Child and Adolescent Hygiene
introduction
1. Child and adolescent health: It is the science of protecting and promoting the physical and mental health of children and adolescents, and it is an important part of preventive medicine.
2. The purpose of children's hygiene: To study the relationship between the physical and mental health of developing children and adolescents, the external environment and heredity, formulate corresponding hygiene requirements and measures, prevent diseases, enhance physical fitness, and promote the health of children and adolescents.
Objective: To protect and promote the health of children and adolescents.
3. Developmental characteristics of children's hygiene: ⑴Pay attention to the three major characteristics of primary and middle school students who are the main service objects: ①In the period of growth and development; ②Education in school; ③Group life. (2) When formulating work goals and proposing intervention measures, pay attention to their growth and development and its influencing factors, prevention and treatment of common diseases and injuries, and also consider their psychological-emotional-behavioral development characteristics and actual needs. (3) The core task is to provide good education, health care and medical services for the transitional characteristics and special problems of adolescents' physical and mental development. 4. Research objects of children's hygiene: Main research objects: primary and secondary school groups (children and adolescents aged 7-18, that is, childhood and adolescence). Age range: 0~25 years old, that is, from birth to mature youth.
2. Subject content of children's hygiene
1. Growth and development:
2. Disease prevention and treatment:
3. Mental hygiene
4. School health education:
5. School environment construction and sanitation supervision:
3. Be alert to the negative impact of "modern civilization" on students' physical fitness and health
1. Stagnant or declining endurance quality of children
Endurance: It is manifested in two aspects: muscle static endurance and speed endurance
Among them: negative growth in indicators such as pull-ups, sit-ups, and endurance running
2. The "bimodal phenomenon" of the nutritional status of students
Obesity: In 1985, the detection rate of obesity was about 0.2% and 0.1%, and the overweight rate was 1%-2%. In 1995, the detection rate of obesity was 6%-8% for males and 4%-6% for females; around 2000 , overweight + obesity:
Boys: 7-9 years old: 25.4%, 10-12 years old: 25.5%; Girls: 7-9 years old: 17.0%, 10-12 years old: 14.3% Malnutrition: Unbalanced nutrient intake, partial eclipse, Bad habits such as picky eaters and eating too many snacks.
3. The prevalence of common diseases among students remains high
Infectious diseases have been greatly reduced, controlled or eliminated, but the prevalence of common student diseases such as myopia, dental caries, and scoliosis, which are closely related to modern lifestyles, has continued unabated, and some are even rising.
Such as: low vision detection rate (mainly myopia):
22.7% in primary school, 55.2% in junior high school, and 76.7% in university.
4. Psychological and behavioral problems increase,
Decreased social adaptability, major behavioral problems in school age, major behavioral problems in adolescence
Chapter 1 Growth and Development of Children and Adolescents
Significance:
① Discuss growth and development laws, mechanism characteristics and trends
②Research on factors affecting growth and development
③Provide a scientific basis for formulating developmental evaluation standards and health policies and measures.
1. The concept of growth and development
1. Growth: Refers to the proliferation and enlargement of cells and the increase of intercellular substance, manifested in tissues, organs,
Changes in the size, length, weight and chemical composition of various parts of the body and the whole body. Contains morphological growth and chemical growth. —— Quantitative change.
2. Development: refers to the process of continuous differentiation and improvement of body tissues, organs and functions of various systems, including the maturity of physical strength, psychology and behavior. ——Qualitative change.
3. Maturity: refers to the stage of growth and development reaching a relatively complete stage, and the individual reaches the adult level in terms of shape, physiological function, exercise ability and psychology-behavior. Have the ability to live independently and give birth to the next generation.
4. Maturity level or maturity (maturity degree): refers to the relative developmental level of specific growth and development indicators, that is, the percentage of the developmental level at that time and the adult level.
5. Plasticity of growth and development: refers to the ability of the structure and function of the human body to change to adapt to positive or negative internal and external environments and life experiences, that is, the possibility of growth and development, which means that the state of growth and development can be shaped by life experiences.
The plasticity of growth and development is also manifested as the plasticity of neural development, that is, the structural and functional responses of neurons to neural activity and environmental changes during the development of the nervous system.
2. Growth and development index system
(1) Physical development indicators
Physical growth usually refers to the development of the external shape of the body, which is an important aspect of the overall development of the human body. There are many measurement indicators for physical development, which can be roughly classified into three categories, namely longitudinal measurement, lateral measurement and weight measurement.
1. Longitudinal measurement
2. Lateral measurements include girth and diameter.
3. Weight measurement is mainly body weight.
4. Derived indicators of physical development are also called body mass index
(1) Quetelet index, or body mass index, is related to the fullness of the human body.
(2) Kaup index or body mass index (body mass index, BMI). BMI is more sensitive to reflect the degree of obesity and thinness of the human body, and has a good correlation with the thickness of sebum.
(3) The Rohrer index is represented by (W/H3)×107, which reflects the fullness of the body.
(2) Physical development indicators
Physical fitness is an important extension of the concept of health, which is used to comprehensively and accurately evaluate the physiological function and health status of the human body.
1. Physiological function indicators: cardiovascular function, lung function, muscle strength development.
2. Athletic ability indicators: strength indicators, endurance indicators, speed indicators, sensitivity indicators, flexibility indicators.
3. Derived indicators of physical development: mainly vital capacity, blood pressure, heart rate, etc.
(3) Psychological and behavioral development indicators
1) Cognitive ability indicators
2) Emotional state indicators
3) Personality development indicators
4) Indicators of social adaptability
Section 2 General Laws of Growth and Development of Children and Adolescents (Questions and Answers)
The general principles of growth and development refer to the phenomena that most children have during their growth and development.
The interaction of genetics and environment
2. Unity of continuity and stages
(1) Continuity of growth and development
Growth and development is a dynamic continuous process, which is the accumulation of quantity and functional maturity.
1. The phenomenon of growth trajectory (growth canalization) refers to the direction, speed and target development of the growth process determined by the genetic potential under normal circumstances.
2. Catch-up growth: When an individual in the process of growth and development is affected by factors such as disease, nutrition, and psychological stress (stress), there will be temporary growth and development retardation. In order to move closer to the original normal trajectory and have a strong tendency to grow and develop. It can be divided into complete overgrowth and incomplete growth. Whether it can return to the original normal trajectory depends on the cause of the disease, the duration and severity of the disease.
(2) Stages of growth and development
There are "critical growth periods" for many vital organs and tissues. Normal development at this time is disturbed, often with permanent defects or dysfunction (brain cells, bone cells).
1. critical growth period
(Question and answer) There is also a critical period or a sensitive period for the acquisition of certain functions or skills. At this time, the function or skill can be obtained with appropriate stimulation or training, otherwise it cannot be obtained or requires more effort. Common developmental critical periods:
② 0-2 years old is a critical period for motor development;
② 1.5 to 3 years old is a critical period for the development of oral language;
③ 4~5 years old is the critical period for word recognition;
④ 0-4 years old is a critical period for visual development;
⑤ ⑤Before the age of 6 is the period for cultivating good habits
2. Developmental age staging and developmental tasks
Divided into six stages:
A Infant period: 0-1 years old
B Early childhood (toddler period): 1-3 years old
C Early Childhood (early child period): 3-6 years old, also known as preschool
D Childhood (child period): 6-12 years old;
E Puberty (addescence): about 10-20 years old, women are 1-2 years earlier than men
F youth period (youth period): about 18 to 25 years old.
Developmental task (developmental task) In a certain age group, the individual's psychological and behavioral maturity should be able to reach a certain level. These developmental tasks are the basic tasks of a specific age, which are not only the educational goals, but also the basis for judging the developmental level.
3. Procedural and temporal coordination
The development process is carried out from first to last, from low level to high level, from simple to complex according to a certain procedure, and genetic factors play a major role in this process. However, the level of growth and development achieved by an individual and the appearance of developmental phenomena will be affected by genetic and environmental factors sooner or later.
(1) Programmatic growth and development
1. Motor-language development and linear growth patterns
①Cephalocaudal pattern: In infants and young children, gross motor (gross motor) proceeds according to the developmental program of raising the head, turning over, sitting, crawling, standing, walking, running, and jumping. The development of body proportions during fetal and infant periods also follows the law of head-to-tail development. Development is from the head, upper limbs, trunk, lower limbs, from top to bottom.
②proximodistal pattern: Gross movements and fine movements follow, that is, the muscles of the limbs near the trunk develop first, and the fine movements of the hands develop later. Features: from near to far, from thick to thin, from simple to complex.
Balance and big movements: 2 lifts, 4 turns, 6 sitting, 7 rolls, 8 crawls, and walking
③ Centripetal pattern refers to the sequence of morphological development during childhood and adolescence.
Features: The lower limbs precede the upper limbs, and the limbs precede the trunk, presenting a regular change from bottom to top, from the distal end of the limbs to the central trunk.
2. Types of development of body organs and systems (questions and answers) Ø
Growth pattern refers to the changes in the maturity of organs and systems with age. Ø ScammonR. Through the description of the developmental level curve, he found that the growth curve of human organs and systems can be divided into general type, lymphatic system type, nervous system type and reproductive system type, which is called Scammon's growth pattern (Scammon's growth pattern)
(1) General system type: including muscles, bones, major organs and blood flow. Characteristic: Two growth spurts (feto-infancy and puberty).
(2) Nervous system type: brain, spinal cord, visual organs, head circumference and head diameter reflecting the size of the skull, etc. Features: There is only one growth spurt, fast at first and then stable. The rapid growth stage occurs from the fetal period to about 90% of maturity before the age of 6.
(3) Lymphatic system type: thymus, lymph nodes and interstitial lymphoid tissue. Characteristics: Only one growth spurt, rising and falling.
⑷ reproductive system type: the most important system for the individual, the last to develop. The reproductive system, except the uterus, almost stagnates before puberty, and accelerates rapidly after puberty begins.
(5) Uterine type: The uterus and adrenal glands grow larger at birth, then rapidly decrease in size, and return to their birth size before puberty begins, and then increase rapidly.
(2) Timing of growth and development
When environmental factors play a role or genetic and environmental factors work together, there are obvious individual differences in the physical and psychological development of children and adolescents.
3. Ecological view of growth and development
When considering individual development, it should be nested within a series of interacting environmental systems in which the system and the individual interact to influence the individual's development.
Spatial dimension: The innermost layer is the microsystem, which is the immediate environment of individual activities and interpersonal interactions, and is constantly evolving and changing. Such as family, kindergarten, school, etc.
The second environmental system is the middle system, which refers to the connection or mutual connection between various microsystems.
The third environmental system is the exosystem: the environment in which children are not directly involved but which influences their development. Such as the work of parents.
The fourth system is the macro system: the culture, subculture and social environment that exist in the above three systems.
time dimension
Chapter II Physical Development of Children and Adolescents
Physical growth refers to the changes in the external shape, body proportion and shape of the human body with age.
A stage of physical development
1. The first growth spurt period: from the second trimester to the end of one year old. Length increases by an average of 50 cm throughout pregnancy.
2. Relatively stable period. From the age of 2 to puberty, children grow about 5-7cm in height and 2-3kg in weight every year.
3. During the second growth spurt stage, the peak height of PHV is 10-14cm in height and 8-10kg in weight per year.
4. Growth stagnation period: In the middle and late stages of puberty, the height growth gradually stops, and the weight also stops growing significantly.
Peak height spurt PHV: The period when an individual's height growth velocity reaches its maximum. Female: 11-13 years old, Male: 13-15 years old, often used as a developmental sequence that marks various signs of puberty.
Significance: ①Supplement proper nutrition; ②Ensure adequate sleep; ③Ensure adequate exercise.
2. Long-term growth trend: It refers to the trend that children and adolescents in developed countries have grown taller from generation to generation, advanced sexual development, and gradually increased adult height since the 19th century, especially after the Second World War. The most prominent phenomenon in human biology in 150 years.
Reasons: Genetics and environment Main manifestations: 1) Newborn's body length and weight increase 2) Children's average height increases, height stops increasing at an earlier age, adult height level increases 3) Sexual maturity advances 4) Others: Brain weight; first constant molars; bone age
Sex Characteristics of Body Composition Development
Gender Differences in Body Fat Development
1) During childhood, body fat decreases in both boys and girls.
2) Entering puberty, for girls, there is mainly an increase in a large number of FM.
3) In general, the body fat content of girls aged 0-20 is higher than that of boys.
Gender characteristics of lean body mass: boys have higher lean body mass from early life; boys still have significantly more lean body mass gain than girls in childhood; boys mainly show lean body mass increase in puberty, and increase in 10-20 years old Up to 30kg, girls are only half of boys.
uSheldon Body Type Classification
① Endomorphy: The body is plump and the digestive organs are well developed.
② mesomorphy: robust body with well-developed skeletal muscles.
③ Ectomorphic body type (ectomorphy): the body is long and thin, with well-developed nervous system and sensory organs.
The characteristics of physical development
1. Unbalanced physical development process
The development speed of different physical fitness indicators varies with age. For example, cardiovascular and pulmonary function indicators increase with age, and there are obvious growth spurts; while heart rate gradually decreases with age.
2. Stages of physical development
① Boys aged 6-14 and girls aged 6-12 are the stage of rapid growth. ② Boys aged 15 to 18 and girls aged 12 to 15 are slow growth stages. About 85% of girls experience a stalled or reduced motor development at this stage. ③ Restorative growth stage, only females have this stage at the age of 16-18. ④ In the stable stage, males are 19-25 years old and females are 19-22 years old.
3. Unbalanced physical development
There is an imbalance in the development of different parts under the trend of overall coordination of the body.
During adolescence, the muscles of the limbs develop earlier than the trunk, and the large muscle groups of the trunk develop earlier than the small muscle groups; overall, the muscle strength development of the large muscle groups lags behind the height by 8 to 10 months, and the small muscles lag behind by 12 to 16 months; the whole body Muscle coordination generally does not develop until late adolescence.
4. Age changes in body fat development
The %BF of both boys and girls increased before the puberty spurt, the growth peak of boys was at 11 years old, then decreased, and continued to rise again in the later period of puberty, and the %BF of girls did not decline throughout the puberty peak. The gender difference in BF% became more and more obvious with age.
5. Age Changes in Lean Mass Development
Lean body mass increases with age, and sex differences widen with age. LBM increased with age, and the peak age was 13 years old for girls and 15 years old for boys.
6. Early life brain development
Early in life (from fertilization to 2 years after birth), the brain grows at an astonishing rate. The last 3 months of fetal life and the two years after birth are called the "accelerated period of brain development", and the central nervous system begins to myelinate from 0 to 18 months. The first part of the brain to mature is the primary motor area and primary sensory area.
Myelination occurs when brain cells divide and grow, and some glial cells begin to produce a waxy substance called myelin, which increases the speed at which nerve impulses are transmitted.
The brain weight of children aged 2-6 is still increasing rapidly, reaching more than 90% of that of adults at the age of 6. Myelination of the prefrontal cortex may even continue into the 30s.
Chapter Three Psychological and Behavioral Development of Children and Adolescents
Section 1 Children and Adolescents' Cognitive Ability Development
Cognition refers to the process of cognitive activities. It is a high-level psychological activity in which the brain reflects the characteristics, states and interrelationships of objective things, and reveals the meaning and function of things to people.
Cognitive abilities mainly include perception, memory, attention and thinking.
Sensation Definition: When a material object acts on human sensory organs, the reflection of its individual attributes in the brain is the initial form of perceptual knowledge. the first form of consciousness.
Categories: Vision, hearing, smell, taste, skin.
1) Vision: 6 months ago is a sensitive period for vision development. At birth, you can only see objects with a fixed focal length of 19cm. After about 2 months, the visual adjustment is mature. The sight first focuses on moving or brightly colored objects, especially for human faces. Especially for human faces, it is easy to produce visual concentration, and can follow objects moving in the horizontal direction. Babies around 4 months begin to have differentiated reactions to colors, and appear color vision. 2 to 3 years old can correctly distinguish the four basic colors of red, yellow, green and blue.
2) Hearing Speech hearing develops rapidly in infants and young children, and the hearing ability of normal newborns has been well developed. They can not only hear sounds, but also distinguish the frequency, intensity and duration of sounds. The baby's perception of music is shown very early. After the age of 2, the perception of hearing music is shown very early. Already quite sensitive to changes in rhythm, often exhibiting body movements that follow the beat of the music.
3) Taste Taste is most developed in infants and children, and gradually declines later. Newborns who are only 2 hours old can distinguish sweet, sour, bitter, salty and other tastes. Babies who are 4 to 5 months old will show a very sensitive reaction to any change in food, like sweet taste, and refuse to eat or not. favorite food.
4) The skin sense is the most developed sense of touch, and the sense of pain, cold, and temperature gradually arises and develops. The sense of touch is particularly sensitive to the lips, palms, soles, forehead and eyelids. Children aged 2 to 3 can well distinguish the different properties of various objects, such as soft, hard, cold, hot, rough, smooth, etc.
5) perception (perception)
Definition: The overall direct reflection of matter in the brain, which goes further than sensation. It forms time perception, space perception and motion perception through the organization and interpretation of sensory information.
Features: selectivity, relativity, integrity, constancy, etc.
Children's Perceptual Development
Babies have the ability to distinguish simple shapes at 3 months, babies before 6 months can distinguish size, and children aged 2 to 3 can distinguish up and down. The generation of these spatial perceptions is the result of the coordination of vision, hearing, kinesthetic, balance and other sensory functions of infants.
6) Illusion:
¢ Meaning: Human perception cannot correctly express the characteristics of external things, and various distortions appear.
¢ There are many types of illusions, the common ones are size illusions, shape illusions, direction illusions, weight illusions, tilt illusions, movement illusions, and time illusions.
Infancy is a critical period of psychological and behavioral development, and it is also the initial formation stage of personality.
Attention is the selective concentration of mental activities on certain objects. Attention is not an independent psychological process, it is a necessary prerequisite for people to acquire knowledge and improve work efficiency.
Preschool children are still dominated by unintentional attention, with a low stable level of attention, short attention time, easy distraction, and small attention range. After children enter elementary school, conscious attention gradually develops, but unintentional attention still plays an important role. The attention development of school-age children is highlighted in the following aspects.
Attention is the selective concentration of mental activities on certain objects. Attention is not an independent psychological process, but a necessary prerequisite for people to acquire knowledge and improve work efficiency.
The development of attention
Unintentional attention: attention that has no predetermined purpose and does not require will effort is called unintentional attention, also known as involuntary attention. Intentional attention: attention that has a predetermined purpose and requires a certain amount of will effort if necessary.
(1) The breadth of attention The breadth of attention refers to the number of things and objects that a person can clearly notice in an instant, that is, how large the scope of attention is.
(2) Distribution of attention Attention distribution refers to the ability to direct attention to different related objects at the same time when a person is performing two or more activities.
(3) Stability of attention Attention stability refers to the duration of attention on the same object.
(4) Attention shifting Attention shifting refers to people's ability to adjust attention from one object or activity to another object or activity actively and purposefully in a timely manner according to needs.
The development of thinking and imagination
Imaging is the process of processing and transforming existing appearances to form new images.
Thinking is the indirect and general reflection of the human brain on objective things, and it can recognize the essence of things and the internal connections between things.
development of thinking skills
Infants and toddlers: Direct action thinking Intuitive action thinking depends on a certain situation Intuitive action thinking cannot be separated from children's own actions.
1. The baby's splashing action in the bathtub will only happen when he is in the bathtub. This movement stops when leaving the tub
2. Children often draw without purpose in advance, that is, they do it first and then think about it, or think while doing it, and only after they draw it do they know what they are drawing.
Early childhood: the critical stage of transformation from intuitive action thinking to concrete image thinking.
1. Although young children can do the calculation of 2+3=5, they do not analyze and synthesize abstract numbers when they actually calculate, but rely on the appearance of things reproduced in their minds, such as adding 2 apples to 3 apples, or 2 fingers plus 3 fingers, and then count the result is 5 apples or fingers to calculate the result.
2. Ask children what are the similarities between electric lamps and candles, and the answer is often "both are white and long."
Preschool stage: From intuitive action thinking to concrete image thinking and then to abstract logical thinking
Preschool stage: Intuitive action thinking develops to concrete image thinking and then to abstract logical thinking, in which concrete image thinking dominates. In the late preschool age, the germination of abstract logical thinking begins to appear.
School age: Concrete visual thinking gradually transitions to abstract logical thinking, which is a qualitative change in the process of thinking development.
Adolescence: abstract logical thinking gradually gains an advantage
At the age of 3-4, the imagination begins to develop rapidly, which is basically free association.
4. The development of children and adolescents' speech ability
Speech: An objective phenomenon in human society, it is a socially established symbol system, which is composed of words (including shape, sound, and meaning) according to a certain grammar.
language development of children and adolescents
ØThe speech development of infants and young children can be divided into three distinct stages:
Preparatory period of speech development (from birth to 1 year old): the pre-speech stage of word and sentence period (1-1.5 years old) and multi-word sentence period (1.5-3 years old).
Before babies master language, there is a long preparation stage for speech occurrence, which is called "pre-linguistic stage".
The first intelligible and truly understood "word" spoken by the baby between 11-13 months marks the official occurrence of speech. During the period of 10-15 months, an average of 1-3 new words are added every month. After 18 months, the speed of mastering new words increases to about 25. This phenomenon of sudden acceleration of mastering new words is called "word Explosion" imagine. 20-30 months is the critical period for infants to basically master the vocabulary and syntax, and 3 years old can already express basically complete sentences.
The development of oral expression skills
The internal language of school-age children develops gradually. The development of the internal language generally goes through three processes:
The first is the period of thinking aloud; the second is the transitional period; the third is the period of silent thinking.
Written language development The mastery of written language generally goes through three processes: literacy, reading and writing.
Section 3 Emotional, Personality, and Social Development of Children and Adolescents
1. Emotional development
Emotions are produced by whether objective things meet human needs, and reflect the relationship between objective things and human needs.
Feeling is related to whether people's high-level social needs are met, and is gradually formed in the practice of social interaction, such as friendship, morality, beauty, and rationality. This is a unique emotional state of human beings.
2. The baby laughs
Spontaneous smile: Physiological response appeared in 0-5 weeks; social smile: non-selective appeared after 5 weeks; selective appeared after 4 months.
The characteristics of emotional development
(1) Characteristics of emotional and emotional development of infants and young children
1. It is directly related to whether the physiological needs are met. 2. It is the innate genetic instinct of children
(2) Characteristics of emotional and emotional development of preschool children (
1. Emotional impulsiveness gradually decreases
2. Emotions and emotions are mainly explicit and implicit
3. Emotions and emotions are mainly volatile, and the stability gradually develops
(3) Characteristics of emotional and emotional development of school-age children
1. Emotional content is gradually enriched
2. Emotional depth and stability gradually increase
3. Advanced Emotions Gradually Develop
(4) Characteristics of emotional and emotional development in adolescence
1. Moods and emotions are rapid and intense, with polarity
2. Implicit and expressive co-exist
3. Higher emotions have developed considerably
4. Personality development
1. Personality, also known as personality, refers to the entire mental outlook of an individual, that is, the sum of psychological characteristics with a certain tendency. The concept of personality is rich in connotation. It is complex, multi-dimensional and multi-faceted, including three aspects of a person's personality tendency, personality psychological characteristics and self-awareness.
2. Temperament is a relatively obvious and stable personality characteristic that is first manifested in infants and young children after birth.
It plays a very important role in the social development of infants and young children. Thomas and Chess (Thomas and Chess) divided infants and young children into four temperament types, easy type accounted for about 40%, difficult type accounted for about 10%, slow type accounted for about 15%, and intermediate type accounted for about 35%.
3. Personality development
Infancy and early childhood: It is the period when personality is initially formed. Various components of personality in infancy have been initially produced, and individual differences in interests and hobbies gradually appear in early childhood, but they are not stable. School-age children: A relatively stable personality tendency has been formed, the scope of interests has gradually expanded, and values have transitioned from individual values to group values. Teenagers: Interests are broad and diverse, forming a central interest. Ideals develop from specific image ideals to comprehensive image ideals, and general ideals develop. This period is also a critical period for the formation of world outlook, and the formation of world outlook is an important sign of the maturity of youth's psychological development.
4. Development of self-awareness
Ø It is the process of continuous socialization of individuals. Marks the basic formation of personality. Including self-concept, self-evaluation and self-experience.
Self-concept (self-concept) refers to the impression of oneself in one's mind, including the understanding of one's own existence, as well as the understanding of one's own physical ability, character, and attitude, as well as the understanding of one's own physical ability, personality, and attitude , thinking and other aspects of understanding. Self-evaluation (self-evaluation) is the main component and main symbol of the development of self-awareness. Self-experience is the emotional feeling towards oneself formed on the basis of the former two.
The sequence of development of self-awareness in early childhood is as follows:
Self-awareness-self-naming-self-evaluation.
Preschool children: The self-experience of 5-6-year-old children gradually develops, and continues to deepen and develop from emotional experience (anger, happiness) related to physiological needs to social emotional experience (self-esteem, grievance, shame). experience (self-esteem, grievance, shame) deepens and develops.
School-age children: Self-experience has also been further developed in the early school-age, resulting in an important form of self-experience-self-esteem.
Adolescence: This period is the second leap in self-awareness. Self-evaluation ability begins to mature, more comprehensive, objective and increasingly profound.
5. Children's socialization refers to the process in which children form a personality suitable for the society and culture in a specific social and cultural environment, master the behaviors recognized by the society, and become qualified members of society. It is the process in which individual children gradually internalize social culture through a series of social learning.
The lifelong process of inheriting and disseminating norms, customs and ideologies, providing an individualwith the skills and habits necessary forparticipating within his or her own society. Socialization is thus “the means by which social and cultural continuity are attained”
basics of socialization
1) Learning and Mastering Life Skills
2) Accept and adapt to social norms
3) Recognize and develop specific social roles
4) Establish life goals
5) Formation of self and personality (or personality)
6. Peer relationship is a kind of interpersonal relationship among children, especially among peers, established and developed in the process of communication.
The development of early peer relationship in infants and young children goes through the following three stages:
1. Subject center stage (6 months to 1 year old) Babies at this stage usually ignore each other, just
Take a look, smile, or grab a mate.
2. Simple communication stage (1-1.5 years old) Infants and young children at this stage
The infant has been able to respond to the behavior of the companion and try to control the behavior of the other infant, and the behavior between the infants has begun to respond.
3. Complementary communication stage (1.5-2.5 years old) With the development of infants and young children, the content and form of communication between infants and young children are more complicated. Infants and young children after the age of two are gradually accustomed to being separated from their caregivers and interacting with their peers.
Chapter Four Adolescent Growth and Development
Adolescence is a period of gradual transition from childhood to adulthood, and is an extremely important stage in the process of growth and development. The age range is set at 10 to 20 years old.
WHO defined puberty as such a period according to the physical, psychological and social developmental characteristics of adolescents at the global conference on "Adolescent Pregnancy and Miscarriage":
① It is the physiological development process of an individual from the emergence of secondary sexual characteristics to sexual maturity;
② It is the psychological process of an individual developing from a child's cognitive mode to an adult's cognitive mode;
③ It is the transition of individuals from economic dependence to relative independence.
(2) Developmental characteristics of puberty
①Physical growth acceleration;
②Various visceral tissues and organs increase in size and weight, and their functions are maturing;
④ Active secretion function;
④Mature reproductive system function;
⑤ Rapid development of male and female external genitalia and secondary sexual characteristics;
⑥ Adolescent-specific psychological and behavioral problems.
age stages of puberty
1) Early puberty: mainly manifested as growth spurt, sexual organs and secondary sexual characteristics begin to develop, generally lasting about 2 years.
2) Middle puberty: characterized by the rapid development of sexual organs and secondary sexual characteristics, menarche/first spermatorrhea occurs, and lasts for 2 to 3 years.
3) Late puberty: physical growth slows down significantly until the epiphyses are fully fused; sexual organs and secondary sexual characteristics continue to develop to adult levels, and psychosocial development accelerates, lasting for about 2 years.
2. Morphological development characteristics of puberty
(1) Pubertal growth spurt
The growth rate in adolescence is significantly faster than that in childhood, and a second growth spurt occurs. A growth spurt is a phenomenon in which the growth rate is relatively stable in childhood and suddenly appears to increase rapidly. During the pubertal growth spurt, a spurt peak occurs. The peak of sudden increase is also called the peak of growth velocity. For height and weight, they are called peak height velocity (PHV) and peak weight velocity (PWV) respectively.
Girls generally enter the puberty spurt at 10 years old and boys 12 years old.
(2) Phase changes of pubertal growth spurt
1. There are two intersections in the horizontal curve of the growth of height and weight with age for men and women:
1) The first crossover: Appeared around the age of 10, the reason: the growth spurt has started for girls but not yet for boys. 2) The second crossover: Appeared around the age of 14, the reason: the sudden increase of girls began to decline, and the sudden increase of boys began.
2. In early puberty, the growth order of each body part is roughly foot length-lower limb length-hand length-upper limb length. Due to the early growth of the lower limbs, the sitting height index (sitting height/height) gradually decreases in the early stage of puberty, and reaches the lowest point in the middle stage, so the uncoordinated posture of long arms and long legs appears in puberty. In the middle and late stages of puberty, the growth rate of the trunk is accelerated, and the sitting height index increases again. In adulthood, it is 54.2 for males and 54.3 for females.
(3) Growth pattern and developmental type
Judging from the start time of puberty, pubertal development types are usually divided into three types: normal, early maturing, and late maturing.
1) Precocious type: short and fat body with wide basin and narrow shoulders; the earliest start; the burst lasts for about 1 year
2) Late maturing type: tall, thin body with narrow basin and broad shoulders; 2-3 years
3) General type: 2 years
(4) Changes in body composition Weight (W) = fat mass (f) + lean mass Gender difference:
1) Body fat
2) Lean body mass (LBM); the weight of other body components other than fat, of which muscle is the main part.
Three, puberty sexual development One of the most important characteristics of puberty is sexual development. It includes the morphological changes of internal and external reproductive organs, the maturation of reproductive function, and the development of secondary sexual characteristics.
Secondary sexual characteristics refer to the external differences in gender that appear between males and females after puberty, except for the reproductive organs.
(1) Male sexual development Male reproductive organs are divided into two parts, the inner part and the outer part. The internal genitalia include the testes, vas deferens, and accessory glands, and the external genitalia include the scrotum and penis. Nocturnal emission is a normal physiological phenomenon of male pubertal development, and it is an important symbol of male pubertal development.
(2) Female sexual development The female reproductive organs are divided into inner and outer parts. The internal genitalia include the vagina, uterus, fallopian tubes, and ovaries. The external genitalia include the mons pubis, labia minora, clitoris, vestibule, and perineum. Menstrual cramps: an external marker of reproductive maturity.
a. Short stature: that is, the height is below the third percentile of the normal value for its sex-age group.
b. Tall stature means that the height of an individual is above P97 of the normal value for its sex-age group.
c. Sexual precocity is a group of abnormal sexual development syndromes characterized by early sexual maturity.
From the perspective of sexual development, adolescents with precocious puberty and late puberty exhibit different time characteristics.
Precocious puberty generally refers to those who develop testicular enlargement before the age of 9 in boys, breast development in girls before the age of 8, or menarche before the age of 10. Precocious puberty is generally divided into two types: idiopathic and secondary. The etiology of idiopathic precocious puberty is unclear, and secondary precocious puberty is mostly caused by intracranial tumors, sequelae of encephalitis, or the use of exogenous gonadotropic drugs.
For late-maturing adolescents, it is judged that boys do not have testicular enlargement at 14 years old, and girls do not have breast development at 13 years old. Reasons for late maturation include hypothalamic, pituitary, gonadal diseases, chromosomal abnormalities, systemic or wasting diseases, constitutional or familial factors, and nutrition, psychology, and exercise training.
(3) One of the most important features of puberty is sexual development. It includes the morphological changes of internal and external reproductive organs, the maturation of reproductive function, and the development of secondary sexual characteristics.
Spermatorrhea is an important sign that male reproductive function begins to mature.
The first spermatorrhea is usually between 12-18 years old
After the first spermatorrhea, the growth rate of height gradually slows down, and the second testis, epididymis, and penis develop rapidly, gradually approaching the adult level.
(4) Breast development: it begins at the earliest, with an average age of 11 years; pubic hair and armpit hair appear: pubic hair appears 6 months to 1 year after breast development, and armpit hair generally appears half a year to 1 year after pubic hair appears.
The tone becomes higher and the fat is female.
(5) Sexual and psychological development in adolescence
1. The Contradiction Between Rapid Sexual Physiological Development and Relatively Childish Sexual Psychology
2. The contradiction between the rapid growth of self-awareness and the relative slowness of social maturity
3. Emotional turmoil requires release and the contradiction between external expression and inclination
Chapter Five Factors Affecting Growth and Development
Section 1 Genetic Influencing Factors of Growth and Development
Heredity: Refers to the similarity between offspring and parents in terms of morphological structure, physical and mental development, and physiological functions.
1. Family genetic influence
1) The heritability between the adult height and the average height of the parents is 0.75
2) Family aggregation of growth and development
3) Sexual maturity, personality, etc. are related to family inheritance
2. Racial genetic influence
Appearance, body shape, age of menarche, growth and development level, etc. are related to racial inheritance.
3. Research on twins Twins include identical twins and fraternal twins. Research on these two types of twins can distinguish the relative effect of genetic and environmental factors, which can be expressed by heritability.
Heritability: It is an index to measure the relative effect of genetic and environmental factors on the total variation of phenotypic traits.
The closer the heritability is to 1, the greater the genetic effect; the closer to 0, the greater the environmental effect.
Section 2 Social determinants of growth and development
1. The influence of social economy on growth and development Differences between urban and rural areas
2. The impact of family factors on growth and development Family economic status, parental education level, family structure, parenting style
3. The influence of modern media on growth and development
Section 3 Environmental Influencing Factors of Growth and Development
1. Nutrient factors are achieved through the five major categories of nutrients: protein, fat, carbohydrates, vitamins, and minerals.
1. Energy 2. High quality and sufficient protein 3. Fat essential fatty acids 4. Carbohydrates 5. Vitamins and minerals The micronutrients that Chinese children and adolescents are likely to lack are calcium, iron, zinc, iodine, and vitamins A and D.
The Impact of Nutrition on the Brain and Intelligence (Question and Answer)
1) The quantity and quality of brain cells: From the late pregnancy to one year after birth, it is a critical period for the growth of brain cells, and the number of brain cells increases. The brain cells grow all at once.
2 Energy supply 3) Metabolism and neurotransmitter synthesis
2. Physical exercise factors
1. Promote metabolism assimilation > alienation accumulation > consumption
2. Promote skeletal muscle development
3. Improve cardiopulmonary function
4. Regulate endocrine and promote pubertal development
3. Disease factors The nature, severity, extent of disease, duration of disease, sequelae, etc. of the disease
Catch-up growth: refers to the phenomenon that once the disease factors that hinder growth are overcome, children will grow at a rate exceeding that age, thereby catching up with the normal growth trajectory to varying degrees.
Significance: 1) Actively treat children, use catch-up growth, develop children's growth potential, and achieve normal development 2) To achieve catch-up growth, early detection and early treatment are necessary
3) Control to catch up with the growth rate and avoid excessive weight growth
4. Seasonal factors of geography and climate The height of a person is positively correlated with the number of sunshine hours and the average annual temperature difference, and negatively correlated with the annual precipitation. The Han people in China are taller around the Bohai Sea and the shortest in Guizhou in Southwest China.
5. Chemical environmental pollution
1. Air pollution inflammation, asthma
2. Indoor air pollution asthma, blood system diseases, affect intellectual development and immune system function.
3. Lead blood lead ≥ 100ug/L mainly damages the nervous system, hematopoietic system, skeletal system and liver and kidney functions.
4. Environmental Estrogens
6. Physical environmental pollution
1. Noise pollutes vision, hearing and nerves
2. Electromagnetic radiation pollutes mobile phones
3. Radioactive pollution is more harmful than adults.
Section 2 Social determinants of growth and development
The impact of family factors on growth and development: family economic status, parental education level, family structure, parenting style, etc.
Chapter 6 Investigation and Evaluation of Growth and Development
Purpose:
1. Study the law of growth and development;
2. Explore the effects of various internal and external factors on growth and development;
3. Formulate normal values or evaluation standards for the growth and development of children and adolescents in the region;
4. Evaluate the effectiveness of health care interventions.
Section 1 Growth and Development Investigation Methods:
1. Current Situation Survey
1. Cross-sectional survey (cross-sectional survey) selects a representative group in a certain area within a relatively short period of time, and selects certain indicators for a one-time large sample survey.
2. Growth surveillance (growthsurveillance) is the continuous collection and arrangement of some growth and development indicators in a certain area and a certain group.
1) Clarify the purpose of monitoring.
2) Clearly monitor the population and establish a "crowd monitoring" system.
3) The monitoring system is fixed, and the indicators are simple and easy to implement.
4) There are strict quality control measures.
5) The analysis results should be fed back in time.
6) Formulate and adjust intervention measures in a timely manner based on monitoring results.
2. Prospective investigation
1. Longitudinal survey refers to the same group of subjects, who conduct regular and continuous surveys over a long period of time to observe their developmental dynamics.
2. A cohort study is a follow-up investigation, but a control group needs to be added in advance.
3. Semi-longitudinal investigation (semi-longitudinal investigation) combines cross-sectional survey and follow-up survey to make up for the lack of long-term follow-up survey and easy loss of samples.
Section 2 Growth and Development Survey Design
1. Normal value and "standard" Status norm samples come from the middle-level population in the region, and only individuals whose development is affected by chronic diseases or disabilities are excluded, reflecting the reality of the population and also the target of intervention. The ideal normal value (ideal norm) object has higher requirements. For example: all should be full-term newborns with normal weight; live in a suitable environment since childhood, have no history of chronic diseases, and have good living conditions and health services; individuals who grow up in this environment have a high growth level and can fully develop their growth potential .
1) The ideal normal is higher than the status quo normal; once established, it can be used for a long time.
2) At present, it is still difficult to find an "ideal" group of people in our country; it is more realistic to establish the normal value of the status quo.
3) The current normal value is time-sensitive and should be revised every 5-10 years.
Methods for developing normal values: Traditional approach: use the mean and standard deviation. Mainly for normal people, analyze the distribution of different grades in the group. The current international common practice: adopt the percentile method modified by the LMS method. Suitable for screening abnormalities and "suspected abnormalities".
Standard (standard, criterion)
1) The sample should be as close to "ideal" as possible.
2) A unified evaluation standard should be formulated across the country. However, my country has a vast territory, and various regions can also establish normal values suitable for their own regions.
3) Provincial normal values can be established, but cannot replace the national unified standard.
4) Areas where conditions permit can also use international common standards and domestic standards at the same time.
a) International standards are generally applicable to childhood (particularly infants and pre-school years) when group differences are small.
b) The genetic influence of race will increase significantly after the onset of puberty, so it is more appropriate to use the national standard.
5) Try to use advanced statistical methods to make the selected boundary points as accurate as possible.
6) As a "standard", the cut-off point should be based on the presence of clinical symptoms.
2. Develop a survey plan
1. The representativeness of sampling objects and the randomness of sampling. All objects have a chance of being detected.
2. The sample size and the number of each subgroup should reach more than 150 people (200 people in adolescence).
3. Grouping Newborns before the age of 6 are generally divided into a group of 1-6 months old, a group of 7-12 months old every month, a group of 1-2 years old every 2 months, and a group of 3-6 months old every 3 months. 6 years old, one group every 6 months Ø Calculation of age In my country, the calculation is based on chronological age (date of test - date of birth). Anyone who is 7 years old and one day short of 8 years old is 7 years old. There is an algorithm in foreign countries that the day before the age of 6 and a half to the age of 7 and a half is 7 years old. Care should be taken to eliminate this difference when comparing data across countries.
4. Featured Survey Indicators
a. Select targeted indicators.
b. Reasonably select different types of indicators to improve the prediction level of the indicator system.
c. The more indicators the better, the better the number of similar indicators should be.
d. All indicators should be recognized, easy to test, and have good repeatability.
5. Design the survey form one person at a time, standard name, with clear and concise instructions for filling out the form
3. Follow the principles of ethics
1 Application report 2 Informed consent 3 Contraindications for children and adolescents 4 Treat the control group correctly
Section 3 Growth and Development Evaluation
significance:
1) Understand the growth and development status, grade and development trend of individuals and groups
2) To provide a basis for evaluating genetic and environmental factors, examining the effectiveness of school health work, and carrying out health care interventions
3) Screening and diagnosis of growth and development disorders
Growth and development evaluation can be aimed at both individuals and groups, and consists of four categories: growth and development level, growth speed, developmental symmetry, and comprehensive physical fitness evaluation.
(1) Deviation method (deviation method): It is a commonly used method to evaluate the growth and development level and current situation of individuals and groups of children and adolescents. There are mainly two methods: grade evaluation method and graph method.
① Rank value method (rank value method) uses the standard deviation and mean value to divide the grade. During the evaluation, the measured value of the individual development index is compared with the development standard of the corresponding index of the same age and sex to determine the development level.
Advantages: ① It can evaluate the developmental level of individual and group children; ② The method is simple and easy to promote; ③ The graph method can track and observe the developmental dynamics of a certain index. Disadvantages: unable to evaluate the speed of development and the degree of symmetry
②Graph method: It is the mean value and mean value of a certain developmental index of different gender-age groups in a certain place. +1 standard deviation value, mean +2 standard deviation value are respectively plotted on the coordinate graph.
Advantages: ①The method is simple, the result is intuitive, and it is easy to use; ②It can describe the developmental level of children; ③It can track and observe the developmental trend and speed of a certain index of children; ④It can compare the developmental levels of individual and group children.
Disadvantages: Each index of different genders needs to make a picture, and it is impossible to evaluate several indexes at the same time, analyze and compare the symmetry of development.
(2) Index method (index method): It is based on the proportional relationship of various parts of the body, and two or more indicators are converted into indices using mathematical formulas to evaluate developmental level, body shape, physical fitness or nutritional status.
The disadvantage is that it is relatively mechanical, and the evaluation results should be reasonably explained in combination with professional knowledge.
Can be divided into three categories:
① Body shape index: It is composed of height, sitting height, weight, bust, shoulder width, disc width and other indicators, such as bust/height, pelvic width/shoulder width. ② Nutritional index: such as weight/height, BMI (body mass index, when evaluating infant nutrition). ③Functional index: such as grip strength/weight, vital capacity/weight, etc.
③ Percentile method: The principle process is similar to the dispersion method. Disadvantages: The requirements for sample size are relatively high when formulating standards.
④Standard deviation method ⑤Correlation regression method ⑥Growth speed evaluation method: compare the growth speed between individuals and groups, groups and groups, and understand the growth speed and changing rules of this index in children and adolescents.
The developmental age appraisal method (developmental age appraisal) refers to the use of the average developmental level and normal variation of certain physical shape, function, and secondary sexual characteristics indicators to make a standard age and evaluate the developmental status of an individual.
There are four commonly used developmental ages: morphological age, secondary sexual age, dental age, and skeletal age.
The age of secondary sexual characteristics: according to each indicator, it is divided into different development stages from the beginning of development to maturity, and then the degree of sexual development is judged by using a multivariate analysis model or making a graded scoring standard.
Skeletal age evaluates the degree of skeletal calcification in children and adolescents by comparing it with bone development standards.
⑧Nutritional status evaluation method 2. Weight for age 3. Height for age 4. Skinfold thickness
3. Indexes that reflect body shape
Body mass index, also known as Quetelet index, expresses the weight of height and reflects the solidity of the human body.
Quetelet index = [weight (kg) / height (cm) X100%]
Tired child index: It is the comprehensive expression of the development of muscles, bones, fat and internal organs, and the fullness of the unit volume of the human body.
index reflecting nutritional status
BMI=weight (kg)/height (m)2
Kaup = weight (kg) ÷ [height (cm)] 2 × 104
Four,
The Z-score method, with the median as the center, generally converts the data from a skewed distribution to a normal distribution, and then takes ±1Z, ±2Z, and ±3Z as critical points to establish normal values. Divided into upper class, upper middle class, middle class, lower middle class, and lower class.
Advantages: There is no unit, which significantly facilitates horizontal and vertical comparisons between individuals and groups, regardless of gender, age and other factors.
‡Disadvantage: The skewed distribution of the sample has not been fundamentally corrected and can still adversely affect the accuracy of the assessment.
5. LMS method
Firstly, the L, M, and S values of each age group were calculated according to the measured data, and then the cubic spline function was used to smooth and fit the curves, and three curves of L, M, and S with age as the independent variable were respectively obtained. L is the confidence of Box-Cox. M is the normalized median corresponding to the L value. S is the normalized coefficient of variation corresponding to the L value.
Advantages of the LMS method: The normal value or standard made by both inheriting and correcting the percentile method and the Z standard deviation method can be accurate to one digit, or even one digit after the decimal point. There is no crossing, inversion, or overlap between adjacent percentile values, and precision is significantly improved.
Chapter VII Health Status of Children and Adolescents
Section 1 Children and Adolescents Health Index System
Vital indicators reflect birth and survival conditions, expressed in terms of death rate and case fatality rate.
1. Infant mortality rate (infantmortality rate, IMR): refers to the number of deaths per 1,000 live births between 0 and 1 year old in a given year, reflecting the death probability of live births within one year. It is an important symbol recognized by the international community to measure a country's and region's economic culture, residents' health status and health care development, and it plays an important role in the calculation of the average life expectancy of the population.
2. The underfive mortality rate (U-5MR) refers to the probability of death per 1,000 live births before reaching the age of 5 in a given year. It reflects the living conditions of children aged 0 to 4, and children in this age group are the main objects of child health services, including child nutrition, vaccination, prevention and treatment of common diseases, growth monitoring, clean water supply and health education, etc. A comprehensive reflection of various inputs. 3. Age-specific death rate (ASDR) refers to the average number of deaths per thousand population in different age groups in a certain year.
4. Case fatality rate (CFR) refers to the percentage of death caused by a certain disease or a certain type of disease within a certain period (usually 1 year), which can reflect not only the severity of the disease, but also the medical level and quality.
5. Millennium Development Goals (Millennium Development Goals, MDGs) At the United Nations Millennium Summit in September 2000, world leaders agreed on a set of time-bound goals to eliminate poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women. Goals and metrics.
disease indicator
1. Incidence rate (incidence rate) refers to the frequency of occurrence of a certain disease (including accidental injury) in a certain population within a certain period of time (such as 1 year, 1 quarter, 1 month).
2. Attack rate (attack rate) specifically refers to the incidence rate within a short period of time within a certain limited area (such as a school, kindergarten, etc.). The denominator time in the formula can be day, week, month, etc. It is suitable for outbreaks of infectious diseases and unexplained diseases, food poisoning, etc. within a specific range.
3. Prevalence rate (prevalence rate) reflects the prevalence of a certain disease among the number of people tested at the time of investigation and inspection. The denominator is the number of people tested, and the numerator is the number of sick or positive people among the people tested, generally expressed as a percentage or per thousand.
4. The absence rate due to illness is calculated in units of months, the number of hours absent due to illness and the ratio of the number of days to the total number of teaching hours. Also known as the monthly sick leave rate.
5. The average number of days absent from school due to illness is the number of days absent due to illness for each leader in a semester in the whole school/class.
Health-related quality of life refers to the physical, psychological and social functional status of an individual. Early intervention for high-risk children, rehabilitation of children with developmental disabilities.
growth and development index
Growth level, nutritional status, intelligence
Major health problems of children and adolescents
1. Injuries are the number one cause of death among teenagers
2. The burden of mental disorders is becoming increasingly prominent
3. The declining trend of physical fitness needs to be reversed urgently
4. Severe situation brought about by changes in disease spectrum
growth quality index
1) Index of activities of daily living (also known as ADL-Katz Index) Functional independence measure (FIM) is an indicator that has been used more and more in recent years and can be used in children Evaluation of developmental disabilities and evaluation of rehabilitation effects. FIM is divided into 7 grades from complete dependence to complete independence from 6 aspects of self-care, bladder and bowel control, activity transfer, exercise, communication and social interaction.
2) Assessment of psychosocial function
It is evaluated from the aspects of individual's subjective well-being, psychological discomfort symptoms, social adaptation behavior and so on.
3) Specialized quality of life assessment scale
It is a standardized assessment method formulated for the impact of specific diseases or health conditions on quality of life.
4) Comprehensive biochemical quality assessment scale
Chapter VIII Prevention and Treatment of Common Diseases in Children and Adolescents
Section 1 Poor vision and myopia
1. Poor vision (lowvision), also known as low vision, refers to the use of distance vision chart (standard logarithmic vision chart), uncorrected visual acuity below 5.0 is poor vision. Poor vision includes various refractive errors such as hyperopia, myopia, astigmatism, amblyopia and other eye diseases.
Two, myopia
Myopia (myopia) refers to the lower than normal visual ability of the eyes to identify distant (above 5m) objects. At this time, the parallel light rays coming from a distance pass through the refractive system of the eye and are focused and imaged in front of the retina, making it difficult to see the image of distant objects clearly.
2. Classification
(1) According to the classification of myopia diopter, it is divided into: low, medium and high myopia. Low myopia (-0.25D～-3.00D) Moderate myopia (-3.25D～-6.00D) High myopia (-6.25D～-9.00D)
(2) According to the presence or absence of adjustment factors, it can be divided into false, true and semi-true myopia.
(3) According to the change of refractive elements, it can be divided into axial myopia and refractive myopia.
The nature of myopia in children and adolescents
3. Nature: It is caused by the incompatibility between the refractive power of the eye and the axial length of the eye. „
4. Classification and formation of myopia
„Refractive myopia: the length of the eye axis is normal, but the refractive power of the eye's refractive system is too strong.
„Pseudomyopia, accommodation myopia, functional myopia
Axial myopia: Due to the long anterior-posterior axis of the eyeball, the refractive power of the eye's refractive system is normal.
(true myopia)
„Mixed myopia: It has the common characteristics of refractive myopia and axial myopia
The formation of myopia causes the ciliary muscle to contract and the suspensory ligament to relax
3. The characteristics of the prevalence of myopia among adolescents in my country are: (question and answer)
1) The prevalence of myopia increases with age and school age, and the impact of school age is more important than age;
2) The progression of myopia accelerates during adolescence
3) The age of onset tends to be advanced
4) Cities are higher than villages;
5) The Han nationality is higher than the minority nationality;
6) The composition of severe myopia is relatively large
4. Measures to protect eyesight and prevent myopia (questions and answers)
(1) Take the prevention of myopia as the focus of school health work
(2) Cultivate good reading and writing habits
(3) Create a good living environment
(4) Seriously do eye exercises
(5) Strengthen perinatal health care and reduce the occurrence of premature and low birth weight infants.
(6) Check eyesight regularly
(7) Health Education
5. The principle of myopia correction: safe, reliable, simple and easy
Correction of myopia
Mainly for the adjustment of tension myopia for correction.
„Anti-spasmodics: Atropine Cloud method: Convex lens wearing Eye surgery treatment:
Dental caries
Caries, dental caries, also known as dental caries (commonly known as tooth decay), is a chronic, bacterial disease of dental hard tissues. Under the influence of internal and external environmental factors, the inorganic salts of dental hard tissues A disease in which decalcification and electrolyte decomposition cause damage and loss of tooth tissue.
1. Epidemiological evaluation indicators
1) Caries prevalence rate = (number of people with caries, fillings, and missing)/number of inspections. It is the main indicator reflecting the prevalence of dental caries.
2) Average caries = number of carious and missing fillings / number of people examined;
3) Average caries of patients = number of carious and missing fillings/number of patients. It is an index reflecting the severity of the disease.
4) The number of dental caries and missing fillings (DMFT): It is an indicator reflecting the treatment of children's dental caries.
2. Epidemic characteristics (questions and answers) and hygienic significance
①Caries prevalence rate: lower than foreign countries, but on the rise. Kindergartens>elementary schools>middle schools; big cities>medium and small cities>rural areas. Tips: Key areas and populations for prevention and control.
②Caries filling rate: developed countries>my country, cities>rural areas. Tip: Timely correction becomes the focus of caries prevention.
③Average caries and patient caries average: deciduous teeth caries average: 2 at 1 year old, 5 at 3 years old, 5.9 at 7 years old, and decreased year by year thereafter. Average permanent tooth caries: 0.3 at 6 years old and 1.7 at 16 years old. It is suggested that the focus of caries prevention should be on kindergarten children and primary school students.
④Degree distribution of dental caries: shallow caries rate is higher than deep caries rate
⑤ Prone teeth and predisposed parts: Molars are predisposed teeth, and the occlusal surface of molars is a predisposed part
2. Pathogenic factors (questions and answers)
The "quadruple factor theory" points out that the four factors (bacteria and plaque, host, food and time) that affect the occurrence and development of dental caries are indispensable, and caries occurs when they work together.
② Bacteria (root cause): Streptococcus mutans, Actinomycetes (root caries), Lactobacillus (deep caries).
② food (material basis).
③ Host (important conditions): systemic and local, including teeth, saliva, behavioral habits and lifestyle.
④ time (development process). 18 months on average
3. Preventive measures for dental caries (questions and answers)
(1) Regular inspection and early diagnosis
(2) Control plaque
(3) Enhancing the host's ability to resist caries in terms of food hygiene
(4) Improve the school oral disease prevention network
Section 3 Simple Obesity
It refers to the excessive accumulation of fat in the body caused by the combination of overnutrition, lack of exercise and genetic factors.
1. Obesity-prone period
There are four peak periods of childhood obesity: „
late pregnancy
infancy
early adolescence"
late adolescence
This coincides with several fat reunions in the development of children and adolescents. The earlier the age of obesity, the higher the degree of obesity, the greater the possibility of developing adult obesity in the future.
Childhood obesity is mainly due to excess fat cells
Obesity in adulthood is mainly due to increased fat cell volume.
Obesity in both childhood and adulthood is active in simple obesity.
2. Diabetes
1. Overview Diabetes is an endocrine and metabolic disease that affects the body's use of energy and is the third major disease that threatens human life and health.
2. Types of diabetes
(1) Insulin-dependent diabetes mellitus (IDDM) can occur at any age, and is more common in children and adolescents under the age of 20. Symptoms: polyphagia, polydipsia, polyuria and weight loss (three more and one less). Treatment: Oral hypoglycemic drugs are ineffective, and insulin is required.
(2) Non-insulin-dependent diabetes is more common in people over 30 years old. Treatment: diet control, regular exercise can control blood sugar; in severe cases, oral hypoglycemic drugs or insulin are required.
3. Strategies for simple obesity
1. "Prevention first", starting from an early age
2. Establish a government-led, socially-participated, school-family-community-based prevention and control network.
3. Realize the potential of personal health
4. Give full play to the advantages of public health
5. Divide the whole population into three categories: general population, susceptible population, and overweight and obese population, from three levels of universality, pertinence, and comprehensiveness.
1) Universal prevention: create a social and material supportive environment; mobilize community members to actively participate; develop health knowledge and skills; provide health services; advance obesity prevention to infants and young children
2) Targeted prevention: establish a good dietary system, ensure a reasonable distribution of calories for three meals, and a balanced diet; correct unhealthy eating behaviors; reduce the time spent on static activities such as watching TV, playing video games, and using computers; in addition to ensuring more than 30 minutes of physical activity every day Exercise and actively participate in various physical activities; prevent blind weight loss.
3) Therapeutic intervention
Chapter Ten Mental Hygiene of Children and Adolescents
1. Mental health of children and adolescents and its influencing factors
Mental health: also known as mental health, is a science that studies how to maintain and promote people's mental health, including taking various preventive, therapeutic and educational measures so that people can perform activities according to their physical and mental potential.
"Standards" for Children's Mental Health: (Questions and Answers)
(1) Normal intellectual development;
⑵ happy mood, moderate response;
(3) Psychological and behavioral characteristics in line with age;
(4) Psychological adaptation to interpersonal relationships;
(5) sound and stable personality;
Mental health problems: Behavioral bias that occurs in children and adolescents is a symptom of a specific disease in the past ten years, and most of them can gradually disappear with age.
Mental disorder: The severity and duration of a mental health problem exceeds the allowable range.
Contains the following features:
a. Individuals themselves endure different degrees of painful experiences;
b. The individual shows varying degrees of functional impairment in behavior;
c. These difficulties and obstacles have the potential to further aggravate the individual's impairment.
3. Common psychological disorders or abnormalities in children
1) learning problems;
2) Emotional problems;
3) conduct issues;
4) Psychosomatic diseases of children;
5) Bad habits and behaviors;
6) Pervasive developmental disorders;
7) Psychological and behavioral problems in adolescence;
8) Post-traumatic adverse emotional experience.
Section 2 Main Objectives and Contents of School Mental Hygiene Work
1. The main goal of school mental health work
1) Help students know themselves, accept themselves, and manage themselves;
2) Understand and master the surrounding environment, and keep adapting to the environment;
3) Help students solve the problems they face and cope with crises;
4) Enable students to control and eliminate uncomfortable psychological symptoms
5) Guide students to make choices, make decisions, and formulate action plans;
6) Encourage students to seek and understand the meaning of life, recognize their own potential, develop their personal potential, and live a healthy, meaningful and self-satisfied life.
Section 3 Common Children's Psychological Disorders
1. Attention-deficit hyperactivity disorder (attention-deficit hyperactivity disorder, ADHD), also known as ADHD, refers to a syndrome characterized by inattention, hyperactivity, emotional impulsivity and learning difficulties. The disease is related to many factors such as family inheritance, nervous system damage, environmental side effects, and bad parenting.
The main manifestations are hyperactivity; inattention; impulsiveness; learning difficulties and poor grades.
2. Learning disabilities (LD) refer to children who have one or more specific obstacles in basic psychological processes such as reading, writing, spelling, expression, and calculation. LD children have normal intelligence, no sensory organ and motor function defects, and learning difficulties are not caused by primary emotional disorders or educational deprivation. Commonly categorized as dyslexia, expressive language disorder, dyslexia, and visuospatial learning disability.
3. Autistic-spectrum disorder (ASD), also known as autism, is a childhood developmental behavioral disorder characterized by deficits in social function and language communication accompanied by abnormally narrow interests and behaviors. Including autism, Asperger syndrome, pervasive developmental disorder unspecified, Rett syndrome and disintegrating mental disorders, of which autism and Asperger syndrome are the most common.
Typical symptoms are delayed or impaired language development; social impairment; narrowed interests, stereotyped behavior; most children with ASD have mental retardation.
4. Children's emotional disorders (emotional disorders) are a group of diseases involving anxiety, terror, depression, obsessive-compulsive and other symptoms as the main manifestations. It does not necessarily have a certain continuity with adult neurosis. This disease is very common, but because it is difficult to distinguish from normal anxiety, it is particularly easy to be ignored and missed diagnosis, and it cannot receive timely treatment and intervention.
1. Anxiety disorder: refers to the occurrence of episodic tension and inexplicable fear without obvious objective reasons, accompanied by obvious autonomic dysfunction, which is divided into separation anxiety disorder and generalized anxiety disorder.
2. Depression: an extreme form of mood disorder, which refers to a diffuse mood or feeling of unhappiness. Children usually express that they feel sad and lose interest in many things, and are prone to angry. The main clinical manifestations are sluggishness of thinking and movement, decreased movement, apathetic withdrawal, self-blame and low self-esteem; antisocial behavior; physical symptoms, such as headache and dizziness.
3. Phobia: Refers to children’s excessive, age-inappropriate, and unreasonable fear of certain things and situations, and the behavior of avoidance and withdrawal, which can affect daily life and social functions, and can be classified as Specific phobias and social phobias.
4. Obsessive-compulsive disorder (OCD): called obsessive-compulsive disorder, refers to a psychological disorder with obsessive-compulsive ideas and compulsive actions as the main symptoms, accompanied by anxiety and adjustment difficulties, including obsessive-compulsive ideas and compulsive actions.
5. Posttraumatic stress disorder (PTSD): refers to the state of persistent anxiety and helplessness that occurs after children suffer severe traumatic experiences. The main manifestations are intrusive experience; hypervigilance; continuous avoidance; aggression, excessive drinking, drug dependence, self-injury, suicidal behavior, etc. may occur.
5. Conduct disorders (conduct disorders, CD) refer to repeated and persistent aggressive and antisocial behaviors in children and adolescents; these behaviors violate age-appropriate social behavior norms and moral standards, and affect their learning and socialization functions, harm others or the public interest.
Oppositional defiant disorder (ODD): more common in children under 10 years of age, mainly manifested as annoying behavioral characteristics such as obvious disobedience, confrontation, passive resistance, irritability, provocation, roughness, uncooperative and destructive behavior.
Tertiary Prevention
(1) Primary prevention: improve the mental health of children and adolescents, and prevent diseases before they happen. Combined with prenatal and postnatal guidance work, popularize and educate community members on mental health knowledge.
(2) Secondary prevention: provide early diagnosis and early intervention for the initial stage of children's psychological and behavioral problems. Shorten the duration of the illness and prevent worsening and relapse of mental health problems.
(3) Tertiary prevention: mainly to take rehabilitation measures to reduce the damage caused by mental health problems, promote recovery, return to society early, and lead a normal and healthy life.
Six, adolescent psychological counseling (psychological counseling)
(1) Specifically refers to the use of techniques, procedures and methods of psychological counseling for adolescents after puberty to help them form a correct understanding of themselves and the environment, correct their psychological imbalances, change their attitudes and behaviors, and have a positive impact on society. There is a good adaptation to life.
(2) Principles of adolescent psychological counseling
1. Confidentiality
2. The time limit is limited to 30-50 minutes for each consultation, 1-2 times a week is appropriate.
3. Voluntary
4. Emotional self-limitation
5. Postponement decision
6. Comply with ethical norms
Chapter 11 Adolescent Health Risk Behaviors
1. Overview of adolescent health risk behaviors
The concept of youth health-risk behavior (youth health-risk behavior): any behavior that directly or indirectly damages the health status of adolescents and even the health and quality of life in adulthood.
Characteristics of Health Risk Behaviors of Adolescents
1. Significant deviation from the expectations of individuals, families, schools, and society.
2. The degree of health hazard varies.
3. Individual aggregation and group aggregation.
4. Clearly learned.
5. Good plasticity.
Teen health risk behaviors can lead to immediate or far-reaching harm
1. Threat to health and life
More than 3/4 of teen deaths are linked to risky behavior
Injuries are the number one cause of death among teens
2. Potentially harmful adult diseases (cardiovascular and cerebrovascular diseases and cancer)
3. Unplanned, unprotected and unsafe for causing sexually transmitted diseases
2. Classification of adolescent health risk behaviors
Behavior contributing to unintentional injury
Behavior contributing to intentional injury
Substance abuse behavior
psychoactive behavior
Risky sexual behavior
Unhealthy dietary and weight-control behavior
physical activity-absent behavior
3. The formation model and prevention and control strategies of adolescent health risk behaviors
1. Problem Behavior Theory
Health risk behavior is the result of a series of natural and social factors, and also the product of the complex interaction between people and the environment. Its occurrence and development depend on three major psycho-social factors:
Personality factors: individual attitudes, value orientations, expectations, and beliefs about self, others, group affiliation, and group
Environmental Perception Factors: Individuals look back at their own behavioral performance while feeling partners, parents, teachers, relatives and friends, and their attitudes towards these behaviors. Social Identity Factors: Individuals' feelings about whether their behaviors are accepted by society.
2 Hazard and protective theory
Risk factors: Refers to those social and psychological variables that can directly induce and increase health risk behaviors and their negative consequences.
Protective factors: Refers to those psychosocial factors that can directly or indirectly reduce the negative consequences of health-risk behaviors, or keep adolescents away from such behaviors.
To effectively eliminate health risk behaviors
Improving the environment is critical: the environment in which adolescents live must be continuously improved (caring, non-violent homes, supportive school climate, good partnerships);
Improve self-awareness: people's needs, motivation, health cognition, and personal beliefs are all psychological factors that have an important impact on behavior
3. Social ecology model: The emergence of health risk behavior is the result of the interaction between the individual and the living environment.
4. Prevention and control strategies
1. Establish an intervention platform on the basis of health-promoting schools
2. Partnership Life Skills Education
3. Strengthen monitoring
4. Establish a comprehensive community system
Chapter 12 Injury and Violence to Children and Adolescents
Injury is a general term for a class of diseases that cause temporary or permanent damage, disability or death to individuals caused by various physical, chemical, biological events and psychological behavioral factors.
Unintentional injuries to children (unintentional injuries), also known as childhood accidents (childhood accident). Refers to the temporary or permanent injury, death or disability of a child due to unexpected reasons. At present, it has been relatively agreed that although accidental injury is an emergency, it is also a disease that can be effectively prevented and controlled.
The Four Es of Injury Prevention
a. Engineering intervention (engineering intervention): The purpose is to affect the effect of media and physical environment on the occurrence of injury through intervention measures.
b. Economic intervention: The purpose is to influence people's behavior with economic incentives or fines.
c. Enforcement intervention: The use of legal and regulatory measures to influence people's behavior. d. Educational intervention: influence people's behavior through reasoning education and popularization of safety knowledge.
2. Haddon model, the theory of "three factors and three stages"
The occurrence of injury depends on the result of the interaction of the host, the medium and the environment. The interaction of the three factors runs through the whole process before, during and after the event. Interventions should be formulated according to the characteristics of the three factors at different stages. measures to control damage.
Section 2 School Violence
1. Violence refers to a type of behavior that deliberately abuses power or physical strength to threaten or harm oneself, others, groups or society, resulting in physical and mental damage, death, developmental disabilities or deprivation of rights.
School violence (school violence) includes what happens on campus, on the way to and from school, activities organized by the school, and all other violent behaviors related to the school environment. Divided into physical violence, verbal/emotional violence, and sexual violence.
The performance is:
① Violence among students;
② Teachers punish students physically, or students commit violence against teachers;
③ People outside the school commit violence against teachers and students in the school.
2. Prevention and intervention of school violence
"Social Ecology Theory" is by far the most ideal theoretical model for preventing school violence, and its intervention steps are mainly as follows:
①Comprehensive understanding of the occurrence of group health risk behaviors (including violent tendencies).
② Analyze family, school, society and other environmental risk factors and their interactions.
③ Formulate preventive measures for the above risk factors, and establish a school-family-community triple barrier.
Common tertiary prevention models:
① Establish a school-family-society triple barrier
② Incorporate violence prevention into the youth health risk behavior intervention system
③Discover and eliminate hidden dangers in time
④ Start the emergency mechanism in time
3. Child maltreatment and neglect (hereinafter referred to as child maltreatment) refers to the deliberate or unintentional infliction of various physical and mental abuse, Neglect and exploitative behavior is an umbrella term for a category of harm to the latter's health, dignity, survival and development.
(2) Classification of child abuse
1. Physical abuse (physical abuse) such as whipping, whipping with tools (such as broomsticks), kicking, shaking, pinching, burning or suffocating children.
2. Sexual abuse (sexual abuse) forces children to accept or participate in a group of sexual activities that they do not understand, cannot consent to, violate the law or violate social norms, including sexual intercourse, molestation, oral sex, touching sexual organs, forcing girls into prostitution or making pornographic videos wait.
3. Emotional/psychological abuse (emotional/psychological abuse) includes restricting activities (such as being locked in a dark room), scolding, threats, intimidation, discrimination, ridicule, and other non-physical forms of rejection or hostility. Witnessing violence to children is also an important form of emotional abuse.
4. Neglect includes physical neglect (having material conditions but not providing children with the necessary food, clothing, shelter and a safe environment for normal growth), educational neglect (depriving children of educational opportunities), emotional neglect (not giving children the care and emotional support), etc.
3. Suicide and self-injury
1. Suicide: It is an act of an individual voluntarily (not forced) to end his own life in a harmful way when he is conscious, and it is an intentional injury.
Suicide is the third cause of death among adolescents aged 15 to 34, and the age trend continues to decrease.
Suicide and self-injury are not only a serious public health problem, but also a social issue that deserves high attention.
Since 2003, WHO has designated September 10th as the "World Suicide Prevention Day", calling on the whole society to pay attention to and prevent suicide, and to be kind to life.
2. Suicidal ideation (suicidal ideation): There is a thought of ending life, but no action is taken.
Attempted Suicide: Taking action but failing due to inappropriate means or being revived.
Completed suicide: Intent and actions that ultimately lead to death, the death of which has a distinct "self-inflicted" (self-inflicted).
3. Self-injurious behavior (self-injurious autolesionism)
Broad sense: generally refers to suicide, attempted suicide, and behaviors that harm one's physical and mental health in any way;
Narrow sense: specifically refers to deliberate and direct bodily harm. The intent is not to cause death, also known as "non-suicidal self-injury behavior"
Chapter 13 Educational Hygiene and School Health Services
Characteristics of cerebral cortex functional activity and their health implications: (questions and answers)
(1) Dominance rule: It refers to selecting a small number of stimuli from a large number of stimuli to form a dominant excitatory focus in the cerebral cortex, while other parts of the cerebral cortex are in a state of inhibition.
Hygienic significance: use the law of superiority to improve learning efficiency; consider the characteristics of children's different ages to determine the duration of teaching; various teaching methods.
⑵Starting adjustment: the working ability level of the cerebral cortex is low at the beginning of the work, and gradually increases after the starting process. Visible at the start of the school day, week, and year.
Hygienic significance: The teaching process should be gradual and gradually increase the difficulty of the work.
⑶ Dynamic stereotypes: When the internal and external conditional stimuli are repeated several times in a certain order, the neural circuits related to this on the cerebral cortex are fixed, forming a so-called "habit". This kind of temporary neural connection formed under certain conditions, configured and formed according to a certain order, strength and weakness is called dynamic stereotypes.
Hygienic significance: The training and cultivation of all skills and habits is the process of forming dynamic stereotypes. The younger the age, the greater the plasticity, and the easier it is to establish dynamic stereotypes. It is necessary to cultivate good hygiene habits from an early age, and do not easily change the completed dynamic stereotypes.
(4) Mosaic activity: The cerebral cortex in learning shows a mosaic activity mode of excitation area and inhibition area, work area and rest area.
Hygienic significance: the rotation of courses of different natures, the exchange of mental and physical activities; the younger the age, the more frequent the rotation of various activities.
(5) Protective inhibition: When the activity of the cerebral cortex exceeds its functional limit, it enters into a state of inhibition in a feedback manner.
Hygienic significance: pay attention to the early manifestations of students' fatigue, and organize in time to promote the recovery of cerebral cortex functional activity. ⑹Terminal excitation: The cerebral cortex causes prodromal excitement for the upcoming rest activities, and the mental work ability rises. This phenomenon can be seen during the school day, week, and end of term.
Hygienic significance: Appropriate use of this feature in teaching to improve learning efficiency.
4. Changes of mental work ability: ⑴School day changes:
1 Type I: The working ability gradually increases after the beginning, reaches the peak after about two hours, and then gradually decreases; it rises after the lunch break, and then gradually decreases; at the end of the school day, it decreases to a level slightly lower than that at the beginning of the school day.
2 Type II behaves similarly to Type I except that there is a terminal arousal phenomenon at the end of the school day, ie a slight recovery in work ability.
3 Type III is characterized by a persistent increase in work capacity from the beginning of the school day to the end of the school day.
4 Type IV is the opposite of Type III, showing a rapid decline in work capacity
Types Ⅰ and Ⅱ conform to the characteristics of cortical functional activity, and there is no serious decline in work ability at the end of the school day, and recovery after rest.
Types III and IV are unfavorable types of change. Type III indicates that the function of the cerebral cortex is in a state of high tension, which will inevitably lead to cortical inhibition and energy exhaustion. The excitability of type Ⅳ decreased rapidly, suggesting that the function of the cortex was already in a state of inhibition.
1. Not high at the beginning of the middle of the school day → gradually ↑ after a period of time → reached the peak after about 2 hours → then gradually ↓ → rose again after the lunch break → then gradually ↓ → dropped to slightly lower than before the school day at the end of the school day level; or due to terminal stimulation → a slight recovery in work ability.
2. The ability to work is not high on Monday during the school week → start on Tuesday ↑ → reach a peak on Wednesday → gradually ↓ later; or due to the end of the week before the end of the week → the ability to work slightly recovers.
3. The first half of the first semester of the school year is not high → the second half of the first semester ↑ reaches the peak (the first peak) → the phenomenon of "terminal excitation" is often seen before the winter vacation → there is another peak at the beginning of the second semester, but The peak is lower than the first semester, and then gradually ↓ → the end of the second semester (the end of the school year, before the summer vacation) drops to the lowest point of the whole school year. The general rule is not high at the beginning → gradually ↑ reaches the peak after the initial adjustment → later ↓ → drops to slightly lower than the initial level at the end; or due to terminal stimulation → the working ability rebounds slightly.
5. Factors affecting mental work ability:
①age (key); ②health status; ③gender factor; ④learning motivation; ⑤learning interest; ⑥emotional and emotional factors; ⑦learning and living conditions;
2. Evaluation of learning load
1. Basic concepts:
(1) Learning load refers to the intensity and time of mental work during learning. Evaluation indicators: The purpose of studying study load on study time is to formulate health standards for study load and evaluate the sanitation of the work and rest system, to detect early fatigue in time, and to take measures to prevent the occurrence of chronic fatigue.
(2) Fatigue: Protective inhibition caused by over-intensity, excessive stimulation, or low-intensity but sustained long-term action, cerebral cortex cell function depletion exceeds the limit.
(3) Tiredness: It is a subjective feeling of people. (the younger you are, the more out of synch fatigue and tiredness)
⑷Overwork: Chronic fatigue, caused by long-term study overload, is a pathological condition. (Tiredness and overwork should not be used as the basis for formulating health standards for study load)
(5) Study load and study fatigue
Pathways of fatigue: early fatigue—chronic fatigue—excessive fatigue
Fatigue: It is a protective inhibition caused by the excessive consumption of cerebral cortex cells under the action of too strong, too violent stimulation, or the stimulation intensity is not large but lasts for a long time.
Early fatigue: It is a physiological phenomenon that can be recovered in a short time; the appearance of early fatigue is an indicator that the student's physiological load has reached a critical limit.
Excessive fatigue: It is a pathological state caused by the long-term continuation of fatigue leading to chronic fatigue and further development, which cannot be recovered by short-term rest. It is very harmful to learning efficiency and physical and mental health.
(6) Phase performance of learning fatigue
Phase I - Early Fatigue: Decreased dominant excitability with one of the following changes
Inhibition disorder, unable to inhibit the surrounding area, can only respond to individual conditioned stimuli
Generalization of excitement: restlessness, inattention
Phase II - Prominent Fatigue: Co-occurrence of Interinhibition Disorders and Excitatory Generalization
Yawning, dozing off during class
Abnormal responses to conditioned stimuli, weak responses to strong stimuli, strong responses to weak stimuli, or both strong and weak stimuli
Phase III - Excessive Fatigue
Memory decline, comprehensive impairment of logical thinking, imagination, judgment, and reasoning
Indifference to the surrounding things, depression, temper tantrum
Signs include pale skin and mucous membranes, malaise, weakness, and sometimes tremors in the hands.
2. The performance of learning fatigue:
3. Evaluation method of learning fatigue:
(1) Signs and behavior observation methods: including direct and indirect observation methods, and health survey methods.
⑵ educational psychology methods: short-term memory.
(3) Physiological methods: 1. Determination of persistence of photopic vision; 2. Determination of critical flicker fusion frequency.
⑷ Dose homework determination, language strengthening motor conditioned reflex method (visual-motor response, auditory-motor response). Notes on the evaluation method:
①Contrast before and after my work;
② The selection method should be suitable for the age characteristics of the subjects;
③Train until the results are stable before formal testing.
3. Hygienic work and rest system
1. Work and rest system: generally refers to the daily life system, that is, the time arrangement of various elements of people's life in a day and night is reasonably allocated and the order of alternation is stipulated.
2. The basic principles of children and teenagers' work and rest system: (questions and answers)
①According to the characteristics of the functional activities of the cerebral cortex and the changing rules of mental work ability, reasonably arrange the alternation of activities and rests;
②Suitable for the needs of children and adolescents of different ages and health conditions;
③ It can meet both learning needs and physiological needs
④ The school and family work and rest systems are coordinated and unified;
⑤ Once the work and rest system is determined, do not change it easily;
Basic Principles of Physical Exercise
1) Age-, gender- and health-appropriate characteristics
2) Cultivate students' interest and habit in physical exercise
3) step by step
4) Comprehensive exercise
5) There must be preparatory activities and tidying activities
6) Alternate exercise and rest appropriately
Chapter 15 Sanitation of School Buildings and Equipment
1. School address
1. Selection of school site:
⑴The school is set up according to the local population and density to specify its service radius.
⑵Service radius: the maximum distance between the school and the student's home address.
⑶ site selection principles:
①It is convenient for students to enroll nearby;
②Service radius: Kindergarten <400-500 Primary school: 10 minutes on foot Middle school: 15-20 minutes on foot
③ Surrounding environment: No pollution and strong noise, and the noise in the school should not exceed 50dB.
④ Sufficient sunlight, air circulation, dry site, high terrain, smooth drainage.
2. School land: Including construction land, sports field and green land. Building density = total building base area/building land area; building volume ratio: the total building area per hectare of building land. Elementary and middle school building volume ratio ≤0.8 ≤0.9 Number of floors ≤4 ≤5 Sports field ≥2.3m2/person ≥3.3m2/person Green land ≥0.5m2/person ≥1m2/person General layout of the campus: clear divisions and reasonable layout , Contact convenience, mutual non-interference.
The requirements for building spacing are: Sunshine spacing: for ordinary classrooms facing south, the full window sunlight on the ground floor should not be less than 2 hours on the winter solstice day. Noise-proof spacing: When the long sides of two rows of classrooms are parallel, the spacing should not be less than 25m. After the above two distances are determined, take the higher value.
2. Rational layout of teaching rooms
1) Orientation: generally south.
2) Corridor: In the form of an outer corridor or a single inner corridor, do not use the inner corridor type. The width of the outer corridor should not be less than 1.8m, and the width of the inner corridor should not be less than 2.1m. The height of the verandah railing (or fence) should not be lower than 1.1m.
3) Stair design:
4) The principle of ensuring the safety of students, easy walking and evacuation, respectively makes requirements for lighting, stair steps, railing height, stair slope, and stairwell.
5) The number of classrooms and the clear height of the room:
a) Beginner classes are downstairs and advanced classes are upstairs.
b) Corridors should not be too long and aisles should not be too narrow.
c) The area of various teaching rooms.
6) Wind and rain playground: size, height, lighting, ground, etc.
3. The internal layout and hygiene requirements of the classroom
Basic hygiene requirements for classrooms:
1. Sufficient indoor area;
2. Good lighting and indoor microclimate;
3. Prevent noise interference;
4. It is convenient for students to sit and pass, easy to clean and develop good hygiene habits.
(1) Orientation: It is determined by the opening direction of most windows, preferably facing south
(2) Shape: generally rectangular, the ratio of length to width is 3:2 or 4:3
(3) Size: The classrooms for each primary and secondary school student occupy an area of 1.22m2 and 1.15m2 respectively.
1. Number of students accommodated:
Floor area per person (m2) Clear classroom height (m) Primary school 1.04~1.18 3.1 Middle school 1.06~1.18 3.4
2. Arrangement of tables and chairs:
①The primary school table is 1.1m long, and the middle school table is 1.2m long.
②Aisle not less than 0.5 is set between each column.
3. Visual and auditory requirements:
① Blackboard: Length: primary school ≥ 3.6m, middle school ≥ 4m; Width: both primary and secondary schools ≥ 1m ② Podium: height 0.2m. ③ Vertical distance between the lower edge of the blackboard and the podium: 0.8-0.9m for primary schools and 1-1.1m for middle schools.
④The horizontal distance between the back edge of the last row of desks and the blackboard: ≤8m for primary schools and ≤8.5m for middle schools.
⑤The horizontal distance from the front edge of the front table to the blackboard is ≥2-2.5m to ensure that the viewing angle is ≥30°
⑥Observation angle: the horizontal angle between the horizontal realization of the blackboard and the blackboard surface formed by the students in the first row against the wall. Vertical angle of view: the vertical angle formed by the first row of students looking at the upper edge of the blackboard and the blackboard surface is at least 45°.
4. The allowable noise level of noise should be ≤50dB.
5. Requirements for improvement of lighting and lighting in classrooms Hygienic requirements for natural lighting in classrooms (questions and answers)
1. Meet the lighting standards, and the desk and blackboard surface must have sufficient illumination;
2. The illumination distribution is relatively uniform;
3. The light for single-side lighting should enter from the left side of the student seat, and the main lighting window for double-side lighting should also be set on the left side;
4. Avoid strong glare effect.
Steps you can take to increase natural lighting: (Q&A)
(1) Lighting direction: The light should come from the left side (the main lighting surface and the secondary lighting surface should be considered when lighting on both sides).
(2) Glass-to-ground area ratio: Glass-to-ground area ratio = light transmission area of the window/ground area should not be less than 1:6
(3) Room depth coefficient: the ratio of the height of the upper edge of the window from the ground to the room depth. Single side lighting>1/2 Double side lighting>1/4
⑷Projection angle: the angle between the horizontal line drawn from a point on the indoor working surface to the side of the window and the point to the upper edge of the window is not less than 20°~22° Minimum opening angle: the connection line from the measuring point on the desktop to the apex of the opposite blocking object The angle between this point and the line connecting the upper edge of the window is not less than 4°~5°.
⑸Height of the lower edge of the window (window sill height): 0.8~1m, window spacing ≤ 1/2 window width; strip window
⑹The indoor surface is decorated with high brightness and low chroma
(7) Daylighting coefficient: refers to the ratio of the illuminance at one point of the indoor working surface to the horizontal illuminance of the scattered light in the open sky at the same time. The minimum daylighting factor on the desktop should not be lower than 1.5%. The minimum daylighting factor is an index for comprehensively evaluating classroom daylighting. Critical illuminance: 5000Lx
Glare (giddylight) and its control:
(Questions and Answers) Definition: Glare is the light that causes uncomfortable interference or visual fatigue in the field of vision. Divided into direct glare and reflected glare.
Measures to be taken to reduce glare from natural lighting in classrooms:
1) Limit the brightness of the light source
2) Adopt appropriate suspension height and necessary protection angle
3) Appropriately increase the ambient brightness and reduce the brightness ratio
4) Lamp arrangement: the long axis is perpendicular to the blackboard surface
2. Artificial lighting:
Health requirements:
Ensure that there is sufficient illumination on the desk and the black panel;
Uniform illumination distribution;
avoid shadows or glare;
The indoor temperature is not too high due to artificial lighting, which affects the quality and safety of the air.
1. All classrooms should be equipped with artificial lighting. The lamps should be controlled lamps. The lighting source should be fluorescent lamps. The arrangement of the lamp tubes should be arranged with their long axes perpendicular to the blackboard surface. The minimum hanging height of the lamps from the desk should not be less than 1.7m; 2 .The average illuminance value of the classroom desk should not be lower than 150Lx, and its illuminance uniformity should not be lower than 0.7;
3. Locally controlled lighting should be installed on the blackboard surface, the average vertical illuminance value should not be lower than 200Lx, and the uniformity of illuminance should not be lower than 0.7.
Protective angle: the line from the edge of the lamp to the filament and the horizontal line form an angle
4. Standards for natural lighting in classrooms
Glass-to-ground area ratio: not less than 1:6
The ratio of the light transmission area of the window to the floor area of the classroom.
Room depth coefficient: the ratio of the height of the upper edge of the window to the ground and the depth of the room
Unilateral: no less than 1:2; bilateral: no less than 1:4
5 natural lighting
Projection angle: the angle between a point on the indoor working surface and the horizontal line drawn from the side of the window and the line between the point and the upper edge of the window.
Not less than 200~220
Opening angle: the angle between the line connecting a point on the indoor working surface to the vertex of the opposite shelter and the line connecting the point to the upper edge of the classroom window. Not less than 40~50.
6. The illuminance of 200lx is the turning point of the change speed of visual function. It is recommended that the illuminance standard on the classroom desk should choose this value, or a value close to it should not be lower than 150lx.
The average illuminance of the classroom desktop is not lower than 150lx; the blackboard is not lower than 200lx.
Uniformity of illuminance: the ratio of the minimum illuminance to the average illuminance. Not less than 0.7.
7. Glare and its control
Control: limit the brightness of the light source;
Appropriate suspension height and necessary protection angle: height 1.7m
Protection angle: preferably 45°, at least not lower than 30°.
Properly increase the ambient brightness and reduce the brightness ratio.
The arrangement of the light tubes should be arranged with their long axes perpendicular to the blackboard surface.
6. Hygiene of desks and chairs
1. Hygienic requirements for desks and chairs: meet the needs of education, suitable for sitting children, provide a suitable distance between eyes and books, and maintain a good sitting posture.
Good posture:
① Front sitting posture: the posture in which the center of upper body weight falls on or in front of the ischial tuberosity. At this time, the tension of the back muscles and the thighs are used to maintain balance. Fatigue occurs easily. When writing, you must adopt a posture with your upper body leaning forward slightly.
②Posterior sitting posture: the center of upper body weight falls behind the ischial tuberosity (i.e. back sitting posture), which is suitable for resting, listening to lectures, reading and writing.
2. Dimensions of desks and chairs and their basis:
1. The desktop is flat or inclined, with an inclination of 10°~12°.
2. The height from the desktop to the bottom of the box in the space under the table should not exceed 1/2 of the height difference between the table and chairs.
3. The seat face is tilted backward by 0°~2°.
4. The back 2/3~3/4 of the thigh should be placed on the chair surface, and there should be a gap behind the calf.
5. Table and chair height difference = the difference between the height of the near edge of the table and the height of the table For school-age children, the appropriate height difference between tables and chairs is 1/3 of their sitting height; for teenagers, it should be increased by 1~2.5cm on this basis.
6. The height of the chair is 1cm above or below the head of the fibula.
7. The back of the chair is tilted backward by 5°~10°, and the upper edge is as high as the lower angle of the scapula.
8. The distance between tables and chairs is preferably a negative distance within 4cm.
3. Lighting factor:
The ratio of the natural illuminance at a point on the indoor working surface to the horizontal illuminance of the scattered light in the open sky outdoors at the same time.
It should not be lower than 1.5%, and not lower than 2% in foggy areas.
Critical illuminance: the outdoor illuminance when the indoor natural illuminance is equal to the minimum value specified in the standard.
It is the outdoor illuminance limit for turning artificial lighting on or off