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1
Wells, Jessica. "Puerperal Fever in Britain: Failed Models of Disease Causation." Scholar Commons, 2010. http://scholarcommons.usf.edu/etd/3699.
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In eighteenth- and nineteenth-century Britain, a bacterial infection which we now
know to be caused primarily by a streptococcus, was killing women in childbirth at an
alarming rate. The disease, called puerperal, or childbed, fever, was being transmitted
primarily from doctor to patient by a doctor’s unwashed hands and filthy, contaminated
clothing and linens. Despite this evident and, in retrospect, obvious vector, the doctors of
this period never discovered how to prevent their patients from dying a gruesome and
painful death. Many physicians wrote extensive accounts of the illness but often ended
their works in despair, unable to find the cause. Much of the historical literature blames
this befuddlement on personality traits of the physicians, arguing that egos and
professional hostilities prevented the kind of cooperation that could have led to progress.
This study attempts to show that this failure was not a product of personalities but
of the modern physicians’ assumptions and logic. The assumptions were the stillpowerful,
but often unnoticed, dictates about the human body handed down from ancient
Greek medicine. The logical errors were a product of pre-scientific notions of definition,
explanation, and evidence. The author argues that it was not a lack of data that thwarted
the physicians, but a series of these intellectual roadblocks that prevented them from
understanding and extended the terror of puerperal fever for another two centuries.
2
Aurell, Susanna, and Billström Linnea Rasmusson. "Vilka råd bör distriktssköterskan ge föräldrar till barn med feber? : En integrativ litteraturstudie." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-17341.
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Bakgrund: Feber drabbar barn någon eller några gånger om året, framförallt under småbarnstiden. En vanlig missuppfattning är att feber är ett potentiellt farligt tillstånd som kräver behandling. I motsats till detta har feber gynnsamma effekter när det kommer till kroppens bekämpande av infektioner. Kunskapsläget bland distriktssköterskor som ska tillhandahålla föräldrar rådgivning kring feber och febernedsättande läkemedel varierar, varför föräldrar riskerar att erhålla motstridiga och direkt felaktiga råd. Syfte: Syftet med denna litteraturstudie var att beskriva föräldrars kunskap rörande feber hos barn samt att belysa vårdpersonals attityder kring feberhantering. Metod: Arbetet har utförts i form av en integrativ litteraturstudie som inkluderade totalt 15 artiklar, såväl kvalitativa som kvantitativa. Integrativ studiedesign tillåter kvantitativa data att kvalificeras och kvalitativa data att kvantifieras så att de kan kombineras och sammanfogas till en gemensam helhet. Resultat: Det finns brister i kunskapen om feber hos barn hos vårdpersonal och föräldrar. Feberfobi är en samlande term för den okunskap och oro som riskerar leda till övernitisk behandling med antipyretika, både genom föräldrars eget initiativ och efter rekommendation från vårdpersonal. Feberkramper kan inte förhindras med febernedsättande läkemedel, trots det erhåller barn läkemedel i detta syfte och utsätts därmed för onödig biverkningsrisk. Diskussion: Ett behov av djupare kunskap hos både vårdpersonal och föräldrar finns för att inte evidensbaserad behandlingsregim ska riskera att gå förlorad till förmån för inadekvata och hemsnickrade varianter med onödig administration av antipyretika och vidare spridning av feberfobi. Nyckelord: Antipyretika, Barn, Feber, Feberfobi, Kunskap, LitteraturstudieIntroduction: Fever is something children, especially during infant years, experience one or a few times each year. A common misconception is that fever is a dangerous condition that requires treatment; however contrary to these misconceptions, fevers have positive effects when it comes to body’s ability to fight infections. The level of knowledge on this subject of district nurses, whose task it is to guide parents with advice concerning fevers and antipyretics, varies. This results in parents getting contradictory and erroneous advice. Aim: The aim of this literature study was to describe parents’ knowledge concerning fever in children, and to illuminate attitudes concerning fever treatment among health care professionals. Method: A literature review of 15 scientific articles where examined in accordance with an integrative study design. The integrative design allows qualitative and quantitative data to be combined and merged into a common whole. Results: There is a lack of knowledge about fevers in children among health care professionals and parents. Fever phobia is a collective term for the lack of knowledge and worrying that can lead to overzealous treatment with antipyretics; based on parents’ own initiative and recommendations from health care professionals. Antipyretics do not prevent febrile seizures, but many children are still medicated for this purpose. This, in turn, leads to increased risk for side effects. Discussion: There’s a need for a deeper knowledge, in both health care professionals and parents, to ascertain that an evidence-based treatment regimen is not replaced by inadequate and home-grown techniques, leading to unnecessary administration of antipyretics and further propagation of fever phobia. Keywords: Antipyretics, Children, Fever, Fever phobia, Knowledge, Literature study
2012-11-09
Utbildningsstöd har erhållits från FoU - Forskning och Utbildning i Landstinget Västernorrland.
3
Sharber, Elizabeth Jane 1958. "A comparison of methods to reduce fever in young children." Thesis, The University of Arizona, 1994. http://hdl.handle.net/10150/291660.
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Tepid sponge baths can distress febrile children, and are of unproven value for reducing fever. This study compared the cooling effect of acetaminophen alone, and acetaminophen plus a 15 minute tepid sponge bath. Twenty children (age range: 5 to 68 months) seen at the Urgent Care or Emergency Department with fever of ≥ 38.9°C were randomized to receive (1) no sponge bath, or (2) a 15 minute sponge bath 30 minutes after the acetaminophen. Subjects received a 15 mg/kg dose of acetaminophen. Tympanic temperature was monitored every 30 minutes for two hours, and subjects were monitored for signs of discomfort (crying, shivering, goosebumps). Significance level was set at 0.05. Sponge bathed subjects cooled faster during the first hour; however, there was no significant difference between groups in overall temperature change after two hours. Sponge bathed subjects had significantly higher discomfort scores during the bathing period only (p ≤ 0.009).
4
Staedke, Sarah Grace. "Evaluation of home-based management of fever in urban Ugandan children." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536830.
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Rekstad, Lindsay C. "A comprehensive study of the effects of allergic rhinitis on the performance and conduct behavior of school-aged children." Online version, 2008. http://www.uwstout.edu/lib/thesis/2008/2008rekstadl.pdf.
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Huthmaker, Julie Weisenbacher. "Improving Dengue fever knowledge, attitude, and practices in primary school children in Florida through animation." Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3685619.
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Background: Incident rates of dengue fever are rapidly increasing worldwide. Contributing factors including climate change, urbanization, globalization, and vector mutation, are creating significant public health challenges. Dengue fever has no vaccination, and no cure; therefore prevention through vector control is the primary method of public protection. Research indicates that community involvement is critical in achieving vector control, and that children, disproportionally burdened by this disease, are an effective and appropriate population to target with interventions. Innovative, sustainable, cost effective strategies are needed. Objective: It was theorized that an educational animation regarding dengue fever, created using CDC guidelines, would be effective at improving knowledge, attitude, and practices in primary school children in Florida. An animation entitled "Dengue Fever Comes To Town" was developed to assess this concept. Methods: A pretest/posttest study was conducted. Knowledge changes were statistically evaluated using a Two-tailed Paired Sample t-test. Attitude changes were evaluated using a Wilcoxon Matched Pair Signed Rank. Practice changes were evaluated using a chi-square test. Results: The animation was effective at improving knowledge, attitude, and practices in third through fifth grade levels, for both males and females. Recommendations: Given the vulnerability of the population, and the increasing risk of dengue fever, establishment of preventive education is recommended, including adding the educational animation to school curricula in Florida.
7
Kojima, Kazue. "Gender, family and fertility : why are Japanese women having fewer children?" Thesis, University of York, 2013. http://etheses.whiterose.ac.uk/5164/.
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Japanese women are having fewer children than ever before. There have been many quantitative studies undertaken to attempt to reveal the reasons behind this. The Japanese government has been concerned about the future economic decline of the country, and has been encouraging women to have more children. Although the Japanese government has been supporting women financially, it has not focused on gender equality, making it more difficult for women to be able to pursue their chosen careers. Japanese women have greater access to higher education than ever before, yet the Japanese patriarchal social structure still compels women to rely on men and all but eliminates their independence. The Japanese male-dominated society is resistant want to change. Family ties are still very strong, and women are expected to take care of the household and do unpaid work, while men work outside the home and earn a paid salary. In the labour force, women do not enjoy the same level of equality and opportunity as their male counterparts, as it is naturally marry, have children, and take care of the family. The system is skewed in favor of the males. Women are not able to pursue the same career path as men; even from the start, women are often considered as candidates for potential wives for the male workers. In the course of this research, I conducted a total of 22 interviews of single and married Japanese women. I set out to explore and discover the causes behind why Japanese women are choosing to postpone marriage and have fewer children, as well as touching upon the much deeper issue of gender inequality due to the Japanese patriarchal social structure. Women cannot live how they want to and only for themselves; they must always put their families first. This study reveals the struggles of Japanese women and how many are confused, and how some resist the patriarchal system. Many women waste their education, careers, knowledge and experience, all in the name of maintaining family ties and the patriarchal social structure.
8
Machado, Beatriz Marcondes. "Avaliação clínica de crianças de 0 a 36 meses com febre sem sinais localizatórios." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-22062010-113213/.
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Introdução: A febre sem sinais localizatórios é definida como presença de febre de até 7 dias de duração, sem identificação da causa após anamnese e exame físico detalhados. A maioria destas crianças apresenta doença infecciosa aguda autolimitada ou está em fase prodrômica de uma doença infecciosa benigna. Poucas têm infecção bacteriana grave: bacteremia oculta, pneumonia oculta, infecção urinária, meningite bacteriana, artrite séptica, osteomielite ou celulite. Embora a febre seja uma das queixas mais comuns nos serviços de emergência, a abordagem da criança febril permanece controversa. Objetivos: avaliar a aplicabilidade de um protocolo padronizado para o atendimento e seguimento das crianças até 36 meses de idade com febre sem sinais localizatórios e analisar os fatores de risco para infecção bacteriana grave nestas crianças. Métodos: estudo prospectivo em crianças até 36 meses de idade que procuraram o pronto socorro do Hospital Universitário da Universidade de São Paulo, com quadro de febre sem sinais localizatórios, durante o período de um ano (junho/2006 a maio/2007). As crianças foram atendidas conforme protocolo que estratifica o risco de infecção bacteriana grave de acordo com a presença ou não de toxemia, idade e valor da temperatura. Conforme a avaliação de risco, indicava-se triagem laboratorial (hemograma, hemocultura, sedimento urinário, urocultura e, se necessário, radiografia torácica, liquor e coprocultura). Os fatores de risco para infecção bacteriana grave estudados foram: sexo, idade, presença de toxemia, temperatura, número total de leucócitos, número total de neutrófilos e número total de neutrófilos jovens. Resultados: Foram seguidas 215 crianças, sendo 111 (51,6%) do sexo feminino. A média de idade foi de 11,85 meses (DP ± 8,91). Vinte crianças, na avaliação inicial, apresentavam algum grau de toxemia, e 195 estavam em bom estado geral. Nas crianças de 3 a 36 meses não toxêmicas, 95 tinham temperatura axilar >39ºC. Em 107 crianças (49,8%), houve melhora espontânea do quadro febril; em 88 (40,9%), foi identificada doença benigna autolimitada; e em 20 (9,3%), infecção bacteriana grave. Dentre as infecções bacterianas graves, identificou-se 16 infecções urinárias, três pneumonias e uma bacteremia oculta. Das 215 crianças, 129 (60%) não receberam qualquer antibioticoterapia, e 86 receberam antibiótico em algum momento. O antibiótico empírico foi mantido por, em média, 72 horas. Na análise univariada, dos fatores utilizados para estratificação de risco para infecção bacteriana grave, apresentaram níveis descritivos inferiores a 0,05 a temperatura >39oC, o número total de leucócitos >15.000/mm3 e >20.000/mm3 e o número total de neutrófilos >10.000/mm3. Na análise multivariada apenas o número total de neutrófilos >10.000/mm3 mostrou-se estatisticamente significante. Conclusão: o protocolo aplicado mostrou-se adequado para o atendimento e seguimento destas crianças utilizando para busca de infecção bacteriana grave exames simples e passíveis de serem realizados na maioria dos serviços. A maioria das crianças apresentou resolução espontânea do quadro de febre. Todas as infecções bacterianas graves foram identificadas, sendo a infecção urinária a mais comum. Dentre os fatores de risco o número total de neutrófilos >10.000/mm3 associou-se de maneira estatisticamente significante com infecção bacteriana grave, tanto na análise univariada como na multivariada.Introduction: Fever without localizing signs is defined as the presence of fever of up to 7 days duration, without identifying the cause after history and physical examination. Most of these children presented self-limited acute infectious disease or is in the prodromal phase of a benign infectious disease. Few have serious bacterial infection: occult bacteremia, occult pneumonia, urinary tract infection, bacterial meningitis, septic arthritis, osteomyelitis or cellulitis. Although fever is a common complaint in emergency departments, the approach to febrile children remains controversial. Objectives: To evaluate the applicability of a standardized guideline for the management of children up to 36 months of age with fever without localizing signs and examine the risk factors for serious bacterial infection in these children. Methods: Prospective study involving children up to 36 months of age with fever without localizing signs treated at the emergency department of Hospital Universitário, Universidade de São Paulo, Brazil, from June 2006 to May 2007. The children were treated according to the guideline that classifies the risk of serious bacterial infection according to the presence or absence of toxemia, age and temperature. The laboratory screening was based on risk assessment (blood test, blood culture, urine sediment, urine culture and, if necessary, chest radiograph, cerebrospinal fluid and stool culture). Risk factors for severe bacterial infection were studied: sex, age, presence of toxemia, temperature, total number of leukocytes, total number of neutrophils and total number of young neutrophils. Results: We studied 215 children, 111 (51.6%) females. The mean age was 11.85 months (SD ± 8.91). Toxemia was found in 20 children, and 195 were well-appearing. Among the children from 3 to 36 months without toxemia, 95 had axillary temperature >39ºC. In 107 (49.8%) children, there was spontaneous resolution of fever; in 88 (40.9%), benign self-limited disease was identified; and in 20 (9.3%), there was serious bacterial infectious. Among the serious bacterial infections, we identified 16 urinary infections, three cases of pneumonia and one occult bacteremia. Of the 215 children, 129 (60%) received no therapy, and 86 received antibiotics at some point. Empirical antibiotic treatment was maintained for an average of 72 hours. The temperature >39°C, the total number of leukocytes >15.000/mm3 and >20.000/mm3 and the total number of neutrophils >10,000/mm3 were statistically significant (p<0,05) in univariate analysis of the factors used for risk stratification for serious bacterial infection. In multivariate analysis only the total number of neutrophils >10.000/mm3 was statistically significant. Conclusion: The guideline was shown to be appropriate to follow up these children using simple laboratory tests that can be carried out at most health facilities. Most of the children had spontaneous resolution of fever. All serious bacterial infections were identified, and the urinary tract infection was the most common. Among the risk factors studied the total number of neutrophils >10.000/mm3 was statistically significant with serious bacterial infection in both, univariate and multivariate analysis.
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Ba-Saddik, Iman Ali Mahmoud. "Rheumatic fever and rheumatic heart disease : prevalence among Yemeni school children and studies of the immunopathogenesis of the disease." Thesis, University of Liverpool, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569117.
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Background: The epidemiological, genetic and host immunogenetic association between Group A P haemolytic Streptococcal (GAS) pharyngotonsillitis and the subsequent development of Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) is an area of major interest. RHD still remains an important contributor to cardiovascular disease in children and adults in Yemen. Aims: The purpose of this study was to determine: (i) the prevalence ofRHD among primary school children in Aden City, Yemen, (ii) the prevalence of GAS and Non Group A β haemolytic Streptococcal (SNA) pharyngotonsillitis among patients attending primary health care centres, (iii) the distribution of emm genotypes and selected superantigen prophage exotoxin anasofgenes among GAS and SNA , (iv) the antimicrobial susceptibility pattern of GAS and SNA in patients with a history of ARF and RHD, (v) comparision of a profile of selected cytokines and chemokines between ARF and recurrent rheumatic fever (RRF) patients. Methods: A cross-sectional case-finding survey of RHD was conducted in 6000 school children aged 5 - 16 years in Aden City to determine the prevalence of RHD. A cross- sectional descriptive survey was undertaken in 730 children aged 1- 16 years with acute pharyngotonsillitis to determine the prevalence of GAS and SNA infections. Thirty four throat culture isolates from patients with GAS and SNA pharyngotonsillitis with history of ARF and echo-proven cases of RHD were analyzed by a multiplex PCR method to determine the emm genotypes, presence of superantigen prophage-associated virulence genes and so! genes. Antibiotic sensitivity tests were conducted on 24 GAS and SNA throat culture isolates using the BSAC disc diffusison method. Fourteen serum cytokine and chemokine concentrations including interleukin-Iβ (IL-lβ), interleukin-6 (IL-6), interleukin-7 (IL-7), interleukin-8 (IL-8), interleukin-9 (IL-9), interleukin-10 0 (IL-I0), interleukin-12p70 (IL-12p70), tumor necrosis factor (TNF-α), interferon gamma (IFN- γ), chemokines monocyte chemotactic protein-I (MCP-1), macrophage inflammatory protein-I a (MIP-1 a), macrophage inflammatory protein-I P (MIP-I P), human interferon inducable protein-I 0 (IP-IO) and regulated upon activation, normal T-cell expressed and secreted (RANTES) protein levels from children with ARF and RRF were analyzed by the BD F ACS Array Bioanalyzer using FCAP Array Software. Results: The prevalence of RHD was 36.5/1000 school children which is one of the highest reported among school echo cardiography surveys in the world. RHD had a high preponderance in 10-16 years old students. 49.8% had mitral regurgitation (MR) lesions, 26.6% had MR with mitral valve prolapse (MVP) and 17.8% with combined MR and aortic regurgitation (AR) lesions. RI--ID was diagnosed in more than one family member in 53 (24.2%) of the children. A high prevalence of GAS pharyngotonsillitis (41.5%) was noticed in children of 11 - 15 years of age. A red erythematous uvula and petechie on the soft palate were observed significantly more commoinlyin GAS pharyngotonsillitis. Group B (GBS), Group C (GCS) and Group Gβ haemolytic streptococci (GGS) were isolated from pharyngotonsillitis in 4.3% patients with history of ARF/RHD. The most frequent GAS isolates among ARF and RI-ID patients with pharyngotonsillitis were emm87, emm12, emm28 and emm5. This is the first report of emm87 and emm28 genotypes to be potentially rheumatogenic. The 11 emm87 GAS isolates shared a common PFGE pattern and profile of five exotoxin prophage genes spec, spdl, sdn, sUC and silD with the sof 87 sequence. emm12 and emm28 GAS strains were positive for gene sof , spec and spd1. This is the first report to describe the pattern of exotoxin prophage genes of spec, spd1, sdn, silC and silD among emm87,-emm12, emm28 and emm5 GAS and SNA (GBS, GCS and GGS) isolates with history of ARF and RHD. The genotypic characteristics of GBS, GCS and GGS isolates confirmed seven new emm sequence types first detected among children with acute pharyngotonsillitis. GAS and SNA isolates were susceptible to the β-lactam antimicrobials, penicillin and amoxicillin. Erythromycin resistance was detected in so! positive emm 12 and emm28 in 50% and 33% of isolates respectively. Chemokine MCP-l was significantly correlated with cytokines, IL-lβ, IL-6, IL-l0, IL- 12p70, TNF-α, IFN-γ and RANTES in patients with RRF. This suggests that MCP-l could serve as a potential inflammatorybiomarker for patients with RRF having underlying RHD. MIP-1~ had significant correlations with IL-8, IL-lO, IL-12p70, IP- 10, TNF-α and IFN-γ in patients with ARF. MIP-l~ may serve as a potential inflammatory biomarker in patients with ARF without RHD. Conclusions: The high prevalence of RHD is an alarming public health problem in Yemen. Urgent screening surveys and a preventive RHD prophylactic program with appropriate management of GAS pharyngotonsillitis are required. Future studies are needed to confirm the rheumatogenic GAS and SNA strains with their exotoxin prohage genes and the role of the chemokines and cytokines as biomarkers for ARF within the complex network of auto immune reactions in RF/RHD. This study hopes to provide a further small step in elucidating the pathogenesis of this complex immunological disease.
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Hernandez-Rodriguez, Jose P. "Developing interventions to improve parental and carer performance of temperature measurement, fever care and knowledge of feverish illness in children." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:a2882960-81f1-4c3d-9f97-db09b24580dc.
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Background: Fever is often the initial feature of infectious diseases, which remains a major cause of morbidity and an important cause of mortality in children in the UK, and is one of the most common reasons for children to be taken to a general practitioner. Febrile illness therefore places a considerable burden on children, their families and health care services. The initial disease identification and diagnostic challenge starts at home, with parents and carers differentiating children with suspected serious illness from the vast majority who have self-limiting or minor infections. This thesis aims to understand caregivers’ knowledge, beliefs and actions in the existence of a fever in comparison with NICE guideline advice, and suggests some recommendations to improve their knowledge and management of fever. Method: Four studies were conducted for this thesis. First, a systematic review of 47 studies, including 20,427 participants, was used to understand parents’ knowledge regarding interpretation of temperature measurements, actions to manage a fever, and their beliefs. Second, two focus group interviews in primary care, with 9 parents, were used to explore parental views and beliefs on the management of fever and temperature measurement. Third, a thermometer survey, with 123 thermometers, was used to assess the consistency of advice from information contained in commercially available thermometers, with respect to evidence-based guidelines for feverish illness in children. Fourth, a questionnaire survey, in primary care, with 309 participants, was used to find out carer knowledge of temperature measurement and fever management in children 5 years or younger. Results: Carer knowledge about normal body temperature and fever in children was poor: mild fever was misclassified by many as high. Understanding of what actually constitutes fever ranged widely; carers actively reduced mild fever with antipyretics, used non-recommended methods, and most learned to use a thermometer from its instructions. Most parents did not know what a fever was and believed that it was a harmful condition that may be linked to a more serious disease. Parents wanted to be provided with specific and practical information on the identification of fever and its management. Most of the thermometer information did not include guidance on fever management or thermometer use, did not take into account parental and carer interpretation of fever and disease, however, incorporated unnecessary referrals into health services. Thermometer cost had no influence on the quality of the information provided. Conclusions: The research presented in this thesis suggests that caregivers often lack basic knowledge on temperature measurement and fever care. The study proposes that a simple NICE guideline based educational intervention may help them to correctly take a temperature measurement while assessing other signs of illness, and allow them to provide appropriate management methods at home, and more importantly, seek further referral where necessary. This may help towards decreasing unnecessary attendances in primary and secondary care.
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Mwale, Evans L. "Assessment of the clinical management of children suspected of having malaria in Lusaka District, Zambia." University of the Western Cape, 2016. http://hdl.handle.net/11394/4909.
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Magister Public Health - MPHIn Zambia, there had been a large scaling up of new interventions to control malaria since 2003, which included the distribution of rapid diagnostic tests (RDTs), used to immediately determine if someone with symptoms suggestive of malaria actually has malaria; training of health workers in the use of the RDTs; and the prescription of artemisinin-based combination therapy (ACT) to which the malaria parasite is sensitive, rather than the old treatment regime of chloroquine to which the malaria parasite had become resistant. The use of RDTs to confirm the presence of malaria before treating for it with ACT became known as the „test and treat‟ policy. Previously, since the 1960s, in malaria endemic areas such as Zambia, children presenting with fever (the commonest symptom of malaria) without any obvious other cause for the fever, were assumed to have malaria and were hence treated for it with chloroquine. This was known as "presumptive treatment" of malaria. The combination of "presumptive treatment" and the use of a single medication led to the development of high levels of resistance to chloroquine, to the extent that it is now no longer an effective treatment for malaria. Years after the introduction of the "test and treat" policy, it was still unclear to what extent it was being implemented, as there was initial reluctance by health workers to test all children presenting with fever for malaria and if they did test they may not have followed the management guidelines of treating those who test positive with ACT and further investigating those who test negative for the cause of the fever. It seemed that staff had gotten used to the "presumptive treatment" approach to malaria over almost 4 decades and hence were quite reluctant to abandon it. The conflicting guidelines for malaria treatment in children between IMCI and "test and treat‟ has promoted a paradox between presumptive treatment for malaria and "test and treat" approach as IMCI teaches health workers to treat febrile children presumptively for malaria whereas the "test and treat" approach requires them to first make a definitive diagnosis before treating. Hence although the "test and treat" approach was instituted to overcome the problems with presumptive treatment approach it now had to contend with the competing and contradictory influence of the IMCI approach. This study therefore aimed to assess what proportion of children aged five years and younger who presented with fever were managed via the "test and treat" guidelines and which factors were associated with this, in Lusaka District, Zambia. Methodology: A cross sectional analytical study design was used based on a review of medical records. A sample size of 800 medical records of children presenting with fever was selected from 10 out of the 23 health care facilities in Lusaka, using a multistage stratified random sampling technique. Four hundred records were sampled from 2008 records (five years after commencement of the "test and treat" policy) and 400 from 2011 records (eight years after commencement of the "test and treat" policy). Trained data collectors used a data extraction tool to transcribe demographic and clinical data from the medical records in a standardized manner. Data Analysis: Univariate descriptive statistics analysis was performed using measures of central tendency and measures of dispersion to analyze numerical (continuous) variables such as age, weight and body temperature; and using frequencies for categorical variables such as gender, area of residence, RDTs/microscopy malaria tests conducted, received ACT if RDT positive, presence of an ACT treatment chart on the health centre wall and availability of a weighing scale. To determine the relationship between variables, bivariate analysis via the prevalence ratio was conducted. Results: Just over half (55%) of all children with fever were tested for malaria in 2008 and this gratifyingly increased to (73%) in 2011. Overall, the proportion of children correctly and appropriately treated with ACT, which means that those who tested positive for malaria were given ACT, was 85% in 2008 but regrettably dropped to 72% in 2011. Although "presumptive treatment" decreased from 24% in 2008 to 11% in 2011, the proportion of children with fever not tested for malaria, and although not treated for malaria, but left without a definitive diagnosis of their fever being made, remained high but dropping (22% in 2008 and 16% in 2011). Similarly the proportion of children who tested negative for malaria but then did not undergo any further investigation also unfortunately remained very high and rising (57% in 2008 and 89% in 2011). A combination of the above poor clinical management practises resulted in only 38% of children with fever in 2008 and unfortunately dropping to only 33% in 2011 being correctly managed (tested for malaria via RDT or microscopy and treated with ACT if positive, while further investigated for the cause of fever if negative). On preparedness of the health facility to implement the "test and treat" policy, it was noted that only 4 out of 10 health facilities were at least minimally prepared to do so, but paradoxically on bivariate analysis those minimally prepared were less likely (PR 0.62; 95% CI 0.41-0.94) to correctly manage the patients in 2011 than those who were unprepared. A similar paradox occurred for those correctly treated with ACT after testing positive, with facilities which were minimally prepared being less likely to do so (PR 0.28; 95% CI 0.14-0.58) in 2011 than those facilities which were unprepared to implement the "test and treat" policy. However these associations were inconsistent over time, as the associations were not present in 2008. Similarly all other factors such as staff category (doctor, nurse, clinical officer) and type of presenting symptoms besides fever (anorexia, lethargy, pallor) assessed, were not consistently associated with testing for malaria in both 2008 and 2011. The same applied for the other two main outcome variables of 'treated with ACT after test positive for malaria' and 'correctly managed child with fever', in that there were no factors that showed a consistent association with them in both 2008 and 2011. Conclusion: Testing of children with fever for malaria is at a low level but rose between 2008 and 2011. Paradoxically the proportion of those diagnosed with malaria who were correctly treated with ACT dropped between 2008 and 2011, as did the proportion of children with fever who were correctly managed. No factors assessed in this study were found to be consistently associated in both 2008 and 2011 with either testing for malaria, or treating confirmed malaria cases with ACT, or managing patients with fever correctly. Recommendations: In order for health workers to correctly implement the "test and treat" policy, which involves a series of complex steps, they ought to be formally trained to do so, mentored and constructively supervised. Additionally health facilities should be adequately equipped to enable health workers to fully implement the policy. Further studies to assess factors associated with the correct management of malaria via the "test and treat" policy are warranted.
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Ferdousi, Hosne Ara. "Pollinosis in children with special reference to the development of asthma /." Linköping : Univ, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med842s.pdf.
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Park, Jinkyu. "Korean parents in 'English fever' and their 'early study-abroad' children in the United States parental beliefs and practices concerning first language peers /." [Bloomington, Ind.] : Indiana University, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3278230.
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Thesis (Ph.D.)--Indiana University, Dept. of Language Education, 2007.Source: Dissertation Abstracts International, Volume: 68-09, Section: A, page: 3770. Adviser: Mitzi A. Lewison. Title from dissertation home page (viewed May 8, 2008).
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Lantto, U. (Ulla). "Etiology and outcome of PFAPA (periodic fever, aphthous stomatitis, pharyngitis and adenitis) syndrome among patients operated with tonsillectomy in childhood." Doctoral thesis, Oulun yliopisto, 2018. http://urn.fi/urn:isbn:9789526219677.
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Abstract Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a syndrome characterized by regular, high-fever episodes with healthy periods in between. In a classic phenotype of the syndrome, the fevers begin in childhood before the age of five, and fever flares are accompanied by aphthous stomatitis, pharyngitis, and/or cervical adenitis. The etiology of the syndrome is unknown, but tonsillectomy (TE) has been shown to be an effective treatment for the disease. The purposes of this study were as follows: (1) to assess the long-term outcome of PFAPA patients treated by TE with either the classic or incomplete phenotype (later onset of the disease and/or missing oropharyngeal symptoms), (2) to compare the health and growth of PFAPA patients with healthy controls, and (3) to compare the histological and microbiological findings of the tonsils of PFAPA patients with controls via conventional and modern sequencing technologies. In this approximately 9-year follow up, 97% (n = 56) of patients with the classic phenotype and all patients (n = 50) with the incomplete phenotype achieved a prompt and constant response after TE. There were no differences in either the length of fever episodes or flares between patients with both the classic and incomplete phenotypes. The health and growth of 119 PFAPA patients was compared to that of sex- and age-matched controls (n = 230), and no differences in prevalence of chronic diseases or growth were found between the groups. Infections, oral thrush, and pollen allergy were more common in the history of the PFAPA patients than in the controls. Microbiological and histological findings of the tonsils of PFAPA patients (n = 31) were compared with the findings of the controls (n = 24) who had undergone TE for other reasons. Biofilm formation and Candida albicans were more frequently found among PFAPA patients than the controls, but Staphylococcus aureus, varicella zoster, and herpes simplex viruses were more common in the controls. While comparing the bacterial microbiota between the groups, we found significant differences in the presence and relative abundance of many bacteria. For example, Cyanobacteria were more common and abundant in the case samples than in the controls. Because the long-term outcome after TE was excellent, both in classic and incomplete PFAPA patients; a new diagnostic criteria for the syndrome is proposed. The microbes of the tonsils in PFAPA patients differ from that of the controls, which may play an important role in triggering the inflammatory processes that lead to symptoms of PFAPATiivistelmä Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrooma, on oireyhtymä, jossa potilaat kärsivät hyvin säännöllisesti ilmaantuvista, toistuvista kuumejaksoista, joiden välillä potilaat ovat terveitä. Klassisessa tautimuodossa kuumeilut alkavat lapsuudessa ennen viiden vuoden ikää ja kuumevaiheeseen liittyy liitännäisoireita: suun limakalvojen rakkuloita, nielutulehdusta ja/tai kaulan imusolmukkeiden suurentumista. Oireyhtymän syytä ei tiedetä, mutta nielurisaleikkaus (TE) on osoittautunut tehokkaaksi hoidoksi. Tutkimuksen tarkoituksena oli (1) arvioida PFAPA potilaiden vointia pitkäaikaisseurannassa TE:n jälkeen ja vertailla taudinkuvaa niiden PFAPA potilaiden välillä, joilla oli klassinen PFAPA tai epätyypillinen PFAPA. (2) Lisäksi tutkimme myös TE:lla hoidettujen PFAPA potilaiden sairastuvuutta, yleistä terveydentilaa ja kasvua vertaamalla näitä sukupuoli- ja ikävakioituihin kontrolleihin ja (3) selvitimme mikrobiologisia ja histologisia löydöksiä PFAPA potilaiden nielurisoissa verrattuna muista syistä TE:ssa käyneiden lasten nielurisoihin. Tässä noin yhdeksän vuoden seurannassa TE:n jälkeen oli täysin parantunut 97% (n = 56) potilaista, joilla oli klassinen PFAPA, ja kaikki (n = 50) potilaat, joilla oli epätyypillinen PFAPA (tauti oli alkanut viiden ikävuoden jälkeen ja/tai klassiset liitännäisoireet puuttuivat). Kuumeprofiilit eivät muilta osin eronneet ennen nielurisaleikkausta näissä ryhmissä. PFAPA potilaiden (n = 119) kasvu ja yleinen terveydentila eivät eronneet väestökontrolleista (n = 230). Krooniset ja autoimmuunisairaudet olivat yhtä harvinaisia molemmissa ryhmissä. Potilaat raportoivat sairastaneensa enemmän infektioita ja sammasta lapsuudessa ja heillä oli enemmän siitepölyallergioita. PFAPA potilaiden (n = 31) ja muista syistä TE:ssa käyneiden lasten (n = 24) nielurisojen mikrobiologiaa ja histologiaa tutkittiin ja vertailtiin. Biofilmimuodostusta nielurisan pinnalla ja Candida albicansia löytyi enemmän tapauksilta kuin kontrolleilta, kun taas Staphylococcus aureusta, varicella zoster- ja herpes simplex -viruksia tavattiin enemmän kontrolleilla. Myös mikrobiomi erosi ryhmien välillä, esimerkiksi syanobakteerit olivat yleisempiä PFAPA risoissa kuin kontrolleilla. Klassisten ja epätyypillisten PFAPA potilaiden terveydentila TE:n jälkeen oli pitkäaikaisseurannassamme erinomainen ja siksi ehdotamme, että PFAPA –syndrooman diagnostisia kriteereitä tulisi muuttaa. Nielurisojen mikrobisto on erilainen kontrolleihin verrattuna ja tällä voi olla merkitystä PFAPA syndrooman inflammatorisessa prosessissa
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Watt, Ian. "Why Are You Here? Exploring the Logic Behind Nonurgent Use of a Pediatric Emergency Department." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804858/.
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Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited impact on utilization outcomes among families with poor access to primary care. Afterhours primary care should be expanded to accommodate families with rigid work schedules and limited transportation resources.
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Scarcella, Anne C. "Comparison of auxillary and rectal temperature readings in children age one to five years old who present with fever to an out patient pediatric clinic /." Staten Island, N.Y. : [s.n.], 2002. http://library.wagner.edu/theses/nursing/2002/thesis_nur_2002_scare_compa.pdf.
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Adhiambo, Oreje Joy Susan. "Assessment of prescribing patterns and availability of anti-malarial drugs to children under five years of age in a rural district in Kenya." University of Western Cape, 2013. http://hdl.handle.net/11394/3927.
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Magister Public Health - MPHAim: The aim of this study was to assess the prescribing practices and availability of antimalarial drugs to children under five years of age in primary health care facilities in Bondo district.
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Gomes, Roberta Cunha. "Características clínicas e laboratoriais de 847 pacientes com lúpus eritematoso sistêmico juvenil em três grupos etários ao diagnóstico da doença: um estudo multicêntrico brasileiro." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-07022019-161409/.
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Introdução: A idade ao diagnóstico do lúpus eritematoso sistêmico juvenil (LESJ) pode influenciar a expressão da doença em termos de apresentação clínica inicial, padrão de envolvimento de órgãos e achados sorológicos. Objetivo: Avaliar dados demográficos, características clínicas e alterações laboratoriais no momento do diagnóstico da doença em três grupos etários diferentes de pacientes com LESJ: grupo A com início precoce (< 6 anos), grupo B com início em idade escolar ( >= 6 e < 12 anos) e grupo C com início em adolescentes ( >= 12 e < 18 anos). Métodos: Estudo multicêntrico brasileiro de coorte retrospectiva em 10 centros de reumatologia, incluindo 847 pacientes com o diagnóstico de LESJ. Resultados: Os pacientes foram divididos em três grupos: A com 39 (4%), B com 395 (47%) e C com 413 (49%). Dos 39 pacientes com LESJ do grupo A, 3 (8%) tinham < 2 anos, 4 (10%) >= 2 e < 3 anos e 32 (82%) >= 3 e < 6 anos. Setenta e quatro pacientes com LESJ foram analisados para os níveis séricos de C1q e a deficiência completa de C1q foi observada em 3/74 (4%), todos estes pertencentes ao grupo A. Os grupos foram semelhantes quanto às altas frequências de sexo feminino, nefrite, envolvimento neuropsiquiátrico, SLEDAI-2K ( >= 8), perfil de autoanticorpos, proteínas de fase aguda elevada e baixos níveis de complemento (p > 0,05). No entanto, as frequências de febre (78% vs. 61% vs. 47%, p < 0,0001), hepatomegalia (42% vs. 29% vs. 14%, p < 0,0001), esplenomegalia (28% vs. 12% vs. 4%, p < 0,0001) e lúpus discoide (13% vs. 4% vs. 4%, p=0,020) foram significantemente maiores no grupo A em comparação com os grupos B e C. As frequências de perda de peso > 2kg (19% vs. 28% vs. 36%, p < 0,017), fotossensibilidade (34% vs. 41% vs. 51% p < 0,006), leucopenia < 4.000/mm3 (14% vs. 25% vs. 30%, p=0,048) e linfopenia < 1.500/mm3 (22% vs. 41% vs. 47%, p=0,011) foram significantemente menores no grupo A. Conclusão: O presente estudo multicêntrico identificou que a apresentação inicial de LESJ foi caracterizada por alta frequência de envolvimento de órgãos internos nos três grupos estudados e algumas características clínicas e laboratoriais distintas nos grupos de início precoce e adolescentesIntroduction: Age at diagnosis of childhood-onset systemic lupus erythematosus (cSLE) may influence disease expression in terms of initial clinical presentation, pattern of organ involvement and serological findings. Objective: To evaluate demographic data, clinical and laboratory features at disease diagnosis in three different age groups of childhood systemic lupus erythematosus (cSLE): group A early-onset ( < 6 years), group B school age ( >= 6 and < 12 years) and group C adolescent ( >= 12 and < 18 years). Methods: Brazilian multicenter cohort retrospective study in 10 Pediatric Rheumatology centers, including 847 cSLE patients. Results: Patients were divided in three groups: A with 39 (4%), B 395 (47%) and C 413 (49%). Of 39 cSLE patients of group A, 3 (8%) were < 2 years, 4 (10%) >= 2 to < 3 years and 32 (82%) >= 3 and < 6 years. Seventy-four cSLE patients were analyzed for C1q levels and complete C1q deficiency was observed in 3/74 (4%), all of them of group A. Groups were similar regarding high frequencies of female gender, nephritis, neuropsychiatric involvement, SLEDAI-2K ( >= 8), autoantibody profile, elevated acute phase proteins and low complement levels (p > 0.05). However, the frequency of fever (78% vs. 61% vs. 47%, p < 0.0001), hepatomegaly (42% vs. 29% vs. 14%, p < 0.0001), splenomegaly (28% vs. 12% vs. 4%, p < 0.0001) and discoid lupus (13% vs. 4% vs. 4%, p=0.020) was significantly higher in the group A compared to groups B and C. The frequency of weight loss > 2kg (19% vs. 28% vs. 36%, p=0.017), photosensitivity (34% vs. 41% vs. 51%, p=0.006), leukopenia < 4,000/mm3 (14% vs. 25% vs. 30%, p=0.048) and lymphopenia < 1,500/mm3 (22% vs. 41% vs. 47%, p=0.011) was significantly lower in the group A. Conclusions: Our large multicenter study identified that the initial presentation of cSLE is characterized by comparable high frequency of internal organ involvement and some distinct clinical and laboratory features in early-onset and adolescent groups
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Benido, Impouma. "A meta-analysis of artesunate plus sulfadoxinepyrimethamine alone for treatment of uncomplicated malaria in children." Thesis, 2006. http://hdl.handle.net/10539/1835.
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Faculty of Health Science
School of Public Health
0418444d
benido_impouma@yahoo.comStudy objectives The objective of this meta-analysis was to review the comparative efficacy and tolerance of sulfadoxine-pyrimethamine (SP) given alone or in combination with one (SPAS1) or three (SPAS3) doses of artesunate in children with uncomplicated P. falciparum malaria, aged 6 months to 10 years. Specifically, it assessed cure rate, fever and parasite clearance time, gametocyte carriage and tolerability. Methods The methodology used was a systematic review and a meta-analysis of four randomised controlled trials. The primary endpoint was the parasitological cure rate at day 28. Secondary endpoint included the parasitological cure rate at day 14, time to fever and parasite clearance, gametocyte carriage and occurrence of adverse events. Results Cure rate at day 28 corrected by PCR was 2.5 times higher in the combination of SPAS3 than in SP alone (pooled OR=2.55, 95% CI 1.93 to 3.37). There was no difference in cure rate at day 28 corrected by PCR between the combination of SPAS1 and SP alone (pooled OR=1.06 95% CI 0.98 to 1.15). Fever and parasite clearance times were significantly faster in both SPAS1 and SPAS3 compared to SP alone (p<0.001). By day 28 all children on the combination therapy were agametocytaemic as opposed to those on SP alone (p<0.001). All drug regimens were well tolerated and safe. Conclusion The combination of SPAS3 is more efficacious than SP alone in treatment of children with uncomplicated P. falciparum malaria. The combination is recommended for adoption as a replacement for SP alone in areas where malaria is endemic.
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Bbosa, Richard Serunkuma. "Caregivers' home-based management of fever in Uganda." Thesis, 2009. http://hdl.handle.net/10500/3649.
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Malaria is endemic in Uganda. The study attempted to determine how Ugandan caregivers managed home-based care of fever. Structured interviews were conducted with sixty caregivers of children under five. In 15 (25.0%) out of the 60 interviewed households, at least one child had reportedly died from malaria.
Caregivers’ decisions were influenced by health education, family members, community leaders and other caregivers. Most caregivers knew about malaria, but lacked knowledge about its danger signs, and about the services of village drug distributors. Most caregivers initiated treatment for fever at home before taking the children to health units. Mosquito nets, indoor residual spraying and other malaria preventive measures were rarely used due to lack of funds.
The recommendations include that anti-malaria drugs should always be available and accessible, the services of village drug distributors should be improved, health education should be enhanced, malaria preventive measures should be implemented and sustained.Health Studies
M.A. (Public Health)
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Yung-chang, Huang, and 黃永昌. "The Model of Local Competition Pressure under Fewer Children Impact." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/31499980590881918301.
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碩士育達科技大學
資訊管理所
103
The tendency of fewer children impacts the development of Taiwan’s education because the structure of population has been changed in Taiwan. Thus, the investigation of the phenomenon of fewer children has its urgent conditions and its important significance. This study mainly tries to discuss the affections of fewer children for local junior high and elementary schools, and investigates the influences for operating schools under the competition pressures. In addition, this work tries to find out that the disbursement policy would provide the characteristics and images of school to cope with the competition under the tendency of fewer children. Such a phenomenon would discuss through the simulation behaviors. Actually, the simulated results could provide some concrete suggestions for a school under the local competition pressures. The relevant variables of operating schools are complicate, especially in discussing the local competition pressures. In social sciences, the investigations of operating schools under competition pressure always adopt the static qualitative approach, but lacking the dynamic discussions. However, the dynamic discussions are more nearly practice. Based upon this, this paper is to construct a systems dynamic model to explore the complicate influences of operating school under the tendency of fewer children and the pressure of local competitions. Most studies of school operations are limited in static investigations, but this work is going to conduct dynamic discussions through the development of system dynamic model. The systems dynamic model not only improves the study from static level to dynamic level, but makes the discussing topics more practice. Simulated results reveal that more equipment cost input won’t make the amount of students increase linearly, it would be the referenced suggestion while policy making. In addition, the percentage policy of budget balance would adopt staged policy, the higher policy is applied in the front stage and the lower policy is adopted in the rest stage. Moreover, the higher marketing percentage policy is applied through the whole simulated period because the higher marketing percentage would result the more amount of students and the stronger competitiveness. In summary, this study can be regarded as a valuable tool because it can easily duplicate to solve other cases by changing its input parameters only. Keyword: tendency of fewer children, systems dynamic, competition pressure
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Ting, Chang, and 張婷. "The Effect of Fewer Children on the Marketing Strategies of Colleges." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/06695733515723293325.
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碩士開南大學
商學院碩士在職專班
101
In Taiwan, the newborn number declined from 1990 and reached the new low in 1998. However, the number of colleges gradually rose since 1999. The year of 2016 will be critical for colleges' survival. The core of this study is based on the 4P concept of marketing strategies including four aspects: product strategy, price strategy, place strategy, and promotion strategy. The freshmen of H university are surveyed and the results are used to explain the critical factors of choosing colleges and develop the best recruiting strategies. According to the findings, my recommendations are: educational institutions need to address the impact of declining the effect of fewer children and establish a complete set of measures; a clear purpose for establishing schools of all levels, as the number of schools cannot expand indefinitely; assisting students from all schools in obtaining their jobs certificates, so that they can find employment; helping students apply for student loans or increasing work-study opportunities; providing students with comprehensive software and hardware to use; developing a distinct brand image, with strong word of mouth marketing; strengthening administrative staff training; and establishing a dedicated admissions team.
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Chen, Tung-Che, and 陳東徹. "The Impact of Fewer Children to the Land Demand of Elementary School." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/17460206800161117139.
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碩士逢甲大學
都市計畫所
98
As Taiwan became developed countries in recent years, having fewer children seems to be the modern trend. School-age population has dropped from 12% to 6.8% since 20 years ago; the total decrement was nearly 726,000 students. According to Council for Economic Planning and Development (CEPD) report, the future school-age population will continue to decline until the year 2041, and the students will reduce from present 1,677,000 to 968,000 by nearly 40 percent. Therefore, the adjustment of the land demand for elementary schools has a pressing need to the country. In this research, we examine the way how elementary school size is determined. According to the law, there is a higher rate, 75% of the urban and the non-urban area that both school size fail to meet the requirement or standard. Furthermore, we discover a large gap in size for per student bases, between urban and non-urban area. The current method of calculate the elementary school size is inefficient and will not fulfill the future need. The sample in this research contains 2563 elementary schools. First, we separate all schools into both urban and non-urban areas, and use the cluster analysis method to divide all elementary schools into number of clusters. Under each group it is best to set 3 clusters. Small elementary schools prevail in both urban and non-urban areas. 540 students are the largest school size (66%) in urban areas, whereas 120 students are the largest school size (89%) in non-urban areas. According to the population reference report of CEPD, this research estimate the scale of future elementary school during 2041 to 2056, the rate of small elementary schools will reach 85% or higher in both urban and non-urban areas. Hence, this research comes up with a new resolution to the division of elementary school size; the size of elementary school should be divided based on the small elementary school. According to the literature review, this research recommendation the optimal size of elementary schools and school size per student of urban and non-urban area are as follows: 1、The most appropriated small-sized elementary school in urban area should be 1.6 hectares; The medium-sized of the elementary school should be 3 hectares. Both kind of the school should increases 750 and 600 square meters for additional 1 classroom, for the kind of 18～39 classrooms and 40 classrooms school type separately, therefore, the average school size will become 20 to 30 square meters per student. 2、The most appropriated small-sized elementary school in non-urban area should be 1 hectares. The medium-size of the elementary school should increase 600 square meters for additional 1 classroom, for the kind of 12 classrooms school type separately, therefore, the average school size will become 30-40 square meters per student.
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Huang, Yi-Wen, and 黃以文. "The influence of Trend of Fewer Children on Teacher of Exercise and Games curriculum." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/18500310305049650153.
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碩士國立體育大學
體育推廣學系碩士班
97
The purpose of this study was to investigate the influence of trend of fewer children on teacher of exercise and games curriculum, and to discover the difference between their background and its’ solution. Collect data from eight teachers of exercise and games curriculum in pre-school by using in-depth interview. The results indicated that: 1. Most interviewee believed the influence of trend of fewer children on work were market recession, and competitors increase sharply; values changed and working hours decreased affected their salary; schools rigid operated affected working hours; much extra time to interact with teachers of pre-school, teacher of exercise and games curriculum need to what they had to do and grasp interact timing well, but fewer chances to interact with parents or language barrier; using professional and good attitude to face personnel change and pursue value identity. 2. Most interviewee believed the influence of trend of fewer children on teaching were evaluate number of practice to achieved effect of exercise and the quality; designed the curriculum by needs and personal assistance to maintain the curriculum variety; different conditions with different teaching strategy; attracted children to spontaneity participant and using one by one teaching making relationship closer; controlled time to increase number of operating; personal space became larger, equipment to fit in with numbers of participants; class management became easier and elevate children’s concentration. 3. Interviewee didn’t feel differences because of their diverse sexual or schools; three interviewees worked for six to ten years believed no influence of trend of fewer children on gob hunting, two interviewees working for seven and fifteen years believed no influence of trend of fewer children on teaching. 4. Participated in conference to get the professional license; researched for new teaching skills and equipments; stayed good attitude and continue studying; presented yourself in different ways, and paid attention on each diversity, enforced small class and small school, held more interacting activities for children and parents and served for school to enhance your value. Key words: Teacher of Exercise and Games curriculum, Trend of Fewer Children.
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Yang, Hui-Chin, and 楊惠芹. "A Comparison of the Policy of the trend of fewer children in Japan and Taiwan." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/958276.
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碩士義守大學
應用日語學系
106
Due to the rapid changes of the times, the social values have become more and more diversified. The phenomenon of "The trend of fewer children" has become an unavoidable trend in global social development.Almost all the developed countries in the world are facing the problem of declining birth rate and population aging. Japan was the earliest child-less in Asian countries. With the development and progress of business, Taiwan is facing the same problem with Japan.The total fertility rate in Taiwan dropped from 7.04 in 1951 to 2.17 in 1983 and below 2.1 in 1985 for the replacement level.In 2016, the total fertility rate in Taiwan was even lower at 1.17 than that of Japan''s 1.44.From this, we can see that the birth rate in Taiwan has fallen more than that in Japan. Taiwan is the country with the fastest rate of " The trend of fewer children." The problem of " The trend of fewer children " is more serious than Japan. Facing the problem of "The trend of fewer children", the Japanese government began to propose solutions in the 1990s. Such as "Angel Plan" and "New Angel Plan" to provide good childcare measures, a working environment, and a reduction of family economic burden. So far, a unique "countermeasure for "The trend of fewer children" has been established.According to a population vital statistics released by the Japanese Ministry of Health, Labor and Welfare, the total fertility rate in 2016 was 1.44, a clear upward trend from 1.32 in 2006 ten years ago.This shows that the policy of "The trend of fewer children" in Japan has been effective in raising the total fertility rate. Japan''s policy of "The trend of fewer children" has been a long time, it is the first country in Asian. Compared with Japan, Taiwan seems to lack a complete policy of "The trend of fewer children".This study will use the solution by Japan''s policy of "The trend of fewer children" to discuss and solve the problem of Taiwan''s "The trend of fewer children".
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CHEN, YA-WEI, and 陳亞薇. "The Development and Demand of Endowment Insurance for Aging Society and Trend of Fewer Children." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/44345087050325847303.
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碩士義守大學
財務金融學系
101
With advances in medical technology and environmental health factors changes, that caused human longevity. By the impact of social change, the birth rate and marriage rate declined, aggravates the aging and low fertility trend. According to statistics, until 2012 of the population aged over 65 has more than 260 million people and aging will be serious. Many of the problems caused by an aging population, it will influence economic development, so several bills were enacted by the government to solve these problems, but these bills will solve only a fraction of that. Therefore, people need to buy the Commercial Insurance in order to remain at the same level of life in retirement. In 1994 the World Bank advocates Three-Pillar Model, one is mandatory publicly managed pillar, one is mandatory privately managed pillar and the other one is voluntary saving pillar. The paper researching into that the development and demand of endowment insurance on aging society.
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"Use of curative care for fever, acute respiratory infections, and diarrhea among children in rural areas of Democratic Republic of Congo." Tulane University, 2010.
Find full textAbstract:
High prevalence of childhood disease and low use of health facilities are reported for developing countries. In this study factors affecting the incidence of fever, cough and diarrhea and the factors predicting health facility use in rural DRC were analyzed. This study uses the data collected by the World Bank household survey in 2007 from eight health districts. In the districts, clusters were randomly selected for inclusion, and then a systematic selection of households was performed until the targeted number of children was reached. Data on health status of 5860 children during the previous two weeks were collected from 4838 households Bivariate analysis using Pearson chi-square was performed to identify potential determinants of childhood diseases. For cough and fever, multinomial logistic equation has been used to explain the choice of healthcare providers in comparison to the health center, the facility being promoted in DRC Percent of children who suffered from fever, cough and diarrhea were 46.2%, 33.3%, and 21.2% respectively. Age of the child, household size, and health district location were important in affecting the incidence of childhood diseases, while number of children under-five in the household and number of individuals per room were important in explaining the incidence of fever and diarrhea respectively. Health facility use was relatively low (47% for fever, and 35% for cough), but it was not as bad as reported by earlier studies. Income, education, cost of care, quality of care, type of symptom, hospital bed and geographic location were predictors of health facility use for fever and cough. The use of Oral Rehydration Salt for diarrhea was affected by income, age of the child and population density Children whose mothers believed cost of care was affordable were 52.2% and 43.8% less likely not to seek help (OR = 0.478 and 0.562) for fever and cough respectively. For hospital visit versus health center use, children from poorest households were 42.1% and 81.0% less likely to visit hospitals compared to the children from the least poor households (OR = 0.579 and 0.190). The findings may be used to encourage higher level of use of health centersacase@tulane.edu
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SU, Ling-Yu, and 蘇玲玉. "The Phenomena of Fewer Children and Local Government Welfare Expenditures-the Case of Taiwanese Local Governments." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/y9wkgg.
Full textAbstract:
碩士國立高雄應用科技大學
財富與稅務管理研究所碩士在職專班
101
Taiwan had the lowest fertility rate in the world in 2010. The total fertility rate was 0.9. The population growth rate is expected to be negative in 2023. To investigate the determinants of the declining fertility rates, we estimate a fixed-effect panel data model by using crude birth rates of 23 local governments in Taiwan during the period of 2001 to 2010. Our empirical results show that per capita social welfare expenditure is positively correlated to crude fertility rates. Moreover, female labor participation rates and violence criminal rates are negatively correlated. To increase the fertility rates, we suggest the local government raise social welfare expenditure, provide comprehensive child care services and maintain the social order.
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"PREVALENCE AND DETERMINANTS OF ATOPY AMONG SCHOOL-AGE CHILDREN IN RURAL SASKATCHEWAN, CANADA." Thesis, 2014. http://hdl.handle.net/10388/ETD-2014-08-1652.
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Background & Objectives: There has been few investigation of the association between the farming related activities or specific characteristics and atopic disease in rural Canadian children. In population-based studies, assuring the quality of information from questionnaires is of concern. We conducted this study in order to: first, identify the prevalence and risk factors of atopy and allergic conditions among school-age children in a rural region of Canada. Also, we sought to evaluate the validity and reliability of a questionnaire report of allergy to assess in this population.
Methods: As part of a longitudinal study of lung health in rural residents, we conducted a cross-sectional baseline study in rural Saskatchewan, Canada. This included an initial survey phase followed by a clinical testing phase. A sub-sample of 584 children (grades 1-8) completed skin prick testing to assess atopic status. Of these, 480 children completed a questionnaire report of allergy and atopic outcomes and participated in skin prick testing (SPT). Atopy was defined as a positive reaction to any of 6 allergens (local grasses, wheat dust, cat dander, house dust mite, Alternaria, Clasdosporium)≥3mm compared to the negative control. Agreement between questionnaire report and objective measures of atopy was considered overall and between the specific allergens tested on SPT and those assessed on questionnaire. We considered percent concordance, Kappa, sensitivity, specificity, and the positive and negative predictive values of reported allergies or allergic conditions in comparison to SPT as the gold standard.
Results: The prevalence of atopy as well as allergen-specific sensitizations was similar between farm and non-farm children but supported the notion that livestock farming is protective against atopy. Also, we found that 25.0% of children reported a history of allergic conditions by questionnaire and 19.4% were atopic detected by skin pick test. In our study, the agreement between questionnaire report of specific allergic triggers and atopy measured by SPT was high (83.0% - 89.5%).
Conclusion: In children, livestock exposure has a protective effect on SPT positivity.The agreement between questionnaire report of allergic symptoms and atopy measured by SPT was high and the agreement between atopy and report of allergic conditions was moderate.
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CHANG, WEI-LING, and 張薇苓. "The trend of fewer children of domestic has impact on job stress of private college administrative staff." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/w2kut9.
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碩士中華大學
企業管理學系
106
This study is to explore the impact of the domestic trend of fewer children of job stress of private college administrative staff. The questionnaires survey was adopted in this study and a “Questionnaire of the trend of fewer children of domestic has impact on job stress of private college administrative staff” were used as a research tool. The results of this study were as the following: 1.The significant influence was found on job stress of private college administrative staff by age. 2.The significant influence was found on job stress of private college administrative staff by the human reduced,the change of administrative business,and the change of administrative organization with the trend of fewer children.
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Ko, Li-Ying, and 柯瓅穎. "A Study of the Trend of Fewer Children and the Director''s Operational Strategy in Private Kindergartens." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/60881002785396630272.
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碩士國立屏東教育大學
幼兒教育學系
99
This study adopted qualitative research sampling methods to select six directors of private kindergartens, through interviews and non-participant observations. It discussed the operational strategy practice of the directors of private kindergartens cases under the trend of fewer children. The strategy included the director''s operational philosophy, developmental features, teachers'' professional development, curriculum and instruction design, environmental equipment planning, cooperation between parents and teachers, community resource linking, admissions promotion model, and internal and external risk assessment. According to the data analyzed, the conclusions of this study are as follows: 1)The director''s operational philosophy:Focus on the importance of features and positioning, through meetings and text messages to gather the relationship of teachers and directors and to enhance the quality of kindergartens. 2)The developmental features:Find out the features and control the resources to express the advantages. 3)Teacher professional development:Emphasis on teachers'' professional quality and image to encourage and actively promote the professional development of teachers. 4)Curriculum and instruction design:To provide opportunities for mutual cooperation and self-development for teachers through dialogue or records of meetings in operational circumstances. 5)Environmental equipment planning:Environmental equipment security, planning, detail and implementation of regular maintenance and repair. 6)Cooperation between parents and teachers:Feedback and demands are important as is freedom of information to enable interaction between parents and teachers. 7)Community resource linking:A bridge to establish cooperative initiatives within the community. 8)Admissions promotion model: Create reputation through positive attitudes and establish image with effective strategy. 9)Internal and external risk assessment: Enhance the ability to identify features by focusing on image. Finally, recommendations were made based on the conclusions: i.Recommendations for government agencies: Enhance the quality of early childhood education by establishing an evaluation system. ii.Recommendations for private kindergarten directors: The establishment of clear operational objectives and philosophy, communicate and implement specific programs, promote diversified public relations, enhance marketing practices to create clarity in characteristics of kindergartens though image. iii.Recommendations for follow-up studies: Propose suggestions for the objectives, methodology and research examined.
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Lo, Fen-fang, and 羅芬芳. "An Empirical Study on the Organization Marketing Operation Model of National Compulsory Education for the Trend of Fewer Children." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/92199134886141534226.
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碩士國立屏東教育大學
教育行政研究所
100
From the information “Taiwan population estimation from 2006 to 2051” which announced by Economic Construction Committee in 2006, children will decrease 16% in future ten years, while 29% in future twenty years. The trend of fewer children will decrease the number of school-age child, makes some schools having no enough students, and the school operation will be serious impacted, from primary school, high school to university. So, the operation strategy becomes more important when the phenomenon of fewer children trend becomes more serious. Therefore, throws out the conservative operation model, the marketing operation will be the future school competitive model. This research tries to investigate the organization marketing operation model of national compulsory education for the trend of fewer children, and future possible strategy. This research contains the triangle marketing aspect which according to the investigation (Y. L. Huang, 2005) about the applicability of triangle structure in school marketing index, then comes out three dimensions including internal marketing, external marketing and interaction marketing, also several intersections. Furthermore, it tries to find out the relation of all aspects using population background variable as controllable variable, the aspect of environmental organization transition from fewer children trend as independent variable, while application of marketing strategy (4P) as dependent variable. This research uses non-random sampling to release questionnaire in Kaohsiung and Pingtung area, total 30 schools and 600 samples separated by junior high school and primary school, also city and country area, retrieved 562 samples including 509 effective ones finally. Not only makes different analysis by multiple variables, this research also uses SEM structural formula model to investigate the relation of all aspects. This research shows that for the trend of fewer children, employees of school will bring out positive influence in triangle marketing and school marketing strategy when feel out the transition of environment. For the triangle marketing, factors between internal, external and interactive marketing will be positive influenced mutually, also have high relation. That means, internal, external and interactive marketing should be consolidated, influence to each other and influence positively to school marketing strategy aspect. As to the population statistic variable, the characteristics of school employees are female, high educated and middle-high income, and are faithful to school after being hired. For the investigation of educational system, regionalism and city, there are some differences revealed, but the result still supports the connections of all aspects partially.
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Lin, Shuhua, and 林淑華. "A Study On The Impact Of The Trend Of Fewer Children On The Supply And Demand Of Elementary School Teachers." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/29668150467264005760.
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碩士義守大學
資訊管理學系碩士在職專班
100
Due to a tendency of decreasing birth rate, Taiwanese population structure has been enormously changed—a trend of fewer children. Therefore, there are certain urgency and significance for the exploration of the trend’s impact on the supply and demand of the national elementary school teachers. The present study begins with an investigation on the current structure and tendency of Taiwanese school-age population base on the data provided by Ministry of the Interior and the Department of Statics of Ministry of Education. Then according to the amount of the students and classes in first-grade elementary schools from 2012 to 2017 academic year, the condition of the supply and demand of elementary school teachers in the future six years is conjectured through empirical research. The investigation aims to find out the effects of the trend of fewer children on the supply and demand of elementary school teachers and explore its critical impact on surplus teachers of elementary school. Furthermore, the study also includes introspection on policies which are focused on the unbalance and difficulties of the teachers’ supply and demand. To provide educational policy designers some references while making policies, the study proposes feasible coping strategies and brings up practical suggestions. Hopefully, the teacher resource’s supply and demand in compulsory education can be more balanced through proper adjustment and control mechanism.
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Chao, Yueh-Hua, and 趙月華. "The Study of Management Strategy for Kindergarten under the Trend of Fewer Children—The case of Taipei County and Taipei City." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/15095700684785065136.
Full textAbstract:
碩士淡江大學
教育政策與領導研究所碩士班
95
The purposes of this study are to explore how kindergartens are being impacted and what strategies can be taken under the trend of fewer children (thereafter, TFC). By using kindergartens located in Taipei as my research sample, I gain the following major findings. First, the impact of the TFC on kindergarten practitioners can be classified as 12 categories, in which ‘promoting competitive among kindergartens’ is being recognized as the most serious one and ‘leaving classroom and teaching equipment idle’ as the least. The extent to which kindergarten practitioners are affected by the TFC falls between least and middle, and private kindergartens are adversely affected more than public ones. Second, my findings demonstrate that ‘pursuing differentiation and innovation’ is recognized as the most important strategy under the TFC and ‘diversifying operations’ as the least. A further comparison shows that ‘diversifying operations’ is the only strategy which presents significant difference between private and public kindergartens in the importance of operating strategy facing the TFC. Third, my survey in the operating strategy shows that ‘pursuing differentiation and innovation’ is the most popular strategy used at the present time and ‘diversifying operations’ is the least. A further study shows that kindergartens in Taipei City make more efforts than those in Taipei County in differentiation and innovation, and private kindergartens are better than public kindergartens in terms of ‘pursuing differentiation and innovation,’ ‘diversifying operations,’ ‘improving teaching qualify,’ and ‘reducing cost.’ Last, ‘resources integration’ and ‘marketing orientation’ are the most important strategies recommended by the present study to reduce the impact of the TFC. Furthermore, this study recommends that improving interchange of teachers among different faculties is the top priority of action which should be taken in the ‘resources integration’ strategy, and working together with local citizens to promote their recognition is the top action which should be taken in the ‘market orientation’ strategy.
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Lin, Mei-Line, and 林美蓮. "A Study on the Management Strategies of A Remote Elementary School in Yilan County to Address the Trend of Fewer Children." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/20146874545536961662.
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碩士國立東華大學
教育行政與管理學系
101
This study adopts a certain elementary school in Yilan County as the study subject, collecting data in the manner of conducting interviews and observation. It involves six participants and is aimed at understanding the management strategies of the case school to deal with the trend of fewer children. Based on the records of interview and observation as well as the information of school background, this study encodes and analyzes the collected data. Moreover, this study adopts triangulation to improve its reliability and validity. Afterwards, it concludes the study result as follows: 1. The number of students in the case school is decreasing annually due to the trend of fewer children, the decline of communities in the neighborhood and the competition of neighboring fellow schools. 2. The trend of fewer children seems to have a great impact on the case school in terms of“the crisis of school termination/ amalgamation due to insufficient new students,”“thelack of school facilities due to funding shortage,” and “low competitiveness due to insufficient students.” 3. Facing the trend of fewer children and the decline of communities, the case school proposes five measures to address these issues: “strive for promising management qualifications such as mutual school district, free school district, and grand school district,” “shuttle bus delivery,”“free after-school academic assistance and school clubs,”“devoted teachers,”and“multiple subsidies.” 4. School administrations value the communication and negotiation with teachers to improve the quality of teaching as well as administration. 5. School teachers devote themselves to caring for students in a comprehensive manner to win the trust of parents. 6. Bridge the gap between school and parents with the help of teachers to build up the positive images of school. 7. Encourage teachers to pursue further studies to foster their expertise and to benefittheir students. 8. Develop diverse learning strategies and allow students to grow, to learn, to develop,and to realize their dreams. 9. The leader empowers the school staff to work in groups so that they may have active,positive, and profound viewpoints. 10. The school emphasizes the importance of managing performance to strive for the participation of social resources.
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HSIU-CHEN, CHU, and 朱秀貞. "The Exploration of Impacts of Fewer-Children Trend on Over-populated Vacancy Pressure and Work Involvement for Elementary School Teachers in Taichung." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/yfey69.
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碩士僑光科技大學
企業管理研究所
102
This study aims to explolre the current situation of over-pupulated vacancy pressure, work involvement, and the relationships between them for elementary school teachers in Taichung. This study adopts the research methd of questionnaire survey to construct a questionnaire of “Over-populated vacancy pressure and work involvement study for elementary school teachers in Taichung” to investigate the pressure caseued by class reduction and current situation of work involvement; and variance analysis and predictive analysis for teachers under different back ground. The results of studys show that: Teachers in elementary school consider that education administration should elevate the unit number of employed teachers, reduce the number of students in classes, and plan for future of over-poulated teachers. The teachers which are younger, married, non-administrative work associated, in senior, middle-size school, and whose school used to be over-populated face more pressure from class-reduction. Female, older, and married teachers tend to involve more on teaching. Elementary teachers’ class reduction and over-populated pressure positively affects each aspects of teaching involvement with weak association; in which the more class-reduction pressure, the higher focus on teaching involvement.
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Wang, Zhi-Hong, and 王智弘. "The management strategy in response to the trend of fewer children - Taking S Industrial High School in Changhua County as an example." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/meu2b7.
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碩士國立臺南大學
經營與管理高階經營碩士在職專班(EMBA)
107
In view of the sharp decline in population fertility, strictly become the global trend, Taiwan has become one of the lowest fertility countries, in response to the changes and lack of labor and manpower structure caused by the child-giving, and the resulting national competitiveness decline, family structure and care and many other problems, the phenomenon of child-son has been listed as an issue of national security , In line with Taiwan's prepared nature, the relevant government ministries have stepped up planning of various measures to encourage fertility and related supporting measures to increase fertility and promote the rational growth of the population. However, the results have not yet been demonstrated , Fertility is still not effectively rising. The decline of the fertility rate of Taiwan's population and the appearance of a small-child pattern in the social structure will affect the direction of school operations. This study analyzes the causes of the population's small-childization, summarizes the impact of the population's sub-generation on the educational development of schools, and needs to run schools from the perspectives of school management strategy, teacher-student concept, strategic alliance, fitness teaching, small class system and integrated educational resources. In this way, it should effectively mitigate the impact of child-rearing on the development of school education. Managerial implications and further research suggestions are discussed.
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KAO, CHIH-NAN, and 高至男. "A Study on the Critical Success Factors of Science & Language Tutorial Centers for Kids under the Trend of Fewer Children in Taiwan." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/n8s26s.
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碩士國立中正大學
企業管理學系碩士在職專班
105
This study analyzes the critical success factors of science and language tutorial centers for kids under the trend of fewer children. Through in-depth interview, it discusses the market changes and management strategies of the business owners. The studies resulted in the following changes under the impact of fewer children: the difficulties of new enrollment due to fewer students, the number of new classes and students has lowered; chain tutorial centers become mainstream while private ones shrunk; the essence of students and parents changed. To deal with the alterations, the management strategies have been adjusted as followed: 1. adjusted the content and develop the features of each class ; 2. combine the concept of education and service ; 3. reinforce the management systems. In conclusion, the critical success factors are: 1. Put students in priority and develop class with unique features. 2. Put parents in priority and offer sensible services. 3. Put employees in priority and improve personnel system.
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Lai, Chi-Shing, and 賴奇星. "A Study on the Critical Success Factors of Increasing the Sales of Disposable Baby Diapers in Response to the Trend of Fewer Children." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/e4n8a4.
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碩士國立彰化師範大學
資訊管理學系所
105
Disposable baby diaper sales are among the top three star merchandise sales in the household category. However, the sales have failed to grow in recent years due to fewer children. This study aims to explore the key factors of successfully boost the sales of disposable baby diapers under the influence of fewer children with Delphi Method, and to propose effective countermeasures. In recent years, there have been more traders joining the disposable baby diaper market. The main issue addressed in this study is how the manufacturers keep working on attracting the attention of the consumers to effectively increase the sales of disposable baby diapers by improving product quality and adopting proper marketing strategies. The research employs related literature reviews and semi-open interviews with expert scholars, gathering critical success factors to boost the sales of baby diapers under the influence of fewer children. An expert questionnaire is designed and answered by five expert scholars, together with another fifteen Delphi experts answering the Delphi questionnaire three times. With reference to the viewpoints of the expert scholars and those of the adviser Professor Huang, this study lists five critical success factors of increasing the sales of disposable baby diapers in response to the trend of fewer children: the pathway factor, the policy factor, the organization factor, the product optimization factor, and the promotion factor, as well as ten minor issues, inclusive of providing consumers with multiple pathways to purchasing disposable baby diapers, perfecting the babysitting and educational system, improving economic circumstances, encouraging childbirth, increasing manufacturers' sensitivity and swift reaction to competitive markets, adjusting marketing strategies with plentiful data, requesting manufacturers to supply adequate people for DPSM and promotion activities, upgrading the absorption, breathability, and leak-proof function of disposable baby diapers, and launching promotion activities regularly. The result of this study hopes to provide reference and information for interested managers and marketing executives to effectively integrate diverse resources of their companies and raise the sales of disposable baby diapers.
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蘇美莉. "A case study on the impacts of the trend towards fewer children on junior high schools in Kaohsiung City and its coping strategies." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/20235666056849768551.
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碩士國立高雄師範大學
成人教育研究所
100
This study aims to explore the impacts of the trend towards fewer children on junior high schools in Kaohsiung City and the reacting and coping strategies in implementing policies. To take two principals and five managers from three public junior high schools in Kaohsiung City as examples so as to embark on qualitative research through interviews, participative observations and documentary analyses. The conclusions are as follows: 1. The advantages of the trend towards fewer children are including small-class teaching, the drop of student-teacher ratio beneficial to the promotion of teaching qualities, the improvement of cooperation and interaction between parents and teachers, and more space available which could meet the demands of teaching. 2. The disadvantages are including closing or merging schools, the difficulties on requiring funds, spaces unused in campus, the increasing of administration workload, and conceivably excessive interruption of school operations form parents. 3. To face the impacts of the trend, the schools have been using coping strategies as follows: the development of refined teaching, the shaping of school characteristics, reinforcing school marketing, enhancing the interaction between parents and teachers, effectively using every space available in campus and every resource of communities and establishing a introduction-hiring system to solve the problems of overflowing teachers. 4. Using SWOT Analysis to analyze the strengths, weaknesses, opportunities and threats so as to construct the coping strategies, thereafter reaching a consensus through meetings and committees to implement those strategies decided. 5. The implementing of the coping strategies are advanced by every administration and position through periodical and non-periodical meetings to communicate and negotiate the division of labor so as to make all the plans desired. 6. The impact brought about by the trend towards fewer children could be settled by an effective implementing of those coping strategies mentioned above. 7. There are some factors which could actually confine the coping strategies such as requiring funds, spaces unused, closing or merging of schools, human ( teacher ) resources management and the insufficient strengths of junior high schools. Finally, some suggestions for junior high school managers, teachers and the administrations of education as well as future studies are proposed in this research. Key words: the trend towards fewer children; junior high schools; coping strategies
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kao, Chao-Huang, and 高昭煌. "A Study of Senior High School and Vocational High School Management Indicators Responding to Trend of Fewer Children and 12-year Compulsory Education." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/95594271288570504338.
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碩士國立彰化師範大學
工業教育與技術學系
101
The purpose of this research is to explore the efficiency of Senior High School and Vocational High School under the influences of Trend of Fewer Children and 12-year Compulsory Education as well as to construct the Senior High and Vocational High School Management indicator and analyze the importance. In order to achieve the purpose, this research includes 3 approaches. First, the researcher gathered and analyzed the structures of School Management Indicators through reviewing the literatures. Second, the researcher adopted the expert validity and the third one, Delphi Method. There are 15 experts invited as the Delphi Method committees to evaluate the contents of schools’ indicator and importance by encountering Trend of Fewer Children and 12-year Compulsory Education anonymously. The committees comprise 3 profession relevant college scholars, 3 Senior High School principals, 3 Vocational High School principals, 3 Senior High School directors and 3 Vocational High School directors. By observing the research processes, the study has the following results; the Senior High Schools and Vocational High Schools’ indicator of confronting Trend of Fewer Children and 12-year Compulsory Education have 7 aspects, 25 items, and 81 sub-items, which consist of 30 “important” ones and 51 “extremely important.” ones . In summary, the study concludes some suggestions for references in School management of responding to Trend of Fewer Children and 12-year Compulsory Education.
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SHEN, FANG-JU, and 沈芳如. "The Study about the Impact of Family Background and Sibling Influence on Children's Academical Achievement Under the Circumstance of Fewer Children Tendency in Taiwan." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/uca93j.
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碩士長榮大學
管理學院經營管理碩士班
106
This study explores the impact of Family Background and Sibling Influence on children’s academic achievement in the current low birthrate trend in Taiwan. In the context of family background, this study analyzes parental academic degrees, socioeconomic status, average family incomes, and places of residence, as well as the effects of Sibling Influence on children’s academic achievement. In the aspect of Sibling Influence, the factors of the number of siblings, the genders of siblings, and the birth order of siblings will be considered to verify Sibling Influence on children’s academic achievement. Birth cohort study will be initiated to find out whether sibling effects will have varied impact throughout the process of the changing economic development during the period of low birth rate. The research sample of this study is based on the data of RR2014, Fifteenth Year Plan of the "Panel Study of Family Dynamic " (PSFD). There are a total of 4672 master samples in this database. After preliminary data analysis and collation, the number of samples included in this study is 680. In this study, firstly, the one-way variance analysis is applied on the effect of family background and of Sibling Influence over children's academic achievement respectively, and the conclusions obtained are as follows: 1. In the trend of low birth rate tendency, there is a significant correlation among the number of years of parental education in the family background, the average socioeconomic status of the parents, the average income of the family and their children’s educational achievements. 2. Under the declining birthrate, the average family income has a significant impact on children’s educational achievements, but it has been weakened due to different stages of economic development. 3. Under low birthrate trend, parental occupation (average social and economic status of parents) is still an important factor affecting children's chances for higher education. 4. Under the declining birthrate trend, there are significant differences in the aspect of Sibling Influence, out of the factors of the number of siblings, the genders of siblings, and the birth order of siblings over children’s academic achievement. Secondly, this study established a linear regression research model to explore the possibility of forecasting family background and Sibling influence on children's academic achievement, and results obtained are as follows: 1. In the trend of low birth rate, living in the middle and north parts of Taiwan has significant influence on children’s academic achievement. 2. Under the low birthrate tendency, the influence of the family background on children's academic achievement is no longer as obvious as before, due to the popularization of education, but there are still significant differences. On the basis of the above findings, we conclude that children’s academic achievement is deeply influenced by family background. This study can be provided not only for future further studies but also for the reference of teachers and parents of primary and secondary school students and education authorities in finding the right causes to students’ lower academic performance so as to come up with a better solution or policy to help the students.
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Chen, Chih-Hao, and 陳志豪. "The Impact of Ecological Education and Green School Management Strategies on School Visibility, Parent Satisfaction, and Willingness of School Attendance under the Trend of Fewer Children." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/52699732108138658461.
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碩士康寧大學
企業管理研究所
103
This study aimed to explore the improvement of school visibility through “ecological education” used by schools as a blueprint for teaching and the ”green school” as the innovative management strategy for campus hardware and software building under the existing trend of fewer children. The research results are expected to serve as coping strategies for schools suffering from the trend of fewer children, thereby achieving the goal of sustainable development. The questionnaire survey of “The Impact of Ecological Education and Green School Management Strategies on School Visibility, Parent Satisfaction, and Willingness of School Attendance under the Trend of Fewer Children” was adopted as the research tool in this study. The contents consist of four parts: “basic information”, “the impact of the trend of fewer children on schools”, “ecological education and green school strategies on school visibility and parent satisfaction”, and “willingness of school attendance”. A sampling survey was conducted on schoolteachers teaching different grades. A total of 247 valid questionnaire copies were recovered, accounting for the recovery rate of 90.1%. The main research methods include reliability and validity analysis, descriptive statistical analysis, ANOVA, regression analysis, etc. Findings show that ecological education and green school management strategies indeed had an impact on school visibility, parent satisfaction, and willingness of school attendance. Finally, effective recommendations on the education environment were put forth.
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Mabate, Blessing. "Exploration of interaction between Plasmodium falciparum Hsp70-x (PfHsp70-x) and human Hsp70-Hsp90 organizing protein (human Hop)." Diss., 2017. http://hdl.handle.net/11602/934.
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MSc (Biochemistry)Department of Biochemistry
Malaria is a disease that claims about half a million lives annually, mainly children. There are 5 Plasmodium species that cause malaria; namely, P. falciparum, P. ovale, P. malariae, P. knowlesi and P. vivax. P. falciparum is the most virulent of them all. The parasite upregulates some heat shock proteins (Hsps) in response to stress it encounters during its life cycle. These Hsps play a major role in proteostasis. The drug resistance of P. falciparum to traditionally used remedies has led to a need for the development of novel drugs. Hsps have been implicated as antimalarial drug targets. Hsps act as molecular chaperones and some make complexes, which are important in facilitating protein folding. As an example, heat shock protein 70 (Hsp70) and heat shock protein 90 (Hsp90) form a functional complex through an adaptor protein, Hsp70-Hsp90 organizing protein (Hop). P. falciparum expresses six Hsp70s that are localized in different subcellular compartments. Amongst them, P. falciparum Hsp70-x (PfHsp70-x), is exported to the erythrocyte where it is implicated in host cell remodeling. PfHsp70-x possesses an ATPase domain, substrate binding domain and a C-terminal subdomain. PfHsp70-x possesses an EEVN motif on its C-terminus which is implicated in interactions with co-chaperones amongst them, Hop. Although some of the chaperone functions of PfHsp70-x have been reported, its interaction with human chaperones has not been investigated. The availability of PfHsp70-x in the infected erythrocyte cytosol presents a possibility that this protein may functionally cooperate with human Hsp90 via human Hop (human Hop). This hypothesis that PfHsp70-x interacts with human chaperones is strengthened by the absence of Hsp90 and Hop of parasite origin in the infected erythrocytes. The main aim of this study was to explore the chaperone activity of PfHsp70-x and its functional co-operation with human Hop. Recombinant PfHsp70-x (full length and EEVN deletion mutant) proteins were expressed in E. coli XL1 Blue cells and purified using nickel affinity chromatography. PfHsp70-x was found to be structurally comprised of mostly alpha helices and demonstrated heat stability based on circular dichroism (CD) spectrometry studies. It was established that the EEVN motif may be important for the ATPase activity of PfHsp70-x. However, it was established that the EEVN motif was not important in regulating the holdase chaperone (protein aggregation suppression) function of PfHsp70-x. Furthermore, PfHsp70-x and its mutant preferentially bound to asparagine-rich peptides. Parasite proteins have high asparagine repeat regions as compared to human proteins. In addition, preference for asparagine-rich proteins iii could signify that PfHsp70-x is biased towards binding proteins of parasitic origin. Surface plasmon resonance (SPR) analysis suggested that PfHsp70-x interacts with human Hop with relatively higher affinity compared to its EEVN minus derivative. In conclusion, the removal of the EEVN motif of PfHsp70-x does not affect the chaperone function of PfHsp70-x. However, the EEVN motif is essential for the interaction of PfHsp70-x with human Hop.
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Hsieh, Tseng-Hsueh, and 謝增學. "The research of marketing strategies for twelve year compulsory education and the trend towards fewer children in Kaohsiung private vocational schools- Using students in four departments as samples in a private vocational school in Kaohsiung." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/736efg.
Full textAbstract:
碩士國立高雄餐旅大學
餐旅教育研究所在職專班
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After many years’ criticism and chang, the twelve year compulsory education, which has being discussed for many years, finally began in August 2014. For coping with the needs of social development and in line with the trend of education reform, the government declared that many educational policies which were developing students’ talents by their personality, pluralistic ways for students to get into higher education, and balancing urban and rural areas. All these policies directly affect schools, teachers, students, parents and the community thoughts. Recently, each vocational school enrollment generally faces insufficient enrollments because of the trend towards fewer children, especially in most serious private vocational schools, resulting in a lack of incentives to improve the quality of power for private schools. This may cause the private schools to be closed, and seriously impact the survival and development of the private schools. The participants of this research were103 freshmen senior high school students in Kaohsiung. The purpose of this paper is to present the view of level of satisfaction in private vocational school admissions policy. A total of questionnaires were 400 pieces, 390 of them are sent to the participants, and the recovered rate was 97.5%. Using T test as the statistical method to investigate the questions about high school freshman students invest in education marketing activities and equipment, and using them to find effective enrollment marketing strategies In addition using school’s characteristics, customer-oriented way to divided students’ marketing resource, and make sure educational resources for schools’ equipment can be fully utilized to search for effective resources of students for effective education marketing. By using these methods, there will be a superior performance in terms of administration, teaching and research, promotion of innovation, performance and other student life. Also improving the overall competition of schools, and establish an effective recruitment marketing strategies to make schools can continue to develop, and having a positive function for development of technical and vocational education
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Vinnemeier, Christof David. "Establishment of a clinical algorithm for the diagnosis of P. falciparum malaria in children from an endemic area using a Classification and Regression Tree (CART) model." Doctoral thesis, 2015. http://hdl.handle.net/11858/00-1735-0000-001F-00E4-1.
Full textAbstract:
Die Weltgesundheitsorganisation WHO schätzte die Zahl der an Malaria erkrankten Menschen im Jahr 2009 auf weltweit 225 Millionen. Auf dem afrikanischen Kontinent betrafen 85% der durch Malaria verursachten Todesfälle Kinder unter fünf Jahren. Obwohl die Inzidenzen der P. falciparum-Malaria in einigen Teilen des subsaharischen Afrika sinken und andere Erkrankungen mit ähnlichen Symptomen wie denen der Malaria an Bedeutung gewinnen, ist eine vorsorgliche medikamentöse Behandlung im Verdachtsfall weiterhin üblich. Ziel dieser Arbeit ist die Generierung eines auf das Lebensalter bezogenen klinischen Algorithmus, der mit einfachen klinischen Symptomen die Diagnose einer P. falciparum - Parasitämie ermöglicht.
Die Studie wurde in einem ländlichen Krankenhaus in der Ashanti-Region in Ghana durchgeführt, welche über das ganze Jahr hinweg holoendemisch für Malaria ist. Insgesamt wurden 5447 ambulante Besuche von 3641 Patienten im Alter zwischen 2-60 Monaten analysiert. Alle Kinder wurden von einem Pädiater klinisch untersucht und es wurden ein kleines Blutbild sowie ein Malariaausstrich (‘Dicker Tropfen’) angefertigt. Mit Hilfe einesClassification and Regression Tree (CART) wurde ein klinischer Entscheidungsbaum für die Prädiktion einer Plasmodium-Parasitämie generiert und prädiktive Werte für alle erfassten Symptome berechnet.
Eine Parasitämie wurde bei Kindern im Alter von 2-12 Monaten mit einer Prävalenz von 13.8% und bei Kindern im Alter zwischen 12 und 60 Monatenmit einer Prävalenz von 30.6% gefunden. Das CART-Modell ergab altersabhängige Unterschiede in der Fähigkeit der Variablen eine Parasitämie vorherzusagen. Während sich bei Kindern im Alter zwischen 2 und 12 Monaten die „palmare Blässe“ als das wichtigste Symptom herausstellte, gewannen die Variablen „Fieber in der Anamnese“ und „erhöhte Körpertemperatur ≥ 37.5°C“ bei Kindern im Alter zwischen 12 und 60 Monaten an Bedeutung. Die Variable „palmare Blässe“ war bei Kindern jedes Alters signifikant (p<0.001) mit niedrigeren Hämoglobinwerten assoziiert. Im Vergleich zum Algorithmus des Integrated Management of Childhood Illness (IMCI) hatte das CART-Modell eine deutlich höhere Spezifität sowie einen höheren positiven prädiktiven Wert für die Vorhersage einer Parasitämie.
Die Anwendung von altersbezogenen Algorithmen erhöht die Spezifität der Vorhersage einer P. falciparum - Parasitämie. Selbst in einer Population mit einer hohen Prävalenz an Anämie ermöglicht der prädiktive Wert der „palmaren Blässe“ eine Erkennung von signifikant geringeren Hb-Werten. Die Bedeutung der „palmaren Blässe“ sollte daher in der Schulung von Gesundheitshelfern hervorgehoben werden. Mangels ausreichender Sensitivität kann allerdings weder auf Basis des besten Algorithmus noch mit „palmarer Blässe“ als einzelnem klinischem Zeichen eine Therapieentscheidung getroffen werden. Sie sind daher kein Ersatz für eine vorsorgliche medikamentöse Behandlung und einen Erregernachweis.