The purpose of this study was to describe the experiences of elderly people caring for HIV positive orphans on antiretroviral treatment in Swaziland. An exploratory, descriptive and contextual qualitative study based on a phenomenological approach was conducted. Data was collected by means of semi structured interviews with twelve elderly people purposively selected at Mbabane Government Hospital antiretroviral treatment clinic. The findings of the study highlighted that the elderly people were giving care under compulsion with very little support from the government, the community or other organisations. Their care giving capacity was compromised by many challenges which included the heavy burden of caring for a number of dependents; economic constraints; poor infrastructure; food insecurity, and physical, psychological and social constraints. The elderly were employing a number of coping strategies to counteract the challenges that they were facing. The researcher concluded that the elderly people were vital in ensuring the survival of sick orphans under the paediatric antiretroviral treatment programme in Swaziland if afforded sufficient support and empowerment. / Health Studies / M.A. (Public Health)

The study reported in this thesis explores the experiences of Educators-As-Lay-Counsellors (EALCs) of the Read-me-to-Resilience (Rm2R) intervention strategy with black South African orphans in order to theorise about the value of providing EALCs with a ready-made intervention tool in the interest of supporting their resilience. EALCs are educators who are assigned the role of pastoral carer or are voluntarily fulfilling this role. Most educators who fulfil lay counselling roles are not formally equipped to be skilled helpers. Not only are educators in general poorly trained to cope with the social and emotional needs of orphaned and other vulnerable children, but working as an EALC has additional challenges. One possible way of supporting EALCs to be resilient in the face of the challenges endemic to being a lay counsellor in South Africa in the 21st century is to support EALC access to counselling tools and resilience-supporting interventions. However, existing resilience and other literature does not document how valuable providing EALCs with ready-made counselling tools/intervention programmes might be. Thus, the purpose of this study was to theorise about the value of providing EALCs with ready-made intervention tools. A secondary, but related purpose was to explore EALCs‟ experiences of the Rm2R intervention strategy as a pathway to resilience for orphaned South African learners and for the EALCs themselves. To achieve this purpose, 16 South African educators voluntarily implemented the Rm2R (as an example of a ready-made intervention) for 11 weeks with orphaned learners. Its usefulness was investigated using a pre-intervention/post-intervention design and qualitative data generation techniques (the draw-and-write technique, focus group interviews and research diaries). Participating educators reported that using the Rm2R intervention promoted their positive adjustment to the challenges of lay counselling. This included the development of a positive attitude towards lay counselling roles, and greater counselling competence and cultural awareness. Four resilience-supporting pathways were reported for orphaned learners, including the promotion of life skills, positive distraction, constructive attachments and an appreciation of cultural resources. Although the Rm2R intervention was useful as a ready-made intervention, refinements were suggested to address frustrations experienced during implementation. These findings allowed theorisation about the usefulness of providing EALCs with ready-made interventions. The study concluded that there is limited value in providing EALCs with a ready-made intervention tool in the interest of supporting EALC resilience. / PhD (Educational Psychology), North-West University, Vaal Triangle Campus, 2013

The study reported in this thesis explores the experiences of Educators-As-Lay-Counsellors (EALCs) of the Read-me-to-Resilience (Rm2R) intervention strategy with black South African orphans in order to theorise about the value of providing EALCs with a ready-made intervention tool in the interest of supporting their resilience. EALCs are educators who are assigned the role of pastoral carer or are voluntarily fulfilling this role. Most educators who fulfil lay counselling roles are not formally equipped to be skilled helpers. Not only are educators in general poorly trained to cope with the social and emotional needs of orphaned and other vulnerable children, but working as an EALC has additional challenges. One possible way of supporting EALCs to be resilient in the face of the challenges endemic to being a lay counsellor in South Africa in the 21st century is to support EALC access to counselling tools and resilience-supporting interventions. However, existing resilience and other literature does not document how valuable providing EALCs with ready-made counselling tools/intervention programmes might be. Thus, the purpose of this study was to theorise about the value of providing EALCs with ready-made intervention tools. A secondary, but related purpose was to explore EALCs‟ experiences of the Rm2R intervention strategy as a pathway to resilience for orphaned South African learners and for the EALCs themselves. To achieve this purpose, 16 South African educators voluntarily implemented the Rm2R (as an example of a ready-made intervention) for 11 weeks with orphaned learners. Its usefulness was investigated using a pre-intervention/post-intervention design and qualitative data generation techniques (the draw-and-write technique, focus group interviews and research diaries). Participating educators reported that using the Rm2R intervention promoted their positive adjustment to the challenges of lay counselling. This included the development of a positive attitude towards lay counselling roles, and greater counselling competence and cultural awareness. Four resilience-supporting pathways were reported for orphaned learners, including the promotion of life skills, positive distraction, constructive attachments and an appreciation of cultural resources. Although the Rm2R intervention was useful as a ready-made intervention, refinements were suggested to address frustrations experienced during implementation. These findings allowed theorisation about the usefulness of providing EALCs with ready-made interventions. The study concluded that there is limited value in providing EALCs with a ready-made intervention tool in the interest of supporting EALC resilience. / PhD (Educational Psychology), North-West University, Vaal Triangle Campus, 2013

Inaug.-diss.--Rostock. / Lebenslauf. "Schriftum:" p. 9-11.

The purpose of this study was to describe the experiences of elderly people caring for HIV positive orphans on antiretroviral treatment in Swaziland. An exploratory, descriptive and contextual qualitative study based on a phenomenological approach was conducted. Data was collected by means of semi structured interviews with twelve elderly people purposively selected at Mbabane Government Hospital antiretroviral treatment clinic. The findings of the study highlighted that the elderly people were giving care under compulsion with very little support from the government, the community or other organisations. Their care giving capacity was compromised by many challenges which included the heavy burden of caring for a number of dependents; economic constraints; poor infrastructure; food insecurity, and physical, psychological and social constraints. The elderly were employing a number of coping strategies to counteract the challenges that they were facing. The researcher concluded that the elderly people were vital in ensuring the survival of sick orphans under the paediatric antiretroviral treatment programme in Swaziland if afforded sufficient support and empowerment. / Health Studies / M.A. (Public Health)

Student Number : 7809567 - MSc dissertation - School of Therapeutic - Faculty of Health Sciences / HIV/AIDS in Sub-Saharan Africa has resulted in a major increase in the number of HIV infected children and orphans. HIV infected children are at risk of developmental delays and growth impairments which is further compromised by poor living conditions. Institutionalisation is not the preferred method of caring for children in need, however, it does provide a stable environment, shelter, nutrition and medical care. Objective: To compare the anthropometric measurements and neurodevelopment of HIV infected and HIV uninfected children who were vertically infected, not on antiretroviral treatment and residing in institutions in Gauteng, South Africa. Method: A comparative, longitudinal study of 16 HIV infected and 24 HIV uninfected children between the ages of 16 and 42 months. The Bayley Scale of Infant Development II (MDI and PDI) was used to evaluate neurodevelopment. The children’s mean z-scores for weight-for-age, height-for-age, weight-forheight and head circumference-for-age were calculated. Evaluations were carried out at two time points, seven months apart. Results: The HIV infected children scored significantly lower than HIV uninfected children at both time points, in neurodevelopmental (MDI p<0.02 and p<0.00; PDI p<0.00 and p<0.00) and anthropometric measurements for-age (weight p<0.00 and p<0.01; height p<0.00 and p<0.00; head circumference p<0.00 and p<0.07). Both groups (HIV infected and HIV uninfected) showed a significant improvement over time regarding to their weight-for-age (p<0.00; p<0.01) and head circumference-for-age (p<0.01 and p<0.08). The height-forage showed no significant improvement in the HIV infected group (p>0.2) but did in the HIV uninfected group (p<0.03). There was a severe delay in the mental abilities of both the HIV infected and HIV uninfected children and the motor abilities of the HIV infected children, which did not change over time, but the motor abilities of the HIV uninfected children did improve significantly. Conclusion: The HIV virus affects the neurodevelopment and growth of HIV infected children. Both groups showed an improvement over time in their growth particularly weight-for-age indicating that they may have benefited from their institutionalisation.

Akademisk avhandling--Engelsk litteratur--Uppsala, 1980. / Bibliogr. p. 109-112. Index.

京都大学 / 0048 / 新制・課程博士 / 博士(薬科学) / 甲第21717号 / 薬科博第108号 / 新制||薬科||12(附属図書館) / 京都大学大学院薬学研究科医薬創成情報科学専攻 / (主査)教授 土居 雅夫, 教授 竹島 浩, 教授 中山 和久 / 学位規則第4条第1項該当 / Doctor of Pharmaceutical Sciences / Kyoto University / DGAM

Philosophiae Doctor - PhD / Literature evidence on challenges facing the grandparents caring for AIDS orphaned children has shown inaccessibility to health care services, inability to afford basic needs, absence of social security provisions (with the exception of the pension scheme) and lack of attention from the government and Non-Government Organizations (NGOs). In South Africa, there is insufficient documented evidence of available sustainable approaches to supporting grandparents caring for AIDS orphans in all health dimensions. This study aimed to develop strategies to improve support for grandparents caring for AIDS orphans in the Western Cape Province of South Africa.

Abstract : Rare diseases are debilitating conditions often leading to severe clinical manifestations for affected patients. Orphan drugs have been developed to treat these rare diseases affecting a small number of individuals. Incentives in the legal framework aimed to recoup the research and development cost of orphan drugs for pharmaceutical companies have been implemented in the United States and the European Union. At the present time, Canada is still lacking a legal and policy framework for orphan drugs. Several problems at the federal and provincial levels remain: lack of research funds for rare diseases, discrepancies on orphan drug policies between provinces, difficulties to access and reimburse these high price drugs. Recommendations and measures are proposed, such as a pan-Canadian (national) scientific committee to establish evidence-based guidelines for patients to access orphan drugs uniformly in all provinces with a disease specific registry, a formal agreement for a centralized Canadian public funding reimbursement procedure, and increasing the role of “guardian” for prices by the Patented Medicines Review Board in Canada. These recommendations and measures will be beneficial for the implementation of a policy framework for orphan drugs in Canada. / Résumé : Les maladies rares sont des maladies sérieuses pouvant causer des manifestations cliniques sévères chez les patients atteints. Les médicaments orphelins ont été développés pour le traitement de ces maladies rares qui touchent un petit nombre d’individus. Un cadre légal permettant des incitatifs pour les compagnies pharmaceutiques aux États-Unis et au niveau de l’Union Européenne a favorisé la recherche et le développement desdits médicaments. Présentement, il n’existe pas de cadre juridique et de politiques spécifiques au Canada entourant les médicaments orphelins. Ceci a mené à plusieurs problèmes tant au niveau fédéral que provincial dont: un manque de support financier consacré à la recherche pour les maladies rares, des disparités entre les provinces concernant les politiques pour les médicaments orphelins, des difficultés d’accès et de remboursement desdits médicaments dont les coûts sont élevés. Des recommandations et mesures sont proposées, telles l’implantation d’un comité scientifique pancanadien (national) afin d’établir des lignes directrices fondées sur des données probantes pour faciliter un accès uniforme aux médicaments orphelins pour les patients, y compris un registre spécifique élaboré pour chaque maladie, établir une entente formelle centralisée pour tout le Canada pour un financement public de remboursement des médicaments orphelins, augmenter le rôle de « gardien » des prix par le Conseil d’examen du prix des médicaments brevetés au Canada. Ces recommandations et mesures serviront à l’implantation d’un cadre de politiques pour les médicaments orphelins au Canada.