Wisconsin's Quality Rating and Improvement System (QRIS) was implemented in 2010 to improve quality of care for young children enrolled in childcare programs. Due to the recent initiation of the state's QRIS, empirical evidence on the effectiveness of the initiative to improve quality care for young children is limited. This qualitative case study explores childcare stakeholders' perceptions on the effectiveness of Wisconsin's QRIS as a quality improvement program. Bronfenbrenner theorized that exosystems such as state governments impact early childhood environments and the development of young children through initiation of programs. The research questions address the efficiency of the state's QRIS and the effects of the program on children, parents, and providers. Data sources included interviews exploring stakeholders' perceptions (n = 8), analysis of documents, and observations of childcare teachers (n = 2) for substantiation of effects. Using NVivo to aid in coding and theme development, the data showed that childcare stakeholders had positive and negative viewpoints on the expectations and effectiveness of the QRIS. Stakeholders acknowledged that the initiative enhanced the quality of programming for young children. Due to increased formal education requirements for caregivers and classroom expectations, the participants responded negatively about the effects of the QRIS on childcare staff. To improve the state's QRIS, stakeholders suggested that all state licensed childcare providers be mandated to participate, formal raters assess the quality in accredited and city certified childcare programs, and frequent communications between officials to eliminate misinformation. The recommendations may help the initiative operate more efficiently and effectively, thereby improving the quality in childcare programs and enhancing the development of young children.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Goal and Objectives. The main goal of this study is to assess childcare center directors (CCCDs) oral health literacy, knowledge, and attitudes towards pediatric oral health. We also determined the associations between CCCDs oral health literacy, knowledge, attitudes towards pediatric oral health, and 1) number of oral health preventive strategies (OHPS) implemented in their child care center (CCC), and 2) intent to adopt OHPS in the future. Background. Childcare utilization has substantially increased over the past decade with children enrolled in these centers spending substantial amount of time. CCCs, a non-traditional setting, can be used to actively promote pediatric oral health. However, before this setting can be used to promote oral health, a better understanding of Florida CCCDs' oral health literacy, knowledge, and attitudes on pediatric oral health is needed. Methods. In this cross-sectional study we used a 45-item pre-tested questionnaire to survey Florida CCCDs working primarily in licensed CCCs through survey monkey online portal. Descriptive, bivariate statistics and multivariate regression analyses were conducted using SAS analysis software. Results. Of the 877 CCCD participants, 90% did not train staff about traumatic dental injuries, 87% did not have an oral health consultant, and 82% did not promote enrollees to brush their teeth after meals or snacks. Mean oral health literacy (12.3±2.3) and attitude levels (16.8±2.7) were high, however mean oral health knowledge (1.6±2.0) was low. CCCDs with more years of experience (p=0.01), who work at Head Start CCCs ( p<0.0001), and have more positive attitudes (p<0.0001), were more likely to have implemented OHPS in their centers compared to their counterparts. Non-White CCCDs (p=0.03), those with more positive attitudes(p=0.001), and who reported to have already implemented one or more OHPS (p=0.002) were more willing to implement OHPS in the future compared to their counterparts. Conclusions. No significant associations between oral health literacy, knowledge and number of OHPS implemented were observed. Similarly, oral health literacy, oral health knowledge was not associated with intent to implement OHPS in the future. CCCDs with more positive attitudes towards pediatric oral health had implemented more OHPS within their CCCs, and also were willing to implement more OHPS in the future compared to their counterparts.

No description available.

This thesis considers the extent to which tax and transfer policies in South Africa support children between 2000 and 2008. The analyses are carried out using a four-dimensional analytical framework which separates the dimensions of welfare ideology, policy aims, policy instruments and welfare outcomes. This approach is adopted in recognition of the fact that the extent to which tax and transfer policies support children is seen to vary according to the dimension of analysis. The analysis of welfare ideology, policy aims and policy instruments is undertaken by considering key legislative texts, including the Bill of Rights in the South African Constitution, budget speeches and policy documents. Welfare outcomes are analysed at the individual and household level using microsimulation modelling. A microsimulation model for South Africa, SAMOD, is developed specifically for these analyses. The findings of this thesis add conceptual and empirical understanding to the impact of tax and transfer policies on children. Children are found to be supported by policy to some extent, and have been prioritised in reforms to social assistance. However, recent reforms to tax policy have not benefited children and the analyses indicate that child poverty rates in South Africa could be lower than they are at present had the government pursued alternative policy reforms. The construction of the microsimulation model SAMOD is a valuable tool to facilitate future policy evaluation in South Africa. Further development of SAMOD is recommended to continue to progress and enhance debates on policy reforms. In addition, this thesis highlights some key areas for future research including developing further understanding of the patterns of inter and intra-household income allocation and the impact that this may have on poverty measures for different groups.

This research examines the impact of work-family reconciliation policies on gender inequality in the labour market, and on the division of paid work and care in the household. Policies designed to help families meet their work and care responsibilities have undergone considerable reform over the last fifteen years. The research aims to understand how this has affected the way that earning and caring are divided between mothers and fathers, and the implications of this for mothers’ labour market outcomes. The research compares two cohorts; the National Child Development Study (NCDS) tracks individuals born in 1958, and the British Cohort Study (BCS) those born in 1970. These cohorts experienced the key childbearing years of their early thirties on either side of a fairly sharp discontinuity in work-family reconciliation policy. The research aims to link this difference in policy environments to differences the way that couples in each cohort divide paid work and care, and in the labour market behaviour of mothers and the penalties they face when they are in employment. Logistic regression models are employed to quantify the magnitude and significance of the impact of cohort membership on the work and care outcomes of interest, controlling for other variables that affect these outcomes. Some case-level analysis of the data is also carried out; individuals representing typical family arrangements are highlighted, to demonstrate the relevance of the theoretical model and assist with hypothesis generation. Case stories illustrate the interplay of individual circumstances with policy and other external factors, in a way that is difficult to achieve using statistical methods. A key finding is that the younger cohort is less likely to report equal sharing of childcare than the older cohort, even after controlling for other factors that might influence the division of labour. This is also in spite of the finding that mothers in the younger cohort are more likely to be in work. This suggests progress to some extent, in that mothers perhaps find it easier to be in employment. However at the same time it represents a regressive step at the household level, as they not only continue to shoulder the majority of the care work, but are even more inclined to do so. Analysis of pay and status gaps also yields interesting results. The findings suggest that the penalty to motherhood in terms of labour market status accrues by virtue of the interrupted human capital accumulation that results from periods out of the labour market or working part time. However, the motherhood penalty in pay persists even after controlling for other wage determinants, suggesting that these gaps are a direct result of motherhood itself and not of the labour market behaviour changes that occur as a result. The research contributes theoretically and substantively to the wider literature on this topic. It brings together human capital perspectives with theories of gender, power and resources, and of the impact of policy on family life, and uses Amartya Sen’s capability approach to reconcile and move forward these ideas. It also contributes to the practical understanding of the impact of policy on the way that families reconcile work and care, and in particular the implications of policy for gender equality. Finally, its methodological contribution is in the use of a narrative approach to large-scale quantitative data, alongside more conventional statistical techniques, in order to further exploit the detailed, longitudinal data available.

Fifteen million children have been orphaned by AIDS. A growing body of evidence documents impacts of parental deaths on orphans, but little is known about impacts faced by AIDS-orphan carers. This study set out to: (a) investigate physical and mental health outcomes of adults caring for children in Umlazi, a high HIV prevalence township in South Africa; (b) assess whether AIDS-orphan carers face worse outcomes compared to other carers; and, (c) identify risk and protective factors for health. Using a cross-sectional survey, data was gathered from a representative community sample from August 2008 to March 2009 resulting in the largest known study conducted on AIDS-orphan carers to date (n=1599). The majority of carers looked after non-orphaned children (66.85%) followed by AIDS-orphan (22.45%) and other-orphan children (10.69%). Orphan carers had significantly worse general health and functioning, depression, and post-traumatic stress than non-orphan carers but patterns were less clear when orphan carers were disaggregated into AIDS-orphan and other-orphan carers for comparison. This suggests that health interventions might target orphan carers, rather than singling out AIDS-orphan carers. Differences in age, gender, education, economic assets, and source of household income fully accounted for the association between being an orphan carer and poor health. Social policy grants reduced negative health disparities between orphan carers and non-orphan carers. Social support, education, economic assets, food, access to water, and housing were iii also identified as risk and protective co-factors that might reduce orphan carer disparities in health. By highlighting health as a serious issue for orphan carers and identifying risk and protective factors for health, this study offers policy and program insights into how to mitigate negative impacts faced by carers in high HIV prevalence communities facing escalating numbers of orphans.

Over the past twenty years, parental choice has become the favoured Government policy governing school allocation and the dominant legislative approach for improving educational attainment. The existing sociological research on school choice has primarily focused on the ways in which families of different socioeconomic backgrounds have engaged with the process of listing preferences for secondary schools; while class has been emphasised, the choice processes of ethnic minorities have received little attention. Yet the persistent educational challenges faced by Afro-Caribbean students across class boundaries since the early years of migration to England raise questions about whether choice policies’ promise of improved academic performance extends to all ethnic groups. This study focuses on Afro-Caribbean families and their engagement with the process of selecting secondary schools in Birmingham. Twenty individual families in semi-structured interviews and ten additional mothers in two focus groups shared their experiences of listing school preferences. To develop a fuller understanding of how these Afro-Caribbean families made their school choices, this study draws upon Courtney Bell’s (2005) application of ‘choice sets’ to education. Families’ choice sets – the schools which they perceived to be available options – were shaped by various factors, including past school experiences, the schools available in the local authority, and Birmingham’s school allocation criteria. Additionally, geographic considerations, the ethnic mix of a schools’ student population, and families’ access to social networks also influenced which schools families saw as possibilities. Ultimately, while there was no single ‘Afro-Caribbean’ way of selecting schools, this study highlights the circumstances and structures faced by many Afro-Caribbean families which constrained their choice sets, and consequently, the schools to which their children were allocated. Though this thesis is limited in its generalisability, its conclusions lay the foundations for future research into the ways in which ethnic identity is lived in the educational context.

Children around the world need care outside their families for a variety of reasons including poverty, war and epidemics such as HIV/AIDS. The majority of these children live in developing countries where there are limited resources to care for them. As a result of concerns about the effects of institutional care on children, and following trends in the developed world, there is a movement in developing countries to replace large residential institutions with a system of adoption, foster care and small group homes. The aim of this study is to examine the experience of orphan, abandoned, and neglected or abused children who grew up in residential institutions in the Caribbean nation of Trinidad and Tobago, to learn the positives and negatives of residential care in order to contribute to developing a model of care suited for high need, low resource countries. Oral history methodology was used to collect the stories of 24 alumni (12 men and 12 women) from seven homes in Trinidad and Tobago. The homes were categorized as 1) state— partially funded by the state but managed by the Anglican and Catholic dioceses, 2) faith-based— run by religious communities, and 3) community homes run by individuals in the community. The findings of the study show that overall experiences were positive. For poor and working-class children, life in the home was better than their life would have been if they had remained with their families. However, discharge and transition from the homes were less favourable. Alumni from the state-funded homes experienced more difficulties than the faith-based and community homes as a result of poor planning and a lack of post-departure supports. Women suffered more hardships than men, often leading to sexual exploitation. The findings also show that being admitted with siblings and staying at the same home over the duration of care—as was the norm—correlated positively with educational outcomes for the majority of alumni. Some life-long relationships were maintained with volunteers and with friends made among peers at the homes. The study concludes that large group care is not necessarily harmful for children. It may be even beneficial and may be cost effective—a factor that is very important for low resource countries. An aftercare plan, with planning beginning at admission might ease the transition process and gender must be considered in discharge and transition policies. / October 2016

Background: Orphanhood is a major consequence of the HIV/AIDS epidemic in sub-Saharan Africa. There is little evidence concerning psychological problems for AIDS-orphaned children. This thesis explores the relationship between orphanhood status and mental health. It also examines mediating influences of environmental risk and protective factors, and interactions between factors, on children’s psychological problems. Methods: 1200 isiXhosa-speaking children were interviewed, using standardised questionnaires, in deprived urban settlements of Cape Town. A qualitative stage with 60 AIDS-orphaned children, 42 caregivers and 20 professionals explored participant perceptions of risk and protective factors. A quantitative stage compared 1025 AIDS-orphaned children to control groups of other-orphans and non-orphans. Data were analysed with t-tests, chi-sq, anovas, regression and log-linear analyses. The study took place in collaboration with Cape Town Child Welfare. Results: AIDS-orphaned children reported more depression (p<.001), peer relationship problems (p<.001), post-traumatic stress (p<.001), suicidal ideation (p<.05), delinquency (p<.001) and conduct problems (p<.001) than other-orphans and non-orphans. Anxiety showed no differences. Compared to Western norms, AIDS-orphaned children showed higher levels of internalising problems and delinquency, but lower levels of conduct problems. These differences remained when controlling for socio-demographic factors. A number of factors strongly mediated the relationship between AIDS-orphanhood and mental health. These include poverty-related factors (food, education and social security, p<.001). caregiving-related factors (caregiver illness, p<.001, excessive housework p<.001, being a streetchild, p<.001) and AIDS-related stigma (p<.001). Cumulative effects were also found. Food insecurity and AIDS-related stigma interacted to raise likelihood of disorder from 19% to 83%, and orphanhood status and bullying interacted to raise likelihood from 12% to 76%. Conclusions: This thesis shows clear evidence of heightened psychological problems amongst AIDS-orphaned children. It also indicates mediating factors and points to areas of possible intervention. The South African Ministry of Social Development plans to scale up the study to a national survey of AIDS-orphanhood.

Segundo Organização Mundial da Saúde (OMS), a Família é o local onde se estabelecem, pela primeira vez, comportamentos e decisões relativas às questões da saúde e onde têm origem os valores, a cultura e as normas sociais dos indivíduos. Promover a educação em saúde ofertando informações, motivação e auxílio às famílias e comunidades, em busca de seu empowerment para que tenham a possibilidade de vir a adotar comportamentos favoráveis à saúde têm sido orientação de órgãos internacionais como a União Internacional de Promoção e Educação para a Saúde (UIPES) e o Fundo das Nações Unidas para a Infância (Unicef). Este trabalho teve como objetivo avaliar o instrumento de promoção ao cuidado infantil, a cartilha educativa “Toda Hora é Hora de Cuidar", através da análise da percepção dos cuidadores sobre os temas por ela discutidos. Caracterizou-se como um estudo descritivo de natureza quantitativa e abordagens qualitativas, através de entrevista de 89 cuidadores usuários do Programa de Saúde da Família do município de São Paulo. A análise dos dados foi realizada com a utilização do programa Statistical Package for the Social Sciences - pacote estatístico para as ciências sociais (SPSS). Observou-se no resultado uma predominância de mulheres, mães, com ensino fundamental incompleto que relataram compreensão e interesse pelos conteúdos da cartilha. Para a análise foram construídas categorias acerca da percepção do cuidador em relação ao cuidado enquanto ação afetiva e ação de labor, e em relação à rede social a Unidade Básica de Saúde destaca-se como uma importante instituição de apoio e que a rede de ajuda das famílias é frágil e necessita ser fortalecida. Conclui-se que existem evidências de efetividade da cartilha enquanto instrumento promotor de habilidades e potenciais da comunidade, família e indivíduos, sendo importante a construção de um instrumento facilitador do processo de aprendizado com enfoque na promoção da saúde e do “empowerment" das comunidades assistidas e a sua incorporação pelos serviços de Saúde da Família, enquanto locais privilegiados para o desenvolvimento e orientação de novas práticas em Educação para a Promoção da Saúde e da Cidadania / World Health Organization (WHO) states: \"the family is where health behavior and decisions are first established, and where culture, values, and social norms are first molded\" (WHO,2003). To promote health education offering information, motivation and help whit families and communities, searching for their empowerment, for the possibility of having positive health behavior has been orientation of International Organizations like The International Union for Health Promotion and Education (UIPES), The United Nations Children\'s Fund (UNICEF) and WHO. The objective of present study is the evaluation of instrument children´s care promotion, the education booklet: \"Toda Hora é Hora de Cuidar\" through the analysis perception family´s carer about their subjects. This is a descriptive study of quantitative nature and qualitative boarding, through 89 carer´s interview, Programa de Saúde da Família´ users, from São Paulo city. The date´s analysis was realized with the Statistical Package for the Social Sciences (SPSS). The results observed a predominance of woman, mothers, with incomplete education basic who had told to understanding and interest for the contents of the booklet. For the analysis categories concerning the perception of the carer in relation had been constructed to the care while affective action and action of work, and in relation to the social net the Basic Unit of Health is distinguished as an important institution of support and that the net of aid of the families is fragile and needs to be fortified. One concludes that evidences of effectiveness of booklet exist while promotional instrument of abilities and potentials of the community, family and individuals, being important the construction of a helper instrument of the process of learning with approach in health promotion and \"empowerment\" of the attended communities and its incorporation for the services of Family Health, while privileged place for the new development and orientation of practical in Education for the health promotion and the citizenship