TASHKENT MEDICAL ACADEMY General and radiation hygiene DEPARTMENT

TASHKENT MEDICAL ACADEMY General and radiation hygiene DEPARTMENT «PHYSICAL CONTROL OF « CHILDREN»

The employment purposes: To create skills of work on an individual estimate of physical development of children and teenagers at students; To train students in carrying out a comparative estimate of physical development of the organized children's collectives

Pedagogical tasks: Training of students: - to ability to use standards of physical development; - to ability of carrying out an individual estimate of physical development of school students; - to ability of carrying out an individual estimate of physical development of children of preschool age; - to ability of carrying out a comparative estimate of physical development of collectives.

On termination of training studentsкерак: should know Талаба билиши Concept about standards of physical development of children and teenagers; Order of an individual estimation of indicators of physical development of children and teenagers of school age on a regress scale; Order of carrying out of a comparative estimation of physical development of the children's organised collectives.

ON TERMINATION OF TRAINING STUDENTS SHOULD BE ABLE: Have skills of an individual estimation of physical development of children and teenagers on a regress scale; Have skills of an individual estimation of physical development of children of preschool age. To carry out calculation of average parametres of physical development of the children's organised collectives Define reliability of distinctions of indicators of physical development of compared children's collectives

At present, the GP seeks mandatory monitoring of physical development, as each individual observed the child, and physical development of children's organized groups. This allows you to properly evaluate and adjust environmental factors such children as food, the level and nature of physical activity, organization of work, the rationality of the regime of the day, as well as the mode and nature of school hours, the correct plumbing child care, the quality of indoor lighting, etc. In addition, an individual analysis to determine the physical development of the tactics of GPs in respect of each individual child: the need for additional tests, therapeutic interventions.

Indicators of physical development of children and teenagers in many respects depend on conditions of training and education, both in a family, and in preschool institutions and at schools. Most thus such factors as food, level and nature of physical activity, the organization of a workplace, rationality of a day regimen, and also mode and character of school lessons, correctness of the sanitary equipment of child care facilities, quality of lighting of rooms, etc. have importance. In this regard the doctor has to be able to investigate and estimate indicators of physical development of children and teenagers and on the basis of the obtained data to judge quality of conditions of their training and education.

Research and an individual estimate of the physical development of children should take place at least once a year, with mandatory entry of the results into individual card of the child. (026 i/с)

On the physical development of children and young people of school age are judged on a number of parameters (or signs) of physical development, which can be divided into three groups: 1. Somatometrical attributes - height, weight, chest circumference; 2. Fiziometrical indicators - muscular strength, vital capacity, the value of the A / D, pulse rate, the thickness of subcutaneous fat; 3. Somatoskopical signs - the state of the skeleton, the skin, the number of permanent teeth, the formula of sexual development.

1. SOMATOMETRICAL ATTRIBUTES Ø Ø Carrying out the somatometricheskikh of researches depends on the contingent of children It is accepted to allocate the main indicators of anthropometrical researches

MEASUREMENT OF GROWTH IN CHILDREN For measure the growth of preschool children can be used stadiometer with a vertical scale or a child can stand on a flat hard floor: -Child is back to the vertical surface of the stadiometer or a line perpendicular to the floor, the wall. Back, hips and heels should touch the line or wall. -Legs should be barefoot. Heels together, toes apart. Your arms should be extended along the trunk , The head should be set so that an imaginary line connecting the ear and the outer corner of the eye, parallel to the floor. -Smooth wedge strap falls down. If the measurement is used for wall, then put a note on the wall. The distance between the top of the head and heels is read from the line stadiometer or measured from the floor to the mark on the wall, the accuracy of measurement - 0. 5 cm

MEASUREMENT OF BODY WEIGHT IN CHILDREN Weight was determined by medical weights morning. Given the age of the children (the need for mandatory breakfast, about 0. 3 kg) and the weight of clothes (depending on the season 0. 3 -0. 8 kg) of the measured weight must be subtracted 0. 5 (in the summer) - 1 (winter) kg.

CIRCLE THORAX Circle thorax define measuring tape, which is applied at the rear corners of the blades, and in front of boys - 4 edge, the girls - the upper edge of the areola.

2. FIZIOMETRICAL INDICATORS Muscle strength measured by hand (hand muscle strength) or become (strength of the back muscles) dynamometer. Lung capacity is determined spirometer, preinstructing children on how to achieve a full exhalation. Arterial hypertension the tonometer pressure, pulse rate - by palpation. The thickness of subcutaneous fat measured by specific caliper and expressed in cm

DYNAMOMETRY Ø Development of muscular force is defined by dynamometry, the received results are estimated on 1 -3 mark scale Ø Research of thickness of hypodermic and fatty cellulose is defined by a caliper

TECHNIQUE OF CARRYING OUT DYNAMOMETRY Defines extent of development of muscular force and carries out dynamometry The checked has to stand exactly, to develop hands in the parties and to squeeze out a dynamometer to the maximum Research is conducted on a 2 -3 raz and the maximum indicator in kilograms gets out

3. SOMATOSKOPICAL INDICATORS Ø Ø Somatoskopical indicators are investigated in the afternoon at a temperature of room not less than 18 -20 degrees At somatoskopical research needs to be defined a structure of skeletal system, the child's constitution, a structure of hands and feet, thickness of a adipopexis and structure of sexual development

Ø Scoliosimetеr consists of a leather hoop and the centimetric tape attached to it Ø The hoop of a scoliosimetеr puts on investigated on a neck at the level of the 7 th cervical vertebra Ø The assessment of indicators is carried out vertically from the device on the lowering tape to a cervical bend

DEFINITION OF A SHAPE OF A BACKBONE Ø Distinguish normal, lordosis, kyphosis forms of a backbone. The normal backbone in the sagitat plane has S – a figurative form. Cervical and lumbar curvature is small, turned forward, chest camber is turned back. For lordosis– small cervical curvature and sharply expressed lumbar.

Ø At correct a constitution the physiological curvature is defined at the level of a neck and a waist, their sizes have to be the most approximate each other. For children of younger school age they make 3 – 4 cm, for middle school age of 4 - 4, 5 cm. Thus it is necessary to consider the next moments – investigated has to stand directly, the head is raised, shoulders are straightened, the stomach is pulled in, feet on width of shoulders

DEFINITION OF A STRUCTURE OF FEET : The investigated costs directly, feet together. Knees have to adjoin, at "O" - type knees don't meet, at the "X" type - knees adjoin, and the lower part of feet disperse. Foot — is musculoskeletal body. At a normal structure of feet, stop can be normal, flattened, flat. When determining existence of platypodia define type of a structure of feet, natural curvature of foot, the area of contact of foot with a surface.

Ø For detection of platypodia do foot prints. Methylene blue by means of a wadded tampon moisten with solution foot and put the child on the clean sheet of paper developed on a floor. For wetting it is possible to use 10% solution of one and a halfof chloride iron, paper thus is moistened 10% with tannin solution in alcohol.

Ø For the purpose of definition like foot it is necessary to pay attention to the received print. Carry out a tangent to the most acting points of an inner edge of foot. From the middle of a tangent restore a perpendicular to the outer edge of foot, then calculate % the relation of length of that part of a perpendicular which passed through a print to all length.

Somatoskopical express descriptive signs and symptoms of puberty is described using formulas. For boys in the formula most often include a description of the development of pubic hair and axillary (eg, Ro Ax 1 means that the boy had no pubic hair, and axillary marked individual hairs). The formula puberty girls also include a description of the development of the mammary glands and the start of menstruation, menarche (eg, P 2 Ax 2, MA 2 Me 13 means that the degree of development of the two girls pubic hair and armpits, breasts are raised above the chest, and menstruation began with 13 years).

Evaluation of physical development of children and adolescents is done by comparing the actual values with the standards of physical development. Individual assessment of physical development can be done in three ways: on a scale of regression on integrated circuit on centil scales.

EVALUATION SCALE REGRESSION The scale takes into account the change in the regression weights and circle thorax when the growth of 1 cm, ie defining feature in this method is the growth of the child (Shalu demonstrate regression for students of Uzbekistan, 1998).

The order of individual assessment of physical development: -To determine the exact age of the child, taking into account the date of birth and date of the survey; -Find-scale regression, as appropriate to the age, sex, nationality and place of residence; -To determine how to apply the values of the child's development with the growth (average, above average, below average, etc. ); -Is to find the scale, what should be the weight and the circle thorax at a given height (m + δ); -Determine the value of Δδ (sigmal deviation) for weight and DC. For example, the actual weight is 30 kg. According to the table the weight should be 32. 1 + 3. 1, hence Δδ = weight (32. 1 - 30) = 3. 1 to 0. 7. If the values of Δδ will be within + 1δ, then the development is considered to be harmonious; +1 -2 δ - disharmonious, more 2δ sharply disharmonious.

A PRACTICAL OF CLASSES Implementation students the following tasks: 1 lesson: 1. Measure main indicators of physical development of three or four students (height, weight, circle thorax, muscle strength, vital capacity) 2. Provesti assess the physical development of children 2 -3 (situational tasks) on a scale of regression Algorithm Action steps: Find-scale regression for the corresponding sex, age, nationality and place of residence -To determine the level of development on growth -To determine the values of weight and circle thorax (CT), as well as the value, corresponding to a given growth -Calculate the private sigmalnye deviation for body weight and circle thorax -Evaluate the harmonious development, depending on the calculated deviations

2 lesson: Comparative evaluation of physical development teams Students are encouraged to make a comparative estimate of the physical development of the two groups of children by one of the following options: Algorithm action steps: -calculate the values of M ± m for each indicator in each comparison group -determine the amount of the significance of differences «t» : -assess the significance of differences - To conclude the evaluation compared indicators of children's groups

USE OF THE ROUND TABLE METHOD Distribution of questions The written answer on questions with the subsequent transfer of questions to other group students Division of students on small groups Transfer of sheets with questions and answers another to small groups Activity assessment small groups Collecting sheets with answers students in 12 minutes

Questions to control the initial level of knowledge of students: 1. Why physical development of children and adolescents is intergalnym indicator of their health 2. What parameters characterize the physical development of children and adolescents 3. What is the basis for assessing the physical growth of children and adolescents 4. What standards of physical development is in the Republic of Uzbekistan 5. Why evaluation of physical development of children and adolescents on a scale of regression is considered one of the best methods for the estimate 6. Indicate algorithm in assessing the physical development of the scale of the regression 7. For which conducted a comparative evaluation of the physical development of children's organized groups 8. Indicate sequence of actions when evaluating the physical development of children organized