Technology is now the norm in our educational setting. The literature shows a vast increase in technology implementation and use both inside and outside the classroom over the past few decades. Overall, the studies show a balanced mix of positive and negative perspectives of using technology for educational purposes from students, teachers, administrators, as well as from outsiders. The literature also shows a mix of academic and social effects. Unfortunately, there is little known about how adolescents perceive their use of technology for enhancing their personal academic and social performance, two areas of developmental importance. Using mixed methods design, set in an urban junior high school in Northeast Texas,research questions addressed how much and how often technology is being used in the classroom, as well as specific ways it is being used, through educator surveys. This study also explored adolescent learners’ attitudes toward and opinions about using technology in the classroom, specific ways adolescent learners use technology for academic purposes both inside and outside the classroom, as well as how adolescent learners are engaging with peers through technology versus face-to-face, through independent interviews. Findings indicated that overall, the teacher reports align with the literature: technology is used in the classroom at a high frequency and duration, and there is a wide range of specific ways it is being used. Additionally, the majority of adolescent learners reported perceived benefits when using technology as an aid to one’s academic development. Adolescent learners expounded on the specific ways technology is being used both inside and outside the classroom. Adolescent learners also expounded on how they are engaging with peers through technology versus face-to-face, with the majority of adolescent learners claiming technology is not a perceived aid to one's social development nor is it commonly present when engaging with peers face-to-face. It is recommended that future studies look at any relevant differences between both males’ and females' specific technology use for both academic and social purposes. It is also recommended that future research be conducted on adolescents possibly multi-tasking with both academic and social technology use and any perceived effects of such behavior

Indiana University-Purdue University Indianapolis (IUPUI) / Objective: Investigate if the prevalence of depression/suicidality changed from 2001 to 2015 among adolescent females exposed to sexual assault or physical fighting, and if various violent exposures or the accumulation of events induced differential levels of risk. Methods: Eight national Youth Risk Behavior Surveillance (YRBS) cross-sectional databases (2001-2015) were analyzed using complex survey techniques. For the trends analyses, logistic regression was used to evaluate linear, quadratic or cubic trends, with contrast statement methods to identify inflection points. Multiple logistic regression models were built to understand associations with other risk factors. The 2015 database was used for the differential analyses and hypotheses were tested using logistic regression models. Results: There was a statistically significant decline in depression/suicidality from 2001 to 2009 followed by an incline through 2015 for sexual assault victims (P=0.0001) and physical fighters (P<0.0001). Bullying and electronic bullying contributed to increases in latter years. For sexual assault victims, methamphetamine use declined (2001-2015) and team sports participation increased (2009). For physical fighters, sexual assault and carrying a weapon had a similar quadratic trend. Among fighters the prevalence of other violent exposures (1+) was approximately 2 times greater than non-fighters (2001-2015) and exceeded 65% when accounting for bullying and electronic bullying (2011-2015). Differentiation of risk between various violent events was only observed for electronic bullying (OR=2.51; 95% CI=[2.02, 3.13]) vs. bullying (OR=1.43; 95% CI=[1.13, 1.79]) and victimization (OR 3.79; 95% CI=[3.33, 4.30]) vs. violence related behaviors (OR=2.31; 95% CI=[1.81, 2.96]). There was a positive dose-response relationship with the cumulative number of violent events, one event produced a risk of 1.40 (95% CI=[1.33, 1.48]) which increased with each additional exposure. Conclusions: The direction of depression/suicidality prevalence changes among sexual assault victims and physical fighters may be attributable to unique modifiable risk factors. The emergence of electronic bullying contributed to increases in depression/suicidality, poly victimization, and induced greater risk than bullying. The accumulation of violent exposures is seemingly a stronger predictor of depression/suicidality. Overall, efforts to reduce exposure across multiple or more prevalent forms of violence has the potential to reduce the risk of depression/suicidality among female adolescent victims and aggressors of violence. / 2 years

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MSc (Med), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand / Background 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.

Cyberbullying is one of the major problems of social networking sites, which has been known to have prolonged adverse psychological effects on social network users. Cyberbullying has been discussed a lot in the literature, but little research has been done on cyberbullying and its related factors. This study seeks to examine the factors influencing cyberbullying on Instagram among young adults. Instagram was chosen as a case study for the thesis because research shows that Instagram is the most preferred social networking site among the age cohort (18–30), who are popularly referred to as young adults. An extensive review of the literature was carried out, and six constructs (Instagram Usage, Vulnerability, Peer Pressure, Anonymity, and Instagram Features) were used to examine the influence of cyberbullying among young adults on Instagram. This study draws from the theory of routine activity theory (RAT), which is grounded on the postulation that criminal acts can be easily committed by any individual who has the opportunity. The researcher reviewed the process and deployed a methodological and concept-centric approach to create a comprehensive conceptual model that included key factors. This dissertation is different from most cyberbullying research in the sense that it reviews cyberbullying behaviours from the context in which they occur rather than the intent or motivation of the perpetrator. The model allowed a holistic examination of factors that influenced cyberbullying behaviours on Instagram. Using a survey methodology, over 201 Instagram users who are also students at the University of Cape Town completed an instrument measuring factor influencing cyberbullying. The researcher deployed Smart PLS, a statistical package for the social sciences, to test for reliability, validity and to analyse the entire dataset. The study critically examined the factors that influence cyberbullying among young adults. The results of this dissertation indicated that peer pressure and online vulnerability have a strong significance in cyberbullying behaviours. Surprisingly, Instagram usage had a weak correlation with cyberbullying behaviours. This study contributes significantly to the exciting research on cyberbullying as it helps identify the factors that contribute to cyberbullying behaviours. From this research, cyberbullying interventions or solutions can be accurately developed.

Substance use and substance use disorders (SUDs) pose a significant health and economic concern in the United States. Conditions and comorbidities exist that are associated with substance use onset, continuation, and outcomes. In the theory of Reinforcer Pathology, we can categorize these conditions into vulnerabilities, or factors that may be associated with susceptibility to substance use onset and poorer outcomes in substance use recovery. The theory of vulnerabilities and reinforcer pathology is tested through three investigations. The first investigation sought to establish the relationship between cumulative vulnerabilities and adolescent substance use in a cross-sectional analysis. The second investigation evaluates the temporal relationship of cumulative vulnerabilities and substance use among adolescents. The final investigation establishes the relationship of cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, these reports suggest that the intersection and cumulation of vulnerabilities to substance use and substance use disorders are directly related to substance use outcomes. Future research and reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns. / Doctor of Philosophy / Substance use and substance use disorders are a great health and economic concern in the United States. Conditions that are related to trying substances, using substances, and outcomes of this substance use. In the theory of Reinforcer Pathology, we can call these conditions vulnerabilities, or conditions that may be associated with the likelihood of starting to use substances and having poorer substance use outcomes in the long-term. Three studies investigate the theory of vulnerabilities and Reinforcer Pathology. First, the relationship between cumulative vulnerabilities and substance use among adolescents is assessed cross-sectionally or simultaneously. The second study examines the relationship between cumulative vulnerabilities and adolescent substance use over time. The third study examines the relationship between cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, the studies in this report suggest that the overlap and cumulation of vulnerabilities to substance use and substance use disorders is related to substance use outcomes. Future research and other reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns.

Acne is one of the most common skin conditions worldwide, affecting 80% of people between the ages of 11 and 30 with over $3 billion dollars spent annually on treatment in the United States alone. While the visible symptoms of acne (comedones and inflammatory lesions) are well-known, acne is more than skin-deep. Up to 85% of adolescents with acne will experience a negative psychosocial outcome related to their skin condition. The most common negative outcomes are anxiety, depression, body dysmorphic disorder, decreased self-esteem, and decreased quality of life. These comorbidities can be extremely detrimental if unrecognized and untreated; acne is the second-most common skin condition to end in suicide. One of the major difficulties in providing well-rounded care for the acne patient beyond their dermatologic needs has been the identification of these psychosocial comorbidities. There is no current standard for evaluating for the presence of these symptoms and they can be difficult to elicit in a pediatric population. While surveys can screen for symptoms (the Children’s Dermatology Life Quality Index; the Cardiff Acne Disability Index), they are infrequently used. Subsequently, necessary treatment for these symptoms is foregone when the problem goes unrecognized. In order to better identify and treat the negative psychosocial impacts of acne, a multidisciplinary approach involving a concurrent medical and psychological approach is recommended. Examples include support groups, educational interventions, and multidisciplinary clinics. The aim of this proposed study is to evaluate the utility of a multidisciplinary behavioral health clinic in which patients are seen by a dermatologist and a psychologist at the same session. With this model, the dermatologist can evaluate the patients’ skin and encourage them to discuss how their acne may be impacting their life. Then, the psychologist can offer advice on what may help each patient’s individual symptoms. This advice may include coping strategies or referrals to specialists for further support. Patients will attend the clinic monthly and their progress will be recorded via Children’s Dermatology Life Quality Index scores, acne severity, and psychological diagnoses made at the clinic. It is predicted that the multidisciplinary behavioral health clinic will reveal previously undiagnosed psychological conditions in acne patients, improve patients’ quality of life, and improve the severity of their acne. This is clinically significant in providing a comprehensive treatment approach to the pediatric acne patient, recognizing that the symptoms and outcomes of acne are more than skin deep.