abstract / Human Performance / Doctoral / Doctor of Philosophy

Previous reports have demonstrated that children’s physical activity is typically intermittent in nature. Accelerometers are reliable and valid tools for quantifying the pattern of activity in children. However, in order to interpret accelerometer output it is necessary to apply appropriate accelerometer thresholds for classifying physical activity intensity. Currently multiple accelerometer thresholds are available in the literature and it is unclear which are the most appropriate or whether thresholds should be sample specific. Additionally, there is little information regarding how the pattern of activity in children varies across groups and how activity patterns relate to health. The overall aim of the thesis was to describe the pattern of habitual physical activity, using objectively-measured physical activity data, in relation to health outcomes in pre-adolescent boys. The first objective was to characterize the pattern of boys’ habitual physical activity, using objectively-measured physical activity data. The second objective was to investigate the relationship between habitual physical activity and specific aspects of the activity pattern and health outcomes in boys. The final objective was to investigate the effects of continuously- versus intermittently- accumulated physical activity on acute health outcomes in boys, using an intermittent activity protocol based on the measured pattern of habitual activity in boys. The first four studies used a sample of 54 boys, aged 8 to 10 years. The final study used a different sample of 10 boys, aged 9 to 11 years. Both samples were from the county of Devon, UK. The first study of this thesis established sample-specific accelerometer-intensity thresholds through calibration research with ActiGraph accelerometers (counts•2s-1) in boys. The second study in the thesis demonstrated that relationships between time accumulated at different activity intensities and health (fatness, peak oxygen consumption and resting blood pressure) in boys were similar irrespective of whether sample-specific or published thresholds were employed as long as the threshold was at least equivalent to a brisk walk (i.e. >4 METs). However, the prevalence of children reported as meeting activity guidelines did differ according to thresholds employed. Study three showed that, despite little difference between overweight and normal weight boys in overall activity, time spent sedentary and minutes of light, moderate and vigorous intensity activity accumulated, aspects of the activity pattern (frequency, intensity and duration of ≥4 s (short) and ≥5-min (long) bouts of ≥light, ≥moderate, ≥vigorous and ≥hard intensity activity) differed by weight status. Overweight boys accumulated fewer and shorter bouts of activity, particularly sustained bouts of activity which were of moderate intensity or greater. Study four examined the relationship between activity pattern and health in boys further, focusing on body fatness, aerobic fitness, blood pressure and microvascular function. Results demonstrated that summary measures of activity were negatively related to body fatness, and positively related with both aerobic fitness (i.e., total, moderate, vigorous and hard activity) and endothelial function (i.e., total and light activity). Time spent sedentary was negatively related to endothelial function. The frequency and duration of activity bouts of ≥moderate intensity and the intensity of all activity bouts (i.e., ≥light intensity) were most important for body fatness and aerobic fitness. The frequency of all bouts (short and long) of at least light intensity was most important for endothelial health. Finally, study five moved away from chronic measures of health and examined the acute physiological effects of the recommended daily amount of physical activity (60 minutes of physical activity of ≥moderate intensity) on postprandial lipaemia and microvascular function in boys the following day. Furthermore, the study aimed to assess whether the effects differed depending on whether the activity was accumulated continuously or in a manner more similar to the children’s typical activity patterns identified in studies 3 and 4. In contrast to findings from adolescents and adults, 60 minutes of >moderate intensity activity did not impact on postprandial lipaemia or microvascular function the following day in healthy, active boys, regardless of how it was accumulated. The results of the present thesis indicate that aspects of the activity pattern are significantly related to health in boys and differ according to type of day and weight status. Furthermore, the benefits of sporadically-accumulated activity are equally as strong as continuously-accumulated activity to body fatness, aerobic fitness and endothelial health in boys. Since children typically accumulate short, intermittent bouts of activity, the promotion of sporadic activity (i.e., in intervention research and current physical activity guidelines for children and youth) might increase enjoyment and adherence. The benefits of acute intermittent exercise (which simulates free-living activity) on postprandial lipaemia and microvascular function in inactive children with risk factors for cardiovascular disease should be investigated. Longitudinal investigations into the activity pattern of a much larger and more age-diverse sample of boys and girls are needed to determine whether any changes in aspects of the activity pattern might alter these and other health outcomes (i.e., cardiovascular risk factors).

Fong, Hildy Felicia. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 221-234). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendix also in Chinese.

Thesis (MPH.) -- University of Limpopo, 2019 / Background: School children are mostly affected by diarrhoeal and respiratory infections and these are related to lack of proper hand washing. For children to be able to practice proper hand washing, they must have the knowledge and necessary resources to practice hand washing. The study’s purpose was therefore to establish the knowledge and practice of hand washing among primary school children. Purpose: The study’s aim was to assess the knowledge and practices of hand washing among primary school children in Kweneng Central Sub-District. Methods: A quantitative approach using a self-administered structured questionnaire to collect data regarding knowledge and practices on hand washing among primary school children was used. An observation checklist was also used to assess the practice of hand washing among primary school children. A stratified random sampling method was used to come up with a sample size of 330. SPSS 24.0 version was used to analyse the data. Results: The study revealed that the majority of primary school children had knowledge on hand washing but lacked proper hand washing practices. The results also showed that hand washing knowledge and practice among primary school children had no association with their age and gender. However, there was association between washing hands after going to the toilet and gender as well as the availability of bucket/basin to wash hands and gender. Conclusion: Children spend much of their day time at school; therefore schools are the right institutions to impart hand washing information and emphasise the importance of hand washing to the children. The availability of facilities such as clean water and soap are paramount to the facilitation of hand washing among primary school children and as such should be adequately provided in schools. Keywords: Hand washing, knowledge, practice, children, primary school.

This dissertation assesses the factors that lead to the emergence of infectious diseases in children, particularly the emergence of multidrug-resistant organisms (MDROs) and diarrheal pathogens in vulnerable pediatric populations. It includes three manuscripts. The initial study is a systematic review that summarized the role of antibiotic exposure on the acquisition of MDROs in children. Twenty-nine studies met the inclusion criteria and a positive association between prior antibiotic use and subsequent colonization or infection with an MDRO was identified in most studies. There were wide variations among study sites, populations, and definitions of antibiotic use and MDROs. Therefore, limited inferences could be made on which components of antibiotic exposure have the greatest impact on MDRO development. The second analysis examines the relationship between prior stay at a pediatric long-term care (LTC) facility and infection with an MDRO among hospitalized children. This study included 2,945 infections in 258,664 pediatric admissions from 2006 through 2016. At least 1 MDRO was identified in 10% of infections. Of the 1,198 children who had previously resided in a pediatric LTC facility, only 1 child (0.08%) had an MDRO infection. However, prior receipt of pediatric LTC was associated with an increased likelihood of infection (OR 2.4, CI95 1.66 – 3.43), C. difficile infection (OR 2.57, CI95 1.26 – 5.25), days of antibiotic use (OR 1.01, CI95 1.01 – 1.02), length of stay (OR 1.01, CI95 1.01 – 1.01), and death (OR 4.38, CI95 2.93 – 6.55). The concluding study evaluates the association between animals living in or near the home and diarrheal disease in children. This research is a secondary analysis of the Global Enteric Multicenter Study case control study, which investigated the epidemiology of diarrheal illness in children <5 in sub-Saharan Africa and south Asia. Of 9,439 cases and 13,128 controls, 87% had ≥1 animal in their home. In a multivariable analysis adjusting for exclusive breastfeeding, water source, sanitation facility, number of children <5 years in the household, and wealth index, any animal on a child’s compound decreased the odds of diarrhea by 33% (aOR 0.66, CI95 0.59 – 0.74). However, children with diarrhea who had an animal present were not more likely to have a positive stool culture. Overall, the three studies provide a thorough analysis of several factors associated with the infectious disease emergence in children, particularly as related to MDROs and diarrheal disease. Environmental characteristics, including antibiotic use and interaction with animals, were shown to be important factors for emergent infectious disease across diverse settings. The development of pediatric infection prevention interventions should take into consideration environmental risk factors in order to effectively mitigate the risks posed infectious disease emergence.

Asthma prevalence in children under age 18 has risen steadily in the U.S. since the mid-1970s. Most researchers attribute this increase to air pollutants, socioeconomic status or urban residence. This study examined asthma prevalence in Lane County, Oregon, using children's asthma hospital discharges (1990-1995), and data from 10 of 16 school districts. The overall asthma prevalence in Lane County was 5.8%, ranging from 1.9% (coastal Siuslaw District) to 10% (urban, industrial Bethel District). Asthma prevalence during 1988-1997 was examined for the largest school district, Eugene 4J (43% of the total study population). Eugene 4J is divided into four regions: North, South, Churchill, and Sheldon. The largest asthma prevalence increase during this time was detected in North Region (2.5%-8%), while the overall district prevalence nearly doubled (3.3%-6.2%). No correlation was found between socioeconomic status and asthma prevalence, and there was not a consistent pattern between asthma prevalence and location of each school district (urban vs. rural). Two out of the three urban school districts had higher asthma prevalence than five of the rural school districts. However, three school districts did not follow this pattern, either being lower than expected for an urban area or higher than expected for a rural area. Asthma hospitalization rates increased for most children between 1990 and 1995, with a 20-fold increase for ages 15-19 years. The results of this study show an increase in prevalence and severity of asthma in school children in Lane County. Further studies are warranted to investigate the contribution that geography, meteorology, and proximity to industry have in asthma prevalence in Lane County. / Graduation date: 1999

The ground work for this research thesis was completed seven years ago when the Dow Pharmaceutical Company selected Muncie, Indiana to test their new rubella vaccine. In the Fall of 1970, 311 seronegative elementary school children were innoculated with HPV-77, DK12 rubella vaccine. Of the 302 children who seroconverted, 98 were available for follow-up six years post innoculation. The participant's sera drawn six years previously was recovered in order to determine a six week and six year post innoculation titer on paired specimens. All 98 children, when retested, has measurable antibody. The geometric mean titer six years post innoculation was 55; a 14% decrease from the geometric titer of 64 six weeks after innoculation. At the six year point in time, there was at least a 9.2% incidence of subclinical reinfection, detected by a fourfold rise in the HI-titer, within the study group.Ball State UniversityMuncie, IN 47306

An instrument measuring Perceived Vulnerability was administered to grades three through twelve across a rural school district. The background literature base for the concept and validity of the Perceived Vulnerability measurement is reviewed. A series of means is calculated for the above data and subjected to a simple analysis of variance. Resulting data support a relative unchanging level of Perceived Vulnerability with a possible rise in the fifth grade level only. It is concluded that an adequate control value for this rural school district is established which can be used to measure impact of teaching programs. The need for further research to investigate the fifth grade "window" is noted.Ball State UniversityMuncie, IN 47306

The objective of this study was to investigate the relationship between the attitudes of parents toward outdoor environments and their children spending time outdoors, and how these attitudes related to their children's overall health. The sample for this study consisted of parents of six to thirteen year old children from the U.S., who accessed the survey from the Aggie Horticulture homepage between March and August 2009. Surveys were collected until 142 completed questionnaires were received. The online questionnaire included questions about parents' attitude toward nature; their children playing outdoors, play site rating, and children's overall health and demographic questions. Descriptive statistics were used to tabulate mean scores on the Parental Attitude About Nature Scale, and Parental Attitude About Their Children Spending Time Outdoors Scale, both of which indicated overall positive views. Pearson's product-moment correlations indicated statistically significant relationships between the Parental Attitude About Nature Scale, and Parental Attitude About Their Children Spending Time Outdoors Scale (P=0.001), and between these two scales and time children spent outdoors (P=0.008, P=0.05). No correlation existed between Parental Attitude About Their Children Spending Time Outdoors score and the Health Problems score (P=0.459). Also, there were statistically significant relationships between time spent indoors on video games or watching TV and health problems of children (r=+0.182, P=0.031), congestion (r=+0.192, P=0.023), and children having trouble sleeping (r=+0.237, P=0.005); asthma attacks and with the time spent in indoor organized sports (r=+0.274, P=0.001) and outdoor organized sports (r=+0.177, P=0.036). Additionally, time spent outdoors in free play was negatively correlated with body pain or discomfort (r=-0.219, P=0.009), repeated upset stomach (r=-0.179, P=0.034), or feeling tired or having low energy (r=-0.289, P=0.001). In regards to play areas a post-hoc analysis (Tukey's HSD) revealed that all the outdoor play scene pictures had statistically significantly higher mean scores in ratings of approval by parents (P=0.001) when compared to the indoor play area and that the outdoor scene picture with the black hardtop surface had a statistically significantly lower mean score (P=0.001) than the other outdoor play scene pictures. This indicated that, in general, parents preferred play areas with a greater amount of natural elements.

Darbo tikslas. Ištirti Kauno Vaiko raidos klinikos „Lopšelis“ stacionaro teikiamų paslaugų kokybę nepilnamečių pacientų atstovų požiūriu. Uždaviniai. Įvertinti stacionaro teikiamų paslaugų apimtį nepilnamečių pacientų atstovų poži��riu, ištirti nepilnamečių pacientų atstovų nuomonę apie paslaugų prieinamumą, įvertinti pacientų atstovų pasitenkinimą suteiktomis paslaugomis. Tyrimo metodika. Anoniminė anketinė apklausa vyko 2007 m. sausio – gruodžio mėnesiais. Buvo išdalinta 131 anketa. Gautos 115 anketų (atsako dažnis 87,8 proc.). Ryšiai tarp požymių buvo vertinami chi kvadrato kriterijumi bei laisvės laipsnių skaičiumi. Statistinių hipotezių reikšmingumui įvertinti pasirinktas statistinio reikšmingumo lygmuo p. Rezultatai. Beveik trys ketvirtadaliai tyrime dalyvavusių pacientų atstovų (72,9 proc.) nurodė, jog juos pilnai patenkino paslaugų apimtis. Didžiąją dalį respondentų (80,5 proc.) pilnai tenkino procedūrų trukmė. Statistiškai reikšmingai didesnė dalis pasitikinčių specialistų kompetencija respondentų (77,9 proc.) lyginant su mažiau pasitikinčiais (33,3 proc.) teigia, jog juos pilnai patenkino įstaigoje teikiamų paslaugų įvairovė (p < 0,01). Beveik pusė (44,6 proc.) apklaustųjų teigė, jog iš karto buvo priimti į gydymo įstaigą. Beveik visi dalyvavę tyrime vaikus lydintys asmenys (96,5 proc.) teigė, jog atvykus į skyrių, jie buvo informuoti apie skyriaus darbo tvarką. Didžioji dalis dalyvavusių tyrime (89,1 proc.) nurodė, jog norėtų sugrįžti į šią gydymo įstaigą, jei to... [toliau žr. visą tekstą] / Aim of the study. To investigate the quality of in-patient service from the perspective of minor patients’ representatives at Kaunas child development clinic “Lopšelis”. Objectives. To evaluate in-patient service extent from the perspective of minor patients’ representatives, to examine the opinion of minor patients’ representatives about accessibility of service, to evaluate satisfaction of minor patients’ representatives with the provided service. Methods. Anonymous survey of 115 patients’ representatives (response rate – 87.8%) was carried out in 2007. SPSS statistical analysis program was used to process the data. Statistic data reliability was tested by chi square test of independence, degrees of freedom quantity and statistical significance (p). Results. Almost three thirds of surveyed patients‘ representatives (72.9%) indicated, that they were satisfied with the extent of service. The majority of respondents (80.5%) were satisfied with the duration of procedure. Statistically significant bigger part of respondents trusted in competence of specialists (77.9%) in comparison with the less trusted in competence of specialist (33.3 proc.) maintained, that they were satisfied with the diversity of provided service (p<0.01). Nearly half of the respondents (44.6%) revealed, that they were immediately admitted to the institution. Almost all survived entourage (96.5%) stated, that on the arrival at department, they were informed about procedure in the department. The majority... [to full text]