The proposed prognostic models of children and adolescent’s incidence risk have proved their applicability and can be used in policlinics during planned outpatient examinations. The high clinical effectiveness of the proposed models is shown.
INTRODUCTION
By the decree of the President of the Russian Federation V.V. Putin (No. 240 dated May 29, 2017), the period from 2018 to 2027 was declared the Tenth Anniversary of Childhood and the Government of the Russian Federation was instructed to approve the Plan of the main activities until 2020, carried out within the framework of the Decade of Childhood.
The health status of boys and young men attending preschool and school educational institutions is largely due to the conditions of their upbringing, education, lifestyle, and catering. Educational institutions should provide not only the basic foundation of the intellectual development of children, but also create the most favorable conditions for them. harmonious growth, development and health formation.
The results of modern scientific research indicate that the most pronounced increase in the prevalence of chronic diseases and functional deviations in physical development is associated, inter alia, with changes in the conditions of upbringing in educational institutions and coincides with the period of intensive growth and development of children.
Conducting a comprehensive assessment of the health status of boys and young men in educational institutions of the central region and study of the features of their physical development.
MATERIALS AND METHODS
To improve the decision-making system in pediatric practice, both at the level of pediatricians and at the level of healthcare organizers, it is expedient and relevant to use models, algorithms and mathematical methods based on the knowledge of experts using large volumes of archive and operational information. In this work, the method of expert evaluation is used.
The purpose of the study was, in addition to the above, the formation of predictive models of the health of boys and adolescents, taking into account their age. Table 1 shows the estimates of experts and the values x of the weights for the formation of the health model of boys aged 0-4 years
The research was carried out in several stages. At the first stage, for each indicator, all its possible values x are ranked according to the degree of significance. For the rank assessment of each value, a priori ranking method is applied using expert information. This method makes it possible to objectively assess the subjective opinion of specialists (experts), since with a large number of parameters, the opinion of experts about the degree of influence of a particular factor may differ.
RESULTS
As a result of the calculations, the predictive health model for boys aged 0-4 years will look like this:
Y1 = 0.4 (6) * x11 + 0.18 (3) * x12 + 0.31 (6) * x13 + 0.41 (6) * x14 + 0, (3) * x15 where X11— Congenital anomalies, X12 — Diseases of the nervous system, X13 — Diseases of the digestive system, X14 — Diseases of the blood and hematopoietic Organs, X15 — Diseases of the circulatory system.
The values of the developed model lie in the interval Y1ϵ [0..1.7].
The predictive health model for boys aged 5-9 will look like this:
Y2 = 0.2 (6) * x21 + 0.28 (3) * x22 + 0.1 * x23 + 0.3 * x24 + 0.61 (6) * x25, where X21 — Diseases of the musculoskeletal system, X22 — Diseases of the digestive system, X23 — Diseases of the respiratory system, X24 — Diseases of the nervous system, X25 — Diseases of the eye and its appendages.
The values of the developed model lie in the interval Y2ϵ [0..1.6].
The predictive health model for boys aged 10-14 will look like this:
Y3 = 0.18 (3) * x31 + 0.21 (6) * x32 + 0.28 (3) * x33+0.18 (3) * x34 + 0.31 * x35, where X31 — Diseases of the musculoskeletal system, X32 — Diseases of the digestive system, X33 — Diseases of the eye and its appendages, X34 -Diseases of the respiratory system, X35 — Diseases of the endocrine system
The values Y of the developed model lie in the interval Y3ϵ [0..1,2].
The predictive health model for boys aged 15-17 will look like this:
Y4 = 0.1 * x41 + 0.2 (3) * x42 + 0.2 * x43 + 0.4 * x44 + 0.4 * x45
Where X41 — Disease-muscular system, X42 — Diseases of the eye and its appendages, X43- Diseases of the digestive system, X44 — Diseases of the circulatory system, X45 — Diseases of the nervous system.
The values Y of the developed model lie in the interval Y4ϵ [0..1.4].
The predictive health model for boys aged 0-17 will look like this:
Y5 = 0.1 (6) * x51 + 0.2 * x52 + 0.28 (3) * x53 +0.38 (3) * x54 + 0.21 (6) * x55, where X51 — Diseases of the musculoskeletal system, X52 — Diseases of the digestive system, X53 — Diseases of the nervous system, X54 — Diseases of the eye and its appendages, X55 — Diseases of the endocrine system
The values Y of the developed model lie in the interval Y5ϵ [0..1.3].
Table 1
Risk levels of developing a health disorder
| The level of risk of developing health disorders | High | Medium | Low |
| Y1(age 0-4) | 1,2-1,7 | 0,4-1,2 | 0-0,4 |
| Y2(age 5-9) | 1,1-1,6 | 0,4-1,1 | 0-0,4 |
| Y3(age 10-14) | 0,9-1,2 | 0,3-0,9 | 0-0,3 |
| Y4(age 15-17) | 0,9-1,4 | 0,4-0,9 | 0-0,4 |
| Y5(age 0-17) | 0,9-1,3 | 0,4-0,9 | 0-0,4 |
DISCUSSION
The developed models of the level of risk of developing health disorders and the development of various diseases in children and adolescents of the Belgorod region were tested at the «Children’s Regional Clinical Hospital» in Russian central region. The models showed their clinical effectiveness.
The results of the study indicate the presence of a negative trend in the dynamics of physical development and health status of young men, which is primarily due to inappropriate nutrition, lack of physical activity with a predominance of static and intellectual educational loads. In this regard, important tasks of modern Russian pediatrics are, first of all, the development and implementation of preventive, treatment and rehabilitation technologies and priority programs in the work of educational institutions, in particular, rational organization of nutrition in educational institutions, optimization of the motor regime of children and adolescents.
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