This master project addresses the problem of stage fright in a musical performance context. To meet my personal, uncomfortable feelings of stage fright, I decided to “prepare” my body for such situations by doing breathing exercises developed by Ilse Middendorf (The Perceptible Breath). With help and support of the Berliner Centrum für Musikermedizin at the Charité the project became a pilot study about how Ilse Middendorf's breathing exercises could minimize bodily stress of a non-wind instrument player in a stress situation. Following method was applied. I did breathing exercises over a period of six weeks. I made three recordings of the same cello piece that I know well (Josef Haydn’s Cello Concerto in D-major, 1. movement, exposition): before the six-week period, in the middle of it and at the end. The recordings represent the stress situations. The impact of breathing exercises on my cello practice and recordings were evaluated in three ways. I documented my subjective perceptions of my personal development with a questionnaire and a report. The objective results were then documented in two ways. The three recordings were sent out to professional audience members who did not know in which order recordings were done. They listened and rated them in order of their quality. Finally, I measured a series of body parameters which indicate the level of stage fright (e.g. heart rate, finger temperature, blood pressure) before and after the recordings. The results of my project are quite encouraging. On the subjective level, I felt less stress, more musicality and a new body awareness. The recordings were rated by audience members in exactly the order in which I recorded them which indicates a musical quality improvement. The body measurements showed that breathing exercises lead to a decrease in bodily stress symptoms (blood pressure and heart rate).

The effects of electrical stimulation of the A5 noradrenergic cell group of the ventrolateral pons was assessed in rabbits. Stimulation administered through either concentric bipolar or monopolar electrodes produced current-intensity related increases in mean arterial pressure (MAP). Decreases in heart rate (HR) accompanied the increases in MAP, but were essentially eliminated by bilateral vagotomy or destruction of the nucleus and tractus solitarii (NTS), thereby indicating that the HR decelerations were secondary to activation of baroreceptor reflexes. Neither vagotomy nor midcollicular section of the brainstem altered the MAP response to A5 stimulation. Bilateral destruction of the NTS slightly enhanced the response. Several rabbits received microinjections of 6-hydroxydopamine (6-OHDA) into the A5 region 2 weeks before the experiment. Other rabbits received vehicle injections and served as control subjects for the non-specific effects of the 6-OHDA injections. 6-OHDA injections, but not vehicle injections, prevented the vasopressor effects of A5 stimulation. However, stimulation of the A1 noradrenergic nucleus of the ventrolateral medulla produced decreases in MAP in rabbits given prior microinjections of 6-OHDA into A5. These observations are interpreted to indicate that the 6-OHDA injections produced neurotoxic effects which were relatively restricted to the A5 region. Furthermore, the data from all of these experiments are interpreted as indicating that the vasopressor effects observed as a consequence of electrical stimulation of A5 are due to excitation of the noradrenaline-containing neuron cell bodies of this region and that this effect is mediated via pathways arising from this region and terminating in the intermediolateral cell column of the spinal cord.

Summary: The effects of an alpha2 adrenoceptor blocker, yohimbine, and an alpha1 adrenoceptor blocker, phenoxybenzamine, and the central alpha2 adrenoceptor agonist, clonidine, on changes in arterial blood pressure and heart rate were studied during fatiguing muscular contractions to determine whether an adrenergic-opioidergic system might be involved in the mediation of cardiovascular function. Fatiguing contractions of the gastrocnemius and plantaris muscles of cats caused an increase in mean arterial blood pressure to 150-170 mmHg from resting values of 110-120 mmHg. Injection of clonidine into the cerebral aqueduct eliminated the increase in blood pressure; this effect was dose dependent. Naloxone antagonised the effects of the highest dose of clonidine (5 μg). Injections of yohimbine (1 μg) into the cerebral aqueduct had no significant effect on this pressor response. Yohimbine (1 μg) effectively counteracted the antipressor effects of clonidine when the two drugs were injected together until higher doses of clonidine (2-5 μg) were used. Phenoxybenzamine had no effect on the pressor response itself but unlike yohimbine was able to attenuate the effects of clonidine only when injected together. These data suggest that activation of muscle ergoreceptor afferent nerve fibres (group III and IV fibres) during muscular contractions may cause an increase in arterial blood pressure by interfering with an inhibitory adrenergic-endorphinergic pathway in the medullary region of the brainstem.

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Extensive literature review inspired a mediational model of the relationship between Religiosity/Spirituality (R/S) and Blood Pressure (BP) tested through secondary analyses of data from the TIPS program. Participants included 205 (92.1% Caucasian; age M=23.72, SD=5.33) pregnant Southern Appalachian women drawn from the region's at-risk pregnancy population. The only variables correlated with BP were women's weight (r=.430, r=.467, p<.01, for diastolic and systolic BP, respectively) and prenatal care use (r=.138, p<.05, with diastolic BP), but not R/S. Multiple regression analyses confirmed participant weight as the only significant independent predictor of BP. Previous findings of health benefits of R/S cannot be assumed to generalize to pregnant women without further study. Limitations of this study and possible explanations for the findings are discussed.

This integrative review of the literature focused on sodium (Na) content in drinking water (H?O) supplies and the subsequent effect on blood pressure levels in children. Studies for this review were drawn from the Cumulative Index of Nursing and Allied Health, PubMED, Science and Technology Databases, PsychInfo, United States (US) Environmental Protection Agency (EPA) and EPA in Florida websites. Criterion for inclusion in the data base searches were hypertension, high blood pressure, sodium in drinking water, drinking water salinity, children or preg'. Subsequently, further article selection criteria included children (under 18 years of age) and published in the English language (N=59). Findings of the review as summarized in this thesis could guide nursing research, education, policy and practice related to primary, secondary and tertiary interventions associated with sodium levels in drinking as a contributing factor to blood pressure levels in children.

BACKGROUND: Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS: A total of 6,134 diagnosed hypertensive subjects aged ≥ 20 years were collected from the National Health and Nutrition Examination Survey 1999-2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS: Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37-0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35-0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40-0.96). Mexican Americans have a stronger association of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS: The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.