Arztliche Jugendkunde最新文献

Considerations of the essential aspects of establishing diagnosis are explained fro a psychologist's point of view who has the possibility of observing the course of all children with cerebral injury registered early in the district polyclinic. Their qualitative performance parameters are evaluated, especially attention and the mother-child relation. Subsequently, we discuss the courses of development for 130 children who attended a rehabilitation nursery, and refer to constellations of symptoms which rendered it more difficult to establish early diagnoses.

A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.

Close cooperation between paediatricians and dentists is of growing importance for the early diagnosis of malformations and exogenous pathological changes in the oral region and for the furtherance of preventive measures. There are good possibilities especially for preventing caries and periodontal disorders by means of plaque control, nutritional guidance and fluoridation in the context of preventive medical examinations.

The results of the examinations of a representative cross-section were used as the basis for bringing up to date the standard values and ranges of variability of the body measurements of newborns according to gestational age, of head circumference up to the 3rd year and of body height and weight from 0-18 years. Tables and somatograms were also drawn up for the evaluation of body weight in relation to specific types of build, and standard values for skinfold thickness and total body fat were worked out in order to permit a biologically meaningful assessment of the physical development and nutritional status of children and adolescents. Alongside the description of the individual stages in the development of selected characteristics of maturation used in assessing sexual maturity, percentiles for the average age on reaching each of these stages of development will be available, together with a new series of photographs of breast, pubes and genital development.

Psycho-physical presuppositions may be influenced by well planned training. With regard to their individual presuppositions test persons with very low mathematical performances show the best growth of performance after training of mental speed.

Two Bremerhaven growth studies serve as examples for analysing methods of collecting and evaluating data on menarche age. Problems are outlined which arise when inadequate methods are used.

The results of longitudinal investigations of 1,294 girls born in Görlitz in the years 1968 to 1970 included the correlation of their birth weights and menarcheal age with their months of birth. In the process we found very interesting patterns of seasonal distribution. Girls born in January had the lowest, those born in February the highest birth weight on average. Girls born in August reached their menarche at least 4 months later than those born in October. It is conceivable that the season of birth may be much more important to human development than is generally supposed.

Using the official data of WHO statistics, the impact of some social, biological and medical factors on infant mortality rates (IMR) was compared for countries with very high, high, moderate and low IMR: Factors reflecting a low quality of life (illiteracy, low level of women's education, low urbanization, malnutrition etc.) showed a highly significant statistic correlation with increased IMR. The lack of a nationwide family planning program and a low level of medical care (prenatal care, presence of medical personnel during delivery, availability of contraceptives etc.) act in the same direction. In developing countries the GNP per capita did not markedly influence the IMR nor the rate of infants of low birth weight (UGR). One of the main reasons of this phenomenon is probably the wide gap of the income between different social groups in these countries. In contrast to this the GNP in economically developed countries (Europe, Australia, North America) correlates very closely with IMR and UGR. The impact of family planning differs between countries with legally artificial abortion and those with a more restrictive legislation. The nutritional status (i. e. in these countries hyperalimentation) shows a positive correlation with UGR but no impact on IMR. Some countries (in Europe Greece, Spain, Ireland/Yugoslavia, Romania) show a significant deviation (positive/negative) from the mean calculated according to the WHO data. These deviations can be (and should be) analysed for detecting and evaluating factors which could be influenced by strategies of social or/and medical interventions in order of further improvement of IMR.

According to a medical check-up on the whole group of school beginners for one year in the town of Görlitz and considering the results of their first school year, the authors observed that the age on starting school has a very important influence on school achievement. While girls are better able to compensate for developmental retardation, it is advisable to postpone the admission of very young boys for one year in doubtful cases or to provide individual coaching.