Pediatrics as a science about a healthy and sick child. Periods childhood. Health groups. Dentist importance in child’s health care. SAKHAROVA Inna.Ye., MD, PhD

General birth rate of the population, ‰= The number of people which were born alive during one year×1000 Mid-annual population

General mortality rate of the population, ‰=  The number died during one year ×1000  Mid-annual population

Infant mortality rate, ‰ =  Number of infant which were born alive and under the age of one year×1000  The common number of infant which were born alive for a year

Neonatal mortality rate, ‰=  Number of infant which were born alive and have died on the first month of a life×1000  The common number of infant which were born alive during one year

Early neonatal mortality rate, ‰=  The number of infant which were born alive and have died in the first 6 days×1000  The common number of infant which were born alive during one year

Stillbirth rate, ‰=  The number of infant which were born dead after 28 weeks of pregnancy×1000 The number of infant which were born alive and dead during one year

Health indices Demographically indices (birth rate, mortality rate, neonatal mortality rate, early neonatal mortality rate, still birth rate, infant mortality rate ).  Morbidity indices (primary, general, according to preventive services, hospital morbidity, morbidity with temporary disability ).  Invalidity indices (primary, general).  Indices of physical development.

Health groups I. Healthy children without any deflections according to all signs of health; they don’t get ill or get sick rarely; children with insignificant deflections which don’t influence health condition and don’t need any correction.  II A. Children with burdened biological history (pathology of pregnancy, pathologic or difficult labor, multiple pregnancy, immature pregnancy, complicated early neonatal period) and aggravated social history (harmful parents’ habits, divorced parents, orphans, etc.), but with normal physical and psychomotor development, without functional disorders.  II-B. Children with functional disorders; children which have been ill often and longly; with often and long episodes of virus respiratory diseases; children with risk of developing chronic pathology; reconvalescent children after severe acute diseases.  III. Children with chronic pathology in compensation.  IV. Children with chronic pathology in subcompensation.  V. Children with chronic pathology in decompensation.

 Risk group- Children from the II health group, which haven’t developed chronic pathology, but they have different functional and morphological deflections that may course change the health condition for the worse. Risk groups:  with risk of developing pathology of central nervous system;  immature babies;  with risk of developing throphical disorders;  with risk of developing anemia;  with risk of developing respiratory pathology;  with congenital defects;  group of social risk.

Prenatal period: it lasts from conception to birth. Prenatal period is divided into embryonic and fetal periods.  Embryonic period begins from conception to 8 weeks of gestations.  Fetal period lasts from 8 to 40 weeks of intrauterine life (by the birth).  A rapid growth rate and total dependency makes this one of the most crucial periods in the developmental process. The relationship between maternal health and certain manifestations in the newborn emphasizes the importance of adequate prenatal care to the health and well-being of the infant.

 The common diseases that appear in embryonic period (embryopathy):  anencephalia,  hydrocephaly,  pylorostenosis,  congenital malformation of lungs, kidney,  congenital heart defect.  The common diseases that appear in fetal period (fetopathy):  microsomia – decreased sizes of some parts of the body,  hypoplasia – organ or system of organs underdeveloped,  macrosomia – increased sizes of some parts of the body,  intrauterine infection (herpetic infection, hepatitis, rubella, mycoplasmosis, toxoplasmosis).

Infancy period: it lasts from birth to 12 months. Infancy is divided into neonatal and infancy.  Neonatal period: it begins from birth of the baby and lasts by 28 days.  Infancy lasts from 1 to 12 months.  The infancy period is one of rapid motor, cognitive, and social development. Through mutuality with the caregiver (mother), the infant establishes a basic trust in the world and the foundation for future interpersonal relationships. The critical first month of life, although the part of the infancy period, is often differentiated from the remainder because of the major physical adjustments to extrauterine existence and the psychologic adjustment of the mother.

 The common diseases that appear in neonatal period:  embryopathy,  fetopathy,  intrauterine infection,  birth ingeries (cephalhematoma, caput succedaneum, skull fracture, fractures of clavicle, humerus, facial paralysis, brachial palsy).  The common diseases that appear in infancy:  rickets, rachitis,  anemia,  hypotrophy,  paratrophy,  acute diarrhea,  acute respiratory virus infections,  acute pneumonia,  infantile eczema.

Early childhood includes the children in age from 1 to 6 years. It is divided into toddler and preschool periods.  Toddler period lasts from 1 to 3 years.  Preschool period begins from 3 years and ended at 6 years.  This period, which extends from the time children attain upright locomotion until they enter school, is characterized by intense activity and discovery. It is a time of marked physical and personality development. Motor development advances steadily. Children at this age acquire language and wider social relationships, learn role standards, gain self-control and mastery, develop increasing awareness of dependence and independence, and begin to develop a self-concept.

 The common diseases that appear in toddler period:  acute children infections (rubella, measles, scarlet fever, pertussis, chickenpox, dysentery). The common diseases that appear in preschool period:  acute children infections (rubella, measles, scarlet fever, pertussis, chickenpox, dysentery),  tuberculosis,  bronchial asthma,  obesity,  rheumatism,  ingery.

Middle childhood: it lasts from 6 to 12 years.  Middle childhood includes prepubertal period: it begins from 10 years and completes at 12 years.  Frequently referred to as the "school age," this period of development is one in which the child is directed away from the family group and is centered around the wider world of peer relationships. There is steady advancement in physical, mental, and social development with emphasis on developing skill competencies. Social cooperation and early moral development take on more importance with relevance for later life stages. This is a critical period in the development of a self-concept.  A developmental task is a set of skills and competencies peculiar to each developmental stage that children must accomplish or master in order to deal effectively with their environment.

 The common diseases that appear in middle childhood:  chronic heart diseases (myocarditis, rheumatism),  chronic kidneys diseases (pyelonephritis, glomerulonephritis),  diseases of nervious systems,  scoliosis,  disease of eye sight.

Later childhood (adolescence period): it lasts from 12 to 18 years.  The tumultuous period of rapid maturation and change known as adolescence has been described in various ways. It is considered to be a transitional period that begins at the onset of puberty and extends to the point of entry into the adult world - usually high school graduation. Biologic and personality maturation are accompanied by physical and emotional turmoil, and there is redefining of the self- concept. In the late adolescent period the child begins to internalize all the previously learned values and to focus on an individual, rather than a group, identity.

 The common diseases that appear in later childhood:  dysfunction of the nervous system,  dysfunction of the cardiovascular system,  dysfunction of the digestive system,  dysfunction of the endocrine system,  chronic heart diseases (myocarditis, rheumatism),  chronic kidneys diseases (pyelonephritis, glomerulonephritis),  diseases of the nervous systems.