Master of Public Health - MPH / Tuberculosis (TB) continues to be a major cause of ill health and the leading cause of death from a single infectious agent worldwide. Furthermore, young children, especially those under five years old and infants, are at risk of developing more severe forms of TB. TB cases continue to cluster among disadvantaged groups such as the poor whose lives are characterised by adverse living conditions. Defaulting from treatment poses a severe threat to children’s health because untreated TB or breaks in treatment could lead to a child developing more severe forms of TB, or worse, could result in mortality. Currently, long-term hospitalisation has the most successful TB treatment outcomes. Therefore, to ensure compliance, children are taken out of their social environment and admitted to hospital. However, being separated from one’s family, especially at a crucial stage of development, could have long-terms effects on the child’s development. The study explored, factors influencing access to care that caregivers of children; who are five years and younger, who received prolonged treatment at a specialised TB hospital in the Western Cape, South Africa experienced. A qualitative approach allowed the researcher to use personal interactions as a focus for studies and was suitable when aiming to understand health behaviour in its everyday context as experienced by the participant. The study results indicated the factors that enable caregiver visitation, is largely dependent on availability of finances. Furthermore, the hospital itself was identified as being accommodating with regards to visiting hours, telephonic calls and served as important mediator between health service provider, the children, their caregivers and the rest of the staff. Visitation depended on availability of finances, and this was the main barrier that was identified by caregivers. The challenges that hampered visitation were unemployment, lack of access to private and public transport and challenges related to farm-workers. A large number of caregivers work on farms in the Cape Winelands and many of them are dependent on seasonal work which results in inconsistent income. This limited availability of finances for visitation. Furthermore, the working conditions, long shifts and lack of employment benefits which were associated with farming, prevented caregivers from visiting. This study revealed that there are a series of factors which influence access to care of caregivers; this is especially the case in children hospitalised for TB. These factors need to be considered by policy makers as well as the Specialised Tuberculosis facility when dealing with children under five as the best way to ensure that treatment is completed through hospitalisation. Therefore, the strategies to assist families of children with TB need to be explored to assist in the continuity of care as well as the child’s development.

During last couple of decades, the paid child care has become one of the central issues of feminist research. The agencies mediating child care are relatively the new actor in child care arrangements in the Czech Republic. This MA thesis argues that they not only fill the gap in the market by offering a child care. Above all, far from providing the simple supply that reacts to the demand on the market, the agencies create the demand for specific care. Drawing upon qualitative research conducted with owners of these agencies, the text looks into the ways how the child care is constructed. The analysis consists of two parts. In the first one the agencies are understood as expert systems generating specific trust. In the second part, the issues of qualified, specialized, and professionalized care are discussed. The thesis aims at showing that child care in the agencies is deconstructed as a natural female activity and is reconstructed as a gendered activity requiring particular skills that are submitted to professional screening.

Philosophiae Doctor - PhD / The growing interest in the well-being of children who have been orphaned due to HIV/AIDS is widely reflected in the emerging body of research. Children orphaned by AIDS-related causes are identified as a vulnerable population of youth who display lower levels of psychosocial well-being and experience increased psychosocial distress. While HIV-related stigma remains a salient risk factor hindering the psychosocial well-being of children orphaned by AIDS, the concept remains elusive and poorly understood. Hence, the call for a comprehensive understanding to support an effective response to stigma reduction, and for the systematic identification and response to the psychosocial needs and challenges of children in the context of HIV/AIDS. The overall aim of this study was therefore to develop a model to understand the manner in which HIV-related stigma affects the psychosocial well-being of children orphaned by AIDS. A mixed method, exploratory, sequential design situated within a theory generative research approach was implemented in four sequential phases geared towards model development. The specific objectives of this study were to: (1) review existing literature focusing on the relationship between HIV-related stigma and the psychosocial well-being of children orphaned by AIDS (systematic review); (2) explore children orphaned by AIDS perceptions and experiences of HIV-related stigma (qualitative exploratory design); (3) develop a model that offers an understanding of the manner in which HIV-related stigma affects the psychosocial well-being of children orphaned by AIDS (a theory generative design); and (4) determine the functionality of the developed model through the use of the Delphi technique (a modified Delphi technique). The systematic review conducted in Phase I indicated the presence of HIV-related stigma, which inhibited the psychosocial well-being of children orphaned by AIDS. The findings further highlighted the mediating role of maladaptive coping strategies and social support likely to reduce healthy psychosocial well-being and cause psychosocial distress among children orphaned by AIDS. Similarly, the findings arising from the qualitative exploration in Phase II indicated that children orphaned by AIDS were highly perceptive and experienced HIV-related stigma as a result of parental illness and death. These experiences negatively affected the psychological, emotional, and social well-being, self-concept and self-esteem, and future orientation of children orphaned by AIDS. The theory generative design in Phase III identified, classified, and defined six focal concepts upon which the model is based, namely, (1) enacted stigma, (2) perceived stigma, (3) internalized stigma, (4) coping strategies, (5) psychosocial well-being, and (6) interpersonal relations. The developed relationship statements of the model indicated: (1) the bidirectional relationship between enacted, perceived, and internalized stigma; (2) the mediating role of coping strategies; (3) the direct and indirect influences of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS; and (4) the contextual role of interpersonal relationships in which the process of stigmatization may unfold. The modified Delphi technique conducted in Phase IV indicated that the developed model was simplistic, clear, generalizable, accessible, and important for use in research and practice. The developed model will aid future studies by providing a theoretical lens through which HIV-related stigma and its influence on the psychosocial well-being of children orphaned by AIDS may be viewed. HIV-related stigma should be considered strongly when addressing the well-being of orphaned children, so that tailored programs, interventions, and services may be set in place to effectively bring about the reduction of stigma and ensure the psychosocial well-being of children. The recommendations set out serves to further inform practice and programs and form a baseline for future empirical research focusing on HIV-related stigma and the psychosocial well-being of children orphaned by AIDS.

Submitted in fulfillment of the requirements for the degree of Doctor of Education in the Department of Educational Psychology at the University of Zululand = Proefskrif voorgele ter vervulling van die vereistes vir die graad DOCTOR EDUCATIONIS in die Fakulteit Opvoedkunde (Departement Psigopedagogiek) aan die UNIVERSITBT VAN ZOELOELAND, 1994 / Eng; = The aim of this investigation was to determine the awareness and capability of house parents in children's homes to meet the educative need of the children who have been entrusted to their care. An introductory historical overview was provided of the origin and development of children's homes in the Republic of South Africa with specific reference to the children's homes of the Dutch Reformed Church, as well as the "idealised" task of these homes. The admission of a child to a children's home was described in terms of the Child Care Act, Act No. 74 of 1983. Aspects that need to be considered when placing a child in a children's home, such as the child's cultural and religious affiliation and the distance from his parental home, were discussed. The fact that the child is admitted to the children's home as an educationally neglected child, was considered. By adopting the education situation as point of departure, educational neglect as the outcome of the inadequate realisation of educative intervention, was elucidated. The non-accountable interventional assistance of the child's own parents who are incapable, causes the child to experience the education relationships as impaired. Arising from this, the education sequence structures and the education activity structures are inadequately actualized. As outcome of the non-accountable educative intervention the normative image of adulthood which is strived for as educational aim, is not adequately realised and is posed as a delayed education aim. An own parental home with both parents available, was scrutinised. The importance of a happy and normal family life for the becoming child was discussed by referring among others, to the significance of the father and the mother in the education of the child. The group situatedness of the child in the children's home, which entails both positive and negative educative lived- experiences, was addressed. Attention was given to the special educative task of the house parents, which includes the physical, psychological and spiritual "re-education" of the child in the children's home. Sufficient physical care of the child is imperative for the creation of a basis for all other educative actions. The educationally neglected child's emotional education (affective education) shows a distorted image in becoming. The house parents' unconditional acceptance of the child and their willingness to provide assistance, aid and guidance, are necessary to winning his confidence and enabling him to live-experience acceptance. Through mutual trust and acceptance, and authoritative guidance the child experiences security. Certain aspects of the educational task of the house parents with regard to the cognitive education of the child, are highlighted. Through the support and guidance of the house parents, the child must be assisted in learning how to cope with his emotions. The child can only pay full attention to his school work and studies when he experiences a stable emotional life. Attention is also given to the moral education, soda} orientation and religious guidance of the child in the children's home. For the purpose of the empirical investigation, self-structured questionnaires were used. The questionnaires were completed by the principals (directors) and house parents of the children's homes of the Dutch Reformed Church in the Republic of South Africa. An analysis was done of 179 questionnaires completed by house parents, and twenty which were completed by the principals. The data thus obtained was processed and interpreted with descriptive and inferential statistics. In conclusion, the findings emanating from the literature study and the descriptive and inferential statistics were presented. Based on these findings, the following recommendations were made; Urgent attention must be given to further training of house parents and improved conditions of service for them. No house parent must be responsible for more than ten children. Educational support services must gradually be incorporated in the assistance and control over the children in the children's homes. Afr = 'n Eie auerhuis met albei auers teenwaardig, is bespreek. Die belangrikheid van 'n gelukkige en ncrmale gesin vir die volwaardige valwassewording van die kind is ender die loep geneem deur ondermeer na die ral van die vader en die moeder in die opvoeding van die kind te verwys. Die graepsgesitueerdheid van die kinderhuiskind wat sowel pasitiewe as negatiewe opvoedingsbelewenisse inhou, is aangespreek. 'n Beskrywing is gegee van die besondere opvoedingstaak van die huisauers ten aansien van die fisiese, pSlglese en geestelike "heropvoeding' van die kinderhuiskind. Toereikende fisiese versorging van die kind is onontbeerlik vir die daarstelling van 'n basis vir alle ander opvoedingsaktiwiteite. Die opvoedingsverwaarloosde kind se gevoelsopvoeding(affektiewe) apvoedingtoon'n wordingsgeremde beeld. Die huisouer se onvoorwaardelike aanvaarding, bereidwilligheid tot hulpverlening en steungewing is inderdaad voorwaarde vir die ontsluiting van vertroue en die belewing van aanvaarding by die kinderhuiskind. Deur wedersydse aanvaarding, vertraue en simpatieke gesagsleiding beleef die kind affektiewe gebargenheid. Sekere aspekte van die huisouer se apvoedingstaak rakende die kagnitiewe apvoeding van die kind is uitgelig. Deur middel van steungewing en leiding maet die kinderhuiskind gehelp word am beheer oar sy gevoelens te kry. Eers wanneer hy sy gevoelens as stabiel beleef, kan die kind sy volle aandag aan sy skoolwerk en studie gee. Aandag is oak aan die sedelike opvoeding, sosiale orUintering en religieuse leiding van die kinderhuiskind gegee. In die empiriese ondersoek is van selfgestruktureerde vraelyste as meetinstrumente gebruik gemaak. Die vraelyste is deur die hoofde (direkteure) van die Nederduitse Gereformeerde Kerk kinderhuise in die Republiek van Suid-Afrika voltooi. 'n Ontleding is gemaak van die 179 vraelyste wat deur die huisouers en 20 wat deur die kinderhuishoofde voltooi is. Die gegewens wat uit die vraelyste verkry is, is verwerk en geinterpreteer aan die hand van beskrywende en inferensiele statistiek. Ten slotte is sekere bevindings voortspruitend uit die Iiteratuurstudie, beskrywende en inferensiele statistiek aangebied. Na aanleiding van di~ bevindings is die volgende aanbevelings gemaak: Verdere opleiding van huisouers moet dringende aandag geniet en beter diensvoorwaardes moet vir huisouers beding word. Elke huisouer moet vir hoogstens tien kinders verantwoordelik wees. Opvoedingshulpdienste(Onderwysdepartemente) moettoenemend betrek word by hulpverlening aan en beheer oor die kinders in die kinderhuise. / University of Zululand

Childcare programs that provide high quality care can strengthen children's early development. One component of a quality program is having providers who are knowledgeable in child development; however, despite the understanding of these known predictors of child development, Wyoming does not require childcare providers to complete any training before beginning to work with children. Guided by the constructivist theories of Piaget, Vygotsky, Dewey, and Bruner, this objectives-based program evaluation investigated the Pathways to Professional Development program to determine participants' perceptions of the strengths and weaknesses of the program. A researcher-produced survey was created based on the objectives of the program and consisted of open-ended and Likert scale questions. This survey was completed by 35 childcare providers who completed the 3 modules of the Pathways program. Data analysis began by identifying potential categories, comparing and contrasting emerging themes, and looking for emerging patterns in participant responses. Key results indicated that the participants of this program gained knowledge about child development and developmentally appropriate practice. The implications for social change from this research are directly related to the early childcare providers, children, and ultimately the communities of Wyoming. By increasing the knowledge of childcare providers, higher quality care can be provided, leading to positive relationships, stimulating learning experiences, and to a greater likelihood of children reaching their full potential.

On-site childcare is an ever-increasing form of childcare. By understanding the decisions, experiences and feelings of mothers using on-site centers, informed policy decisions about viable childcare models can be made. In the broadest terms current literature reveals that economic, societal, functional, and psychological factors influence a mother's decisions in regards to using childcare. This study used these markers as the basis for the development of questions to ascertain the experiences, feelings and decisions of mothers using on-site childcare. A phenomenological method was used. Twenty-four participants using on-site childcare from four organizations in different industries were located through a snowball sample for in-depth interviews. The interviews were audio-recorded, transcribed, and coded to derive themes of experiences. The findings reveal that on-site childcare impacts previously described effects of childcare. The factors of primary influence are child proximity and organizational support. The influence of close proximity can be seen in the themes of Networking, Organizational System Oneness, Family/Community Perception, Mothering Style, Center Quality, Work Time, Commuting Time, Nursing/Lactation, Guilt, Stress Management, and Employee Loyalty. Organizational assistance and support impact and overlap with proximity as a primary theme source. This can be seen in the themes of Cost, Networking, Organizational System Oneness, Waiting List, Center Quality, Work Time, Commuting Time, Nursing/Lactation, Stress Management and Employee Loyalty. The quality of the childcare, which in large part is made possible by the supporting organization, is held in such high regard that in some cases it overcomes the mother's desire for proximity. The implications of these findings are that high quality on-site childcare provides a significant benefit for mothers, organizations and communities. Family friendly organizational policy and feminist urban planning methods are better informed.

The early childhood administrator is tasked with overseeing all operations within the early childhood program. Operational functions include functions traditionally associated with education including the design and implementation of curriculum, creating and maintaining the learning environment, and ensuring the health and safety of children enrolled in the program. The administrator of the early childhood program is also tasked with other functions including human resource functions, budgeting, as well as income and cost management. Additionally, the administrator should be an advocate within public policy concerning early childhood education. Research has acknowledged the functions associated with the early childhood administrator role. In 1992, Paula Jorde-Bloom named the early childhood administrator as the “Gatekeeper of Quality”. Since then, research has supported that establishing and maintaining quality is yet another responsibility of the early childhood administrator. The current study examined the role of the administrator, particularly the preparation that the administrator receives, in an effort to determine the impact that the administrator has on the quality of the program. A sample (n = 224) was pulled from early childhood administrators in Mississippi. The preparation received by these administrators, including formal education and additional training, was measured and regression analysis with Early Childhood Environment Rating Scale Revised (ECERS-R) scores measuring quality of the early childhood program regressed with an aggregated early childhood administration preparation variable to determine if administration preparation could predict overall quality within the early childhood program. As the literature indicated that fiscal management practices also fall under the scope of responsibilities of the administrator, fiscal management preparation was isolated and regression analysis with ECERS-R scores was conducted to determine if fiscal management preparation could predict overall quality within the early childhood program as well. The study found that administration preparation was a significant predictor of quality. However, preparation specific to fiscal management knowledge was not found to be a predictor of overall quality. Practical implications and suggestions for future research are addressed.

The purpose of this study was to investigate preschool and child care directors' perceptions about the potential for introducing family therapy-related services into a child care or preschool environment, and in particular, to explore their opinions about the extent to which children are affected by parental stress, to assess directors' awareness of the field of marriage and family therapy, to determine the extent of their current collaboration with family therapists or other mental health providers, and to gather their thoughts concerning the possibility of successfully bridging the professions of child care and family therapy in the future. Seventy-two of the 197 directors surveyed responded to the mailed questionnaire. Descriptive statistics were used for the quantitative data, while the qualitative data was evaluated using the method of content analysis. Quantitative results revealed: 1) Most of the participants believed that children are at least somewhat affected by their parents' stress, 2) Over half of the participants were familiar with marriage and family therapists as trained professionals who focus on systemic treatment of the family as a whole unit, 3) Less than half of the participants currently offer on-site mental health services, 4) While it seems that participants routinely refer parents to and consult with mental health providers, they are least likely to consult with or refer to marriage and family therapists, and 5) Almost all of the participants identified at least one obstacle to providing family therapy-related services in their child care centers or preschools. Limitations and implications for clinicians and future research are also discussed. / Master of Science

This PhD by published work consists of: • 1 single authored monograph; • 1 single authored paper in a refereed journal; • 4 main authored articles in refereed journals; • 3 joint authored articles in refereed journals; • 1 joint authored paper in a non refereed journal; and • 3 joint authored published reports. It covers the period 2009-2014 This thesis and the papers submitted demonstrate my significant contribution to a body of knowledge that provides a rich and unique insight to the development of changes in legislation and protocols in child protection practice. Particular expertise is threefold: the impact on the practice of all professionals involved with vulnerable families and children; the impact on the assessment of risk and working with families and children; and the impact on the ‘timetable for the child’. The publications reflect an examination of pre-proceedings protocols over a 5-year period. Throughout, the work demonstrates a theoretical and practical commitment to fairness and justice for families. The rationale that underpins this thesis is the need to explore the impact of procedural changes to the lives of children and their families. The rhetoric of improving pre-proceedings work in an attempt to divert cases away from court, and to ensure decisions that are made for children are both rigorous and timely, is at odds from the reality of practice on the ground. The recent hegemonic concern with the timetable for the child (Holt and Kelly, 2014) reinforces a change agenda that was ushered in ahead of the Children and Families Act that became law on 22nd April 2014. The President of the Family Division, Sir James Munby, has stated that 26 weeks completion time when cases progress to court is ‘a deadline not a target’, reinforcing the message that only a ‘comparatively small number of exceptional cases’ will fall outside it (Munby, 2013:4). This leaves little time for the court to intervene when cases have not been properly progressed at the pre-proceedings stage. The evidence from detailed observations of practice at all levels within pre-proceedings protocols affords an opportunity to send a clear message to legislators, policy makers and practitioners. Front-loading and diverting more cases into pre-proceedings protocols is quite simply a strategic measure to reduce the financial burden away from the courts and to place this elsewhere. Local authorities have child protection systems that are properly designed to support children who are in need of protection, and where it has been decided by professionals from a range of agencies working with families that the risk cannot be managed without the need to seek the involvement of the court, there should be no further delay. My concern is that in many instances children are already left holding the risk for too long. The question must be raised as to why, when a range of professionals working with the child and their family make the decision that an application to court should be made, a system that purports to hold children and families at the heart builds in further delay.

No description available.