Faculty of Health Sciences (ETDs)

Permanent URI for this communityhttps://hdl.handle.net/10539/37925

Browse

Subject: search.filters.subject.Adolescents

Search Results

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Development and validation of a school-based mental health education programme for in-school adolescents in Lagos, Nigeria
    (University of the Witwatersrand, Johannesburg, 2023-07) Olowe, Atinuke Oluwatoyosi; Tshabalala, Amme; Bruce, Judith
    An increasing prevalence of mental health challenges among adolescents, with its onset identified in early/mid-adolescence, has called for global concern. Mental health disorders account for most of the leading causes of adolescent disease burden. Its impact, as measured by the financial cost and the overall risks on adolescents, families, and the community, cannot be overemphasized, especially among Low Middle-Income Countries like Nigeria. The study aimed to determine adolescents' knowledge, attitude, and mental health status and explore stakeholders' perspectives as well as documented literature on school-based mental health programmes. Then, use the information to develop and validate a school-based mental health education programme for adolescents in the school setting. A sequential, multi-method study design involving six objectives, all in three phases, was employed in this study. Phase one entailed baseline data identification involving a quantitative survey to determine the knowledge, attitude, and mental health status of in-school adolescents, qualitative exploration of stakeholders' perspectives through in-depth interviews and a scoping review to determine international literature on school-based mental health education programme. In phase two, the findings from phase one were merged to create overlapping themes. These themes identified domains from which the school-based mental health education programme was developed. In the third phase, a group of experts validated the programme's content for relevance and clarity through two rounds of Delphi. A pool of 50 items under six domains was generated for the second round of the school-based mental health education programme after the content validity was carried out. Evidence from the scoping review revealed that a theoretical framework is optional in developing a school-based mental health education programme. Also, most programmes reviewed used the universal level of intervention for comprehensive coverage. Although not all mental health programmes were part of the school curriculum, break time and after-school hours were used by some facilitators in delivering mental health education programmes. In determining the knowledge, attitude, and mental health status of in-school adolescents in Nigeria, the findings showed that only a quarter of the in-school adolescents had high knowledge of mental health. The age of in-school adolescents (p=0.005) and their class (p<0.001) were the socio-demographic information significantly associated with the attitude of in-school adolescents. Five themes and fifteen subthemes emerged from the in-depth interviews that explored stakeholders' perspectives. Overlapping themes from the scoping review, data sources from the quantitative survey, and qualitative interviews generated the domains for the designed school-based mental health education programme for adolescents. The school-based education programme was subjected to validation by a group of experts to ensure the relevance and clarity of the items in the programme. The overall scale level content validity index (S-CVI) for the second round of Delphi was 0.90. The school-based mental health education is designed based on evidence, with good content validity as regards relevance and clarity. Hence, the programme can improve adolescents' knowledge and attitude towards mental health.
  • Thumbnail Image
    Item
    Local control of Ewing sarcoma/peripheral primitive neuroectodermal tumour using multimodality treatment approach in children and adolescents in Johannesburg: a retrospective review
    (2024) Ndamase, Ncumisa
    Background Ewing sarcoma and peripheral primitive neuroectodermal tumours (ES/pPNET) are aggressive bone and soft tissue malignancies that are most common in children and adolescents. The use of a multimodality treatment approach improves outcome especially following advancement in systemic chemotherapy. Local treatment strategies for local disease control continues to show promise in improving overall survival and local control rates in patients with localized disease. Objective The objective of this study was to determine the effectiveness of treatment in ES/pPNET by comparing surgery and radiotherapy in overall disease and event free survival. Materials and Methods This was a retrospective analysis of medical records of ES/pPNET patients treated in a public academic institution in Johannesburg. Records of fifty-four (54) patients with localized tumours treated from January 2000 to December 2015 were included in the study. Five-year overall survival and event-free survival as well as incidence of recurrence were estimated using the Kaplan-Meier for the analyzed cohorts. Cox regression models were used for analysis of prognostic factors and estimating odd ratios with 95% confidence intervals. Results The estimated 2-year and 5-year overall survival (OS) was 88.9% (95% CI: 0.7693 – 0.9485) and 77.7% (95% CI: 0.6400 – 0.8664) respectively. Based on the local treatment received, the 5-year OS was 73.3% for surgery only, 83.3% for radiotherapy only and 76.0% for patients that had both surgery and radiotherapy In total, 18 (33.3%) of the 54 patients experienced recurrence; isolated distant recurrence occurred in 15 patients, the commonest site being the lungs (55.6%), followed by the [vi] spine (14.8%) and the pelvis (14.8%). Combined local and distant recurrence occurred in 3 patients. The site of local recurrence in these three (3) was the pelvis. The estimated 5-year event free survival (EFS) for all patients was 65.8% (95% CI: 0.5130 – 0.7691). The estimated 5-year EFS was 63.6% (95% CI: 0.2042 – 0.8045) for surgery only, while for radiotherapy only, 66.7% (95% CI: 0.3771 – 0.8234) and for both surgery and radiotherapy 66.2% (95% CI: 0.4347 – 0.8149). No patient in this cohort of ES/pPNET had isolated local recurrence or failure following local treatment. Patients with tumour size ≥ 8cm are 2.54 times likely to have local or distant tumour recurrence compared to patients with tumours < 8cm (OR: 2.54, 95% CI: 1.05-6.13, p=0.019). Patients with high pretreatment lactose dehydrogenase (LDH) level (at diagnosis), had approximately 5 times increased odds of recurrence compared with those with normal LDH (OR: 4.59, 95% CI: 1.34-15.74, p=0.010). The factors associated with recurrence were tumour size (OR: 2.64, 95% CI 1.08-6.45) and LDH (OR: 4.01, 95% CI 1.15-13.99). For mortality, LDH level (p<0.001) and disease recurrence (p<0.001). Conclusion Overall disease control in ES/pPNET is comparable for patients treated with surgery or definitive radiotherapy with chemotherapy. The risk of local failure is commoner in patients treated with definitive radiotherapy than surgery. Although radiation therapy is frequently applied in unfavorable disease group, local control outcomes are good and in many cases similar to surgical treatment outcomes. Distant failures account for the majority of relapses in this disease; therefore there is need for better and improved systemic therapies for both local and distant disease control
  • Thumbnail Image
    Item
    Evaluation of the neuroprotective effects of simvastatin against alcohol-induced damage to the sciatic nerve and the somatosensory barrels in adolescent C57BL/6J mice
    (2024) Efuntayo, Alice Adetokunbo
    Alcohol is a commonly used and abused drug among adolescents which has an adverse effect on the body’s overall health, especially on the developing brain. It causes neurodevelopmental, neurobehavioral, neurocognitive, and social problems because alcohol exerts its neurodegenerative effects by up-regulating oxidative stress which is responsible for neuronal death. The rising prevalence of alcohol-related diseases and disabilities and the cost to the government necessitates investigation into interventions that could protect the neurons against the damaging effects of alcohol. One drug with antioxidant properties is Simvastatin, a U.S. Food and Drug Administration (FDA) approved drug for lowering blood cholesterol levels. The neuroprotective effects of Simvastatin against alcohol neurotoxicity were evaluated on the sciatic nerves and the somatosensory barrel cortices of adolescent mice. 40 four–week old C57BL/6J male and female mice were administered 20% alcohol (i.p.), 5 or 10 mg/kg Simvastatin orally followed by 20% alcohol (i.p.) or the controls (i.e. 5 mg/kg Simvastatin only or non-treated) consecutively for 28 days. The axonal density, myelin thickness and g-ratio of the sciatic nerves were assessed as well as the sizes of the Posteromedial barrel subfield (PMBSF) barrels. The results confirmed alcohol neurotoxicity on the axonal density and myelination in both sexes. At the same time, Simvastatin was effective against the onset of alcohol nerve damage. For the somatosensory barrels, alcohol did not significantly reduce the mean areas of (I) the PMBSF barrels, (II) the enclosure, or (III) the septal portion in both sexes. However, the barrel-to-barrel comparison revealed alcohol toxicity on specific barrels in specific rows and arcs of the PMBSF barrels. Both concentrations of Simvastatin were also effective against alcohol–induced damage on those specific barrels. These may explain the reasons for the sensory-motor delays that are often seen in alcoholics due to possible delays in the relaying of sensory input and the processing and interpreting of information from the somatosensory cortex. Simvastatin seems to have the ability to protect against the damaging effect of alcohol on the peripheral nerves and the somatosensory cortex and this may be beneficial in reducing the prevalence of alcohol-related diseases or disabilities, especially in adolescents that are prone to abusing alcohol.
  • Thumbnail Image
    Item
    Predictors of resilience among adolescents living in rural Mpumalanga in 2018: a cross sectional study
    (2024) Snijder, Michelle
    Literature suggests that resilience can be reached by practicing behaviours, thoughts and attitudes that promote resilience. To understand which behaviours, thoughts and attitudes foster resilience, predictors of resilience should be studied. This study aimed to examine predictors of resilience among adolescents living in the rural Mpumalanga Province, South Africa. Data were collected using a questionnaire from a sample of 245 adolescents between 13.1 and 15.2 years (median age 14.1 (13.1- 15.2); sex 52.7% female and 47.4% male). The questionnaire included questions from depression, stress and resilience scales as well as additional questions relating to communication with parents, and socio-demographic characteristics. The 20 question Centre for Epidemiological Studies Depression Scale (CES-D) measured depression, the 10-item Perceived Stress Scale (PPS-10) measured stress while the 25-item Connor Davidson Resilience Scale (CD-RISC-25) measured resilience. The prevalence of resilience was estimated at 46.1%. The findings suggest that perceptions of stress did not significantly predict resilience. Experiencing depressive symptoms and healthy interpersonal relationships significantly predicted high resilience. Although healthy relationships with parents predicted high resilience, adolescents relied more on relationships with friends to build resilience. However, regularly meeting with friends predicted low resilience, while always meeting with friends decreased the chances of low resilience. Thus, the study suggests that healthy relationships with both parents and friends may predict high resilience. However, when relationships with friends replaces that of parents, low resilience results. Finally, this study supports the need for further studies on the validity and acceptability of the PPS-10 and CES-D scales in the South African context.