[The organization of the preventive work in educational institutions: problems and solutions].

Prevention measures are relevant for children and adolescents as among them there is the high prevalence of leading risk factors for chronic diseases. For the improvement of the preventive work it is necessary the introduction of amendments into the legislative documents and orders of the Ministry of Health, governing health care for children and adolescents in educational organizations. The consistent methodology for primary health care must be provided with the appropriate protocols. It is necessary to perform the systematic work on the reduction of the prevalence of risk factors for children's health and a healthy lifestyle. The number of doctors and nurses in the preschool and educational institutions is insufficient, and in organizations of primary and secondary vocational education is disastrous. Medical personnel departments of medical assistance to students due to the excessive load is not capable to fufill all of their functional responsibilities. Due to the low wages there is a constant reduction of health workers in schools and kindergartens. In the paper there are proposed measures aimed at improving the quality of preventive work in educational organizations.

[Morbidity rate and mental capacity of Moscow schoolchildren (longitudinal study)].

In the article there are presented data of longitudinal study of the health of Moscow schoolchildren (426 children), followed throughout from the 1st to 9th class, inclusively. Students were annually clinically examined in the school. There was performed a comprehensive study of mental health and functional state of the organism in the process of education students in high school (over 2700 pupils of 5-9th classes). The health status of students was shown to deteriorate due to the increase of the prevalence of chronic disease, the rise in occupancy of the III-IV health groups, the decrease of the number of children referred to I and II health groups. Unfavorable trends in the health state among boys are more pronounced than in girls, while they are also characterized by lower functional capabilities of the CNS and lower resistance to the development of training fatigue. Relatively favorable stage of school ontogeny is characterized by period with reduced morbidity in children studying in 4th-6th classes. Deterioration in the health of students as a significant rate of the rise of chronic diseases morbidity is observed in 7-9th classes. Along with this, in the 7th and 9th classes there is revealed the deterioration of mental capacity and high frequency of the pronounced signs of fatigue among schoolchildren.

[Hygienic evaluation of educational conditions and health status in junior pupils from rural schools].

Clinical and epidemiological examinations were made in rural junior (8-10-year-old) schoolchildren from the Vyazma District, Smolensk Region. The clinical findings were compared with the results of evaluation of sanitary-and-hygienic school welfare (SGW), made by the regional branch of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, and with those of a sociological survey of school directors and teachers. In the rural schools referred to as Group III morbidity, the incidence of diseases was ascertained to be significantly higher and their patterns had its peculiarities as compared to good hygienic and social educational institutions. There was evidence that the worse schooling conditions, the more children suffered from chronic diseases, chronic mental diseases and physical malformations in particular.

[Scientific-and-methodic bases of adolescents' health protection and promotion in Russia].

The problems that have a considerable impact on health in population groups of all ages but on that of adolescents in particular, have been formed during the complex and unstable situation in Russia and with high morbidity rates among the children, adolescents, and young people. Power bodies, concerned ministries, agencies, and nongovernmental organizations show no consistency of actions in elaborating and implementing programs and measures to prevent and correct adolescents' health and developmental disorders. The foregoing suggests that the "dolescents' Health and Development in Russia" strategy that considers Russian and international experience with the rising generation's health care is urgent. The paper presents basic principles, study areas, and indicators of the expected efficiency of the complex activities of ministries, agencies, governmental and public organizations, medical and pedagogical communities for ensuring normal development and health promotion for the adolescents.

[Hygienic assessment of projects on better organization of pupils' nutrition].

The paper deals with the hygienic bases of experimental projects for improving the organization of school nutrition. The purpose of the designs was to make a systematic monitoring of the successive implementation of all stages of regional integrated programs on healthy school nutrition. Today's school nutrition problems and ways of their resolution are outlined. A concept of schoolchildren's health monitoring in the implementation of experimental projects is presented. Methods and groups of parameters on which schoolchildren's health monitoring will be based are described.

[Morbidity and problems in medical provision of vocational school pupils].

The medical provision system for vocational college (VC) pupils was apparently destroyed at the turn of the 20th century, causing their health to become worse. In the past 10-12 years, there has been an appreciable increase in the rates of functional impairments and chronic diseases. Cases of profession-related diseases have been revealed in some VCs. Examination of the negative impact of vocational work-related and psychological factors on adolescents' health could substantiate general and differential recommendations to optimize a training process, to prevent diseases, and to improve the health status of pupils from VCs of different profile.

[Methodological approaches to the assessment of pathological processes dynamics in schoolchildren based on the results of preventive examination].

Analysis of prevalence of various functional disorders and chronic diseases diagnosed in children and adolescents during comprehensive prophylactic examination in educational institutions does not provide complete information about health tendencies because the same statistical data may reflect both favourable development of a pathological process and its deterioration. Such information can be obtained by thorough analysis of complaints, medical histories and catamnestic observations, fulfillment of the complete range of regimented clinical examinations. An algorithm and criteria for characterization of a pathological process as "improving", "worsening" or "unaltered" were developed for different nosological forms and classes of diseases in 2006. It was shown that stage by stage differential assessment of pathological processes and functional disorders in junior and senior schoolchildren in different periods of their development during school years yields new data on different phases of adaptation, occurrence of its favourable and unfavourable outcomes; also, it permits to identify schoolchildren in need of urgent curative and preventive aid.

[Moscow schoolchildren's morbidity in the past 50 years].

The paper analyzes morbidity among Moscow schoolchildren in the past 50 years on the basis of the results of in-depth studies of pupils by the researchers of the Research Institute for the Hygiene and Health Care of Children and Adolescents. There is a significant reduction in the number of absolutely healthy children, the proportion of which is 2-4%. There is a considerable increase in the prevalence of dysfunctions and chronic diseases among schoolchildren. Particularly high increment rates of morbidity were observed in the 1990s. The morbidity structure has changed in the past 50 years. Both biomedical and psychosocial factors are responsible for changes in the morbidity levels and structure of children and adolescents.

[Schoolchildren's health status and problems in the choice of professions].

Poor trends in the health status of children and adolescents were responsible for as high as 80% of the number of young men and girls with health limitations to have vocational training and labor activity. Medical professional advice is a system of measures to assist young men and girls with health abnormalities in choosing professions or specialties that would promote their health and favor their successful adaptation to the conditions of obtaining vocational training and further work. Qualified medical professional advice should be based on the new science-based lists of medical contraindications, which are to be commissioned by the joint orders of the Ministry of Health and Social Development and the Ministry of Education and Science of the Russian Federation.

[First-form children's health status and mental development].

The task of the study was to comparatively analyze neuropsychic features in first-form children at the end of the first school year depending on the results of a medical examination and the opinions as to the appropriateness of each child's entering a school. The cognitive functions, psychomotor system, functional visual analyzer lability, that reflected nervous system fatigue in a schoolchild, and psychosocial adaptation measures were studied. The findings indicated that there were no differences between first-form children with debilitated health and their schoolmates in the performance of cognitive functions and schooling achievement. However, they showed decreased functional lability of the visual analyzer, difficulties in taking and carrying out rapid decisions, and lowered psychosocial adaptability. The specific features of mental development of first-form children with poor health set them under special conditions of an educational process, which are not conductive to better health.

[Morbidity among schoolchildren and vocational college students upon completion of education].

The health status of adolescent schoolchildren and vocational college (VC) students aged 15-18 years was monitored for 3 years. It was found that morbidity rates increased from the 9th to 11th forms in the schoolchildren and from the 1st to 3rd courses in the VC students, pathology and functional disorders most intensively developed in VC girls. On completion of school education, there was an increase in the prevalence of mainly functional disorders among the girls and in that of chronic diseases among young men. The course of nervous and mental disorders was found to become worse in most VC students. The specific features of the formation and development of pathological processes were identified in relation to the profile of VC and the influence of professional and occupational factors. The results of the study provide a means of developing differential health-promotion measures for pupils and students with consideration of gender, age, the type of an educational establishment, and the profile of a vocational college.

[Health status of adolescents and modern approaches to holding medical professional consultations]. / Sostoianie zdorov'ia podrostkov i sovremennye podkhody k provedeniiu vrachebnykh professional'nykh konsul'tatsii.

Due to unfavorable trends in the health state of contemporary children and teenagers, the total number of young males and females, who have health-related limitations in educational and occupational spheres, went up to 80%. A medical professional consultation belongs to a system of measures, whose purpose is to assist the young males and females with impaired health to choose professions or occupations, which would maintain their health intact and promote successfully their adaptation to professional training conditions and subsequently to actual occupational conditions. A timely and high-skilled implementation of medical professional consultations with a subsequent rational employment of teenagers and youth with impaired health should be regarded as a secondary prevention of pathologies. The holding of such medical professional consultations for teenagers is reasonable both at the stage, when a teenager makes his or her choice of a job (i.e. at school), and at the stage of receiving a professional education, so that the schoolchildren and students could get a job in line with their health status and that they could be employed with respect to doctor's recommendations. The Research Institute for Children's Health elaborated a number of methodological and regulating documents to promote the efficiency of the medical professional consultations; an automated assessment system is in the process of construction at the above institution.

[Health and physical activity in adolescents of today]. / Sostoianie zdorov'ia i fizicheskaia aktivnost' sovremennykh podrostkov.

The results of clinical and epidemiological studies conducted by the researchers of Research Institute of Hygiene and Care of Children and Adolescents, Health Research Center, Russian Academy of Medical Sciences, are indicative of a substantial deterioration of health in adolescents in the late 20th century. Inactivity typical for young people of today has been found to be a major risk factor of cardiovascular functional disorders and metabolic osteopathies whose prevalence has increased among adolescents. There is evidence for that there is an association of low activity with the occurrence of calcium homeostatic disorders that result in osteomuscular diseases, cardiovascular functional disorders, deteriorated physical development, decreased functional (force) capacities of the growing organism in adolescents. In addition to inactivity, excessive exercise experienced by young athletes also causes marked disorders, in girls in particular.

[An automated expert system for medical professional orientation of teenagers and youth]. / Avtomatizirovannaia ékspertnaia sistema dlia meditsinskoi proforientatsii podrostkov i molodezhi.

The paper outlines a concept of the automatic medical examination system (MES) designed to aid a physician during his/her medical professional orientation. The authors propose a general MES schedule, define the term "professional inability" (in the medical sense). They provide evidence for that it is necessary to use the assessments made experts as to the professional disability of adolescents and young people who have chronic diseases and dysfunctions. The common principles in the construction of expert MES matrices are outlined. After its completion, MES may be used for purposes of medical professional orientation.

[Health problems of school education reform]. / Gigienicheskie problemy reformirovaniia shkol'nogo obrazovaniia.

The paper deals with impact of educational load in pupils at present general educational establishments on their health. The great total educational load in them was found to violate the schoolchildren's routine. This more frequently forms inadequate physiological responses, develops neurotic disorders. The incidence of chronic diseases is higher in children going to new-type schools. The findings provide evidence for some medical and organizational measures to promote schoolchildren's health.

[Professional orientation of youth: medical and psychophysiological aspects]. / Professional'naia orientatsiia molodezhi: meditsinskii i psikhofiziologicheskii aspekty.

The scientific and practical aspects of medical and psychophysiological professional orientation in teenagers and young people have become more and more pressing due to their poorer health along with higher demands for their resistance to unfavourable factors. The aid of a physician and a psychophysiologist in their choice of a future profession promotes the prevention of general and occupational morbidity. Work on professional orientation should be began at school in the 5th-6th and done through school life during which they get a general and vocational education. Guidelines have been developed for effective medical and physiological professional counselling.

[Systemic approach to medical professional counseling to adolescents and young people]. / Sistemnyi podkhod k provedeniiu vrachebnykh professional'nykh konsul'tatsii podrostkov i molodezhi.

An increasing importance of medical professional orientation of and medical specialist advice to teenagers and young people is evidenced. Data on morbidity among schoolchildren and young employed people are presented. The author shows it necessary to make new lists of medical contraindications for vocational training, a standard and methodological basis, and automatic systems for medical and professional orientation.