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Objective: The purpose of this dissertation was to examine which student- and school-level factors differentiated (1) susceptible never smokers from non-susceptible never smokers, (2) experimental smokers from never smokers, and (3) current smokers from experimental smokers among a nationally representative sample of Canadian students in grade 9-12. Methods: Student-level data from Canada???s nationally representative 2008-2009 Youth Smoking Survey (2008 YSS) were linked with school-level data from the 2006 Census, and one built environment characteristic, and examined using multi-level logistic regression analyses. Results: Overall as hypothesized in these three studies, student-level and school-level characteristics were associated with smoking susceptibility among never smokers, experimental smoking and current smoking. The likelihood of susceptibility among never smokers (P=0.0002), experimental smoking (P<0.0001) and current smoking (P<0.001) significantly varied across schools. This study identified that attending a school in an urban (AOR=0.62; 95% CI 0.46-0.82) setting or in a high socioeconomic status (SES) neighbourhood (AOR=0.88; 95% CI 0.79-0.98) was inversely associated with odds of a student being an experimental smoker (versus a never smoker) when adjusting for student-level characteristics. The number of tobacco retailers located within a 1-km radius of each school was associated with the odds of a student being a current smoker (versus an experimental smoker) (AOR 1.03; 95% CI 1.01-1.05) and also associated with a student being a susceptible never smoker (versus a non-susceptible never smoker) (AOR 1.01; 95% CI 1.00-1.02) when adjusting for student-level characteristics. Additionally, several student-level intrapersonal and social context characteristics were associated with smoking susceptibility, experimental smoking and current smoking. Conclusions: This study showed that the characteristics of the school a student attends may increase their likelihood of a student being in any of the smoking stages that were examined. Additionally, several student-level factors were also associated with the three smoking stages. Understanding these factors will provide more insight to guide stakeholders interested in developing anti-tobacco strategies that are responsive to the risk and protective factors of adolescents in different smoking stages.

Importance: Childhood and adolescent overweight and obesity have more than tripled over the past two decades. Bariatric surgery is becoming more common for adolescents. Currently, there are few studies that describe outcomes after bariatric surgery in adolescents and no studies that describe nutritional behaviors that predict sustained weight loss in this population post-surgery. Objective: To describe pre-surgery dietary intake in adolescents who underwent a sleeve gastrectomy between 2011 and 2013 at an outpatient pediatric weight loss clinic. This study specifically aims to determine whether there is a correlation between fruit and vegetable intake before surgery and weight loss post-surgery in adolescents. Design, Setting, and Participants: The participants in this study received the sleeve gastrectomy procedure. Patients were between the ages of 13-17 years old and had a BMI between 35 kg/m2 to 60 kg/m2. All patients had undergone extensive counseling and assessment by a team of medical professionals (pediatrician, psychologist, exercise physiologist, nurse, and dietitian) for at least six months before surgery. Weekly number of servings of fruits and vegetables, cups of sweetened beverages (separated as fruit juice or soda), servings of fried foods eaten, and meals eaten from or at restaurants as reported at the initial consultation were collected and analyzed. Results: The mean age of participants (n=11) was 17.1 ± 1.51 years. Mean servings of vegetables consumed at baseline was 7.32 ± 4.38 servings per week and mean weekly consumption of fruits was 6.0 ± 4.16 servings per week. There were no statistically significant correlations between baseline fruit (p = 0.50) and vegetable (p = 0.44) consumption with weight (kg) lost six months after surgery. Conclusion: While the relationship between fruit and vegetable consumption with weight lost six months post-surgery failed to reach significance, there was a trend such that patients who consumed more servings of fruits and vegetables at baseline had lost more weight at 6 months. It is interesting to note that none of the patients in the study consumed the recommended daily servings of fruits or vegetables at baseline in accordance with the USDA guidelines. A longer study may reveal a more significant relationship between dietary patterns before surgery and changes in weight after surgery.

While there is a vast amount of research focusing on the importance of school connectedness for short-term outcomes related to alcohol use, few studies have looked at the longer-term consequences of poor school connectedness. The aim of the current study was therefore to investigate the gender-specific association between school connectedness (1966) and alcohol- related hospitalization in adulthood (1973-2007). Moreover, the role of adjustment problems in adolescence was examined. Logistic regression analysis was based on a cohort of Swedish children, born in 1953 in Stockholm, Sweden, including 6,269 males and 6,106 females. The results revealed a statistically significant relationship between having a lower level of school connectedness in childhood and an increased risk of hospitalization due to alcohol misuse in adulthood, among males. The findings for females were less conclusive. Controlling for socioeconomic background and adjustment problems in adolescence reduced the strength of the association but did not explain it. In sum, this study shows that school connectedness appear to have long-term consequences for alcohol-related diseases, but further research is needed to understand the mechanisms behind this finding.

Healthy spiritual development of adolescents is lacking in our society. Research shows that the topic of spiritual development for adolescents has been neglected for some time. It is clear from Scripture that spiritual development needs to take place in the life of a believer and that it is in fact an ongoing process. Even though spirituality has not been classified as something scientific during the modern era, spirituality has made its way back in scientific circles. The scientific disciplines of sociology and psychology have indicated that adolescents have a need for spiritual development and that spiritual issues are important to them. However, adolescents of the twenty-first century also face some unique challenges that have an impact on their spiritual development. Both the quantitative and qualitative methods of research were used and it was clear from both these studies that there were certain areas with regard to spiritual development that needed attention. The results in particular showed that the majority of those adolescents who took part in the research did not spend enough time on spiritual practices and most of them have taken part in some form of risky behaviour. The overall influences from family, friends and youth leaders were positive and in general it seemed that the majority of adolescents who took part in the research had a good relationship with parents and youth leaders. Adolescents need help in their spiritual development and according to Scripture parents and youth/church leaders have the responsibility to assist them. Guidance was given to adolescents and to major role players in their lives to assist them in the process of spiritual development. / Thesis (MA (Pastoral Studies))--North-West University, Potchefstroom Campus, 2013

This study aims to investigate the perception and experience of emotion self-regulation in a group of late adolescents. An exploratory, qualitative survey design was used to collect data from a group of 54 Afrikaans-speaking late adolescents by means of a semi structured emotion self-regulation questionnaire. Data were assessed by means of directed thematic content analysis (Hsieh & Shannon, 2005). It was established that participants primarily have a positive perception of emotions, and that more participants display higher levels of emotion awareness. However, despite this, most participants experience emotions negatively. At most, therefore, a balance is struck between the constructive and unconstructive handling of emotions. Throughout it was endeavoured to relate the results to late adolescence as a developmental stage. Study conclusions include that emotion self-regulation in late adolescents is strongly influenced by uncertainty about the handling of emotions, self-consciousness with regard to emotions in a social context, and a lack of self-control. A few recommendations are made on the basis of these conclusions. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2008.

The aim of the research was to explore the relationship between the use of SMS communication by adolescents and their perceived feelings of loneliness. The SMS seems to be the new communication medium for young people as they are most comfortable with and enthusiastic about this technology and its applications. The adolescent stage is characterised by the building of own social networks, the definition of boundaries between themselves and parents, self-presentation constructed on a social stage in relation to others and characterised by the development of romantic attachments, feelings of anxiety, self-esteem development and maintenance which may result in feelings of isolation and loneliness. Loneliness can be defined as an emotional and cognitive reaction to having fewer and less satisfying relationships than one desires. This includes the absence or self-perceived absence of satisfying social relationships and the unpleasant experience that occurs when a person's network of social relations is deficient in some important way. The motivation for this research was to get insight into the relationship between the use of SMS communication and loneliness in the South African context. An internet search on the 13th February 2006 indicated that no research has yet been done on the relationship between the use of the SMS and loneliness of adolescents in South Africa. An availability sample was used. One hundred and seventeen Grade 11 and 12 learners from two schools in the North West Province participated in the research project. An explanatory cross-sectional survey design with features of qualitative data analysis was used in this investigation. Three methods were used to obtain data, namely the UCLA Loneliness Scale (Version 3), Satisfaction with Life Scale as well as a self-compiled questionnaire. After scoring the UCLA scale the researcher determined which of the participants had the highest level of loneliness and the lowest level of loneliness. Two groups were chosen, each consisting or 15 learners, according to the highest and lowest scores on the loneliness scale respectively. These two groups represented the top and bottom 14% of the sample. The data obtained from the self-compiled questionnaire and Satisfaction with Life scale were qualitatively compared. Analysis of the data indicated that there might be a relationship between the experience of loneliness and the following: gender; number of siblings; involvement in romantic relationships; amount of money spent on bill (financial constraints); quantity of SMS messages sent and received; need to stay in contact with friends over the weekend; reasons for sending SMS messages; feelings regarding sending or receiving SMS messages; feelings regarding no response to SMS messages; feeling with regard to not receiving SMS messages from a friend for a long time; initiating of friendships via cellphone and the SMS rather than face-to-face communication. Suggestions for future research projects were made. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2007

Adventure based experiential learning programmes (AEPs) are certainly nothing new (Louw et al., 2007). Its inception can be traced back as far as Plato after which it was revised as a result of the contributions of Kurt Hahn, the German educationalist and organisations such as Outward Bound (Hattie et al., 1997). The positive contribution to personal- and life effectiveness as a result of participation in AEPs and which adventure enthusiasts have laid claim to, has been in existence since the start of Outward Bound in 1942 (Neill, 2000:3). Witt and Crompton (1996) further emphasised value of AEPs by stating that they are internationally recognised as a scientific method that assist in developing the life effectiveness of adolescents and adults. One of the most critical challenges for adventure based experiential learning organisations in the 21st century is the development of applicable AEPs for less privileged groups, according to Neill and Flory (2000a). High school pupils in this day and age pose much bigger challenges to educational institutions. They are more diverse in terms of age, race, socio-economic status, culture, sex, stability, attitudes and values (Upcraft, 1993). To adhere to the above mentioned challenges Kimball and Bacon (1993) recommend AEPs that take place in nature as this serves as a therapy for the gaps in the current educational- and community systems. The purpose of this study was to obtain scientific information regarding the contribution of an adventure based experiential learning program (AEP1) to the improvement of the life- and personal effectiveness of black high school pupils, specifically in light of the current transformation- and empowerment processes. Black high school students were specifically used in this study because no results regarding their participation in AEPs have been found in South Africa. The results of this study will deliver important scientific information regarding this topic, especially in light of the current focus on transformation and empowerment. The test subject consisted of an experimental- (20 boys and 20 girls) and a control group (20 boys and 20 girls) aged between twelve and seventeen years with an average age of 14.5. The experimental group participated in a five day AEP in the Vredefort Dome in the North West province. The study is conducted in the form of a quantitative pre-test post-test design (Thomas & Nelson, 1996:321-322). The questionnaires were administered before, directly after and six months after the initial evaluation to determine the immediate and long term effect thereof. To measure life effectiveness, use was made of the Life Effectiveness Questionnaire (LEQ-H) (Neill et al., 1997:6) with a Cronbach Alpha-value of between 0.78 and 0.93 to measure the development of life effectiveness of the group. The instrument focuses on psychological and behavioural aspects that are key components of life effectiveness. The LEQ-H consists of 24 questions and assesses the following dimensions: achievement motivation, active initiative, emotional control, intellectual flexibility, self confidence, social competence, task leadership and time management. The results yielded an overall intra-group effect size of d= 0.03 in the short term and a negative effect size of d=-0.03 in the long term. The inter-group results, however, yielded an overall small effect size of d=0.35 in the short term and a medium effect size of d=0.49 in the long term. The overall results obtained indicate that an AEP had a significant intergroup short- and long term effect on the life effectiveness of black high school pupils but it did not have a significant intra-group effect. The hypothesis regarding the positive, immediate and long term effect of the AEP on the life effectiveness of black high school pupils was thus rejected. Albeit that the life effectiveness of black high school pupils did not necessarily improve as a result of the AEP, it is important to note that the socio-economic environment as well as the family structures of the participants seems to have had an impact on the outcome of the study. Furthermore, the fact that the questionnaires were not in their home language, could also have impacted on the results. To measure personal effectiveness, use was made of the Review of Personal effectiveness and Locus of Control (ROPELOC) with a Cronbach Alpha-value of between 0.79 and 0.93 (Richards et al., 2002:1-4). The ROPELOC consists of 45 questions and is made up of six major components with sub-constructs namely personal abilities and beliefs (self-confidence, self-efficacy, stress management, open thinking), social abilities (social effectiveness, cooperative teamwork, leadership ability), organisational skills (time management, quality seeking, coping with change) active. The difference can be determined with regard to the main components as well as the underlying subcomponents. The results yielded an overall small intra-group effect size of d=0.28 in the short term and a small effect size of d=0.42 in the long term. The inter-group results yielded an overall medium effect size of d=0.54 in the short term and a large effect size of d=0.87 in the long term. The overall results obtained indicate that an AEP had a significant short- and long term effect on the personal effectiveness of black high school pupils. The hypothesis regarding the positive, immediate and long term effect of the AEP on the personal effectiveness of black high school pupils was thus accepted. It is thus recommended that AEPs be utilized to improve personal effectiveness of black high school pupils in South Africa. / Thesis (Ph.D. (Recreation Science))--North-West University, Potchefstroom Campus, 2009.

South African adolescents are at high risk of becoming victims of sexual abuse. However, research and experience by practising social workers show that adolescents are reluctant to report sexual abuse immediately. This could be due to the lack recognised guidelines available by which to report abuse and receive the necessary help. The purpose of the research was to investigate the reasons why adolescents fail to report sexual abuse in order to establish relevant guidelines. This would also determine the role of the forensic social worker in the report of sexual abuse by adolescent victims. The research followed a combined quantitative and qualitative approach. 220 adolescents from two high schools and six Welkom social workers were involved in the investigation. Both groups of participants completed questionnaires while the social workers were also involved in a focus group. Forensic social workers work is a new field of specialisation in the social work profession. There is a serious misconception about the role of the forensic social worker not only among other practising social workers, but also among the general public and adolescents in specific. The forensic social worker can play an important role in establishing guidelines for the report of sexual abuse by adolescent victims. The findings clearly showed that adolescents do not report sexual abuse within the family. The abused adolescent becomes a victim as South Africa does not yet have definite guidelines available for the report of sexual abuse. The study found that the forensic social worker has a definite role to play in the report of sexual abuse by adolescents. / Thesis (M.A. (MW Forensic))--North-West University, Potchefstroom Campus, 2009.

Adolescence proves to be one of the most vulnerable development stages in the life of humans and therefore dietary assessment of this group is important, but complex. This is due to rapid growth during puberty and the development of new eating patterns that influence dietary intake. Adequate dietary intake in this age group is crucial, since adverse effects such as iron deficiency anemia, inadequate growth and dental caries can occur. Furthermore, dietary imbalance is a significant risk factor that can lay the groundwork for developing preventable complications in late adolescence and adult life such as non-communicable chronic diseases including obesity and diabetes mellitus type II and certain cancers, all leading causes of morbidity and mortality. Given the vulnerability of adolescents in terms of dietary intake, understanding their dietary intake is crucial. Dietary assessment of adolescents is influenced by social, physiological and psychological changes making accurate measurement of this group difficult. Hence, it is of fundamental importance to find a golden standard in terms of a dietary assessment method to use in this group. Several international studies investigated validity and reproducibility of the dietary intake of adolescents, measured with different dietary assessment methods. However, in South Africa only three validity and reproducibility studies have been published and none of them focused exclusively on adolescents. Since the validity of the results of dietary assessment methods of international studies cannot be extrapolated to South African black adolescents, this study emanated from the need to investigate whether multiple 24-hour recalls are valid and reproducible when used to assess the dietary intakes of black adolescents in a convenience sample of grade eight learners from a high school in a township in the North West Province. The study was nested in the multidisciplinary "Physical, Activity in the Young" (PLAY) study. Firstly, the optimal number of 24-hour recalls was determined by calculation of reproducibility coefficients for energy, selected nutrients and food groups. Results showed that four repeated 24-hour recalls provided the optimal reproducibility for black peri-urban South African adolescents. Secondly, the search for a reference method to compare energy intake against energy expenditure led to an investigation into basal metabolic rate equations and physical activity factors with the intention of estimating the energy expenditure. Validity of reported energy intake assessed by multiple 24-hour recalls and estimated energy expenditure was tested using the Pearson correlation coefficient and the dependent t-test. The Pearson correlation test revealed low associations between energy intake and energy expenditure for boys (0.32) and girls (0.17), while the dependent t-test of the energy intake between the different measured occasions showed little difference, which could be explained by the high within participant variation and lower variation between the different participants. The low correlation coefficients showed that there was no association between reported energy intake and mean estimated energy expenditure; thus also no agreement. As a result, multiple 24-hour recalls measured over two years with only five 24-hour recalls did not give a valid measurement of the energy intake of black peri-urban adolescents. Lastly, the ratio of reported energy intake over energy expenditure was evaluated against the energy cut-off points, specifically calculated for age and ethnic group. It indicated that 85% of the participants underreported their energy intake. These results could have been influenced by the estimated basal metabolic rate equations that could have estimated the basal metabolic rate of this group incorrectly or could be due to the inability of the group to recall their physical activity levels correctly. Therefore it is recommended that further validity studies regarding dietary intake need to be performed on adolescents. It is suggested that energy expenditure as a reference method should be measured by using a calorimeter or the doubly labeled water method and then compared with the reported energy intake. Analysing different biochemical determinants of nutritional intake could also be used as an objective reference method to assess the validity of dietary data obtained from questionnaires. / Thesis (Ph.D. (Dietetics)--North-West University, Potchefstroom Campus, 2009.