Enhancing primary care is key to the Canadian health care reform. Considered as an indicator of primary care access and quality, hospitalisations for ambulatory care sensitive (ACS) conditions are commonly reported by Canadian organisations as sentinel events signaling problems with the delivery of primary care. However, the literature calls for further research to identify what lies behind ACS hospitalisation rates in regions with a predominantly urban population benefiting from universal access to health care. A theoretical model was built and, using an ecological design, multiple regressions were implemented to identify which neighbourhood characteristics explained the socio-economic gradient in ACS hospitalisation rates observed in Ottawa. Among these neighbourhoods, healthy behaviour and - to a certain extent - health status were significantly associated with ACS hospitalisation rates. Evidence of an association with primary care accessibility was also signaled for the more rural neighbourhoods. Smoking prevention and cessation campaigns may be the most relevant health care strategies to push forward by policy makers hoping to prevent ACS hospitalisations in Ottawa. From a health care equity perspective, targeting these campaigns to neighbourhoods of low socio-economic status may contribute to closing the gap in ACS hospitalisations described in this current study. Reducing the socio-economic inequalities of neighbourhoods would also contribute to health equity.

Afrikaans: Die doel van dié studie is om die verbale en nie-verbale kommunikasie gedrag, wat moeders vanuit lae sosio-ekonomiese omstandighede teenoor hul nege maande oue babas gebruik, te beskryf. Ten einde aan die doel te beantwoord, is 'n literatuurstudie en empiriese studie onderneem. Die literatuurstudie verskaf 'n oorsig van moeder-kind kommunikasie interaksie as basis van taalverwerwing. Die verwantskap tussen die aard van interaksie en die sosiaal¬interaktiewe konteks waarin moeders met 'n lae opvoedingspeil en inkomste hulle plaaslik bevind, is beklemtoon. Hierdie verwantskap voorsien 'n raamwerk waarbinne die waargenome interaksie patrone toepaslik geïnterpreteer kan word. Daar is ook verwys na die problematiek wat die Kleurlinggemeenskap as minderheidsgroep in Suid-Afrika tipeer, ter ondersteuning van die belang van konteks sensitiewe interpretering van data. Die navorsingsmetodiek het, met behulp van drie gevallestudies van moeders met hul pre-verbale kinders, kwalitatiewe beskrywende data jeens moeder-kind kommunikasie interaksie verskaf. 'n Data-insamelingsprotokol is op grond van die literatuur en bestaande evaluasie materiaaI saamgesteI, om agtergrondsinligting van die proefpersone in te win asook insig aangaande moeders se kommunikasie gedrag te ontwikkel. Hierdie inligting is bekom deur middel van onderhoude en video-waamemings van spelinteraksies en versorgingsaktiwiteite, wat op die data-insamelingsprotokoI vasgelê is. Die resultate van hierdie studie het onvoldoende interaksionele vaardighede by proefpersoon moeders aangedui. ' n Gebrek aan responsiewe gedrag op hul babas se vokale gedrag en ongemakseine soweI as beperkte verbale stimulasie, blyk daartoe aanleiding te gee dat voorlopers van taalvaardighede nie genoegsaam by die pre-verbale kinders gefasiliteer word nie. Daar is verder bevind dat moeders se persepsies aangaande vroeë verbale stimulasie, spel en gesamentlike boeklees betreklik eng voorkom, wat waarskynlik verband hou met beperkte kennis weens lae opvoedingspeiI en gebrekkige blootsteIIing aan spraak-taalterapeutiese oudiologiese dienste in hulle gemeenskap. Gevolglik is die bewusmaking en lewering van vroeë kommunikasie intervensie dienste in Eersterus en soortgelyke lae sosio-ekonomiese gemeenskappe noodsaaklik. Die bekendstelling van Kommunikasiepatologie en motivering vir vroeë kommunikasieintervensie behoort ook professionele persone vanuit mediese en opvoedkundige beroepe sowel as beleidsbepalers op distriks en nasionale vlak, in te sluit. Die implikasies voortspruitend was van teoretiese en kliniese aard. Die kliniese implikasies het aanpassings in die struktuur van diensverskaffing, asook inhoud van familiegebaseerde tuisprogramme tydens vroeë kommunikasie intervensie in die gemeenskap, voorgestel. Die verkreë inligting word as waardevol vir vroeë intervensie terapeute betrokke by families van lae sosio-ekonomiese omstandighede, beskou, aangesien spraak-taalterapeutiese en oudiologiese dienslewering, deur die gebruik van sodanige konteks toepaslike data, bevoordeel kan word. Hierbenewens is voorstelIe vir verdere navorsing, om databasisse rondom moeder-kind kommunikasie interaksie in lae sosio-ekonomiese gemeenskappe uit te brei en kommunikasie agterstande te voorkom of te verminder, aan die hand gedoen. English: The aim of this study is to describe the verbal and non-verbal communicative behaviour of mothers with low socioeconomic status towards their nine month-old babies. In order to achieve this aim a literature review, as well as an empirical study, was undertaken. The literature review provides an overview through which mother-infant communication interaction can be viewed as the key element in language acquisition. The relationship between the nature of the interaction and the specific socio-interactive context within which mothers with low levels of income and education find themselves is emphasised. This relationship provides a framework for the appropriate interpretation of observed patterns of interaction. To support contextually sensitive interpretation of data reference is also made to the problems typical to a minority group in South Africa, such as the colored community. Qualitative descriptive data regarding mother-infant communication interaction was obtained through research methodology, by means of three case studies of mothers with their pre-verbal children. In order to collect background information on participants and to develop insight into their communicative behaviour, a data collection protocol was compiled based on a literature review and on existing evaluation material. The information was obtained through interviews and video recordings of play and caregiving interaction based in this data collection protocol. The results of this study indicate that mothers demonstrate insufficient interaction skills. Limited Response to their infants' vocal and discomfort cues as well as limited verbal stimulation of infants appears to contribute to the fact that language skill precursors are not facilitated sufficiently appropriately in these pre-verbal children. Furthermore, it is apparent that mothers' perceptions with regard to early verbal stimulation, play and joint book-reading are fairly limited. These findings may be as a result of insufficient knowledge due to low levels of education as well as limited exposure to speech-language therapy and audiological services in their community. Thus, the development of public awareness and the provision of early communication intervention services in Eersterus and similar low socioeconomic communities are essential. The introduction of Communication Pathology and motivation for early communication intervention has to include medical and educational professionals as well as policy makers on a district and national level. The resulting implications are theoretical and clinical in nature. The clinical implications recommend that adaptations be made to the structure of service delivery, especially regarding the content of family-centred home programmes in this community. The data obtained may be viewed as valuable by early intervention therapists working in families with low socioeconomic status, since a database which is contextually appropriate may benefit speech-language therapy and audiological services. Future research topics are proposed in order to further develop databases on mother-infant communication interaction in low socio-economic communities communities and in order to prevent or reduce communication deficits. / Dissertation (MA (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / unrestricted

The purpose of this study was to explore and understand the resilience processes employed by families from a low socio-economic background living in a predominantly black township (Mamelodi). The study further aimed to assess how the participants’ experiences have shaped their perceptions of their society. Walsh’s family resilience framework (2003) served as a conceptual framework for the study. Two grandparent-headed households were selected from an ongoing study at a nongovernmental organisation and drop-in centre in Mamelodi. A qualitative methodology was suitable for this study, because it aims to understand how the participants derive meaning from the social and cultural contexts within which they live. The two focus group discussions were conducted in isiZulu, with a translator present during the grandmothers’ focus group discussion, because one of the grandmothers spoke Xitsonga. The sessions were audio-recorded and later transcribed. The transcripts were analysed using thematic analysis in order to deduce themes that emerged from the participants’ experiences. Based on the results, a better understanding of how families from low socio-economic backbackgrounds develop their resilience was established through the themes that emerged, which were as follows: belief system, flexibility of roles and connectedness, unsupportive environment, and self-empowerment. The results were related to existing literature and Walsh’s family resilience framework. / Dissertation (MEd)--University of Pretoria, 2015. / Educational Psychology / MEd

Raising children is a highly demanding job for any family; the demands are even higher when the child has a disability. The cost of raising a child with a disability is said to be three times higher than that of raising a non-disabled child. Unfortunately, children with disabilities could be born into any family, including the poorest of the poor, who, due to their low socio-economic status, already have less than what is necessary to meet the needs of the non-disabled members. There is limited research into the coping strategies of families raising the children with disabilities in Lesotho, for this reason, the researcher decided to undertake this particular study to feed the curiosity on how families with low socio-economic status managed to raise the children with physical disabilities in this poverty stricken country. Following the Qualitative methodology, the researcher utilised both the purposive and the simple random sampling techniques to select participants from a list provided by the Department of Social Development. A total of ten (10) interviews were conducted with representatives of low socio-economic status families raising children with physical disabilities in the Makaota E12 community council of the Mafeteng district. The study revealed that the majority of families were coping well and that they were generally happy despite the presence of a child with a disability in their homes. The study further revealed a number of factors that played a role in determining the coping ability of each family; these include availability of the support structures and the severity of the child's disability. Finally, the study raised a need for post diagnosis counselling and educational campaigns intended to equip the families of children with physical disabilities with relevant skills and information they require to assist the children to develop to their full potential. The study further raised a need for broader research into the lives of children living with disabilities and their families, for better understanding of the area and for improved service delivery. / Mini Dissertation (MSW)--University of Pretoria, 2016. / Social Work and Criminology / MSW / Unrestricted

South African education has undergone many changes in the past two decades. In an attempt to educate all South African children and provide as many prospects as possible, a funding system was adopted with the intention of achieving "redress, equity and quality" (DoE, 2006). The goal of redress was important to begin solving system discrepancies between different social groups in the country whereas the goal of equity is one of the means to attain redress. The Quintile Funding System has been considered the means to achieve equity and redress. This tiered system directs more funding to those learners in need of financial support than more affluent learners. By increasing funding to learners of a lower socio-economic status (SES), learners who would otherwise be disadvantaged, could possibly reap the benefits of more opportunities through good quality education. This study aims to investigate the functionality and relevance of the quintile funding system. By using the preProgress in International Reading Literacy Study (prePIRLS) 2011 reading literacy test results and background survey questionnaire data, the SES of each quintile is examined. The reading literacy achievement is also used as a proxy for education quality and, by examining the differences in prePIRLS 2011 reading literacy achievement of the quintiles, the levels of quality may be established. The SES and reading achievement enables a comparison between quintiles to justify the use of a five-tiered funding system. An effective funding system should ensure that the largest number of learners in the country reap the most benefits from a good quality education. / Dissertation (MEd)--University of Pretoria, 2016. / Science, Mathematics and Technology Education / MEd / Unrestricted

The purpose of the study was to explore and understand how orphaned adolescents in grandparent-headed households achieve healthy functioning and how they rise above unfavourable circumstances. In exploring and gaining understanding, the research was approached from an interpertivist stance as it entails an inductive qualitative enquiry suitable to gaining a better understanding of the experiences and perceptions of orphaned adolescents. A qualitative methodological design was followed to ensure that the research questions could be answered. Purposive sample selection was used to select participants for this research study. The sample included nine adolescent orphans who reside in grandparent-headed households and are affiliated with Stanza Bopape Community Centre. Data collection included biographical questions, focus group interview and semi-structured interviews. Five of the nine participants took part in a focus group interview and the remaining four participated in individual semi-structured interviews. All interviews were conducted and transcribed by the researcher. Inductive thematic analyses was utilised to identify themes which emerged from the data. The themes which emerged were: the person I am, the supportive roles in parenting, role models in my life, things that are important to me, the future in me. These themes reflect the factors which contribute to the participants’ resilience and can be deduced as the mediating factors which assist them in achieving healthy functioning. The risks identified are aligned with residing in a township and attending a township school, however these risks were not experienced as demotivating adversities for the participants. They rather viewed them as motivating factors to achieve a better future. Bronfenbrenner’s bio-ecological theory served as the theoretical foundation for the study and it emerged that factors which contribute to the orphaned adolescents’ resilience (maintaining factors) come from various systems. Based on the findings of the study it can be concluded that orphaned adolescents residing in grandparent-headed households, although generally of low socio-economic status, are aware of their challenges and utilise certain processes to strengthen their resilience and overcome their challenges. / Dissertation (MEd)--University of Pretoria, 2018. / Educational Psychology / MEd / Unrestricted

Introduction: Early Childhood Caries (ECC) is a serious public health concern globally especially in developing countries like South Africa. The main source from which infants acquire the causative bacteria - Mutans Streptococci (MS) is their mothers. The mothers with high levels of MS have a greater chance of transmitting the bacteria, particularly if they are involved in practices such as tasting the infant’s food and/or sharing eating utensils. Current research indicates that dental public health programmes fail to prevent ECC because of late intervention. Objective: This study sought to determine the existing knowledge, attitudes and perceptions (KAP) of pregnant women about ECC in a population in Tshwane district, Gauteng province, South Africa and to compare these KAP across socio-economic groups (SES). Methodology: A cross-sectional analytical study involving consenting pregnant women recruited from selected private and public antenatal healthcare facilities in the Tshwane District area was conducted. This study involved the use of a validated self-administered structured questionnaire and an oral epidemiological clinical examination (modified by WHO Oral Health Assessment 1997 Guidelines). One calibrated examiner using a dental explorer and a mouth mirror under natural light carried out the oral examination. Data analysis included descriptive statistics, principal component analysis to obtain a composite score for participant’s attitude towards ECC; and chi-square and independent student’s T-test to compare different groups. Significance level was set at p<0.05. Results: Response rate was 88.9% (n=353). Respondents’ age ranged from 18-44years (Mean age=31years). Only 18.7% of the respondents had complete knowledge of the cause of dental caries i.e. both sugar (diet) and biologic agent (bacterial plaque) whilst over half of the respondents (55.5%) mentioned only one factor. The participants’ knowledge of the cause of ECC was significantly associated with SES. A few mothers-to-be (13.9%) believed in the caries transmission from mother to child. Reported mean age for the child’s first dental visit was 2 years and 8 months. Only a quarter of respondents received oral health education for their unborn child during the antenatal visits. The majority of the pregnant women (93.8%) expressed the desire to receive information during the antenatal visit. The participants’ attitudes towards ECC was significantly associated with SES. The caries prevalence of the pregnant women was high at 64.3%, with mean DMFT of 2.97(SD 3.20). High participant DMFT was significantly associated with reports of ‘rotten teeth’ in their other children. Only 19.3% mothers-to-be had visited a dental care provider in the last 6-months. Conclusion: The knowledge of the pregnant women studied on ECC is incomplete and limited, while their attitudes and perceptions towards ECC was satisfactory. Therefore there is a need for the integration of oral health education with maternal and child health activities in both antenatal and post-natal clinics. There is a need for the oral health professionals to collaborate with other health works to reduce the prevalence of ECC. / Dissertation (MSc Dent)--University of Pretoria, 2019. / Community Dentistry / MSc Dent / Unrestricted

This study directly tests the relationship between income inequality and student mathematics achievement. Furthermore, I examine the degree to which the relationship between income inequality and student achievement is moderated by student SES. To test these relationships, I created a database of national wealth measures and linked it with student achievement data from the 2009 Programme for International Student Assessment (PISA). The results of multilevel models indicated that income inequality is negatively related to student achievement scores. Additionally, this relationship is not moderated by student SES, indicating that the relationship between income inequality and student achievement is the same for both low- and high-SES students. The results of this study suggest that nations seeking to improve student achievement can do so by decreasing income inequality.

Smoking in childhood and adolescence is associated with a range of health issues, as is the exposure of young people to the second hand smoke of their parents and other family members. The initiation of smoking in adolescence is also associated with an increased risk of smoking in adulthood and all the subsequent health problems that are attached to this. Whilst smoking rates in adolescent have fallen in recent years there remains a significant number of adolescent who initiate smoking every year, and this risk is higher in certain groups such as those from areas of low socio-economic status. Under-age adolescents also continue to be able to obtain cigarettes despite recent changes in legislation and availability. Social influence has been identified as a major causal factor of initiation of adolescent smoking. This can take place in a number of settings, including the home, at school and in the community. Whilst the evidence for the relative effects of these sources of influence is mixed there is an overall lack of research in the UK on familial influences and factors. A survey of 100 adolescents was conducted for the current study at a local college and included items on smoking behaviour, family structure and several other factors. No overall significant effects of parental attitudes were found. However in light of the existing literature recommendations are made to further research family and home influences and to develop anti-smoking health education strategies which more fully take these factors into account.

The purpose of this study was to examine the relationship between two sets of variables with the first including parental involvement, literacy skills, and socio-economic status and the second including graduation rates, incarceration rates and psychiatric hospitalization rates. The study methodology included three separate multiple regression analyses. Data were collected from archival sources through the Mississippi Department of Education (MDE), Mississippi Department of Mental Health, and the Mississippi Department of Human Services Youth Divisions. The results of this study indicated that socio-economic status has a statistically significant relationship with high school graduation rates and youth psychiatric hospitalization rates in the State of Mississippi.