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Introdução: O conhecimento do surgimento gradual dos núcleos de ossificação secundários do cotovelo é importante na avaliação de trauma em crianças, possibilitando o diagnóstico de fraturas e luxações ou mesmo descartando estas patologias, fatores estes que influenciam diretamente na decisão do tratamento, evolução e prognóstico da lesão. É amplamente difundido na literatura mundial que a ordem cronológica de aparecimento desses núcleos seja: capítulo do úmero, cabeça do rádio, epicôndilo interno ou medial, tróclea do úmero, olécrano e epicôndilo externo ou lateral, além da idade de seus surgimentos, porém estas informações apresentam certas divergências em diferentes estudos e publicações e sofrem alterações conforme a população estudada. Objetivos: Avaliar a ordem de surgimento e de fusão dos núcleos de ossificação secundários do cotovelo, correlacionar com a idade e gênero e descrever suas características na nossa população. Materiais e Métodos: Foram avaliados pacientes de 0 a 18 anos de idade já submetidos por indicação clínica ao exame de radiografia simples do cotovelo nas Unidade Campus e Unidade de Emergência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP) no período de setembro de 2010 a setembro de 2015. Foram realizadas duas avaliações por 2 radiologistas de forma independente e às cegas com um intervalo de tempo de dois meses entre as leituras. Resultados: Em nosso estudo, observou-se uma tendência do núcleo de ossificação do olécrano surgir antes da tróclea, porém sem significância estatística. Nos pacientes do sexo feminino, notou-se que os núcleos surgem e se unem mais precocemente do que nos pacientes do sexo masculino, com exceção do capítulo e do rádio, além disso os núcleos do rádio e do epicôndilo medial apresentaram uma tendência de surgirem em idades semelhantes. Conclusão: Os núcleos de ossificação do cotovelo surgem e se fundem antes no sexo feminino. Além disso, há tendência do núcleo de ossificação do olécrano surgir antes da tróclea em ambos os sexos, bem como o do rádio e do epicôndilo medial aparecerem em idades semelhante no sexo feminino. / Introduction: The knowledge of the gradual appearance of secondary ossification of the elbow is important in the evaluation of trauma in children, allowing the diagnosis of fractures and dislocations or even discarding these conditions. These factors directly influence the treatment decision, evolution and prognosis of lesions. It is widespread in the literature that these nuclei appear in chronological order which is: the humerus capitellum, radial head, internal or medial epicondyle of the humerus trochlea, olecranon and outer or lateral epicondyle, as well as the age of their appearances. However, these information changes as diverse populations are studied in different studies and publications. Objectives: To evaluate the order of appearance and fusion of secondary ossification of the elbow cores correlate with age and gender and describe their characteristics in the studied population. Materials and Methods: We evaluated patients 0-18 years of age who have undergone a clinical indication to take simple elbow radiography in Campus Unit and Emergency Unit of the Hospital das Clínicas de Ribeirão Preto, University of Sao Paulo ( FMRP-USP) from September 2010 to September 2015. Two independent and blind evaluations were performed by two radiologists with a two-month time interval. Results: In our study, we observed a tendency of ossification nucleus of the olecranon to appear before the trochlea, but without statistical significance. In female patients, it was noticed that the nuclei arise and fuse earlier than in male patients, except for the capitellum and radio. Also, the nuclei of radio and medial epicondyle tended to arise in similar ages Conclusion: The elbow ossification centers arise and fuse before in females than in males. In addition, there is a tendency of ossification nucleus of the olecranon to appear before the trochlea in both sexes, as well as the radio and the medial epicondyle nuclei appear at similar ages in females.

In the qualitative phase of the study, 47 parents in Beijing were interviewed using a design that was unstructured and allowed free conversations and responses. The results are as the following: Confucianism has lost its dominant role in parenting beliefs. Most parents held the view that the relationship between parents and children should be equal rather than hierarchical and girls and boys should be treated equally. Collectivism is not regarded as the standard in regulating children's social behavior. Most parents were not aversive toward aggression but were very negative about social withdrawal. Chinese parenting is characterized by a stronger presence of warmth rather than control. Parents showed high levels of warmth which was related to children both psychologically and physically. Parental control, on the other hand, was exercised with children's input and understanding. Children's academic and cognitive development represents a particularly strong focus in Chinese parenting. Most parents invested heavily in advancing children's academic performance in terms of both time and economic expenditure. / In the quantitative phase of the study, 645 children and their parents were administered a set of questionnaires. Factor analysis and structural equation modeling and other analyses yield the following findings: The data analysis support the multi-dimension structure of Chinese parenting. Besides the dimension proposed by the western researchers Chinese parents also show their warmth and control to the children physically. Mean levels in modern parenting beliefs, authoritative parenting style, psychological and physical warmth, and behavioral control were higher than those of traditional parenting beliefs, authoritarian parenting style, psychological and physical control, respectively. Modern parenting beliefs, psychological and physical warmth, authoritative parenting style played positive roles in children development. Traditional parenting beliefs, psychological and physical control, and authoritarian parenting style were negatively associated with children's self-concept and academic achievement, and were positively associated with aggression and withdrawal. Children's self-concept play a mediating role in the relationship of parenting and children's development. Finally, the effects of gender and age was also discussed. / This study used both qualitative and quantitative methods to explore parenting and its effects on child social and academic development in modern urban China. / 王燕. / 論文(哲學博士)--香港中文大學, 2005. / 參考文獻(p. 176-193). / Adviser: Lei Chang. / Source: Dissertation Abstracts International, Volume: 67-01, Section: A, page: 0096. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in English. / School code: 1307. / Lun wen (Zhe xue bo shi)--Xianggang Zhong wen da xue, 2005. / Can kao wen xian (p. 176-193). / Wang Yan.

This study explores discourses around private three- and four-dimensional (3/4D) ultrasound scans in pregnancy, the experiences of women who have 3/4D scans and what impact these scans may have on pregnant women. A critical discourse analysis of scanning company websites was undertaken to explore the discourses, identities and genres set up on the websites. Longitudinal interviews exploring women’s experiences of 3/4D scans were analysed using interpretative phenomenological analysis. Case studies, using longitudinal questionnaire and interview data, were used to investigate the psychological impact of 3/4D scans on pregnant women. The critical discourse analysis revealed mixed discourses, identities and genres. While 3/4D scans are not overtly medical, they nevertheless contain medical aspects. They are promoted as enhancing bonding and reassurance. In the interview analysis, two superordinate themes emerged: ‘Getting to know the baby’ and ‘Experiences of pregnancy’. While the women’s physical and emotional experiences of pregnancy varied considerably, there were more convergences in the desire to ‘get to know’ the fetus and how women approached this. While routine and 3/4D scans played an important role, fetal movement also emerged as a significant factor. The case studies showed that the psychological impact was not consistent. Scans had no effect on fetal health locus of control, may have reduced anxiety about specific issues for some women and may have had a positive impact on some components of bonding for some women. It is not possible to state categorically that they reduce anxiety or increase bonding. The psychological impact of 3/4D scans appears to be individually mediated and depends on pregnancy experience and individual psychological differences, highlighting the significance of individual factors in both research and practice. Two opposing discourses portray 3/4D scans as either beneficial, by enhancing reassurance and bonding, or problematic, by undermining women’s embodied knowledge and experience and being potentially risky. This study suggests that neither of these two conflicting discourses are reflected in women’s experiences. The women in this study were not motivated primarily by bonding or reassurance when choosing 3/4D scans, but considered them a nice experience; on the other hand, the scans do not seem to have had a detrimental impact either. The interview analysis suggests that women acquire knowledge about the fetus through scans and fetal movement and combine these to make sense of the fetus. This study also provides evidence that the concept and measurement of bonding during pregnancy is problematic and that professional and academic perspectives are not necessarily reflected in women’s experiences.

MSc (Med), Population-Based Field Epidemiology, School of Public Health, University of the Witwatersrand, 2009 / Background: MDG 4 commits the international community to reducing mortality in children younger than 5 years by two-thirds by 2015.The biggest burden of child mortality lies in Saharan Africa. Objective: To investigate how distance from home to the nearest health facility is associated with infant and child (1-4 years) mortality in a typical rural setting of sub Saharan Africa. Methods: A secondary analysis of 28,823 under five children in Ifakara Health and Demographic surveillance system between 2005 and 2007 was carried out. Both Euclidean and networked distance from the household to the nearest health facility was estimated using geographical information system methods. Cox proportional hazard regression models were used to investigate the effect of distance from home to the nearest health facility on infant and child mortality. Results: Children who lived in homes with networked distance >5KM experienced about 18% increased mortality risk [HR=1.18;95%CI 1.02-1.38 p-value 0.05] compared to those who lived less than 5KM networked distance to the nearest health facility. Death of mother, death of preceding sibling and multiple births were the strongest independent predictors of child mortality. Malaria/AFI and pneumonia/ARI were the leading causes of death in children although there was no evidence to show association of cause specific mortality with networked distance in the study. vi Conclusions: Staying closer to the health facility improved the survival probability of the children. This effect was similar to that reported elsewhere in other studies which re-emphasize the usefulness of having fully functional health facilities closer to the populations that need them. The inconsistency of the Euclidean distance in the study further suggests that the networked distance is a better estimator of geographical accessibility and should be the preferred proxy distance measurement option in public health research. 1 Faculty of Health Sciences, University of the Witwatersrand; South Africa. 2 Ifakara Health & Demographic Surveillance System; Tanzania. 3 Iganga/Mayuge Health & Demographic Surveillance System; Uganda

The aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age). The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.

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Child welfare social workers are excellent advocates for children in the foster care system. These children can greatly benefit from long lasting relationships as well as long term supportive relationships such as that of a social worker. The researcher took on a positivist approach with an aim to answer the research question “Do factors such as supervision, peer support, and organizational factors have a positive impact on social worker retention at a child welfare agency?” The research site was a foster family agency (FFA) located in the Southern California Inland Empire region. A self-administered survey was provided to participants. The findings demonstrated a strong positive relationship between variables such as supervision and peer support.

Currently, there exists no conclusive etiology of child abuse although there are two major and contrasting theories which attempt to impart a systematic interpretation to the data. The purpose of this study was to determine what are the significant factors in child abuse and to what extent the respective theories render a coherent and comprehensive explanation of these factors. This study aggregated the data on the demographic, social, economic, and psychological features of the child abuse victim and perpetrator. Each study was analyzed according to a methodology of review which considered the problems involved in eliciting meaningful data from a group of studies grounded on different assumptions and conducted according to disparate research designs. The studies were compared and contrasted to determine what factors were significantly related to child abuse. Thereafter, both major theories of child abuse were tested against the findings of the literature review to determine to what extent the respective theories successfully predicted and related significant factors in child abuse. The review of the literature clearly established a demographic profile of the child abuse victim and his family. The abused child is usually very young, typically below the age of three. Neither race nor gender are specifically related to the age of the victim. Abusing families tend to have more than the average number of children, but usually select only one child - frequently, the eldest or the youngest - as the target for abuse. The child is likely to have been born prematurely and to have had more than the usual number of serious physical illnesses or disabilities throughout his life. In addition, a significant number of abused children display intellectual, social, and psychological dysfunction which may have resulted from injuries sustained from previous abuse. Most injuries stemming from child abuse fall into the general category of superficial bruises and welts although compared with accidental childhood injuries, there is a higher frequency of fractures and head injuries. The pattern that emerges from the somewhat limited data is that abused children are unusually impaired in intellectual, social, and psychological functioning. Nearly all child abuse is committed by parental figures most of whom are the natural mothers and fathers of abused children. Most abusing parents are around twenty-five years old reflecting the fact that the majority of abuse victims are infants and younger children. Mothers are the most frequent child abusers. Although only one parent actually attacks the abuse victim, generally speaking, the other parent is overtly, or at least covertly involved in abusing the child. Abusing parents are characterized by a history of anti-social behavior and psychological problems. A general atmosphere of instability and disruption surrounds the child abusing family indicated by frequent discord among married parents, as well as separations and divorces. On all measures of socioeconomic status, child abusing families have low achievement and face the stresses of poverty and its associated conditions. However, neither race nor socioeconomic status distinguish the abusing family when compared with the social, racial, and economic groups to which they belong. Abusing families are distinguished by their transience and inability to maintain social contact with the community or affiliation with social organizations. Neither a sociocultural or a psychodynamic theory of child abuse effectively relates and explains all the significant findings of the literature review. While the former predicts the several environmental factors significantly related to child abuse and the latter explains the significant findings associated with the perpetrator, neither theory provides an explanation of the role of the child abuse victim. This review suggests that an alternative theoretical framework which incorporates environmental factors and relates significant factors about the child abuse victim and perpetrator will produce the most comprehensive explanation of child abuse.

Thesis (MPA)--University of Limpopo, 2009. / The South African government should ensure that each and every South African has food to eat, as well as clothes and shelter. The existence of widespread poverty in South Africa led to Child Support Grants being introduced as a means of assisting in poverty alleviation programmes. The South African government has also put poverty alleviation on its priority list, yet there are many reasons that lead to poverty.The main aim of this study was to examine and describe the perceptions of grant recipients of FONDWE VILLAGE and their parents or guardians, focusing on advantages and disadvantages. The perceptions of the Social Development authorities through their agents, South African Social Security Agents (SASSA), about the impact of the grant were also examined. Data were gathered by means of structured interviews. Interviews were utilized to collect data in an effort to explore different facets of the study and to get a range of information. These interviews were used as the main method of data collection. Questions in the interview schedule were pre-tested. Some participants in a pilot group were used to test the interview guide. The researcher compiled three different interview schedules, namely: • for young mothers, (grant recipients) • for parents or guardians of grant recipient or young mothers, and • for social and welfare authorities all with interview questions. The findings show that most young mothers (recipients) know the purpose of the Child Support Grant, but are often just ignorant, careless and selfish in their use of it. The following recommendations were made: • Grant recipients should, when their children’s age next birthday is 13 years, if they are not themselves at school or in full-time employment, offer their voluntary services at public institutions situated near them until their children are no longer receiving the Child Support Grant. Such voluntary services may be offered for 3 work days in a week. The public institutions concerned can include schools, clinics, hospitals, tribal and government offices. This might also help them to acquire useful skills which might help them be more permanently employable. • Rather than giving grant recipients money which they can spend on inappropriate things, vouchers should be introduced that enable the recipients to purchase only what is needed for children • Parents or guardians should be led to see the importance of informing the Social Development authorities of any Child Support Grant abuse. They should be assured that this would not in any way disadvantage the child/children in question, but would be very much to their benefit. • Young mothers should also be encouraged to inform the Social Development Authorities of any difficulties they encounter due to their receiving the grant,such as pressure to share it with their spouses or boyfriends.