There are comprehensive accounts of the nephrotic syndrome in childhood in temperate countries. Many of the important features of this disease have been known for close on to two decades. The causal link between malaria and nephrosis in tropical Africa has also been recognised and documented for a similar length of time. Very little was known of the nephrotic syndrome in the sub-tropical zones of Africa where malaria is not endemic. Anecdotal evidence in South Africa suggested that African children with this disease appeared to have steroid resistant nephrosis and a more protracted clinical course than expected from prevailing accounts in the literature and that Indian South African children generally responded to steroids. This thesis is the result of detailed investigations in to this disease in African and Indian children in Durban, South Africa. 2. Preliminary Study A preliminary study was undertaken in which 53 (12 African and 41 Indian) children with the nephrotic syndrome defined by clinical and biochemical criteria 1 ii were studied. Renal biopsies were not available on these patients. The results revealed that two thirds of the African children were over 5 years of age and 50% were males. Of the Indian children 50% were under 5 years of age and 50% were males. Nine African children were treated with steroids and 8 did not respond whereas 31 of the 39 Indian children treated clearly responded to steroid therapy. In addition 5 Indian patients were treated with cyclophosphamide and 3 responded. On follow-up 7 of the African children had persistent proteinuria, 2 experienced remissions and 3 were lost to follow-up. All the Indian patients experienced remissions. The differences between the 2 groups of nephrotic patients were quite striking and therefore a more detailed prospective study of this problem was undertaken. 3. Prospective Study of Primary Nephrotic Syndrome One hundred and seventy children of whom 104 were African and 66 Indian with primary nephrotic syndrome were studied. In both racial groups the male sex dominated, Indian children tended to present iii at a younger age group whereas African children presented at two peak ages, 5 years and between 5 - 10 years. 3.1 Histological Differences The histological types found on light microscopic examination of renal tissue were distinctly different between the African and the Indian children. The majority (85.6%) of the African children had 'obvious' glomerular lesions, the commonest being extramembranous nephropathy (29.8%). Although the proliferative group was the single largest group (40%) none of the subgroups exceeded the extramembranous type in their number. Minimal change accounted for only 14.4% of the African children with nephrotic syndrome. The majority of Indian children (72.7%) had minimal change on light microscopy, 9.1% focal glomerulosclerosis and 12.1% had proliferative changes. 3.2 Immunofluorescence Immunofluorescent studies also indicated differences between the two groups of patients. Generally, heavier deposits of immunoglobulins iv and complement components were identified on renal biopsy specimens of African children. This occurred even in MCNS where most African children had heavy IgG, light IgM, IgA and complement components whereas only a few of the Indian children had light IgM deposits. Similar differences were observed in diffuse mesangial proliferative glomerulonephritis and focal glomerulosclerosis where the numbers of patients were comparable. 3.3 Presenting Features Clinical features at presentation in the two groups were different, as expected from the nature of the histological findings in each group. In the African children (all histological groups) haematuria occurred in 35.5%, hypertension 16.3% and renal failure in 2.9%. The clinical features in the Indian children were not too different from MCNS elsewhere. Haematuria occurred in a small percentage (3%) of MCNS but was more frequent (10.7%) in other groups. Hypertension and renal failure occurred infrequently in histological categories other than MCNS where they did not occur at all. 3.4 Course and Outcome In view of the above it was not unexpected to find that the clinical course and outcome in the two groups were quite dissimilar. African patients in certain of the histological groups fared reasonably well, but none of the groups had the excellent prognosis of Indian MCNS. 3.4.1 Minimal Change One third of the African MCNS patients remitted and this was unrelated to steroids. The remainder who were followed for a reasonable duration of time remained proteinuric. None developed signs of serious renal impairment (azotaemia, hypertension). Indian MCNS experienced an excellent prognosis with 97.8% achieving remission and 81.6% being steroid sensitive. One third of these patients had a single episode of nephrosis while frequent relapses occurred in 28.2%. 3.4.2 Extramembranous Nephropathy Patients with extramembranous nephropathy, the largest group in the African patients, experienced hypertension more often (20%) vi and remission less often (30%) than do children in temperate climates. The clinical presentation, course and outcome in the majority of these patients were similar to adults with extramembranous nephropathy. 3.4.3 Proliferative Glomerulonephritis The patients in the proliferative group had a variable outcome depending on the subgroup to which they belonged. In diffuse mesangial proliferation, African patients had a higher incidence of hypertension and fewer remissions and fared less well than Indian patients. The diffuse endocapillary glomerulonephritis, membranoproliferative and focal proliferative nephritis groups of patients suffered severe disease with a failure to remit and progression to death. In the diffuse exudative group, remissions occurred or proteinuria persisted but severe relapse and death did not occur. The worst prognosis was in the focal proliferative group with the highest incidence of persistent relapse. 3.4.4 Focal Glomerular Sclerosis Focal glomerular sclerosis was an unusual vii histological diagnosis in the African child (3.9%) with a poorer prognosis (persistent proteinuria or death) when compared to Indian children in whom one third remitted and the rest had persistent proteinuria. 3.4.5 Tropical Nephropathies It is difficult to comment on the course of the tropical nephropathy (not related to malaria) and tropical extramembranous groups as the numbers are small. However, in tropical extramembranous, none remitted (all African children) and in tropical nephropathy one Indian child remitted but one of 2 African children died and the other had persistent proteinuria. 3.5 Response to Therapy Perhaps the most important practical aspect of the nephrotic syndrome in the African child was the response to steroid therapy. Thirty two African children were given steroid therapy. Thirty (93.7%) did not respond. Five children deteriorated or died during steroid therapy. Very few patients (4) were given cyclophosphamide and none responded. viii Generally intravenous albumen, diuretics and a high protein diet were not very effective in those patients with severe, clinical disease but were of benefit in milder disease. Indian children taken as a whole, responded well to steroid therapy. Seventy-eight percent of the whole group responded to steroids and 21.4% developed cushingoid features. Of the 19 Indian children (all MCNS) treated with cyclophosphamide 63.2% responded of whom about a quarter got toxic side effects (alopecia, darkened nails and leucopenia). Chlorambucil therapy in 4 children (all MCNS) was successful in all. 3.6 Complications Serious infections (septicaemia, peritonitis, urinary tract infection, meningitis, arthritis, osteitis, measles, chicken pox) occurred in 8.7% of the African patients. Eighteen percent had less severe infections. Just over a quarter of the Indian children suffered severe infections. The majority of these patients were MCNS and about 50% were on steroids or cyclophosphamide at the ix time of their infection. Renal biopsy complications were minor, these being abdominal pain and tenderness or transient haematuria. A few patients developed renal haematomas which were detected or monitored by ultrasonography. The single serious complication was the development of a renal abscess at the biopsy site requiring partial nephrectomy. 3.7 Mortality The overall mortality was 5.8%. Seven of the 10 deaths were African children in the Proliferative Group and 3 of the 10 deaths were Indian children. 4. Secondary Nephrotic Syndrome The secondary nephrotics formed an interesting group of patients. Of the 22 patients classified as secondary nephrotics 11 (50%) were related to streptococcal infection either as rapidly progressive glomerulonephritis or transient NS following APSGN. HBsAg was detected in the blood of 8.6% of the African patients. However the HB sAg carrier rate in this age group is 7.4%.The incidence in these patients probably reflects the high incidence in this population group. Collagen vascular disease occurred in 2 patients, both Indian. 5. Conclusions and Recommendations The results of this study demonstrates the strikingly different incidences of the various histological categories in the two race groups studied with a less favourable prognosis and fewer remission rates being achieved in African children. Indian children had more serious infections more often than African children. Steroid and immunosuppressive agents were of no value and probably hazardous in the African child. Some patients deteriorated on these drugs. Indian children who had an excellent response to these drugs were however at significant risk of developing serious infections. Why African children in Durban develop obvious glomerular lesions has not been established. Known or possible aetiological agents such as malaria, schistosomiasis, streptococcal infections and collagen diseases have been excluded. The answer to the above question may in fact lie in genetic predisposition,host factors and environmental influences, either singly or in combination, predisposing to the development of obvious x i glomerular lesions. These require more intensive investigation and judging from the yield of similar studies in other areas of the world expectations have to be guarded. / Thesis (M.D.)-University of Natal, 1981.

In this study the experience of Zulu African mothers who have adolescents who are misbehaving in urban townships in Durban were identified and explored. A qualitative, descriptive, contextual and interpretive research design was used to capture the experiences of ten mothers whose adolescents are misbehaving. Data was collected by means of individual semi-structured interviews as well as feedback and collaboration with the mothers. Data was analysed using Tesch’s eight steps of data analysis, through which, four themes emerged. Themes are clustered around the support of mothers’ perceptions of themselves, mothers’ fearful emotional responses and mothers’ suggestions on managing adolescents who are misbehaving. The strongest themes that emerged, which were reported by all the mothers were family support, despair and worry. Mothers mentioned that they experienced lack of support from their extended families, schools and other structures in helping them deal with their experiences. Mothers also mentioned feelings of worry about their children’s life, and despair in relation to not knowing what to do or who to turn to for help. Guidelines and strategies in the form of recommendations are made to assist mothers in managing their adolescents who are misbehaving and also to facilitate adolescents in gaining parenting skills in schools. / Thesis (M.Ed.)-University of KwaZulu-Natal, 2007.

Kinship care is increasingly supplementing the more traditional forms of out-of-home care. Because related foster care has potential great value, the possibility of placement with relatives needs to be explored first. At its best it provides the child love and security with known people and possibly in a familiar environment. Yet, important as it is, this area of practice is seriously underdeveloped - few publications especially in South Africa exist on how children fare in this arrangement. This situation exists in spite of the fact that many children find themselves in both legal as well as privately arranged related foster care placements. Equally of course no comprehensive study has been undertaken to study the black family's perception of formal foster care and their adjustment to formal foster care practice which for many is a new encounter in their lives. More clarity on these issues pertaining to kinship care will not only improve our understanding but can lead to a better service. Socio-political influences have weakened the mutual aid system in African families. This has resulted in needs· and problems which the African family find it difficult to deal with. This has prompted families to make use of non-family support particularly services from specialized and other welfare agencies. Formal foster care is a foreign practice to the black community as a result of their tradition and custom. It offers a new method of coping with child care problems and indicates a shift from the conventional patterns among South African blacks. As a result there is often confusion and a lack of understanding, making the community not to make proper use of this service. This study is exploratory-descriptive. The sample comprised thirty foster parents. The main objective of this study was to investigate the nature and practice of formal foster care in the black community with specific emphasis on related foster care and its perception. The study has raised a number of issues for practice and policy consideration. Notable findings were: the need to (1) promote much more active involvement of foster parents, foster child and their families (2) educate the community about foster care (3) prepare, train, support and supervise foster parents. The study revealed that these placements have become indistinguishable from natural parenthood and the foster children have become absorbed into the foster family. A need exists for permanency planning in foster care. It is hoped that the research findings will contribute to the existing body of knowledge and that more studies will be undertaken in future.

M.A. (Social Work) / As a result of the ruling Government's policy, a diverse group of individuals and organisations identified certain critical needs of black people - through their own initiative. In doing so they utilised basic community development principles which forms part of a new approach regarding need satisfaction in the new South Africa. The focus of this particular study is on one such a non-Governmental organisation, which developed from grass roots level to satisfy the needs of black children and their parents with regard to teaching and education. In the light of the growing demand for an educational service and the school's need to effectively address this problem, a need-sassessment was required in order to identify the needs of the children in the context of the school, from the perspective of key-persons and parents. Given the institution's development from grass roots level through community development principles, the institutions requirement of a needs-assessment as well as the fact that implementation of community development will ensure that community needs be addressed, this study will therefore be done in the framework of community development.

This dissertation provides evidence to suggest that teaching/learning difficulties with geography in Std 3 are largely attributable to textbooks which fail as well constructed discourse and include uninterpretable illustrations. The discourse properties most likely to affect the readability of textbooks intended for ESL/EFL pupils are identified. Selected passages from two widely used Std 3 geography textbooks are analysed in terms of these properties, and are shown to fail extensively as well constructed discourse. Following classroom observation and informal interviews which confirmed the inappropriacy of the texts for Std 3 pupils, the passages were re-written, following the necessary properties of well constructed expository discourse. The readability of these two sets of texts was then tested on a group of nine Std 3 teachers in two structured interviews. The findings reveal that the re-written passages are significantly more readable than the textbook passages. Recommendations that affect education authorities, curriculum designers, syllabus makers, textbook authors, publishers and teacher training colleges are provided

Please read the abstract (summary) in the section 00front of this document / Dissertation (MA (Alternative and Augmentative Communication))--University of Pretoria, 2007. / Centre for Augmentative and Alternative Communication / MA / unrestricted

Please read the abstract in the 00front part of this document. See also General Summary and Opsomming after chapter 7 (pp162-165) / Dissertation (DPhil (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

Black boys in American schools are often subjected to crisis narratives that negatively impact teacher-student relationships, limiting teachers from recognizing the intellectual capability of Black boys. A review of American schools paints a portrait of Black males crowded in special education and nearly absent in gifted education. There seems to be a gap in the available research about Black males in education, especially when trying to identify and review the literature surrounding educational opportunities, positive learning environments, and teacher/student relationships for the youngest learners in American schools. Given previous research findings of positive relationships between Black male teachers and Black male students in Grade 3 and higher, this study looked at these relationships within early childhood classrooms, as research suggests that relationships between teachers and students play a meaningful role in young children’s social and emotional development. Utilizing interviews, observations, and through the collection of student-created artifacts, in situated ways this study found that Black male teachers perceived their relationships with Black boys in early childhood classrooms as: • being grounded in providing explicit role models for Black boys; • empowering young Black boys to see their individual potential and future success in life as Black men; • focusing on showcasing affection that is often not expressed towards Black boys in early childhood due to implicit biases, through explicit verbal praise, loving gestures, and body language; and • an understanding that early childhood classrooms should serve as a space for children to learn through their mistakes, as this is a key component in the development of positive feelings towards schooling and learning. The implications for practice point to the importance of recruiting more teachers who view their teacher identities as being intricately connected to role modeling and the empowerment of Black boys. Additionally, because love is foundational to justice, Black boys need teachers who love them—accepting, caring, displaying respect, defending their right to be children, and regarding the education of Black boys as their responsibility. Finally, young Black boys thrive in classrooms where there is the freedom to make mistakes.

Please read the abstract (Summary) in the section 00front of this document / Dissertation (MA (Psychology))--University of Pretoria, 2000. / Psychology / MA / unrestricted

The present study examined the relationship between parenting styles and the socioemotional adjustment of children at school. A sample size of 90 research participants was selected and included black South African grade I school children aged between 6 and 7 years from single parent households in Pretoria Central. Factor analyses and Cronbach's alphas were determined in order to establish the validity and reliability (alpha= 0.89 and 0. 72 respectively) of the measurement instruments. In general, results were inconsistent with previous findings: The three parenting styles had no direct relationship with children's socio-emotional adjustment at school. Except for two links, non- significant relations between parenting styles and six subscales of socio-emotional adjustment were detected. However, maternal age, preschool attendance and gender of the child interacted in different combinations with four of the six subscales of socio-emotional adjustment. Future studies investigating parenting styles should take account of other areas of adjustment. / Psychology / M.A. (Psychology)