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 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

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

The aim of the study was to gain in-depth understanding of teachers ’experiences with regard to the provision of care and support to school children on antiretroviral therapy in Swaziland in order to recommend approaches for enhancing support and care offered to children on ART by teachers. The study explored the experiences of teachers providing care and support to school children on antiretroviral therapy in Swaziland. The study used interpretative phenomenological analysis design. The study population was primary schools teachers in Swaziland. Data were collected through individual semi structured interviews from 16 purposively selected teachers. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three superordinate themes emerged from data analysis namely: (1) Increased responsibility, (2) inadequate support and (3) psychological impact. The increased responsibility is related to ensuring that children who are on antiretroviral therapy have eaten before taking antiretroviral treatments, are properly dressed, receive proper education and health care and protected from bullying and social exclusion. Inadequate support for teachers makes caring for the learners very challenging. The psychological impact of caring for these learners are sense of accomplishment, demotivation; helplessness and emotional pain. Recommendations are made to ensure support for teachers rendering care and support to children on antiretroviral therapy. / M.A. (Nursing Science) / Health Studies

Providing adequate sanitation facilities for the poor remains one of the major challenges in all developing countries. In South Africa, an estimated 11,7% of the schools are without sanitation. The South African government has a constitutional responsibility to ensure that all South Africans have access to adequate sanitation. When sanitation systems fail, or are inadequate, the impact of the health of the community, on the health of others and the negative impact on the environment can be extremely serious. In rural South African schools, many Enviro-Ioo toilets are available today. They are designed to suit a variety of water scarce areas and where there is a high risk of contamination of ground water resources. It is important to realize that any Enviro-Ioo system programme requires an education programme to ensure that the principles of use and maintenance are clearly understood by the user group. Their maintenance requires more responsibility and commitment by users. This study is an interpretive case study that indicates how sanitation in a rural Ramashobohle High School in Polokwane municipality was managed through an EcoSchools Sanitation Community of Practice, and how this developed action competence for sanitation management in the school. The study established that the earlier practice and knowledge of the Ramashobohle Eco-Schools community of practice exercised in maintaining Enviro-Ioo systems was inadequate; unhealthy and unsafe according to the data generated through focus group interviews, observations, interviews, action plan, workshops and reflection interviews. The data generated also indicates that the Eco-Schools community of practice was not committed to maintaining sanitation in their school because they were not sharing sanitation knowledge; they were not communicating and not updating one another concerning Enviro-Ioo systems maintenance as they had no adequate knowledge as to how to maintain the facilities; and the school management was also not supportive and was not taking responsibility. The study shows how this situation was turned around as an Eco-Schools Sanitation Community of Practice focussed on developing action competence in the school community. It provides a case based example of how knowledge and action competence, supported by an Eco-Schools Community of Practice, can find and implement solutions to inadequate sanitation management practices in rural schools, and shows how members of the school community can be engaged in learning how to manage and maintain school sanitation systems through a participatory process that develops action competence. The study points to important dimensions of developing action competence, such as providing knowledge and demonstrations, inviting experts to the school, involving learners in observations and monitoring and in ensuring that adequate facilities are available. In particular, a workshop conducted by Enviro-Ioo consultants, organised and supported by the Eco-Schools Sanitation COP, together with a follow up action plan, provided the main impetus for changes in practice in the school and served to support action competence development. Finally the study provides research findings and recommendations for further research.

The purpose of this study was to determine the progress of the immunization program for Contagious Diseases in the City Schools of Dallas, Texas, over a period of ten years, dating from September 1928, to September 1938. An endeavor was made to determine how the Health Works Program of the Dallas Public Schools developed, and the protection it gave the public children.

In conclusion, the current air pollution levels in Hong Kong had a risk for school children's respiratory and cardiovascular health. In comparison between the highly- and least-polluted districts, a rise of 8 mug/m 3 annual mean for PM10 concentration was significantly associated with increased risks for some respiratory symptoms such as wheezing, cough, and phlegm, with decreased lung function in FEF25-75% and FEF75%, and with decreased cardiopulmonary fitness in predicted VO2max, after adjustment for confounding factors. An increase of 13 mug/m3 annual mean for NO2 in the moderately-polluted district did not individually cause adverse effects on children's respiratory and cardiopulmonary health. Physical activity appears to have no positive health effects on the children's VO2max in moderately- and highly-polluted districts. / In the past year preceding the study (May 2003 to April 2004), the annual means for PM10, NO2, SO2 and O3 were respectively 55.1 mug/m3, 51.4 mug/m3, 15.4 mug/m3, and 42.5 mug/m3 in the least-polluted district (LPD); 56.3 mug/m3, 64.7 mug/m3, 15.2 mug/m3, and 35.2 mug/m3 in the moderately-polluted district (MPD); and 63.8 mug/m3, 64.1 mug/m3, 22.2 mug/m3, and 31.7 mug/m3 in the highly-polluted district (HPD). The 99th percentiles were 178 mug/m3, 158 mug/m 3, 104 mug/m3, and 140 mug/m3 in the LPD; 169 mug/m3, 181 mug/m3, 106 mug/m 3, and 113 mug/m3 in the MPD; and 226 mug/m 3, 177 mug/m3, 140 mug/m3, and 137 mug/m 3 in the HPD. The average daily 1-h maximum O3 (peak O 3) was 83.7 mug/m3 in the LPD, 73.6 mug/m 3 in the MPD, and 64.8 mug/m3 in the HPD. / Lung function indices included FVC, FEV1, FEV 1/FVC, FEF25-75%, FEF25%, and FEF75%. Children in the HPD had lower FEV 1/FVC, FEF25-75%, and FEF25% than those in both the LPD and MPD, after controlling for their corresponding confounders. In comparison between the LPD and HPD, the adjusted mean differences for FEV1/FVC, FEF25-75%, and FEF25% were respectively 1.39%, 85 ml, and 113 ml in boys, and 1.60%, 86 ml, and 225 ml in girls. In addition, the decreased FEF75% of HPD was found in boys (62 ml) but not in girls. When comparing the MPD with LPD, the increased FEF25% was observed in girls in the LPD (158 ml), whereas boys in the LPD had lower FEF75% than those in the MPD (81 ml). There were no significant differences in children's FVC and FEV1 between districts. / The multistage fitness test (MFT) with the Matsuzaka's function was employed to predict cardiopulmonary fitness (VO2max) of children. After adjustment for the factors, girls in the LPD had significantly higher VO 2max than those in the MPD and HPD by 0.19 and 0.75 ml&middot;kg -1 &middot;min-1 respectively. The VO 2max among boys in the LPD was 0.48 ml&middot;kg-1 &middot;min -1 higher than those in the HPD. When we compared the VO 2max between students in MPD and HPD, higher VO2max in both boys and girls in the MPD were observed---by 0.49 and 0.56 ml&middot;kg -1 &middot;min-1 respectively. In LPD, significantly higher VO2max values were observed in both boys and girls who were physically active (children who took part in sports and/or vigorous free play at least three times a week for at least 30 minutes each time) compared with those who were not (0.71 and 0.65 ml&middot;kg-1 &middot;min -1 respectively), but those differences in VO2max among students in MPD and HPD were small and insignificant. / There were totally 2,641 (82.9%) children who participated in the study, and 2,203 participants were involved in analyses. After adjustment for confounding factors, girls living in the HPD had significantly increased odds ratios (ORs) for wheezing without cold (4.75), cough at night (1.71), phlegm without cold (3.61), compared with those in the LPD. Boys in the HPD had increased OR only for phlegm without cold (1.88). When comparing the MPD with LPD, the adjusted OR for cough at night achieved significance in girls (1.74) and marginal significance in boys (1.40). Sneeze with itchy-watery eyes and current/ever allergic rhinitis had negative associations with district. In comparison with LPD, the decreased OR for sneeze with itchy-watery eye in girls in HPD (0.65) reached statistical significance. Both boys and girls in MPD had significantly decreased ORs for current allergic rhinitis (0.72 and 0.50 respectively) and for ever allergic rhinitis (0.74 and 0.55 respectively). There were no significant differences in the prevalence rates of asthma and bronchitis between districts. / To explore associations between air pollution and respiratory and cardiovascular health of school children, a cross-sectional study was conducted among 3,186 primary school children in P3 and P4 from three districts with different air pollution levels in Hong Kong during March to June in 2004. / Gao Yang. / "August 2005." / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6339. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 137-154). / 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. / Abstracts in English and Chinese. / School code: 1307.

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)

Submitted in fulfilment of the requirements for the degree Master of Applied Science in Food and Nutrition, Durban University of Technology, 2015. / Objective: To determine the contribution of packed school lunches to the daily food intake of girls and boys in two Primary Schools in East London. Methods: The study was conducted among 199 girls and boys aged 9-13 years. Three 24-Hour recalls and a Food Frequency Questionnaire were completed during an interview with the participants to gather data on dietary patterns over a period of three consecutive days. Additionally, the contents of one lunch box per participant were recorded and weighed. Anthropometrics and socio-demographics were also completed during the interview. Results: The three 24-Hour Recall nutrient measurements revealed a low energy intake in 91 percent for the girls and 77 percent for the boys who were consuming below the recommended Estimated Energy Requirement for energy. The lunchboxes contributed one-third of the daily nutrient intake of the children. The 24-Hour recall revealed an energy-dense, carbohydrate-based diet. The contribution of total fat (30-32%) to the total energy is higher than the World Health Organization (WHO) recommendation of 15-30 percent. The daily fruit and vegetable intake (215.1g and 216.9g), according to the 24-Hour recall and lunchbox analysis respectively, was insufficient compared to the WHO-recommendation of >400g /day. Although the mean intake of most of the nutrients was sufficient, a large number of the participants did not meet requirements for the age group. The risk of overweight was high (24% for girls and 29.2% for boys) with 1.5 percent falling into the obese category. Conclusion: The results of the study indicated a high-fat and carbohydrate intake and a very low fruit and vegetable intake. The girl participants had better food choices for the lunchboxes but the majority of the participant’s daily intake did not meet the basic requirements of a balanced diet. The risk of overweight in the age category is an increasing problem among low- and high-income countries. Nutritional education should concentrate on healthy food choices in school lunchboxes as a large part of the day is spent at school.