4 pp. / Promoting the health and well-being of families during difficult times.

M.A. thesis, Faculty of Humanities, University of the Witwatersrand, 1999

Class of 2010 Abstract / OBJECTIVES: To determine the perceived level of stress pharmacy students experience related to academics and the methods they use to relieve that stress. METHODS: This was a descriptive cross-­‐sectional study. Questionnaires were administered to first, second, and third year University of Arizona College of Pharmacy students during regularly scheduled class time. Data on perceived level of stress, sources of stress, and methods of relieving stress were collected and analyzed. Data on average hours worked per week, marital status, number of children, age, gender, and number of professional organizations involved in were also collected. RESULTS: The stress survey was completed by a total of 182 students at the College of Pharmacy. The overall stress score was highest in the second year students, although the total score was relatively low (total score 18.7; p=0.04). The four items that resulted in the highest stress scores were exams and/or grades (stress score ≥ 2.1), amount of class material (stress score ≥ 1.8), financial responsibilities (stress score ≥ 1.8) and lack of free time (stress score ≥ 1.6). Stressful situations that the students felt the most during the semester were thinking about the things that they had to accomplish (score ≥ 3.2) and having to control the way they spend their time (score ≥ 2.6). Common stress relievers were spending time with family, friends and pets ( ≥ 27%), watching television or movies ( ≥ 22%) and exercising ( ≥ 17%). Of those students who exercised, >44% felt it helped relieve stress very much. CONCLUSIONS: Little difference in levels of stress was observed between the classes. Based on the results, pharmacy students at the University of Arizona do not appear to be excessively stressed. Spending time with family/friends/pets, watching TV/DVDs, and exercising were the most common ways of relieving stress.

This investigation sought to identify differences in the human psychophysiological stress response when mediated by affiliation, by assessing heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), electrodermal activity (EDA), serum Cortisol (SC) concentration, interleukin-2 (IL-2) concentration, and state anxiety among subjects who underwent an anagram solution task. Thirty male subjects from the University of North Texas were randomly assigned to one of two experimental conditions and asked to solve a series of difficult anagrams either alone or with a companion. Subjects assigned to the control condition were asked to copy permutations of the anagrams. Before, and immediately after the anagram/copying tasks HR, SBP, DBP were measured, blood samples drawn, and The State-Trait Anxiety Inventory (STAI) administered to all subjects. EDA was measured throughout all trials. Changes from baseline through the experimental period for all dependent variables were analyzed by employing difference scores derived from contrasting baseline and experimental measures. These scores were subjected to an analysis of variance (ANOVA) resulting in one significant between group effect among all dependent variables examined. Contrary to stated hypotheses, the alone condition significantly differed from the companion and control conditions by demonstrating a significant decrease in systolic blood pressure from baseline through the experimental period. It was concluded that the decrease in systolic blood pressure from baseline through the experimental period for the alone group was a result of chance sampling of individuals possessing unique psychophysiological response patterns. Appraisals of inter-group differences in response patterns across all dependent variables suggest that an insufficient stressor, and limitations in design, statistical analysis, and measurement may have contributed to this investigation's results. Implications of findings were discussed along with suggestions for future research.

M.Com. (Industrial Psychology) / Please refer to full text to view abstract

Sjuksköterskeyrket innebär ofta långvarig stress och bristfällig arbetsmiljö. Personalbrist, hög arbetsbelastning och bristande inflytande på arbetsplatsen är orsaker till att sjuksköterskor väljer att sluta inom yrket. För lite forskning gällande den upplevda stressen på arbetsplatsen inom sjuksköterskeyrket råder. Därför finns anledning till ökad kunskap kring ämnet. Syftet med studien är att undersöka i hur hög utsträckning sjuksköterskor upplever stress i sin arbetsmiljö, och studien är baserad på 1044 yrkesverksamma sjuksköterskor över hela landet som är medlemmar i Facebookgruppen ”Sjuksköterskan”. Dessa personer har fått svara på enkäten Work Stress Questionnaire med 21 frågor. Resultatet från denna studie visar att arbetsbelastningen ökat och personalen har inte möjlighet att påverka beslut som tas på arbetsplatsen. Konflikter är också förekommande där chefen, i de flesta fall, inte gör något för att lösa dessa konflikter. Sjuksköterskorna sätter höga krav på sig själva och är mycket engagerade i arbetet, men har ofta svårt att sätta gränser. Resultatet visar också att en hög andel har svårt att hinna med familj, vänner och fritidsintressen. Det finns tidigare studier med samma mätinstrument som visar att arbetsbelastningen och ansvarstagandet har ökat under de senaste åren. Eventuellt kan detta i slutändan innebära en risk för ökad utbrändhet och fler sjukskrivningar.

Dissertation Submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, for the degree of Master of Science. Johannesburg 1993 / This dissertation studies the relationship between the use of certain coping strategies and the relapse of'illness, Eighty subjects with 1\'{yalgicEncephalomyelitis (M.E.) were followed OVera nine month period, initially completing a biographical questionnaire which showed some interesting common features, but these characteristics may be attributed to the narrow population from which the sample was drawn. The subjects then completed a battery of tests every eight weeks. These tests monitored appraisal of stressors, ways of coping and general health over the eight weeks since the previous test. Results were analysed using a Pearson's product moment correlation and a principal components factor analysis with a varimax rotation. The subjects were expected to show a positive correlat'on between certain coping techniques (such as denial, avoidance, and self- blame) and the relapse of M.B., while a zero or negative correlation between other coping techniques (such as seeking social support and problem solving when the stressor is controllable) and relapse. Neither of these hypotheses was supported by the data gathered. However, the subjects showed a remarkable consistency inthe types of'coping used, rather than adapting the mode of coping to the type of stressor experienced. It was concluded that the subjects used abnormal coping techniques and that these techniques Weresomehow related to their illness. However, the exact causal relationship between the coping techniques and the illness could not be assessed. It is possible that the subjects' poor coping mechanisms contributed to the development and exacerbation of the illness but it in also possible that the illness limited the repertoire of coping techniques available to the p"atient.

MSc Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 2009 / HIV is having devastating effects on Africa as a whole and more specifically on Sub-Saharan Africa. Children are vulnerable to the disease and in most cases being hit the hardest. Parenting at the best of times involves some form of stress, and caring for a chronically ill child increases the parenting stress levels. Antiretroviral treatment has a positive effect on children with HIV, however it is not well understood what effect antiretroviral treatment has on the parenting stress levels of the caregivers of children with HIV. The aim of the study was to establish whether caregivers of children diagnosed with HIV show a change in stress levels after commencement of anti-retroviral treatment for their children. The objectives of the study were: to determine if any of the subsections of the PSI-SF were affected by the commencement of antiretroviral treatment in the children; to determine if a correlation existed between the CD4 count of the child and the parenting stress level of the caregiver and to determine whether the age of the child impacted on the scores of the PSI-SF. The demographic data of the participants were also analysed. This study involved secondary analysis of existing data for the study "A longitudinal study of neurodevelopmental delay in HIV positive children" conducted by Joanne Potterton utilising a longitudinal pre-post test study design where participants were compared to their own baseline scores. The Parenting Stress Index Short Form (PSI-SF) was used to establish the parenting stress levels within its three different subsections. The PSI-SF was completed by the caregivers at visit one, two and three. These visits were to the Harriet Shezi Clinic at Chris Hani Baragwanath Hospital, Soweto, Johannesburg. The children were antiretroviral naïve at visit one, and at visit two which was six months later, they commenced antiretroviral treatment with a six months follow-up which was visit three. iv Forty-five participants were included in the study. The paired ‘t’ test showed a significant change (‘p’ = 0.02) in the subsections Parent Child Dysfunctional Interaction and Difficult Child(change in mean -3.31 and -2.78 respectively), while the subsection of Parenting Distress had no significant change between visit one and visit two (change in mean -2.09). The change in mean between visit two and three was -1.84 for the Parental Distress subsection, 0.6 for the Parenting Child Dysfunctional Interaction subsection and 0.8 for the Difficult Child subsection. The paired ‘t’ test was applied to visit one and three and the subsection Parenting Distress showed the greatest positive change of 'p' = 0.00 with a change in mean of -3.93. There was no correlation between the CD4 count of the child and the PSI of the caregiver at any of the visits (r=-0.2, 0.11,0.3, p=0.15, 0.5, 0.06 respectively). There was no correlation between the age of the child and the parenting stress of the caregiver at any of the visits (r=0.13,0.08,0.5 p=0.39,0.6 and 0.1 respectively). The stress levels of the caregivers decreased over the study period however there was no significant decrease with the commencement of antiretroviral treatment.

L’ozone (O3) est un gaz reconnu comme un des polluants atmosphériques majeurs du XXIème siècle, de par ses propriétés très oxydantes. Dans les plus basses couches de notre atmosphère, ce polluant secondaire est produit par des réactions photochimiques impliquant des précurseurs émis par les activités humaines et la végétation. De nombreuses études expérimentales ont révélées le caractère phytotoxique de l’O3, qui dégrade sévèrement la photosynthèse, réduit le rendement des récoltes et inhibe la croissance des arbres. Afin de quantifier les effets de l’O3 sur les écosystèmes à l’échelle globale, des modèles numériques ont été développés. Dans cette thèse, nous avons principalement développé un nouveau modèle d’impact basé sur le concept dose/réponse au sein du modèle global de végétation ORCHIDEE. L’approche semi-mécaniste utilisée vise à représenter de manière simplifiée les effets du stress oxydatif causés par l’O3 sur la photosynthèse. L’étalonnage des paramètres a été réalisé en utilisant des données physiologiques issues majoritairement d’expériences de fumigation à l’air libre et en chambres à ciel ouvert menées pendant la saison de croissance de plusieurs espèces végétales. Cette étape de calibration a permis de déterminer les paramètres spécifiques à plusieurs types fonctionnels de plantes. La sensibilité du modèle à l’O3 et à son interaction avec le CO2 et le stress hydrique a ensuite été testée. A l’échelle locale, notre modèle d’impact reproduit fidèlement l’allure de la réponse de la photosynthèse observée in situ à l’échelle saisonnière, et l’élévation du CO2 compense partiellement l’impact de l’O3. En outre, le couplage entre la photosynthèse et la conductance stomatique dans ORCHIDEE permet de simuler la limitation des effets de l’O3 par les flux entrants. La fermeture stomatique réduit également la transpiration, ce qui augmente l’humidité du sol et préserve ainsi la végétation d’un stress hydrique accentué. Cependant, les effets observés sur la respiration autotrophe ne sont pas représentés et l’impact sur la surface foliaire est sous-estimé. Afin d’évaluer la performance du modèle, nous avons comparé l’impact simulé sur la productivité nette (NPP) annuelle avec l’effet estimé par les relations empiriques linéaires standards, recommandées par l’UNECE pour évaluer les risques phytotoxiques chez plusieurs types d’écosystèmes. En outre, à l’échelle globale, nous obtenons des résultats similaires aux estimations réalisées avec un autre modèle de végétation munie d’une paramétrisation d’impact différente. Enfin, nous estimons que les concentrations actuelles causent localement une chute de productivité nette totale annuelle allant jusqu’à 11.7% en moyenne dans le nord-est des Etats-Unis, et réduirait le contenu en carbone du sol de 10.9% dans cette région et de 42.5% en Indonésie si la pollution actuelle perdure pendant 50 ans. Ce travail indique que l’impact de l’O3 sur la végétation est non-négligeable dans le modèle ORCHIDEE, et doit être pris en compte dans les études globales du bilan de carbone terrestre. / Ozone (O3) is a gas recognized as a major atmospheric pollutant of the 21st century, due to its strong oxidant properties. As a secondary pollutant, O3 is produced by photochemical reactions between both anthropogenic and biogenic precursors. Numerous experimental studies have highlighted the phytotoxic effects of O3, which severely impairs photosynthesis, reduces crop yields and forest growth. Numerical models are used in order to quantify the impact of O3 at global scale. In this thesis, the major work was to develop a new parameterization based on the dose/response concept and to integrate it in the global vegetation model ORCHIDEE. We used a semi-mechanist approach to represent the effects of oxidative stress induced by O3 on photosynthesis. Parameters were obtained by comparing modelled and observed physiological variables related to free-air and open-top chamber fumigation experiments, carried out during the growing period for different plant species corresponding to several plant functional types in the model. Sensitivity tests were conducted to evaluate the influence of O3 and its interactive effects with CO2 and water-stress on the ecophysiological processes in ORCHIDEE. We reproduced the curvilinear response observed on photosynthesis at the leaf level during a growing season, and the elevation of CO2 concentration partially mitigates the O3 effect. The induced simulated stomatal closure slows down the impact on photosynthesis coupled to conductance by reducing the entering O3 fluxes. It also decreases transpiration and increases soil water content, which protects vegetation from higher water-stress. However, observed changes in autotrophic respiration are not simulated and the impact on foliar surface is underestimated. In order to evaluate the performance of our model, we compared the simulated impact on annual net primary productivity (NPP) with the empirical linear dose/response relationships recommended by UNECE to assess the risk for different types of ecosystems. Moreover, at global scale, we found results similar to those from another land surface model using a different impact relationship. Finally, we estimated that current O3 concentrations cause locally a decrease in total annual net productivity up to 11.7% on average in the north-west of USA, and could decrease the soil carbon content by 10.9% in this region and by 42.5% in Indonesia, if current O3 pollution remains the same for 50 years. This work confirms that impact of O3 on vegetation is non-negligible in the model ORCHIDEE, and must be considered in global carbon budget modelling.

O stress pode ser definido como uma reação complexa, necessária e benéfica ao organismo, porém quando permanece por um período prolongado cria-se um desequilíbrio no funcionamento global orgânico, enfraquecendo o sistema imunológico e deixando o indivíduo exposto a infecções e doenças oportunistas. Diversos tratamentos são propostos para o controle do stress dentre eles está à acupuntura, uma técnica milenar que consiste na inserção de agulhas em pontos específicos da pele. O eletroencefalograma (EEG) é um instrumento de registro gráfico das variações do potencial de membrana dos neurônios corticais, seu registro e sua interpretação é um processo rotineiro de diagnóstico neurológico e neste caso foi utilizado para verificar se existe alguma alteração no espectro de frequência do EEG imediatamente após a aplicação da acupuntura. Foram selecionados 38 sujeitos randomizados em grupo controle (n= 13), grupo acupuntura (n=13) e grupo eletroacupuntura (n=12). Antes das intervenções os sujeitos foram submetidos ao Inventário de Sintomas de Stress para adultos de Lipp (ISSL), a escala visual analógica (EVA) de stress, mensurados frequência cardíaca (FC) e pressão arterial (PA). As intervenções ocorreram durante vinte minutos e vinte minutos antes e depois das intervenções foram realizados os registros de EEG. Após o término do EEG os sujeitos novamente responderam ao EVA e foram mensurados FC e PA. Para análise dos dados foram utilizados ANOVA, correlação, BOOTSTRAP e teste t-student. Não foram encontradas diferenças significativas em relação ao espectro de frequência do EEG e a EVA antes e depois das intervenções, houve uma diminuição significante da FC após as intervenções. Não houve alteração da PA durante todo o processo. A acupuntura e a eletroacupuntura não apresentaram efeitos imediatos significativos após sua realização no espectro de frequência do EEG, embora tenha apresentado uma tendência a alterações. Não houve relação do espectro do EEG e os quesitos questionário de Lipp e EVA / Stress can be defined as a complex, necessary and beneficial response by the body, but when it remains for a prolonged period creates an imbalance in the overall organ function, by weakening the immune system, leaving exposed the individual opportunistic infections and diseases. Several treatments are proposed for the control of stress among them is acupuncture, an ancient technique that involves inserting fine needles into specific points on the skin. The electroencephalogram (EEG) is a tool of graphic record of the variations of the membrane potential of cortical neurons registration and its interpretation is a routine process of neurological diagnosis and this case was used to verify if there is any change in the frequency spectrum of the EEG immediately after application of acupuncture. 38 subjects randomized into control group (n = 13), acupuncture group (n = 13) and electroacupuncture group (n = 12) were selected. Before the intervention the subjects were submitted to the Inventory of Stress Symptoms for adults Lipp (ISSL), a visual analog scale (VAS) of stress, measured heart rate (HR) and blood pressure (BP). The interventions occurred for twenty minutes and twenty minutes before and after interventions EEG records were performed. After the end of the EEG subjects again responded to the EVA and HR and BP were measured. For data analysis, ANOVA, correlation, BOOTSTRAP and student t test were used. No significant differences were found in relation to the frequency of the EEG spectrum and VAS before and after the interventions, there was a significant decrease in HR after the interventions. There was no change in BP during the entire process. Acupuncture and electroacupuncture showed no significant immediate effect after its completion in the EEG frequency spectrum, although it had a tendency to change. There was no relation of the EEG spectrum and the questions questionnaire Lipp and EVA