The HIV/AIDS pandemic has a substantial impact on children across the globe and particularly in sub-Saharan Africa. Across sub-Saharan Africa, there are a number of organisations and programmes providing care and support to children affected by HIV/AIDS. However, this strong programmatic focus on mitigating the impact of HIV/AIDS on children at community level has not been matched with concomitant research investment into the needs of children who attend these programmes at these organisations, their health and development, how these organisations work, and whether they are effective. This thesis attempts to address this gap by reporting on three separate analyses of data from the Child Community Care study in South Africa and Malawi, and a systematic review on interventions to improve psychosocial wellbeing of this group. The first analysis describes developmental outcomes of children affected by HIV/AIDS attending community-based programmes and the types of services these children are receiving. The second analysis reports on the mental health of carers of children affected by HIV. In the third analysis I report on the relationship between different forms of violence and mental health status among children affected by HIV/AIDS in the sample. The fourth part is a systematic review of interventions developed to improve the psychosocial well-being of children affected by HIV/AIDS, published between January 2008 and February 2016. The results of these studies highlight the complex needs of children affected by HIV/AIDS attending these organisations. CBOs are reaching a vulnerable group of children and their families, and are well-placed to intervene with this population. There are promising models of interventions available, although the evidence base remains small. Caregivers should not be neglected in programming; parenting programmes provide a potential mechanism for delivering integrated interventions that address multiple risk factors for caregiver and child wellbeing. Mental health, particularly of caregivers, should be explicitly addressed as a part of CBO programming. However, funding for programming needs to be implemented with opportunities for training and supervision. In addition, there is a need for increased partnerships between practitioners and researchers in order to evaluate existing programmes and to design evaluation studies that suit community settings, and that can feed into the growing evidence base.

Includes abstract. / Includes bibliographical references. / NGO literature is widely dispersed in numerous publications and often laborious to find. This article attempts to enhance understanding of development NGO performance by collating and discussing influencing factors. A systematic review of academic journal articles, published between 1996 and 2008, identified 31 relevant papers. Findings on facilitators and constraints are presented then discussed from a rational choice perspective. The article argues that NGOs are influenced by an intricate web of factors, and puts forward three main standpoints NGOs utilise in making decisions. Depending on one's perspective, NGO action can be interpreted as either rational or irrational behaviour.

Includes bibliographical references (p. 299-315) / This thesis presents an evaluation of a theory-based HIV prevention intervention designed for grade 8 high school students. The intervention was delivered by teachers over a 6-month period. The objectives of the research were (i) to conduct a systematic review of evaluation studies of international and South African school-based interventions aimed at postponing sexual intercourse and increasing condom use; (ii) to conduct a process evaluation documenting implementation of the intervention; and (iii) to conduct an evaluation to assess the intervention effects on the delay of sexual intercourse and condom use. The study was conducted over a period of 15 months, using a cluster randomised controlled trial design. A multi-stage sampling strategy was employed in selecting the participating schools. Twenty-six schools located in various parts of Cape Town participated in the research, 13 in the experimental group and 13 in the control group. Process evaluation data were collected during and after implementation of the intervention. Interviews, focus group discussions, classroom observations and educator lesson logs were the methodologies employed in the process evaluation. Quantitative outcome evaluation data were collected at baseline 6- and 15-months follow-up, using a self administered questionnaire.

Includes abstract. / Includes bibliographical references (leaves 164-191). / A number of African countries have made attempts to officially recognize traditional healers as health care providers and South Africa is no exception. South Africa has made substantial progress in officially recognizing traditional medicine and its integration into the primary healthcare system. The Traditional Health Practitioners Bill and the draft policy on African Traditional Medicine are examples of this. However, there is limited data on traditional healers and their practices specifically for mental health concerns. This thesis attempts to address this gap by conducting four separate studies.

Includes bibliographical references (p. 256-311). / The primary purpose of the study was to explore, analyse and interpret the lived experiences of male intimate partners of female rape victims and the meaning of such experiences within six months of the rape. A secondary purpose was to formulate a framework grounded in the data gathered from the intimate partners to understand and conceptualise their experiences. The research question that guided the study was the following: What are the lived experiences of intimate partners of female rape victims during the six months following the rape? Selection of study participants involved purposeful sampling. After providing informed consent, nine intimate partners of female rape victims living in Cape Town, South Africa, participated in four separate face-to-face, semi-structured interviews: (a) within 14 days of, (b) a month after, (c) three months after and(d) six months after the rape.The hermeneutic-phenomenological approach of Paul Ricoeur formed the framework for the analysis and interpretation of the findings to ensure congruence between the present study‘s philosophical underpinnings and the research method. Colaizzi‘s procedural steps and the within-case and acrosscase approach, as suggested by Ayres, Kavanaugh and Knafl (2003:873), functioned to supplement Ricoeur‘s method (Speziale & Carpenter, 2003:58-64).

Background: Although mental disorders is of great public health concern among Kenyan populations, mental health services remain poor. Some of the reasons attributed to delivery of poor mental health services are unfavourable work environment and lack of policy guidelines including a conceptual model of nursing.Quality of mental health nursing care significantly impacts on general mental health services in Kenya since they are predominantly provided by nurses. Lack of a model to guide care and improve mental health services created the need to develop the Kenyan Human Interaction Model for mental health nursing practice. Purpose: The purpose of the study was to discover and develop a Kenyan model for mental health nursing guided by two research questions, namely: What are the views of Kenyan mental health nurses with regards to human being, environment, mental health nursing and mental health: What is the appropriate model for mental health nursing practice in Kenya? Methodology: Straussian Grounded Theory method was used in the study. Data were collected for 6 months through in-depth interviews with 33 registered mental health nurses selected by open, purposive and theoretical sampling methods. Inductive and deductive data analysis of the nurses' description of their views and recommendations on the nursing metaparadigms were done Findings: A substantive theory of the Kenyan Human Interaction Model for mental health nursing practice was developed .The four metaparadigm concepts of the discovered theory are: 1. Human being as a unique biopsychosocio-spiritual being and causal condition 2. Environment consisting of homely and hostile dimensions 3. Mental health nursing as a holistic care founded on human interaction 4. Mental health (consequence of holistic care) with optimum and illness dimensions. Mental health nursing was discovered as the central phenomena interacting with its causal, contexts and intervening conditions to determine the mental health dimension of the human being. The quality of mental health nursing determines the mental health dimensions and is influenced by the environment and nurses' characteristics as contexts and intervening conditions respectively. These interactions lead to consequences discovered as optimum mental health. The Kenya Human Interaction Model for mental health nursing practice is customized to the Kenyan situation and contributes knowledge which is relevant to mental health nursing practitioners, students, educators and administrators.

Common mental disorders (CMD) which primarily include depression, anxiety disorders and mixed anxiety depression are leading causes of disability in sub-Saharan Africa. They are particularly common in people living with HIV (PLWH) and may hasten HIV disease progression. This thesis consists of 5 articles which have been submitted for publication and provide evidence on the requirements for developing a psychological intervention to be delivered by lay health workers (LHW) and a strategy for scaling up this intervention to over 50 primary health care clinics in Harare, Zimbabwe. The thesis formed part of formative research leading to a cluster randomized controlled trial(RCT) of a psychological intervention and provides supplementary research to the RCT to support the scale up of the intervention. The first chapter describes the magnitude of the problem and the lack of resources to reduce the treatment gap for CMD. It highlights the growing evidence of using Lay Health Workers (LHW) to reduce this treatment gap.

The purpose of the study was to examine the emotional reactions of music therapy students to simulated auditory hallucinations and music. Eighteen music therapy students (13 female, 5 male) participated in the study. After signing a consent form, participants were randomly assigned to either the control (auditory hallucination simulation) or experimental (auditory hallucination simulation with music) group. Participants completed a demographic survey, PANAS (Watson & Clark, 1988) pretest, listened to eight minutes of respective audio, and then completed a PANAS (Watson & Clark, 1988) post-test. Results were analyzed using two independent t-tests to test for significance, one for positive affect post scores and one for negative affect post scores. No statistically significant results were found. However, there was a noticeable difference in the mean scores for negative affect post scores. The results suggest that music may have assisted in preventing a larger increase in negative affect in the experiment group. Future research should include a larger sample to test for possible significance. Likewise, future researchers should implement similar studies with populations actually experiencing auditory hallucinations to explore the potential for development of emotion regulation interventions using music therapy. / A Thesis submitted to the College of Music in partial fulfillment of the Master of Music. / Spring Semester 2016. / April 13, 2016. / Affect, Auditory Hallucination, Emotion, Mental Health, Mood, Music Therapy / Includes bibliographical references. / Lori Gooding, Professor Directing Thesis; Jayne Standley, Committee Member; Dianne Gregory, Committee Member.

Diabetes and depression are both highly prevalent within the U.S. and it is worrisome that these two conditions are related. Several meta-analyses and studies using qualitative, clinical, and nationally representative cross-sectional quantitative data have shown that depression is associated with an increased risk of developing diabetes (Ducat et al. 2014; Lloyd, Hermanns, Nouwen, Pouwer, Underwood, and Winkley 2010; Katon et al. 2010; Mezuk et al. 2008) and/or those who are diabetic have a moderately increased risk of developing depression (Katon at al. 2010; Moulton, Pickup, and Ismail 2015). Controversy exists as to which way the association may be stronger and whether these conditions are causally related. Additionally, although research into the biological links between these diseases exists, little work has been done that examines the social conditions that link diabetes and poor mental health throughout the life course. Using the National Social Life, Health, and Aging Project (NSHAP), this dissertation examines the biopsychosocial connection between marital biography, mental health, and diabetes with an emphasis on gender differences. I examine 1) how mental health and diabetes are associated cross-sectionally and longitudinally; 2) how marital biography impacts the relationships between mental health and diabetes; and 3) how social mechanisms influence the previously established relationships between marital biography, mental health, and diabetes. Each relationship is examined for the women and men separately and compared to the overall sample. Results add to existing literature by demonstrating that diabetes and depressive symptomology are associated cross-sectionally when each health condition is examined as the dependent variable. Longitudinally, those who are diabetic report higher depressive symptoms over time than non-diabetics. Results vary in magnitude and significance based on gender. For women, those who were diabetic at baseline report higher depressive symptoms over time than non-diabetic women. Results also contribute to the field by showing that marital biography impacts the cross-sectional relationships between diabetes and depressive symptomology. Finally, results also demonstrate that social disconnectedness, social isolation, and perceived social stress mediate the association between diabetes and depressive symptoms. The findings highlight the complexity within diabetes-mental health relationship and demonstrate the importance of understanding the biopsychosocial connection throughout the life course between marital biography, mental health, and diabetes. / A Dissertation submitted to the Department of Sociology in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester 2016. / May 16, 2016. / Aging, Diabetes, Gender, Marriage, Mental Health / Includes bibliographical references. / Isaac Eberstein, Professor Directing Dissertation; Heather Flynn, University Representative; Amy Burdette, Committee Member; Michael McFarland, Committee Member.

Bipolar disorder is a mood disorder that is recognized by the American Psychological Association and characterized by cycles of depression and manic episodes. These symptoms can be highly disruptive to daily life and introduce unique stressors to those that experience the symptoms. The average age of onset of these symptoms coincides with the typical age of a college student in the United States. These students that experience the onset of bipolar disorder during college may face unique challenges when compared to their peers, and these challenges may impact their ability to perform academically in college. While research has been done on supporting students with various types of mental health disorders within the college environment, little research has focused specifically on bipolar disorder. Using heuristic inquiry, a form of phenomenological research in which the researcher is part of the phenomenon being studied, I sought to discover the experiences of four college students, who experienced the onset of bipolar disorder during college, through semi-structured interviews. My insight into the experience of bipolar disorder provided a unique way in which I could connect with these participants and explore their life experiences. Using those experiences, I was able to create a model to show how many facets of bipolar disorder impact student stress, motivation and self-regulated learning within the college context. This model provides valuable insight into how further research can identify the ways in which college campuses and support services can better serve the needs of these students with bipolar disorder. / A Thesis submitted to the Department of Educational Psychology and Learning Systems in partial fulfillment of the requirements for the degree of Master of Science. / Spring Semester 2017. / March 24, 2017. / Bipolar disorder, Emotion, Heuristic Inquiry, Motivation, Self-regulation, Stress / Includes bibliographical references. / Alysia Roehrig, Professor Directing Thesis; Jeannine Turner, Committee Member; Martin Swanbrow Becker, Committee Member.