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This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

The nomenclature of digestive diseases in children was supplemented by the "new" diseases: of esophagus--gastroesophageal reflux disease (GERD), Barrett's esophagus, Zenker's diverticulum; of stomach and duodenum--gastroduodenitis, peptic ulcer disease, polyps, ectopic pancreas in the stomach wall; of the intestine--jejunitis, ileocolitis, Crohn's disease, celiac disease, bacterial overgrowth syndrome in the small intestine; of biliary tract--cholelithiasis, gallbladder cholesterosis, anomalies of the biliary tract; of pancreas--acute and chronic pancreatitis, annular pancreas (2). The features of gastrointestinal diseases in children experiencing the action of factors, not always positively affecting the growing organism, were established. These features include: presence of allergic background; high level of neuro-autonomous and psycho-emotional changes in modern children, not only in schoolchildren, but even in preschoolers; polymorbidity or a combination (syntropy) of lesions of the digestive system; adverse outcomes of certain diseases as chronization, complications development, and as a consequence--a high risk of disability in children; "rejuvenation" of certain diseases of the digestive system (cholelithiasis, gallbladder cholesterosis, Crohn's disease), typical for adults. It is important to emphasize the clinical and social importance of gastroenterological diseases in childhood. Axiomatic is that the origins of many diseases of the digestive organs in adults lie in childhood. Early manifestation of certain diseases such as peptic ulcer disease, gluten enteropathy, Crohn's disease, and others, significantly impact the quality of life of sick children and their parents. It is worth to emphasize high costs of medical and prophylactic (tertiary prevention) activities using the drugs of latest generations. All this causes problems in both applied and scientific pediatric gastroenterology.

The number of medical errors is increasing. Medical errors have negative impact on the professional activities of physicians. Analysis of the causes and incidence of medical errors and conflicts in clinical practice of foreign and domestic doctors is presented based on the author's observations and didactic materials recommended for training doctors to prevent conflict situations in their professional work and for developing a common strategy for the prevention of medical errors.

The development of prophylactic treatment is one of most challenging and socially significant aspects of modern pediatrics. Today, a great variety of natural and artificial physical factors are employed to protect and/or restore the health of the children and to improve it. The broad scope of non-medicamentous technologies used for the purpose makes it possible to elaborate prophylactic programs adapted to the specific requirements of individual patients at all levels of medical care including therapeutic and prophylactic, spa and resort institutions, educational institutions, health improvement and recreational camps of different types, and home care.

The authors analyzed and assessed the actual state-of-art related with the preventive activities undertaken by pediatric clinics. It was established that the practitioners, medical personnel and parents were poorly informed on the issues pertaining to the development and education of small and pre-school children. The actual preventive-aid measures, now available at pediatric clinics, and their real value were found to make 25-30% of the total activity of a district pediatrician. A quality evaluation coefficient applicable to prevention was elaborated and introduced into the operation of pediatric clinics. The coefficient is calculated with respect to the value of its separate components and it is target at the final result in the activity of the pediatrician and of the pediatric service as a whole, which is child's health. It was calculated for all decreed ages from birth to the age of 6. Its maximum values were registered at an age of 3 months (0.62), 1.5 years (0.61) and of 4 years (0.64). The data are processed by a special soft with a final coefficient value being determined: 0.9-1.0--splendid, 0.75-0.89--goo, 0.65-0.74--satisfactory, 0.64 and less--unsatisfactory. The above method made it possible to promote and expand the preventive activity in case of each children's age.

The paper considers the topical aspects of the health status and sociomedical needs of children and adolescents; it shows it necessary to transform the activity of primary pediatric service facilities at the stage of reforming the country's public health system. The results of one of the largest sociological studies conducted among district pediatricians as to the organization of therapeutical-and-prophylactic and sociomedical and to children are discussed.

Analysis of an anonymous questionnaire given to 100 pediatricians at the postgraduate training department is given. Questions involved routes of infection, early detection, clinical aspects and prevention of tuberculosis in children and adolescents. The most typical aspects of inadequate knowledge of phthisiatrics by pediatricians were defined, which may negatively affect the antituberculosis aid given to children and adolescents. The findings were used for the adjustment of a program and the content of phthisiatrics training at the postgraduate training department.

To perfect extracurricular work of the trainee physicians in acquiring new knowledge and skills in childhood neurology, the pedagogical collective of the Chair of Nervous Diseases have elaborated a definite system of training. Apart from the generally accepted methods, namely the solution of topical and situational problems, the trainees participate in specialized thematic discussions, master manual skills, and so forth. The system elaborated favoured more proper preparation of the childhood neurologist for independent work.