3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item How can applied theatre be implemented to address male adolescents' perceptions of their female counterparts? A case study of adolescent boys at Izenzo Kungemazwi Community College(2014-01-28) Molefe, Butana P.Gender based sexual violence against women has become epidemic in South Africa. This study attempts to explore the pedagogical approach of Applied Drama as a qualitative behavioural change programme for adolescent black males. This Practice-based Research Report investigates the efficacy of Applied Drama as a tool to address male adolescent perceptions toward their female counterparts, with particular reference to the case study of Izenzo Community College, Hillbrow, South Africa. The research consisted of a Participation Action Research exploration in three phases over a year, culminating in a Practice-based examination and followed by this written research report. The study argues that Applied Drama is a powerful tool to encourage dialogue amongst adolescent males about complex subject-matter. Chapter One introduces the reader to Izenzo, the framework of the study, and the narrative of the researcher/facilitator. Chapter Two interrogates masculinities in contemporary South Africa. Chapter Three introduces the research problem and methodology, and Chapter Four discusses the two initial phases of research. This highlights the trajectory of research that resulted in the final phase of research that is explored in detail in Chapter Five. Chapter Six analyses the nature of Applied Drama in relation to masculinities. This study affirms the role of Applied Drama as a meaningful approach to tackling the rising crisis of gender based sexual violence in South Africa. It emphasises the central role of the facilitator as the implementer of Applied Drama as a facilitation process that enhances dialogue for change.Item The impact of dietary habits and practices during adolescence on the risk of obesity: the birth to twenty cohort(2013-04-29) Feeley, Alison Bridget BernadetteBackground: South Africa is not exempt from the obesity epidemic and latest figures show that a third of adult men and two-thirds of adult women are either overweight or obese. Concomitant are changes in dietary habits and practices which have been implicated in the risk of obesity. Concern is that obesity and related non-communicable diseases (NCDs) manifest at younger ages. Adolescence, as well as being a stage during the life course when eating attitudes and behaviours are formed, is a particular time when the aetiology of NCDs becomes evident. Little is known about the dietary patterns during adolescence in South Africa, and if policymakers are to attempt to reduce the burgeoning statistics relating to obesity then it is important to understand adolescent dietary habits and eating practices. Aims: To describe adolescent dietary habits and practices among South African adolescents and how they might influence obesity risk. Methods: This study used a mixed methods study design, using both historical and prospective data and included four study components in both an urban (components 1-3) and a rural setting (component 4). Firstly, a cross-sectional assessment of fast-food intake of urban 17-year-olds from the Birth to Twenty Cohort (Bt20); secondly, a longitudinal descriptive analysis of dietary habits and practices of the Bt20 participants over a five-year period, between ages 13 – 17 years followed; thirdly a longitudinal assessment of the relationship between dietary habits, change in socio-economic status (SES) and obesity in the Bt20 adolescents was conducted; and finally, an exploratory survey assessing the availability of fast foods in a rural area. Results: The cross-sectional analysis showed that mean fast food intake was 8.1 (4.6) items and 7.2 (4.7) items/week for males and females respectively. Furthermore, the kota (or quarter) was the most popular fast food item and on average it provided 5 370 kJ, 51 g fat (of which 13 g Saturate fatty acids (SFA)). The longitudinal analysis showed that poor dietary habits and practices were embedded by the age of 13 years and were characterised by: high fast food consumption with at least five items/week consumed from the age of 13 years. Breakfast (weekday and weekend) consumption declined for both genders and females ate breakfast less regularly than males. Snacking while watching television increased with age: with females consuming more (4.0 (4.8) - 7.3 (5.9)) snacks per week than males (3.3 (4.5) - 6.0 (5.8). Two-thirds of participants ate their main meal with their family but among girls there was a trend towards eating this meal less regularly with increasing age. Confectionery consumption remained the same, around nine items/week for males and 10 items/week for females. Lunch box usage declined with age, conversely the number of tuck shop purchases increased with age. The prevalence of combined overweight and obesity was (8.1%) and (27%) in 17-year-old males and females respectively. In males only, soft drink consumption was associated with obesity denoted by BMI z-score and fat mass (p<0.05). In the final multivariate model, soft drink consumption remained positively and significantly associated with both outcomes and „acquiring‟ a fridge over the 12-year period remained negatively associated with both BMI z-score and fat mass (p<0.001). Among females, no associations were found. Thus further data on other lifestyle variables are needed to understand better the exposures related to obesity risk in females. In the rural setting fast food was found to be available albeit a limited variety; two-thirds of the collected samples were either vetkoek (fried dough balls) or fried chips (yielding between 943 kJ – 5 552 kJ and 11 g – 64 g fat). Compared to the kotas available in Soweto, the samples obtained in the rural setting contained more energy and fat (6 300 kJ, 60 g fat vs. 5 369 kJ, 51.5 g fat). Conclusions: This research highlights that poor dietary habits and practices prevail in adolescence which may be implicated in negative health outcomes in later life. Of concern is the finding that poor dietary habits were embedded by the age of 13 years which suggests that interventions need to target families and children prior to adolescence in order to reduce the pervasiveness of these habits in the older child. The prevalence of combined overweight and obesity is higher than the national statistics for both boys and girls at the age of 17-years. This research confirms that some dietary behaviours are associated with obesity risk namely soft drink consumption – but in males only. However soft drink consumption may be a marker for other lifestyle behaviours associated with obesity. Other dietary habits were not shown to be associated with obesity in neither males nor females, which highlights the difficulty in the measurement of exposures relating to diet. This study also showed in males at least, that socio-economic factors are important when considering obesity risk. The availability of fast foods in a relatively impoverished rural area is concerning as it may indicate that this community is undergoing nutritional changes such as those seen in urban environments. With urbanisation and economic transition, households experience a change in SES and these changes drive behaviour which can either enable or disable health outcomes. In this study SES improvement, e.g. fridge ownership seems to enable certain behaviours which can be obesogenic. However we cannot halt development in this context but we must devise ways to improve lifestyle choices which will promote health rather than impede it.Item Association between height at age 2 years and adolescence school performance: evidence from Birth to Twenty Cohort Study(2011-03-25) Nkomo, Palesa ManthabisengBackground The first two years of a child’s life are crucial for cognitive development. In societies where there are high rates of poverty, children are at risk of undernutrition and subsequently stunting. Insufficient nutrition in early childhood results in growth retardation in young infants and subsequently weak school performance later in life due to poorer cognitive development. As far as we know no study has been conducted in South Africa to examine the association between height at age 2 years and school performance at the end of primary school. Purpose The primary objective of this study was to investigate the association between growth at age 2 years and education performance (school performance in Mathematics and English or first language) of adolescents at the end of primary school (grade 7). In addition, other growth variables such as weight-for-age, BMIfor- age and weight-for-height were tested for the association as a secondary objective. Prevalence of stunting, underweight, wasting and obesity at age two years was also investigated. Methods This study is a primary analysis of historical data collected from Birth to Twenty (BT20) cohort in Johannesburg, South Africa. A cohort study conceptualised to v investigate the effects of the urbanization and societal transition on health and development A longitudinal study design within the BT20 cohort was employed. A total of 252 study participants were included in the study. An ordinal logistic model was used to test for association between growth at age two years and school performance. Potential confounders such as maternal education, birth weight and socio-economic status as defined by household assets were adjusted for in the model. Results At age two years, about 29% of the study participants were stunted as defined by height-for-age, based on the WHO 2006 growth standards. The proportion of girls defined as stunted was equal to that of boys. Levels of underweight, wasting and obesity were 9%, 6% and 2% respectively. The risk of low versus combined high and average performance in Mathematics at grade 7 was about three times more likely in study participants whose heightfor- age was below -3SD and seven times more likely for those below -4SD. Participants whose weight-for-age as defined by the WHO reference was below - 2SD were more than three times more likely to achieve a low score versus a combined high and average score in English or first language. There was no evidence of correlation between low birth weight, wasting and obesity and poor education performance for both Mathematics and English results Conclusion: We conclude that there is an association between height at age 2 years and school performance at the end of primary school.Item Risperidone for disruptive behaviour in children and adolescents with learning disability(2010-10-21) Bezuidenhout, HeidreBackground Disruptive behaviour is the most commonly reported mental health problem in individuals with learning disability. Pharmacotherapy is part of a multidisciplinary approach to the treatment of disruptive behaviour. Risperidone, an atypical antipsychotic drug, is the most commonly used treatment for symptom improvement. It is therefore important to establish the efficacy and safety of risperidone therapy in this dependent, vulnerable and young population, given the well documented adverse effects and the potential for long term treatment. Objectives To assess the effects of risperidone for disruptive behaviour in children and adolescents with learning disability. Search strategy The following electronic databases were searched: CENTRAL (Cochrane Central Register of Controlled Trials); MEDLINE; PsycINFO; CINAHL; Clinicaltrials.gov; National Research Register (NRR). In addition, reference lists of relevant publications and narrative reviews were checked; handsearches were done; authors of published trials and pharmaceutical manufacturer of risperidone (Risperdal) were contacted. Selection criteria All randomised or quasi-randomised controlled trials of risperidone versus placebo (or no treatment) for children and adolescents (age less than 18 years) with a diagnosis of learning disability and disruptive behaviour were considered. Data collection and analysis Trial eligibility and data quality were evaluated and analysed by the author and independently verified by an additional reviewer. Unpublished data were considered for inclusion and relevant authors were contacted in the case of incomplete data. Results Four randomised controlled trials involving 279 children and adolescents were identified. The majority of the children were living at home and not institutionalised. Meta-analyses of the primary outcome scales (Nisonger Child Behaviour Rating Form, Aberrant Behaviour Checklist, Behaviour Problem Inventory) measuring several core symptoms of disruptive behaviour, namely conduct problems, self-injury, irritability, aggressive / destructive behaviours and stereotypy suggest statistically significant improvement in disruptive type behaviours in children treated with risperidone compared to placebo. Adverse event data showed that the prevalence of adverse effects viz. weight gain, sedation / somnolence and raised prolactin levels were significantly higher in the children receiving risperidone. Conclusions In the studies included in this review, risperidone treatment for disruptive behaviour in learning disabled children and adolescents appears to have a beneficial effect on certain symptoms of disruptive behaviour. However, the applicability of these findings to wider clinical practice remains unclear, due to poor methodological quality, inadequate study sample size and short duration of treatment of the included studies. Long term safety has not been established and serious adverse effects, affecting growth, are of concern. Further research is required to establish the efficacy and safety of risperidone for disruptive behaviour in learning disabled children and adolescents in clinical practice.Item Adolescents perception of paternal figures' involvement in their sexuality education(2008-12-05T12:01:58Z) Siboyana, BafanaThe main aim of the study was to investigate adolescents’ perceptions of the paternal/father figures’ involvement in their sexuality education. Other aims included to determine adolescents’ perception of paternal/father figures’ knowledge of sexuality education; aspects/topics that are discussed; and the gender differences in paternal figures’ involvement with adolescents’ sexuality education. The study sample consisted of 67 adolescents aged between 13-19 years and was chosen through purposive, non-probability sampling technique from Illinge Secondary School at Vosloorus Township, Ekurhuleni Metropolitan Council. A questionnaire designed by the researcher was used to collect the data for the study. The results of the present study indicated that a small number of the adolescents perceive their paternal/father figures as involved in the discussion of sexuality matters. Nevertheless a highest number of the participants in the study perceive a paternal figure as a right source of sexuality education. However, the study shows that participants perceive their paternal figures as authoritarian and having poor communication about sexuality matters. This study indicated that there is no trend in adolescents’ perceptions of their paternal figures’ adequacy and inadequacy of knowledge regarding competency/incompetence in discussing sexuality topics. The main topic that the participants indicated to be receiving paternal figures’ attention is adolescents’ pregnancy and parenting. However, there is an indication that sexual intercourse is not mentioned as the antecedent to pregnancy. A large number of adolescents in this study indicated that there is a presence of a significant gender difference in the sexuality education. An increased father forum as well as involvement of social institutions and the professional and community based work force is recommended to address the need for father/paternal figures’ involvement in the sexuality education of adolescents.Item Beyond adolescents : The study of sexual behaviour of middle-aged men in Nigeria(2008-12-01T11:32:00Z) Atolagbe, Afolabi SulaimonStudies on sexual behaviour in Nigeria have rather been lopsided largely focussing on adolescents while neglecting the older men. This may not be unconnected with the fact that the young people are often seen as being more sexually active than the older men. In this study, the patterns and the determinants of sexual behaviour of middle-aged men were investigated. This study is based on secondary data analysis of the 2003 Nigeria Demographic and Health Survey male dataset. Data collected from a sample of 633 men whose ages fall between 40 and 59 years in Nigeria were extracted and analysed to achieve the set objectives. The variables of interest were analysed by using relevant statistical techniques with the aid of SAS enterprise guide. Sexual behaviour was measured by three variables namely: current sexual activity, extra marital partnership and condom use. Also, three hypotheses were tested. The Health Belief Model (HBM) was the theoretical model used for this study. The study shows that a high proportion of men (71.2%) aged 40-59 years in Nigeria are sexually active. The study further reveals that about 12% of Nigerian middle-aged men engage in extramarital sex and 30% are in polygynous relationships (i.e. have multiple sex partners) while condom use is very low among them. Extramarital sex is more prevalent in the rural (7.05%) than urban (4.5%) areas. The study shows that the correlates of current sexual activity among the middle-aged men in Nigeria are education and religion while engagement in extramarital sexual activity is determined by ethnicity, age at first intercourse and knowledge of HIV/AIDS. Among the sexually active ones, condom use is influenced by ethnicity, marriage type and extramarital partnership. The sexual behaviour of middle-aged men in Nigeria follows the pattern described in the HBM. That is, individual, socio-economic and HIV/AIDS factors can influence the sexual behaviour of Middle-aged men. The study concludes that in addressing the problems associated with sexual and reproductive health of Nigerian, focus should also be extended to middle-aged men, instead of the narrow focus on only adolescents and youths. Further investigation, using multiple methods of data collection is also suggested.Item Sexually transmitted disease prevention: knowledge, attitudes, and practices among school pupils in rural Ghana(2008-06-06T08:10:12Z) Duong, Le QuyenABSTRACT Introduction: Sexually transmitted diseases (STDs) are serious problems for adolescents and young people. To protect adolescents from these diseases, there is a need to educate them on STD prevention by providing them with relevant information and equipping them with the life skills that will enable them to put knowledge into practice. It is recommended that STD-prevention programmes should take into account sex differences. However, limited data are available on how adolescent boys and girls differ in knowledge, attitudes, and practices regarding STD prevention in the same study setting. Aim: To examine sex differences in knowledge, attitudes, and practices regarding STD prevention among junior secondary school pupils in the Kassena-Nankana district, Ghana. Design: This research report is based on secondary data analysis of a cross-sectional knowledge,attitude, and practice survey of sexual and reproductive health conducted among junior secondary school pupils in the Kassena-Nankana district in 2005. The original survey had been carried out before the subject ‘Adolescent sexual and reproductive health’ was initiated in junior secondary schools in this district as an intervention study. Responses from 6,225 school pupils aged 10-19 years (3,011 schoolboys and 3,214 schoolgirls) were analysed using StataTM version 9.0 software. Results: The study found that school pupils had unsatisfactory knowledge about STDs; boys tended to be more knowledgeable than girls (p < 0.05). In terms of attitude towards condom use, a significantly higher percentage of boys (70%) compared with girls (61%) felt confident about insisting on condom use whenever they had sex. However, boys were more likely to be involved in sexual risk behaviours than girls. Eighteen percent of boys and 8% of girls reported being sexually experienced (p < 0.05). Boys started having sex earlier than girls (at 14.5 compared with 15.1 years, p < 0.05). Sixty-two percent of boys had sex with multiple partners compared with 32% of girls (p < 0.05). The mean number of lifetime sexual partners of boys and girls was 4.2 and 2.5, respectively (p < 0.05). The percentage of people reporting non-use of condoms during last sexual encounter was significantly higher among boys (37%) than girls (29%). Differences were observed in association of knowledge and attitudes regarding STD prevention with sexual activities among both boys and girls.Item Regional patterns and correlates of gender differences in HIV risk behaviour among Nigerian adolescents and young adults(2008-05-06T12:10:28Z) Obisie-Nmehielle, Nkechi C.Context: Heterosexual transmission has been found to be the major route of HIV infection in Nigeria. Thus prevention of HIV infection by reducing risky behaviors has been identified as a public health priority. This study examines regional pattern and correlates of gender differences in HIV risk behaviors among Nigerian youths aged 15-24 years. As different geo-political regions have specific gender ideologies and practices, there is need to find out if gender differences in Nigeria regions drive HIV risk behaviors among youths. Method: Data from the 2003 Nigeria Demographic and Health Survey were analyzed for never married, sexually experienced 342 males and 630 females. Multiple sex partnerships and pattern of condom use were the HIV risk behaviors examined. Respondents were asked the number of sexual partners in the last 12 months while pattern of condom use is a composite variable of four items in the 2003 NDHS. Univariate, bivariate, and multivariate analyses were done using STATA 9.SE. Binary and multinomial logistic models were used for multivariate analyses. Results: The study shows that there is high level of risk behaviours in the population. This cuts across gender and regions. For instance, 54% of males and 69% of females engage in inconsistent condom use and 30% of males and 9% of females in multiple sex partnership. This pattern is consistent across the regions. It is also shown that while correlates of HIV risk behaviours vary by gender, its regional variation by gender is inconsistent. The study highlights inconsistent gender differentiation by regions. Further investigation is necessary to explain this observation.Item Experiences of pregnant adolescent girls(2008-03-10T14:39:25Z) Maseko, VellaABSTRACT This study sought to explore the experiences of pregnant adolescent learners. It solicited information around challenges faced by pregnant adolescent girls, the impact of pregnancy on interpersonal relationships and psychological functioning, the support system that pregnant learners have, as well as their current feelings and perceptions about their experience. It is a qualitative study, and it employed thematic content analysis to analyse the results. The sample, comprising of five adolescent girls, was drawn purposively from Soweto High Schools. Adolescent pregnancy is generally perceived as a social problem because of the negative consequences often associated with it. Literature also suggests that low socio-economic circumstances and developmental factors predispose adolescents to a higher risk for unplanned pregnancy. The results of this study indicate that an experience of pregnancy during adolescence often results in challenges that may have a negative impact on normative development. Another finding is that most adolescent mothers receive very little or no financial and emotional support from families, partners or formal structures.