., 1989; Dobrovolskij L.A., Radvansky E.L., 1989; Alexeys S.V., 1994). The characteristic of a state of health of children doyo is given
The school age, living in industrial cities (Hachatrjan R. S, Slivnjak I.M., 1986; Babadzhanov A.S., 1989; Timonov M. A, JUshko JA.K., 1989; Rappoport ZH.ZH., 1990; Doshchitsin J.P., 1991; Veltishchev J.E., Fokeeva V. V, 1992; Dutkiewicz T. et al., 1994; Lee S.M., 1994). Concepts are entered Into daily practice "ekopatologija", "ekoyologicheski pure space". Now the international register of potentially-toxic substances includes hundreds the known ecologically harmful bonds rendering sensitising, toxic, razdrayozhajushchee, immunopatologicheskoe action (Smirnov G. I, Smirnov I.V., 1991). SHiroYOkoe introduction of immunologic methods of research has allowed to estimate reyozistentnost a children's organism and to tap adverse influence antroyopogennyh environmental contaminations already at initial stages (Rappoport ZH.ZH., 1989; Shandala M. G and co-workers., 1989; Narzulaev S.V. and co-workers., 1990; Stenelova R. et al. 1989). Influence of pollution of atmospheric air on a functional condition of respiratory and cardiovascular systems, occurrence hromoyosomnyh and not chromosomal anomalies (Maranly and co-workers is proved., 1989; Narzulaev S.V. and with - avt., 1990), and potable water with adverse mineral structure - on deyojatelnost mochevydelitelnoj systems (Lagutina L.E. and co-workers., 1990; Pochueva L.P. and co-workers., 1990; Reznik B.J. and co-workers., 1991). Disturbances morfofunktsioyonalnogo developments (Ignatyev, 1980 are established not only functional izyomenenija under the influence of the ecological reasons, but also; Wojoik A., 1992). Are described metabolic reakyotsii in reply to "ecological explosion", testifying to possibility peyorehoda adaptatsionno-adaptive reactions in pathological conditions
At ascending of action of harmful factors of an environment (Zabrodina Z.V., Gorokhov G. L, 1993).

As it has already been noted, the majority socially-hygienic issleyodovany is carried out now under complex programs (Gagarin S.A., 1984; Albitsky Century JU, Baranov A.A., Purtov I.I., 1986; Veselov N.G., 1986; Sadova N.G., 1987; Erman L.V., 1990; Pechora K.L. And co-workers., 1990; Chernuha A.D., 1992; Absava T.A., 1995; JurYoev V. K and dr., 1995; Michelsson, 1988). At the heart of the specified method it is put in pawn provedeyonie routine inspection by certain criteria - a deviation in an early ontogenesis, an age estimation of a condition physical and nervously-psiyohicheskogo developments, resistance of an organism according to acute zabolevaemoyosti, presence or absence of chronic diseases and congenital developmental anomalies, an estimation of the social status of a surveyed contingent. A result komyopleksnoj estimations is diagnostics of groups of health on which basis the average index is defined, and some authors (Prokhorov B.B., 1988) - health level. As indicators of an estimation of level of health of the population variety of indicators is used. V.N.Luchaninova and co-workers. (1988) offer to introduction a health average index - private from the sum of products grupyopy health on number of children of corresponding group to the general number of children. DoYOstoinstvom the given indicator its objectivity and comparability reyozultatov serves. N.A.Kazberjukom and co-workers., (1989), using a health average index, the authentic aggravation of symptoms of health of children for a year of stay in children's home has been shown. A.N.Gurov (1987) offers at a health estimation
The population to lean against the medicogeographical description of region of the research, including administrative device; demographic hayorakteristiku the population; the basic indicators of the industry, rural hoyozjajstva and t.d. To the same point of view some are declined also foreign avyotory (Rosenlerg et al., 1994). A.F.Dmitriev, J.D.ShCherbin (1985) in quality most inyoformativnyh health indicators consider expedient to use sleyodujushchimi criteria: the general case rate of organs of breath and allergoyopatologija; a condition of cardiovascular system on hemodynamic and elyoektrokardiograficheskim to indicators; a condition of immune system on autoyomikroflore and allergic reaction to medicines, vaccines; features reakyotsy cardiovascular system according to functional assays; fiziyocheskoe development at a birth and in a current of the first year of a life of the child taking into account age of mother. As indicators of a state of health it is standard isyopolzovanie demographic indicators, a case rate, physical razviyotija (Jurev V. K, 1993).

Demographic indicators share on two basic directions. Indicators of a statics of the population concern: a sex, age, a trade, natsionalyonost, formation, a residence, klimato-geographical characteristics of region of residing and dr. Dynamics of the population occurs under influence razyolichnyh migratory processes, and also as a result of natural movement of the population. From indicators it is necessary to note birth rate, a mortality (with razdeyo
leniem on maternal, perinatalnuju, an infantile mortality), estestyovennyj an increase in population and dr.

Separate sotsialnoyodemograficheskih groups it is possible to carry researches of health of children to complex researches of health of children from mnogoyodetnyh families (Tcherepanov I.S., 1985; Kasymov G. P, 1990; Pozdnyakov M. A, 1994); children in young families (Grinina O. V, Panichina M. I, 1982); children of the erratic population (Bova A.A., 1987); children who were born at juvenile mothers (the Eagle of Century I, 1991); girls - buyodushchih mothers (Jurev V. K, 1989); children in children's homes (Kuznetsova E.JU., 1989), boarding schools and children's homes (Ananin S.A., Usanova E.P., 1988; Albitsky Century JU, Ananin S.A., 1989); children in families of workers (Kusova A.R., 1990); children, royodivshihsja out of marriage (Titova E.J., 1992); Latin American children in the USA (Mendoza F.S., 1994); children of various ethnic groups in the Netherlands (Verrips G.H., 1994); rural children in Nigeria (Dixon R.A., 1993), etc.

And among researches of a state of health of children in various regions it is necessary to note the works spent in Leningade (Veselov N.G., 1986); in the Seyovero-east of Russia (Seamy side A.D., 1992); in Murmansk area (Gun G. E, 1994); in Baikalsk and Cherepovets (Erman L.V., 1990); Lipetsk (Ogryzko E.V., 1990); Chelyabinsk (Djukareva A.M., 1993); in the Tver area (Ivanov A.G., 1991); Pskovyosky area (Krasavina L.V., 1993); the Novgorod area (Jurev V. K and co-workers., 1995); Izhevsk (Molchanov L.F., 1990); Stavropol Territory (Maksimenko L.L., 1991); Komi to Republic (Absava T.A., 1995); the European North (Makarova V. I, 1995), etc.

The case rate is the second important criterion characterising health of the population. The indicator represents difficult system of concepts: actually a case rate (primary); prevalence (morbidity); pathological porazhennost (the frequency of diseases taped at proyofilakticheskih surveys). It is proved (Winds of Century P and co-workers., 1984; Efimova A.A. and with - avt., 1985), that the case rate on appealability does not give a true picture patoyologicheskoj porazhennosti the population. Much bigger value has studying of a case rate according to profound medical inspections. In structure payotologicheskoj porazhennosti the majority of authors notes prevalence patoyologii a locomotorium, ENTs-bodies, caries in group of children with II group of health on S.M.Grombahu (Nikulina L.D. and co-workers., 1980; Balandin V. A, 1985; Briskly P, 1987; Baranova I.P. and co-workers., 1989; Ritter G., 1990). In this group of children a specific gravity often is high and is long ill children (Kravets E.B. and co-workers., 1990; Debiec B., 1986). Not less important indicator in socially-hygienic issledovayonijah is prevalence of diseases which allows to judge about reyozistentnosti a children's organism to adverse factors of an environment during the various age periods. Undertaken Century JU Nazarov (1990) obyosledovanie children with different level of a case rate has taped significant klinikoyoimmunologicheskie differences. One of the most used indicators zayobolevaemosti are served by group often and is long ill children. The problem chasyotoj case rates of children, in view of serious medical and socially-ekonomiyocheskih consequences, is one of leaders in pediatrics (Albitsky
Century JU, Baranov A.A., 1986; Andreeva E.I., Musin B.K., 1990; Makarova Z.S., Chertok T.J., Tonyokova-Jampolsky River V, 1990). Frequent respiratory diseases lead vyrayozhennym to disturbances in a state of health of children and promote foryomirovaniju to the chronic pathology quite often leading to an invalidism in zreyolom age (Puzyrev O. I, 1988; Makarova Z.S. and co-workers., 1990; Sosnin V.V., Razumtseva G. A, 1991). With reference to preschool age it is necessary to allocate a number of the works, risk factors of a high case rate concerning studying. It is studied vlijayonie socially-hygienic (Zubitsky M. K, 1983; Komissarova R. A and co-workers., 1990; Pennington E., 1984; Grosch Ch. et al., 1985), technogenic (Shtejman G. R and co-workers., 1987; Haladova E., 1988); social and economic (Albitsky Century JU, Rams A.A., 1986; Aspens A.JA., 1990; Chiswick M.L., 1985; Bodzsar B.E., 1985; Johannesson M., 1994) factors, vlijajuyoshchih on a case rate of children visiting preschool centres. In S.I.Mandrova's work (1987) the forecast of risk factors and requirement in dispanyoserizatsii children of preschool age on the basis of updating veyorojatnostnogo method Bajersa (a method of rationing of intensive indicators) is presented.

At separate zabolevayonijah the considerable quantity of researches also is devoted a complex estimation of a state of health of children: at konstitutsioYonalno-ekzogennom adiposity (Glushchenko V. A, 1994), at congenital anomalies of development (Stukolkin O. N, 1994), at congenital anomalies peripheric soyosudov (Zdorovtseva I.V., 1991), among girls with disturbances of a menstrual cycle (Starovojtova O. L, 1994), often ill children (Kamayev I.A., 1993), sick inyofektsionnymi diseases (Pugach S.K., 1992), it is long and often ill deyo
tej (Karimbaev SH.D., 1991), children with traumas (Durmanova I.P., 1982), not full-term children (Vasilev V. E, 1994), children with an ENT-pathology (Suslov G. A, 1989), etc.

Physical development is the third important indicator of a state of health of the population. As physical development understand set moryofologicheskih and the functional properties of an organism causing formation of type and the sizes of a body. Physical development influence as internal factors (hereditary, ethnic), and external (biogeographical, social and economic, ecological). One authors prefer influences on length of a body of genetic factors, on the general physical development - vneshnesredovyh factors, and with the years, in process of depression of lability and plasticity of an organism, degree of influence of factors of an environment is weakened, and expression of influence of internal factors amplifies (Krylov D.N., Kulakova T.P., 1982; Berkey C.S., Reed R., Valadian Y., 1983; Chang et al., 1994; Saigal et al., 1994). Other authors note the big importance in the course of growth and development biological and to socio-economic factors (Serdjukovsky N, 1981; Cat T.N., 1987; Salivan I.I. and co-workers., 1989; Gritsinsky Century L, 1993; Rona R.T., 1981; Bodzsar D.E., 1985; Eiben O.G., Panto E., 1986; Rzepka Y., Smylla B., 1989; Hauser R.M., 1994; Lindgren G., 1994). In negative influence on physical development such socio-economic factors as nedosyotatochnoe or a defective food, physical work and an academic load, zayonjatija sports, and also formation and a trade of parents have the greatest value.

The basic signs characterising physical development, javljayojutsja length of a body, body mass, a thorax circle, a head circle (Shirinsky Century A, 1985; Zhdanov A.G., 1990; Jampolsky JU.A., 1990; Sorva R. et al., 1990). For an estimation of indicators use of a method of the nonparametric analysis is standard. This method is entered into use C.Stuart, H.V.Meredith in the early thirties. TSentilnyj the method allows to estimate rates of development of the child in an ontogenesis (Tashbaev O. S, 1989; Jakovlev J.G. and co-workers., 1989; Tanner Y.M., 1986; Basel D. et al., 1987). Specifications of physical development are under construction on the basis of inspection odnoyorodnyh groups of the children's population. Drawing up and regular (1 time in 10-15 years) updating of standards can be an example population monitoring (Derjabin V. N, 1985; Treasurers of Century P, 1988; Sorva R., 1990). Standards can be regioyonalnymi, uniform, vnevozrastnymi. The last are used as orientiroyovochnye. The relation to necessity of working out of regional standards razyolichna. One authors specify in unfitness of use of the same specifications for an estimation of a condition of physical development of children and the teenagers living in different climatic, geographical, economic zones (ApaYonasenko G. L, 1985; Kardashenko V. N and co-workers., 1988; Miklashevsky N.N., 1988; Berkey C.S. et al., 1983; Tanner Y.M., 1985). Others, being based on absence social razliyochy in the conditions of a life of children of all regions of the country, suppose use of uniform standards (Serdjukovsky N, 1981; Maksimova T.M., Yanin V. N, 1984; Ilyin B.N., 1987; Shtejman G. R and co-workers., 1987; Maksimova T.M., Orlova E.V., 1990). Use of both kinds of standards will allow to define a level of development most precisely
As individual (on the basis regionarnyh standards), and populations in tseyolom (on the basis of all-union standards) to establish connection with factors of medium and to develop actions for its improvement.

For today the considerable quantity of works according to physical development of children living in various klimato-geografichesYokih zones is executed: to an average strip of Russia (Grehova I.P., Zhukova N.P., Kobzeva L.F., 1984; Butler E.N. And co-workers., 1987; Matveeva N.A., Kobzeva L.F., 1988; Jakovlev J.G. and with - avt., 1988; Bal L.V., Kardashenko V. N, 1991; Dronova S.T., 1993); Belarus (Verenich G. I, 1991; Bernstein G. F and co-workers., 1992; Usoeva N.A., 1992); Kazakhstan (Asaturova E.V. and co-workers., 1986; Kirina L.E., 1984); Dagestan (Tuchalaev S.R., 1987); to Baltic (Andrjulis E.K., SHimkunene D, 1981; Veldre R. V, 1985); Siberia (Balandin V. A, 1985; MoroYOzova T.L., 1985); the Far East (Zamaraev V. A, 1990); in northern districts of Russia (Zhvavyj N.M. and co-workers., 1990; Nuts of Century R and co-workers., 1990); Finland (Sorva R. et al., 1990).

The multifactorial estimation spent at complex studying soyostojanija of health, demands application of variety of matematiko-statistical methods. The part of these methods is resulted in methodical references, podgoyotovlennyh by group of authors (Kobrinskij B.A. and co-workers., 1981), with which proanaliziyorovany theoretical preconditions of application of some mathematical meyotodov (a method of the main things a component, consecutive statistical analysis Valdtsa, the variance analysis, a method of correlation galaxies, etc.), are resulted concrete examples of a quantitative estimation of separate risk factors and them soyochetany. Certain interest for studying of risk factors represents isyo
Using of the theory of sets (Taperova L.N., 1981), algorithm "a statistical admixture" (Serdobolsky Century I, Ovseneva T.L., 1980). Application of columns-models and "derevyoev" communications (Zhilinsky M. V and co-workers., 1980) allows to spend a statistical estimation of interrelation of signs in various groups and to define potentially opasyonye for health of children signs.

Thus, for today at carrying out sotsialnoyogigienicheskogo researches it is necessary to use complex methods of an estimation of a state of health. The powerful base of the mayotematiko-statistical methods is developed and introduced in practice, allowing to define degree of influence on a state of health enough the big set of adverse factors. The researches carried out socially-gigenicheskie have taped different level of a state of health of children living in various klimato-geographical, social, demographic conditions. To answer a question, than these differences - features of population and conditions of environment or absence mezhtsentrovoj standardization of methods of inspection are caused, researches under the uniform methodical standards, spent in various regions can only.

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Scientific source Homich Michael Mihajlovich. COMPLEX MEDIKO-SOCIAL ESTIMATION of HEALTH of CHILDREN VISITING PRESCHOOL INSTITUTIONS, In VARIOUS REGIONS of the NORTHWEST of Russia. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 1996. 1996

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