My doctoral research has explored how young children’s participation was put into practice—how it was ‘lived’ and negotiated—in the context of one early learning and childcare setting. The concept of children’s participation is rooted in large part in the UN Convention on the Rights of the Child (1989), which enshrines children’s right to express their views and have those views taken into account. However, young children’s participation rights are often overlooked. The more prominent discourse about young children has been one that focuses on early childhood as a preparatory period of life, in which adults must intervene and shape children’s development. My research has therefore focused on child-adult relationships within the early childhood setting, looking at how young children and early childhood practitioners ‘lived’ children’s participation and negotiated the tensions and challenges that arose for them. To carry out the research, I used an ethnographic methodology to study one fieldwork site in depth. ‘Castle Nursery’ was an early learning and childcare setting in Scotland, where practitioners professed to work in participatory ways with young children. The long-term nature of ethnography allowed me to observe how children’s participation was lived and negotiated at Castle Nursery over an eight-month period of fieldwork. The research found that practitioners challenged adult-led, ‘schoolified’ practices by foregrounding young children’s knowledge and contributions to the setting. Children’s participation was embedded into play-based pedagogy at Castle Nursery, with practitioners organising time and space to allow young children a great deal of influence over their daily experiences. Rather than planning adult-led learning activities, practitioners instead cultivated a rich learning environment for children to explore, through free-flow play. The thesis has also highlighted a variety of tensions and challenges that arose. Even at Castle Nursery, where practitioners were proud of the ways their work challenged conventional norms about young children, there were limits to how far practitioners would take a participatory approach. The thesis has particularly highlighted the importance of reflective practices about the ethical dimensions of early childhood practice. Uncertainty seemed to be an inevitable and enduring feature of living young children’s participation.

Background: Breastfeeding has the potential to significantly improve public health. As part of UK government policy peer support interventions have been recommended to increase breastfeeding rates but the evidence base for this is of low quality. Methods: The aim of this thesis was to investigate the effect of breastfeeding peer support on initiation though a systematic review; on continuation through an RCT and a systematic review; and to explore women’s experiences through a qualitative study. Results: Universal peer support to improve breastfeeding initiation was ineffective. Peer support for breastfeeding continuation in both the RCT and review findings appears to be effective in low/middle income countries; when provided in an intensive schedule of contacts (>5 contacts); and given in the postnatal period. Women’s experience of peer support is generally positive and those interviewed gave several suggestions to how current local services may be modified. Conclusions: Peer support per se, in any format in the UK-setting, has not been supported. Targeted and intensive peer support may improve breastfeeding rates in the UK but this must be evaluated using high-quality methodologies. Peer support appears to be effective in the developing world, were it is intensive and targeted to those already considering breastfeeding.

The Zen (Ch'an) poets Han-shan (circa 6th-9 thC.) and Ryokan (1758-1831) participate in literary activity, reclusion, and ordinary emotions in a manner that questions their typical image as models of transcendence. They participate in literary activity without attachment to either linguistic adequacy or a dualistic notion of "beyond words," and poetry serves as their mode of communication from reclusion. Reclusion is a context to realize the nature of the conventional world rather than a means of transcendence to an ultimate realm and is significant as a social and political act. Interpreted through the functional model of language, the poets' expressions of sorrow experienced in their reclusive lives embody the Zen ideal of selflessness. Ultimately, the poetry of both Hanshan and Ryokan supports a non-transcendent, or trans-descendent, ideal consistent with the nondual logic of Zen Buddhism and contrary to scholarship that assumes a dualistic view of Zen enlightenment.

Background: Breastfeeding is globally recognised as a gold standard of nutrition, recommended for the first six months of an infant’s life. Despite its benefits, most women in Ghana do not breastfeed, as recommended by World Health Organization (WHO) and United Nations International Children Emergency Fund (UNICEF). Aim: To gain in-depth understanding of first-time Ghanaian mother lived experience of breastfeeding. Design/Method: A longitudinal qualitative design was adopted, underpinned by the hermeneutic phenomenological approach, as described by van Manen (1990). The study explored the lived experiences of thirty first-time women recruited from antenatal clinic. A series of three semi-structured, in-depth interviews were conducted; the first in late pregnancy, the second in the first week following childbirth and the final one between four and six months postpartum. Findings: Inductive thematic analysis informed by van Manen (1990) and principles of hermeneutic interpretation allowed the emergence of four main themes: the ‘Breastfeeding Assumption,' Breastfeeding as Women’s Business,’ the Postnatal Experience of Breastfeeding and ‘Family as Enabler or Disabler’. Within the context of this study, breastfeeding is expressed as an activity within the family and social environment. The overall phenomenon that emerged was ‘Social Conformity’. This demonstrates an understanding of the breastfeeding experience suffused with emotions as women project an image of themselves as successful breast feeders in order to conform to family and social expectations. Conclusion: Findings from the study demonstrated the multifactorial dimensions of breastfeeding. Most importantly, it was identified that first-time breastfeeding women use emotion work to cope with their experience of breastfeeding, within the social context. It was suggested that midwives play a pivotal role in helping women develop realistic expectations prior to breastfeeding. Furthermore encouraging family centered education that promotes holistic support for women. The findings therefore suggested the need for better antenatal education based on evidence-based practice. Breastfeeding women require individualised support that assesses their emotional needs and offers encouragement. Developing policies that ensure training of midwives and breastfeeding advocates was recommended. Future research could explore the impact of these interventions on breastfeeding practices, helping first time women to breastfeed effectively.

Aims There is an increasing focus on factors associated with resilience in parents of children with disabilities. Two such resilience factors are hope and locus of control. This thesis aimed to review the existing literature on hope and its relationship to psychological outcomes, in parents of children who have a disability. A research study aimed to explore relationships between two resilience factors, hope and locus of control, and their links with knowledge of behavioural principles and challenging behaviour. Methods To address the first aim, a systematic review of the literature was conducted for hope (operationalised using Snyder’s model of hope). Nine online databases were systematically searched using a set of pre-defined criteria. Eligible papers were rated for quality using an established tool (SIGN, 2008) adapted for this review. Secondly, a cross-sectional research study sampled mothers of children with an intellectual disability (N=32) who completed four self-report measures online: State Hope for the Child Scale (based on the State Hope Scale), Parental Locus of Control Scale (child control and parental control subscales), Behavior Problems Inventory for Individuals with Intellectual Disabilities – Short Form, and the Knowledge of Behavioural Principles Questionnaire (KBPQ), which was developed for the study. Results The systematic review identified 11 papers; three were rated as good quality, seven rated as fair quality and one rated as poor. Studies included participants whose children had a range of disabilities. Participants in the following groups were overrepresented: white, middle to high socio-economic status mothers, educated to college or graduate degree level and who self-selected to participate. For all studies, mean hope was higher than the median value for each scale used, suggesting the presence of hope in most parents. Hope was positively associated with a range of variables, such as, quality of life, and negatively associated others, including stress. There were differences in the interactions between hope components of agency and pathways, and psychological variables. There were also differences between how maternal and paternal hope related to psychological variables. The characteristics of those recruited to the research study mirrored those found in previous research. The majority of participants were married/cohabiting mothers, living in areas of higher socio-economic status, and caring for a child with a moderate or severe ID. In addition, there was a higher incidence of children with autism spectrum disorder in this sample. Mothers reported feeling hopeful, although they experienced a range of challenging behaviours (mean 14.6 behaviours per child). Due to poor psychometric properties of the KBPQ, data was not included in the analysis; however, some areas of strength and weakness in knowledge were evident. Correlational analysis showed that higher levels of resilience factors were associated with lower levels of self-injurious and aggressive/destructive behaviour. Stereotyped behaviour was not associated with either hope or locus of control. In contrast to previous research, higher hope was associated with a more external locus of control for the child control subscale. Conclusions and implications Hope is an established resilience factor in the general population. Findings from both the systematic review and research study suggest that hope is present in parents and caregivers of children with a disability. The systematic review demonstrated consistent adaptive relationships between hope and psychological variables. This highlights hope’s role as a resilience factor in parents of children with a disability. The research study added to the literature on how maternal hope and locus of control inter-relate in this population. Generalisability of study results was limited by sample size, population characteristics and by scales used. However, overall findings suggest that it would be beneficial to consider resilience factors when planning and evaluating interventions and research. Furthermore, examining specific aetiologies of disability, such as ASD, might also clarify whether these affect the relationships between hope and other psychological variables.

No description available.

Introduction: Breastfeeding offers the substance exposed mother and child potential short and long-term health benefits, with breast milk shown to alleviate the severity of Neonatal Abstinence Syndrome. Substance dependent women, however, have limited success establishing breastfeeding with physical, psychological and institutional factors cited as barriers. This study aimed to develop and test the feasibility of an evidence informed and theory based intervention to support continued breastfeeding for this group. Methods: The research was a two-phase feasibility study. Phase 1 informed intervention development using a mixed methodology approach which included (a) a comprehensive systematic literature review of breastfeeding support for women from disadvantaged groups (b) expert advisory group recommendations and (c) ‘think aloud’ verbal protocols with opioid dependent women. Phase 2 underpinned the evidence with the theoretical constructs of behaviour change, prior to testing the acceptability and implementation fidelity of the intervention in a feasibility study with an embedded small-scale randomised controlled trial. Results: Phase 1 identified the barriers to breastfeeding continuation as low maternal self-efficacy; neonatal feeding difficulties associated with withdrawal and unsupportive healthcare practices. Evidence and theory synthesis resulted in an integrated breastfeeding support model founded on practical, informational, psychological, person-centred and environmental components. Phase 2 demonstrated that the intervention was feasible to implement and acceptable to participants. The randomised controlled trial reported higher rates of continued breastfeeding and a greater level of maternal confidence in breastfeeding ability in the intervention group compared to the control group. Breastfed infants were less likely to require pharmacological management and had corresponding shorter durations of hospitalisation than formula fed infants. Conclusion: The research provided an original contribution to the development of a complex healthcare intervention which is meaningful to both existing research and clinical practice. The findings highlighted the potential of the intervention to support breastfeeding for the substance exposed mother and baby, which has wide ranging implications for the improved health and social equalities of this group.

This thesis investigates the acceptability and efficacy of a brief universal preventive parenting intervention for child behavioural and emotional difficulties. The methodology included a systematic review, a literature review, a pilot randomised controlled trial and focus group discussions. The systematic review aimed to show whether behavioural and emotional difficulties are a significant problem in Greece. Greek children appeared to display high scores on, and prevalence of behavioural problems, compared to children from other countries. The results suggested that, based on parental reports, Greece seems to have a high prevalence in child behavioural and emotional difficulties. The literature review explored the effectiveness of universally delivered Triple P preventive interventions and identified research gaps. There was also insufficient evidence on the effectiveness of brief universal Triple P programmes to draw any definitive conclusions. No randomised trial had examined the short-term and long-term effectiveness of the Triple P brief universal interventions (Seminar Series). The pilot randomised trial explored the efficacy of the Triple P Seminar Series for the reduction of child behavioural and emotional difficulties. 124 parents were randomly allocated to receive three seminars on positive parenting, while parents in the control group received information on child development. There was a significant reduction in behavioural problems over time (primary outcome), and a reduction in parenting dysfunctional difficulties in the short-term. Parents gave positive feedback on the intervention indicating that overall it was acceptable, feasible, culturally relevant, and useful. Preliminary moderator analyses indicated that there were no moderator variables affecting the relation between group allocation and change in child disruptive scores. Preliminary mediator analyses suggested that a reduction in dysfunctional practices partially explained improvements in children's disruptive behaviours over time. Lastly, 46 parents of the intervention group shared their personal experiences regarding the Seminar Series during six focus groups. The facilitators of positive parenting were relevant to what they did before, during, and after their practices, while barriers included child, parent and external factors. The final conclusions after triangulation and the implications of this thesis for practice and further research were discussed.

Objectives: To evaluate the effectiveness of a theory-based and culturally adapted community level behaviour change intervention to improve weaning-food preparation and handling in rural Gambia. Methods: (1) A systematic review of the literature on weaning-food hygiene interventions. (2) Mixed method formative research to identify critical control points (CCP) and motivational factors for mothers‟ behaviour on weaning-food, (3) Formulation of the weaning-food hygiene intervention including performing arts. (4) Implementation and evaluation of the intervention with a cluster randomized controlled trial (cRCT). Results: The systematic review found 4 RCTs on weaning-food hygiene interventions. Formative research prioritized 5 CCPs with 6 corrective messages and 5 motivational factors. For the intervention compared to the control arm the composite behaviour score primary outcome was 72% in the intervention versus 19% respectively (p < 0.001). Each individual behaviour was significantly improved except washing of pots dried on clean surface. There was a significant reduction of contamination of weaning-food immediately after cooking and before second feeding, of children's drinking water, of diarrhoea and respiratory symptoms reported for the past 7 days, and hospital admission for diarrhoea. Conclusion: Our public health, community level intervention for mother's hygienic preparation and handling of weaning-food was effective in rural Gambia.

Practitioners working with children under three are often marginalised; both in terms of group settings and in terms of being a focus of research (see Manning-Morton, 2006; McDowell-Clark and Baylis, 2012). This research prioritizes the practitioner’s voice by exploring the subject area of personal theory. In this thesis, personal theory is conceptualised as a composite of understandings and experiences including policy, organisational procedures, Early Years literature, training and Continuing Professional Development as well as personal and professional experiences, beliefs, and values. As Stephen and Brown (2004) indicate, particular constructions of care, learning, and children shape what is considered desirable educational practice. Drawing on Aristotle’s intellectual virtue of phronesis, this research’s aim is to understand how practitioners’ personal and professional experiences and understandings contribute to practitioners’ construction of personal theory. Research questions focus on: 1) understanding which relationships are particularly influential, 2) understanding which experiences are particularly influential and 3) identifying key features of practitioners’ personal theories. Case study methodology frames the research design. The research demonstrates that although personal theory is tacit, linking to specific instances of practice enables practitioners to articulate personal constructions of care, learning and children. Findings relate to six key characteristics of practitioners’ personal theories: practice as an ‘Ethic of Care’, practice as pedagogy, practice as ‘subsitute mothering’, practice as distinctive for children aged birth to three years, practice as rooted in experience and practice as emotional activity. Joan Tronto’s (1993, 2013) ‘Ethic of Care’ affords further consideration of personal theory; particularly the contradiction between personal theory that shapes engagements with young children as an ‘Ethic of Care’ and that which shapes engagements as ‘substitute mothering’. The thesis’ discussion highlights how the articulation and discussion of personal theory enables a richer construction of Early Years professionalism and professional identity within Birth to Three settings.