Dissertations / Theses on the topic 'Day care centers Health aspects'

Antibiotic resistance is a growing threat to human health and is defined by the World Health Organization as a crisis that must be managed with the utmost urgency. Antibiotic resistant bacteria increase both mortality and morbidity and have a great impact on the global economy. Resistance is not confined to human health care, but is present also among animals and in our environment at large. Indeed, resistant bacterial strains have now been found in virtually all parts of the world, even in locations without direct human contact. The human gastrointestinal tract is populated by a complex, dynamic, diverse and highly interactive collection of microorganisms, including bacteria, archaea, fungi, yeasts and viruses, which constitutes our gastrointestinal microbiota. This microbiota is an important reservoir of resistance genes (our gastrointestinal resistome) and a “melting pot” for transfer of resistance genes between microbes, including potential pathogens. In this thesis I investigated the prevalences of two clinically important kinds of antibiotic resistance: extended-spectrum β-lactamases (ESBL) and vancomycin-resistant enterococci (VRE), as well as asymptomatic carriage of potential enteropathogens among healthy preschool children in Uppsala. Fecal samples from unidentified, individual diapers were collected in 2010 (125+313 samples) and in 2016 (334 samples). In addition, 204 environmental samples from the children’s preschools were collected in autumn 2016. A prevalence of 2.9% ESBL-producing Enterobactericeae was demonstrated in the first samples from 2010. No VRE were found and the occurrence of enteropathogens were reassuringly low. Results on ESBL prevalence in 2016 and transmission of resistance between children will be presented when the manuscript is published and at the dissertation.

Day care centers and schools are important environments for children, but few epidemiological studies exist from these environments. Mould, dampness, fungal DNA and allergens levels in these environments and respiratory health effects in school children were investigated in this thesis. In the day care centers studies, Allergen Avoidance Day care Centers (AADCs) and Ordinary Day care Centers were included. One third of the Swedish day care centers had a history of dampness or mould growth. Total fungal DNA levels were positively associated with risk construction buildings, reported dampness/moulds, rotating heat exchangers, linoleum floors and allergens (cat, dog, horse allergen) levels. The two school studies included secondary schools in Johor Bahru, Malaysia and elementary schools from five European countries (Italy, Denmark, Sweden, Norway, and France) (HESE-study). In Malaysia, 13 % of the pupils reported doctor-diagnosed asthma but only 4 % had asthma medication. The prevalence of wheeze in the last 12 months was 10 % in Malaysia and 13 % in the HESE-study. Cough and rhinitis were common among children in the HESE-study. There were associations between fungal DNA and reported dampness or mould growth. Fungal DNA levels and viable mould (VM) concentration in the classrooms were associated with respiratory symptoms (wheeze, rhinitis, cough, daytime breathlessness) in school children. In the HESE-study, associations were found between total fungal DNA, Aspergillus/Penicillium DNA and respiratory symptoms among children. Moreover, Aspergillus versicolor DNA and Streptomyces DNA were associated with respiratory symptoms in Malaysia and the HESE-study, as well as reduced lung function [forced vitality capacity (FVC) and forced expiratory volume in 1 second (FEV1)] among children in the HESE-study. In conclusion, fungal DNA and pet allergens were common in day care centers and schools and respiratory symptoms in school children were common. The associations between VM concentration and fungal DNA levels in the schools and respiratory health effects in school children indicated a need for improvement of these environments. Moreover, risk constructions should be avoided and buildings should be maintained to avoid dampness and microbial growth. Health relevance of microbial exposure and biodiversity needs to be further studied using molecular methods.

A trend toward non-institutionalization of the elderly, in conjunction with the increasing size of the elderly population has resulted in the development of a variety of community programs and services to help meet their complex and diverse health care needs in the community setting. Although there is substantial documentation pertaining to the needs of the elderly in the community and the available services (Lifton, 1989; Padula, 1983; Starrett, 1986; Wallace, 1987), this documentation has been generated primarily by health care professionals and agencies, rather than from the perspectives of the elderly themselves. Adult Day Care [ADC] programs were established in the late 1960s as one means of attempting to meet the needs of the frail elderly in the community (Padula, 1983). On the surface, these programs appear to be effective in meeting the needs of clients through the provision of nursing services and a wide variety of therapeutic programs and social activities. This exploratory descriptive study was based on the premise that there exists a need to gain insight into the clients' perspectives regarding the ways in which ADC services are instrumental in meeting their perceived needs. Data were collected and analyzed to identify the self-perceived needs of ADC clients and their perceptions of how the ADC nursing services were instrumental in assisting them to meet these needs. Two interviews were conducted with each of the 11 ADC participants comprising the sample, using a semi-structured interview guide developed by the researcher. The two needs most commonly identified by participants included the need to cope with a range of concurrent and/or successive losses, and the need to establish new support systems. Participants identified the most significant components of the nursing role as those of the provision of emotional support through counselling, and the provision of health monitoring services. Participants viewed the overall ADC program as important in assisting them to meet their needs by providing access to social outings, individualized care, emotional support, and the opportunity to enhance their self-esteem, confidence, and feelings of belongingness.
Applied Science, Faculty of
Nursing, School of
Graduate

This thesis examines socialization in the homes and crèches of a rural area in a time of change. Change which is controlled and initiated from outside the local context, creates a dilemma for socialization agents when it introduces a knowledge paradigm different from that operating locally. Rural South African communities frequently experience exogenous change. The introduction of rural preschools, locally known as crèches, provides one example of such change challenging local socialization agents. While rural residents may not operate within knowledge paradigms to deal effectively with such change, they are not necessarily defeated by it. They "grapple" with the uncertainty, developing ways of coping and containing the change. This forms the focus of this thesis. Vygotsky's concept of mediation and conceptualization of the individual/society relationship, informs the examination of "grappling" with change. Two central questions are addressed: In an unfamiliar situation, what is mediated and what resources are drawn on? The research was designed around the recognition of the process nature of research, the constructivism inherent in research and the significance of the social context. Two central mediators, the mother and the crèche teacher, and the broader social context of the home and the creche, were examined. Three levels of investigation were utilised. An analysis of mediation in dyads working on an unfamiliar task provided insight into the social/psychological dynamics. Interviews with residents highlighted socialization beliefs and practices and the social context. Analysis of verses and stories taught to children revealed the inherent ideology of socialization. The main findings of this study are that: Rural residents "grapple" with social change by drawing on their own resources; in "grappling" with the unfamiliar what is mediated is an adult/child interactional status based on the inherent ideology of socialization and the dominant resource drawn on is the "culture of orality". It is argued that in the situation of neither mastery nor defeat, rural residents have used intermediary strategies of coping and containing the effect of the preschool as an agent of exogenous, social change. Recommendations are made for integrating "socialized" and "learned" knowledge from the home and the crèche.

Introdução – O desenvolvimento de programas de intervenção tem sido uma das estratégias para diminuir a ocorrência de alteração de voz em educadores de creche, mas pouco tem sido discutido sobre a sua eficácia na prevenção. Objetivos – Analisar os efeitos de um programa de intervenção desenvolvido junto a educadoras de creche, verificando sua opinião quanto à voz ideal, analisando as mudanças após o programa e os fatores associados à alteração vocal. Métodos – Participaram 58 educadoras das creches junto às quais são desenvolvidas ações do Programa Creche do Curso de Fonoaudiologia da Faculdade de Medicina da USP. As educadoras foram divididas em dois grupos – experimental e controle – e todas passaram por avaliação inicial da voz e da fala e preencheram questionários. O programa teórico-prático foi desenvolvido junto ao grupo experimental em cinco encontros mensais, com duração total de 12 horas. Ao final, todas as educadoras passaram novamente pelos mesmos procedimentos de avaliação. Resultados – As educadoras definem como clara, resistente, flexível e agradável a voz ideal de um educador. Foram observadas algumas mudanças positivas no grupo experimental e outras negativas no controle. Foi fator associado à presença de alteração vocal a auto-percepção do agravo, antes e após a intervenção. Conclusões – As poucas modificações observadas não tiveram impacto no uso da voz no trabalho. É fundamental que haja maior envolvimento das instituições para que mudanças mais robustas ocorram neste quadro, assim como políticas públicas mais efetivas.
Introduction – The development of intervention programs has been one of the strategies to decrease the occurrence of vocal disorders in day-care center educators, however little has been discussed concerning its efficacy in prevention. Objectives – to analyze the effects of an intervention program developed with day-care centers educators, verifying their opinion regarding the ideal voice, analyzing the changes after the program and the factors associated to vocal disorders. Methods – 58 educators, from day-care centers where Crèche Program of the Speech Pathology and Audiology Course of USP School of Medicine activities are developed, took part in this study. They were divided into two groups – experimental e control – and all of them were submitted to a initial vocal and speech evaluation and filled in questionnaires. The theoretical-practical program was developed with the experimental group in five monthly meetings, with total duration of 12 hours. In the end, all educators were again submitted to the same evaluation procedures. Results – The educators define the ideal voice of an educator as clear, resistant, flexible and pleasant. Some positive changes were observed in the experimental group while negative ones were observed in the control group. Self-perception of the disorder was an associated factor to the presence of vocal alteration, before and after the intervention. Conclusions – The few modifications observed did not have impact on the voice usage at work. It is essential that there is greater institution involvement so that stronger changes happen in this situation, as well as the implementation of more effective public policies.

Promover saúde à criança é garantir cuidados de qualidade que proporcionem seu desenvolvimento integral. A creche é um dos locais onde muitas crianças vivem grande parte da infância, o que justifica buscar compreender como são os cuidados oferecidos a elas nesse serviço. A presente investigação teve como objetivo geral caracterizar aspectos relacionados à implementação de cuidados de saúde infantil em creche e como objetivos específicos identificar percepções de educadoras e proposta institucional acerca dos cuidados de saúde às crianças. Foram realizadas entrevistas com quatro professoras e a coordenadora pedagógica de uma creche pública municipal, na cidade de São Paulo, e análise de documentos institucionais. Nos discursos das educadoras, a integração das funções de educar e cuidar aparece como própria do trabalho na creche, mas vários fatores dificultam seu exercício, tais como a precária formação para as questões de cuidado, particularmente os de saúde, e a sobrecarga de atividades. Face às dificuldades, surgem questionamentos acerca da possibilidade de efetivar amplamente essa integração. A educação ainda aparece como o foco principal do trabalho das professoras, ficando o cuidado como algo inevitável, dada a situação de dependência das crianças. As ações de cuidado ficam restritas ao corpo e são valorizadas somente enquanto atividades a serem ensinadas, visando à independência da criança. As propostas institucionais identificadas nos documentos ainda apresentam lacunas no que diz respeito à inclusão efetiva do cuidado como categoria independente e inerente à função profissional do educador em creche. Em conclusão, reafirma-se a necessidade de persistir na construção de propostas apropriadas a esse nível de atendimento infantil, com apoio das diferentes disciplinas que atuam na área de atenção à criança.
To promote children health is to guarantee care quality to provide their integral development. The child day-care center is a place where children live great part of their days, justifying the attempt to understand how this care is offered to them. The aim of the present study, as a general objective, was to characterize the aspects related to the implementation of health care in day-care center and as specific objectives to identify the caregivers‘ perceptions and institutional proposal concerning the child health care. Interviews had been carried out with four teachers and the pedagogical coordinator of a municipal public day-care center, in the city of São Paulo, as well as the analysis of institutional documents. Based on caregivers speeches, the integration of education and care seems to be as a characteristic of the work itself in the day-care center, but many factors made this implementation difficult, such as the deficient personnel formation in relation to care, particularly those in the health area, and the burden of activities. In view of these difficulties, questions concerning the possibility to extensively accomplish this integration arouse. Education still appears as the main focus of the teachers’ work, and care seems to be something inevitable since the child is very dependent. Therefore, care actions remain restricted to the body itself and are only emphasized when they are considered as activities to be taught, aiming the independence of the child. The institutional proposal identified in documents presents gaps concerned to the effective inclusion of the care as an independent and inherent category that is a characteristic of caregivers in day-care centers. In conclusion, it is pointed out the need to continue improving the construction of appropriate proposals to this level of childhood attendance, with support of other knowledge areas that perform childcare.

Nas últimas décadas, observou-se um grande avanço no estudo das relações organizacionais com relação a saúde. O presente estudo teve por objetivo avaliar o impacto das condições bucais na qualidade de vida de pré-escolares matriculados em creches comunitárias no Município de Porto Velho-RO e verificar o perfil socioeconômico das famílias e seu estado nutricional. A amostra foi constituída por 210 pré-escolares entre 3 e 5 anos de idade onde foi adotado o Índice ceod para avaliação de cárie dentária e o Índice de Massa Corpórea para avaliação do estado nutricional. Foram aplicados questionários de avaliação de influência da saúde bucal na qualidade de vida (ECOHIS) e perfil socioeconômico aos pais ou responsáveis dos respectivos pré-escolares. A estatística descritiva foi realizada por meio de frequências relativas e absolutas e a sua análise por meio do teste de Correlação de Spearman (p<0,05). Foi encontrado um ceod de 2,11 (3,04) e um Sic Índice de 5,84 (2,59), observando-se 49,52% de crianças livres de cárie dentária. A classificação socioeconômica mostrou que 80,95% encontram-se na classe média inferior e que 40,29% tem renda familiar inferior a 2 salários mínimos. Quanto ao estado nutricional, 60,48% encontravam-se eutróficas e 25,71% magreza, não apresentando influencia significativa quanto a saúde bucal (p<0,05). Foi verificada relação estatisticamente significativa entre o ceod e seus componentes na qualidade de vida (p<0,05). Concluiu-se que o impacto das condições socioeconômicas e influência da saúde bucal na qualidade de vida de crianças na idade pré-escolar podem nortear novas práticas em saúde objetivando reduzir as desigualdades na distribuição da cárie dentária na população.
In recent decades, there was a major breakthrough in the study of organizational relationships for health. This study aimed to evaluate the impact of oral conditions on quality of life of preschool children enrolled in community day care centers in the city of Porto Velho-RO and assessed the socioeconomic profile of their families and their nutritional status. The sample consisted of 210 preschool children between 3 and 5 years of age where we adopted the dmft index for assessment of dental caries and body mass index to assess nutritional status. Questionnaires were applied to evaluate the influence of oral health on quality of life (ECOHIS) and socioeconomic profile of parents or guardians of their preschoolers. Descriptive statistics were performed descriptively by means of relative and absolute frequencies and their analysis using the Spearman correlation test (p<0.05). It was found a dmft of 2.11 (3.04) and a Sic Index 5.84 (2.59), with polarization of dental caries in the population studied (49.52%). The socioeconomic classification showed that 80.95% are lower middle class and 40.29% have incomes below two minimum wages. The nutritional status, 60.48% were normal weight and thinness 25.71%, showing no significant influence in the oral health (p<0.05). Statistically significant relationship was found between the dmft and its components in the quality of life (p<0.05). It was concluded that the analysis of the socioeconomic status and influence of oral health on quality of life for children in preschool can guide new practices aimed at reducing health inequalities in the distribution of dental caries in the population.

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The first years of a child life is recognized as determinant to the establishment of concepts and attitudes that impacts its whole life. In this sense, child day care centers, throughout the relationships offered, are of great influence. The present study contributed with the qualification of these places when assumed as its aim to comprehend the health approach developed by educators of child day care centers. It adopted the Symbolic Interactionism as theoretical reference and the Thematic Content Analysis as the methodological reference. Interviews with twenty educators were developed. Insecurity in health approach revealed to be the central phenomena and the thematic categories health in child day care centers ; Child day care centers contexts as limit and Need of partnerships described conceptions, needs and actions in the process of including health in the educators practice. Reach the integration of health and education in child day care centers is an actual challenge and claim for investments.
Os primeiros anos de vida de uma criança são reconhecidos como determinantes para o estabelecimento de concepções e atitudes, com desdobramentos para o resto da vida. Neste sentido, os espaços de educação infantil despontam-se como de grande influência, por meio das interações ali vivenciadas. Esta pesquisa buscou contribuir com a qualificação destes espaços ao tomar como objetivo compreender a abordagem de saúde da criança pelos educadores no espaço de educação infantil. Adotou o Interacionismo Simbólico como referencial teórico e a Análise de Conteúdo na modalidade temática enquanto referencial metodológico. Foram realizadas entrevistas com vinte educadoras. Insegurança frente a abordagem da saúde da criança revelou-se como fenômeno central e as categorias temáticas Saúde no espaço de educação infantil ; Contexto da escola como limite e Necessidade de parcerias retratam significados, necessidades e ações desenvolvidas pelos educadores no processo de incluir saúde em suas praticas. Alcançar a integração saúde e educação nos espaços de educação infantil revelou-se como desafio atual e que carece de investimentos.

This case study considers the relationship between context, school policy and environmental teaching and learning processes at a community-based early childhood development centre in South Africa. The study recognises that educational practices in the early childhood development field are shaped by historical, cultural, economic and political realities at both local and national levels. It is from the understanding that each school is a unique composition of these shaping factors that the research was designed to consider the community-based school participating in this study. By compiling a contextual profile, this study attempts to consider dominant contextual factors affecting the school. Through the critical discourse analysis of a school policy document, this study considers local level policy, and through the literature chapter, national policy. Teacher interviews provide insight into teacher understanding of school policy in response to contextual issues, as well as providing insight into how teachers perceive their translation of policy into teaching practice. Observations of lessons in the centre provided an. opportunity to see how context and policy translated into and influenced environmental teaching and learning processes. This study looks at how environmental education is addressed in the Raglan Road Child Care Centre, and provides insight into how environmental education within the context of the school and in relation to school policy may be strengthened. It comments on the tensions and ambivalences arising from the relationships between context, policy and environmental teaching and learning processes and makes recommendations to address these ambivalences in ways that are contextually relevant. The main recommendations were designed to be practically useful for the school involved in the study and are focused around engaging the ambivalences emerging from this study to open up 'spaces' for deliberating environmental teaching and learning processes and other tensions arising out of the study at an ECD level. Recommendations included: 1) engaging with the strong development focus in school policy and the educational focus in national policy and teacher discourse; 2) deliberating the ways in which school policy and national policy respond to risk; 3) engaging with the ambivalence in the school-parent relationship; 4) the re-alignment of the explicit curriculum and broadening the contextually-based view of whole child development; and 5) engaging the ambivalence in approaches to education at the centre.

A alimentação na fase pré-escolar constitui-se um processo complexo devido aos fatores relacionados ao desenvolvimento próprio dessa fase e aos referentes às condições ambientais. Visto que os hábitos alimentares adquiridos na infância tendem a se solidificar na vida adulta, é de suma importância atitudes assertivas durante esta fase do desenvolvimento infantil, estimulando assim, precocemente, a formação de hábitos saudáveis. Assim, é fundamental que o enfermeiro conheça as dificuldades e atitudes das mães diante da alimentação de seus filhos, para que possa atuar de maneira efetiva, promovendo desta forma a saúde das crianças a médio e longo prazo. Este estudo teve como objetivo conhecer as percepções de mães sobre a alimentação de seus filhos de 3 a 6 anos que freqüentam Instituição de Educação Infantil (IEI). Trata-se de pesquisa qualitativa, utilizando entrevistas semi-estruturadas para coleta de dados. A população deste estudo compreendeu mães de pré-escolares matriculados em uma IEI, sendo 10 mães de crianças em período integral e 11 em período parcial. A análise de conteúdo possibilitou a identificação de seis unidades temáticas: a importância da alimentação da criança; como é a alimentação da criança; as estratégias utilizadas durante as refeições; alimentação da criança na instituição; influência da IEI no hábito alimentar dos pré-escolares e expectativas das mães referentes à alimentação. Identificou-se que a alimentação dos pré-escolares assume grande importância para as mães, sendo que estas preocupam-se com a qualidade e quantidade de alimentos ingeridos, além de suas conseqüências para a saúde de seus filhos. Os fatores que influenciam na alimentação dos pré-escolares, segundo suas mães, são: influência do ambiente familiar, influência da IEI e influência da etapa do desenvolvimento infantil, sendo este último o grande causador das dificuldades maternas devido ao desconhecimento das mães acerca das mudanças no comportamento alimentar próprias da fase pré-escolar. As mães utilizam várias estratégias durante a alimentação de seus filhos: barganha, castigo, coação, persuasão, “camuflar” ou misturar os alimentos recusados com os aceitos, as brincadeiras, a conversa e oferecer os alimentos preferidos das crianças. As mães deste estudo desconheciam como eram os momentos de alimentação na IEI, porém perceberam mudanças em seus filhos após estes freqüentarem a IEI: mudança nos horários das refeições, autonomia para servir-se à mesa e mudanças no hábito alimentar, sendo que esta última foi observada em sua maioria pelas mães de crianças em período integral. Salienta-se que essas mudanças positivas aconteceram mesmo ao se levar em conta que a instituição não tinha um programa de promoção da alimentação que pudesse ser considerado plenamente adequado. As mães deste estudo esperam que haja mudanças no hábito alimentar e na quantidade de alimentos ingeridos por seus filhos em casa. Quanto à instituição, esperam: receber informações quanto ao cardápio e ingesta de seus filhos na instituição; que a instituição influencie no hábito alimentar de seus filhos e uma alimentação mais nutritiva nos lanches e mudança no horário destes. Conclui-se que deve haver maior comunicação entre as famílias e a IEI, e esta deve amparar as mães em suas preocupações, trocando experiências e elaborando conjuntamente com as famílias estratégias para lidar com as dificuldades. Finalmente, recomenda-se que as instituições de educação infantil brasileiras implementem seus programas de saúde, e especialmente os de cuidado alimentar, foco deste trabalho, e que tal implementação se dê com o auxílio dos profissionais de enfermagem.
Nourishment in the pre-school phase constitutes a complex process due to the factors related to the development peculiar of this phase and regarding the environmental conditions. Since eating habits acquired in childhood tend to solidify in the adult life, assertive attitudes during this child development phase are essential to stimulate the formation of healthy habits at an early age. Thus, it is important that the nurse knows the difficulties and the mothers’ attitudes regarding their children nourishment, so that he or she can effectively work to make an important contribution to these children’s health at medium and long term. The objective of this study is to know the mothers’ perceptions of the nourishment of their children aged 3 to 6 years that attend an infant education institution (IEI). It is a qualitative research, using semi-structured interviews for data gathering. The population of this study comprised mothers of pre-school children enrolled in an infant education institution (IEI), of which 10 were mothers of children enrolled in full-time class and 11 part-time. The content analysis enabled the identification of six thematic units: the importance of the child nourishment; how the child nourishment is made; the strategies used during the meals; the child nourishment in the institution; IEI influence on eating habits of pre-school children and the mothers’ expectations regarding nourishment. The study identified that the nourishment of pre-school children is very important for the mothers, who are concerned with the quality and quantity of ingested food, besides their consequence for their children’s health. The factors that influence the nourishment of pre-school children according to their mothers are: influence of the family environment; influence of the IEI and influence of the child development phase, the latter being the mothers’ major concern because of their lack of knowledge of the changes in the eating behavior peculiar of pre-school phase. The mothers use several strategies during their children meals, such as: bargain, punishment, coercion, persuasion, disguise or mixture of refused food with the one accepted, play, talk and offer their favorite food. The mothers of this study did not know how the meals or snacks were served at the IEI, however they noticed changes in their children after the IEI attendance, such as: change in the meal times, autonomy to help themselves and changes in eating habits, the latter being noticed by most mothers of children enrolled in full-time course. It is important to highlight that these positive changes happened even taking into account that the institution did not have a nourishment program that would be considered fully appropriate. The mothers of this study expect that there are changes in the eating habits and in the quantity of food eaten by their children at home. Regarding the institution, they expect to receive information about the menu and the quantity of food eaten by their children in the institution, expect that the institution influence the eating habits of their children and expect more nutritive food in the snacks and change in their time schedule. One of the conclusions reached is that there should be a better communication between the families and the IEI, and the latter should help the mothers regarding their concerns, exchanging experiences and creating strategies together with the families to deal with the difficulties. Finally, it is recommended that Brazilian infant education institutions implement health programs, especially of healthy eating, focus of this study, the implementation of which should be supported by nursery professionals.

This project examines the role of immunization registries and their effect on a health care delivery system. Recent efforts to attain coverage of child populations by recommended vaccines have included initiatives by federal and state agencies, as well as private foundations, to develop and implement statewide community-based childhood immunization registries.

O objetivo do presente trabalho foi subsidiar a implementação de sistemas de qualidade em Unidades de Alimentação e Nutrição (UAN) de centros de educação infantil municipais a fim de garantir a segurança dos alimentos oferecidos às crianças assistidas, as quais constituem um grupo de risco. A amostra constituiu-se de dois centros educacionais infantis (CEI) municipais, representativos do município de Piracicaba/SP. A avaliação das Boas Práticas de Fabricação (BPF) foi realizada a partir do emprego de uma lista de verificação, do monitoramento das temperaturas de equipamentos e de preparações integrantes das refeições e análises microbiológicas de amostras coletadas em diferentes etapas de produção de duas preparações consideradas de maior risco, de cada UAN. Com base nos resultados desta avaliação destacaramse as não conformidades com prioridade de adequação e as respectivas ações corretivas, as quais foram consideradas superadas na elaboração do fluxograma vertical e na descrição das etapas das preparações selecionadas. Os perigos e pontos críticos de controle foram identificados, para cada preparação selecionada, assim como as ações preventivas, os procedimentos de monitoramento, das ações corretivas e de verificação, de acordo com os princípios estabelecidos para a implementação do Sistema de Análise de Perigos e Pontos Críticos de Controle – APPCC. A avaliação das BPF demonstrou um nível de adequação aos procedimentos de, em média, 64,3%. Dos procedimentos não conformes, 35,7% são condicionados à capacitação e supervisão de pessoal e podem ser superados com os recursos municipais, uma vez que se observou a disponibilidade de equipe técnica especializada na área de alimentação e nutrição no setor responsável pelo gerenciamento do Programa. Considerando-se que as BPF são o principal prérequisito na implementação do Sistema, o atual nível de adequação e condições estruturais das unidades municipais devem, ainda, contar com investimentos da Prefeitura Municipal para atingir um padrão satisfatório à implementação da APPCC. Os resultados obtidos constituem-se em importantes subsídios para o planejamento do Sistema que poderá ser implantado, com as devidas adequações, em toda a rede de CEI, pois as condições operacionais se repetem nos demais por terem o gerenciamento centralizado.
The objective of this work was to subsidize the implementation of quality systems in foodservice establishments at municipals day-care centers in order to guarantee the security of foods offered to the attended children, which constitute a risk group. The sample consisted of two municipals day-care centers, representative at Piracicaba/SP. The evaluation of Good Manufacture Practices (GMP) was based in a check-list, a temperatures verification of equipment and integrant preparations of the meals and microbiological analyses of samples collected in different stages of production of two preparations considered of higher risk, in each day-care center. Based on this results, emphasized the non conformities with priority of adequacy and the respective corrective actions, which had been considered surpassed in the elaboration of the vertical flux diagram and in the stages description of the selected preparations. The hazards and critical control points had been identified, for each preparation, as well as the preventive actions, the procedures of monitoring, corrective actions and verification, in accordance with the principles of the Hazard Analysis and Critical Control Point (HACCP). The evaluation of the GMP demonstrated an adequacy level to the procedures of, in average, 64,3%. The 35,7% nonconforms refered to the qualification and supervision of staff and can be surpassed with municipal resources, through the technical team specialized in the foodservice and nutrition responsible for the Program management. Considering that the GMP are the main prerequisite in the implementation of the System, the current level of adequacy and structural conditions of the municipal units must need on investments of the Municipal Administration to reach a satisfactory adequacy to the implementation of the HACCP. The results consist in an important subsidies for the planning of the System that could be implanted, with adequacies, in all the CEI attended for the Program, because of centralized management provide the same operational conditions.

No Brasil as crianças estão sobrevivendo mais e crescendo melhor, assim torna-se importante avaliar o seu desenvolvimento. Objetivo: avaliar o desenvolvimento neuropsicomotor através do teste de Denver II. Metodologia: um estudo de corte transversal foi realizado com pré-escolares de 4 a 5 anos de idade e o desempenho comparado quanto à idade, sexo, escolaridade materna e renda. Resultados: dos 960 pré-escolares, 67,0% apresentarem desempenho normal, 30,2% questionável e 2,8% anormal. O desempenho foi pior em famílias com escolaridade e renda baixas. Conclusões: o desempenho dos pré-escolares de Cuiabá foi semelhante ao de Denver, destacando-se os mais jovens e as meninas
Brazilian children are surviving more and growing better, as aconsequence now is important evaluating the development. Objective: to evaluate the development by Denver II's test. Method: A cross sectional study with children preschool of 4 to 5 years old was developed and the performance compared according to age, sex, maternal education and income. Results: Out of the 960 children 67,0% had a normal performance; 30,2% questionable and 2,8% abnormal. The worse performance occurred in the families with poor education and low income. Conclusions: The performance of Cuiabá's preschool child and the Denver's one was identical and the youngest children and the girls were the best

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Introdução: Em áreas urbanas marginalizadas as creches representam política social promissora para a diminuição da pobreza, promoção da educação e da segurança alimentar para a cidadania. Em dois anos ocorreu no Brasil aumento de 11,2% no número de matrículas, passando de 1,6 milhões em 2007 para mais de 1,8 milhões em 2009. Uma das grandes responsabilidades da creche é a alimentação da criança. A introdução adequada dos novos alimentos no primeiro ano de vida, bem como a disponibilização de alimentos variados, saudáveis e em ambiente agradável permite que a criança inicie a aquisição das preferências alimentares responsáveis pela formação do hábitos alimentares saudáveis. De acordo com a Sinopse Estatística do Professor 2009 no Brasil existiam 127.657 professores de creches. Desses 46,18% (58.954) haviam concluído o ensino superior. O educador tem papel fundamental enquanto promotor de hábitos alimentares saudáveis e adequados. Apesar disso, não existem no país cursos de formação específica para educadores de creche, no que diz respeito à saúde e alimentação da criança. Objetivo: Avaliar o efeito de um treinamento específico sobre saúde e nutrição nos conhecimentos e práticas de educadores de berçários de creches sobre alimentação e nutrição infantil. Métodos: Ensaio institucional randomizado realizado em oito creches da subprefeitura de Santo Amaro - SP, 4 de administração direta e 4 de administração indireta. Duas creches de cada grupo foram sorteadas para receberem um treinamento. Para avaliar o conhecimento sobre alimentação infantil foi utilizada metodologia quantitativa através da aplicação de um questionário estruturado e pré-codificado com questões fechadas. Para avaliar a prática dos educadores quanto a oferta da alimentação foi utilizada abordagem qualitativa com aplicação da técnica de grupo focal. Resultados: Os resultados das análises quantitativas mostraram que as educadoras das creches expostas ao treinamento obtiveram diferença entre a nota inicial e final maior do que as de creches não expostas (p<0,05). Quando a nota foi analisada por sub-tema, constatou-se que essa diferença se deu principalmente devido à incorporação de conhecimento do tema alimentação complementar (p=0,006). A análise dos grupos focais identificou que o discurso das educadoras que participaram do treinamento está pontuado de indícios de mudanças, de reconhecimento de que é preciso e possível mudar, além disso, o treinamento reforçou a importância da formação continuada. Conclusão: O conceito de que uma escola deve ter profissionais qualificados que conheçam os princípios básicos sobre alimentação, higiene e desenvolvimento infantil deve ser reforçado. Os dados encontrados neste trabalho demonstram que a educação continuada é de extrema relevância. Educadores devem ser capazes de lidar com a alimentação em um sentido amplo, não só para saber como avaliar um cardápio e cuidar das condições higiênicas, mas também saber como transformar este momento em uma experiência lúdica e de aprendizagem. Este estudo mostra que investimentos na formação de recursos humanos são de grande importância, para que assim ocorra melhoria da relação de custo-efetividade para os elevados investimentos públicos realizados no país em creches.
TEDE
BV UNIFESP: Teses e dissertações

As creches estão relacionadas ao aumento do risco de doenças transmissíveis e programas de controle de infecção são necessários. Foi realizado estudo descritivo para identificar normas de controle de doenças em creches hospitalares do município de São Paulo. Rotina escrita para a lavagem de mãos foi encontrada em 36% e para a troca de fraldas em 24%. Havia luvas descartáveis em 68%, porém rotina escrita para o descarte de luvas usadas em 12% e instruções sobre precauções padrão em 28%. Normas para o afastamento por doença transmissível existiam em 16%. Treinamento padronizado em controle de infecção era oferecido em 12%. As creches hospitalares não possuem normas suficientes para reduzir a transmissão de doenças. Padronização dos procedimentos e regulamentação são necessárias para promover o controle de infeccção
Child day-care centers (DCC) are known for the spread of infectious diseases. Standards for infection control in child care have been established worldwide. A study was conducted to obtain policies used to reduce disease in hospital day-care centers in São Paulo, Brazil. Written handwashing procedures were available at 36% and written instructions on diapering at 24%. Gloves were used in 68% but written disposal procedures were available in 12% and at 28% were instructions offered on standard precautions. A policy for exclusion due to communicable illness was obtained in 16%. Standard staff training on infection control was offered in only 12%. Hospital DCC's lack policies and routine procedures for reducing the spread of disease. Child care standards and regulation are needed in order to promote disease control

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The early diagnosis of Autism Spectrum Disorder – ASD – is a fundamental condition to obtain better results in therapeutic interventions. The synergic articulation between education and health professionals is an effective strategy for hosting suspected cases and immediate referral to specialized care services in the area. Given this scenario, this research aimed to know the perception of the teachers of Early Childhood Education on the TEA and the institutional support network built from the suspect cases. It was assumed that the teachers' understanding of autism could still be insufficient, and that the institutional social network linked to the Municipal Infant Education Centers – CMEIs – to support children with suspected ASD in Foz do Iguaçu was not well constituted. The development of research has taken place through the qualitative approach. The field of research consisted of 10 CMEIs of the northern region of the city, place of greater concentration of school units. One teacher from each CMEI was selected, totaling 10 participants. The inclusion criteria were teachers with more than 3 years of teaching experience and acting at levels above that of the nursery. The data collection was done through semi-structured interviews and the construction of the minimum map of the institutional social network, carried out with the teachers, between September and December 2016. For the treatment and analysis of the data, the analysis was used content, thematic modality. Institutional social network maps were interpreted in the light of the criteria described by Walter Ude, of the principle of integrality in care and the Psychosocial Attention Networks recommended by the Ministry of Health for individuals with ASD in Brazil. From the analysis of participants' speeches, we observed that teachers have knowledge about the main characteristics of ASD, despite the need to clarify the wide phenotypic variety of the disorder. The impact of the teacher's experiences with the TEA in the classroom was a recurring theme in the speeches. In the analysis of the minimum network maps, it was observed that the main support of the schools in hosting the suspected cases of ASD was the direction or coordination of the SMEs, families and professionals of the "Building Citizenship Program". It was considered that, despite the need for further clarification, teachers are currently able to identify students with suspicious signs of ASD in the classroom, and can be included in the Psychosocial Attention Network as autism tracing agents. It was also pointed out that the institutional social network supporting the school in Foz do Iguaçu is still precarious, and therefore needs to be reformulated and strengthened.
O diagnóstico precoce do Transtorno do Espectro do Autismo – TEA – é condição fundamental para que sejam obtidos melhores resultados nas intervenções terapêuticas. A articulação sinérgica entre profissionais da Educação e da Saúde se constitui em uma estratégia eficaz para acolhimento dos casos suspeitos e imediato encaminhamento para serviços de atenção especializados na área. Diante deste cenário, esta pesquisa objetivou conhecer a percepção dos professores da Educação Infantil sobre o TEA e a rede de apoio institucional construída a partir dos casos suspeitos. Partiu-se do pressuposto que a compreensão dos professores sobre o autismo ainda pudesse ser insuficiente, e que a rede social institucional vinculada aos Centros Municipais de Educação Infantil – CMEIs – para o suporte às crianças com suspeita de TEA em Foz do Iguaçu não estivesse bem constituída. O desenvolvimento da investigação se deu por meio da abordagem qualitativa. O campo de pesquisa constituiu-se de 10 CMEIs da região norte da cidade, local de maior concentração de unidades escolares. Foi selecionado 1 professor de cada CMEI, totalizando 10 participantes. Os critérios de inclusão foram professores com mais de 3 anos de experiência docente e com atuação em níveis acima ao do berçário. A coleta de dados se deu por meio de entrevistas semiestruturadas e a construção do mapa mínimo da rede social institucional, realizados com os professores, entre os meses de setembro e dezembro de 2016. Para o tratamento e análise dos dados, utilizou-se a análise de conteúdo, modalidade temática. Os mapas de rede social institucional foram interpretados à luz dos critérios descritos por Walter Ude, do princípio da integralidade no cuidado e das Redes de Atenção Psicossocial preconizadas pelo Ministério da Saúde para indivíduos com TEA, no Brasil. A partir da análise dos discursos dos participantes, observamos que os professores possuem conhecimento sobre as principais características do TEA, apesar da necessidade de esclarecimento sobre a ampla variedade fenotípica do transtorno. O impacto das experiências do professor com o TEA na sala de aula foi um tema recorrente nas falas. Na análise dos mapas mínimos de rede, observou-se que os principais apoios das escolas no acolhimento dos casos suspeitos de TEA foram a direção ou coordenação dos CMEIs, as famílias e os profissionais do “Programa Construindo a Cidadania”. Considerou-se que, apesar da necessidade de mais esclarecimentos, os professores atualmente têm condições de identificar alunos com sinais suspeitos de TEA em sala de aula, podendo ser inseridos na Rede de Atenção Psicossocial como agentes de rastreamento do autismo. Destacou-se, também, que a rede social institucional de suporte à escola em Foz do Iguaçu ainda é precária, necessitando, portanto, ser reformulada e potencializada.

Estudo transversal do universo de pré-escolares (1544) de creches filantrópicas de Santo André, SP, Brasil, para estimar por antropometria seu crescimento e estado nutricional. Observou-se que o crescimento alcançado no conjunto está acima do referencial CDC/NCHS. Não se encontrou desnutrição, mas sim sobrepeso e obesidade, respectivamente em 16,8 e 10,8% das crianças, com tendência crescente com a idade. Entre os fatores de risco para esta condição encontrou-se o sexo feminino e o peso de nascimento mais elevado. Estes resultados apontam para a presença de uma etapa adiantada de transição epidemiólogica nutricional inclusive na população de pré-escolares de baixa renda deste Município
Cross sectional study of the universe (n=1544) of preschool children attending to philanthropic daycare centers of Santo André (SP- Brazil), to evaluate by anthropometrics their growth and nutritional status. The attained growth by the whole group was above the CDC/NCHS reference. There was no undernutrition but overweight and obesity with a prevalence of 16,8 and 10,8%, respectively, with a trend to increase with age. Higher birth weight and feminine gender were risk factors for these nutritional problems. The results pointed out an advanced step of nutritional transition, affecting the children between 2 and 6 years of age, of low income families, in this Municipality

Objetivo: este estudo teve por objetivo verificar a eficácia de um procedimento para a identificação da deficiência auditiva em crianças pré escolares de uma comunidade de baixa renda por pessoas não especialistas. Casuística e métodos: funcionários da creche e da unidade de saúde foram treinados para aplicarem um questionário para triagem auditiva nos pais de 224 crianças de 3 a 6 anos de idade, que foram submetidas à triagem audiométrica e imitanciométrica. Resultados: verificou-se alta concordância na coleta de dados por meio do questionário entre a pesquisadora e os não especialistas. O questionário apresentou melhor sensibilidade e pior especificidade. Os não especialistas relataram aprendizado com a pesquisa e conscientização sobre a importância da audição. Conclusão: é possível treinar agentes comunitários a identificarem a deficiência auditiva em suas comunidades com instrumentos de baixo custo.
Aim: this study aimed to access the efficacy of a low cost instrument used by non professionals to identify hearing loss in pre-school children in a low income community. Methods: employees of a nursery school and a health unit were trained to use a hearing screening questionnaire with parents of 224 children aged 3 to 6 years. The children underwent audiological screening. Results: the results showed that the non - specialists were capable of reproducing the evaluation of the professional regarding the use of the questionnaire. The questionnaire presented better sensitivity than specificity. The non - specialists reported learning and awareness of the importance of hearing in children. Conclusion: the questionnaire offers a low cost option for hearing screening, specially if it is administered by non professionals resources

碩士
國立暨南國際大學
社會政策與社會工作學系
96
The purpose in this study discusses Social Adult Day Care for old peoples’ self-perceived health status and health-related quality of life and finds out the factors. According to the result of the study, we provide some suggestions for Social Adult Day Care policy and work. After surveyed seven centers of Quixotic Implement Foundation, this study collected 164 samples, completed 88.6% by WHOQOL-BREF Taiwan survey. After analyzed the statistic, this study found out 3 points. 1.The mean of 164 old peoples’ WHOQOL-BREF Taiwan surveys was 55.48 score that belonged to meddle level. The highest score was 14.59 in social relationship domain and the lowest score was 12.88 in psychological domain. 2.Economic status in monthly and affected illness or not were the most important variables that influenced how long the old participated in Social Adult Day Care Service. The old felt their self-perceived health status best or worst by some variables that included sex, age, religion, economic status in monthly, affected illness or not, amount of illness, functional status and how long they participated in service. These variables in self-perceived health status study were 75.0%~86.4% correctly. 3.Some variables influenced the score of health-related quality of life. Those were age, marital status, level of education, economic status in monthly, affected illness or not, amount of illness, the score of ADL and IADL, how long they participated in service, self-perceived health status presently and self-perceived health status compared with contemporaries. All of variables explained physical domain was 27.8%, psychological domain was 17.0%, social relationship domain was 17.2%, environment domain was 12.1% and overall health-related quality of life was 27.0%. The results of 3 points, the study provide some suggestions: (1)In policy, we are going to advocate the concept of successful ageing and create friendly community-care environment for the old. We are going to attach great importance to development in adult day care policy abidingly, encourage the old participate in adult day care service and make their life more quality. Pay more attention to the olds’ economics status in their old life in order to upgrade their self-perceived health status and health-related quality of life. (2)In work, we need to notice that social adult day care service is a long time public service. When we supply social adult day care service, sex and age are the most important focuses. The object of design activities and content in service is promoting the old health-related quality of life comprehensively. (3)In study, we need to pitch into the study of social adult day care service and expand the research area in Taiwan. We need to discuss other variables in self-perceived health status and health-related quality of life continually. To increase social work practice with the old in education for more professional take care more old people. Key Words：day care、the old、self-perceived health status、health-related quality of life

In this qualitative study the researcher explores the experiences of various caregivers at a day care centre for developmentally challenged children. This study also attempts to draw a distinction between the experiences of formal and informal caregivers’ experiences. The study is underpinned by two assumptions: 1) that in order to obtain a rich understanding of a phenomenon, the views and voices of a variety of individuals need to be considered and 2) that cultural values and practices play a significant role in the way individuals experience a certain phenomenon. The experiences of both formal and informal caregivers are documented using thematic analysis. An analysis of the participants’ global themes revealed that “education/learning/skills development” and “communication barriers” were common themes among both participant groups. Each participant group also expressed unique experiences such as “being a parent”, “becoming a foster parent” and “being useless as a professional-in-training”. Focal areas for further research are highlighted.
Clinical Psychology
M.A. (Clinical Psychology)

Submitted in fulfilment of the requirements for the degree Master of Applied Science in Food and Nutrition, Durban University of Technology, 2015.
Introduction: According to the American Dietetic Association, Child care facilities (CCFs) play an essential role in the nutritional status of children as children typically spend 4-8 hours a day at a facility. As a result, the meals should provide at least 50 – 60% of daily nutritional requirements. Worldwide CCF feeding has been found to be nutritionally inadequate as energy and most micronutrient requirements are not met by the meals provided, due to the lack of nutrition knowledge of the caregivers. Studies have shown that with appropriate training there has been improvement in nutritional standards. Aim: The aim of this study was to analyse the nutritional adequacy of menus offered; and to determine the nutritional status of children aged two to five years old in registered child care facilities in the Inanda area. Methodology: CCFs (n=10) in the Inanda area were randomly selected from multiple options to participate in the study. This study was conducted on children (boys (n= 91) and girls (n=109)) of ages two to five years old. Trained fieldworkers and teachers assisted in interviewing parents to complete the socio-demographic questionnaire. The researcher gathered menus and recipes for analysis, using Foodfinder Version 3 Software. The researcher also conducted plate-waste studies to determine consumption patterns during CCF meal times. Anthropometric measurements for weight and height were collected. In order to establish BMI-for-age and height-for-age, the WHO Anthro Software and WHO AnthroPlus Software were used. Ten food handlers (FHs) were interviewed by the researcher on food preparation and serving. Results: Most children (79.40%) originate from extended families that are female-headed. The highest form of education attained by most caregivers in the sample is standard 10 (47.74%) and 45.73% are unemployed. Of the 54.27% employed, 64.71% are informally employed. Most respondents (72.87%) are living on a total household income of less than R2500. The anthropometric results of the children show very low prevalence of severe stunting (1.74%) and stunting (5.42%). Less than halve (34.48%) of the children were at a possible risk of being overweight, 13.79% were overweight and 2.46% obese. The top 20 foods served in CCFs in Inanda were cereal-based staples of rice and maize meal more frequently than meat, dairy products and fruit and vegetables – all served far less frequently. All the CCFs did not meet the 60% of daily requirements for energy, fibre, calcium and vitamin C in foods served. The CCFs have well-equipped, designated kitchens for food storage, preparation, serving and good hygiene practices. Conclusion: Meals served to two to five year olds in registered CCFs in the Inanda area are nutritionally inadequate as most facilities do not contain 60% of the daily nutrient requirements from both daily meals served. Recommendations: CCF owners and Food handlers should receive proper training and retraining on food safety and hygiene and menu planning. The government should increase the subsidy to CCFs in order to meet the nutritional needs of children in order to aid in the alleviation of under-nutrition.

Summaries in Afrikaans and English
Text in Afrikaans
The child's becoming is influenced by the education situation as a whole. The mother-child relationship plays a crucial role to the child's becoming, hence the initial bonding between mother and child is considered all-important. All further becoming is based on the motherchild relationship. Another factor that influences becoming is the family situation, with specific reference to the father. Because the family functions in the context of a particular society, the shift of emphasis in the modem family and social factors cannot be discounted in the discription of becoming. Becoming takes place in conjunction with learning, development and maturation. These processes are differentiable but inseparable. The different domains of becoming and development, namely the affective, cognitive, normative, physical and social, form the overall context within which the child is investigated. An adequate educational environment leads tot the child's adequate becoming. At the centre of any adequate educational environment is the educator acting as mediator between child and learning content. Both the primary and the secondary educational situation should comply with the requisites for adequacy. An empirical investigation was undertaken in accordance with ideographic research methods. The status of overall becoming and development in children who had been subjected to different types of daycare was determined in relation to the education situation as a whole, which is why both the primary and the secondary educational situation were drawn into the investigation. This research has produced the finding that daycare does not necessarily harm the child's becoming. The overall educational situation must be considered at all times. Daycare has a recognisable influence on the child's becoming, but the mother-child relationship is the most decisive factor for the child's becoming.
Kinderlike wording word deur die opvoedingsituasie as totaliteit belnvloed. Die moederkindverhouding speel die allerbelangrikste rol by kinderlike wording. Daarom word die aanvanklike binding tussen moeder en kind baie hoog aangeskryf. Alie verdere wording word geskoei op die moeder-kindverhouding. Die gesinsituasie, met spesifieke verwysing na die vader, is verdere faktore wat wording belnvloed. Omdat die gesin binne 'n bepaalde samelewing funksioneer, kan die klemverskuiwing van die moderne gesin en die samelewingsfaktore nie buite rekening gelaat word by die beskrywing van wording nie. Wording vind sy neerslag in samewerking met leer, ontwikkeling en ryping. Hierdie begrippe is onderskeibaar, maar kan nooit geskei word nie. Die verskillende domeine van wording en ontwikkeling, naamlik die affektiewe, kognitiewe, normatiewe, fisieke en sosiale domeine, vorm die totaliteit waarbinne die kind beskou word. 'n Toereik:ende opvoedingsmilieu gee aanleiding tot toereikende wording by die kind. Midde 'n toereikende opvoedingsmilieu staan die opvoeder as bemiddelaar tussen die kind en die inhoud. Die primere sowel as die sekondere opvoedingsituasies behoort aan die vereistes van toereikendheid te voldoen. 'n Empiriese ondersoek is aan die hand van die ideografiese navosingsontwerp onderneem. Die wording en ontwikkeling van kinders vanuit verskillende tipes dagsorg is bepaal. Die wording en ontwikkeling van die kind in totaliteit word in aanmerking geneem. Wording word dan in verband gebring met die opvoedingsituasie in sy totaliteit. Daarom is die primere sowel as die sekondere situasies by die ondersoek betrek. Hierdie navorsing bevind dat kinderlike wording nie noodwendig negatief deur dagsorg beinvloed word nie. Die totale opvoedingsituasie van die kind moet telkens in berekening gebring word. Dagsorg oefen wel 'n invloed op kinderlike wording uit, maar die moederkindverhouding is die mees bepalende faktor by kinderlike wording.
Psychology of Education
D. Ed. (Psychology of Education)

The purpose of this study was to investigate the possibility of implementing community based care for moderately mentally retarded persons in a specific centre in the Port Elizabeth area. The objectives of the study were to identify • the needs of the moderately mentally retarded children. • the physical, psychosocial and vocational rehabilitation means of meeting these needs. • how involved the communities, parents and government were in the care of moderately mentally retarded children. A quantitative, exploratmy and descriptive design was used. A sample of 50 moderately mentally retarded children was utilised. Data were collected by means of questionnaires and semi-structured interviews. The major research findings indicate that community care for MMRPs could only be feasible with sufficient resources, expertise and community involvement. All these aspects appeared to be lacking in the centre where this research was conducted raising questions as to benefits which the mentally retarded children and their parents and the community could derive from these services. However recommendations were made on identified shortcomings, problems and needs.
Health Science
M.A.(Nursing Science)