Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

Abstract The law with special provisions on the care of young people (SFS 1990: 52) (LVU) regulates a possible way out for the social service to compulsorily act to protect children and young people who in different ways are disadvantaged. When an intervention is made in accordance with this law, high legal security requirements are set for each child in each unique case. The purpose of this essay is to analyze whether the administrative law highlights the rights of the children and the best interests of the child in a legal process regarding. This is done through an analysis of administrative law judgments. The study also includes an examination of how the administrative law chooses to take the best interest of the child into account when making a decision. The results of the study show that, in the majority of cases, administrative law emphasizes the importance of the best interests of the child coming to the forefront and the rights of the child to be fulfilled. It also emerges that the child's age and maturity are of great importance for how the administrative law views the credibility of the child's story. If the child has been able to maintain his story over time, it also appears to be something that the administrative law takes into account in the decision-making process. Whether a child is to be represented in the legal process is clear in guidelines and conventions, but how the child's story is taken into account seems ambiguous. How the children should be considered in a legal process seems obvious in theory, but through the course of the study, the reality has turned out to be different. Although the child's perspective and the best interests of the child are described as important, in some cases the administrative law is considered to have a poor child perspective.

Increasing tourism numbers in third world countries affect their economies and certain aspects of their society positively; however, there are concomitant negative effects that expose the dark side of the tourism industry. One of these is the escalating commercial sexual exploitation of children (CSEC), particularly child prostitution (CP) in the context of tourism, a phenomenon known as child sex tourism (CST). Although tourism plays an important role in creating the perfect storm of poverty-stricken children colliding with wealthy tourists, it is not solely responsible for this phenomenon. Internationally and nationally, the lacuna of knowledge on CST in particular hampers an informed response by way of resource allocation and coordinated service delivery to both victims and perpetrators. Utilising a qualitative research approach, and the collective case study and phenomenological research designs complemented by an explorative, descriptive and contextual strategy of inquiry, the researcher explored the status of the knowledge of and response to the CSEC through the lens of closely associated role players, who were purposively selected for inclusion in the study. These were adult survivors who were as children engaged in sex work and victims of child sex tourism, social workers and non-social workers involved in rendering child welfare and protection services, members of the Family Violence Child Protection and Sexual Offences (FCS) Unit of the South African Police Service (SAPS) and representatives of the hospitality and tourism industry. Data was collected via individual in-depth semi-structured interviews, telephone interviews, and email-communication and thematically analysed. The researcher found that a range of microsystem level factors, such as poverty and family dysfunction, pushed children to the street, and as a means to survive engage in sex work, enabling tourists (i.e. local - out of towners) and foreigners, mainly men from varied sexual orientation) to commercially sexually exploit both boys and girls, from as young as nine years of age, and of different race groups, which leave them with physical and psychological scars. The following main findings surfaced: The social workers, in comparison to the non-social workers, who have a primary responsibility to provide child welfare and protection services were ill-informed in terms of identifying CST as phenomenon, untrained and/or slow to respond appropriately with interventions directed to the victims and perpetrators of CSEC. The service provider groups, as microsystems interfacing on a mesosystem, were fraught with perceptions that the social workers and the SAPS were being inadequate. Furthermore a lack of cooperation, collaboration and communication between the service provider groups to respond to CSEC existed. The hospitality and tourism industry service representatives were also ill-informed about the phenomena of CP and CST with a response that at best can be labelled as fluctuating between an indirect response to that of turning a blind-eye. From the findings, recommendations for social work practice, education and training and recommendations specific for the other closely associated role players in responding to the CSEC were forwarded. / Social Work / D.Phil. (Social Work)

Increasing tourism numbers in third world countries affect their economies and certain aspects of their society positively; however, there are concomitant negative effects that expose the dark side of the tourism industry. One of these is the escalating commercial sexual exploitation of children (CSEC), particularly child prostitution (CP) in the context of tourism, a phenomenon known as child sex tourism (CST). Although tourism plays an important role in creating the perfect storm of poverty-stricken children colliding with wealthy tourists, it is not solely responsible for this phenomenon. Internationally and nationally, the lacuna of knowledge on CST in particular hampers an informed response by way of resource allocation and coordinated service delivery to both victims and perpetrators. Utilising a qualitative research approach, and the collective case study and phenomenological research designs complemented by an explorative, descriptive and contextual strategy of inquiry, the researcher explored the status of the knowledge of and response to the CSEC through the lens of closely associated role players, who were purposively selected for inclusion in the study. These were adult survivors who were as children engaged in sex work and victims of child sex tourism, social workers and non-social workers involved in rendering child welfare and protection services, members of the Family Violence Child Protection and Sexual Offences (FCS) Unit of the South African Police Service (SAPS) and representatives of the hospitality and tourism industry. Data was collected via individual in-depth semi-structured interviews, telephone interviews, and email-communication and thematically analysed. The researcher found that a range of microsystem level factors, such as poverty and family dysfunction, pushed children to the street, and as a means to survive engage in sex work, enabling tourists (i.e. local - out of towners) and foreigners, mainly men from varied sexual orientation) to commercially sexually exploit both boys and girls, from as young as nine years of age, and of different race groups, which leave them with physical and psychological scars. The following main findings surfaced: The social workers, in comparison to the non-social workers, who have a primary responsibility to provide child welfare and protection services were ill-informed in terms of identifying CST as phenomenon, untrained and/or slow to respond appropriately with interventions directed to the victims and perpetrators of CSEC. The service provider groups, as microsystems interfacing on a mesosystem, were fraught with perceptions that the social workers and the SAPS were being inadequate. Furthermore a lack of cooperation, collaboration and communication between the service provider groups to respond to CSEC existed. The hospitality and tourism industry service representatives were also ill-informed about the phenomena of CP and CST with a response that at best can be labelled as fluctuating between an indirect response to that of turning a blind-eye. From the findings, recommendations for social work practice, education and training and recommendations specific for the other closely associated role players in responding to the CSEC were forwarded. / Social Work / D. Phil. (Social Work)