Objective: Little is known about health-related behaviours and their co-occurrence among male adolescents in Saudi Arabia. The main purpose of this study was to determine the prevalence of health related behaviours, and to investigate the associations between socio-demographic variables and health related behaviours and the clustering of health risk behaviours. Research Methods: A cross-sectional study using a self-completion anonymous questionnaire was undertaken between February and April, 2008. A stratified random sample of 1501 male adolescents was recruited from one private and public high school in each of the five districts in the city of Riyadh, Saudi Arabia. Main Outcome Measures: Prevalence and associations between health, social and demographic factors and health-related behaviours, including dietary behaviours, oral health, physical activity, smoking, violence, injuries and safety, and mental health factors. Results: The results of this study showed that only 24.2% and 39.9% of the students consumed fruit and vegetables on a daily basis (at least once every day), and only 7% and 13.7% ate fruit and vegetables 3 times or more every day. Also, only 52.4% consumed dairy products at least once every day and only 18.3% of the students consumed dairy products 3 times or more every day. 48.1% reported to not consume any fish products on any day of the week. About 48.7%, 60.2% and 25.2% of the students consumed sweets, soft drinks, and energy drinks at least once every day. The results of this study also showed that only 36.7% of students eat breakfast regularly (? 5 days per week). Eating breakfast regularly was positively associated with lower age, liking school, good academic performance, not eating high fat food every day, drinking soft drinks ? 1 time/day, drinking milk every day, low BMI, brushing teeth every day, physical activity ? 3 days/week, and not engaging in physical fights. Around half (51.3%) participants reported good teeth health status, 22.6% brushed their teeth two times daily, 29.7% brushed their teeth once daily, whereas 47.7% of the subjects do not brush their teeth daily and 54.3% never visited the dentist during the past year. About 29.5% of participants suffered teeth pain sometimes or most of the time and 16.4% missed some school days for this reason. Brushing teeth every day was positively associated with higher standards of parental education, attending private school, living district, good academic performance, liking school, visiting dentist during the last year, good teeth status, and not suffering from teeth pain. Only 18.4% of the students were physically active and only 65.2% participated in physical activity classes in schools. Regular physical activity was positively associated with younger age, liking school, good health status, lower BMI, father’s, mother’s, siblings’ and peers’ physical activity, not smoking, not fighting, not wanting to use drugs or alcohol, and not feeling lonely. Over a third (36.3%) of the participants were overweight or obese. A fifth (20.8%) of the adolescents were current smokers. 20.8% of the students were current smokers. Smoking among students was positively associated with higher age, studying in private school, poor health status, poor school performance, not liking school, father smoking, mother smoking, sibling smoking, peers smoking, low physical activity, wanting to use drugs and alcohol, carrying weapons, fighting, performing car drifting, and being abused by teachers. ii Over half the sample (55.5%) reported an injury, 21.8% had been threatened or injured by weapons. Just under half (49%) of the adolescents reported they were involved in a physical fight. Moreover, fighting among students was positively associated with the interaction of low parental education, not liking school, poor academic performance, skipping breakfast, low physical activity, current smoking, being threatened or injured by weapons, carrying weapons, joining people performing car drifting, bullying others, being abused by teachers. Carrying weapons during the last 30 days was reported by 36.6% of the sample. Carrying weapons was positively associated with higher age, not liking school, poor academic performance, current smoking, fighting, being threatened or injured by weapons, performing car drifting, joining people performing car drifting, taking part in bullying others, and being abused by family. Some (26.1%) of participants reported having been bullied and 24.6% of the students reported bullying others. Many of the adolescents reported being abused by a family member (34.4%) or one of their school teachers (39.5%) during the past 12 months preceding the survey. During this time period, many of the students reported feeling lonely (22.8%), feeling very worried about something that they could not sleep at night sometimes or more (27.0%), and feeling very sad or hopeless almost every day for two weeks or more (40%). About 14% of the participants in this study reported that they had wanted to use alcohol or drugs. A small but notable proportion (13.9%) of the participants reported that they had thought of attempting suicide and 6.9% had actually attempted suicide. Over a third (36.1%) of adolescents had performed car drifting 12 months preceding the survey. However, car drifting was positively associated with higher age, attending a private school, not liking school, poor academic performance, not brushing teeth every day, current smoking, wanting to use drugs and alcohol, carrying weapons, joining people who performing car drifting, bullying others, and attempting suicide. The majority (78.7%) of participants drove vehicles and 96% and 97.7% reported that they did not use a seat belt when doing so and did not use a seat belt when riding in a car as a passenger, respectively. Only 2.1% and 1.4% of participants wore a helmet when used motorized vehicle or nonmotorized. Conclusions and implications: The results of this study reveal that the adolescents engage in multiple health-risk behaviours, and these risk behaviours are relatively common among adolescents and cluster together. Health related behaviours are associated with several socio-demographic variables (age, father’s and mother’s education, school factors, health status and living districts), although not necessarily in the same order. However, the data emphasized the need for further quantitative and indepth qualitative research throughout Saudi Arabia, including other cities, rural communities, female adolescents, and other Middle Eastern countries. Cross-sectional research to gather evidence on youth health to collect population-based data on a range of health-related behaviours along with physical and social environments amongst school-age students and out-of-school youth facilities are important and highly needed to investigate health-related behaviours and associated risk factors and to measure change over time.

The purpose of this thesis was to develop a model that predicts therapy outcome for children and adolescents who stutter, taking the independent variables of initial stuttering severity, self-esteem, anxiety, the psychosocial impact of stuttering, bullying, motor abilities and language abilities into account. In order to address these issues, three new instruments were developed and validated: (1) the Speech Questionnaire to assess the psychosocial impact of stuttering on the child’s life; (2) the Bullying Questionnaire to obtain information about stuttering related bullying; and (3) the MAMS Orofacial Assessment to assess orofacial abilities. Correlations between therapy outcome and the factors initial stuttering severity, language abilities, and orofacial abilities were found. These factors were used to design a predictive model. Relations of the findings to existing models are outlined. The knowledge obtained about the factors that influence therapy outcome may allow clinicians to tailor therapy programs individually towards the needs of the children. To obtain more information about the daily experiences of children who stutter during an intensive treatment a fourth questionnaire, the Daily Questionnaire was developed and validated. Results of a study with 19 participants during a three-week intensive treatment showed a significant relationship between the impact of other people on the previous day and the experience of general speaking abilities of the subsequent day. Furthermore, a correlation between emotions on the previous day and experience of own speaking abilities on the current day was found. Outcomes of the studies presented in relation to existing models are discussed and a new multi-factor model is presented.

In this thesis I undertake an autoethnographic, phenomenological investigation of the experience of being bullied as a child by an adult; namely my mother, and to some extent my father, throughout my deeply religious upbringing, and its consequences and outcomes in my life. Using as a framework the story of the hero’s journey, I explore through layered storytelling and reflective analysis, how I came to marry a bully, and experience domestic violence, and my response. I investigate the difficulties I encountered in my relationship with my first son as he became a toddler. The areas I cover are the experience of being bullied and the effects on my choice of a partner and on our relationship. As I write I am brought up against my ‘self’ as I look at the concept of intimate partner violence and the subject of violent women, along with family terrorism, and whether or not violence is gendered. I also investigate bullying behaviour between adults, at how bullies and victims are created, and how I came to act out both of these behaviours. I describe my journey through counselling to gaining a new attitude towards children. Other influences which have shaped me, including religion and faith are examined, to see how they have provided resilience, and how these aspects of my life have been transformed to influence how I came to work with and for children in the educational field. I describe how my work has continued to inform and transform my views of the way adults treat children, the recognition that when children behave ‘badly’ there is a cause, and describe why I have a passion to see that adults find new ‘ways of being’ with them.

Building on a small body of research, the present study explores the perceptions of teaching staff about their work with Gypsy, Roma, Traveller (GRT) children and young people. Specifically the research is concerned with participants’ views about the relationship between GRT children and schools in relation to attainment, social inclusion, the GRT culture and lifestyle and wider systemic factors. Existing literature and research about the educational experiences of GRT children and young people is explored. Situated within a critical realist epistemology, the present study utilises semi-structured interviews with 13 members of teaching staff across five schools in Greenshire County Council (pseudonym). Transcripts were subjected to thematic analysis following the model proposed by Braun and Clarke (2006). Six superordinate themes (educational outcomes; barriers to education; GRT parents; social inclusion; cultural dissonance and inclusive practices) were identified. Findings are explored in relation to previous research. One key finding concerns the views participants expressed about GRT children’s reports of bullying or racism. Implications for practice and future research are considered.

Despite abundant literature about bullying, previous research has predominantly focussed upon the characteristics of those who bully, peer influences in bullying and anti-bullying interventions, with little acknowledgement of how young people who bully and their counsellors experience counselling. This research seeks to address the gap by asking; how well young people who bully feel able to express themselves to their counsellor, and what facilitates or inhibits the therapeutic relationship for both counsellors and young people who bully? These research questions derive both from existing literature and my profession as a counsellor of young people who bully. Using interpretative phenomenological analysis (IPA), data were gathered using focus groups and semi-structured interviews with a sample consisting of six participants representing four young people and two counsellors. In IPA, the researcher’s use of self is equally implicated in the collection and analysis of data (Smith & Osborn, 2003); consequently, my dual identity as counsellor and researcher has asserted differing perspectives. The three superordinate themes identified in the current study focus upon attachment states (Bowlby, 1977, 1988), the therapeutic relationship, and the influence of emotional management upon counsellors. Trust and risk emerged as pervading concerns for the young people and have been integrated into discussion of the superordinate themes. The research received favourable ethical opinion from the Faculty of Health and Medical Science (FHMS) ethics committee. Findings suggest that young people who bully experience insecurities which manifest as mistrust, inhibiting the relationship with their counsellor. It also appears that a counsellor’s life experiences and occupational identity variously affect the therapeutic relationship. Individual counselling may not be a panacea but I recommend that if undertaken expertly, it has potential. Future research could focus upon confidentiality where equivocal standards are confusing for young people who bully.