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Objectives: Poor knowledge of eye health, concerns about the cost of spectacles, mistrust of optometrists and limited geographical access in socio-economically deprived areas are barriers to accessing regular eye examinations and result in low uptake and subsequent late presentation to ophthalmology clinics. Personal Medical Services (PMS) were introduced in the late 1990s to provide locally negotiated solutions to problems associated with inequalities in access to primary care. An equivalent approach to delivery of optometric services could address inequalities in the uptake of eye examinations. Study design: One-way and multiway sensitivity analyses. Methods: Variations in assumptions were included in the models for equipment and accommodation costs, uptake and length of appointments. The sensitivity analyses thresholds were cost-per-person tested below the GOS1 fee paid by the NHS and achieving break-even between income and expenditure, assuming no cross-subsidy from profits from sales of optical appliances. Results: Cost per test ranged from £24.01 to £64.80 and subsidy required varied from £14,490 to £108,046. Unused capacity utilised for local enhanced service schemes such as glaucoma referral refinement reduced the subsidy needed. Conclusions: In order to support the financial viability of primary eye care in socio-economically deprived communities, income is required from additional subsidies or from sources other than eye examinations, such as ophthalmic or other optometric community services. This would require a significant shift of activity from secondary to primary care locations. The subsidy required could also be justified by the utility gain from earlier detection of preventable sight loss. / Yorkshire Eye Research, NHS Leeds and RNIB

Au croisement d’une histoire sociale du pouvoir local, d’une ethnographie des mobilisations électorales et d’une sociologie des porte-parole, cette thèse se consacre à l’étude des conditions de représentation électorale des habitants des cités dans une ancienne municipalité communiste de la banlieue parisienne. Elle s’intéresse aux processus de production de porte-parole et à leur accès au pouvoir municipal. L’enquête s’appuie sur des entretiens approfondis et croisés avec les différents protagonistes, sur des observations directes, sur l’analyse d’archives ainsi que sur des statistiques descriptives. La thèse montre que la faible représentation des porte-parole de cités parmi les élus n’est pas tant liée à une crise des vocations qu’à une crise des débouchés dans un marché électoral fermé et dans un contexte de dévaluation du militantisme partisan. La première partie rend compte du déclin du modèle ouvriériste de représentation des classes populaires et du creusement de la distance sociale entre les élus de la gauche municipale et les fractions minoritaires des classes populaires. La seconde partie explique comment les métiers « d’éducateurs » deviennent une filière propice au porte-parolat et offrent un modèle alternatif de militantisme, faisant de l’encadrement de la jeunesse populaire, un nouvel enjeu de luttes dans l’espace du pouvoir local. Enfin, la dernière partie envisage les logiques d’importation de ces conflits associatifs et professionnels dans le champ électoral. La mobilisation des éducateurs de cités aux élections se déroule en plusieurs étapes, passant de la recherche d’alliances avec la gauche municipale à des logiques de concurrence partisane, puis d’opposition. / At the intersection of social history of local power, ethnography of electoral canvassing, and sociology of spokespersons, this thesis focuses on the study of the conditions of the electoral representation of the inhabitants of deprived estates in a former communist local council in the suburbs of Paris. It deals with the process of developing spokespeople and their access to the local power. The survey is based on thorough research, which included interviews with people from a wide variety of political backgrounds, direct observations, and the analysis of archives for study of relative statistics. Thisthesis shows that the poor representation of spokespeople from deprived estates among the elected members of the local councils isn’t so much linked to a lack of vocation as to a lack of prospects in a closed electoral market and in a context of devaluation of partisan commitment. The first part of this thesis accounts for the decline in the working class pattern of representation among the popular classes and the widening of the social gap between the elected members of the municipal left and the minority groups from the popular classes. The second part explains how the roles of community workers are becoming a route for spokespeople and providing an alternative pattern for activists, to guide theworking class youth into the new political arena which focuses on the struggles in the area of local power. Finally, the third part considers the process of bringing a range of conflicts into the electoral landscape. The recruitment in the elections of the youth workers from deprived estates goes through several stages, ranging from attempts to form an alliance with the municipal left to a process of partisan competition, then opposition.

The challenges of backlogs experienced amongst Grade R-learners, results in learners not being school and learning ready when entering Grade 1. Obstacles for example are insufficient stimulation, under developed perception, and poor gross and fine motor skills, require early intervention and ought to receive attention in Grade R. From the socialecological perspective and taking into consideration the great amount of learners in South Africa originating from deprived environments, the study is focused in the domain of the Social Deprivation Theory. The bio-ecological context within which learners find themselves, influence the cognitive and perceptual development of every learner. Epistemologically the study focuses on the similarity between Critical Theory and Interpretivism. Critical Theory highlights the meaning of experience as manifested in relation to social circumstances and developmental background. Interpretivism in this study focuses on the meaning which individuals attach to their experiences in the spotlight and results in greater understanding and insight of the researched phenomenon. Circumstances of deprivation occur worldwide, even in developed countries like United States of America (USA) and England. Already for decades in USA young children gain in their development through intervention in early childhood (Ludwig & Phillips, 2007). Duncan and Brooks-Gunn (2000) identified a relation between child poverty/deprivation and poor school performance in the USA. Research in England (Thompson, 2000) shows that the impact of social neglect of children have serious consequences. The National Education Policy Act (Pandor, 2008; SA DvO, 1997:2) uses Early Childhood Development (ECD) as an umbrella term which refers to the development processes whereby children physically, intellectually, emotionally, spiritually, morally and socially grow and develop from birth to the age of nine years (SA, DoE, 1995, White paper 5,). The kind of education learners receive in Grade R is crucial to their further development in the education system (Van Zyl, Le Roux & Janse van Rensburg 2011, DvO, 1997:2). Learners lacking an adequate foundation may experience difficulties throughout their school career. In South Africa there is concern as to the standard of education and training, manifesting in a low pass rate on Grade 12-level. This study is undertaken to determine the current shortages in the South African educational system which may hinder the learning potential of Grade R-learners. An attempt is made to determine which handicaps/backlogs Grade R-learners experience, which fits the framework of the deprivation theory, which can undermine learner readiness. This study determine whether intervention by means of a perceptual-motor skills programme can enhance the school readiness of pre-school learners. Finally to determine which shortages/ backlogs exists in the perceptual-motor skills of Grade R nlearners from deprived backgrounds in South Africa. Guidelines for a perceptual-motor intervention program was developed through this study. A combination of quantitative and qualitative data-analysis is used in this study (Onwuegbuzie, Johnson en Collins, 2009). The dissertation is compiled in article format. In the first article of the study, the issues of teacher development and support mechanisms and equipment at primary schools and kindergartens are explored. Qualitative and phenomenological research was undertaken and information was gathered by means of questionnaires directed at teachers. In the following article the school readiness of 48 Grade R-learners from deprived backgrounds were tested. The research participants came from similar sosio-economic background, from quintile one and two schools. Seeing that those were the only primary schools with Grade R classes in that area, they were identified on behalf of their availability. In this study the data was analysed and descriptive statistics (means, averages, standard deviations, minimum and maximum values, percentages) and t-tests were used to determine variations in terms of perceptual motor skill development and learning readiness. An experimental group of 21 Grade R learners followed a 10 week long perceptual-motor skills intervention programme. In the follow-up school readiness test (article 3), results indicated that the intervention showed a positive response with regards to the school readiness of the Grade R learners. Drawing to a conclusion (article 4), the intervention programme is critically discussed and recommendations were made to all those concerned with Grade R teaching (teachers, principals, Departments of Education). The conclusion according to the results of the research shows that the intervention had a positive effect on the school and learning readiness of this group of Grade R learners. / Thesis (PhD (Curriculum Development Innovation and Evaluation))--North-West University, Potchefstroom Campus, 2012

The challenges of backlogs experienced amongst Grade R-learners, results in learners not being school and learning ready when entering Grade 1. Obstacles for example are insufficient stimulation, under developed perception, and poor gross and fine motor skills, require early intervention and ought to receive attention in Grade R. From the socialecological perspective and taking into consideration the great amount of learners in South Africa originating from deprived environments, the study is focused in the domain of the Social Deprivation Theory. The bio-ecological context within which learners find themselves, influence the cognitive and perceptual development of every learner. Epistemologically the study focuses on the similarity between Critical Theory and Interpretivism. Critical Theory highlights the meaning of experience as manifested in relation to social circumstances and developmental background. Interpretivism in this study focuses on the meaning which individuals attach to their experiences in the spotlight and results in greater understanding and insight of the researched phenomenon. Circumstances of deprivation occur worldwide, even in developed countries like United States of America (USA) and England. Already for decades in USA young children gain in their development through intervention in early childhood (Ludwig & Phillips, 2007). Duncan and Brooks-Gunn (2000) identified a relation between child poverty/deprivation and poor school performance in the USA. Research in England (Thompson, 2000) shows that the impact of social neglect of children have serious consequences. The National Education Policy Act (Pandor, 2008; SA DvO, 1997:2) uses Early Childhood Development (ECD) as an umbrella term which refers to the development processes whereby children physically, intellectually, emotionally, spiritually, morally and socially grow and develop from birth to the age of nine years (SA, DoE, 1995, White paper 5,). The kind of education learners receive in Grade R is crucial to their further development in the education system (Van Zyl, Le Roux & Janse van Rensburg 2011, DvO, 1997:2). Learners lacking an adequate foundation may experience difficulties throughout their school career. In South Africa there is concern as to the standard of education and training, manifesting in a low pass rate on Grade 12-level. This study is undertaken to determine the current shortages in the South African educational system which may hinder the learning potential of Grade R-learners. An attempt is made to determine which handicaps/backlogs Grade R-learners experience, which fits the framework of the deprivation theory, which can undermine learner readiness. This study determine whether intervention by means of a perceptual-motor skills programme can enhance the school readiness of pre-school learners. Finally to determine which shortages/ backlogs exists in the perceptual-motor skills of Grade R nlearners from deprived backgrounds in South Africa. Guidelines for a perceptual-motor intervention program was developed through this study. A combination of quantitative and qualitative data-analysis is used in this study (Onwuegbuzie, Johnson en Collins, 2009). The dissertation is compiled in article format. In the first article of the study, the issues of teacher development and support mechanisms and equipment at primary schools and kindergartens are explored. Qualitative and phenomenological research was undertaken and information was gathered by means of questionnaires directed at teachers. In the following article the school readiness of 48 Grade R-learners from deprived backgrounds were tested. The research participants came from similar sosio-economic background, from quintile one and two schools. Seeing that those were the only primary schools with Grade R classes in that area, they were identified on behalf of their availability. In this study the data was analysed and descriptive statistics (means, averages, standard deviations, minimum and maximum values, percentages) and t-tests were used to determine variations in terms of perceptual motor skill development and learning readiness. An experimental group of 21 Grade R learners followed a 10 week long perceptual-motor skills intervention programme. In the follow-up school readiness test (article 3), results indicated that the intervention showed a positive response with regards to the school readiness of the Grade R learners. Drawing to a conclusion (article 4), the intervention programme is critically discussed and recommendations were made to all those concerned with Grade R teaching (teachers, principals, Departments of Education). The conclusion according to the results of the research shows that the intervention had a positive effect on the school and learning readiness of this group of Grade R learners. / Thesis (PhD (Curriculum Development Innovation and Evaluation))--North-West University, Potchefstroom Campus, 2012