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Content
INTRODUCTION
CHAPTER 1
1.1. Characteristics of gynecological diseases of patients of the Center for Reproductive Health of Adolescents "Juventa
1.2. Center for Reproductive Health of Adolescents "Juventa"
1.3. The essence and main provisions of the nursing process in gynecology
CHAPTER 2
2.1. Organization of the study
2.2. Description of the research base
2.3. Analysis of the results of the study
CHAPTER 3
3.1. Organization and methods of medical and social work of a nurse in teaching adolescents
3.2. Reminders for patients
CONCLUSIONS
CONCLUSION
BIBLIOGRAPHY
APPLICATION

Introduction

The medical and social role of a nurse in teaching adolescents suffering from gynecological diseases.

Fragment of the work for review

Bibliography

"BIBLIOGRAPHY
1. Ailamazyan E.K. Obstetrics: Textbook for honey. universities. St. Petersburg: SpetsLit, 1999, pp. 74-78.
2. Akunts K.B. Obstetrics. Certification questions for obstetrician-gynecologists, family doctors, students and midwives. M.: Triada-X, 2002.
3. Obstetrics and gynecology. Collection of tests. / Ed. ON THE. Guskova. M.: ANMI, 2002.
4.Beyer P., Myers Y. Theory and practice of nursing in the context of adult health. M., 2001. p. 17-25.
5. Voronin K.V. Handbook of the midwife. M.: Triada-X, 2002. - 412 p.
6. Diseases of the cervix, vagina and vulva (Clinical lectures) Ed. Prof. V.N. Prilepskaya. M.: 2005. - 156 p.
7. Krylova EL. Nursing in obstetrics and gynecology. Rostov n / D .: Phoenix, 1999. - 232 p.
8. Lineva O.I., Dvoynikov S.I., Gavrilova T.A. Nursing in obstetrics and gynecology. A guide for students of the faculties of the VSO. Samara: GP "Perspektiva", 2000. p. 23-35.
9. Matveychik T.V., Ivanova V.I. Organization of nursing. Minsk: Higher School, 2006. -302 p.
10. Mikhailenko E.T., Bublik-Dornyak G.M. Physiological obstetrics and gynecology. Kyiv: Higher School, 1999. - 416 p.
11. Nursing care. A guide for nurses. Edited by Petrov V.N. St. Petersburg: Dilya, 2006. - 416 p.
12. Nursing: professional disciplines. Edited by Kotelnikov G.P. Rostov-on-Don: Phoenix, 2007. - 698 p.
13. Slavyanova I.K. Nursing in obstetrics and gynecology. Rostov-on-Don: Phoenix, 2008. - 379 p.
14. Smirnova L.M., Saidova R.A., Braginskaya S.G. Obstetrics and gynecology: Textbook. M.: Medicine, 1999. - 456 p.
15. Yagovdik N.Z. etc. Venereal diseases. Minsk: Belarusian science, 2000. p. 12-14.
Information network Internet:
16.www.juventa-spb.info;
17.www.teen-info.ru

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MINISTRY OF HEALTH OF THE TULA REGION

UZLOV BRANCH

STATE EDUCATIONAL INSTITUTION

SECONDARY VOCATIONAL EDUCATION

"Tula Regional Medical College"

COURSE WORK

Level of education: basic

Specialty: Nursing

Qualification: medical brother

THE ROLE OF THE NURSE IN THE PULMONOLOGY DEPARTMENT

Completed:

Student of the group M.S. A 9 IV

Major Evgeny Dmitrievich

Supervisor:

Fomenko Marina Valerievna

Nodal, 2015

Introduction……………………………………………………………......................3

Chapter 1. The structure of the human respiratory system………………………………........................... ...................................6

1.1 Airways…………………………………………………..6

1.2 Lungs…………………………………………………………………..7

1.3 Auxiliary elements of the respiratory system………………...8

Chapter 2. Inflammatory diseases of the respiratory system and their treatment ... 9

2.1 Acute inflammation of the upper respiratory tract……………………9

2.2 Inflammation of the bronchi - bronchitis……………………………………...10

2.3 Bronchial asthma……………………………………………………..11

2.4 Inflammation of the lungs - pneumonia…………………………………….13

Chapter 3

3.1 Types of occupational respiratory diseases………………………………………………………………………………………. ................................................. ..15

3.2 Prevention and treatment of occupational respiratory diseases……………………………………………………………………………...17

Chapter 4. Prevention of diseases of the respiratory system…….18

4.1 Smoking cessation……………………………………………………….18

4.2 Exercise and weight…………………………………...20

4.3 Hardening…………………………………………………………..23

Conclusion………..……………………………………………………………...24

List of sources used…………………………………………...25

Applications……………………………………………………………………....27

INTRODUCTION

IN Everyday life under the care of the sick (compare - care, take care) usually understand the provision of assistance to the patient in meeting his various needs. These include eating, drinking, washing, moving, emptying the bowels and bladder. Care also implies the creation of optimal conditions for the patient to stay in a hospital or at home - peace and quiet, a comfortable and clean bed, fresh underwear and bed linen, etc. The importance of patient care cannot be overestimated. Often the success of treatment and the prognosis of the disease are entirely determined by the quality of care. So, it is possible to flawlessly perform a complex operation, but then lose the patient due to the progression of congestive inflammation in the lungs resulting from his prolonged forced immobility in bed. It is possible to achieve a significant recovery of damaged motor functions of the limbs after suffering a cerebrovascular accident or complete fusion of bone fragments after a severe fracture, but the patient will die due to pressure sores formed during this time due to poor care.

Thus, patient care is an essential part of the entire treatment process, which to a large extent affects its effectiveness. Therefore, there was a need for research work on this topic.

Purpose of the study:

• Studying the role of a nurse in the pulmonology department
• Analysis of the work of a nurse in the pulmonology department

Research objectives:

• Determining the level of diseases in the pulmonology department
• Evaluation of the effectiveness of caring for patients in the pulmonology department
• Study of the nursing process in the pulmonology department
• Communication with patients in the pulmonology department

Research objects:

• Patients in the pulmonology department
• Nurses in the pulmonology department

Subject of study:

• Nurse at the pulmonology department

The relevance of research: This topic is relevant and widespread throughout the world. The role of the nurse in the pulmonology department attracted me because the care and prevention of respiratory diseases is the main type of their treatment.

Location of the study:

• State health institution "Uzlovskaya RB"

Hypothesis: Elucidation of the pattern of recovery of the patient from the professionalism of the nurse of the pulmonology department

Research methods:

• Literature study
• Observation
• Conversation
• Analysis and comparison

CHAPTER 1. The structure of the human respiratory system

The human respiratory system consists of tissues and organs that provide pulmonary ventilation and pulmonary respiration. In the structure of the system, the main elements can be distinguished - the airways and the lungs, and the auxiliary elements - the elements of the musculoskeletal system. The airways include: nose, nasal cavity, nasopharynx, larynx, trachea, bronchi and bronchioles. The lungs consist of bronchioles and alveolar sacs, as well as arteries, capillaries and veins of the pulmonary circulation. Elements of the musculoskeletal system associated with respiration include the ribs, intercostal muscles, diaphragm, and accessory muscles of respiration.

1.1 airways

The nose and nasal cavity serve as conductive channels for air, in which it is heated, humidified and filtered. Olfactory receptors are also enclosed in the nasal cavity.

The outer part of the nose is formed by a triangular bone-cartilaginous skeleton, which is covered with skin; two oval openings on the lower surface - the nostrils - each open into the wedge-shaped nasal cavity. These cavities are separated by a septum. Three light spongy curls (shells) protrude from the side walls of the nostrils, partially dividing the cavities into four open passages (nasal passages). The nasal cavity is lined with a mucous membrane. Numerous hard hairs serve to clean the inhaled air from solid particles. Olfactory cells lie in the upper part of the cavity.

The larynx lies between the trachea and the root of the tongue. The laryngeal cavity is divided by two mucosal folds that do not fully converge along the midline. The space between these folds is the glottis.

The trachea begins at the lower end of the larynx and descends into the chest cavity, where it divides into the right and left bronchi; its wall is formed by connective tissue and cartilage. In most mammals, cartilage forms incomplete rings. The parts adjacent to the esophagus are replaced by a fibrous ligament. The right bronchus is usually shorter and wider than the left. Entering the lungs, the main bronchi gradually divide into ever smaller tubes (bronchioles), the smallest of which - the terminal bronchioles - are the last element of the airways. From the larynx to the terminal bronchioles, the tubes are lined with ciliated epithelium.

1.2 Lungs

In general, the lungs look like spongy, porous cone-shaped formations lying in both halves of the chest cavity. The smallest structural element of the lung - the lobule consists of the final bronchiole leading to the pulmonary bronchiole and the alveolar sac. The walls of the pulmonary bronchiole and alveolar sac form recesses - alveoli (Fig. 2).

This structure of the lungs increases their respiratory surface, which is 50-100 times the surface of the body. The walls of the alveoli consist of a single layer of epithelial cells and are surrounded by pulmonary capillaries. It is generally accepted that the total surface of the alveoli through which gas exchange takes place depends exponentially on body weight. With age, there is a decrease in the surface area of ​​the alveoli.

Each lung is surrounded by a sac called the pleura. The outer pleura adjoins the inner surface of the chest wall and the diaphragm, the inner one covers the lung. The gap between the sheets is called the pleural cavity.

1.3 Auxiliary elements of the respiratory system

The respiratory muscles are those muscles whose contractions change the volume of the chest. Muscles from the head, neck, arms, and some of the upper thoracic and lower cervical vertebrae, as well as the external intercostal muscles connecting rib to rib, raise the ribs and increase the volume of the chest.

Diaphragm - a muscular-tendon plate attached to the vertebrae, ribs and sternum, separates the chest cavity from the abdominal cavity. This is the main muscle involved in normal inspiration (Fig. 3). With increased inhalation, additional muscle groups are reduced. With increased exhalation, the muscles attached between the ribs (internal intercostal muscles), to the ribs and lower thoracic and upper lumbar vertebrae, as well as the muscles of the abdominal cavity, act; they lower the ribs and press the abdominal organs against the relaxed diaphragm, thus reducing the capacity of the chest.

CHAPTER 2. INFLAMMATORY DISEASES OF THE RESPIRATORY SYSTEM AND THEIR TREATMENT

The most common inflammatory diseases of the respiratory system in medical practice are acute inflammation of the upper respiratory tract, inflammation of the bronchi - bronchitis, bronchial asthma, pneumonia - pneumonia and tuberculosis.

2.1 Acute inflammation of the upper respiratory tract

This is the most common disease in general and the respiratory system in particular. At different times, this disease was called differently - catarrh of the upper respiratory tract, acute respiratory disease (ARI), acute respiratory viral disease (ARVI). Causes of the disease: viruses (influenza, parainfluenza, adenoviruses, rhinoviruses, coronaviruses, enteroviruses); bacteria (streptococci, meningococci); mycoplasma. The main contributing factor is a cold, hypothermia of the body.

Acute inflammation of the upper respiratory tract is always manifested by general non-specific signs due to the introduction of the virus and the intoxication of the body caused by it. The main manifestations of the disease are fever, headaches, sleep disturbances, weakness, muscle pain, loss of appetite, nausea, and vomiting. Particularly severe manifestations are lethargy or agitation, disorders of consciousness, convulsions.

Rhinitis is an inflammation of the nasal mucosa. There are runny nose, discharge from the nose, sneezing, difficulty in nasal breathing. Pharyngitis - inflammation of the pharynx and arches. There is a sore throat, pain when swallowing. Laryngitis is an inflammation of the larynx. Patients are concerned about hoarseness of voice, "barking cough". Tonsillitis - or catarrhal angina - inflammation of the tonsils. Patients complain of pain when swallowing, the tonsils are enlarged, their mucosa is reddened. Tracheitis - inflammation of the trachea. There is a feeling of soreness behind the sternum, a dry painful cough, which can last up to 2-3 weeks.

Treatment of acute inflammatory diseases of the upper respiratory tract is carried out in several directions. In some cases, it is possible to influence the causative agent of the disease. Influenza A is effective rimantadine, adenovirus infection - interferon. To treat inflammation itself, anti-inflammatory drugs are used, most often paracetamol (Acamol) and a number of combined medicines for the treatment of acute inflammatory diseases of the upper respiratory tract.

2.2 Inflammation of the bronchi - bronchitis

There are acute and chronic bronchitis. Acute bronchitis usually develops along with other signs of acute inflammation of the upper respiratory tract, inflammation, as it were, descends from the upper respiratory tract to the bronchi. The main symptom of acute bronchitis is coughing; at first dry, then with a little sputum. During the examination, the doctor determines scattered dry whistling rales on both sides.

Chronic bronchitis is a chronic inflammatory disease of the bronchi. It flows for months and years, periodically, then escalates, then subsides. Currently, the importance of three risk factors for chronic bronchitis is recognized as undoubted: smoking, pollutants (increased dust, gases in the inhaled air) and congenital deficiency of a special protein alpha-1-antitrypsin. Infectious factor - viruses, bacteria is the cause of exacerbation of the disease. The main symptoms of chronic bronchitis are coughing, sputum production, and frequent colds.

Examination of patients with chronic bronchitis includes chest X-ray and examination of respiratory function using modern computerized devices. X-ray examination is necessary mainly to exclude other diseases of the respiratory system - pneumonia, tumors. In the study of lung function, signs of bronchial obstruction are revealed, the severity of these disorders is established.

Chronic bronchitis with a long course naturally leads to the development of serious complications - emphysema, respiratory failure, a kind of heart damage, bronchial asthma.

The most important condition for the successful treatment of patients with chronic bronchitis is smoking cessation. It is never too late to do this, but it is better to do it earlier, before the development of complications of chronic bronchitis. During an exacerbation of the inflammatory process in the bronchi, antibiotics and other antimicrobial agents are prescribed. Bronchodilators and expectorants are also prescribed. In the period of the process calming down, sanatorium treatment, massage, physiotherapy exercises are especially effective.

2.3 Bronchial asthma

Bronchial asthma is a chronic disease manifested by recurrent bouts of severe difficulty breathing (suffocation). modern science considers asthma as a kind of inflammatory process that leads to bronchial obstruction - narrowing of their lumen due to a number of mechanisms:

• spasm of small bronchi;
• swelling of the bronchial mucosa;
• increased secretion of fluid by the glands of the bronchi;
• increased viscosity of sputum in the bronchi.

For the development of asthma, two factors are of great importance: 1) the presence of an allergy in a patient - an excessive, perverted reaction of the body's immune system to the ingestion of foreign proteins-antigens; 2) bronchial hyperreactivity, i.e. their increased reaction to any irritants in the form of a narrowing of the lumen of the bronchi - proteins, drugs, pungent odors, cold air. Both of these factors are due to hereditary mechanisms.

An asthma attack has typical symptoms. It begins suddenly or with the appearance of a dry, agonizing cough, sometimes it is preceded by a sensation of tickling in the nose, behind the sternum. Asphyxiation develops rapidly, the patient takes a short breath and then, almost without a pause, a long exhalation (expiration is difficult). During exhalation, dry whistling rales (wheezing) are heard at a distance. The doctor listens to such wheezing during the examination of the patient. The attack ends on its own or, more often, under the influence of bronchodilators. Suffocation disappears, breathing becomes freer, sputum begins to depart. The number of dry rales in the lungs decreases, gradually they completely disappear.

Long-term and insufficiently treated asthma can lead to serious complications. They can be divided into pulmonary and extrapulmonary, often they are combined. Pulmonary complications include chronic bronchitis, emphysema, and chronic respiratory failure. Extrapulmonary complications - heart failure, chronic heart failure.

The treatment of bronchial asthma is a difficult task, it requires the active participation of patients, for whom special "schools" are created, where, under the guidance of doctors and nurses, patients are taught the right way of life, the procedure for using medications.

As far as possible, it is necessary to eliminate risk factors for the disease: allergens that cause seizures; refuse to take non-steroidal anti-inflammatory drugs (aspirin, drugs for the treatment of pain, joint diseases); sometimes climate change, job change helps.

2.4 Inflammation of the lungs - pneumonia

Pneumonia is an inflammatory process in the pulmonary alveoli, adjacent to them the smallest bronchi, microvessels. Pneumonia is most often caused by bacteria - pneumococci, streptococci, staphylococci. More rare pathogens are Legionella, Klebsiella, Escherichia coli, Mycoplasma. Pneumonia can also be caused by viruses, but here, again, bacteria take part in the inflammation.

Pneumonia occurs more often in people who have had a respiratory viral infection, smokers, alcohol abusers, the elderly and the elderly, on the background of chronic diseases internal organs. Pneumonia that occurs in severe postoperative patients in hospitals is isolated separately.

According to the prevalence of the pneumonia process, it can be lobar and segmental, when the foci of inflammation are large, and small-focal with multiple small foci of inflammation. They differ in the severity of the symptoms, the severity of the course, and also on which pathogen led to pneumonia. X-ray examination of the lungs helps to accurately establish the prevalence of the process.

The onset of the disease with macrofocal pneumonia is acute. There is chills, headaches, severe weakness, dry cough, chest pain when breathing, shortness of breath. The temperature rises significantly and stays at high numbers, if the disease is not treated, 7-8 days. When coughing, sputum with streaks of blood begins to stand out first. Gradually, its amount increases, it acquires the character of purulent. The doctor, when listening to the lungs, determines the altered bronchial breathing. In the study of blood revealed an increase in the number of leukocytes, acceleration of ESR. Radiologically, massive shading in the lungs is determined, corresponding to a lobe or segment.

Focal pneumonia is characterized by a milder course. The onset of the disease can be acute or slower, gradual. Often, patients indicate that before the first signs of the disease appeared, they suffered from acute respiratory infections, there was a cough, a short-term fever. There is a cough with mucopurulent sputum, there may be pain in the chest when breathing, shortness of breath. When examining blood, there may be a moderate increase in the number of leukocytes, an acceleration of ESR. Radiologically, larger or smaller foci of shading are determined, but much smaller than with large-focal pneumonia.

Severe forms of pneumonia with high fever, severe cough, shortness of breath, chest pains are best treated in the hospital, they usually begin treatment with penicillin injections, and then, depending on the effectiveness or ineffectiveness of the treatment, change antibacterial agents. There are also painkillers, oxygen is prescribed. Patients with more light forms pneumonia can be treated at home, antibacterial agents are prescribed orally. In addition to antibacterial agents, chest massage and exercise therapy have a good auxiliary effect, especially at the final stages of treatment. It is necessary to treat patients with pneumonia vigorously, achieving normalization of the blood picture and, most importantly, until the disappearance of radiographic signs of inflammation.

CHAPTER 3. NON-INFLAMMATORY DISEASES OF THE RESPIRATORY SYSTEM AND THEIR TREATMENT

Among non-inflammatory diseases of the respiratory system, an extensive group of so-called occupational diseases can be distinguished. Occupational diseases of the respiratory system include those that occur in a person as a result of a sufficiently long contact at work with harmful environmental factors. This happens when one or another damaging agent exists in a form that allows it to penetrate deep enough into the respiratory tract, is deposited in the bronchial and alveolar mucosa, and remains in the respiratory tract for a long time. The lungs may respond to minerals, organic dust, aerosolized particles, and irritating gases. Asbestos, silica, coal dust have the most adverse effect on the respiratory system from minerals.

3.1 Types of occupational respiratory diseases

Asbestos causes the development of asbestosis, which leads to the growth of connective tissue in the lungs (fibrosis), manifested by increasing shortness of breath, dry cough. In addition, it can lead to an isolated disease of the pleura - pleurisy, is a risk factor for the development of lung cancer.

Silica(sand, quartz), coal dust cause a disease called silicosis, anthracosis or pneumoconiosis. The essence of this group of diseases is the progressive development of fibrosis in the lungs as a result of prolonged exposure to dust. For a long time, there may be no signs of the disease, while radiographic changes are pronounced significantly. The foci of shading in pneumoconiosis are most densely located in the middle and lateral parts of the lung, they are of different sizes, with irregular contours, dense, located symmetrically on both sides, they are practically absent in the root zone. Along with foci of compaction, signs of emphysema are revealed. Prolonged course of the disease gradually leads to dysfunction of the respiratory system, increased shortness of breath, cough.

organic dust. Prolonged contact with organic dust causes a number of diseases. Byssinosis is caused by exposure to cotton dust. "Farmer's Lung" is caused by exposure to moldy hay, which contains actinomycete spores. Diseases close to them are caused by cereal dust in working elevators. When exposed to organic dust, both lungs are affected by the type of fibrosing alveolitis. Its symptoms are shortness of breath with difficulty in both inhalation and exhalation, a cough that intensifies when the patient tries to inhale more deeply. X-ray changes are characteristic, and signs of respiratory failure are detected very early on spirography.

Contacts with aerosols cause occupational bronchial asthma, industrial obstructive bronchitis. Platinum salts, formaldehyde, wood dust (especially arborvitae), dandruff and animal excretions on livestock farms, poultry farms, grain and grain waste at currents and elevators are most often cited as the causes of these diseases. Symptoms of asthma are intermittent attacks of suffocation with sharply difficult exhalation. Obstructive bronchitis is manifested by a prolonged cough and almost constant shortness of breath.

3.2 Prevention and treatment of occupational respiratory diseases

The treatment of occupational lung diseases is a rather difficult task, therefore, in all developed countries, special attention is paid to the prevention of these diseases and their early detection. The legislation establishes the implementation of technical and sanitary measures at enterprises with harmful working conditions. An important role belongs to preventive examinations of workers, which necessarily include a doctor's examination, X-ray examination of the lungs, and spirography.

In order to reduce the risk of respiratory diseases, the safety regulations should be strictly followed. To reduce the amount of inhaled toxins, it is advisable to use a protective mask, respirator or other similar device.

It is important to stop smoking, as it increases the risk of developing many mild occupational diseases and worsens symptoms.

1. PREVENTION OF DISEASES OF THE RESPIRATORY SYSTEM

4.1 Smoking cessation

Numerous medical studies conducted in our country and abroad have proven that smoking harms almost all systems of the human body and is a habit that is not easy to get rid of even with the help of a specialist. Tobacco smoking causes physiological and psychological dependence and, in addition, is closely related to social and cultural factors. While a huge amount of research is devoted to the prevention of smoking abroad, in our country this problem is still not given due attention. The general prevention of smoking is reduced to the formula “Ministry of Health warns”, and narcologists should provide specific assistance to those who want to quit smoking. However, since smoking is a complex behavioral act, in the emergence and development of which not only physiological factors, but also a whole range of social and psychological conditions take part, the efforts of doctors alone are clearly not enough. It is necessary to study the psychological aspects of the emergence and spread of smoking habits, the development of theoretical and practical approaches to smoking cessation, as well as the creation of large-scale implementation of preventive programs.

Figure 4 shows how the lungs of a healthy person look like, but as a smoker.

What are the positive changes that will happen to the body if you stop smoking?

Within 20 minutes after the last cigarette was smoked, the body begins the recovery process. Blood pressure and pulse stabilize and return to normal. Blood circulation improves, the temperature of the limbs (hands and feet) returns to normal. Approximately 8 hours after quitting smoking, the level of carbon monoxide in the blood drops and the level of oxygen increases significantly. Smoking interferes with the normal functioning of the brain and muscles by reducing oxygen levels to a minimum level. The so-called "smoker's breath" ( bad smell from the oral cavity, wheezing, coughing) becomes less pronounced. After 24 hours, the body functions in an almost normal mode. Quitting smoking within 24 hours reduces your average chance of having a heart attack and increases your chances of surviving one if it does occur. The level of carbon monoxide in the blood finally returns to normal. Mucus and toxic foreign substances accumulated during the bad habit will begin to be removed from the lungs, breathing will become much easier. Nerve endings damaged by smoking will begin to recover. After 72 hours, the bronchioles will become less tense, the breathing process will become freer. The risk of thrombosis will decrease, blood clotting will return to normal. From 2 weeks to 3 months, the vital capacity of the lungs will increase by 30%.

In the period of 1-9 months, you will see that your health has improved markedly. Coughing, wheezing, sinus congestion will subside, you will no longer choke. With the restoration of lung function, the risk of developing colds and infectious diseases will decrease. After a year without nicotine, the risk of heart disease is halved compared to smokers. After 2 years without cigarettes, the risk of a heart attack drops to normal levels. Five years after quitting, an ex-smoker who averaged a pack of cigarettes a day cuts his risk of dying from lung cancer in half. The risk of developing cancer of the mouth, throat or esophagus is also reduced by half compared to the average smoker.

Approximately 10 years after quitting a bad habit, the probability of dying from lung cancer is at the same level as that of a non-smoker. The risk of other cancers such as kidney, pancreas and bladder cancer is markedly reduced. After 15 years of smoking the last cigarette, the risk of heart disease is similar to that of a non-smoker. So is it worth the wait, or should I quit right now?

4.2 Exercise and massage

General tonic and special (including breathing) exercises are used in therapeutic physical training for respiratory diseases.

General toning exercises, improving the function of all organs and systems, have an activating effect on breathing. Exercises of moderate and high intensity are used to stimulate the function of the respiratory apparatus. In cases where this stimulation is not indicated, low-intensity exercises are used. It should be noted that the implementation of unusual physical exercises in terms of coordination can cause a violation of the rhythm of breathing; the correct combination of the rhythm of movements and breathing will be established only after repeated repetitions of movements. Performing exercises at a fast pace leads to an increase in the frequency of breathing and pulmonary ventilation, accompanied by increased leaching of carbon dioxide (hypocapnia) and negatively affects performance.

Special exercises strengthen the respiratory muscles, increase the mobility of the chest and diaphragm, help stretch pleural adhesions, remove sputum, reduce congestion in the lungs, improve the breathing mechanism, etc. coordination of breathing and movements.

In the therapeutic use of breathing exercises, it is necessary to take into account a number of patterns. Normal expiration is carried out by relaxing the muscles that produce the breath, under the action of the gravity of the chest. Slow exhalation occurs with dynamic inferior work of these muscles. The removal of air from the lungs in both cases is provided mainly due to the elastic forces of the lung tissue. Forced exhalation occurs when the muscles that produce exhalation contract. Strengthening exhalation is achieved by tilting the head forward, bringing the shoulders together, lowering the arms, bending the torso, raising the legs forward, etc. With the help of breathing exercises, you can arbitrarily change the frequency of breathing.

At present, in our country, A.N. Strelnikova.

Gymnastics A.N. Strelnikova is the only one in the world in which a short and sharp breath is taken through the nose on movements that compress the chest. Exercises actively involve all parts of the body (arms, legs, head, hip girdle, abdominals, shoulder girdle, etc.) and cause a general physiological reaction of the whole organism, an increased need for oxygen. Since all exercises are performed simultaneously with a short and sharp breath through the nose (with an absolutely passive exhalation), this enhances internal tissue respiration and increases the absorption of oxygen by tissues, and also irritates that vast receptor zone on the nasal mucosa, which provides a reflex connection of the nasal cavity almost with all organs

Strelnikovskaya respiratory gymnastics, training the breath "in the back", sends it to the maximum depth and thereby fills all the lungs with air from top to bottom. And, since the breaths go on slopes, squats and turns, the diaphragm is fully included in the work. Of all the muscles involved in both breathing and sound production, it is the strongest.

Strelnikova's breathing exercises are shown to all children and adolescents both as a method of treatment and as a method of prevention. As a method of treatment: it should be done twice a day: in the morning and in the evening, 1200 breaths-movements before meals or an hour and a half after meals. As a method of prevention: in the morning instead of conventional gymnastics or in the evening to relieve daytime fatigue.

With various diseases of the internal organs, massage is often used. This is due to the fact that it is an excellent tool for reducing pain, relieving muscle tension, raising the tone of the body and its general recovery. All these properties are very important in the treatment of various diseases. In the treatment of respiratory diseases, different types of massage are used: classical, intensive, segmental-reflex, percussion, periosteal. Each of them has specific goals. For example, the impact on a specific asymmetric zone (intense massage), increased ventilation (percussion), etc. Applying all these types of massage, you can achieve a good result in the treatment of pulmonary diseases.

4.3 Hardening

Hardening is one of the effective means of preventing colds. The method of systematic training of thermoadaptive mechanisms is aimed at increasing the body's protective reserves. To obtain the maximum result, there are a number of principles and hardening rules:

1) the basic principle of hardening − gradual increase intensity of hardening measures. Insufficient loads reduce the result of hardening, and overdoses prevent it.

2) the regularity and continuity of hardening procedures throughout life. short lived, but frequent procedures hardening is more effective than long-term, but rare. If hardening is interrupted even for a short time, the body's sensitivity to the adverse effects of natural factors increases, and the body's resistance decreases and disappears after 2-3 months.

3) when selecting hardening procedures, it is necessary to take into account the individual characteristics of the body.

4) compliance of loads with the functional capabilities of the body.

5) the use of several physical factors (cold, heat, radiant energy, water, etc.) to achieve optimal results.

6) discontinuity - during the day you should take breaks between different hardening effects. Subsequent procedures can be started only after the restoration of the temperature regime of the body.

7) combination of general and local hardening.

You can start hardening your body at any age. The sooner you start hardening, the better the results will be.

Conclusion

In conclusion, it should be noted that the person himself is the "blacksmith" of his health.

In the 20th century, man actively invaded the natural processes of all the shells of the Earth. The main source of air pollution that we breathe is industrial enterprises, which annually emit huge amounts of harmful waste into the atmosphere. First of all, the high content of chemicals in the air causes respiratory diseases, especially among children. In 2007, in the Uzlovsky district, the proportion of respiratory diseases in the structure of the total primary morbidity in children was 64.3%, and in adolescents - 55.5%. The values ​​of respiratory diseases in children are 4.8 times higher than in adults, and 1.5 times higher than in adolescents. Considerable attention should be paid to this problem, treatment facilities should be built, cities should be greened, and environmentally friendly technologies should be used.

An important social problem that entails diseases of the respiratory system is smoking. Among young people it is necessary to actively promote a healthy lifestyle. Medical personnel should conduct conversations in schools and other educational institutions about the success of a person in all areas of activity if he gives up bad habits.

More attention should be paid to preventive measures. “The disease is easier to prevent than to defeat!” Since prevention is not given attention in our country, this slogan should be heard more often at various public events and actively introduced into society. Enterprises should conduct annual medical examinations and conduct competent diagnostics to detect diseases at an early stage.

As far as possible, it is necessary to heal your body by undergoing spa treatment.

Be attentive to your health!

LIST OF USED SOURCES

1. Arkhangelsk region in numbers. Official publication, 2009 / Ed. S.Ya. Komisarova
2. Bronchial asthma Oleinikov V.E., Bondarenko L.A., Gerasimova A.S.
3. Respiratory diseases. Kiselenko T.E., Nazina Yu.V., Mogileva I.A. - Rostov-on-Don: Phoenix, 2005. 288 p.
4. Internal diseases V.I. Makolkin and others - M.: GEOTAR-Media, 2011
5. Gorky Medical Institute; Under total ed. A.P. Sorokina, 1977, 95 p.
6. Diagnosis and treatment of respiratory diseases in terms of diagnostic and medical-tactical errors. Dukov, L.G. 1996, p. 523-528.-Lit.: p. 529-541
7. Clinical pharmacology of respiratory diseases Yu.B. Belousov, V.V. Omelyanovsky - Universum Publishing, Moscow, 1996
8. Clinical pulmonology Vinogradova T.A.
9. Clinical guidelines. Pulmonology Chuchalin A.G. 2007
10. We treat asthma and pneumonia without drugs Makarova I.N.
11. Massage for respiratory diseases. Chabanenko S.N. - M.: Veche, 2004. 176 p.
12. Urgent conditions. Baeshko A.A., Gaiduk F.M. - M.: Medicine, 1992.
13. Non-drug treatment in the clinic of internal health ailments. Blinder M.A., Bogdanov M.M., Bobov K.D. 1995 -528s.
14. Basics general care for the sick. Grebnev A.L., Sheptulin A.A. 1999
15. Popular medical encyclopedia. Ch. ed. V. I. POKROVSKY. - Ulyanovsk, 1997.
16. Practical latest medical encyclopedia: All the best means and methods of academic, traditional and traditional medicine / Per. from English. Yu.V. Bezkanova. - M.: AST Astrel, 2010. 606 p.
17. Russian Respiratory Society; Ch. ed. A.G. Chuchalin, GEOTAR-Media, 2008, 240 s
18. Russian statistical yearbook. Official publication, 2007 / Ed. V.L. Sokolina. Ruina O.V. Medical encyclopedia for the whole family: Everything you need to know about diseases. - M.: Tsentrpoligraf, 2009. 399 p.
19. Philosophical problems of interaction between society and nature. / Voronovich B. A. - M., 1982
20. Encyclopedia Your own doctor: how to provide first aid in various conditions before the doctor arrives. - M., 1979.

APPENDIX A

Questioning of patients of the Uzlovsky district on the subject of smoking

How do you feel about smoking?

Do you smoke?

How many cigarettes do you smoke per day?

How long have you been smoking?

Do you find it difficult to refrain from smoking in places where smoking is prohibited?

Do you know the health risks of smoking?

A) female

B) Male

Your age?

The survey involved 53 people (from 18 to 60 years old), patients of the therapeutic department of the State Health Institution of Uzlovskaya RB.

The survey revealed that 40 (75%) patients have a negative attitude towards smoking (from 18 to 40 years old - 18 people (45%), from 40 to 60 years old - 12 people (30%)), 10 people (20% ) are neutral about smoking, and only 3 people (5%) are positive about it.

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Essay

On the topic of: " Hardening of children and adolescents"

Ayvazyan L.

Moscow 2012

WITHcontent

1. What is hardening

2. The physiological essence of hardening

3. Features of hardening children

1. What is hardening

The famous Russian physiologist Academician I.R. Tarkhanov, the author of the book "On Hardening of the Human Body" published in 1899, defining the essence of hardening, wrote: hardening, giving them greater hardness and durability.

This idea was supported by the well-known Russian pediatrician, an active supporter of hardening G.N. Speransky, who believed that the concept of hardening in medical science came from technology, which implies the transformation of a relatively soft metal into a harder, more elastic and durable one. So in relation to a person, the scientist concludes, hardening means an increase in the body's resistance to all those harmful influences to which it is exposed.

In the definition given by V. Dahl in the Explanatory Dictionary of the Living Great Russian Language, the following interpretation of hardening in relation to a person is given. V. Dahl believed that to harden a person means "to accustom him to all hardships, needs, bad weather, to educate him in severity." And the last definition of hardening, so to speak, is modern, taken by us from the third edition of the Great Medical Encyclopedia: "Hardening of the body is a system of procedures that help increase the body's resistance to adverse environmental influences, the development of conditioned reflex reactions of thermoregulation in order to improve it."

Any improvement, including improvement in the mobilization of the body's defenses under the influence of unfavorable conditions, is achieved only through long and systematic training. Hardening is a kind of physical culture, the most important link in the system of physical education.

Therefore, one cannot but agree with the interpretation of the Soviet scientist V.V. Gorinevsky, who considered hardening as the upbringing in the body of the ability to quickly and correctly adapt to changing external conditions. Any improvement is a long training. Therefore, hardening is a kind of training of the body's defenses, preparing them for timely mobilization.

This idea was even more definitely expressed by the Soviet physiologist A.A. Parfenov, who considers hardening of a person as a special case of training aimed at improving the body's ability to perform work related to increasing the resistance of its tissues to the action of harmful influences, in which natural environmental factors would not cause any undesirable consequences in it. Or, according to yogis, hardening leads to a natural merging of the body with nature.

For hardening, natural factors of nature are used - air, water And Sun. The impact of these factors is not only necessary for life. They are able to modify the material organization of the vital functions of the body, and under certain conditions can cause a violation of various functions, become a source of disease.

Despite the nonspecific nature of hardening, the rapid and expedient response that occurs to the action of one or another stimulus is of a specific nature. At the same time, functional changes of an adaptive nature occur only in response to that stimulus that has repeatedly acted on the body as a hardening factor.

Thus, repeated exposure to cold causes functional shifts, which manifest themselves only when the body is cooled, and do not change its response to the action of heat. Conversely, increasing the body's resistance to overheating does not provide protection from cold exposure. This suggests that there is no general hardening: hardening to heat does not provide hardening to cold.

True, under the action of various temperature stimuli, similar responses of the body may occur. However, adaptation is not associated with separately arising reactions to one or another stimulus, but provides for complex rearrangements in all functional systems of the body, which manifest themselves to the proper extent only in response to the stimulus that previously acted repeatedly.

An increase in resistance is possible not only to one, but also to several environmental factors, but this can only happen if, noted the Soviet physiologist M.E. Marshak, if the body is systematically subjected to repeated action of this particular combination of stimuli.

The use of hardening procedures is aimed at improving protective adaptive reactions that can overcome adverse factors of the external and internal environment on the body, so that it can quickly mobilize its protective reserves and thereby withstand influences hazardous to health. “Physical exercises and hardening are factors for increasing immunity,” wrote the well-known Soviet pathophysiologist I.V. Davydovsky, “which in recent years have been credited with an important role in preventing premature aging, atherosclerosis, and even cancerous diseases. hardening disease immunity protective

Hardening does not cure, but prevents the disease, and this is its most important preventive role. A hardened person easily endures not only heat and cold, but also sudden changes in external temperature, which can weaken the body's defenses. It is less susceptible to various kinds of diseases: influenza, catarrh of the upper respiratory tract, tonsillitis, pneumonia.

The main thing is that hardening is acceptable for any person, that is, people of literally all ages can do it, regardless of the degree of physical development.

Hardening increases the efficiency and endurance of the body. It includes psycho-training and a culture of strong-willed efforts that help to withstand serious trials. We must not forget about one more important value of hardening: in the process of developing the body's resistance to the effects of environmental factors, such character traits as perseverance, purposefulness, and the will to achieve the goal are formed.

Tempering procedures normalize the state of the emotional sphere, make a person more restrained, balanced, they give vigor, improve mood.

Thus, hardening can also be considered as an extensive system of educational and hygienic measures aimed at increasing a person’s resilience to endure staying in adverse meteorological conditions without harm to health and performance, as well as measures to expand his physiological reserves.

It is impossible not to mention the importance that is currently attached to hardening as a factor that accelerates the process of human adaptation to the new climatic and geographical conditions of various zones of our country, in particular to the climatic conditions of the Far North and Siberia. So, according to the doctor G.S. Beloborodova, systematic classes in the winter swimming section in Magadan for 5 years or more, in addition to the general hardening effect, expressed in a decrease in morbidity, accelerate the processes of human adaptation to the conditions of the Far North, forming adaptive reactions in the body of a visiting person, which in form and direction approach those of the indigenous population.

2. The physiological essence of hardening

So, hardening is a system of special training for the body's thermoregulatory processes, which includes procedures aimed at increasing the body's resistance to hypothermia and overheating.

Under the action of these environmental factors, a complex physiological complex of responses arises in the body, in which not individual organs participate, but functional systems organized and subordinated to each other in a certain way, aimed at maintaining body temperature at a constant level.

With the slightest change in temperature environment The brain receives millions of impulses per second. It begins to work at a higher level of general tone, its centers become more active and the whole organism is included in the work.

The information coming from the receptors is processed in the central nervous system and from here it is sent to the executive organs - muscles, blood vessels, heart, lungs, kidneys, sweat glands, in which various functional shifts occur, ensuring the adaptation of the body to given environmental conditions.

Any functional system of our body, including the functional system of thermoregulation, is highly plastic and has a significant margin of safety, P.K. Anokhim. If a person consciously accustoms his body to the action of a wide range of strength and intensity of environmental factors on him, then this guarantees him from their harmful influence and from the sudden restructuring of his regulatory mechanisms that occurs at the same time, which can also lead to undesirable consequences.

In all people, nature has the same mechanisms of thermoregulation, but not all of them operate equally efficiently and rationally. We ourselves create individual reactions to cold or heat. And very often, unfortunately, we lose sight of the obvious fact that both the body's defenses and its adaptive capabilities, just like muscle training or memory improvement, can be educated and trained.

A healthy person is distinguished by the presence of a temperature balance in his body, which means that under any external influences, the body temperature remains at a constant level or changes very slightly. This is achieved by a balanced change in the intensity of heat transfer and heat production processes. The impact of extreme factors (in this case, extreme temperatures) causes emotional temperature stress in the body.

Hardening helps the body get past this kind of emotional stress by bringing the body into a state of balance. It is training and only training using any methods of hardening that improves the functioning of the thermoregulatory apparatus and expands the possibilities of adapting the body to changing temperature conditions.

In a non-hardened organism, even a short cooling disrupts the processes of thermoregulation, which leads to an excess of heat transfer processes over heat production processes, and this is accompanied by a progressive decrease in body temperature. In this case, the vital activity of the so-called conditionally pathogenic microorganisms is activated and, as a result, a disease occurs.

A hardened person is distinguished by the fact that even prolonged exposure to cold does not violate his temperature homeostasis (constancy of body temperature). In such an organism, when cooled, the processes of heat transfer to the external environment decrease and, conversely, the mechanisms that contribute to its production increase, metabolism increases, which ensures the normal course of physiological and biochemical processes in the body.

The physiological essence of hardening is, therefore, in the improvement of thermoregulatory mechanisms. At the same time, a high coherence of the processes of heat production and heat transfer is achieved, which ensures adequate adaptation of the whole organism to environmental factors.

Hardening is, first of all, the skillful use of the physiological mechanisms of protection and adaptation of the body, created in principle by thousands of years of evolution. It allows you to use the hidden capabilities of the body, mobilize defenses at the right time and thereby eliminate the dangerous influence of unfavorable environmental factors on it.

In the broad sense of the word, this is a conscious regulation and restructuring of the thermoregulatory system of the body, aimed at increasing the potential of a person to resist the action of adverse environmental factors by more quickly and effectively turning on all the links that make up the functional system of thermoregulation. In the process of hardening, the coordination connection between the individual functional systems of the body is improved, due to which the most perfect adaptation to changing environmental conditions is achieved.

air hardening

An important and exclusive feature of air procedures as a hardening agent is that they are available to people of different ages and can be widely used not only by healthy people, but also by those suffering from certain diseases. Moreover, in a number of diseases (neurasthenia, hypertension, angina), these procedures are prescribed as a remedy.

This type of hardening must begin with the development of a habit of fresh air. “Fresh air not only preserves life, but also observes health,” wrote S.G., an outstanding Russian doctor of the 18th century. Zybelin.

The beneficial effect of fresh air on the body, its importance for maintaining and strengthening health has been proven by many years of experience of many people. The great Russian artist I.E. Repin did gymnastics every day, worked in the garden every morning, and always took walks before going to bed. According to the memoirs of contemporaries, he slept all year round in a room where wooden bars were inserted instead of glass, and in winter he slept in a sleeping bag. I.E. Repin lived to a ripe old age and retained his mental and physical performance until the end of his days.

Another Russian artist V.D. Polenov in a letter to I.I. He wrote to Levitan: “Of course, come to us to breathe ozone, which is just a lot from melting snow. I, too, am a sick person and suffer from the same ailment (neurasthenia. - V. M.) as you ... The main medicines - it is clean air, cold water, a shovel, a saw and an axe."

And the famous therapist G.A. Zakharyin believed that fresh air is "a means to improve health, surpassing all others in its effectiveness," and at the end of the last century he urged everyone to stay outside the city as much as possible. The great Russian commander A.V. Suvorov "walked naked for several hours in order to accustom himself to the cold and overcome the weakness of his nature. With this habit and dousing himself with cold water, he, one might say, tempered his body from the influence of bad weather," wrote one of his contemporaries.

Walking in the fresh air is of great importance for health promotion. “Walking to a certain extent enlivens and inspires my thoughts,” said the French philosopher Jean Jacques Rousseau, “Remaining at rest, I cannot think, it is necessary that my body be in motion, and then the mind also begins to move.” The same thought was expressed by Goethe: "Everything most valuable in the field of thinking, best ways expressions of thought come to my mind when I walk. " L.N. Tolstoy loved walking. When he was 60 years old, he walked in six days from Moscow to Yasnaya Polyana.

And how not to remember the pages of I. Pavlenko's novel "Happiness". Addressing the hero of the novel, the doctor says: "... Your illness requires a simple cure - air. More of it - both in reality and in a dream. You need to blow yourself through, wash every cell of your body with fresh air ... Eat in the open air. And sleep by all means ... So, start taking air in the most unlimited doses.

The hardening effect of air on the body helps to increase the tone of the nervous and endocrine systems. Under the influence of air baths, digestion processes improve, the activity of the cardiovascular and respiratory systems improves, the morphological composition of the blood changes (the number of red blood cells and hemoglobin increases in it). Staying in the fresh air improves the overall well-being of the body, influencing the emotional state, causes a feeling of cheerfulness, freshness.

The hardening effect of air on the body is the result of a complex effect of a number of physical factors: air temperature, humidity and mobility (direction and speed of air movement). In addition, especially on the seashore, a person is also influenced by the chemical composition of the air, which is saturated with salts contained in sea ​​water.

According to temperature sensations, the following types of air baths are distinguished:

hot (over 30°),

warm (over 22°),

indifferent (21--22°),

cool (17--21°),

Moderately cold (13--17°),

cold (4--13°),

very cold (below 4°).

It should be borne in mind that the irritating effect of air affects the skin receptors the sharper, the greater the difference in skin and air temperatures:

Cool and moderately cold air baths have a more pronounced effect. Taking increasingly cooler air baths for the purpose of hardening, we thereby train the body for low ambient temperatures by activating compensatory mechanisms that provide thermoregulatory processes. As a result of hardening, first of all, the mobility of vascular reactions is trained, which act as a protective barrier that protects the body from sudden changes in external temperature.

Warm baths, while not providing hardening, nevertheless have a positive effect on the body, improving oxidative processes.

Humidity in combination with fluctuations in its temperature can have different effects on the processes of thermoregulation. Each of us knows that air of the same temperature can be perceived by a person as either colder or warmer. Water vapor, which is saturated with moist air, having a higher specific heat capacity, conducts heat better than dry air. Therefore, at a higher relative humidity and low temperature, a person gives off more heat to the environment, and his feeling of cold is more pronounced than at the same temperature and low humidity.

The intensity of evaporation of moisture from the surface of the skin and lungs depends on the relative humidity of the air. In dry air, a person easily tolerates much higher temperatures than in moist air. Dry air contributes to the loss of moisture from the body. In air saturated with water vapor, evaporation either sharply decreases or completely stops. A person does not feel well in humid air even at a relatively low ambient temperature (20 °). High air humidity combined with high ambient temperature due to a violation of the process of evaporation of sweat from the skin can lead to overheating of the body.

When taking air baths, air mobility (wind) is also important. The wind affects the body due to its strength and speed, and its direction also matters.

It is known that in cold, but calm weather, it is warmer than in warmer, but with wind. This is due to the fact that in still air around the human body an air layer is formed, which quickly heats up to skin temperature, is saturated with water vapor and prevents heat transfer to the environment.

When air moves, the air shell is "blown away", more and more particles of the surrounding cold air come into contact with the skin, and additional heat is required to heat them. By blowing away the boundary layer of air saturated with moisture, the wind brings new layers of drier air into contact with the skin, which increases the rate of evaporation. Water vapor, evaporating from the surface of the skin, takes away heat and thereby lowers the temperature even more. skin. In this case, the feeling of cold intensifies. Thus, the wind, contributing to the enhancement of heat transfer by the body, increases the cooling power of the air.

Damp air and wind in any weather significantly enhance the cooling effect of the air, significantly increasing the loss of heat from the body. It should be borne in mind that subjective sensations under the action of wind on the body may occur later than the onset of the corresponding reaction from the heat-regulatory processes. These sensations arise as a result of noticeable heat losses, especially if, simultaneously with the wind, other external factors also have an adverse effect on the body.

Air procedures for the purpose of hardening can be used either in the form of a dressed person being outdoors (walking, sports activities), or in the form of air baths, in which there is a short-term effect of air of a certain temperature on the naked surface of the human body.

Tempering children with air

Hardening by air is the most accessible and effective method of improving the health of children. Children are more sensitive to fresh air than adults and their need for oxygen is 2 s. once again higher. Children who spend a lot of time in stuffy, poorly ventilated rooms are usually lethargic, irritable, pale and often complain of headaches and abdominal pain, they have poor appetite.

It is necessary to start hardening with the fact that the room where the child is located must be systematically and thoroughly ventilated. In order to avoid the influx of cold air into the room in the presence of a child, the window should be curtained with two or three layers of gauze. However, regardless of weather conditions, the child's room must be ventilated before going to bed for 10-15 minutes, and it is even better to teach the child to sleep with the window open.

In the room where children are located, the following air temperature should be maintained: for infants- plus 20 - 22 °, for children from one to three years old - plus 18 - 19 °. Higher temperatures cause increased sweating in children, and they become whiny and moody. It is necessary to protect the air of the room where the children are from pollution. And it is absolutely unacceptable not only in the nursery, but also in the apartment smoking.

To ensure the comfort of the child, it is important not only to maintain the optimum air temperature, but to dress him accordingly. You can’t wrap a child at home, this can lead to overheating due to imperfection of thermoregulatory processes. Increased sweating, which in this case will occur, even with a small influx of fresh air, can lead to a cold. Therefore, a timely change of clothes prevents excessive hypothermia or overheating of the body.

We must strive to ensure that the child spends as much time as possible outdoors, in the fresh air. In this regard, walking and sleeping in the fresh air are of great general strengthening importance.

Daily walks in any weather should be an indispensable part of the regimen for every child, regardless of age. "A day spent by a child without a walk is lost for his health," wrote G.N. Speransky. Walking strengthens the nervous system, improves blood circulation, hardens and protects against rickets, and improves appetite. Walks and excursions, country trips, in addition to a general strengthening effect, also have a general emotional impact, which in itself enhances the effect of fresh air on the body.

A child born in the summer can be taken out for a walk from the first days of life, if the air temperature is not lower than 12--15 °. If the child was born in the cold season, for the first time he should be taken out for a walk in the third or fourth week at an air temperature not lower than -5 °. Before walking, such a child is gradually accustomed to the cold. To do this, he is dressed as if for a walk on the street, but placed in a crib or stroller near an open window or transom. In the early days, the walk should last no more than 10 minutes. Over time, its duration increases to 30-45 minutes. Winter walks should begin on clear and quiet days, and in the future you should walk with him in any weather.

Children of the first two or three months are taken out into the street at an air temperature of at least -10 °. On cold days, it is better to take walks with them twice a day for 20-30 minutes each. In the warmer season, children of this age can stay outdoors for 45-60 minutes or more.

At the age of three to six months, the child should also walk twice a day, but the duration of walks can be longer - from 1 to 2-3 hours. The ambient temperature must be at least -15°.

With two or three-year-old children, at an air temperature of minus 15--16 °, they usually walk twice a day. In areas with more cold winter, but with less humid air on calm days, the child can be outdoors and at a lower temperature.

Older preschoolers and schoolchildren should be outdoors for at least 3-4 hours in winter.

A child for walks should be dressed according to the weather to ensure freedom of movement and the necessary thermal comfort. Too warm clothes interfere with proper perspiration, delaying the evaporation of sweat from the surface of the skin. In addition, excessive wrapping leads to effeminacy and lethargy, and such a child can get sick even from the slightest breeze.

Daytime sleep in the open air is very useful: on a veranda or in a garden, in a room well ventilated, and with an open window, regardless of the season. In the middle lane, daytime sleep in the open air can be carried out even in frost (at a temperature of minus 10--15 °, but in the absence of wind).

Clothing, as well as when walking, should be appropriate for the weather and season. IN winter time the child can be laid on the veranda in a sleeping bag, leaving the face uncovered. If the child sleeps in the room, then the need for a sleeping bag disappears.

In the cold season, he should be dressed in flannelette pajamas or a shirt, and in summer - in light underwear with short sleeves. As soon as the child is put to bed, you need to open the window or window, which will accelerate the onset of deep sleep. 15-20 minutes before the rise, the window can be closed so that the air in the room warms up.

Thus, thanks to walks and sleep in the fresh air, the child is in the open air 4-5 hours a day.

A strong hardening agent for children are air baths, which can be carried out all year round. Baths are partial and shared. The action of air baths is the more effective, the lower the air temperature, the faster its movement and the longer the bath time. However, those who first begin hardening should be careful when taking air baths.

As a hardening agent, air baths are used for children from the age of two months. The baby begins to take the first air baths already at the moment when the mother changes diapers. In this case, the child can be left naked for 1-2 minutes, but while playing with him, encourage him to active movements. It is necessary to watch that at this time the child's body remains pink and warm. The optimum temperature for such an air bath is + 22 °.

Some time later, the duration of the bath for him can be increased from 1-2 (2-3 times a day) to 10-15 minutes (4 times a day).

In summer, an infant can take air baths outdoors. To do this, the crib or stroller where he lies is placed in a place protected from wind and direct sunlight. During the bath, the child must be turned over several times. At a temperature of 20-22 °, the bath is taken for 3-5 minutes, gradually bringing it up to 20-30 minutes.

Air baths for children older than a year are prescribed at an air temperature of at least 20 °, with a gradual decrease in it to 18 °. The first air baths spend 3-5 minutes, increasing their duration for two to three-year-old children up to 45-60 minutes.

hardening by the sun

The use of sunlight as a hardening and healing agent has been known since ancient times. This procedure was widely used by Hippocrates, Galen, Celsus. And the outstanding Tajik doctor Avicenna believed that people exposed to sunlight are better protected from various diseases than those who have been deprived of such an opportunity for a long time.

The sun is a constant source of energy, which spreads in all directions from it at a speed of 300,000 kilometers per second. Before reaching the Earth, solar energy undergoes changes when passing through the earth's atmosphere at a height of 60-70 kilometers: part of the solar energy is absorbed and dissipated by the atmosphere. The percentage of absorption is directly dependent on the thickness of the air layer, the content of water vapor and all kinds of dust.

The biological effect of sunlight on the human body depends on their wavelength.

infrared rays have a pronounced thermal effect on the body. Of the total solar energy flow, 59% of infrared rays reach the Earth. They contribute to the formation of additional heat in the body. As a result, the activity of the sweat glands increases and the evaporation of sweat from the surface of the skin increases: the subcutaneous vessels expand and skin hyperemia occurs, blood flow increases, and this improves blood circulation in all tissues of the body.

When sunbathing, one should not forget that infrared radiation enhances the effect of ultraviolet radiation on the body. Ultraviolet rays have a predominantly chemical effect and a very weak thermal effect. The earth reaches only 1% of ultraviolet radiation from the total amount of solar energy. Nevertheless, it is ultraviolet radiation that plays an extremely important role in the life of all life on Earth.

ultraviolet irradiation has a great biological effect: it promotes the formation of vitamin D in the body, which has a pronounced anti-rachitic effect; accelerates metabolic processes; under its influence, highly active products of protein metabolism are formed - biogenic stimulants.

Influencing the body, ultraviolet rays help to improve the composition of the blood, have a bactericidal effect, thereby increasing the body's resistance to colds and infectious diseases; they have a tonic effect on almost all body functions. All this suggests that ultraviolet rays are extremely important for the body and their reasonable use has a hardening effect, increasing its defenses.

According to A.P. Parfenov, there are practically no absolute contraindications for irradiating a person with sunlight, and talking about the contraindication of sunlight for a person is just as absurd as talking about the contraindication of nutrition and breathing. Only those or other doses of solar radiation can be contraindicated, and the optimal method of sunbathing should be recommended.

Due to the above features of the impact on the body, the sun's rays are a natural healing factor, but their physiological activity is so great that exceeding the permissible doses has a destructive effect on the tissues of the body.

The positive effect of sunlight occurs only with a moderate dose of solar radiation. Those who think that the strengthening effect of irradiation is the higher, the stronger the tan, are completely wrong.

You should not seek a tan, by all means, so as not to damage your own health. It must be remembered that the sensitivity of people to ultraviolet radiation is different: it is determined by the color of the skin and its condition, and also depends on the individual characteristics of each person.

The skin of different people has a different degree of sensitivity to solar radiation. This is due to the thickness of the stratum corneum, the degree of blood supply to the skin and its ability to pigmentation. For example, in fair-haired and fair-skinned people, the skin is highly sensitive to the sun's rays, and, nevertheless, with careful use of sunbathing, they can tan quite well. The skin of people with dark hair and dark skin is less sensitive to sunlight.

In children and the elderly, sensitivity to solar radiation is somewhat reduced. Women are less sensitive to radiation than men. Reduced sensitivity to ultraviolet radiation and weakened by past diseases. Wet skin is more susceptible to radiation than dry skin.

Under the action of ultraviolet radiation, pigmentation of the skin occurs, which, among other things, has a protective value for the body. Pigmented skin reduces its reactivity to repeated irradiations and protects the tissues located under it from infrared radiation, thereby preventing overheating of the whole organism.

water hardening

"Now let's move on to water procedures" - with these words the daily morning exercises on the radio end, and with the same words we begin a new section of the brochure.

Water procedures - the most effective remedy hardening. "Ice water is good for the body and mind," A.V. liked to say. Suvorov. “The washstands were never served to him,” recalled Sergeant Sergeev, who served with A.V. Suvorov, “instead of that, two buckets of the coldest water and a large copper basin in two buckets were brought into the bedroom. For half an hour he splashed water out of the buckets on his face, saying that it helps his eyes. After that, his servants had to pour the remaining water on his shoulders so that the water rolled down in a stream, rolled down his elbows.

Most centenarians, recognizing the important role water procedures in strengthening health, throughout their long lives systematically used them. So, I.P. Pavlov swam in the Neva in any weather until late autumn. "Since childhood, water, the river is everything for me," he confessed to his employees. According to the memoirs of L.S. Pushkin, brother of the great Russian poet, A.S. Pushkin in the winter, "woke up, sat in a bath of ice, and then went to the river running under the mountain."

Water procedures, perhaps, are the most common means of hardening the body. Their effect is determined by the combined influence of thermal, mechanical and physico-chemical factors on the body. Water affects the body through numerous thermo-, baro-, mechano- and chemoreceptors located in the skin. In addition, water procedures in natural conditions have a beneficial effect on visual, auditory and olfactory analyzers. No wonder I.P. Pavlov said: "In general, my strongest emotions are associated with water ... and with its noise and appearance."

Any water procedure causes responses from the body, which are of a general nature. But first of all, it is accompanied by a reaction of the skin vessels, changes in the cardiovascular and respiratory systems.

The effect of water on the body is associated with some of its physical and chemical features: high heat capacity and thermal conductivity, mechanical and chemical influences.

Due to the greater heat capacity, water can take away a large amount of heat from the human body even when the difference between the temperature of the water and the body is small. The specific heat capacity of water is 1. In most objects and substances surrounding a person, the heat capacity is less: for example, the heat capacity of glass is 0.160, and iron is 0.113.

The thermal conductivity of various substances depends on and. density: with a decrease in density, the thermal conductivity of a substance also decreases. The thermal conductivity of water is 28 times higher than the thermal conductivity of air. Therefore, at the same temperature, water seems colder than air. So, according to Soviet scientists Yu.N. Chusova and G.M. Kukolevsky, at plus 13--15 °, the air seems cool to a person, and the water - cold, at + 22 °, the air is indifferent, and the water is cool, at + 33 °, the air is warm, and the water is indifferent.

Therefore, a general air bath at a temperature of plus 26--27 ° is pleasant and can be long. Water of this temperature for a long bath is unacceptable, as it is too cold and can be used only in the form of short-term procedures (pouring, bathing in a pond), and in combination with active movements.

If the human body is exposed to water under some pressure (shower, bathing), then its mechanical effect on the body also becomes important.

When bathing in sea water, the human body also perceives its chemical effects due to various salts and gases dissolved in it.

When using water procedures as a hardening agent, the temperature of the water is of the greatest importance. The perception of thermal irritation of water, according to I.M. Sarkizova-Serazini, depends on:

the difference between the temperature of the skin and water, while the higher this difference, the stronger the irritation;

The size of the body surface and the place of exposure to water on the body (as we have already noted, the temperature of human skin in different parts of the body is different, therefore, the perception of a thermal stimulus will be different);

suddenness, speed and duration of temperature exposure;

recurrence of irritation;

The functional state of the body and its individual characteristics.

According to the temperature sensation, water procedures are divided into hot (over 40 °), warm (35--40 °), indifferent (33--35 °), cool (20--33 °) and cold (below 20 °).

You can start hardening with water at any time of the year, starting with the simplest and most affordable at home (wiping, dousing, foot baths), and not stop it throughout the year.

Since water procedures are diverse in strength and nature of their effect on the body, this makes it possible to choose the one that is most favorable for a person. Hardening with the help of water procedures provides for the exclusion of sudden irritations of the body through the action of low temperature water on it. It requires gradual getting used to the water and a gradual decrease in its temperature. The initial temperature of the water should be such that the recipient of the water procedure endures it completely calmly, without irritation. People in good health and having pre-hardened can start with water at an indifferent temperature. And only by preparing the body, you can gradually reduce the temperature of the water.

3. Features of hardening children

Back in the 18th century, the Russian physician and physiologist S.G. Zybelin wrote: "Education is twofold - bodily and moral." Concerning bodily, or, as they say now, physical, education, he recommended that childhood to promote health water, air, sun and movement.

These views have not lost their relevance today. It is enough to refer to the thoughts of the largest Soviet rheumatologist Professor A.I. Nesterov.

“Among the specific preventive antirheumatic measures for human health, and especially for children, hardening of the body in relation to external temperature influences: cooling, drafts, etc., is of primary importance,” he writes. “It is precisely the increase in the stability and resistance of the body from early childhood through the maximum use of fresh air and water, hardening of the body, physical culture, physical labor, sports, observance of the Rules of personal hygiene (showers, baths, rubbing), home hygiene (fresh air, dust control in the air of dwellings), labor hygiene is the basis for preventing rheumatism and those foci of infections that precede its development.

A hardened child is able to withstand sudden and prolonged cooling, he freely tolerates exposure to solar radiation, becomes better adapted to sudden transitions from heat to cold, to physical exertion, etc.

When starting to harden a child, it is necessary to remember some anatomical and physiological features of his body. When carrying out hardening procedures that create a certain load on the child's body, it is necessary to take into account the adaptive capabilities of its physiological functions.

Thermoregulation in children of preschool and primary school age is not yet sufficiently developed. The fact is that they have a relatively large surface of the Skin with a small mass. This factor, combined with a large number of superficially located blood vessels, contributes to a higher heat transfer than in adults, which in some cases is fraught with rapid hypothermia of the body, in others - overheating of the child's body.

Proper hardening of children should be taken care of from a very early age, and then continued without interruption in toddler, preschool and school age. In this case, a positive effect can be achieved only with strict adherence to the basic principles of hardening.

When hardening children, parents require sufficient patience and maximum perseverance. However, this persistence should by no means be coercive.

Hardening of children can be started at any time of the year, but it must be carried out all year round. Soviet pediatrician A.A. Kissel wrote about this: "In terms of improving the health of children, winter is more important than summer. Our short summer is completely insufficient to improve the health of children. We can say that summer is for the soul, and winter is for health." When choosing a hardening procedure for a child, one should take into account his individual characteristics: the state of the body, the nature of physical and mental development, and the reaction to the environment. The condition of the child is assessed based on his age and previous illnesses.

Hardening should be started only when the child is healthy. However, the opinion is completely erroneous that hardening is contraindicated for children who are weakened, often ill, with reduced appetite and restless sleep. On the contrary, hardening procedures carried out under the supervision of a doctor contribute to health promotion.

Temperature map of the body of a newborn child.

Parents need to remember that constant monitoring of the health of children is required. Advice on hardening children, especially young children, can be obtained in the office of a healthy child, which exists at every children's clinic.

Polyclinic doctor, having studied characteristics the child, his development, will establish the dosage of all types of hardening. If the baby goes to a nursery or kindergarten, then parents should agree on the methods of hardening him with the doctor of the preschool institution so that there are uniform approaches to this important and necessary matter.

Naturally, water, air and sun are widely used to harden a child. At the same time, their harmonious combination is the most effective.

Sun exposure of a child

The hardening effect of sunbathing, as was indicated, is associated with exposure to ultraviolet radiation on the body. It is these rays that increase the body's defenses and allow it to resist colds. They are also an important means of preventing and treating rickets.

When using sunbathing, one should not forget that the body is simultaneously affected by the total flow of solar radiation, consisting of direct, scattered and reflected rays. At the same time, the intensity of the effect of scattered solar radiation on the body will be different in different time day. At noon on a clear sunny day, its biological and therapeutic and prophylactic effect is not inferior to direct sunlight, and in the morning and evening hours it is 1.5-2 times higher than them.

The impact of solar radiation on the child's body depends on his condition, the method of irradiation and the meteorological conditions in which the irradiation occurs. Together, these factors determine the body's response to exposure to sunlight. It is especially important to take into account the principle of gradualness, that is, the time spent in the sun in order to get a tan should increase gradually. Passion for sunbathing, too long exposure to the sun can only weaken the child's body, lead to overheating.

If a child develops lethargy, a sharp reddening of the face, increased sweating and headache, sunbathing should be stopped immediately. With general malaise, increased nervous excitability, malaria, tuberculosis, thyroid disease, cardiovascular diseases, disorders of the gastrointestinal tract, sunbathing is generally contraindicated.

Sunbathing should not be carried out by children in the same way as adults. Meanwhile, one has to watch how small children are on the beach with adults under the scorching rays of the sun. It is unacceptable. Children under one year old in the summer should be in the "sun shade", or, as they say, in the "lace shade" of trees at an air temperature of at least 20--23 °.-

Children over a year old begin to take sunbaths at an ambient temperature of 19--20 °. The first sun baths last 3-5 minutes. Subsequently, their duration is brought to 20-30 minutes. Sunbathing by children should be combined with quiet play. Do not forget to cover your head with a white panama.

After sunbathing, water procedures are useful - wiping, douching, showering, bathing. The positive effect of sunbathing on the child's body is reflected in a good, cheerful mood, calm and sound sleep, excellent appetite.

In winter, in order to strengthen the body of children, it is advisable to use artificial irradiation with ultraviolet rays of a mercury-quartz lamp.

Rubbing for hardening children

Rubbing can be started from the age of five months. This is a rather gentle and most simple water procedure. Younger children need to be prepared for wiping with water, for which, for 7-10 days, their body is rubbed with a flannel mitten. First, rub the arms and legs towards the heart, then the neck, chest, stomach, back. Rubbing with water is usually carried out in the morning after waking up, using the edge of a towel moistened with water and wrung out.

Immediately after wiping any part of the body, it is rubbed to a slight reddening with a dry soft towel, and only after that they begin to wipe the next area. The whole procedure should take 3-5 minutes.

Begin wiping with water heated to 35--36 °. Every 5–7 days it is reduced by 1° and adjusted for children of the first year of life to 28–30°.

Sponging of preschool children begins with a water temperature of 32--33 °, gradually bringing it to room temperature, but not lower than 16--17 °. The air temperature in the room during the procedure should be at least 20 °. Sometimes table salt is added to the water used for wiping (at the rate of one or two teaspoons per glass of water).

If, for any reason, there was a short break in taking the procedure, then it is resumed from the same water temperature that was during the last procedure. After a long break, the rubdown is resumed with a higher water temperature.

For schoolchildren, the initial temperature of the water during rubbing should be 28--30 °, and the final one should be 15. Pouring for hardening children

Douches, which can be carried out from the age of one, are started after preliminary preparation of the child by rubbing for two to three weeks.

Douche is carried out so that water flows in a wide stream over the body. When dousing the head, it is not necessary to wet it, since even with the most thorough wiping of it, the hair remains wet for some time and the evaporation of water can cause cooling of the body. The duration of dousing is 1-2 minutes. At the end of the procedure, the child is wiped with a towel and the body is rubbed to a slight reddening.

Children aged from one to three years begin to pour water at a temperature of 35--36 °, reducing it every five to seven days by 1 °; for a two-year-old child, the final temperature will be 25--28 °, and for a three-year-old - 24--25 °. For preschoolers, the water temperature can be reduced to 20 - 22 °, and for children six to eight years old - even up to 18 °.

Pouring is done from a watering can, jug or bucket. 16 ° (every two or three days the water temperature must be lowered by 1 °).

Carrying out air baths is useful to combine with gymnastic exercises, outdoor games. The most favorable time for taking air baths is between 8 and 18 hours. They should be taken no earlier than 1.5 hours after eating.

You can not take air baths to chills. At the first signs of cooling (the appearance of "goosebumps", trembling of the lips) or lethargy, the air bath should be stopped and the child should be warmed up quickly. After taking air baths, the child should be cheerful and cheerful.

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HARDENING CHILDREN AND ADOLESCENTS
When carrying out hardening, it is necessary to observe a number of conditions: systematic and gradual, take into account individual characteristics, health status, age, gender and physical development; use complexes of hardening procedures, that is, use a variety of forms and means (air, water, sun, etc.); combine general and local influences.

In the process of hardening, schoolchildren exercise self-control, and parents monitor the child's reactions to hardening procedures, evaluate their tolerance and effectiveness (Table 5).

Means of hardening: air and sun (air and sun baths), water (showers, baths, gargling, etc.).

The sequence of hardening water procedures: wiping, dousing, taking baths, swimming in the pool, rubbing with snow, etc.

When starting to harden children and adolescents, it must be remembered that children have a high sensitivity (reaction) to a sharp change in temperature. An imperfect thermoregulatory system makes them defenseless against hypothermia and overheating.

You can start hardening at almost any age. It is better to start in summer (Table 6) or autumn (Table 7). The effectiveness of procedures increases if they are carried out in an active mode, that is, in combination with physical exercises, games, etc.

In acute diseases, it is impossible to carry out hardening procedures!

Table number 5

Diary of self-control in the process of hardening a student

I.O.___________________ Age ____________ Gender ___________

Indicators	Impact assessment and dosage	date
	continuous, Intermittent Calm
State after sleep	Good, upbeat Lethargy, drowsiness
The desire to temper	strong Don't care
Hours of hardening	Morning, afternoon, evening
hardening frequency	Daily, every other day, occasionally
Types of hardening	Air (or sun) bath, wiping, dousing, bathing, bathing or showering, swimming, bathing (sauna), walking barefoot, rinsing the mouth, etc.
Duration	In minutes, seconds
Exposure temperature	Low, high, medium
Additional hardening factors	Rubbing the skin, massage (self-massage), exercise, UVI, etc.
Mental and physical performance	Good, usual, fast fatigue, unwillingness to do this or that work
Additional data	Measurement of body temperature, heart rate and blood pressure.

Winter swimming is dangerous for the health of children and adolescents. It leads to serious diseases (pyelonephritis, pneumonia, bronchitis, prostatitis).

Hardening has a general strengthening, healing effect on the body, improves physical and mental performance, improves health, reduces the number of colds by 2-5 times, and in some cases completely eliminates their occurrence and exacerbation.

hardening is a set of the following activities:

1. Regulation of room temperature at home and at school. The intermittent temperature is shown. For schoolchildren of younger and middle age, the amplitude of fluctuations of 5 - 7 ° C will be optimal, for older students 8-10 ° C.

2. Use of heat-shielding properties of clothing. Students must be dressed appropriately for the ambient temperature. Thermoregulation of the body ensures the maintenance of thermal equilibrium only within relatively small limits. With active movements (games), the muscles produce a large amount of heat, which, accumulating, leads to overheating of the body. At rest (rest), cooling (hypothermia) occurs, which can lead to a cold. If the games are played outside, especially in windy weather, then excessively warm clothing does not allow the body to cope with temperature changes, and adversely affects health.

3. Conducting large school breaks in the open air, on the move.

4. Stay in the open air (walks, games, etc.). Outdoor activities are a powerful health factor. The tempering effect occurs if the clothes correspond to the weather conditions. Duration of stay in the air - 3-3.5 hours for primary school students; 2.5-3 hours for grades 6-8 and 2-2.5 hours for high school students.

Walks relieve fatigue, psycho-emotional overload, blood is better enriched with oxygen, brain function improves, the child sleeps better.

Specialists have developed special methods for carrying out hardening procedures. Here are some of them.
sunbathing , ultraviolet irradiation (UVI). The sun's rays are a potent remedy that cannot be neglected, it must be strictly dosed:

Sunbathing is taken no later than 1 hour before meals and no earlier than 1.5 hours after meals. You can't take them on an empty stomach.

Table No. 6

A complex of hardening procedures in the summer

hardening factors	Dosage and temperature of hardening procedures
	preschool age		School age
Air baths	Air temperature	From 22 0 -24 0 С up to 18 0 -20 0 С	From 18 0 -22 0 С up to 18 0 -16 0 С
Solar air baths	Duration	5 min to 25 min	10 min to 35 min
Rubdown	Water temperature	From 32 0 C to 28 0 C 18 0 -22 0 С	From 32 0 C to 22 0 C From 18 0 to 20 0 С
Pouring	Water temperature Ambient temperature Duration	From 32 0 С to 18 0 -20 0 С 18 0 -22 0 С 10-15s	From 32 0 С to 18 0 -16 0 С From 18 0 to 22 0 С 15-35s
Pouring feet	Water temperature	From 30 0 to 16 0 С	From 28 0 to 16 0 -14 0 С
Swimming in open water	Water temperature not below Air temperature Duration	not lower than 24 0 C from 3 min to 10 min	Not lower than 18 0 -20 0 С Not lower than 20 0 -22 0 С From 5 min to 20 min.

When sunbathing, protect your head from direct sunlight. Sunbathing is best taken in motion - walking, playing, rowing, etc. After taking a sunbath, it is recommended to swim or take a shower and go into the shade.

In this case, it is necessary to take into account the individual characteristics of each child, to constantly monitor his well-being (severe reddening of the skin, profuse sweating require an immediate cessation of sunbathing).

An indicator of the effectiveness of sunbathing is the well-being of the child.

The optimal time for sunbathing is in the morning: in the southern regions - from 7 to 10-11 hours, in the middle lane - from 8 to 12 hours, in the northern regions - from 9 to 13 hours. To adapt the body to the sun's rays, it is advisable the first 2-3 day is in the shade in the nude. After that, you can take sunbaths.

Table number 7

A complex of hardening procedures in the autumn period

hardening factors	Dosage and temperature	school age
Air baths	Air temperature Duration	From 20 0 -18 0 С to 16 0 -14 0 С 10-45 min
Walks and outdoor games	Duration	3-3.5 hours
Sleep in the air (on the veranda)	Duration	From 1 hour to 2.5 hours
Rubbing with water	Water temperature Ambient temperature Duration	From 32 0 -30 0 С to 16 0 -14 0 С 18 0 -22 0 С 30 to 80 sec.
Pouring	Water temperature Ambient temperature Duration	From 28 0 -26С to 16 0 -14 0 С 18 0 -22 0 С 15 to 20 sec.
Pouring feet	Water temperature Duration	From 28 0 C to 12 0 C From 5 sec to 15 sec.

The duration of sunbathing: the first bath - 5 minutes, the second - 10, the third - 15 minutes, etc. The total duration of a sunbath is no more than 1 hour. For weakened children, this time is reduced.

Compliance with these rules is important because the abuse of sunbathing can cause serious disorders in the body - sun and heat stroke, burns, CNS disorders (sleep disturbance, excitability, etc.).

Contraindications for sunbathing: fever, catarrh of the upper respiratory tract, acute pneumonia, exacerbation of kidney disease, heart disease, etc.

In the autumn-winter season, it is possible to use ultraviolet radiation in solariums or at home from quartz lamps. For children prone to colds, quartzing of the feet and taking ascorbic acid are useful.

Contraindications to sunbathing (or UVI) for adults are: mastopathy, uterine fibroids, hypertension II-III stage, myocardial infarction and various oncological diseases.

Air baths take at an air temperature not lower than 16 ° -18 ° C, first for 5-10 minutes, then bring it to 12 ° C by the 25th minute. Air hardening must be combined with physical exercises, games, etc. When using air baths, certain rules must be observed:

air baths are taken an hour before lunch or 1.5 hours after;

air baths can be taken at almost any time;

the bathing place should be protected from harsh winds;

take no more than one air bath per day;

during the procedure, it is necessary to control the well-being of schoolchildren.

Water procedures - more intense hardening agents. The main factor in hardening here is the temperature of the water. Start hardening with water should be in summer or autumn. It is better to harden in the morning after sleep and morning exercises (gymnastics) or cross-country. The air temperature should be 17°-20°C, and water - 33°-34°C. Then the water temperature is reduced every 3-4 days by 1 degree. During the procedures, there should be no discomfort and chills. Below are the most accessible and common methods of hardening with water.

Hardening of the nasopharynx - gargling with cool, and then cold water. In cold weather, you should breathe through your nose, this excludes cooling of the tonsils and throat. The air passing through the nasopharynx is warmed.

Pouring feet made from a watering can or jug. Water temperature - 28°-27°C, every 10 days it is reduced by 1-2 degrees, but not less than 10°C. Then the feet are wiped dry. Usually this procedure is carried out in the evening before going to bed.

Foot baths . The legs are immersed in a bucket or basin of water. The initial temperature is 30°-28°C, the final temperature is 15-13°C. Every 10 days it is lowered by 1-2 degrees. The duration of the first foot baths is no more than 1 minute, and at the end up to 5 minutes. After the bath, the feet are wiped dry and rubbed.

Contrasting foot baths. Two buckets or basins are taken. Hot (temperature 38-42°C) is poured into one bucket (basin), and cold (30-32°C) water is poured into the other. First, the legs are immersed for 1.5-2 minutes in hot water, then for 5-10 seconds - in cold water. This change is made 4-5 times. Every 10 days the temperature of cold water is reduced by 1-2 degrees and by the end of the course is brought to 15-12°C.

Walking barefoot - one of the oldest methods of hardening. Recommended in summer and autumn. The duration of walking depends on the temperature of the earth (you can walk on the dew, along the river or sea). At home, walk on a rug previously moistened with cold water. It is also useful to walk barefoot in the snow after visiting the sauna (bath), followed by a visit to the steam room and warming up the legs (pour hot water into the basin and lower the legs into it for 1-2 minutes).

Rubdown - the initial stage of hardening with water. To do this, use a soft mitten or a terry towel dipped in cold water. Wipe sequence: arms, legs, chest, abdomen, back. The direction of movements is from the periphery to the center, along the neurovascular bundle.

The water temperature drops every 10 days by 1-2 degrees. For younger schoolchildren, the initial temperature in winter is 32-30°С, in summer - 28-26°С, the final temperature is 22°-20°С and 18°-16°С, respectively. For schoolchildren of middle and older ages in winter it should be 30°-28°C, in summer - 26-24°C, the final temperature, respectively, 18°-16°C and 16°-14°C. Rubbing is recommended to be done in the morning after exercise, followed by rubbing the whole body with a dry terry towel. Air temperature - 15°-16°С.

Pouring over the torso - the next stage of hardening. Start with water at room temperature, reducing it gradually to 20°-18°C. Pouring is done from a jug or watering can. It is not recommended to pour over the head. The initial water temperature for younger schoolchildren in winter should not be lower than 30 ° C, in summer - not lower than 28 ° C, the final one, respectively, - 20 ° C and 18 ° C. The decrease should occur gradually every 10 days. For schoolchildren of middle and senior classes, the water temperature in winter is 28°C, in summer - 24°C, the final temperature is 18°C ​​and 16°C, respectively.

After dousing, dry the body with a terry towel.

Swimming in open water - one of the best and most powerful ways of hardening (sea, river, lake, pond). When carrying out the hardening procedure, it is necessary to ensure the safety of children and follow a number of rules:

bathing should be no later than 1 hour before meals or 1-1.5 hours after;

in the water you need to actively move (swim, do some exercises);

do not enter the water sweaty, hot or in an unhealthy state;

water temperature should be - 20°-22°C and air - not lower than 24°C.

After bathing, the body is wiped dry with a terry towel, if “goosebumps” appear, then the body should be rubbed with a towel and put on dry warm underwear.

The duration of bathing is determined by the temperature of water and air. The lower the water temperature, the less you should be in the water.

Rubbing with snow or swimming in cold water (winter swimming). Walking in the snow and rubbing with snow when visiting a bath (sauna) is possible only for hardened children. Winter swimming for children and adolescents is an undesirable procedure, since their thermoregulation system is still imperfect, and exposure to low (winter swimming) or high (sauna) temperatures leads to various diseases (kidneys, lungs, endocrine glands, etc.).
Developed by a teacher of additional education MOU secondary school No. 4 M.G. Ilyenko for work with parents Based on the materials of the monograph "HOW TO PRESERVE AND STRENGTHEN HEALTH", Brook T.M. - Doctor of Biological Sciences, Professor Bahrakh I.I. - Doctor of Medical Sciences, Professor, Honored Worker of the Higher School of the Russian Federation

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