A method for assessing the effectiveness of children's health improvement in summer children's health centers. Assessment of the effectiveness of health improvement Health effect in children how to calculate

Size: px

Start showing from the page:

Transcript

1 Assessment of the effectiveness of health improvement for children and adolescents in summer recreational institutions I. General provisions: METHODOLOGICAL RECOMMENDATIONS APPROVED by the Head of the Federal Service for Surveillance in the Sphere of Consumer Rights Protection and Human Welfare, Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko Methodological recommendations were prepared with the aim of ensuring uniformity in the conduct of medical examinations of children and adolescents in summer recreational and recreational institutions for children and adolescents, eliminating subjective approaches to assessing the effectiveness of summer recreation. Methodological recommendations are intended for implementation by: country health institutions (country seasonal health institutions, including sanatorium shifts of country seasonal health institutions; labor and recreation camps on the basis of seasonal health institutions; country year-round health institutions, including sanatorium shifts of country year-round health institutions ; country sanatorium and health institutions, sanatorium shifts for children at the bases of sanatoriums, recreation centers (for adults), children's sanatoriums, sports and recreational and defense sports institutions); day camps for schoolchildren, including work and recreation camps based on day camps for schoolchildren. Methodological recommendations provide for medical examinations of all children at the beginning and end of the health-improving shift with an assessment of the effectiveness of the health-improvement. II. Terms and definitions: assessments of the effectiveness of health improvement (hereinafter referred to as indicators) indicators characterizing height, body weight, muscle strength and vital capacity (VC), assessment of the dynamics of which during the summer health shift is mandatory to determine the degree of effectiveness of health improvement (high, weak, absent) . Body mass index (BMI, Quetelet Index) is an indicator characterizing physical development, representing the ratio of body weight in kg to height in m2. Functional state is a complex of properties that determines the level of vital activity of the body, the systemic response of the body to physical activity, which reflects the degree of integration and adequacy of functions to the work performed. III. Determination of indicators for assessing the effectiveness of summer health improvement: To assess the effectiveness of health improvement, it is recommended to use data from the dynamics of at least 4 indicators (height, weight, muscle strength and vital capacity of the lungs (VC). The choice of indicators is due to their potential variability during the period of summer recovery under the influence (favorable or unfavorable) of the environment and the possibility of assessing the dynamics of indicators during the recovery shift. The dynamics of indicators depends on the direct impact of environmental factors, including nutrition, physical activity, daily routine, health procedures carried out in the institution and physical culture work. They react sensitively to a decrease in the body’s resistance and diseases suffered during the healing season. At the same time, they are easy to measure and evaluate. The equipment necessary to evaluate the indicators is a floor scale, a stadiometer, a hand dynamometer, a spirometer.

2 If necessary, you can also supplement the list with additional indicators (functional tests of the cardiovascular system, respiratory system, general physical performance). IV. Assessment of the effectiveness of health improvement: For a comprehensive assessment of the effectiveness of the health improvement of children in summer recreation and health institutions, on the 1st-2nd day from the start of the health-improvement shift, as well as the day before its end, the institution organizes and conducts a medical examination of all children being healed with anthropometric and physiometric research methods. All measurements are carried out on a half-naked child in the first half of the day. The evaluation criteria for each indicator are given in table. 1. The criteria for assessing additional indicators are similar. To assess the effectiveness of the health improvement of each child and the team as a whole, information based on the results of the medical examination is entered into the journal “Evaluation of the Health Effect” (Table 2), which provides for entering information for each child at the beginning of the shift, as well as at its end. The note column is filled in if the BMI is greater than or equal to the upper limit of normal (see terms and definitions), as well as if the child left the institution before the end of the shift. Table 1 Efficiency of recovery high weak no dynamics dynamics points dynamics points dynamics points Weight* increase more than 1 kg 2 increase from 0 to 1 kg 1 decrease 0 increase increase in height 2 no changes muscle strength indicators increase 5% or more 2 increase up to 5% 1 no increase 0 vital capacity increase of 10% or more 2 increase up to 10% 1 no increase 0 Criteria for assessing “mandatory” indicators of health improvement effectiveness Note: if BMI is greater than or equal to the upper limit of normal, then the decrease in body weight is assessed as 2 points, the increase is from 0 to 1 kg 1 point, weight gain of more than 1 kg 0 points. Standard BMI values: 7-

3 years norm: 13.5-17.5; 8 years 13.5-18; 9 years 14-19; 10 years 14-20; 11 years 14.5-21; 12 years 15-22; 13 years 15 22.5; 14 years old,5; 15 years 16.5 24; 16 years old The final score is the sum of the scores for each indicator and is assessed in accordance with table. 3. If a child leaves the institution before the end of the shift, he automatically falls into the group with no healing effect. The assessment of the effectiveness of the health improvement of children and adolescents is carried out based on the final summary assessment; for its detail, the indicators in Table 1 are also subject to assessment. 4 “Assessment of the health effect” Table 2 Beginning of change of full name G.B. Squad Group of occupations FR Height mass strength Vital capacity Ivanov Vanya Lev -20 Right main Continuation of table 2 End of shift Efficiency assessment in points Score Height mass strength Vital capacity Height mass strength Vital capacity note total Lev - 23 Rights high Table 3 Criteria for the overall assessment of the effectiveness of health improvement

4 Efficiency of health improvement (points) high low Absence* less than 3 Table 4 Assessment of the effectiveness of health improvement for children and adolescents (final table) Number of children and adolescents having: INDICATORS pronounced health-improving effect weak health-improving effect no health-improving effect (deterioration) Weight Increase in muscle strength Vital capacity Final score

5 Specific gravity (%) according to the final assessment Appendix 1 to the MR (mandatory) Methodology for determining the “main indicators” for assessing the effectiveness of health improvement Weighing is carried out on medical scales, correctly installed and adjusted. The scales should be installed on a level place and in a strictly horizontal position. When weighing, the child must stand motionless in the middle of the platform. To measure body length, a stadiometer is used, which is a vertical bar with a centimeter scale printed on it, mounted on a platform. The height meter should be installed on level ground and in a strictly horizontal position. The child is placed on the platform with his back to the vertical stand so that he touches the stand with his heels, buttocks, shoulder blades and the back of his head. The arms should be extended at the seams, the heels together, the toes apart, the head should be held so that the tragus of the ear and the outer corner of the palpebral fissure are on the same horizontal line. The tablet is lowered onto the head. Hand muscle strength is measured with a hand dynamometer. In this case, the hand should be moved to the side, the dynamometer is compressed with maximum effort, without jerking. Two measurements are taken and the best result is recorded. The strength of the muscles of the right and left hand is measured. Spirometry is a method for determining the vital capacity of the lungs (VC) - closing the nose with the fingers, a teenage child takes a maximum breath, and then gradually (over 5-7 seconds) exhales into the spirometer. It is necessary to repeat the measurement procedure 2-3 times. The maximum one is selected from the obtained results. The resulting value of vital capacity is called actual. (c) Federal Service for Supervision of Consumer Rights Protection and Human Welfare,

Document provided by ConsultantPlus ASSESSMENT OF THE EFFECTIVENESS OF HEALTH CARE FOR CHILDREN AND ADOLESCENTS IN SUMMER HEALTH INSTITUTIONS METHODOLOGICAL RECOMMENDATIONS I. General provisions APPROVED by the Head of the Federal

MUNICIPAL FORMATION THE CITY OF URAY Khanty-Mansiysk Autonomous Okrug - Ugra ADMINISTRATION OF THE CITY OF URAY Municipal budgetary educational institution of additional education for children “Center for Additional Education”

State sanitary and epidemiological regulation of the Russian Federation 2.4.4. HYGIENE OF CHILDREN AND ADOLESCENTS. SUMMER HEALTH INSTITUTIONS Methodology for assessing the effectiveness of health improvement in suburban areas

METHODS OF SELF-CONTROL OF HEALTH AND PHYSICAL DEVELOPMENT Anthropometric measurements: concepts, types, indicators. Let us recall that health is a dynamic state of physical, spiritual and social

2.4.4. Hygiene of children and adolescents. Summer health institutions Methodological recommendations MP 2.4.4.0011-10 "Methodology for assessing the effectiveness of health improvement in country stationary recreation institutions

TRAINEE'S DIARY 1 UDC (075.8) BBK 75.1я73 B 91 Trainee's diary: workbook on summer teaching practice: Methodological development / Ananyeva L.Ya., Burmistrova M.N., Gabedava

CURRENT ISSUES OF APPLIED BIOLOGY AND BIOLOGICAL EDUCATION F. E. Ilyin, A. K. Zakharova Indicators of physical development of students at the Faculty of Natural Science, Geography and Tourism of Leningrad State University named after. A.S. Pushkin

Municipal budgetary educational institution of additional education for children "House of Children's Creativity" Assessment of individual physical development in adolescence by the method of calculating sigma

Self-control during physical education and sports. 1. Study of the state of the vestibular analyzer: - Bondarevsky test; - Yarotsky's test. 2. Assessment of functional state: - orthostatic

Physical education tests for students in grades 9-11. Read the task carefully, think about it and choose the correct answer. 1. The meaning of physical culture as a component of the culture of society is to: strengthen

HYGIENE OF CHILDREN AND ADOLESCENTS. SUMMER HEALTH INSTITUTIONS Methodology for assessing the effectiveness of health improvement in suburban inpatient recreation and health institutions for children Methodological recommendations MR 2.4.4.0011-10

Romanov K.Yu., Trofimenko A.M., Levina E.P. 327 INFLUENCE OF PHYSICAL EDUCATION AND HEALTH TECHNOLOGY ON PHYSICAL HEALTH INDICATORS OF STUDENTS Belarusian State Medical University, Minsk, Belarus

PHYSICAL EDUCATION AND HEALTH-SAVING ACTIVITIES Elena Anatolyevna Aleksandrova teacher, MAOU Kindergarten 377 “Golden Fish”, Kazan, Republic of Tatarstan INFLUENCE OF PHYSICAL ACTIVITY ON

ADMINISTRATION OF THE CITY OF BELGOROD DECISION of March 19, 2010 41 ON PROVIDING RECREATION, HEALTH AND EMPLOYMENT OF CHILDREN (as amended by resolutions of the administration of the city of Belgorod of 04/09/2010 56, dated 06/16/2010

ALL-RUSSIAN OLYMPIAD OF SCHOOLCHILDREN IN PHYSICAL EDUCATION 2015 2016 academic year. MUNICIPAL STAGE 9 11th grades Instructions for completing tasks You are offered tasks that meet the level requirements

Sidukova O. L. TO ASSESS THE EFFECTIVENESS OF CHILDREN’S HEALTH CARE IN THE USSR AND THE REPUBLIC OF BELARUS Belarusian Medical Academy of Postgraduate Education, Minsk The root cause of the emergence of children's medical and health

ENTRANCE TEST PROGRAM IN THE DISCIPLINE “PHYSICAL EDUCATION” for applicants of 2015 specialty 1-03 02 01 “Physical Education” full-time and part-time forms of higher education Institutions

On the acceptance of summer health institutions in 2017, Head of the Department for Supervision of Educational and Training Conditions of the Office of Rospotrebnadzor for the Irkutsk Region I.V. Sgibneva Federal Law (465-FZ

APPROVED by a resolution of the Administration of the Primorsky Territory PROCEDURE for maintaining the Register of recreation and health organizations for children providing services in the territory of the Primorsky Territory I. GENERAL PROVISIONS 1.1. Real

MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION Federal State Budgetary Educational Institution of Higher Professional Education "Baikal State University of Economics"

Set of exercises 2.1. Perform 1-2 times a day at home. The number of repetitions is from 2 to 6 times. 1. IP lying on your back, arms along the body. Relax all muscles, check the correct position of the torso Completely

CHIEF STATE SANITARY DOCTOR FOR THE MURMANSK REGION DECISION of the city of MURMANSK dated April 4, 2016. On ensuring sanitary and epidemiological well-being when organizing health improvement and recreation

Municipal budgetary preschool educational institution "Child Development Center Kindergarten 188" ANNOTATION TO THE WORK PROGRAM for the prevention of flat feet and poor posture in preschool children

Organization of recreation and health improvement for children and youth 2017 Ekaterina Aleksandrovna Sibirtseva, Head of the Education Department of the Yekaterinburg City Administration Regulatory framework: Resolution

APPROVED by the Deputy Head of the district, chairman of the interdepartmental commission for organizing recreation, recreation and employment of minors in the Tyumen municipal district O.V. Zimina March 10, 2017

The program is compiled in accordance with the Federal State Educational Standard of Higher Professional Education in the direction of training 49.03.01 “Physical Culture” (Approved by order

1. Results of mastering the “Athlete” course. Program for the unification of additional education “Athlete”. The goal of the program is to improve the quality and increase the efficiency of the educational and training process. For achievement

Purpose of physical classes, their role and significance in the daily routine, presentation by a student of class 8 “A” Malyshev Egor Physical culture is part of the general culture of society, one of the areas of social activity aimed

Organization of recreation and health improvement for children and adolescents The priority activity of the institution is the organization of recreation and health improvement for children and adolescents in difficult life situations.

Dated June 17, 2016 183 Gorno-Altaisk On amendments to the resolution of the Government of the Altai Republic dated June 8, 2010 104 The Government of the Altai Republic decides: 1. Approve

In order to ensure the implementation of recreation and recreation for adolescents during the Summer Health Campaign 2012 (hereinafter referred to as LOC 2012), the following work is being carried out in the Ulyanovsk region: 1. Management

V. V. Zenkovich ASSESSMENT OF THE DYNAMICS OF PHYSICAL DEVELOPMENT OF MILITARY SERVICE SERVANTS Scientific supervisor: Ph.D. honey. Sciences, Associate Professor D. I. Shirko Department of Military Epidemiology and Military Hygiene, Belarusian State

“Sanitary and epidemiological requirements for the conditions and organization of training in general educational institutions” Sanitary and epidemiological requirements First shift of classes 25 people in a class and 2.5 sq.m.

GOVERNMENT OF THE REPUBLIC OF KOMI DISTRIBUTION dated December 23, 2009 506-r Syktyvkar In order to ensure the health, recreation and employment of children living in the Komi Republic, in 2010: 1.

1 Studies of the state of the vestibular analyzer. Bondarevsky test: stand on one leg, the other is bent and its heel touches the knee joint of the supporting leg, hands on the belt, head straight. Exercise

Self-control during physical education and sports Before you start exercising on your own, you need to get recommendations on your physical mobility regimen from your local doctor or the regional physical education clinic.

PREPARATION FOR THE SUMMER HEALTH CAMPAIGN 2017 MEDICAL ORGANIZATIONS IN MOSCOW WILL PROVIDE ASSISTANCE IN STAFFING SUMMER HEALTH INSTITUTIONS (LHI) WITH MEDICAL WORKERS IN 2017

Appendix 1 to Order 237 of February 09, 2017 PROCEDURE for the departure from the territory and entry into the territory of the Bryansk region of organized groups of children for the purpose of recreation and health improvement 1. General provisions Procedure

APPROVED by the resolution of the mayor's office of the Tolyatti city district from the PLAN of activities for organizing recreation, health and employment of children of the Tolyatti city district in the summer of 2012, item Name

Resolution of the administration of the Miass city district of the Chelyabinsk region dated March 31, 2015 N 2039 “On the procedure for organizing children’s recreation during the holidays and providing subsidies in 2015” B

Committee of General and Professional Education of the Leningrad Region Regulatory legal acts Recreation and health improvement for children and adolescents 2018 federal 1. Federal Law of the Russian Federation dated 31

GOVERNMENT OF THE ALTAI TERRITORY DECISION 04/24/2017 132 Barnaul R)6 organizations in 2017-2019 ~1 recreation, health improvement and employment of children In order to implement the Federal Law of 12/28/2016 465-FZ

“ACCEPTED” By the decision of the Pedagogical Council of the municipal government educational institution Lyceum 2 of the resort city of Zheleznovodsk, Stavropol Territory Pr 4 dated 12/14/12 “APPROVED” Director of the municipal

2 I. EXPLANATORY NOTE The program for recreational swimming in groups “Mother and Child” was compiled in accordance with the Federal Law of the Russian Federation dated December 29, 2012. 273-FZ “On education in the Russian Federation”

Conditions for protecting and promoting the health of students. New federal standards for preschool education, developed for educational institutions, focus the staff of preschool educational institutions on even closer attention

From 03/20/2015 15 DECISION of the Deputy Minister of the Chief State Sanitary Doctor of the Republic of Belarus On state sanitary supervision of the health of children in the summer of 2015

Tasks of the preparatory period of the summer health campaign 2017, head of the department for supervision of hygiene for children and adolescents of the Rospotrebnadzor Office for the Chelyabinsk Region V.V. Makarova Regulatory

Physical education and health work Physical education and health work in a state budgetary preschool educational institution kindergarten 17 Human health is determined by numerous internal

The physical education system for children and adolescents provides for daily morning exercises and physical education lessons according to a special state program within the school hours.

Municipal budgetary educational institution of additional education for children "House of Children's Creativity" Study of physical performance by determining the respiratory capabilities of the body.

On ensuring sanitary and epidemiological well-being in children's health camps in the Ustyansky district of the Arkhangelsk region Reporter: I.N. Tyulkin, head of the Velsk territorial department

“APPROVED” Director of the Volkhov Secondary School 1 A.Yu. Harutyunyan Order 585 dated October 20, 2017 LESSON SCHEDULE of the municipal educational budgetary institution "Volkhov Secondary General Education

Modern approaches to organizing hygienic education for specialists in summer health organizations Sidukova O.L. senior lecturer at the Department of Hygiene and Medical Ecology of BelMAPO Relevance

Sets of exercises for the prevention of poor posture in preschool children. The child spends most of his time in kindergarten, therefore, prevention of poor posture should be carried out

Project GOVERNMENT OF THE KARACHAY-CHERKASSIAN REPUBLIC DECISION 2017 On amendments to the Decree of the Government of the Karachay-Cherkess Republic dated 10.10.2014 289 “On providing rest and health

PHYSICAL EDUCATION AND HEALTH-SAVING ACTIVITIES Saushkina Anna Vladimirovna primary school teacher MAOU "Secondary School 112 with UII" Novokuznetsk, Kemerovo region INFLUENCE OF A COMPUTER ON A CHILD Abstract:

For those working while sitting For those working while standing To relieve fatigue of the visual organs A set of industrial gymnastics is performed at the workplace in order to prevent fatigue, increase efficiency,

Appendix 1 to the resolution of the administration of the Novoaleksandrovsky municipal district of the Stavropol Territory The procedure for organizing recreation and recreation for children and adolescents in the territory of Novoaleksandrovsky

DECISION OF THE HEAD OF ADMINISTRATION (GOVERNOR) OF THE KRASNODAR REGION from the city of Krasnodar On the draft law of the Krasnodar Territory "On amendments to the Law of the Krasnodar Territory "On ensuring the rights of children to

Nursing technologies in organizing summer country holidays for children Completed by: N.A. Tanina RESEARCH OBJECTIVE: Scientific substantiation of the nursing model of health-improving and preventive measures in

MINISTRY OF HEALTH OF RUSSIA State budgetary educational institution of higher professional education "IRKUTSK STATE MEDICAL UNIVERSITY" (GBOU VPO ISMU Ministry of Health

PATIENT AND CAREGIVE ALERT General Exercise Program: Level 2 This information describes Level 2 of a general exercise program that will help you with physical recovery.

APPENDIX to the order of the Director of Sports Center LLC dated April 4, 2016 for 6 CHAPTER 1 GENERAL PROVISIONS REGULATIONS ON THE STRUCTURAL DIVISION OF SPORTS CENTER LLC - SPORTS AND HEALTH CAMP 1.1.

Explanatory note Summer holidays are the most important cyclical process of healing and relaxation of the body of children and adolescents. It helps relieve physical stress from the child and adolescent body,

Kavalerovsky municipal district name of the municipality Department of Labor and Social Development of the Territory name of the authorized body Register of Children's Recreation and Health Organizations

MOBILE (PORTABLE) EQUIPMENT FOR TESTING CENTERS FOR IMPLEMENTING TYPES OF TESTS (TESTS), GTO STANDARDS All-Russian All-Russian Physical Culture and Sports Complex “Ready for Labor and Defense”

Test tasks in Physical education for all areas 1. Physical education is a) an academic subject at school b) performing physical exercises c) the process of improving capabilities

Appendix to the resolution of the Vladimir city administration dated September 16. 3340 “Appendix 1 to the Program Subject Name of the activity Duration of execution SYSTEM of program activities Amount of funding (thousands.

ADMINISTRATION OF THE KIRZHACH DISTRICT OF THE VLADIMIR REGION RESOLUTION 03/17/2014 275 On the organization of health improvement and employment of children and adolescents in 2014 in the territory of the Kirzhach district For the purposes of

1. General provisions 1.1. This Regulation has been developed in accordance with: - the Federal Law of the Russian Federation “On Education in the Russian Federation” 273-FZ of December 29, 2012 273-FZ; - By order

Assessing the effectiveness of children's health

In the age group of schoolchildren from 7 to 8 years old, 50% of high and weak health effects are observed in all schoolchildren (Table 3). In the age group of schoolchildren from 9 to 11 years old, a high health-improving effect was observed in 8 boys (53.5%) and 7 girls (50%). Weak healing effect in 5 boys (35.7%) and 6 girls (42.8%). The lack of health benefits for children in this age group is equal to 7.2% for boys and girls.

In the age group of schoolchildren from 12 to 14 years old, a high health-improving effect was observed in 4 boys (40%) and 6 girls (75%). Weak healing effect in 6 boys (60%) and 2 girls (25%). No health-improving effect was observed for children in this age group.

Thus, it can be noted that the maximum rate of high health-improving effect is observed in children in the age group from 7 to 8 years, in all boys and in 50% of girls, and in the age category from 12 to 14 years it is 57.1% for boys and 50% for girls. The maximum rate of no effect is typical for the age group from 9 to 11 years, which was equal to 7.2% for girls and boys.

Table 3

Comprehensive assessment of the effectiveness of schoolchildren’s health improvement

Comparative assessment of the effectiveness of children’s health improvement in different conditions of stay

For a comparative assessment of the effectiveness of children’s health improvement in different conditions of stay (in the country camp Chaika, (Romanikhin, 2011), a school camp in the village of Ochur and aal Sapogov), I assessed high and weak health effects in 2 age groups: from 9 to 11 children and from 12 to 14 years (Table 4). It was found that the maximum rate of high health-improving effect in the Chaika camp was observed in children in the age group from 9 to 11 years - 46.9%. The weak health effect was about 28.1%. In the age group from 12 to 14 years, a minimally high health effect is observed - 23.1%. The indicator of weak health effect is slightly higher - 30.4%. In the village of Ochury, the maximum indicators were noted in the age group from 9 to 11 years, where the high health-improving effect accounts for 56.5%, and the weak - 40.3%. In the age group from 12 to 14 years, the ratio of high and weak health effects is almost the same. In Aal Boots, a high health-improving effect prevails more than 50% both in the age category from 9 to 11 years and in the group from 12 to 14 years. The minimum health indicator was noted in the group from 9 to 11 years old - 39.2% and in the age category from 12 to 14 years old.

Table 4

Comparison of the health benefits of schoolchildren

Note:

p - indicator (%), t - confidence coefficient, m - error of the indicator.

When comparing the effectiveness indicators of children's health improvement in three age groups from 9 to 11 years and from 12 to 14 years old in the conditions of two school playgrounds (the villages of Ochury and the village of Sapogov) and the country camp "Chaika", it was found that the indicators of the health improvement effect were both high , and weak, obtained in different conditions of children’s rest do not differ significantly (Table 5). The tst coefficient does not exceed the standard values ​​of 1.96 - 2.58 - 3.29 (Appendix B). since the coefficient of difference in the effectiveness of health improvement in different conditions of stay is statistically less than 95%, therefore the effect of health improvement in different conditions of stay is the same.

Table 5

Assessing the reliability of children's health outcomes in various conditions

Note:

tst - Student's t test

Appendix No. 12

to the Organization Procedure

Sanitary and hygienic

^

TRANSPARENCY

districts of the Leningrad region with natural foci of tularemia

^ List of areas endemic for tick-borne encephalitis.

All districts of the Leningrad region and seven districts of St. Petersburg: Kolpinsky, Krasnoselsky, Kurortny, Primorsky, Petrodvortsovy, Pushkinsky, Moskovsky.

Appendix No. 13

To the Organization Procedure

Sanitary and hygienic

Anti-epidemic support

Children going on summer holidays to health institutions in 2011.

The collection, storage and disposal of medical waste in suburban children's institutions is carried out in accordance with the sanitary rules and norms of SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions”:

1. Waste classification is regulated by clause 3 of SanPiN 2.1.7.728-99.

2. For suburban children's institutions, the most relevant waste is class A, class B, class D.

3. The general rules for organizing a system for collecting, temporary storage and transportation of waste are regulated by clause 4 of SanPiN 2.1.7.728-99.

4. The general procedure for disinfection of waste and reusable equipment is carried out in accordance with paragraph 6.1; 6.2; 6.3 SanPiN 2.1.7.728-99.

5. For disinfection, disinfectants that have a certificate of state registration should be used in concentrations and exposure times specified in the relevant instructions for their use.

6. The head of the out-of-town children's institution approves instructions establishing the rules for waste management, which must be submitted to the relevant Territorial departments when approving the out-of-town children's institution.

7. To organize waste management and day-to-day control, by order of the head of a children's country institution, a responsible specialist (medical worker, deputy for administrative and economic work) is appointed, who is required to undergo training on the rules of safe handling of medical waste.

^ Table No. 1 to Appendix No. 13

to the Organization Procedure

Sanitary and hygienic

Anti-epidemic support

Children going on summer holidays to health institutions in 2011.

^ Instructions for the collection, storage and disposal of medical waste in country health institutions.

Appendix No. 14

To the Organization Procedure

Sanitary and hygienic

Anti-epidemic support

Children going on summer holidays to health institutions in 2011.

^ Assessment of the effectiveness of health improvement

“Assessment of the effectiveness of health improvement for children and adolescents in summer

health institutions")

For a comprehensive assessment of the effectiveness of children's health improvement in summer recreation and health institutions, on the 1st - 2nd day from the start of the health-improvement shift, as well as the day before its end, the institution must organize and conduct a medical examination of all children recovering with mandatory anthropometric and physiometric tests. research methods.

All measurements should be taken on a half-naked child in the first half of the day.

The evaluation criteria for each “mandatory indicator” are given in table. 1. The criteria for evaluating “additional indicators” are similar.

Table 1

^ CRITERIA FOR EVALUATING "MANDATORY" INDICATORS

HEALTH EFFECTIVENESS

Note: if BMI is greater than or equal to the upper limit of normal, then a decrease in body weight is assessed as 2 points, an increase from 0 to 1 kg - 1 point, an increase in body weight by more than 1 kg - 0 points. Standard BMI values: 7 years - normal: 13.5 - 17.5; 8 years - 13.5 - 18; 9 years - 14 - 19; 10 years - 14 - 20; 11 years - 14.5 - 21; 12 years - 15 - 22; 13 years old 15 - 22.5; 14 years old - 16 - 23.5; 15 years - 16.5 - 24; 16 years - 17 - 25.

To assess the effectiveness of the health improvement of each child and the team as a whole, information based on the results of the medical examination is entered into the journal “Assessment of the Health Effect” (Table 2), which provides for entering information for each child at the beginning of the shift, as well as at its end. The note column is filled in if the BMI is greater than or equal to the upper limit of normal (see terms and definitions), as well as if the child left the institution before the end of the shift.

table 2

^ "ASSESSMENT OF HEALTH EFFECT"

The final score is the sum of the scores for each indicator and is assessed in accordance with table. 3. If a child leaves the institution before the end of the shift, he automatically falls into the group with “no healing effect.”

Table 3

^ CRITERIA FOR THE TOTAL ASSESSMENT OF HEALTH EFFECTIVENESS

Assessment of the effectiveness of the health improvement of children and adolescents is carried out without fail based on the final summary assessment; for its detail, “Mandatory” indicators are also subject to assessment - table. 4.

Table 4

^ ASSESSMENT OF THE EFFECTIVENESS OF HEALTH CARE FOR CHILDREN AND ADOLESCENTS

(FINAL TABLE)

Annex 1

to MR N 2.4.4.01-09

(required)

METHODOLOGY

^ DEFINITIONS OF "KEY INDICATORS" OF AN ASSESSMENT

HEALTH EFFECTIVENESS

Weighing carried out on medical scales, correctly installed and adjusted. The scales should be installed on a level place and in a strictly horizontal position. When weighing, the child must stand motionless in the middle of the platform.

^ To measure body length They use a stadiometer, which is a vertical bar with a centimeter scale printed on it, fixed on the platform. The height meter should be installed on level ground and in a strictly horizontal position. The child is placed on the platform with his back to the vertical stand so that he touches the stand with his heels, buttocks, shoulder blades and the back of his head. The arms should be extended at the seams, the heels together, the toes apart, the head should be held so that the tragus of the ear and the outer corner of the palpebral fissure are on the same horizontal line. The tablet is lowered onto the head.

^ Hand muscle strength is measured with a hand dynamometer . In this case, the hand should be moved to the side, the dynamometer is compressed with maximum effort, without jerking. Two measurements are taken and the best result is recorded. The strength of the muscles of the right and left hand is measured.

^ Spirometry is a method for determining vital capacity of the lungs (VC): Having covered his nose with his fingers, the teenage child takes a maximum breath, and then gradually (over 5 - 7 seconds) exhales into the spirometer. It is necessary to repeat the measurement procedure 2 - 3 times. The maximum one is selected from the obtained results. The resulting value of vital capacity is called actual.

Appendix No. 15

To the Organization Procedure

Sanitary and hygienic

Anti-epidemic

Providing for children

Traveling on summer holidays to

Health institutions in 2011

LIST OF REGULATIVE DOCUMENTS

1. Code of the Russian Federation on Administrative Offenses of December 30, 2001. No. 195-FZ.
^

2.Federal Law “On the sanitary and epidemiological welfare of the population” dated March 30, 1999. No. 52-FZ.

3. Federal Law “On the quality and safety of products” dated January 2, 2000. No. 29-FZ.

5.Federal Law “Technical Regulations for Oil and Fat Products” dated June 24, 2008. No. 90.

6. Federal Law “Technical Regulations for Juice Products from Fruits and Vegetables” dated October 27, 2008. No. 1 78-FZ.

7. Federal Law of 02/07/1992 No. 2300-1 “On the protection of consumer rights.”

8.Federal Law “On Education” dated January 13, 1996 No. 12-FZ.

9. Federal Law of September 17, 1998 No. 157-FZ “On immunoprophylaxis of infectious diseases”.

10. Decree of the Government of the Russian Federation of December 25, 2001. No. 892 “On the implementation of the Federal Law of June 18, 2001. No. 77-FZ “On preventing the spread of tuberculosis in the Russian Federation.”

11. Sanitary rules and regulations SanPiN 2.3.2.1078-01 “Hygienic requirements for the safety and nutritional value of food products.”

12.SP 2.3.6.1079-01 “Sanitary and epidemiological requirements for public catering organizations, the production and circulation of food raw materials and food products in them.”

13. Sanitary and epidemiological rules and regulations SanPiN 2.3.2.1324-03 “Hygienic requirements for shelf life and storage conditions of food products.”

14. SanPiN 2.3.1940-05 “Organization of baby food.”

15.SanPiN 2.4.4.1204-03 “Sanitary and epidemiological requirements for the design, maintenance and organization of the operating regime of suburban stationary institutions for children’s recreation and health improvement.”

16.SanPiN 2.4.1.2660-10 “Sanitary and epidemiological requirements for the design, maintenance and organization of the operating mode of preschool organizations.”

17. SanPiN 2.4.4.2599-10 “Hygienic requirements for the design, maintenance and organization of the regime in health institutions with daytime stay for children during the holidays.”

18. Sanitary and epidemiological rules and regulations SanPiN 2.1.2.1188-03 “Swimming pools. Hygienic requirements for design, operation and water quality. Quality control".

19.SP 2.5.1277-03 “Sanitary and epidemiological requirements for the transportation of organized children's groups by rail.”

20.SP No. 3.1.958-00 “Prevention of viral hepatitis. General requirements for epidemiological surveillance of viral hepatitis."

21.SP 3.1.1.1117-02 “Prevention of acute intestinal infections.”

22.SP3.3.2.1120-02 “Sanitary and epidemiological requirements for the conditions of transportation, storage and admission to citizens of medical immunobiological preparations used for immunoprophylaxis by pharmacies and healthcare institutions.”
^

23. SP 3.1.2.1108-02 “Prevention of diphtheria.”

27.SP 3.5.1378-03 “Sanitary and epidemiological requirements for the implementation of disinfection activities.”

28.SP 3.1.1295-03 “Prevention of tuberculosis.”

29.SP 3.2.1317-03 “Prevention of enterobiasis.”

30.SP 3.1.2.1203-03 “Prevention of streptococcal (group A) infections.”

31.SP 3.1.2.1320-03 “Prevention of pertussis infection.”

32. SP 3.1.1.2137-06 “Prevention of typhoid and paratyphoid fever”

33.SP 1.1.1058-01 “Organization and conduct of production control over compliance with sanitary rules and implementation of sanitary and anti-epidemic (preventive) measures”, with addition No. 1 SP 1.1.2193-07.

34.SP 3.1.3.2352-08 “Prevention of tick-borne viral encephalitis.”

35. Sanitary and epidemiological rules SP 3.3.2.1248-03 “Conditions for transportation and storage of medical immunobiological preparations” amendments and additions to them SP 3.3.2.2329-08.

36. Sanitary and epidemiological rules SP 3.3.2367-08 “Organization of immunoprophylaxis of infectious diseases.”

37. Sanitary and epidemiological rules SP 3.3.2342-08 “Ensuring the safety of immunization.”

38.SP 3.1.1.2349-08 “Prevention of polio during the post-certification period.”

39. Collection of sanitary and veterinary rules “Prevention and control of infectious diseases common to humans and animals.”

40. Sanitary and epidemiological rules and regulations SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

42. Decrees of the Government of the Russian Federation dated December 1, 2009. No. 982 “On approval of a unified list of products subject to mandatory certification and a unified list of products, confirmation of conformity of which is carried out in the form of a declaration of conformity.”

43. “Unified sanitary-epidemiological and hygienic requirements for goods subject to sanitary-epidemiological supervision (control)”, approved by the Decision of the Customs Union Commission dated May 28, 2010. No. 299.

44. Order of the Ministry of Health and Social Development of the Russian Federation dated January 31, 2011. No. 51n “On approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemiological indications.”

45. Order of the Committee on Health and the Center for State Sanitary Epidemiology in St. Petersburg dated November 26, 1998. No. 246/7-r “On improving work on early detection and specific prevention of tuberculosis in St. Petersburg.”

Significant educational loads, hypokinesia, unbalanced nutrition and other unfavorable factors lead to tension in the child’s emotional sphere, depletion of adaptive reserves, and a decrease in the functional capabilities of the body, which is more evident at the end of the school year.

An important stage in children’s health improvement is a health campaign during the holidays, and one of its forms is the stay of children in out-of-town inpatient recreation and health care institutions for children (hereinafter referred to as out-of-town inpatient recreation institutions).

Country inpatient recreation facilities are designed for the health of children from 6 to 18 years old during the summer and winter holidays. These institutions accept mainly healthy children, children with functional abnormalities, and, partly, children with chronic diseases in stable remission, who do not need special correctional and therapeutic conditions (diet, special regimen, therapeutic prescriptions for maintenance therapy, etc. further) and have no contraindications for active recreation.

However, analyzing the quality of children’s health in these institutions is difficult, since there are no uniform, scientifically based requirements for assessing the effectiveness of health in suburban inpatient recreation and health institutions for children.

The proposed methodology is simple and accessible for use in practice and allows you to evaluate the effectiveness of the health of children in country inpatient recreational institutions based on indicators of the main functional systems of the body, using equipment that is mandatory in every medical office of a countryside inpatient recreational institution (stadiometer, scales) , dynamometer, spirometer, tonometer, stopwatch).

It is recommended to assess physical development using an assessment scheme approved by the Ministry of Health of the Russian Federation for practical healthcare, and to assess the functional state of the cardiovascular system - the “double product” (DP) index, recommended as a criterion for functional state when conducting preventive medical examinations of children .

To assess the physical fitness of children, tests of the all-Russian system for monitoring the state of physical health of the population, the physical development of children, adolescents and young people are recommended, which ensures the continuity of relevant activities throughout the year and is consistent with the modern Eurofit test system developed by the Committee for the Development of Sports of the Council of Europe .

II. Application area

These guidelines are intended for use by bodies and organizations of Rospotrebnadzor when assessing the work of typical local out-of-town inpatient recreation and health care institutions for children, analyzing the quality of children's health in these institutions, and can also be used by medical workers and specialists providing medical care in out-of-town inpatient recreational institutions and children's health improvement, pediatricians, school doctors, as well as specialists - organizers of children's recreation.

III. General provisions

Assessment of the effectiveness of children's health improvement should be carried out based on the analysis of data obtained through medical examinations in the first half of the day at the beginning and end of the health shift: in the first 2 - 3 days after arrival and 2 - 3 days before the end of the shift. The effectiveness of recovery will be evidenced by the positive dynamics of indicators during the shift period.

As criteria for assessing the effectiveness of children's health improvement, it is recommended to use data on the dynamics of indicators of physical development, functional state of the body, physical fitness and morbidity of children during the shift period.

Analysis of the dynamics of these indicators makes it possible to assess the effectiveness of the health improvement of each child during his stay in a suburban inpatient recreation facility.

To assess the dynamics of indicators, a point system is used: positive dynamics of indicators (improvement) is assessed as 2 points, absence of dynamics - 1 point, negative dynamics (deterioration) - 0 points.

3.1. Assessment of the dynamics of physical development indicators

At the beginning and at the end of the shift, the child’s body length and weight are measured to determine the level of physical development - normal physical development (NPD), underweight (LBM), overweight (BMI). Measurements are taken on a scantily clad child.

The assessment is carried out according to regional standards of physical development, which must be provided to the medical staff of a country inpatient recreation facility by local authorities of the Health Administration or authorities of the Health Administration in the constituent entities of the Russian Federation. In the case when a child arrives from another region, standards (taking into account the age of the child) are attached to the medical certificate f. N 079/у. Examples of assessing physical development using assessment tables for the Moscow region (Appendix 1 to these guidelines) are presented below.

Before assessing physical development, it is necessary to calculate the child's age. Age groups are formed as is customary in medical practice. For example, 10 years - children aged from 9 years 6 months to 10 years 5 months 29 days, 11 years - from 10 years 6 months to 11 years 5 months 29 days, etc.

Health improvement will be considered effective in the case when children with underweight weight increase by the end of the shift; in overweight children, the weight will decrease, and in children with NFR, a change in body weight will not lead to a change in the level of physical development.

Examples of assessing the dynamics of physical development indicators:

1. Ira P., 14 years 5 months. (14 years old).

Beginning of the shift: body length - 158.1 cm, body weight - 42.1 kg. Body weight deficiency.

End of shift: body length - 158.4 cm, body weight - 42.6 kg. Body weight deficiency.

By the end of the shift, the girl with DMT had increased her body weight.

2. Nikolay I., 13 years 10 months. (14 years old).

Beginning of the shift: body length - 172.3 cm, body weight - 60.2 kg. Normal physical development.

End of shift: body length - 172.5 cm, body weight - 59.9 kg. Normal physical development.

The level of physical development did not change during the shift.

3. Victor I., 14 years 1 month. (14 years old).

Beginning of the shift: body length - 159.8 cm, weight - 61.2 kg. Excess body weight.

End of shift: body length - 160.1 cm, weight - 60.7 kg. Normal physical development.

By the end of the shift, the boy’s body weight decreased with BMI, and the level of physical development also changed.

Positive dynamics - 2 points.

4. Anna B., 14 years 3 months. (14 years old).

Beginning of the shift: body length - 155.1 cm, body weight - 57.0 kg. Normal physical development.

End of shift: body length - 155.3 cm, body weight - 58.9 kg. Excess body weight. During the shift, the girl gained weight and her level of physical development changed from NFR to BMI.

5. Pavel G., 14 years 1 month. (14 years old).

Beginning of the shift: body length - 154.1 cm, body weight - 56.2 kg. Excess body weight.

End of shift: body length - 154.2 cm, body weight - 56.9 kg. Excess body weight. By the end of the shift, the boy's body weight increased with BMI.

Negative dynamics - 0 points.

3.2. Assessment of the dynamics of functional state indicators

At the beginning and end of the shift, children's blood pressure, heart rate per minute, and vital capacity are measured.

4.2.1. To assess the functional state of the cardiovascular system, the “double product” (DP) index is calculated:

HR - heart rate;

SBP is systolic blood pressure at rest.

The lower the DP at rest, the higher the maximum aerobic capacity and the level of somatic health.

Examples of assessing the dynamics of the “double product” indicator:

1. Nikolay I.

Beginning of the shift: heart rate - 72 beats/min., blood pressure - 118/72 mm Hg. Art.

DP = 72 x 118 / 100 = 85

End of shift: heart rate - 71 beats/min, blood pressure - 110/70 mm Hg. Art.

DP = 68 x 110 / 100 = 78. The value of the indicator has decreased.

Positive dynamics - 2 points.

Beginning of the shift: heart rate - 69 beats/min., blood pressure - 115/62 mm Hg. Art.

DP = 69 x 115 / 100 = 79

End of shift: heart rate - 75 beats/min., blood pressure - 114/65 mm Hg. Art.

DP = 78 x 114 / 100 = 85.5. The indicator value has increased.

Negative dynamics - 0 points.

3. Victor I.

Beginning of the shift: heart rate - 75 beats/min., blood pressure - 120/64 mm Hg. Art.

DP = 75 x 120 / 100 = 90.

End of shift: heart rate - 79 beats/min., blood pressure - 114/67 mm Hg. Art.

DP = 78 x 115 / 100 = 90. The value of the indicator has not changed.

Lack of dynamics - 1 point.

3.2.2. To assess the functional capabilities of the respiratory system, an indicator of external respiration is determined - vital capacity of the lungs (VC).

Vital vital capacity is measured using an air or water spirometer: the subject takes a deep breath through the mouth, tightly clasps the mouthpiece of the spirometer with his lips and exhales vigorously to the end, excluding exhalation through the nose (it is advisable to put a clip on the subject’s nose). The procedure is carried out 2 - 3 times and the best result is recorded.

Recovery will be considered effective if by the end of the shift the initial value of vital capacity increases by 100 ml or more, which will indicate an improvement in the functional state. Negative dynamics will be considered a decrease in the initial value of vital capacity by 100 ml or more. Indicators that do not meet these requirements should be considered as a lack of dynamics.

Examples of assessing the dynamics of the vital capacity indicator

1. Nikolay I.

Beginning of the shift: vital capacity = 2100 ml.

End of shift: vital capacity = 2250 ml. Vital capacity increased by 150 ml.

Positive dynamics - 2 points.

Beginning of the shift: vital capacity = 3200 ml.

End of shift: vital capacity = 3250 ml. Increase in vital capacity less than 100 ml.

Lack of dynamics - 1 point.

3. Victor I.

Beginning of the shift: vital capacity = 2900 ml.

End of shift: vital capacity = 2780 ml. Vital capacity decreased by more than 100 ml

Negative dynamics - 0 points.

3.3. Assessment of the dynamics of physical fitness indicators

An important indicator of improving the functional capabilities of a child’s body is an increase in physical fitness indicators.

At the beginning and at the end of the shift, children's physical fitness indicators are measured: wrist dynamometry, standing long jump, 30-meter run, for boys - pull-ups on the bar, for girls - sitting up in 30 seconds.

3.3.1. The study of maximum muscle strength of the hands (hand dynamometry) is carried out using a flat-spring hand dynamometer, measuring the strength of the muscles of the strongest hand (for right-handers - right, for left-handers - left). The dynamics of hand dynamometry indicators of the same hand (right or left) are assessed. It is unacceptable to assess the dynamics of hand dynamometry indicators of different hands (for example, at the beginning of a shift - dynamometry data of the right hand, at the end of the shift - of the left hand).

The dynamometer is taken in the hand as comfortably as possible, the hand is moved forward and to the side. 2-3 attempts are made and the best result is recorded.

An increase in dynamometry indicators by 1 kg or more is considered positive dynamics and indicates the correct use of physical exercises, in particular, strength and speed-strength orientation in the system of health-improving activities; a decrease in muscle strength by 1 kg or more is considered negative dynamics. Data that does not meet the above requirements should be regarded as a lack of dynamics.

Examples of assessing the dynamics of the hand dynamometry indicator:

1. Nikolay I.

Start of shift: dynamometry (left hand) - 24 kg.

End of shift: dynamometry (left hand) - 26 kg. An increase in the indicator by more than 1 kg.

Positive dynamics - 2 points.

Start of shift: dynamometry (right hand) - 20 kg.

End of shift: dynamometry (right hand) - 20.5 kg.

The indicator increased by less than 1 kg.

Lack of dynamics - 1 point.

3. Victor I.

Start of shift: dynamometry (right hand) - 23 kg.

End of shift: dynamometry (right hand) - 21.5 kg.

The indicator decreased by more than 1 kg.

Negative dynamics - 0 points.

3.3.2. To determine speed and strength qualities, the standing long jump test is used. The test must be carried out on a soft ground surface (sand pit) or on a rubber track. A forward standing jump is performed from a starting position, standing, feet slightly apart, toes in line with the starting line. The participant slightly bends his legs, moves his arms back, tilts his torso forward and, shifting the center of gravity of the body forward, swings his arms forward and pushes his two legs and jumps to the maximum possible distance. Two attempts are used, with the best result counting.

An increase in the length of the jump towards the end of the change is considered a positive dynamics of the indicator, a decrease - a negative dynamics. Data that does not meet the above requirements should be regarded as a lack of dynamics.

Examples of evaluation of indicators of the “Standing Long Jump” test:

1. Nikolay I.

Start of the shift: standing long jump = 175 cm.

End of shift: standing long jump = 181 cm.

Positive dynamics - 2 points.

Start of the shift: standing long jump = 161 cm.

End of shift: standing long jump = 161 cm.

Lack of dynamics - 1 point.

3. Victor I.

Start of the shift: standing long jump = 170 cm.

End of shift: standing long jump = 168 cm.

Negative dynamics - 0 points.

3.3.3. To assess the speed and speed of movements, it is recommended to use the 30-meter run test. The test is carried out by two researchers on a straight, flat path 2 - 3 meters wide, at least 40 meters long, where the start line is marked and after 30 meters the finish line. The race is run in pairs. Children need to run the entire distance as quickly as possible, without slowing down. Participants stand at the line, facing the direction of running, putting one leg back, slightly bending their legs and tilting their torso slightly forward. On the command "March!" children run at full speed to the landmark. Participants are given one attempt. Speed ​​running should be carried out on a stadium track or sports field, from a high start, with the time of covering the distance recorded. Time is measured with an accuracy of 0.1 s. The running is carried out in the presence of medical staff (a first aid kit is required).

A decrease in running time at the end of a shift is regarded as a positive trend, while an increase in running time is considered a negative trend. Data that does not meet the above requirements should be regarded as a lack of dynamics.

Examples of evaluating the indicators of the 30-meter run test:

1. Nikolay I.

Start of shift: 30 meter run = 4.7 s.

End of shift: 30 meter run = 4.3 sec.

The indicator decreased by the end of the shift.

Positive dynamics - 2 points.

Start of shift: 30 meter run = 5.2 s.

The indicator did not change by the end of the shift.

Lack of dynamics - 1 point.

3. Victor I.

Start of the shift: 30 meter run = 4.9 s.

End of shift: 30 meter run = 5.2 s.

The indicator increased by the end of the shift.

Negative dynamics - 0 points.

3.3.4.1. To assess the strength and power endurance of the muscles of the upper shoulder girdle in boys from 7 years of age and young men, the “Pull-up on the crossbar” test is used. While hanging on a bar with straight arms, the boy must perform the maximum possible number of pull-ups, with his arms fully extended, his legs at the knee joints not bent, and movements without jerking or swinging. In this case, the pull-up is considered to be performed correctly, otherwise the pull-up is not counted. Two attempts are used, the best result is taken into account.

An increase in the number of pull-ups by the end of the shift indicates an improvement in the strength and strength endurance of the muscles of the upper shoulder girdle and is regarded as positive dynamics, a decrease in the number of pull-ups - as negative dynamics, the number of pull-ups remains the same as at the beginning of the shift - no dynamics.

Examples of evaluating the indicators of the "Pull-up on the bar" test:

1. Nikolay I.

Start of the shift: pull-ups on the bar = 12 times.

End of shift: pull-ups on the bar = 14 times.

The indicator increased by the end of the shift.

Indicator rating: positive dynamics - 2 points.

2. Pavel G.

Start of the shift: pull-ups on the bar = 7 times.

End of shift: pull-ups on the bar = 7 times.

The indicator did not change by the end of the shift.

Indicator rating: lack of dynamics - 1 point.

3. Victor I.

Start of the shift: pull-ups on the bar = 10 times.

End of shift: pull-ups on the bar = 9 times.

The indicator decreased by the end of the shift.

Indicator rating: negative dynamics - 0 points.

3.3.4.2. Speed-strength endurance of the torso flexor muscles in girls is assessed using the “Squatting torso in 30 seconds” test. The exercise is performed on a gymnastic mat or carpet. From the starting position, lying on your back, legs bent at the knee joints strictly at an angle of 90°, feet shoulder-width apart, arms spread to the sides, touching the floor. On the command "March!" in 30 seconds, the girl performs the maximum possible number of lifts of the body, touching the hips when bending with the elbows and returning with a reverse movement to the starting position, i.e. touching the floor simultaneously with three parts of the body: shoulder blades, back of the head, elbows (correct execution of the test). Participants are given one attempt.

An increase in the number of sit-ups in 30 seconds is regarded as positive dynamics, a decrease - as negative dynamics, without changes - no dynamics.

Examples of assessing the indicators of the test “Raising the body into a squat position in 30 seconds”:

Beginning of the shift: raising the body into a squat position in 30 seconds = 20 times.

End of the shift: raising the body into a squat position in 30 seconds = 22 times.

The indicator increased by the end of the shift.

Positive dynamics - 2 points.

Beginning of the shift: raising the body into a squat position in 30 seconds = 18 times.

End of the shift: raising the body into a squat position in 30 seconds = 18 times.

The indicator did not change by the end of the shift.

Lack of dynamics - 1 point.

3. Marina P.

Beginning of the shift: raising the body into a squat position in 30 seconds = 15 times.

End of the shift: raising the body into a squat position in 30 seconds = 13 times.

The indicator decreased by the end of the shift.

Negative dynamics - 0 points.

3.4. Assessment of morbidity rates during the shift period

When analyzing the effectiveness of health improvement, it is necessary to take into account the indicators of acute and chronic morbidity in a child during the shift period, using a point system: absence of acute morbidity and exacerbations of chronic diseases - 2 points; presence of acute morbidity and/or exacerbation of chronic diseases - 0 points.

Assessment of indicators of physical development, functional state of the body, morbidity of children during the shift period is carried out by medical workers of a country inpatient recreation facility. Assessment of the level of physical fitness is carried out by physical education workers of this institution.

IV. Comprehensive assessment of children's health

For a comprehensive assessment of the health of children in a suburban inpatient recreation facility, it is necessary to evaluate the dynamics of the obtained indicators using a point system: positive dynamics of indicators (improvement) is assessed as 2 points, absence of dynamics - 1 point, negative dynamics (deterioration) - 0 points. The presence ("+") of an acute disease and/or exacerbation of chronic diseases during the shift period is considered as negative dynamics and is assessed as 0 points. The data obtained is entered into the child’s examination card (Appendix 2 to these guidelines).

A comprehensive assessment of the effectiveness of a child’s health will depend on the sum of the scores of all indicators:

Pronounced healing effect - 12 - 16 points;

Weak healing effect - 8 - 11 points;

Lack of healing effect - 0 - 7 points.

In order to analyze the health effects for the squad and the institution as a whole, it is necessary to fill out the tables in accordance with the appendix. 3 and to these methodological recommendations.

Annex 1

Table 1

height in children 14 years old

table 2

Boundaries of normal variants of body mass (weight) at different

height in children 15 years old

“Assessment of the effectiveness of health improvement for children and adolescents in summer

health institutions")

For a comprehensive assessment of the effectiveness of children's health improvement in summer recreation and health institutions, on the 1st - 2nd day from the start of the health-improvement shift, as well as the day before its end, the institution must organize and conduct a medical examination of all children recovering with mandatory anthropometric and physiometric tests. research methods.

All measurements should be taken on a half-naked child in the first half of the day.

The evaluation criteria for each “mandatory indicator” are given in table. 1. The criteria for evaluating “additional indicators” are similar.

Table 1

CRITERIA FOR EVALUATING "MANDATORY" INDICATORS

HEALTH EFFECTIVENESS

Note: if BMI is greater than or equal to the upper limit of normal, then a decrease in body weight is assessed as 2 points, an increase from 0 to 1 kg - 1 point, an increase in body weight by more than 1 kg - 0 points. Standard BMI values: 7 years - normal: 13.5 - 17.5; 8 years - 13.5 - 18; 9 years - 14 - 19; 10 years - 14 - 20; 11 years - 14.5 - 21; 12 years - 15 - 22; 13 years old 15 - 22.5; 14 years old - 16 - 23.5; 15 years - 16.5 - 24; 16 years - 17 - 25.

To assess the effectiveness of the health improvement of each child and the team as a whole, information based on the results of the medical examination is entered into the journal “Assessment of the Health Effect” (Table 2), which provides for entering information for each child at the beginning of the shift, as well as at its end. The note column is filled in if the BMI is greater than or equal to the upper limit of normal (see terms and definitions), as well as if the child left the institution before the end of the shift.

table 2

"ASSESSMENT OF HEALTH EFFECT"

The final score is the sum of the scores for each indicator and is assessed in accordance with table. 3. If a child leaves the institution before the end of the shift, he automatically falls into the group with “no healing effect.”

Table 3

CRITERIA FOR THE TOTAL ASSESSMENT OF HEALTH EFFECTIVENESS

Assessment of the effectiveness of the health improvement of children and adolescents is carried out without fail based on the final summary assessment; for its detail, “Mandatory” indicators are also subject to assessment - table. 4.

Table 4

ASSESSMENT OF THE EFFECTIVENESS OF HEALTH CARE FOR CHILDREN AND ADOLESCENTS

(FINAL TABLE)

Annex 1

To MR N 2.4.4.01-09

(required)

METHODOLOGY

DEFINITIONS OF "KEY INDICATORS" OF AN ASSESSMENT

HEALTH EFFECTIVENESS

Weighing carried out on medical scales, correctly installed and adjusted. The scales should be installed on a level place and in a strictly horizontal position. When weighing, the child must stand motionless in the middle of the platform.

To measure body length They use a stadiometer, which is a vertical bar with a centimeter scale printed on it, fixed on the platform. The height meter should be installed on level ground and in a strictly horizontal position. The child is placed on the platform with his back to the vertical stand so that he touches the stand with his heels, buttocks, shoulder blades and the back of his head. The arms should be extended at the seams, the heels together, the toes apart, the head should be held so that the tragus of the ear and the outer corner of the palpebral fissure are on the same horizontal line. The tablet is lowered onto the head.

Hand muscle strength is measured with a hand dynamometer. In this case, the hand should be moved to the side, the dynamometer is compressed with maximum effort, without jerking. Two measurements are taken and the best result is recorded. The strength of the muscles of the right and left hand is measured.

Spirometry is a method for determining vital capacity of the lungs (VC): Having covered his nose with his fingers, the teenage child takes a maximum breath, and then gradually (over 5 - 7 seconds) exhales into the spirometer. It is necessary to repeat the measurement procedure 2 - 3 times. The maximum one is selected from the obtained results. The resulting value of vital capacity is called actual.

Appendix No. 15

to the Organization Procedure

sanitary and hygienic

anti-epidemic

providing for children,

going on summer holidays to

health institutions in 2011