Monitoring of Adaptation Capability Indicators in Healthy Schoolchildren (Based on the Example of the Krasnoyarsk Cadet Corps)

The dissertation is devoted to a comprehensive study of the adaptation capabilities of healthy schoolchildren aged 10–13 enrolled in a general education institution of a new type — the Krasnoyarsk Cadet Corps. The research was conducted at the Krasnoyarsk State Medical Academy and represents a three-year monitoring program that includes assessment of environmental living factors, physical development taking into account nutrition, the level of general morbidity, and biochemical indicators of non-specific organ resistance (lipid peroxide formation indicators and antioxidant protection indicators). The aim of the work is to develop regional normative documents for the preservation and strengthening of the health of students in cadet corps.

The research established that in first-year cadets, a sharp prooxidant shift in the redox equilibrium is observed, reflecting a tense course of adaptation caused by the weakening of the antioxidant system against the background of adaptation period difficulties and insufficient organism supply with micronutrients. The work demonstrates the possibility of detecting signs of maladaptation at the preclinical stage with subsequent correction through macro- and micronutrients, and substantiates the necessity of comprehensive monitoring of adaptation reserves for planning preventive measures in general education institutions of a new type.

Relevance of the Research

The results of the All-Russian Dispensary Examination of Children in 2003 confirmed the trend toward increasing prevalence of functional deviations and diseases over the period of school education, which may indicate insufficient adaptation capabilities of modern schoolchildren. Among students of general education institutions of a new type, various school-related diseases are detected with significantly greater frequency than among children in general education schools (Bezrukikh M.M., 1998; Stuneeva G.I., Kiryushin V.A., 2001; Sukhareva L.M., Berezhkov L.F., 2001; Kamyk V.P., 2002; Geltisheva E.A., Moiseeva N.A., 2002; Maimulov V.G., 2003; Kuchma V.R., 2003).

A number of authors (Zaitseva N.V., 1999; Istomin A.V., Yudina T.V., 2000; Sukhareva L.M., Berezhkov L.F., 2001; Kuchma V.R., 2003) consider that students of general education institutions of a new type are most susceptible to the influence of intra-school environmental factors, being in an educational institution 1.5–1.8 times more than ordinary schoolchildren.

Under the term "health" is understood not only the state of the organism when all indicators fall within normal limits, but also the presence in the organism at all levels of substantial reserve capabilities ensuring adaptive reactions (Agadjanyan N.A., 1999; Gichev Yu.P., 2003).

Despite the widespread prevalence of symptoms and syndromes of school maladaptation, the question regarding the role of the adaptive potential of children in general education institutions of a new type remains practically unstudied. Scientists have established the relationship between the adaptation capabilities of children and nutrition (Tutelyan V.A., Spirichev V.B., 2000; Prahin E.I., 2001; Kon' I.Ya., Titov E.I., 2003), between the adaptation capabilities of children and physical development (Yampolskaya Yu.A., Berezhkov L.F., 2000; Vyborova S.A., 2003; Kuchma V.R., 2004), and between the adaptation capabilities of children and biochemical indicators of non-specific organ resistance (Garkavi L.I., 2000; Gritsinskaya B.I., Savchenko A.A., Manchuk V.T., 2001; Matorova N.I., 2003).

However, a comprehensive assessment of adaptation capabilities among students of general education institutions of a new type has not been conducted. Timely detection of signs of maladaptation among schoolchildren at the stage of prenosological manifestations will make it possible to conduct timely correction and thereby reduce the prevalence of school-related diseases and preserve the health of students in general education institutions of a new type.

Objective of the Research:

To study the adaptation capabilities of schoolchildren; to develop regional normative documents on the preservation and strengthening of the health of students in general education institutions of a new type (cadet corps).

Tasks of the Research:

1. To study the environmental factors influencing the health of schoolchildren in general education institutions of a new type.

2. To conduct an assessment of the physical development of cadets taking into account the nutritional factor by the Quetelet Index.

3. To conduct an assessment of the health level of cadets based on general morbidity indicators and healthcare utilization rates.

4. To assess the adaptation capabilities of cadets based on biochemical indicators of non-specific organ resistance (LOP / AOS).

5. To develop regional normative documents on the preservation and strengthening of the health of students in the Krasnoyarsk Cadet Corps.

Scientific Novelty:

For the first time, a comprehensive research was conducted that includes the study of lipid peroxide oxidation indicators and antioxidant protection in the assessment of adaptation capabilities of the organism of cadets at the individual and collective levels, under the influence of manageable and unmanageable environmental factors, which made it possible to detect signs of tension in the course of adaptation at the stage of preclinical manifestations.

It has been established that a sharp prooxidant shift in the redox equilibrium of homeostasis (by malonaldehyde), maximally pronounced among cadets in the first year of study, reflects a tense course of adaptation initiated by the weakening of the antioxidant system in newcomers against the background of adaptation period difficulties.

It has been demonstrated that the main causes of tense adaptation among cadets are insufficient organism supply with nutrients (primarily micronutrients) and the influence of adverse environmental factors.

It has been proven that antioxidant insufficiency can be corrected with the help of macro- and micronutrients.

Practical Significance of the Work:

Taking into account the statistically significant differences in the course of adaptation at various stages of study among healthy schoolchildren (10–13 years) based on pro- and antioxidant system indicators, a comprehensive assessment of the course of adaptation is proposed with the detection of early deviations in the health status of children in general education institutions (especially in the first year of study) and the planning of preventive measures aimed at increasing organism resistance.

The research materials made it possible to propose for practical use specific measures for correcting the deficiency of macro- and micronutrients in the nutrition of students in general education institutions of a new type — cadet schools.

The following normative and methodological documents have been introduced into practice:

"Temporary Regulations on the Organization, Equipment, Content, and Mode of Operation of Cadet Corps". Approved by the Chief State Sanitary Doctor of the Krasnoyarsk Krai and the Head of the Administration of the Krasnoyarsk Krai for Cossack Affairs and Cadet Educational Institutions on 22.02.2000 (implementation act 2000); "Organization of Rational Nutrition. Nutrition Norms". Methodological Recommendations for Cadet Corps of the Krasnoyarsk Krai. Approved by the Academic Council of KrasGMA on 24.10.2001 (implementation act 2001); "Organization of Rational Nutrition. Nutrition Norms". Methodological Recommendations for Cadet Corps of the Krasnoyarsk Krai. Approved by the Legislative Assembly of the Krasnoyarsk Krai and the Governor of the Krasnoyarsk Krai. Krasnoyarsk, 2001 (implementation act 2001).

The research materials are used in the educational process of the Department of Hygiene, Pediatric Diseases of the Therapeutic Faculty of the Krasnoyarsk State Medical Academy, in the activities of the Center of Gossanepidnadzor of the Krasnoyarsk Krai, and in the work of cadet corps of the Krasnoyarsk Krai.

Propositions to be Defended:

1. The leading causes leading to maladaptation among students of the cadet corps are ecological characteristics of the surrounding environment, which are classified as unmanageable factors, as well as social conditions, which should be considered conditionally manageable, and nutrition as an important manageable factor.

2. Nutrition provides the possibility of physiological regulation of the course of adaptation processes among students of the cadet corps.

3. Monitoring of adaptation capabilities based on lipid peroxide oxidation indicators and antioxidant protection makes it possible to detect signs of maladaptation among schoolchildren at the stage of preclinical manifestations and ensures an individual approach to the assessment of children's health.

4. The developed normative and methodological documents assist in implementing a system of measures for the preservation and strengthening of the health of children studying in general education institutions of a new type (cadet schools).

Research Validation: The main provisions of the dissertation were reported and discussed at international scientific conferences: "The 8-th International Symposium of the Japan-Russia Medical Exchange" (Blagoveshchensk, 2000); "11-th International Congress on Circumpolar Health" (Harstad, Norway, 2000); "The 9-th International Symposium of the Japan-Russia Medical Exchange" (Kanazava, 2001); "Environment and Human Health" (St. Petersburg, 2003); "Physical Culture and Sport in the Education System. Health-Saving Technologies and Formation of Health" (Belarus, Grodno, 2005); at interregional scientific-practical conferences: "Actual Problems of Healthy Nutrition of Schoolchildren of the Siberian Region" (Krasnoyarsk, 1999); "Quality Nutrition of Schoolchildren — Healthy Generation of the XXI Century" (Krasnoyarsk, 2001); at All-Russian scientific conferences and congresses: "Problems of Ecology and Urban Development" (Krasnoyarsk, 2000); "Modern Problems of Nutrition of the Population and Military Personnel" (St. Petersburg, 2000); "Nutrition of Children: XXI Century" (Moscow, 2000); "Healthy Nutrition: Education, Training, Advertising" (Moscow, 2001); "North — Man: Problems of Health Preservation" (Krasnoyarsk, 2001); "Hygienic Problems of Health Protection of the Population of Siberian Regions" (Kemerovo, 2002); "Influence of Environmental Pollution on Human Health" (Novosibirsk, 2002).

Publications: 26 printed works have been published based on the dissertation materials (4 articles, 18 abstracts), including temporary regulations — 1, methodological recommendations — 2, monograph — 1.

Scope and Structure of the Dissertation: The dissertation is presented on 163 sheets of typed text and consists of an Introduction, a Literature Review, Materials and Methods of Research, three chapters of original research, Conclusion, Conclusions, Practical Recommendations, and a List of References. The work is illustrated by 27 tables and 39 figures. The List of References includes 316 bibliographic publications, of which 236 are domestic and 80 are foreign.