The physical, psychological and social development of school children has been neglected - partly because they were seen as healthy "survivors" of the ravages of childhood illnesses, and partly because of the way in which health services are organized (such as the traditional under-five maternal and child health (MCH) services and the curative PHC clinic services). From the age of five years children undergo rapid and profound bio-psycho-social development, to emerge in adolescence as the next generation of leaders and workers. Securing their future growth and development is vital for any society to be economically and socially productive. A substantial body of national and intemational literature has recognised the detrimental impact of helminthic infections and micronutrient deficiencies on the physical and psychological health and development of school children; which requires appropriate nutritional interventions. Concern has been expressed that these adverse biological, physical and social deprivations have a cumulative impact on several dimensions of children's growth. Most important, apart from stunting physical growth, is the inhibition of educational development of school children. Recent evidence strongly suggests a powerful interaction between physical and psychosocial growth and development of children. Inhibition of either component of a child's well-being has adverse implications. Conversely, investments in the physical and psychological development of children are likely to generate substantial health and educational benefits and are a worthy investment to secure a healthy future generation. In summary, there are a number of reasons for, and benefits of, investing in school-based health and nutrition interventions. They are likely to improve learning at school and enhance educational outcomes; create new opportunities to meet unfulfilled needs; redress inequity; build on investments in early child development and promote and protect youth and adolescent development. Health and nutrition interventions such as school feeding programmes, micronutrient supplementation and deworming aim to improve primary outcomes of macro and micro-nutrient deficiencies, parasitic and cognitive status; as well as secondary outcomes of developing integrated comprehensive school health policies and programmes. This rationale served as the conceptual framework for this study. This theoretical framework views improvements of the health, nutritional, cognitive and scholastic development status of school children as the primary focus of policies, strategies and programmes in the health and education sector. This focus constitutes the central core of this thesis. Optimum social development requires investments in both the health and educational development of school children, so as to maximise the synergies inherent in each sector and to operationalise national and international strategies and programmes. As part of the larger RCT study a comprehensive nutritional, health and psychological profile of rural school children was established through a community-based cross-sectional study. Eleven schools were randomly selected from the Vulamehlo Magisterial District in southern KwaZulu-Natal (KZN). Within each school, all Standard 1 pupils, aged between 8 - 10 years, were selected giving a final study sample of 579 children. Some of the observed prevalence's were stunting (7.3%), wasting (0.7%), anaemia (16.5%) (as measured by haemoglobin below 12 g/dl), vitamin A deficiency (34.7%) (as measured by serum retinol below 20 ug/dl) and serum ferritin below 12ng/ml (28.1%). This study established that micronutrient deficiency, parasitic infestations and stunting remain significant public health problems among school-aged children in South Africa. Combining micronutrient supplementation and deworming are likely to produce significant health and educational gains. To determine the impact of single and combined interventions (anthelminthic treatment and micronutrient supplements) on nutritional status and scholastic and cognitive performance of school children, a double-blind randomised placebo controlled trial was undertaken among 579 children 8-10 years of age. There was a significant treatment effect of vitamin A on serum retinol (P<0.01), and the suggestion of an additive effect between vitamin A fortification and deworming. Vitamin A and iron fortification also produced a significant treatment effect on transferrin saturation (P<0.05). Among the dewormed group, anthelminthic treatment produced a significant decrease in the prevalence of helminthic infections (P<0.02), but with no significant between-group treatment effect (P>0.40). Scholastic and cognitive scores and anthropometric indicators were no different among the treated or the untreated children. Fortified biscuits improved micronutrient status among rural primary school children; vitamin A combined with deworming had a greater impact on micronutrient status than vitamin A fortification on its own; while anthelminthic treatment produced a significant reduction in the overall prevalence of parasite infection. The prevalence's of Ascaris lumbricoides, Trichuris trichiura and Schistosoma haematobium declined significantly sixteen weeks post-treatment. The levels of both prevalence and intensity in the untreated group remained constant. The cure rates over the first two weeks of the study were 94.4% for Ascaris lumbricoides, 40% for Trichuris trichiura, and 72.2% for Schistosoma haematobium. The benefits of targeted school-based treatment in reducing the prevalence and intensity of infection supports the South African government's focus of using school-based interventions as part of an integrated parasite control programme. These strategies and programmes were found to be consistent with the recommendations of WHO and UNICEF. The nutritional transition facing developing and middle-income countries also has important implications for preventive strategies to control chronic degenerative diseases (Popkin B, 1994; WHO 1998; Monyeki KO, 1999). This descriptive study, comparing BMI data of school children over three time periods, found a rising prevalence of overweight and obesity among South African school children. Obesity as a public health problem requires to be addressed from a population or community perspective for its prevention and management. Environmental risk factors such as exposure to atmospheric pollution remain significant hazards for children. Lead poisoning is a significant, preventable risk factor affecting cognitive and scholastic development among children. The prevalence of elevated blood lead (PbB) levels in rural and semi-urban areas of KwaZulu-Natal (KZN) as well as the risk factors for elevation of PbB among children in informal settlements were examined. This study investigated over 1200 rural and urban children in two age groups: 3-5 and 8-10 years old. Average PbB level in peri-urban Besters, an informal settlement in the Durban metropolitan region, was 10 ug/dl with 5% of the children showing PbB level of greater than 25 ug/dl. By comparison, average PbB value in Vulamehlo, a rural area located 90-120 km from Durban, was 3.8 ug/dl and 2% of the children's PbB levels were greater than 10 ug/dl. Since the cognitive and scholastic performance of school children was a primary outcome measure in this study, it was important to explore other factors that influenced this variable. The performance scores of all four tests in the battery, among the cohort of a thousand rural and urban children, were in the lower range. The educational deficit identified in this test battery clearly indicates the impact of the inferior "Bantu" educational system that African children have experienced in South Africa. Aspects of the School Health Services that were investigated in this descriptive study included the services provided and their distribution; assessment of health inspection; health education and referral processes undertaken by the School Health Teams; perceptions of managers, providers and recipients of the service; as well as the costs of the provision of the service in KwaZulu-Natal. In KwaZulu-Natal, there were School Health Teams In all the 8 health and education regions in the province. In total, there were 95 teams in the province, consisting of nearly 300 staff members. The School Health Teams were involved in a wide range of activities - 74% of all teams were involved in health inspection and 80% were involved in health education. The total annual cost of delivering School Health Services in the province in 1995 was estimated to be approximately R8 750 000. Given the rise of HIV and AIDS in the province, School Health Services need to play a central role not only in prevention, but also in assisting with the acceptance of HIV-positive children within schools. It is recommended that the current and future draft SHS policy guidelines be approved by the relevant authorities for immediate implementation. Districts should consider developing "Health Promoting Schools", with School Health Teams being a central resource. This thesis has explored several aspects of the epidemiological profile of school children in rural and urban settings in KwaZulu-Natal. It has established that school children are exposed to a range of risk factors ranging from nutritional deficits, parasitic infections, atmospheric lead poisoning and a rising prevalence of overweight. All of these risk factors may compromise their physical, psychological and social development. A number of health interventions have been identified, which have the potential to address these problems. Such investments are essential to secure the health of future generations. / Thesis (M.D.)-University of Natal, Durban, 2001.

Schoolbag carriage represents a considerable daily occupational load for children (Negrini et al., 1999). Whittfield et al., (2001) and Puckree et al., (2004) have reported that the carriage of heavy schoolbags is a suspected aetiological factor of the daily physical stress of school pupils. Methods: One hundred and eighty-seven pupils voluntarily participated in a controlled, descriptive, epidemiological retrospective study. Subjects’ biographical, epidemiological, exercise history and lifestyle information was gathered by a self-report questionnaire (adapted from Puckree et al., 2004). Subjects’ body mass, stature and mass of their schoolbags were measured using a Detecto stadiometer scale. Digital images, electromyographical muscular activity and a posture profile assessments were captured in the frontal and sagittal planes whilst the pupils were in the loaded (carrying a schoolbag) and the unloaded phases (not carrying schoolbags). These images were analyzed using biomechanical software, Dartfish. The study being retrospective in nature recorded the prevalence of schoolbag carriage musculoskeletal pain over the last 12 months. Descriptive statistical tests such as mean, mode, frequency, percentages and inferential chi-square statistical test (set at a probability of 0.05) were employed to analyze the data. Results: The result indicated that 78.99% of the cohort experience musculoskeletal pain due to schoolbag carriage (p<0.0001). The most prevalent anatomical sites of pain were the shoulders (37.04%), neck (20.37%), lumbar (11.73%) and thorax (10.49%) (p<0.0001). The mean mass of the schoolbag carried by the cohort was 5.45kg which was approximately 11.5% of their body mass. The predisposing factors of the musculoskeletal pain were the methods employed to carry the schoolbag (single strap (20.21%) versus double straps (76.6%), altered posture due to excessive schoolbag mass together with a reduced craniovertebral angle (p<0.05). Discussion & Conclusion: The excessive schoolbag mass carried by the pupils placed strain on the immature vertebral column of these pupils thus causing postural deviations which induced musculoskeletal pain and discomfort. / Thesis (M.Sport Sc.)-University of KwaZulu-Natal, Westville, 2011.

The Old Frankfort Cemetery (15Frl54) is located in downtown Frankfort, Kentucky, at the foot of Fort Hill. Records indicate this cemetery may have been the first in use in Frankfort. It was initially used as a general burial ground for the city in the early 1800s; however, it appears that the cemetery quickly became dilapidated and was primarily used for the poor of the city. Subsequent development of the site through out the 19th and 20`" centuries effectively removed the cemetery from the landscape and public memory. This amnesia was compounded by the social status of those interred at the Old Frankfort Cemetery.The specific aim of this study is to better understand children's health in the Antebellum South. Through a case study of Frankfort, Kentucky, political and economic conditions during the 19th century that affected health conditions will be examined. Documentation of immature skeletal remains from this unknown population will provide insight as to delays in both bone and dental growth and maturity, and epiphyseal closure. It will also provide information on the health of the overall population. Results of this study will not only enhance the social, economic and political intra-relationships between the population of the cemetery, but also the surrounding urban area of Frankfort, KY, during the early 19'h century and Antebellum America. / Department of Anthropology

The purpose of this study was to assess the nutritional practices, physical activity level, and anthropometric measurements of students in grades 4, 6, and 8 in Wells County, IN. The sample included all students enrolled in these grades in the fall of 2002. Parental consent to complete the School Physical Activity and Nutrition (SPAN) survey used to collect food and activity practices and to measure heights and weights was obtained for 670 of the 1,248 students. Individuals were classified into weight groups using the CDC growth charts. Thirty-eight percent of all students were "at risk for overweight" or were "overweight." Students reported spending 3.3 hours of screen time per day. Males consumed more grains and legumes, and participated in more physical activities, than females. Normal weight students consumed more grains and dairy products than overweight students. There were few statistically significant differences by weight classification. Programs that encourage increasing physical activity, decreasing screen time, and making healthier food choices should be emphasized in this community. / Department of Family and Consumer Sciences

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[Truncated abstract] This descriptive study identified correlates of electronic media use among pre-adolescent children (10-12 year olds). It specifically focused on the potential influence of individual factors and the social and physical environment within the family home setting. The prevalence of overweight/obesity in children is escalating. Sedentary behaviour in the form of electronic media use (comprised of television (TV) and video/DVD viewing, video and computer gaming, and computer use) is a contributing and a modifiable risk factor for overweight/obesity. To date, research focused on sedentary behaviour has been largely derived from physical (in)activity data where the absence or observed low levels of physical activity participation or TV viewing only has been used as a proxy for sedentariness. Little is known about the specificities of children's electronic media use; its impact on children's overall leisure and screen-time; and, the potential influencing factors that may operate at the home level. The family home is a context-specific setting where electronic media use is a daily practice for most children. To better understand electronic-based sedentary behaviour among children the following specific aims were addressed; 1) To describe children's leisure time, particularly time spent with electronic media. 2) To explore children and parents' perceptions about electronic-based sedentary behaviour. 3) To determine the prevalence of children's electronic-media use at home. 4) To examine the influence of individual, family social and home physical factors associated with different levels of electronic media use by children. ... The availability and accessibility of a variety of electronic equipment at home, especially in the child's bedroom (particularly among boys), was also associated with children's screen behaviour. Physical aspects of the family home (i.e., lay-out and yard size) had a mixed effect on children's electronic media use. Overall, the nature of electronic media use among children is complex and is influenced by dimensions that present at children's individual, family social and physical home level. The knowledge generated from this study about specific correlates of electronic media use has extended the understanding about its impact on children's discretionary time. Future prospective longitudinal research is warranted given that most studies investigating electronic media and sedentary behaviour are of cross-sectional design. Including other forms of sedentary behaviour such as sitting and talking with friends and family, reading and/or using telephones may provide a more comprehensive measure of sedentariness in the future. Further studies should use multivariate statistical analyses (i.e., modelling) to improve clarity of relationships between multiple variables and gauge mediating factors. This study also calls for future intervention research. Findings on gender-specific correlates of electronic media use provide superior information for the development of tailored behaviour modification strategies aimed at girls and boys respectively. Active involvement of household members in the intervention is also warranted. Utilising this study's findings may strengthen intervention outcomes towards a more directed and sustained behaviour change

The purpose of this study was to describe the utilisation of maternal and child health (MCH) care services by mothers from four selected health facilities in the Balaka District of Malawi. A non- experimental quantitative descriptive research was conducted to determine the knowledge of mothers with regard to MCH services and to identify factors that impact on the utilisation of the MCH care, based on the Andersen’s behavioral model of health services utilization. A combination of proportionate stratified sampling and convenience sampling was used and data was collected by means of self-administered questionnaires. It was found that mothers know the available services and that a number of factors have an impact on the utilisation of health care services. These relate amongst others to educational level, finances and cultural beliefs. / Health Studies / M.A. (Public Health)

Thesis (MTech (Biomedical Technology))--Peninsula Technikon, 2004. / The prevalence of obesity amongst both the adult and paediatric population has assumed almost epidemic proportions in many developed and developing countries. A recent study by the Medical Research Council found that a disturbing 20% of all South African children could be categorized as being obese. Limited data is currently available on the prevalence of obesity in South African children, particularly from the previously disadvantaged population. Given the global epidemic of paediatric obesity, hypertension and type-2-diabetes and the limited available data relating to obese South African children, further studies to enhance the understanding of the risk factors associated with the epidemic are imperative.

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