Malawi enacted the Gender Equality Act (GEA) in 2013 to address gender inequality and promote sexual health and rights. The question the thesis addresses is whether the GEA itself an artefact of the very culture it would want to transform, could contribute to the transformation of social norms to improve the sexual health trajectories of adolescents. The thesis employs a hybrid approach to addressing the question, using a legal doctrinal methodology in combination with a feminist poststructural methodology of discourse analysis. The important assumption the thesis makes is that the GEA is part of a broader framework of discourse. The GEA as discourse draws upon prevailing discourses that shape people’s experience of sexuality. This is a challenge because the GEA’s conceptualisation of gender inequality and its implementation is influenced by the prevailing dominant gender discourses. The thesis explains what it means for the GEA to influence social change. It explores the possibilities of it creating a radical world in which society recognises adolescents as social actors and agents who play a role in constituting their gendered and sexual worlds. Enabling the GEA to be transformational requires policy actors to interpret and implement the GEA to open new possibilities for adolescents. Only then can the GEA transcend its existential predicament of itself being an artefact of cultural discourse. / Thesis (LLD)--University of Pretoria, 2020. / Private Law / LLD / Unrestricted

Magister Public Health - MPH / Despite the known benefits of adolescents knowing their HIV status, parents and caregivers (PCG) often delay the disclosure of their children’s HIV status to them due to the fear of stigma and discrimination, the belief that the child thinks they will die, and the lack of disclosure skills. This delay can affect the children’s adherence to treatment, physical health, mental health and can enable unknowing transmission. The Mini Flipster Disclosure Method (MFDM) was developed to assist healthcare workers (HCWs) in supporting the disclosure of an adolescent’s HIV status by their parent or caregiver. This involves a process of educating the child or adolescent about HIV and how it can be successfully managed before informing them that they have HIV. The current study described the experiences of HIV-positive adolescents of the MFDM and those of their caregivers and HCWs in Mpumalanga.

Type 1 diabetes is an autoimmune disease that involves destruction of pancreatic cells that produce insulin. The disease typically presents in children and adolescents. The burden of disease management, fear of complications, and disruption of normal childhood that the disease causes place youth with type 1 diabetes at increased risk for developing depression compared to peers without the disease. The presence and severity of depression correlates with disease outcomes. Use of continuous subcutaneous insulin infusion pumps has been shown to improve youth’s quality of life compared to use of multiple daily insulin injections. Although quality of life measures are associated with the risk of developing depression, no studies have compared depression symptomatology in youth using insulin pumps to those using multiple daily insulin injections. The proposed project will assess relative depression symptomatology in youth ages 10-17 using insulin pumps and multiple daily insulin injections. The results of this proposed project could help inform clinicians’ decisions about whether to initiate type 1 diabetes therapy in youth with either insulin pumps or insulin injections. Given the financial burden of depression, it could also potentially encourage insurance companies to increase coverage of insulin pumps.

Intuitive eating assesses the degree to which individuals eat based on physiological cues rather than emotional or situational cues. The Intuitive Eating Scale was initially developed using college women. This study extends the work of Tylka and reports on the psychometric evaluation of the Intuitive Eating Scale (IES) in a sample of 515 middle school boys and girls. Exploratory factor analysis uncovered 4 factors: unconditional permission to eat, eating for physical rather than emotional reasons, trust in internal hunger/satiety cues and awareness of internal hunger/satiety cues; confirmatory factor analysis suggested that this 4-factor model adequately fit the data after 4 items with low factor loadings were deleted. Supporting its construct validity, IES scores were negatively related to body mass index, body dissatisfaction, negative affect, pressure for thinness, and internalization of the thin ideal, and were positively related to satisfaction with life, and experiencing greater positive affect.

Most people experience Sweden as a secular country, which could cause problems for Christian adolescents at school. The secular society has become the new normal for many people which results in Christian adolescents often having to defend themselves and their beliefs at school when questioned by their non-Christian peers. We interviewed seven people who wanted to share their experiences from their adolescence. The purpose of the study is to examine how Christian adolescents experience attendance at a non-religious school in a secular country. The theoretical framework from which the analysis is drawn upon is the theory of Socialisation Process by Peter Berger and Thomas Luckmann and the concept of Stigma by Erving Goffman. The results demonstrate there is vulnerability in being a Christian at school in a secular country. Some participants reported that they might be less active in the church during their adolescence. They also reported an unwillingness to discuss their faith with non-Christians when questioned. Several of the respondents describe a qualitative difference between the friends who shared their beliefs and the friends who didn´t. To a large extent the friendship between those who have shared beliefs remains to this day.

Learner mobility and active school travel (AST) has been proposed to improve school attendance and academic performance. In South Africa, approximately 86% of learners have been reported as walking to and from school. AST in Africa is becoming less common in urban areas, and this may be a contributing factor to the increased risk and frequency of noncommunicable diseases due to decreased physical activity. The aim of this wait-list controlled evaluation was to assess the physiological and cognitive changes of access to a bicycle versus walking on adolescents. Specifically, changes adolescent's physical activity levels and executive function in a South African low-income community. Two schools were recruited, with the evaluation school receiving bicycles and the control a school who were yet to receive bicycles. Significant differences were observed across the physiological and executive function assessments. Most notably in the executive function tests, the evaluation group showed significant time to completion decreases across all three tests (N-Back, Arrow Flanker, WCST: p< 0.001). The results from this study are significant, as they are the first to assess anthropometric, physiological and executive function in South African adolescents from low-socioeconomic regions. It is evident that there are potential improvements in working memory, inhibition and shifting due to cycling as a mode of AST or during leisuretime. Further research needs to determine the specific mechanisms associated with these improvements.

Adolescent alcohol consumption is a topic that has been well-researched to date due to the dangers it can pose. A variety of factors may work to contribute to the habits these adolescents develop. One factor that has not been extensively studied is the impact of locations on drinking decisions. Location provides a perspective on how various social factors can intersect to dictate where and when young people will choose to consume alcohol. Most previous literature has focused on the alcohol usage found at parties or bars, but the current research wishes to expand this idea to other locations, such as a friend’s house and the school setting. By identifying these locations and seeking to determine whether various factors impact drinking choices, we can better understand the problem. The current study did so by utilizing data from the Monitoring the Future (MTF) Project. Results revealed that certain locations were more common than others, and that some demographic and social characteristics may influence this fact. Results are discussed, as are limitations and suggestions for future research.

The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the prevalence of psychopathology and level of behavioral symptomatology in incarcerated youth versus youth receiving community mental health services or hospitalization. We randomly recruited youth from middle South Carolina served by a local CMHC (n = 60), youth served by the state adolescent inpatient program (n = 50), and youth in the S.C. Dept. of Juvenile Justice facilities from the same region (n = 75). We used the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and the CBCL and YSR to evaluate behavioral symptomatology. On the DISC, incarcerated youth had significantly higher mean number of diagnoses and symptoms than CMHC youth, but lower numbers than hospitalized youth. Level of "caseness" (at least one diagnosis) was 86% in hospital youth, 72% in incarcerated youth, and 60% in CMHC youth. The groups differed in CBCL mean total T, internalizing T, and externalizing T scores as well as mean YSR internalizing T scores. Our results indicate the comparability in level of psychopathology in incarcerated and community-treated populations of youth, and the need to develop diversionary programs to prevent the entry of such youth into the juvenile justice system.

This paper examines the role that group psychotherapy plays in promoting the development of identity in adolescents who are diagnosed with Attention Deficit Disorder with Hyperactivity (ADHD). Negotiating identity issues is the central task of adolescence (Erikson, 1950). It is also one of the most difficult periods for ADHD adolescents because of their innate and learned sensitivities to the experience of shame. Shame is the feeling we have when we evaluate ourselves using the standards of valued others and of society and determine that we do not meet those standards (Lewis, 1992). Group psychotherapy thus becomes the treatment of choice for adolescents diagnosed with ADHD because the process of group psychotherapy addresses the issues of identity and shame in a way that individual therapy is unable.

Purpose: The current study was conducted to ascertain whether the effects of nativity (i.e., U.S. born vs. immigrant) on Hispanic adolescent substance use is mediated by ecological processes such as family functioning, school connectedness, and perceived peer substance use. Methods: The effects of family, peer, and school processes on adolescent substance use were examined in a nationally representative sample of 742 (358 male, 384 female) Hispanic youth (mean age = 15.9; SD = 1.8). Results: Results from a structural equation model indicated that the higher rates of substance use among U.S.-born Hispanics (compared with foreign-born Hispanics) are partially mediated by perceived peer substance use (as measured by the adolescent). The results also showed that perceived peer substance use and school connectedness mediate the relationship between family processes and substance use, suggesting that family processes may offset some of the deleterious effects of negative peer selection on adolescent substance use. Conclusion: These findings imply that public health behavioral interventions to prevent substance use among both U.S.-born and foreign-born Hispanics may need to attend to multiple ecological processes, including family, school, and peers.