People diagnosed with cancer or undergoing cancer treatment experience a wide range of symptoms. One of the most common symptoms experienced by cancer patients today is cancer-related fatigue. Cancer-related fatigue is a complex condition, recognised as a multidimensional construct and thought to be associated with a cluster of symptoms rather than occurring in isolation. Cancer-related fatigue is distressing and can persist beyond the treatment phase or the disease itself. Current understanding of cancer-related fatigue and its management is limited. Further developing our knowledge of cancer-related fatigue may lead to innovative means of improving the identification, prediction and management of this troublesome symptom. To this end, this thesis aims to: I) identify factors reported to have a relationship with cancer-related fatigue; II) examine the course of cancer-related fatigue during and after radiotherapy; III) determine a method of detecting clinically meaningful change in fatigue; IV) examine whether correlates of fatigue are consistent across all fatigue dimensions or whether each dimension has its own unique pattern of correlates; and, V) develop and trial a group-based educational intervention to target cancer-related fatigue. To address Aim I in this thesis, relevant literature was reviewed to identify factors which potentially influence cancer-related fatigue. Factors identified include underlying medical factors (biomedical mechanisms, disease-related factors, treatment-related factors and comorbid conditions); physical or behavioural factors (poor nutrition, decreased activity, sleep disturbance, pain); psychological factors (anxiety and depression); and sociodemographic factors (social support, employment and education). The range of inter-related factors identified makes cancer-related fatigue a challenging condition to manage. The factors associated with cancer-related fatigue were synthesized into the Fatigue Framework to provide a clinically useful format for health professionals working with people with cancer. The Fatigue Framework was used to guide the remainder of the research into cancer-related fatigue presented in this thesis. This research consists of two main studies; a prospective longitudinal cohort study (to address Aims II, III, IV) and a randomised controlled trial (to address Aim V). The first study in this research examined the factors and effects associated with cancer-related fatigue in a radiotherapy population (n=210). Patients undergoing radiotherapy were recruited for a single-centre prospective longitudinal cohort study. Participants were assessed using a battery of assessments at three time points, at the start of radiotherapy, the end of radiotherapy and six weeks after radiotherapy completion. The results of this study were used to address Aim II, to identify the pattern of fatigue over the course of radiotherapy. The level of fatigue reported was shown to significantly increase from start to the end of radiotherapy and then significantly decrease from the end of radiotherapy to six weeks post-treatment for each subscale of the MFI. The results of this study were also used to address Aim III, to determine a method of detecting clinically meaningful change in fatigue. Whilst there are many tools used to assess cancer-related fatigue, the Multidimensional Fatigue Inventory (MFI) was the assessment chosen for use in this research study and throughout this thesis. The MFI is one of the few fatigue assessments that takes the various clinical dimensions of fatigue into account and has established reliability and validity. However, unlike other fatigue assessments, there were no published minimal clinically important difference (MCID) criteria for its use in cancer populations. MCID criteria determine the smallest change in scores that can be regarded as important, allowing clinicians and researchers to interpret the meaning of changes in patients’ fatigue scores. Determination of the MCID was based on the relationship of MFI scores to four clinically relevant constructs: (1) treatment impact on fatigue, (2) health-related quality of life, (3) performance status and (4) occupational productivity. These constructs were used as external or anchor-based measures to determine a MCID for each sub-scale of the MFI. Multiple MCID criteria were identified through the first study, each from a different perspective based on the anchor-based construct used. However, a two-point reference for each MFI sub-scale was suggested as a generic MCID as it was most consistent across the anchors examined. The MCID criteria validated in this study allow better interpretation of changes in MFI sub-scale scores and allow effect size calculations for determining sample size in future studies. The MFI allows assessment of multiple dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue). Minimal previous research had considered the differential effect of symptom correlates on individual dimensions of fatigue. The data of the prospective cohort study were further utilised to address Aim IV, to determine whether correlates of fatigue were consistent across all dimensions or whether each fatigue dimension had its own unique pattern of correlates. Results indicated that each dimension of fatigue was associated with a different pattern of correlates supporting the concept of multiple dimensions of fatigue. This enhanced understanding of fatigue could be used to guide the development of individually tailored interventions to target specific correlates of fatigue in affected domains, or group interventions to address all relevant fatigue correlates. Because fatigue is associated with multiple symptom correlates, it requires multi-focused symptom management. Education is a commonly recommended fatigue management strategy which can be used to target multiple symptoms simultaneously. There is a lack of information about the content and format used in education programs and the effectiveness of education in managing fatigue. The second study in this thesis addressed Aim V, to develop and trial a group-based educational intervention to target cancer-related fatigue. The study examined a group-based educational intervention (CAN-FIT) targeting cancer-related fatigue in radiotherapy patients. A pilot study of the intervention’s feasibility and acceptability indicated the intervention was acceptable to participants and its operation was feasible. Small modifications to program components were made based on participant feedback. A randomised controlled trial was then conducted to examine effectiveness of the CAN-FIT program and to ascertain the most effective timing for such an educational intervention. The study employed a factorial design and recruited 110 participants. Assessments were conducted at three time points, the start of radiotherapy, the end of radiotherapy and six weeks after the completion of radiotherapy. Results of the randomised controlled trial of CAN-FIT did not show a significant effect of the program on cancer-related fatigue levels, however the pre-radiotherapy education sessions were associated with significant increases in physical activity participation. Furthermore, the study demonstrated the delivery of education prior to radiotherapy was more effective than delivery after radiotherapy. This thesis successfully addresses its stated aims and provides a greater understanding of the concept of cancer-related fatigue. The results more clearly describe the course and correlates of fatigue and their relationship with the dimensions of fatigue. The MCID criteria for the MFI can be used in future research to evaluate outcomes and determine sample size in power calculations. The intervention trialled can be used in clinical practice to provide a low-resource intervention to improve activity levels without any subsequent change in fatigue in radiotherapy patients. Together these studies build upon current knowledge and provide directions for future research to address this difficult symptom.

Magister Artium - MA (Psychology) / Honours students in Psychology typically form larger cohorts with numbers ranging from 20 to 40 students in comparison to other disciplines that have fewer than 10 students in a cohort. The National Qualifications Framework (NQF) requires Honours students to complete a thesis that is equivalent to 300 notional hours or 30 credits. The learning outcome is that students conduct low level research that prepares them for conceptualizing, executing and writing up a research project. The thesis requirement should also prepare them for future studies. The larger cohorts and revised NQF thesis requirement places increased pressure on the staff compliment of Psychology departments. Some of the ways in which departments have attempted to cope with this increased demand include conducting group-based research projects, and secondary research projects. One of the concerns raised is whether these particular types of methodology prepared students adequately for reactive research in further studies. This study aimed to explore students' subjective perceptions about the extent to which group-based systematic review methodology in the Honours year adequately prepared students for conducting research during their masters-level studies. An explorative study was conducted to explore the experiences of purposively selected recent graduates from two identified Honours programmes that have progressed to Masters level studies. Participants were invited on the basis of being graduates or alumni rather than their registration status as Masters students at particular universities.

The future work force will be expected to transition from the familiarity of their school environment into an unfamiliar and unstable career world. Organisational changes have shifted the terms of employment from an employee practicing a life-long vocation to now becoming part of a contingent work force. This infers that employees may have to forfeit their reliance on the company to shape their identity development in lieu of self-management. The acknowledgement of these changes has created a ripple effect in the career counselling field as career practitioners increasingly begin to experience the limitations of traditional career approaches in addressing their clients’ evolving career needs. Subsequently, a post-modern framework to career counselling has been introduced to guide career counselling practices in the 21st century. My study focused on the use of two such approaches, namely life-design counselling and career adaptability. This study was based on a socio-constructivist paradigm, which had developed from an interpretivist worldview. The nature of my research study lent itself well to a collective case study, which involved the participation of five learners from an independent school context in a major South African city. Qualitative data collection, analysis and interpretation techniques were used to explore the effect of life-design counselling on the career adaptability of the afore-mentioned participants. Prior to attending eight group-based life-design counselling sessions, the participants were asked to attend an individual pre-interview. They were also asked to participate in a post-interview upon completion of the last-mentioned sessions. The identified themes generated from the qualitative data collected were as follows: responses related to career adaptability and the related sub-skills based on the Career Adapt-Abilities Scale (CAAS) (Savickas & Porfeli, 2012:357); family/significant others’ influences; financial and economic considerations; components related to emotional intelligence (Bar-On, 2007); adolescent development; school life; childhood dreams, and reflection on the process of life-design counselling. Findings suggest that the participants from my study appeared to benefit from the implementation of a life-design counselling intervention aimed at improving their career adaptability. With this study I aimed to contribute to the field of career counselling by highlighting the specific factors that were likely to influence the career trajectory of the five participants and to demonstrate the positive effect of life-design counselling on their career adaptability. Recommendations have also been made for further research and practice. / Thesis (PhD)--University of Pretoria, 2015. / Educational Psychology / Unrestricted

One of the main challenges experienced during adolescence is that of developing a coherent sense of self, or self-identity (Becht, 2016; Bester & Quinn, 2010; Erickson, 1977). This study used a parallel (or convergent) interactive multi-method design, embedded in an intervention, to explore the possible effects of group based life design counselling on the sense of self of female adolescent peer supporters. The possibility of assisting more individuals by using intervention techniques in groups was also explored. The research study is embedded in a constructivist paradigm and, working from an interpretive stance, the researcher collected, analysed and reported on quantitative and qualitative data to gained insight into the participants’ experiences surrounding narrative group life design techniques and their possible impact on enhancing the sense of self. The overall findings indicate that the intervention programme enhanced the sense of self of the participating peer supporters. The mixed-method research results from this study provide a clearer view of how groups of adolescents can be supported to become better equipped to negotiate transitions in their lives, by enhancing their sense of self. / Thesis (PhD)--University of Pretoria, 2017. / Educational Psychology / PhD / Unrestricted

Ätstörningar är allvarliga sjukdomar som medför stort lidande för patienter och deras närstående. De rekommenderadebehandlingsmetoderna kan hjälpa vissa patienter men det behövs effektivare behandlingsmetoder. Det finns teoretiskt stöd och ännu begränsat empiriskt stöd för att compassionfokuserad terapi (CFT) kan vara hjälpsam för patienter med ätstörningar. I föreliggande studie var syftet att utvärdera CFT i grupp vad gäller metodens genomförbarhet, acceptabilitet och preliminära effektivitet för patienter med ätstörningar som behandlas i dagvård. En åttasessioners manualbaserad CFT-grupp som tillägg till ätstörningsdagvård utvärderades enligt en single-group studiedesign (n=8). CFT-gruppen visade god genomförbarhet och acceptabilitet. Patienter förbättrades med måttliga till stora effektstorlekar vad gäller ätstörningssymptom, vikt, självkritik och självuppmuntran. Dock uppnådde inget effektmått statistisk signifikans. Studiens resultat tyder på att CFT i grupp som tillägg till ätstörningsdagvård kan vara en genomförbar och acceptabel behandling som möjligen kan bidra till tillfriskande av patienter med ätstörningar. / Eating disorders are serious illnesses that cause great suffering for patients and their caregivers. The recommended treatment methods help some patients, but more effective treatment methods are needed. There is theoretical support and still limited empirical support that compassion-focused therapy (CFT) may be helpful for patients with eating disorders. The aim of the present study was to evaluate the feasibility, acceptability and preliminary effectiveness of group CFT for patients with eating disorders who receive day care treatment. An eight-session manual-based CFT group was evaluated as an adjunct to day patient program for eating disorders according to a single-group design (n=8). The CFT group demonstrated good feasibility and acceptability. Patients improved with moderate to large effect sizes on eating disorder symptoms, weight, self-criticising and self-reassuring. However, no effect was statistically significant. Results suggest that group CFT as an adjunct to day patient program for eating disorders may be a feasible and acceptable treatment that may contribute to the recovery of patients with eating disorders.

Background For the 1.2 million older adults residing in U.S. nursing homes, little is known about their experience with physical frailty and cognitive impairment, two critical interrelated aging conditions. Methods Minimum Data Set 3.0 was used. Physical frailty was measured by FRAIL-NH and cognitive impairment by Brief Interview for Mental Status and Cognitive Performance Scale. Demographic and clinical characteristics were adjusted accordingly. Aim 1 described the prevalence of physical frailty and cognitive impairment and longitudinally examined the association between two conditions with the non-proportional odds model. Aim 2 used latent class analysis to identify physical frailty subgroups and estimated their association with cognitive impairment using multinomial logistic regression. Aim 3 fitted group-based trajectory models to identify physical frailty trajectories and cognitive impairment trajectories and quantified the association between the two sets of trajectories. Main Results Around 60% of older residents were physically frail and 68% had moderate/severe cognitive impairment, with improvement and worsening observed in both conditions, particularly in the first three months. Older residents with moderate/severe cognitive impairment were consistently and increasingly more likely to be frail. Three physical frailty subgroups were identified at admission. Greater cognitive impairment was associated with higher odds to belong to “severe physical frailty”. Five physical frailty trajectories and three cognitive impairment trajectories were identified over the first six months. One in five older residents were “Consistently Frail” and “Consistently Severe Cognitive Impairment”. Conclusion Findings emphasized the need for care management tailored to the heterogeneous presentations and progression trajectories of physical frailty and cognitive impairment.

There are many works related to wireless sensor networks (WSNs) where authors present new protocols with better or enhanced features, others just compare their performance or present an application, but this work tries to provide a different perspective. Why don¿t we see the network as a whole and split it into groups to give better network performance regardless of the routing protocol? For this reason, in this thesis we demonstrate through simulations that node¿s grouping feature in WSN improves the network¿s behavior. We propose the creation of a group-based architecture, where nodes have the same functionality within the network. Each group has a head node, which defines the area in which the nodes of such group are located. Each node has a unique node identifier (nodeID). First group¿s node makes a group identifier (groupID). New nodes will know their groupID and nodeID of their neighbors. End nodes are, physically, the nodes that define a group. When there is an event on a node, this event is sent to all nodes in its group in order to take an appropriate action. End nodes have connections to other end nodes of neighboring groups and they will be used to send data to other groups or to receive information from other groups and to distribute it within their group. Links between end nodes of different groups are established mainly depending on their position, but if there are multiple possibilities, neighbor nodes could be selected based on their ability ¿, being ¿ a choice parameter taking into account several network and nodes parameters. In order to set group¿s boundaries, we can consider two options, namely: i) limiting the group¿s diameter of a maximum number of hops, and ii) establishing boundaries of covered area. In order to improve the proposed group-based architecture, we add collaboration between groups. A collaborative group-based network gives better performance to the group and to the whole system, thereby avoiding unnecessary message forwarding and additional overheads while saving energy. Grouping nodes also diminishes the average network delay while allowing scaling the network considerably. In order to offer an optimized monitoring process, and in order to offer the best reply in particular environments, group-based collaborative systems are needed. They will simplify the monitoring needs while offering direct control. Finally, we propose a marine application where a variant of this groupbased architecture could be applied and deployed. / García Pineda, M. (2013). A group-based architecture and protocol for wireless sensor networks [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/27599 / TESIS / Premios Extraordinarios de tesis doctorales

The studies originated from research on group-based emotions and examine emotions and emotion regulation in the context of group-based provocations. In addition, the studies examined the ways in which people identify with their group and how that affects responses to group provocations. I hypothesized that the process of ruminating in contrast to reappraising would increase anger and negative action intentions and attitudes towards the provoking outgroup. I hypothesized that individual differences in ingroup glorification and trait emotion regulation would moderate the relationship between a group provocation and affective and attitudinal responses such that high glorification and high rumination would lead to more anger and more negative attitudes and behavioral intentions. The participants were University of Massachusetts-Amherst undergraduates in the psychology participant pool who identified as United States citizens. Study 1 was an experimental three-level design (rumination, reappraisal control). Study 2 was an experimental three-level design (provocation, no provocation, control). Study 1 demonstrated that response to provocation was affected by the emotion regulation manipulation and level of ingroup identification. Study 2 revealed that individual differences in chronic emotion regulation style and identification interacted to predict responses to the provocation. Implications of the research are discussed.

From 2001-2007, students from India have consistently comprised the largest ethnic group of international students on college campuses across the United States (Open Doors: Report on International Educational Exchange, 2007). Despite a number of studies that have researched the mental health of international students in the U.S., none have done so primarily with Indian graduate students. Theoretical and empirical literature regarding the psychological changes and acculturation patterns that international students undergo after their transition do not explore the possibility of multiple pathways of change. The current study identified four separate mental health trajectories for Indian international graduate students during their first year in the U.S. It also found three distinct patterns of acculturation for the Indian culture and four acculturation trajectories for the European American culture. The size of one's adjustment, feelings about transition, gender role attitudes, and availability of out-group support were all significant contributors to the variability among empirically derived mental health trajectories.

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