Various research sources indicate that effective sensory functioning is critical to the optimal development of a child. However, the influence of problems that are associated with poor socio-economic circumstances, as well as the differences between the genders and groups from different socio-economic backgrounds with regard to sensory functioning and motor development, is not clear. The aim of this study was to determine the possible significant relationship between problems that are associated with poor socio-economic circumstances and the sensory development of five to six year old children from these backgrounds. The study also attempted to compare the sensory development of five to six year old children from poor socio-economic backgrounds on the one side and those from good socio-economic backgrounds on the other. Further aims of this study were to analyse the possible differences between motor and sensory development of five to six year old boys and girls in poor socio-economic circumstances, as well as to determine the possible significant relationship between the general motor and sensory development of five to six year old children in poor socioeconomic circumstances. Fifty families were selected from three hundred families in the Thusano project by making use of a stratified random sampling procedure. All the five to six year old children belonging to these fifty families were selected for the purposes of this study as the QNST test can only be used for analysis on children from the age of five years. The total group that were selected from this poor socio-economic background consisted of twelve girls and eight boys (N= 20). A control group was made up of children from better socio-economic backgrounds and consisted of five girls and six boys between the ages of five and six years (N=11). The children were all evaluated according to the "Peabody Developmental Motor Scales - 2" (PDMS-2) to determine their motor development. The "Sensory Input Systems Screening Test" and the "Quick Neurological Screening Test II" (QNST) were used to evaluate their sensory development. The children with poor socio-economic circumstances were also evaluated by means of a questionnaire to determine aspects related to the birth process, medical history and education of the mother. With regard to aim 1, it is apparent from the results, which were obtained by using 'Statistica', that there are significant differences in the sensory development of children from poor socio-economic circumstances and good socio-economic circumstances when the QNST test was taken into account. The six tests showing the significant differences in the two groups are the two tests for tactile input ('palm shape' and 'hand-cheek'), the tests for auditory input ('sound'), the tests for pro-prioceptive input ('arm-leg extension') and the two tests for vestibular input ('finger-nose' and 'one leg stand'). However, no significant difference was found between the two groups with regard to the Pyfer test. When focussing on aim 2, the results indicated significant relationships between certain problems that are associated with poor socio-economic circumstances and the sensory development of children. With regard to aim 3, it is apparent from the results of t-testing (p≤ 0.05) that the motor skills of girls are better when compared to boys. Significant differences were found in favour of the girls with regard to the gross-motor percentile, the gross-motor grading, the total quotient and the total motor percentile where the girls did better than the boys. With regard to the sensory development, a t-test showed that the girls performed significantly poorer than the boys in the test for visual tracking, while the boys performed significantly poorer than the girls in the tests for spatial orientation ('finger-nose') and bilateral integration ('repetitive hand movements'). With regard to aim 4, correlation analysis indicated that there was a relationship between sensory, general and fine motor development in the group as a whole, while a discriminant analysis showed that visual perception contributed most to the overall motor developmental levels of the group. No relationship was, however, found between the gross-motor and sensory development of the group. These results substantiate that the motor en sensory development of children living in poor socio-economic conditions are hampered by their environment, and that they should receive additional attention to try to prevent deficiencies in this regard. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2005.

This thesis examines the diverse and conflicting ways in which the past is invoked in a village in the coastal area of the Aude department, in the Languedoc region of Southern France. The region of Languedoc has been undergoing turbulent, and unpredictable socio- economic change since the development of viticultural capitalism in the 19th century, and since the 1960s has also witnessed the development of a sizeable tourist industry. These factors, along with the proximity of the village to the city of Narbonne, have led over the past 150 years to the creation of a heterogeneous village population. The thesis details the plurality of ways in which the past was temporalised in the village during the fieldwork period (1996-7), taking account of the various social groups present in the village, and their economic activities and life worlds. It also illustrates the relationship between local temporalities and wider socio-economic developments in the region, in particular in relation to the development of a tourist industry that transforms the past into a commodity. The thesis is partly concerned to assess the relationship between these wider socio-economic developments, and the sociality of the village inhabitants. Drawing on recent anthropological work on time, human temporality is viewed as the product of symbolic processes, through which agents make evident, and act upon, the inherently temporal character of existence. In this sense the apprehension and significance of the past is implicated in a dynamic with present action and future orientations, and interpreted accordingly. However, a 'culturalist' perspective is avoided in the thesis by foregrounding the importance of interpreting all human activity as both historically situated, and implicated in wider political economic processes. In this respect, the thesis also pays attention to issues of political economy, and attempts a partial synthesis of different anthropological approaches: the phenomenological, the symbolic, and the materialist.

Most LDC regimes, especially those with a colonial past, suffer from a deficit in legitimacy. Basing their rule on the personality and achievements of one person, these regimes have failed to pass on their legitimacy to their successors, or sometimes even secure legitimacy for the state. They have drawn up a social contract with their populations that entailed obligations to achieve objectives such as industrialisation, national and economic independence, and welfare of their societies. In return, their populations were expected to support their regimes, and surrender their political rights and liberties. In this research, we focus on the social contract in Egypt, as an example of an LDC state where the regime has suffered from a lack of legitimacy since the country gained its independence in 1952. Over the last five decades, Egyptian regimes have forged a social contract with their populations in order to legitimise their rule. The social contract encompassed achieving objectives adopted by the regime on the domestic and international level according to their visions. The formula of the social contract has been modified by the regime in response to changes in domestic and international factors. One of the main obligations that the regime has committed itself to since 1952 has been welfare provision by the state. The commitment of the regime to provide welfare for the population has been an effective tool to generate legitimacy. Thus, the maintenance of a 'welfare state' has constituted a central component of the social contract since 1952. However, a social contract based on welfare provision has not been durable; this type of contract has secured the regime legitimacy only as long as it has been able to deliver welfare products. As industrialisation failed to take off, Egyptian regimes found it difficult to sustain the welfare state. Their attempts to withdraw from welfare provision, without compromising their legitimacy, have been unsuccessful. This is because the regime has marketed welfare provision by the state as a right of the public based on citizenship; the populace has proved resilient in defending this right. Hence, the regime had to rely upon aid and or external borrowing to postpone the crisis; and modify the social contract by introducing some measures of political liberalisation.

MSc(Med)Population Based Field Epidemiology, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Introduction: In Africa, elderly adult mortality, just like many issues affecting the old has not been adequately addressed by research. This study explored the relationship between socioeconomic status (SES) and elderly adult mortality in an economically deprived region of rural Ghana. Methods: Data from the Navrongo DSS was used for the analysis. SES was determined from the asset data using principal component analysis. A total of 15030 adults aged over 60 years were included in the study, out of which 1315 died. We investigated the above relationship using Cox proportional hazards regression methods while controlling for other variables. Results: Socioeconomic status (SES) was found not to be a determinant of elderly mortality. Compared to the lowest SES quintile, the adjusted hazards ratios were, 0.94 (95%CI: 0.79–1.12) for second quintile, 0.91 (95%CI: 0.76–1.08) for third quintile, 0.89 (95%CI: 0.75–1.07) for fourth quintile and 1.02 (95%CI: 0.86–1.21) for the highest income quintile. However, living without a spouse [HR=1.98, 95%CI: 1.74–2.25], being male [HR=1.80, 95%CI: 1.59–2.04] and age [HR=1.05, 95%CI: 1.04– 1.05] were significant factors for elderly adult mortality. Conclusion: These results indicate that companionship, social and family ties in the health of the elderly adults are of more importance than the socioeconomic status of the household. Efforts should therefore be made to support the elderly, such as stipend for the elderly adults, especially those living alone; lowering the provision of free medical care in public hospitals to cover people over the age of 60 and not just 70 year olds and above as is currently done; encourage family care for the elderly relatives through provision of an elderly caretaker allowance among others.

Master of Arts - Development Studies / This research explores the socio-economic impact of nature-based tourism on surrounding communities in the Pilanesberg National Park (PNP). The study pays particular attention to the Bakgatla community. The study looks at issues of employment creation, and the participation of the community in the management of the park. Of particular importance here is whether, PNP generates employment and income making opportunities for neighbouring communities, most notably, the Bakgatla. The level at which the Bakgatla are involved in decision-making processes of the park is closely scrutinised. Notwithstanding the obvious limitations with regard to the kinds and number of jobs that PNP, as an attraction is able to generate in the area, the study reveals a significant contribution that the park makes in this regard. Lodges serve as the major sources of employment recruitment in the PNP. The bulk of the recruits are mainly people from surrounding communities except in cases where required skills are not available locally. Concerning the question of participation, the study shows that more still need to be done in terms of broadening the concept to include and reflect diverse interests groups within the community. The concept of community participation also needs to be defined beyond mere ‘trickling down’ of benefits to the community, to imply real empowerment. The latter relates to the question of sustainability, which could effectively be realised through meaningful involvement of the community groups and individuals in the making of decisions, and policies affecting their lives.

MSc (Med) Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Focus in public health research is shifting to the role of socio-economic factors in the promotion of health. Hence, an understanding of the roles socio-economic factors plays in improving health and health-seeking behaviour is important for public health policy. This study examined the relationship between socio-economic factors and HIV infection in rural Limpopo Province South Africa, an area characterized by poverty differentials and migration. Various possible social and economic risk factors (such as nationality, education status, marital status, employment status, migration status and socio-economic status) for HIV infection are analysed and discussed. This is secondary data analysis was carried out during the period June 2001 to March 2005 among 2345 14-35 year old residents in eight (8) villages in rural Limpopo. Married participants (OR 0.53 [95%CI 0.28 – 1.00]), those from poor (OR 0.49 [95%CI 0.28-0.85]) and less poor households (0.38 [95%CI 0.21-0.70]) are less likely to contract HIV infection. Noteworthy from these analyses also is the increased risk for HIV infection seen among female participants, those not currently schooling (OR 1.9 [95%CI 1.2 – 3.3]) and non-South African citizens (OR 5.18 [95%CI 1.04-25.8]). Conclusion: Women, out-of school youths and non South African citizens are shown to be high-risk population groups for HIV infection. HIV prevention programs that target identified vulnerable population groups and increased social support for the family may contribute to mitigating the spread of HIV in rural South Africa.

MSc (Med), Popualtion-Based Field Epidemiology, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand / Background Improving the health of the poor and reducing health inequalities between the poor and non-poor has become central goals of international organizations like the World Bank and WHO as well as, national governments in the contexts of their domestic policies and development assistance programmes. There are also unquantified and poorly understood inequalities in access to health services within and between various population groups. Little is known about the factors that determine these inequalities and the mechanisms through which they operate in various sub-groups. Objectives The aim of the study was first to describe under-five mortality trend according to wealth index; second to describe risk factors for under five mortality; and finally to investigate the relationship between socio-economic and demographic factors and under five mortality during the period 2001 to 2006. Methods The study involved all children born in 2001-2006. A total of 22,422 children younger than 5 years were found in 21,494 households yielding 36603.13 Person-Years Observed (PYOs) up to 31st December 2006. Household wealth index was constructed by use of Principal Component Analysis (PCA), as a proxy measure of each household SES. From this index households were categorized into five quintiles (i.e., poorest, poorer, poor, less poor and least poor). Life table estimates were used to estimate mortality rates per 1000 PYO for infants (0-1), childhood (1-5) and underfives children. Health inequality was measured by poorest to least poor mortality rate ratio and by computing mortality concentration indices. Trend test chi-square was used to determine significance in gradient of mortality rates across wealth index quintiles. Risk factors of child mortality were assessed by the use of Cox proportional hazard regression taking into account potential confounders. v Results The result indicates unexpected low mortality rate for infant (33.4 per 1,000 PYO, 95% CI (30.4 – 35.6)) and childhood (15.0 per 1,000 PYO, 95% CI (13.9 – 16.3)). Under-five mortality rate was 18.2 per 1,000 PYO (95% CI (75.6 – 108.0)). The poorest to least poor ratios were 1.1, 1.5 and 1.5 for infants, childhood, and under-five year olds respectively, indicating that children in the poorest quintile were more likely to die as compared to those in the least poor household. Computed values for concentration indices were negative (infant C= -0.02, children C= -0.09 and underfive C= -0.04) indicating a disproportionate concentration of under-five mortality among the poor. The mortality rates trend test chi-square across wealth index quintiles were significant for both childhood (P=0.004) and under-five year old children (P<0.005) but not for infants (P=0.134). In univariate Cox proportional hazard regression, children in the least poor households were shown to have a 35% reduced risks of dying as compared to children in the poorest category [crude H.R =0.65, P=0.001, 95% C.I (0.50 – 0.84)]. The results showed that for under five children, a boy is 1.15 times more likely to die as compared to a girl [crude H.R =1.14, P=0.038, 95% C.I (1.00 - 1.31)]. Second born had a 18% reduced risk of dying as compared to first born [crude H.R =0.82, P=0.048, 95% C.I (0.67 – 0.99)]. After controlling for potential confounders, the adjusted hazard ratio for wealth index decreased slightly. The estimated hazard for wealth index in the univariate was 0.65 while in the multivariate modeling the estimated hazard ratio is 0.60 in the first model. Conclusion The study shows that household socio-economic inequality is associated with underfive mortality in the Navrongo DSS area. The findings suggest that reductions in infant, childhood, and under five mortalities are mainly conditional in health and education interventions as well as socioeconomic position of households. The findings further call for more pragmatic strategies or approaches for reducing health inequalities. These could include reforms in the health sector to provide more equitable resource allocation. Improvement in the quality of the health services offered to the poor and redesigning interventions and their delivery to ensure they are more inclined to the poor.

This dissertation aims at analyzing the relationship between socio-economic status (SES) and mental health and care. It attempts to understand how different socio-economic groups present unequal risk of mental disorders and to what extent different socio-economic groups use unequal quantity, type and quality of mental care. Since its earlier beginnings, psychiatric epidemiology has evidenced the association between socio-economic status and mental disorder. However, the numerous prevalence studies addressing depression have yielded inconsistent results. This calls for a thorough investigation of the sources of such heterogeneity. This dissertation attempts to achieve the following objectives: · To unfold methodological and contextual covariates influencing the SES/mental health relationship. · To assess the longitudinal influences of material deprivation on depression. · To assess the extent to which outpatient and inpatient mental care are fairly used. The methodological influences of socio-economic inequalities in mental health were tackled through a meta-analysis of previously published works. We built a database of previous published studies addressing the socio-economic factors of depression prevalence, incidence and persistence in adults population studies and being published in English, French, German and Spanish after 1979. The lower socio-economic group has 80% more prevalence of depression. Inequalities are more acute for persistent depression than for new episode. The results indicated that inequalities are much more pronounced when mental health is looked at from a subjective point of view or in terms of resulting disability. Social inequalities in mental health are also influenced by geographic context. Europe has a gradient 30% less pronounced than North-America. As the period of reference decreased, the gradient rose, suggesting that duration might be an explanatory factor. Geographical analysis of socio-economic inequalities in mortality is carried out with the death certificates of the Belgian National Institute of Statistics (NIS), covering all causes mortality and 11 specific mortality causes, from 1985 to 1993. Spatial concentration was computed through a Moran’I. We compare a simultaneous autoregressive model with a weighted-least-square model. Findings show that spatial concentration is pervasive, that suicide and mortality by liver cirrhosis are among the most correlated causes of death. Getting rid of spatial autocorrelation leads to significant change in the relationship between deprivation and mortality, suggesting the influence of contextual effects on socio-economic inequalities. The difficulty to move from correlation to causation between SES and depression owes partly to the difficulty of disentangling the direct effect of socio-economic status from other –and numerous- confounding factors such as family history, genetic endowment, cognitive abilities, early schooling experience, which, for most of them are rather stable overtime. The longitudinal analysis attempts to estimate the impact of time-varying socio-economic covariates on depression. The results show that material deprivation (and change of) does not affect the level or the risk of depression while social network does slightly. We found much stronger gradient with time invariant socio-economic factors such as educational level. Inequity in outpatient mental care was assessed with the data of the first Belgian Health Interview Survey (HIS), a cross-sectional household-health interview survey carried out in Belgium in 1997. The Minimum Psychiatric Summary, a case register of all psychiatric admissions in Belgium (1997-98), allowed us to carry out the study of inpatient inequalities of mental care. In terms of mental health services uses, inequalities arise in the setting were care is delivered: less well-off use more primary care and less specialised care, are more likely to be admitted in a non-teaching, psychiatric hospitals with long length of stay. The lower the socio-economic groups with mood disorders are less likely to receive the expected treatment such as antidepressant and psychotherapies. Finally, the outcomes of the hospitalisation, in terms of overall functioning and in terms of psychological symptoms are less favourable for the individuals of lower socio-economic status. Part of such unequal outcome is related to unequal treatment. We concluded that inequalities in health should be addressed in their geographical context, that early and stable socio-economic factors are more important than time-varying factors. Horizontal socio-economic inequities arise in the type of care used as well as in the appropriateness of care. However, for a given equal treatment and use, outcome inequalities remain so that it seems relevant to consider socio-economic status as a general vertical equity principle.

This descriptive study was done 1) to explore and describe the proportional distribution of breast, cervical and colorectal cancers by stage (a proxy measure of availability, access, and utilization of secondary prevention strategies) in northern Saskatchewan First Nations and non-First Nations in comparison to southern Saskatchewan First Nations and non-First Nations; 2) to assess the impact of stage and age on the survival patterns for these cancers in northerners and First Nations whose survival patterns have been shown by previous research to be equal or poorer in comparison to southerners. Univariate and multivariate survival analyses were carried out to ascertain the impact of the different proportions of stage for each study group on survival. Stage at time of diagnosis is a proxy assessment of secondary prevention services, which include formal screening programs.<p> Data for this study was obtained from the Saskatchewan Cancer Registry, which has been maintaining cancer data since 1932. Cancer stage at time of diagnosis information is complete in the registry for different years for each cancer site. Hence data for breast cancer was for the years 1970 to 1995; cervical cancer data for the years 1980 to 1995; colorectal cancer data for the years 1990 to 1995. <p> The proportion of cancer cases for each site by TNM stage and age were compared among the four study groups. First Nation and northern populations were found to have a larger proportion of diagnoses at a later stage in comparison to the southern non-First Nation group. <p> Using Cox's proportional hazards model, both stage and age at time of diagnosis were found to be significant predictors of survival for all study groups. Age and stage adjusted relative risks were calculated and found to be significant in comparison to the southern non-First Nation group for cancer of the breast (RR =1.81 P=0.013). For cervical cancer the relative risk of dying of cervical cancer for southern First Nations in comparison to southern non­-First Nations was found to be 1.38 but this was not statistically significant (p = 0.097). For colorectal cancer, the relative risk of dying of colorectal cancer was found to be better for northern First Nations in comparison to southern non-First Nations (RR = 0.59), however this was not statistically significant (p = 0.45).<p> This study showed that despite adjusting for stage and age at time of diagnosis, there were still some unexplained differences in the survival pattern of northern First Nations, northern non-First Nations and southern First Nations in comparison to southern non-First Nations. Hypotheses as to what these unexplained differences are have been offered. These include differences in socio-economic status as well as availability, accessibility, attitudes towards and knowledge of secondary prevention strategies. Further study into these unexplained differences should be carried out.

Second home ownership is a new and booming phenomenon in China. Although it has been widely discussed in newspaper, radio and other mass media, it has not raised much academic concern. This study is a preliminary research in this field. <br /><br /> In western counties, second home growth has caused a series of socio-economic impacts to the host community, including housing price inflation, displacement of local people, disruption of local service, etc. These effects identified by western literatures are examined in the context of Haikou, China. <br /><br /> Through applications of interview, on-site observation and secondary research, this study generally confirms the impacts addressed by other second home research. Similar to the western experience, the growth of second homes in Haikou has both positive and negative impacts. On the positive side, the increase of second home purchase contributes to the boom of property-related industry. On the negative side, it causes inflation pressure on housing price and affects the affordability of the housing for local people. The seasonality of second home occupation also leads to a "ghost communit" problem. However, as the development of second homes in Haikou is at an early stage, both their positive and negative impacts are not significant. Some effects such as the displacement of locals, the effects on local retail outlets and services are not detectable. Remarkably, this study addresses two problems that can only be found in China: "college entrance exam immigration" and "illegal sale of <em>hukou</em>". <br /><br /> Based on the major findings, policy recommendations for local government are provided. Implications for conducting research in China, and for future research opportunities are also suggested.