Thesis (MA (Psychology))--Stellenbosch University, 2008. / South Africa’s violence and injury death rates pandemic are steadily growing. Global estimates reported by the World Health Organisation (2000) have revealed that there is an increase in worldwide deaths. Approximately 5 million people die as a result of injuries each year and hundreds of thousands more are left physically or psychologically scarred (World Health Organisation, 2000). There are alarmingly high incidences of violence, crime and injury deaths in South Africa and the impact of these injury fatalities is imposing an immense burden on government, communities, families and even individuals. The burden of fatal injury mortalities has not fallen evenly. In South Africa, low socio-economic communities have borne the brunt of this epidemic. This study presents a focus on mortality and injury patterns and emerging problem areas for children and youth in a peri-urban setting. The aim of this study was to provide an overview of the fatal injury mortality and suicide data of children and youth in the Stellenbosch district, in order to develop a comprehensive understanding of the problem areas of injury deaths such as the main causes and consequences and age, sex, race and other pertinent comparisons. The study also aimed to consider the impact and relationship between alcohol abuse and youth injury deaths. Mortuary data were compiled from 591 children and youth cases for the period 2001-2005 in the Stellenbosch district using the National Injury Mortality Surveillance System data form. The present study highlighted several key findings. Transport-related deaths were indicated as a serious cause for concern among both children and youth in peri-urban settings. The importance of specific road safety awareness initiatives within peri-urban areas and among specific age groups were also indicated. Violence-related deaths were determined to be a leading cause of death among the older age groups in the youth category, with sharp force objects being the leading external cause of violent deaths. This highlighted an additional key finding reporting that sharp force objects death are a more serious cause for concern than firearm deaths in peri-urban areas, which challenges previous urban data. vi Burns and drowning were indicated as pertinent cause of unintentional deaths among both children and youth within peri-urban areas. This was suggested to be due to the high use of paraffin enabled heating systems in house in peri-urban areas and the lack of safety surrounding materials such as matches in the home. In addition, suffocation deaths among infants were also identified as a concern. Furthermore, the link between alcohol abuse among the youth age group was indicated by a key finding that alcohol is a prominent risk factor for fatal injury mortalities among youth. However more studies are needed to explore the effects and risks of other substances on youth fatal injury deaths. Several implications of the research findings are identified for health care professionals, policy developers, government departments and non-government organisations to consider in reducing the mortality rates of children and youth. These implications are critical in informing preventative interventions and initiatives aimed at enhancing safety to children and youth living in peri-urban areas within South Africa. vii

Context: There are two ways that digital media may influence alcohol use. The first is commercial alcohol marketing. The second is user-created alcohol promotion, defined as content distributed through new media that promotes consumption, but independent of commercial marketing. This thesis explores how both types of content promote alcohol, what association there is between exposure and alcohol-related attitudes and behaviour, and the differences between marketing and user-created promotion. Method: A mixed method design was employed, divided into two studies. The first was a content analysis of the design features, topical references, and messages suggested about alcohol in digital marketing and user-created promotion on Facebook, Twitter, and YouTube. The second was a cross-sectional survey with young adults (n = 405). This measured awareness of, and participation with, digital marketing and user-created promotion, and the association with consumption, higher-risk drinking, brand recall, expectancies, and drinking motives. Results: The content analysis found that digital marketing had personalised designs which contained subtle and positive messages about consumption, whereas user-created promotion had simpler designs, displayed little ethical practice, and contained overt messages about higher-risk drinking. The cross-sectional survey found that young adults were aware of, and participating with, both digital marketing and user-created promotion, with exposure greater for the latter. Exposure to both types of content was positively associated with alcohol use, higher-risk consumption, and drinking intentions. User-created promotion had a stronger association with all outcomes than marketing. The association between exposure and consumption, for both types of content, was mediated through drinking motives and expectancies. Conclusion: Young adults are aware of, and participating with, a range of digital marketing and user-created promotion. That such exposure is associated with alcohol-related attitudes and behaviour highlights the potential of new media to influence alcohol consumption. Further research is required to better understand young people’s experience with digital media and the challenges of addressing online health risk messages.

MPH / Department of Public Health / The abuse of substances among the youth is a global health problem which has a negative impact on their health and wellbeing, families, educational and professional life, as well as communities and limits their hopes and dreams. An estimated 246 million persons globally (about one out of twenty people) between 15 and 64 years have abused substances in the past three years. The global drug problem has increased to such an extent that more than 1 out of 10 drug abusers is affected by either disorder or drug dependence. The aim of the study was to explore the factors contributing to substance abuse among the youth in Atteridgeville, Tshwane Metropolitan Municipality. The study was conducted in Atteridgeville community. Atteridgeville is a portion of the City of Tshwane Metropolitan Municipality, west of Pretoria in South Africa. The design was qualitative in nature, using exploratory design. The researcher purposively chose the participants from the target population. The population and sampling method was on participants aged between 15 and 35 years, with substance abuse problem, who were referred to Atteridgeville Medical Health Centre for counselling. The researcher used a semi-structured interview guide for gathering data. In-depth interview was used to collect data. A proposed total of number of 20 participants was suggested, and it was guided by data saturation. Data was analysed by using thematic content analysis. A measure of trustworthiness was ensured. Ethical consideration was observed in this study. The findings states that substance abuse problem was identified and certainly noticed by everyone in the community. New drugs remain unchallenged, drug dealers are known, yet, not a single law enforcement institution attempt to raid their houses to search and arrest them. Community involvement is not enough to end the scourge of substance abuse problems in the community. Some police officers were identified and known to be part of drug dealings or have family relatives who are drug dealers. The researcher therefore recommends that parents should be involved in the community forums to deal with substance abuse problems. The community policing and law enforcement should be equipped by developing a tactical team specifically looking at the drug problems in the local communities. In conclusion, the research revealed that, South African citizens are people who see a problem happening but lacks to implement strategies to deal it immediately. / NRF

Indiana University-Purdue University Indianapolis (IUPUI) / Research in the alcohol preferring (P) rat has indicated that peri-adolescent alcohol (EtOH) consumption enhances the acquisition of oral operant EtOH self-administration, inhibits the extinction of responding for EtOH, augments EtOH-seeking behaviors, and increases relative reward value of EtOH during adulthood. Experiment 1 was conducted to determine if these adult effects of peri-adolescent EtOH intake could be observed using an Intracranial Self-Administration (ICSA) model. It was hypothesized that an increased sensitivity to the rewarding actions of EtOH would be manifested in peri-adolescent-EtOH-exposed subjects compared to naive subjects when the opportunity to self-administer EtOH to the posterior ventral tegmental area (pVTA) is available in adulthood. The pVTA is a primary site for EtOH’s reinforcing and rewarding properties in the mesolimbic dopamine (DA) system. Experiment 2 was a dose-response examination of the effects of EtOH administered to the pVTA on downstream DA efflux in the nucleus accumbens shell (AcbSh) via a joint Microinjection-Microdialysis (MicroMicro) procedure. Male P rats were given 24-h free-choice exposure to 15% volume/volume EtOH from postnatal day (PD) 30 to PD 60, or remained experimentally naive, with ad lib food and water. By the end of the periadolescent exposure period, average consumption was 7.3 g/kg/day of EtOH. After PD 75, periadolescent-EtOH-exposed and naïve rats were either implanted with an injector guide cannula aimed at the right pVTA for ICSA (Experiment 1), or two cannulae, one aimed at the right pVTA (injector) and one at the ipsilateral AcbSh (microdialysis) for MicroMicro (Experiment 2). Following one week of recovery from surgery, ICSA subjects were placed in standard two-lever (active and inactive) operant chambers. Test sessions were 60 min in duration and occurred every other day for a total of 7 sessions. Rats were randomly assigned to one of 5 groups (n=4-9/group) that self-infused (FR1 schedule) either aCSF (vehicle, 0 mg%), 50, 75, 100, or 150 mg% EtOH during 4 sessions, aCSF only for sessions 5 and 6 (extinction), and the initial concentration again for session 7 (reinstatement). MicroMicro subjects received six days of recovery from surgery, probe implantation the day before testing, and then continuous microdialysis for DA with 15 min microdialysis samples collected before, during, and then two hrs after 10-min pulse microinjection of either aCSF (vehicle, 0 mg%), 50, 75, 100, or 150 mg% EtOH. Neither EtOH-exposed nor naive groups of P rats self-infused the aCSF or 50 mg% EtOH concentration. While the naive group did not self-infuse the 75 or 100 mg% EtOH concentrations, the peri-adolescent EtOH-exposed group of P rats did readily discriminate the active lever from the inactive lever at these concentrations. Both groups self-infused the 150 mg% EtOH concentration. Pulse microinjections of EtOH during the MicroMicro procedure revealed that 75 and 100 mg% concentrations of EtOH increased downstream DA in the AcbSh of EtOH-exposed, but not naïve, subjects. 150 mg% EtOH increased downstream DA in both adolescent treatment groups. Overall, the results indicate that consumption of EtOH by P rats during peri-adolescence increases the reinforcing properties of EtOH in the pVTA in adulthood. The results also indicate that there were differential effects of peri-adolescent EtOH exposure on DA efflux in the AcbSh. This provides evidence that peri-adolescent EtOH-exposure produces long-lasting alterations in neural circuitry involved in EtOH-reinforcement, during adulthood.

Indiana University-Purdue University Indianapolis (IUPUI) / Abuse of alcohol during adolescence continues to be a problem, and it has been shown that earlier onset of drinking predicts increased alcohol abuse problems later in life. High levels of impulsivity have been demonstrated to be characteristic of alcoholics, and impulsivity has also been shown to predict later alcohol use in teenage subjects, showing that impulsivity may be an inherent underlying biological process that precedes the development of alcohol use disorders. These experiments examined adolescent drinking in a high-drinking, relatively impulsive mouse population, and assessed its effects on adult drinking and adult impulsivity. Experiment 1: Selectively bred High-Alcohol Preferring (HAP II) mice, which are shown to be highly impulsive, were given either alcohol (free choice access) or water only for two weeks during middle adolescence or adulthood. All mice were given free choice access to alcohol following 30 days without access, in adulthood. Experiment 2: Adolescent HAP II mice drank alcohol and water, or water alone, for two weeks, and were then trained to perform a delay discounting task as adults to measure impulsivity. In each experiment, effects of volitional ethanol consumption on later behavior were assessed. We expected adolescent alcohol exposure to increase subsequent drinking and impulsivity. Adolescent mice consumed significant quantities of ethanol, reaching average blood ethanol concentrations (BECs) of 142 mg/dl in Experiment 1 and 108 mg/dl in Experiment 2. Adult mice reached average BECs of 154 mg/dl in Experiment 2. Mice pre-exposed to alcohol in either adolescence or adulthood showed a transient increase in ethanol consumption, but we observed no differences in impulsivity in adult mice as a function of whether mice drank alcohol during adolescence. These findings indicate that HAP II mice drink intoxicating levels of alcohol during both adolescence and adulthood, and that this volitional intake has long-term effects on subsequent drinking behavior. Nonetheless, this profound exposure to alcohol during adolescence does not increase impulsivity in adulthood, indicating that long-term changes in drinking are mediated by mechanisms other than impulsivity. Importantly, this research demonstrates that the HAP II mouse is a good candidate for a model of heavy adolescent alcohol consumption.

The study aimed at investigating the impact of alcohol on the sexual behaviour of male adolescents, with the purpose of establishing whether a relationship exists between alcohol use and risky sexual behaviour (i.e. multiple partners, unprotected, and unplanned sex) by adolescent males. Data was collected by means of an anonymous, self-administered questionnaire. The sample consisted of 176 male high school learners, aged between 14 and 25, from one school in the Nkonkobe Municipality, Eastern Cape Province. The Statistical Package for Social Sciences (SPSS) was used to obtain data analyses which included descriptive statistics and cross-tabulation (with specific reference to Chi-square analysis), and all procedures were performed at 0.05 level of significance with 95% Confidence Interval. A relationship between alcohol use and risky sexual behaviour was found to exist. A statistically significant correlation was found in support of the alcohol/risky sex hypothesis. Another significant finding was the increase noted in safer sex practises among adolescents. Finally, the findings were correlated to implications.

Indiana University-Purdue University Indianapolis (IUPUI) / The objective of this research is to examine the development of the California alcohol outlets over time and the relationship between neighborhood characteristics and densities of the alcohol outlets. Two types of advanced analyses were done after the usual preliminary description of data. Firstly, fixed and random effects linear regression were used for the county panel data across time (1945-2010) with a dummy variable added to capture the change in law regarding limitations on alcohol outlets density. Secondly, a Bayesian spatio-temporal Poisson regression of the census tract panel data was conducted to capture recent availability of population characteristics affecting outlet density. The spatial Conditional Autoregressive model was embedded in the Poisson regression to detect spatial dependency of unexplained variance of alcohol outlet density. The results show that the alcohol outlets density reduced under the limitation law over time. However, it was no more effective in reducing the growth of alcohol outlets after the limitation was modified to be more restrictive. Poorer, higher vacancy rate and lower percentage of Black neighborhoods tend to have higher alcohol outlet density (numbers of alcohol outlets to population ratio) for both on-sale general and off-sale general. Other characteristics like percentage of Hispanics, percentage of Asians, percentage of younger population and median income of adjacency neighbors were associated with densities of on-sale general and off sale general alcohol outlets. Some regions like the San Francisco Bay area and the Greater Los Angeles area have more alcohol outlets than the predictions of neighborhood characteristics included in the model.