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Background: Dietary salt intake in the South African population exceeds the physiological need. Excessive salt intake is associated with elevated blood pressure levels which may lead to hypertension and cardiovascular accidents. A lifestyle modification such as dietary salt restriction is an inexpensive, effective disease prevention option. Objective: The overall main objectives of this investigation was to: 1) compare salt intake, estimated from a short salt frequency intake questionnaire, with the 24-hour urinary salt excretion and blood pressure of young normotensive healthy white and black South Africans; and 2) compare 24-hour salt excretion and 24-hour blood pressure profiles of normotensive white and black individuals in terms of their knowledge, attitude and behaviour towards dietary salt intake. Study design: The study design was cross-sectional and nested in the baseline phase of the African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension in South Africa (African-PREDICT) study. Methods: Multiple methods of data collection were used including anthropometry, biochemical analyses, dietary intakes and cardiovascular measurements. Participants in the study completed the short salt frequency intake questionnaire, describing and quantifying habitual salt intake, and a questionnaire describing knowledge, attitude and behaviour regarding salt intake. Responses to the questionnaires were compared with actual salt intakes estimated from a single 24-hour urine sample and with the 24-hour blood pressure measurements. Results: There was no significant correlation between salt intake based on the questionnaire and 24-h urinary excretion in the white (r=0.07; p=0.40) and black (r=-0.53; p=0.56) participants before and after adjustment for covariates. Estimated salt intake from the questionnaire significantly correlated with systolic blood pressure in white participants (r=0.22, p=0.005) before adjustment for covariates and was no longer significant after adjustment. None of the correlations (unadjusted or adjusted) were significant for the black participants (all p>0.05). The Bland-Altman plots for salt intake showed that the mean difference between the methods used to determine salt intake for the white group is 0.5 g/day, and for the black group is -1.9 g/day. The urinary salt excretion may estimate salt intake to be 9.6 g/day above or 11.1 g/day below the questionnaire’s estimation in the white, and 10.8 g/day above and 18.4 g/day below in the black groups. The level of agreement (Cohen’s Kappa analyses) between the salt frequency questionnaire and the 24-hour urinary salt excretion were determined by categorising the participants in groups who meet the target of <5 grams salt per day or do not. The value of Kappa for the white participants was 0.17 (slight agreement) and for the black participant it was -0.06 (no agreement). In the white participants were a significant increase in both SBP and DBP with increasing tertiles of salt intake according to the questionnaire (p<0.006 and p<0.02 respectively). In the black participants there were no significant difference in BP levels (all p>0.05). The five foods/food groups that contributed most to dietary salt intake in both ethnic groups were discretionary salt, bread, gravy made with stock or gravy powder, soup and biltong. There were no differences in the BP levels between those who answered questions about their knowledge and attitude towards salt intake in both ethnic groups (all p>0.05). Also, there were no differences in their urinary salt excretion (all p>0.05). Only certain behaviours mentioned in the questionnaire were reflected in the salt intake levels and blood pressure. Conclusions: The short salt frequency intake questionnaire can be used to identify food items that contribute to total salt intake. However, the questionnaire considerably underestimates the dietary salt intake. The application of this questionnaire may be helpful in epidemiological studies that evaluate foods which contribute to the total salt intake in order to monitor the average salt intake of a population and to assess the proportion of the population that does not meet the target of less than 5 grams of salt intake per day. It cannot, however, be used to assess the salt intake of an individual. The knowledge, attitude and behaviour of women and men of both ethnic groups are poorly reflected in their actual salt intake and blood pressure, especially among the black participants. The majority of the participants in both ethnic groups consume dietary salt in much higher quantities than the recommended less than 5 grams per day. The current public awareness campaign to decrease salt intake to the target level of less than 5 grams per day by the South African National Department of Health and the Heart and Stroke Foundation is commendable. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

Background: Dietary salt intake in the South African population exceeds the physiological need. Excessive salt intake is associated with elevated blood pressure levels which may lead to hypertension and cardiovascular accidents. A lifestyle modification such as dietary salt restriction is an inexpensive, effective disease prevention option. Objective: The overall main objectives of this investigation was to: 1) compare salt intake, estimated from a short salt frequency intake questionnaire, with the 24-hour urinary salt excretion and blood pressure of young normotensive healthy white and black South Africans; and 2) compare 24-hour salt excretion and 24-hour blood pressure profiles of normotensive white and black individuals in terms of their knowledge, attitude and behaviour towards dietary salt intake. Study design: The study design was cross-sectional and nested in the baseline phase of the African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension in South Africa (African-PREDICT) study. Methods: Multiple methods of data collection were used including anthropometry, biochemical analyses, dietary intakes and cardiovascular measurements. Participants in the study completed the short salt frequency intake questionnaire, describing and quantifying habitual salt intake, and a questionnaire describing knowledge, attitude and behaviour regarding salt intake. Responses to the questionnaires were compared with actual salt intakes estimated from a single 24-hour urine sample and with the 24-hour blood pressure measurements. Results: There was no significant correlation between salt intake based on the questionnaire and 24-h urinary excretion in the white (r=0.07; p=0.40) and black (r=-0.53; p=0.56) participants before and after adjustment for covariates. Estimated salt intake from the questionnaire significantly correlated with systolic blood pressure in white participants (r=0.22, p=0.005) before adjustment for covariates and was no longer significant after adjustment. None of the correlations (unadjusted or adjusted) were significant for the black participants (all p>0.05). The Bland-Altman plots for salt intake showed that the mean difference between the methods used to determine salt intake for the white group is 0.5 g/day, and for the black group is -1.9 g/day. The urinary salt excretion may estimate salt intake to be 9.6 g/day above or 11.1 g/day below the questionnaire’s estimation in the white, and 10.8 g/day above and 18.4 g/day below in the black groups. The level of agreement (Cohen’s Kappa analyses) between the salt frequency questionnaire and the 24-hour urinary salt excretion were determined by categorising the participants in groups who meet the target of <5 grams salt per day or do not. The value of Kappa for the white participants was 0.17 (slight agreement) and for the black participant it was -0.06 (no agreement). In the white participants were a significant increase in both SBP and DBP with increasing tertiles of salt intake according to the questionnaire (p<0.006 and p<0.02 respectively). In the black participants there were no significant difference in BP levels (all p>0.05). The five foods/food groups that contributed most to dietary salt intake in both ethnic groups were discretionary salt, bread, gravy made with stock or gravy powder, soup and biltong. There were no differences in the BP levels between those who answered questions about their knowledge and attitude towards salt intake in both ethnic groups (all p>0.05). Also, there were no differences in their urinary salt excretion (all p>0.05). Only certain behaviours mentioned in the questionnaire were reflected in the salt intake levels and blood pressure. Conclusions: The short salt frequency intake questionnaire can be used to identify food items that contribute to total salt intake. However, the questionnaire considerably underestimates the dietary salt intake. The application of this questionnaire may be helpful in epidemiological studies that evaluate foods which contribute to the total salt intake in order to monitor the average salt intake of a population and to assess the proportion of the population that does not meet the target of less than 5 grams of salt intake per day. It cannot, however, be used to assess the salt intake of an individual. The knowledge, attitude and behaviour of women and men of both ethnic groups are poorly reflected in their actual salt intake and blood pressure, especially among the black participants. The majority of the participants in both ethnic groups consume dietary salt in much higher quantities than the recommended less than 5 grams per day. The current public awareness campaign to decrease salt intake to the target level of less than 5 grams per day by the South African National Department of Health and the Heart and Stroke Foundation is commendable. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

Personer som drabbats av depression återfaller/återinsjuknar ofta en eller flera gånger i livet. Forskning har visat att b la demografiska faktorer, residualsymtom och insomni är prediktorer för återfall. Syftet med studien var därför att undersöka betydelsen av demografiska faktorer, residualsymtom och insomni för nivån av depression 6-12 månader efter avslutad behandling på en psykiatrisk specialistmottagning. Urvalet var alla patienter som diagnosticerats med depression eller recidiverande depression och genomgått KBT-terapi under perioden 2008 – september 2013, och som hade uppföljningsdata vid sex eller tolv-månader, vilket sammanlagt var 111 patienter. Beroendevariabel var resultat på formuläret Patient Health Questionnaire (PHQ-9). Resultaten visade att patienter med residualsymtom inte försämrades signifikant mellan eftermätningen och uppföjningsmätningen, ett fynd som inte överensstämmer med forskning på området. Regressionsanalyser visade ingen signifikant påverkan av kön, ålder och utbildningsnivå på senare nivå av depression vid uppföljningsmätning. Däremot visade regressionsanalyser att sömnbesvär, mätt med formuläret Insomnia Severity Index (ISI), vid framför allt eftermätning hade ett samband med senare nivå av depression vid uppföljningsmätningen. Resultaten indikerade att kvarstående sömnbesvär då behandlingen avslutades predicerade senare nivå av depression. Slutsatsen är att ett tillägg av en sömnintervention för de patienter som har insomni då behandlingen avslutas kan minska sannolikheten för återfall i depression. Då många patienter saknade uppföljningsdata kunde inga säkra slutsatser dras.

Empirical studies focusing on the subjective experience of health among patients in contact with the mental health services are rare and most questionnaires are based on a medical model that emphasizes objectively observed disease-oriented health indicators. In studies I and II perceptions of the concept of health among patients and nurses in mental health services were explored and described using a phenomenographic approach. The perceptions and description categories that emerged from these studies were transformed into a number of items forming a questionnaire intended to measure subjectively experienced health among patients in mental health services. In study III, a randomly selected sample was used to test the psychometric properties of the new Health Questionnaire. A factor analysis revealed three factors labelled Autonomy, Social Involvement and Comprehensibility. The purpose of study IV was to examine the construct validity of the Health Questionnaire. The hypothesis was that subjectively experienced health would be positively associated to self-esteem, empowerment and quality of life, and negatively associated to psychiatric symptoms, perceived stigmatization experiences and perceived attitudes of devaluation and discrimination. This hypothesis was mainly confirmed insofar that overall health was positively correlated to self-esteem, empowerment and quality of life and negatively correlated to symptoms, attitudes of devaluation and discrimination and rejection experiences. The results of this thesis show that health is more than just an absence of disease and support a focus on health promotion interventions in mental health care. / <p>Medicine doktorsexamen</p>

Text in Afrikaans / The purpose of this study was to determine the nature, origin and negative consequences of perfectionism and to set guidelines for the therapeutic handling of perfectionism. Two literature studies were done to investigate the phenomenon and therapeutic techniques with regards to perfectionsim. A questionnaire was developed as aid to the therapist to identify negative perfectionism and associated problem areas. An empirical study was done to investigate the effectivity of the questionnaire and to compose a program and guidelines for the therapist and perfectionist. Results of the study indicated that negative perfectionism resulted in affective, cognitive, interpersonal and behavioural consequences for the client. It further showed that it is necessary to find the origin of the client's perfectionism and to give them insight in their problem to enable the therapist to succesfully apply cognitive behavioral therapy. / Educational Studies / M. Ed. (Voorligting)

Note from the Library: The fulltext electronic version of this thesis has been removed due to restricted content. Please contact the Unisa Library for more details. / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

A literature study was undertaken to investigate the experience of loss and grief in the different developmental stages, as well as to identify characteristics of loss and grief in the young child. Guidelines have been compiled on how to handle loss and grief in young children. The empirical study comprised of workshop presentations. Through these presentations it was also determined as to whether parents and children would benefit from such workshops, as well as if the information regarding loss and grief addressed the parents’ needs. The empirical study found that parents are ignorant about loss and grief in the young child. However, all the parents had questions about loss and grief. After the workshops parents indicated that they became aware of positive changes in their own behaviour towards their children, and also in that of their children. One of the biggest problems in handling loss and grief in the young child seemed to be open and honest communication. / Educational Studies / M.Ed. (Guidance and Counseling)