This cross-sectional study looks at the health profiles of street children both in institutions and on the street between May and November 1989. The former group had a clinical examination, with blood and urine investigations done where possible; the latter group were only interviewed. 159 street children were interviewed of whom 47 were interviewed on the street. 73 children had clinical examinations; 64 of these had blood and urine investigations. The age range was 8 years to 19.8 years. 18.2% were females and 28.3% were black. 59,6% of those interviewed on the street had not been in an institution or shelter for street children. 27, 2% of the total group had been on the street for more 3 years. 3 7, 1 % perceived colds and chest complaints as their main physical health problem. This was confirmed by the fact that 69,2% had a history of respiratory problems. 44,7% said that they would go to a hospital if they injured themselves or were ill; however, 36,5% said they would not use or get any medication for problems such as a headache or a bad cold. 37·, 7% of children used a hospital while they were on street but 59, 7% had not used any facility while on the street. Most street children (72,8%) washed themselves at least occasionally and 61% washed their clothes. 47,2% had suffered trauma significant enough to seek hospital attention. 56% had skin problems (including lice and scabies) while on the street. 15,7% complained of visual problems and 10,7% complained of reduced hearing. Dental problems appeared to be of major concern with 37,7% complaining of either toothache or dental caries (23,3% had obvious caries on examination). 73,4% admitted to solvent abuse, 49,9% had never taken alcohol and 12,7% had never smoked. 43% had tried dagga, 10,8% white pipe (mixture of dagga and "Mandrax" which is smoked) and only 7,6% "Mandrax" alone. 10, 9% of boys and 10, 0% of girls indicated that they had been sexually exploited. Of the 67 examined 32,8% were below 90% of expected height for age, 44,8% were below 80% of expected weight for age and 8,6% had a circumference of head below 95% of standard. There is a 9,4% Hepatitis Bs ag carrier rate. No HIV (human immunodeficiency virus) antibodies were detected in 64 sera tested. On the basis of these results, the following are recommended: 1) Improving accessibility of health care resources. 2) Improving the availability of health care resources. 3)· Initiating contacts with street children by employing field health workers. 4) Drawing up a health care policy for street children institutions and field care workers. 5) Limit venereal disease management to single dose treatment where possible. 6) Further studies need to be undertaken in the following areas: - solvent abuse - utilisation of health care resources utilisation institutions of street children shelters and Further breakdown of habits, physical problems and results of examinations are presented.

Ecuador, a country of multi-ethnic culture, has very acute health problems, especially in rural areas where two out of every three poverty-stricken Ecuadorians live. 77% of the population under 18 years of age is under the poverty level. The greater part of the indigenous population inhabits the rural areas of the Andes and the Amazon. 76% of children in the rural Andes are poor. Little Afro-Ecuadorian boys and girls also face severe disadvantages where, in the rural areas, poverty climbs above 70% of the population under 18 years of age. Academic desertion is another factor that affects especially the young women, who have to assume agricultural and communitary jobs due to the adult men's migration to the cities. In areas of indigenous population, chronic malnutrition in those who are under five years of age ascends to 65.3% while the national average reaches 49.4%. Another at-risk group is expecting mothers. Of every 1,000 births, 70 will die before living one year, and for every 100,000 births, 198 mothers die. The Province of Imbabura is rich in alimentary production and has hot, cold, and temperate climates which in turn contribute to a diversity of cultivated products. Nevertheless, the polarization of wealth and the existence of classes with low income levels lessen the possibility of acquiring good nutrition. To this is added the individual nutritional customs and beliefs of each culture that do not allow adequate nourishment in communities which are principally indigenous, Mestizo, and Black. Indigenous, Mestizo, and Black communities have very small parcels of land (minifundios or "small farms") which they cultivate with few resources and tools. This destines the majority for living conditions of extreme poverty. The majority of Mestizos are unemployed or semi-employed, have limited health services, and lack a basic sanitary infrastructure. Another minority group is the Blacks, the majority of whom cultivate fruit and legumes, who also have limited health services and a barely acceptable sanitary infrastructure. In addition, all of these people are victims of racism and federal neglect, and claim the highest rates in general, infant, and maternal mortality in the country. This reality makes difficult the development of adequate training activities which bring about the improvement of the nutritional state of the designated at-risk groups: nursing babies, children under five years of age, and pregnant women. Facing this lacerative situation, and thanks to the support of the EZRA TAFT BENSON Institute (Agriculture and Food Institute. Brigham Young University), we designed this study to determine the understanding, attitudes, and practices in nutritional traditions and beliefs of mothers of nursing babies, children under five years old, and expecting mothers. These three groups were analyzed within the three ethnic groups in the communities of Chota, La Gangotena, and Chilcapamba-communities selected randomly and because of their ethnic populations. In the mothers of the three ethnic groups, we found similar beliefs regarding certain foods. But, there are also discrepancies regarding other recommended and prohibited foods. Diets have a lack of indispensable foods such as vitamins and minerals. Even though these goods are produced in the communities, they are not administered due to stronger ancestral traditions and beliefs. This study provides profound knowledge of their nutritional traditions and beliefs, and with the results, an appropriate intervening proposition may be formulated. The proposition will permit the bettering of alimentary and nutritional conditions in nursing babies, children under five years, and pregnant women by ethnic groups. The Universidad Ténica del Norte has complied in this manner with the social commitment assigned by the State for improving the quality of life of Ecuadorians in general and of the groups studied in particular.

This study is to give an authoritative reflection of the spirit and procedure of the Child Health and Development Workshop at North Texas State Teachers College, Denton, Texas, July 16 to August 23, 1946.

Kwok Man Ki. / Accompanying CD-ROM entitled: DRAGON program 2005. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 193-203). / Abstracts in English and Chinese; appendices also in Chinese. / Abstract --- p.i / Abstract (Chinese version) --- p.iii / Acknowledgement --- p.v / Table of contents --- p.vi / List of tables --- p.xi / List of figures --- p.xviii / Presentations --- p.xix / Chapter Chapter one: --- Introduction --- p.1 / Hong Kong preschoolers' nutritional health situation --- p.1 / Chapter (I) --- Breastfeeding & complementary feeding practices --- p.1 / Chapter (II) --- "Diet, mealtime and physical activity patterns" --- p.3 / Chapter (III) --- Weight status --- p.6 / Health risk factors accumulated up to preschool age --- p.8 / Childhood Obesity Prevention: School-based intervention --- p.12 / Chapter (I) --- Primary obesity prevention and health promoting schools --- p.12 / Chapter (II) --- Feasibility of health promotion initiatives in Hong Kong kindergartens --- p.14 / Chapter (III) --- Nutrition and physical activity intervention studies --- p.18 / Chapter (IV) --- Hong Kong kindergarten health initiative: DRAGON Program --- p.23 / Aim and scope of the DRAGON Program --- p.28 / Chapter Chapter two: --- Methodology --- p.30 / Kindergarten recruitment --- p.30 / Formative preparatory stage --- p.32 / Chapter (I) --- Teaching kit development --- p.32 / Chapter (II) --- Teaching kit pretesting --- p.33 / Chapter (III) --- Parents' focus group --- p.35 / Chapter (IV) --- Questionnaires development --- p.35 / Chapter (V) --- Ethics approval --- p.37 / Subject recruitment --- p.37 / Pre-intervention stage --- p.37 / Chapter (I) --- Anthropometric measurements --- p.37 / Chapter (II) --- Parental questionnaires --- p.38 / DRAGON Program implementation --- p.38 / Chapter (I) --- Preschoolers' health curriculum --- p.38 / Chapter (II) --- Pre-intervention data management and analysis --- p.39 / Chapter (III) --- Booster activities planning and implementation --- p.40 / Chapter (IV) --- Parents' newsletters --- p.42 / Post-intervention stage --- p.42 / Chapter Chapter three: --- Results --- p.46 / Enrollment and response rate --- p.46 / Between schools baseline comparison --- p.50 / Education vs. Control Schools baseline comparison --- p.53 / Chapter (I) --- Demographic and socioeconomic characteristics --- p.53 / Chapter (II) --- Children's dietary patterns --- p.60 / Chapter (III) --- "Regular meals, snack patterns and other mealtime behaviors" --- p.65 / Chapter (IV) --- Usual activity patterns --- p.67 / Chapter (V) --- Parents' health knowledge and preferred communication channels --- p.72 / Chapter (VI) --- Child's height and weight measurements --- p.77 / Chapter (VII) --- Factors associated with children's weight status --- p.79 / Chapter (VIII) --- "Associations between socioeconomic status (SES) and children's dietary, mealtime and activity patterns" --- p.81 / Process and outcome evaluations of the Dragon Program --- p.90 / Part a) 1st follow up after finishing all health curriculum --- p.90 / Chapter (I) --- Children's dietary patterns --- p.90 / Chapter (II) --- Mealtime behaviors --- p.95 / Chapter (III) --- Usual activity patterns --- p.99 / Chapter (IV) --- Health curriculum effectiveness evaluation by AM/PM sessions --- p.103 / Part b) 2nd follow up after finishing promotional activities --- p.107 / Chapter (I) --- Children's dietary patterns --- p.108 / Chapter (II) --- Mealtime behaviors --- p.116 / Chapter (III) --- Usual activity patterns --- p.122 / Between subgroups comparisons --- p.131 / Chapter (I) --- First follow up --- p.131 / Chapter (II) --- Second follow up --- p.132 / Parent Focus groups (baseline) --- p.136 / Chapter (I) --- Awareness of local adults' and preschoolers' health status --- p.136 / Chapter (II) --- Children's dietary habits and lifestyle --- p.137 / Chapter (III) --- Factors affecting their children's health behaviors --- p.139 / Parent Focus groups (booster activities) --- p.140 / Teachers´ةquestionnaires --- p.142 / Teachers after class assessment --- p.149 / Teachers´ة focus groups --- p.155 / Principals´ة Interviews --- p.157 / Chapter (I) --- Importance of creating healthy school environment --- p.157 / Chapter (II) --- Students' & teachers´ة performance in first half-year DRAGON Program --- p.158 / Chapter (III) --- Comments on implementing second half-year DRAGON Program --- p.160 / Chapter (IV) --- Recommendations for the development of the Program --- p.161 / Chapter Chapter four: --- Discussion --- p.163 / Implications of the findings --- p.164 / Chapter (I) --- Socioeconomic and demographic factors associated with preschoolers' diet and lifestyle at baseline --- p.164 / Chapter a) --- Association between SES and children´ةs dietary habits --- p.164 / Chapter b) --- Association between SES and children's weight status and their mealtime interactions with parents --- p.166 / Chapter c) --- "Association between children's weight status and their dietary mealtime, and activity patterns" --- p.167 / Chapter (II) --- Local preschool age children´ةs health situation --- p.170 / Chapter (III) --- Program Effectiveness assessment --- p.173 / Chapter a) --- After the implementation of the one-term health curriculum --- p.173 / Chapter b) --- After the implementation of health curriculum and promotional activities --- p.179 / Chapter (IV) --- Program acceptability and feasibility --- p.186 / Limitations --- p.189 / Recommendation for future preschool health program --- p.190 / Chapter Chapter five: --- Conclusion --- p.192 / References --- p.193 / Appendices --- p.204 / Chapter A1 --- School invitation letter with program briefing details (English version) --- p.204 / Chapter A2 --- School invitation letter with program briefing details (Chinese version) --- p.209 / Chapter B1 --- School background information (English version) --- p.213 / Chapter B2 --- School background information (Chinese version) --- p.217 / Chapter C1 --- DRAGON Program Teacher's Guide for nursery grade (Chinese version) --- p.221 / Chapter C2 --- DRAGON Program Teacher's Guide for lower level (Chinese version) --- p.244 / Chapter C3 --- DRAGON Program Teacher's Guide for upper level (Chinese version) --- p.269 / Chapter D1 --- Parents´ة focus group (Jan) (English version) --- p.297 / Chapter D2 --- Parents´ة focus group (Jan) (Chinese version) --- p.301 / Chapter E1 --- Teachers´ة self-administered questionnaires (English version) --- p.305 / Chapter E2 --- Teachers´ة self-administered questionnaires (Chinese version) --- p.324 / Chapter F1a --- Parents´ة self-administered questionnaires [baseline] (English version) --- p.344 / Chapter F1b --- Parents´ة self-administered questionnaires [1st follow up] (English version) --- p.349 / Chapter F1c --- Parents' self-administered questionnaires [2nd follow up] (English version) --- p.354 / Chapter F2a --- Parents´ة self-administered questionnaires [baseline] (Chinese version) --- p.359 / Chapter F2b --- Parents´ة'self-administered questionnaires [1st follow up] (Chinese version) --- p.364 / Chapter F2c --- Parents´ة self-administered questionnaires [2nd follow up] (Chinese version) --- p.369 / Chapter G1 --- Parents´ة consent form (English version) --- p.374 / Chapter G2 --- Parents´ة consent form (Chinese version) --- p.376 / Chapter H1a --- Sample health lesson worksheet for nursery grade (Chinese version) --- p.378 / Chapter H1b --- Sample health lesson worksheet for lower level (Chinese version) --- p.379 / Chapter H1c --- Sample health lesson worksheet for upper level (Chinese version) --- p.380 / Chapter 11 --- Sample parents´ة newsletter (English version) --- p.382 / Chapter 12 --- Sample parents´ة newsletter (Chinese version) --- p.387 / Chapter J1 --- Questions for pretest parents´ة newsletter (Chinese and English version) --- p.392 / Chapter K1 --- Principals´ة interview (English version) --- p.395 / Chapter K2 --- Principals´ة interview (Chinese version) --- p.397 / Table A_1 to A_17 --- p.399 / DiscAl DRAGON Program: teaching materials for health lessons --- p.414 / DiscA2 DRAGON Program: materials for three booster activities --- p.414 / DiscA3 DRAGON Program: health lesson worksheets --- p.414 / DiscA4 DRAGON Program: parents´ة newsletters --- p.414

Cheung Yuk Lin Porky. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 236-248). / Abstracts in English and Chinese; appendices also in Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / 論文摘要 --- p.iv / Table of Contents --- p.vi / List of Figures --- p.xii / List of Tables --- p.xiii / List of Abbreviations --- p.xix / Presentations --- p.xx / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter 1.1 --- Overview on Childhood Obesity --- p.1 / Chapter 1.1.1 --- Worldwide Situation --- p.1 / Chapter 1.1.2 --- Hong Kong Situation --- p.3 / Chapter 1.2 --- Consequences of Childhood Obesity --- p.4 / Chapter 1.2.1 --- Physiological Problems --- p.4 / Chapter 1.2.2 --- Psychosocial Problems --- p.6 / Chapter 1.2.3 --- Economic Problems --- p.6 / Chapter 1.3 --- Possible Causes and Associated Factors of Childhood Obesity --- p.7 / Chapter 1.3.1 --- Genetics --- p.7 / Chapter 1.3.2 --- Lifestyle Patterns --- p.8 / Chapter 1.3.2.1 --- Physical Activity --- p.8 / Chapter 1.3.2.2 --- Dietary Factors --- p.8 / Chapter 1.3.3 --- Environmental Influence --- p.10 / Chapter 1.3.3.1 --- Parental Influence and Home Environment --- p.10 / Chapter 1.3.3.2 --- Other External Environmental Factors --- p.10 / Chapter 1.4 --- Prevention and Treatment of Childhood Obesity --- p.12 / Chapter 1.4.1 --- Clinical Trials --- p.12 / Chapter 1.4.2 --- Family Based Interventions --- p.13 / Chapter 1.4.3. --- School Based Interventions --- p.14 / Chapter 1.4.4 --- Other Possible Measures --- p.17 / Chapter 1.5 --- Local Intervention Implementation --- p.17 / Chapter 1.6 --- "Study Rationale, Design，Aims and Objectives" --- p.18 / Chapter 1.6.1 --- Study Rationale --- p.18 / Chapter 1.6.2 --- Study Design --- p.19 / Chapter 1.6.3 --- Study Aims and Objectives --- p.21 / Chapter 1.7 --- Conceptual Framework and Hypothesis --- p.21 / Chapter 1.7.1 --- Conceptual Framework --- p.22 / Chapter 1.7.2 --- Hypothesis --- p.23 / Chapter CHAPTER 2: --- METHODOLOGY --- p.23 / Chapter 2.1 --- Sample --- p.23 / Chapter 2.1.1 --- School Recruitment --- p.23 / Chapter 2.1.2 --- Subject Recruitment --- p.23 / Chapter 2.2 --- Parental Consent --- p.24 / Chapter 2.3 --- Focus Groups --- p.24 / Chapter 2.4 --- Assessment Tools --- p.25 / Chapter 2.4.1 --- Weight and Height measures --- p.25 / Chapter 2.4.2 --- Physical Fitness Tests --- p.25 / Chapter 2.4.3 --- Student Questionnaire --- p.26 / Chapter 2.4.4 --- Parental Questionnaire --- p.27 / Chapter 2.4.5 --- Questionnaires Pre-testing --- p.27 / Chapter 2.5 --- Intervention --- p.28 / Chapter 2.5.1 --- Intervention A: Mighty Heart Health Promotion Program --- p.28 / Chapter 2.5.1.1 --- Materials --- p.28 / Chapter 2.5.1.2 --- Procedures --- p.30 / Chapter 2.5.2 --- Intervention B: Health Club --- p.31 / Chapter 2.5.2.1 --- Materials --- p.31 / Chapter 2.5.2.2 --- Procedures --- p.32 / Chapter 2.6 --- Evaluation --- p.35 / Chapter 2.6.1 --- Qualitative Evaluation --- p.35 / Chapter 2.6.2 --- Quantitative Evaluation --- p.35 / Chapter 2.7 --- Data Manasement --- p.36 / Chapter 2.8 --- Statistics --- p.37 / Chapter 2.8.1 --- Health Knowledge and Food Preferences Scores of Students --- p.37 / Chapter 2.8.2 --- "Health Knowledge, Dietary Habits and Home Food Availability Scores of Parents" --- p.40 / Chapter 2.9 --- Ethical Approval --- p.42 / Chapter CHAPTER 3: --- RESULTS --- p.43 / Chapter PART A: --- Baseline Focus Groups Results / Chapter 3.1 --- Baseline Focus Groups Results --- p.43 / Chapter 3.1.1 --- General Description of Participants --- p.44 / Chapter 3.1.2 --- "Views of ""Health"" held by students" --- p.44 / Chapter 3.1.3 --- "Views of ""Health"" of parents" --- p.45 / Chapter 3.1.4 --- "Views of ""Healthy Eating"" of students" --- p.46 / Chapter 3.1.5 --- "Views of ""Healthy Eating"" held by parents" --- p.47 / Chapter 3.1.6 --- "Perceived views on ""Physical Activity"" by students" --- p.48 / Chapter 3.1.7 --- "Views on ""Physical Activity"" of parents" --- p.49 / Chapter 3.1.8 --- Preferred delivery mode of activities communication channels --- p.50 / Chapter PART B: --- Baseline Profile of Participants / Chapter 3.2 --- Response Rate --- p.52 / Chapter 3.3 --- Baseline Characteristics and Socio-dem ograph ic Profile of Participants --- p.54 / Chapter 3.3.1 --- Students --- p.54 / Chapter 3.3.2 --- Parents --- p.56 / Chapter 3.4 --- "Self-perceived Important Values, Health and Weight Status at baseline" --- p.60 / Chapter 3.4.1 --- Students --- p.60 / Chapter 3.4.2 --- Parents --- p.62 / Chapter 3.5 --- Baseline Physical Activity --- p.63 / Chapter 3.5.1 --- Students --- p.63 / Chapter 3.5.2 --- Parents --- p.69 / Chapter 3.6 --- Baseline Dietary Aspects --- p.71 / Chapter 3.6.1 --- Students --- p.71 / Chapter 3.6.2 --- Parents --- p.81 / Chapter 3.7 --- Summary of Baseline associations between students，and parents 'parameters --- p.94 / Chapter 3.7.1 --- Factors associated with Students' weight status --- p.94 / Chapter 3.7.2. --- Factors associated with Studente´ة Dietary Habits --- p.97 / Chapter 3.7.3 --- Factors associated with students´ة physical Activity Habits --- p.104 / Chapter 3.8 --- Summary of Baseline Profile of Participants --- p.108 / Chapter PART C: --- Outcome Evaluation / Chapter 3.9 --- The Final MH activities Conducted --- p.111 / Chapter 3.10 --- Comparisons of Weight Status --- p.112 / Chapter 3.11 --- Comparisons of Self-perceived Health Status and Important Values --- p.114 / Chapter 3.12 --- Comparisons of Physical Activity Parameters --- p.118 / Chapter 3.12.1 --- Students --- p.118 / Chapter 3.12.2 --- Parents --- p.126 / Chapter 3.13 --- Comparisons of Dietary and Health Related Aspects --- p.129 / Chapter 3.13.1 --- Students --- p.129 / Chapter 3.13.2 --- Parents --- p.148 / Chapter 3.13.3 --- Home Food and Meal Environments --- p.167 / Chapter PART D: --- Results of Health Club / Chapter 3.14 --- Baseline Profile of the Participants --- p.180 / Chapter 3.14.1 --- Characteristics and Health Status --- p.180 / Chapter 3.14.2 --- Baseline Physical Activity --- p.181 / Chapter 3.14.3 --- Baseline Dietary Related Parameters --- p.183 / Chapter 3.15 --- The Final HC Lessons Conducted --- p.187 / Chapter 3.16 --- Outcome Evaluation of HC program --- p.188 / Chapter 3.16.1 --- Physical Fitness and Anthropometric Parameters --- p.188 / Chapter 3.16.2 --- Self-perceived Health Status and Important Values --- p.192 / Chapter 3.16.3 --- Physical Activity Related Aspects --- p.193 / Chapter 3.16.4 --- Dietary Aspects --- p.196 / Chapter 3.17 --- Summary of results of the HC Program --- p.201 / Chapter PART E: --- Process Evaluation / Chapter 3.18 --- Process Evaluations of Mighty Heart --- p.203 / Chapter 3.18.1 --- Students --- p.203 / Chapter 3.18.1.1 --- Comments on Program Activities and Materials --- p.203 / Chapter 3.18.1.2 --- Comments on Program Effectiveness and Acceptability --- p.204 / Chapter 3.18.1.3 --- Overall Comments and Suggestions --- p.204 / Chapter 3.18.2 --- Teachers --- p.205 / Chapter 3.18.2.1 --- Comments on Program Activities and Materials --- p.205 / Chapter 3.18.2.2 --- Comments on Program Effectiveness and Acceptability --- p.205 / Chapter 3.18.2.3 --- Overall Comments and suggestions --- p.206 / Chapter 3.19 --- Process Evaluations of the Health Club --- p.207 / Chapter 3.19.1 --- Students --- p.207 / Chapter 3.19.1.1 --- Comments on Program Activities and Materials --- p.207 / Chapter 3.19.1.2 --- Comments on Program Effectiveness and Acceptability --- p.208 / Chapter 3.19.1.3 --- Overall Comments and Suggestions --- p.208 / Chapter 3.19.2 --- Teacher --- p.209 / Chapter 3.19.2.1 --- "Comments on Program Activities, Educational Materials/Resources" --- p.209 / Chapter 3.19.2.2 --- Comments on Program Effectiveness and Acceptability --- p.210 / Chapter 3.19.2.3 --- Overall Comments and Suggestions --- p.211 / Chapter Chapter 4: --- Discussion --- p.212 / Chapter 4.1 --- Overall Effects of the MH Program --- p.213 / Chapter 4.1.1 --- Changes in PA-related Aspects --- p.213 / Chapter 4.1.2 --- Changes in Dietary-related Aspects --- p.216 / Chapter 4.1.3 --- Changes in Health Status related Aspects --- p.225 / Chapter 4.1.4 --- Acceptability and Appropriateness of the MH --- p.225 / Chapter 4.2 --- Overall Effects of the HC Program --- p.226 / Chapter 4.2.1 --- Changes in PA Related Aspects --- p.226 / Chapter 4.2.2 --- Changes in Dietary-related Aspects --- p.227 / Chapter 4.2.3 --- Changes in Health Status related Aspects --- p.228 / Chapter 4.2.4 --- Acceptability and Appropriateness of the HC --- p.229 / Chapter 4.3 --- Strengths and Limitations of the Study --- p.231 / Chapter 4.4 --- Implications and Recommendations for Future Research --- p.233 / Chapter Chapter 5: --- Conclusions --- p.234 / References --- p.236 / Appendix A Principal/ teacher Questionnaire --- p.249 / Appendix B Consent form for parents --- p.252 / Appendix C Focus group questionnaire - Students --- p.258 / Appendix D Focus group questionnaire - Parents --- p.262 / Appendix E Survey questionnaire -Students --- p.266 / Appendix F Survey Questionnaire - Parents --- p.274 / Appendix G Powerpoint material for teachers´ة monthly sharing --- p.282 / Appendix H Working sheets --- p.283 / Appendix I Newsletters for parents --- p.287 / Appendix J Teachers´ة guide for the “Mighty Heart´حprogram --- p.302 / Appendix K Teachers' guide for Health Club --- p.307 / Appendix L The student workbook --- p.311 / "Appendix M Discussion guide for students participating in the ""Mighty Heart ""program" --- p.312 / Appendix N Discussion guide for students participating in the Health Club --- p.313 / Appendix O Discussion guide for teachers conducting the Mighty Heart program --- p.314 / Appendix P Discussion guide for the teachers conducting the Health Club --- p.316

Chan, Yun Kwan. / Accompanying CD-ROM contains appendix H, I, J, and K. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 161-170). / Abstracts in English and Chinese; three appendixes in Chinese only. / Library's copy: lacks accompanying CD-ROM. / Acknowledgement --- p.i / Abstract --- p.ii / Abstract (Chinese) --- p.iv / List of publications --- p.vi / Table of Contents --- p.viii / List of Figures --- p.xvi / List of Tables --- p.xvii / List of Abbreviations --- p.xxv / Chapter CHAPTER ONE: --- INTRODUCTION --- p.1 / Chapter 1.1 --- Global prevalence of childhood overweight --- p.1 / Chapter 1.2 --- Preschool health situation in HK --- p.2 / Chapter 1.2.1 --- Breastfeeding --- p.2 / Chapter 1.2.2 --- Diet and physical activity patterns --- p.3 / Chapter 1.2.3 --- Prevalence of childhood overweight --- p.5 / Chapter 1.2.3.1 --- Definition of childhood overweight --- p.5 / Chapter 1.2.3.2 --- Local prevalence of childhood overweight --- p.6 / Chapter 1.3 --- Consequences of childhood overweight --- p.7 / Chapter 1.3.1 --- Health consequences of childhood overweight --- p.7 / Chapter 1.3.2 --- Economic consequences of childhood overweight --- p.9 / Chapter 1.4 --- Risk factors of childhood overweight and obesity --- p.11 / Chapter 1.4.1 --- Family Socioeconomic status --- p.11 / Chapter 1.4.2 --- Parental overweight --- p.11 / Chapter 1.4.3 --- Breastfeeding --- p.12 / Chapter 1.4.4 --- Birth order --- p.13 / Chapter 1.4.5 --- Breakfast consumption --- p.13 / Chapter 1.4.6 --- Beverage consumption --- p.14 / Chapter 1.4.7 --- High calcium intake --- p.15 / Chapter 1.4.8 --- Fruit and vegetable consumption --- p.15 / Chapter 1.4.9 --- Physical inactivity --- p.15 / Chapter 1.4.9.1 --- Physical activity recommendations for preschoolers --- p.17 / Chapter 1.4.9.2 --- Screentime recommendations for preschoolers --- p.18 / Chapter 1.5 --- Child development --- p.18 / Chapter 1.5.1 --- Onset of overweight --- p.18 / Chapter 1.5.2 --- Early establishment of lifelong habits at preschool age --- p.19 / Chapter 1.5.3 --- Interaction with parents --- p.20 / Chapter 1.6 --- Justification of preschool multi-component health intervention in Hong Kong --- p.22 / Chapter 1.6.1 --- Local health promotion initiative at preschool --- p.22 / Chapter 1.6.2 --- Justification for DRAGON2006 modifications --- p.23 / Chapter 1.6.2.1 --- Inclusion of family-home component in school- based health intervention --- p.24 / Chapter 1.6.2.2 --- Child BMI monitoring and health report to parents --- p.24 / Chapter 1.7 --- Present school-based preschool health intervention --- p.25 / Chapter 1.8 --- Summary --- p.27 / Chapter 1.9 --- Aims and objectives --- p.27 / Chapter CHAPTER TWO: --- METHODOLOGY --- p.28 / Chapter 2.1 --- Recruitment of preschools and preschoolers --- p.28 / Chapter 2.2 --- Development of DRAGON2006 --- p.33 / Chapter 2.2.1 --- Ethics approval --- p.35 / Chapter 2.2.2 --- Focus groups with parents --- p.35 / Chapter 2.2.3 --- Amendment and pretest of the questionnaires --- p.35 / Chapter 2.2.4 --- Health lessons --- p.36 / Chapter 2.2.4.1 --- Development and adaptation of the health lessons --- p.36 / Chapter 2.2.4.2 --- Improvement of the teaching materials --- p.37 / Chapter 2.2.4.3 --- Lyrics reproduction and CD production --- p.37 / Chapter 2.2.4.4 --- Worksheets --- p.38 / Chapter 2.2.4.5 --- Process evaluation --- p.38 / Chapter 2.2.5 --- Teachers´ة training --- p.38 / Chapter 2.3 --- Intervention Activities and Components --- p.39 / Chapter 2.3.1 --- Opening ceremony --- p.39 / Chapter 2.3.2 --- Health Talks --- p.40 / Chapter 2.3.3 --- Health report --- p.40 / Chapter 2.3.4 --- Parental newsletters --- p.41 / Chapter 2.4 --- Outcome evaluation --- p.42 / Chapter 2.5 --- Data collection --- p.43 / Chapter 2.5.1 --- Recruitment of subjects --- p.43 / Chapter 2.5.2 --- Anthropometric measurements --- p.43 / Chapter 2.5.3 --- Parental baseline and evaluation questionnaire administration --- p.44 / Chapter 2.5.4 --- Teachers´ة pre- and post-intervention evaluation and process evaluation --- p.44 / Chapter 2.6 --- Data management --- p.44 / Chapter 2.6.1 --- Verification of data from the questionnaires --- p.44 / Chapter 2.6.2 --- Data coding --- p.45 / Chapter 2.6.3 --- Data entry and verification --- p.45 / Chapter 2.6.4 --- Data analysis --- p.45 / Chapter 2.5.4.1 --- Descriptive and association analysis --- p.45 / Chapter 2.5.4.2 --- Construction of BMI-for-age percentile and z- score curves --- p.46 / Chapter 2.5.4.3 --- Evaluation of the effectiveness of the program --- p.47 / Chapter CHAPTER THREE: --- RESULTS --- p.48 / Chapter 3.1 --- Organization of the results --- p.48 / Chapter 3.2 --- Baseline comparability between the EG and CG --- p.48 / Chapter 3.2.1 --- General sociodemographic characteristics --- p.48 / Chapter 3.2.2 --- Preschoolers' diet and meal behaviors --- p.54 / Chapter 3.2.3 --- Preschoolers´ة dental health --- p.61 / Chapter 3.2.4 --- Parental child feeding behaviors --- p.62 / Chapter 3.2.5 --- Preschoolers´ة physical activity and sedentary behaviors --- p.66 / Chapter 3.2.6 --- Summary --- p.67 / Chapter 3.3 --- Baseline comparability between the completes and dropouts --- p.69 / Chapter 3.3.1 --- Participant flow in the EG and CG --- p.69 / Chapter 3.3.2 --- General sociodemographic characteristics --- p.70 / Chapter 3.3.3 --- "Preschoolers´ة diet, meal and physical and sedentary activity behaviors and parental child feeding behaviors" --- p.74 / Chapter 3.3.4 --- Summary --- p.75 / Chapter 3.4. --- Evaluation of the effectiveness of the DRAGON2006 --- p.76 / Chapter 3.4.1 --- General demographic characteristics --- p.76 / Chapter 3.4.2 --- Effects on preschoolers´ة anthropometry and weight status --- p.77 / Chapter 3.4.3 --- Effects on preschoolers' diet and meal behaviors --- p.79 / Chapter 3.4.4 --- Effects on parental child feeding behaviors --- p.89 / Chapter 3.4.5 --- Effects on preschoolers´ة physical and sedentary activities --- p.92 / Chapter 3.4.6 --- Summary --- p.94 / Chapter 3.5 --- "Teaching staff members´ة attitudes, perceptions and practices with respect to addressing childhood overweight" --- p.95 / Chapter 3.5.1 --- General demographic characteristics --- p.95 / Chapter 3.5.2 --- Teachers' attitude toward addressing childhood overweight --- p.98 / Chapter 3.5.3 --- Teachers' behaviors toward addressing childhood overweight --- p.99 / Chapter 3.5.4 --- Teachers' perceived abilities to deal with some childhood overweight topics --- p.100 / Chapter 3.5.5 --- Teachers´ة reported helpful factors to implementing a new preschool health program --- p.101 / Chapter 3.5.6 --- Teachers´ة reported helpful factors for and barriers to parents´ة participation --- p.102 / Chapter 3.5.7 --- Comparisons between staff with and without self-reported weight and height --- p.103 / Chapter 3.5.8 --- Summary --- p.105 / Chapter 3.6 --- EG teachers´ة evaluation of the program --- p.106 / Chapter 3.6.1 --- Teachers' perception of DRAGON2006 program before the intervention --- p.106 / Chapter 3.6.2 --- DRAGON teachers´ة process evaluation of the DRAGON2006 curriculum --- p.113 / Chapter 3.6.3 --- DRAGON teachers´ة evaluation of DRAGON2006 program after the intervention --- p.118 / Chapter CHAPTER FOUR: --- DISCUSSION --- p.127 / Chapter 4.1 --- "Baseline findings about the preschoolers' weight status, diet, meal and physical and sedentary activity situation" --- p.127 / Chapter 4.1.1 --- Preschooler and parental overweight and obesity --- p.127 / Chapter 4.1.2 --- Preschoolers´ة diet and meal behaviors --- p.128 / Chapter 4.1.3 --- Preschoolers´ة physical and sedentary activity behaviors --- p.130 / Chapter 4.2 --- "Gender associations with preschoolers´ة diet, meal and physical and sedentary activity behaviors and parental child feeding behaviors" --- p.131 / Chapter 4.2.1 --- Gender associations with preschoolers´ة diet and meal behaviors --- p.132 / Chapter 4.2.2 --- Gender associations with parental child feeding behaviors --- p.134 / Chapter 4.2.3 --- Gender associations with preschoolers´ة physical and sedentary activity behaviors --- p.135 / Chapter 4.3 --- "Age associations with preschooler diet, meal and physical and sedentary activity behaviors and parental child feeding behaviors" --- p.136 / Chapter 4.3.1 --- Preschoolers' age associations with their anthropometry --- p.137 / Chapter 4.3.2 --- Preschoolers´ة age associations with their diet and meal behaviors --- p.137 / Chapter 4.3.3 --- Preschoolers' age associations with their dental health --- p.139 / Chapter 4.3.4 --- Preschoolers´ة age associations with parental child feeding behaviors --- p.139 / Chapter 4.3.5 --- Preschoolers´ة age associations with their physical and sedentary activity behaviors --- p.140 / Chapter 4.4 --- "Family income associations with preschooler diet, meal and physical and sedentary activity behaviors and parental child feeding behaviors" --- p.141 / Chapter 4.4.1 --- Family income associations with some general demographic characteristics of the sample --- p.143 / Chapter 4.4.2 --- Family income associations with preschoolers´ة diet and meal behaviors --- p.144 / Chapter 4.4.3 --- Family income associations with parental child feeding behaviors --- p.147 / Chapter 4.4.4 --- Family income associations with preschoolers' physical and sedentary activity behaviors --- p.148 / Chapter 4.5 --- Factors associated with preschool overweight and obesity --- p.148 / Chapter 4.5.1 --- Preschooler overweight and obesity associations with some general demographic characteristics of the baseline participants --- p.149 / Chapter 4.5.2 --- Preschooler overweight and obesity associations with parental overweight and obesity --- p.150 / Chapter 4.5.3 --- Preschooler overweight and obesity associations with preschoolers' meal behaviors --- p.150 / Chapter 4.5.4 --- Preschooler overweight and obesity associations with their physical and sedentary activity behaviors --- p.150 / Chapter 4.6 --- The evaluation of the effectiveness of DRAGON2006 --- p.151 / Chapter 4.6.1 --- Baseline comparison between the education (EG) and control group (CG) --- p.151 / Chapter 4.6.2 --- Baseline comparison between completers and dropouts --- p.151 / Chapter 4.6.3 --- Follow up comparison between the education (EG) and control groups (CG) --- p.152 / Chapter 4.6.3.1 --- The changes in preschooler anthropometry --- p.153 / Chapter 4.6.3.2 --- The changes in preschooler diet and meal behaviors --- p.154 / Chapter 4.6.3.3 --- The changes in preschooler physical and sedentary activity behaviors --- p.155 / Chapter 4.6.3.4 --- Parental child feeding behaviors --- p.156 / Chapter 4.7 --- The teachers´ة evaluation results of DRAGON2006 and of Color Me Healthy --- p.156 / Chapter 4.7 --- Strengths and limitations of the study --- p.157 / Chapter 4.8 --- Suggestions for improvement of DRAGON --- p.159 / Chapter CHAPTER FIVE: --- CONCLUSION --- p.160 / References --- p.161 / Appendices / Chapter AI --- Invitation letter for preschool (English) --- p.171 / Chapter AIII --- Invitation letter for preschool (Chinese) --- p.172 / Chapter AIII --- Invitation letter for CG preschool (Chinese only) --- p.173 / Chapter BI --- Research proposal (English) --- p.174 / Chapter BII --- Research proposal (Chinese) --- p.178 / Chapter CI --- Purpose and structure of DRAGON2006 health lessons (English) --- p.181 / Chapter CII --- Purpose and structure of DRAGON2006 health lessons (Chinese) --- p.185 / Chapter DI --- Teacher evaluation Part A (pre-intervention) (English) --- p.189 / Chapter DII --- Teacher evaluation Part A (pre-intervention) (Chinese) --- p.191 / Chapter EI --- Teacher evaluation Part B (process evaluation) (English) --- p.193 / Chapter EII --- Teacher evaluation Part B (process evaluation) (Chinese) --- p.205 / Chapter FI --- Teacher evaluation Part C (post-intervention) (English) --- p.218 / Chapter FII --- Teacher evaluation Part C (post-intervention) (Chinese) --- p.222 / Chapter GI --- Child health report (English) --- p.224 / Chapter GII --- Child health report (Chinese) --- p.226 / Chapter H --- Teaching kit --- p.228 / Chapter I --- Music sound track --- p.228 / Chapter J --- Curriculum worksheets (Chinese only) --- p.228 / Chapter K --- Parents´ة newsletters (Chinese only) --- p.228 / Chapter LI --- Focus group study questions (English) --- p.229 / Chapter LII --- Focus group study questions (Chinese) --- p.231 / Chapter MI --- Consent form for EG parents (English) --- p.233 / Chapter MII --- Consent form for EG parents (Chinese) --- p.235 / Chapter MII --- Consent form for CG parents (English) --- p.237 / Chapter MI --- Consent form for CG parents (Chinese) --- p.238 / Chapter NI --- Pre-internvetion parental questionnaire (English) --- p.239 / Chapter NII --- Pre-intervention parental questionnaire (Chinese) --- p.245 / Chapter OI --- Post-intervention parental questionnaire (English) --- p.250 / Chapter OII --- Post-internvetion parental questionnaire (Chinese) --- p.256 / Chapter PI --- Post-intervention staff survey (English) --- p.262 / Chapter PII --- Post-intervention staff survey (Chinese) --- p.264 / Chapter Q --- "Gender differences in preschoolers´ة diet, meal, physical and sedentary behaviors and parental child feeding behaviors" --- p.266 / Chapter R --- "Age differences in preschoolers´ة diet, meal, physical and sedentary behaviors and parental child feeding behaviors" --- p.296 / Chapter S --- "Income differences in preschoolers' diet, meal, physical and sedentary behaviors and parental child feeding behaviors" --- p.313 / Chapter T --- Factors associated with preschooler weight status --- p.334 / Chapter U --- "Maternal education level differences in preschoolers´ة diet, meal, physical and sedentary behaviors and parental child feeding behaviors" --- p.352 / Chapter V --- "Maternal birth place differences in preschoolers´ة diet, meal, physical and sedentary behaviors and parental child feeding behaviors" --- p.374 / Chapter W --- Test-retest reliability of DRAGON2006 questionnaire --- p.394

Our study adds to the understanding of dental caries prevention in underserved populations. Dental caries is the most common disease of childhood but can be easily prevented. It is therefore essential that policy makers use evidence to promote policies that will help reduce the burden of caries in high-risk children. We collected socioeconomic and demographic data through written surveys from parents of children at the Lyford Consolidated Independent School District in Willacy County. We got a 60% response to our survey. The survey data was matched with dental examination data from a teledentistry project. Only 19% of children in our matched sample had any sealant but 43% had at least one dental caries. Of those without sealants, almost half (49%) had caries while of those with sealants only 19% had any caries. We also found that while half (48%) of those from low-income households (ie, annual income <$25,000) had caries, only a third (34%) of those in high-income households had any caries. Our data analysis involved econometric modeling to study the impact of various factors including dental sealants on the occurrence of dental caries. We assumed dental sealant application to be a proxy for past preventive dental care. We used multivariate probit regression to test for endogeneity in our model. The estimation results from univariate probit models showed a strong and robust preventive effect of dental sealants on dental caries. We used Ordinary Least Squares (OLS), logit, probit, and logistic regressions to confirm the results and obtained similar findings. We used our fitted model to simulate the effect of providing sealants to all children in our sample and found that there will be a 52% - 68% decrease in the mean predicted probability of caries in different scenarios. Finally, we used cost estimates from published studies and the annual survey of dental fee by the American Dental Association to calculate cost-benefit of providing sealants through school-based programs. We found school-based sealant programs to be cost-beneficial. Our analysis leads to a recommendation to promote school-based sealant programs in underserved populations. / text

The aim of this study was to investigate whether Sibusiso, a Ready Food Supplement (SRFS), developed by the Gift of the Givers Foundation was able to promote weight gain among underweight children between 1 and 10 years of age. The study also aimed to train CAST community workers on how to assess and identify underweight children and to determine the number of underweight children aged 1-10 years who were currently on the CAST food aid program in Cato Manor and Chesterville in Durban, Kwa Zulu-Natal. This non-randomised intervention study was carried out on a total of 19 out of 20 subjects that initially qualified for inclusion into the study. A monitoring tool was used to collect data on anthropometrical measurements, symptoms experienced, disease conditions identified, level of appetite, meal consumption and energy for each subject for a period of three months. Study subjects were from families living in Cato Manor and Chesterville in Durban, Kwa Zulu-Natal, who were part of a food aid programme run by non-governmental organisation Church Alliance of Social Transformation (CAST). SRFS was compared to Recommended Energy Allowances (REA) and Recommended Daily Allowances (RDA) to determine the amount of energy and macronutrients that SRFS provided to subjects in their different age groups. The predominant health conditions and symptoms experienced by the subjects were assessed. General improvement in appetite, meal consumption and energy levels among subjects were monitored during the supplementation period Out of 19 subjects who were supplemented with SRFS over the three month period, it was established that more children from Chesterville than Cato Manor were part of the CAST food parcel programme. SRFS was not able to meet 100% of the RDA and REA for subjects in their different age groups. However, SRFS was able to promote weight among subjects as 50% of subjects were able to achieve normal weight-for-age growth by the third month of supplementation. Human Immunodeficiency Virus (HIV) infection was the predominant disease condition experienced among subjects. A steady decline in the frequency of infection symptoms experienced among subjects was observed. Appetite, meal consumption and energy levels among subjects increased during the three moth supplementation period. In conclusion, SRFS was successful in promoting weight gain among underweight children and was able to improve the overall wellbeing of subjects by alleviating the burden of disease conditions and infection symptoms while improving appetite, meal consumption and energy levels. SRFS therefore was beneficially utilised in the CAST food aid programme. SRFS had beneficial effects on the health and nutritional status of the study subjects during the observed period of its use in the CAST food aid programme and its continued use is recommended. / Thesis (M.Sc.Diet.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008