INTRODUCTION: Bone marrow examination (BME) is performed in Human Immunodeficiency Virus-infected (HIV+) children with haematologic abnormalities to exclude specific disease (SD). AIMS: To describe the: (1) indications for BME , (2) utility of BME to diagnose SD, (3) patient characteristics associated with SD or non-specific disease (NSD). METHODS: Design: Retrospective review. Definitions: SD: BME positive for opportunistic infection (OI) or HIV-related malignancy. NSD: HIV-related changes only. RESULTS: Eighty six BME’s were done. Suspected SD in 56/86(65.1%) was the most common clinical indication. Bicytopaenia(n=32) and isolated cytopaenia(n=31) were the most common haematologic indications. NSD 48/86 (55.8%) was a more common finding than SD 32/86 (37.2%). Granulomas, pure red cell aplasia and malignancy were the SD identified. Pre- highly active antiretroviral therapy (HAART), advanced stage, and not being virally suppressed were significantly associated with NSD. CONCLUSION: The yield of SD (37.2%) on BME is comparable to adult studies. HAART should be instituted before BME as NSD will be the most likely finding.

This dissertation aimed to describe nonverbal behaviours in South African multicultural HIV treatment contexts. It also aimed to identify the most appropriate method for nonverbal behaviour data analysis and transcription. The study used a single-case, parallel design, which incorporated three qualitative methodological tools; ethnography, a modified form of conversational analysis and interviews. Data used was from a preexisting videotaped database, belonging to a larger research project. Data consisted of 4 videotaped interactions between doctors and caregivers of children with HIV/Aids at the Red Cross Children’s Hospital. Through the use of polyphonic transcription, five nonverbal domains - eye gaze, body posture, facial expression, gesture and head posture – were analysed. Patterns and trends of these transcripts were crosschecked with data from the existing set as well as with data and findings from this and other research sites. Findings identified correlations between nonverbal behaviour patterns, interpersonal dynamics and communicative transfer. Specific critical moments of collaboration between caregiver and practitioner as well as nonverbal behaviour roles in communicative and interactional dynamics were also identified. Study findings thus posses the potential to; facilitate effective medical interactions, direct future nonverbal behaviour research and guide the development of medical education and policy.

D.Cur. / Working with children within a therapeutic relationship requires expert knowledge, expert skills, intuition, feeling and empathy for the child (Weitzman, 2003: 5). Internationally there is a need for the development of creative and effective service delivery models to be implemented by trained play therapists (Weitzman, 2003: 6). The purpose of the study was to develop a model for the advanced psychiatric nurse practitioner to facilitate the mental health of young children diagnosed with HIV by meeting the following objectives: to explore and describe the life-world of young children diagnosed with HIV; to describe and evaluate a model to facilitate the mental health of young children diagnosed with HIV; and to describe guidelines for the implementation of the model.