This empirical double-blind multi-centre empirical study assessed the sources of stress, stress-related symptoms, role of psychosocial moderating variables and the role of micronutrients (specifically the effect of intervention with micronutrient supplementation) on stress levels and symptoms in South Africans. The sample consisted of 300 volunteer, English-speaking South Africans from two centres (KwaZulu-Natal and Gauteng) who had predetermined stress levels. The participants were evenly divided between the two centres (N=150 each). The Experimental Group (Active group) who comprised 151 participants received a multivitamin and mineral combination, while the Control Group (Placebo) group received a placebo. The research dealt with perceived stressors, coping resources and outcomes in the general population (both at baseline and after intervention). Outcome was assessed using standardized self-report instruments which examined stress levels and symptoms, perception of stress levels, anxiety, psychological general well-being and neurocognitive functions (verbal and visual memory). Univariate and multivariate correlational analyses were performed to investigate correlations and the predictive value of risk and rescue factors for the outcome variables. The findings indicate that there were no significant differences in the number of stressors between the two groups at baseline, although they differed in respect of two particular stressors (A>P regarding concern over children's future; P>A regarding life decisions). An interaction of stressors and moderating variables (life orientation and perceived coping incapacity) have an important role in predicting stress and stress outcome, and outcomes themselves may function as stressors. The bidirectional, circular interactive effects of stressors, moderators and outcomes are important in the stress and coping process. The study failed to find any effect of stress on the neurocognitive functions assessed. No significant treatment effect for the micronutrient was found, but a number of trends in respect of efficacy were suggested by the findings. The findings also suggested particular patterns of interactions in this regard for predicting pre-post differences (delta). Strengths and limitations of the study are highlighted and implications for intervention in respect of a stress management programme are also discussed. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2005.

This is the first time that multidisciplinary research has been conducted in South African music venues. The study investigated biopsychosocial health-related variables affecting workers in music venues giving special attention to sick building syndrome. Monitoring methodologies developed for this investigation can be applied in studies of a wide range of workplace environments. This study also resulted in the design of a questionnaire which provided interpretable data within statistical significance limits. The literature review fully describes the multidisciplinary nature of this research. Long established non-smoking offices were selected as controls. An environmental monitoring system was designed to record conditions whilst questionnaires on staff perceptions were personally administered. Psychosocial variables included job satisfaction, self-esteem, personal confidence and social interaction.Environmental comfort assessments included lighting, carbon dioxide, movement, temperature, relative humidity levels and air movement. Pollution impact monitoring involved noise, respirable aerosols, benzene, toluene, xylene, benzo(a)pyrene, total volatile and semi-volatile organic compounds. Comfort criteria were exceeded in all music venues which caused stress. Only 21,1% of respondents did not experience tiredness. Respiratory infection was higher in music venue staff than in office staff. Average age of staff in music venues was 25 years and 67,37% were smokers. Certain smokers were experiencing discomfort from tobacco smoke pollution. Tobacco smoke impact was demonstrated: mean benzene level for music venues was 12,9 u/m3 (maximum 42,44 u/m3) and in offices it was 0,606 u/m3 (maximum 1,24 u/m3). Multivariate models for sick building syndrome and allergies included tobacco smoke odour concern and the tobacco smoke indicators, xylene and toluene. Aerosol levels were 1,75 mg/m3 (maximum 45,98 mg/m3 ) in music venues compared to an office mean of 0,02 mg/m3 (maximum 0,58 mg/m3 ). Contributors were tobacco smoke and theatrical smoke. Burning eyes was the symptom causing most concern for 57,89% of respondents. Symptoms that affected 20% and more of the workers were itchy skin, throat irritation, coughing and difficulty in breathing. Tobacco smoke was considered the main stressor. Noise level mean for music venues was Neq 99,67 dB (A). Only 34,7% of the staff considered music noise a stressor, with 16,9% concerned about people noise. The percentage that considered their environment to be polluted was 81,06%, however, only 48,42% felt stressed. Virtually all univariate and multivariate associations between psychosocial and psychophysical variables suggest that satisfaction with psychosocial factors may have a positive influence on staff in places of entertainment. / Thesis (M.Med.Sc.)-University of Natal, 1995.

This empirical study assessed the perceived stressors in medical school environment and psychological outcomes in undergraduate medical students in a non - western sample. The sample consisted of African and Indian students in the Clinical group (N = 149) and a matched Control group, the Pre-clinical group (N = 158) bringing the total number of participants to 307. The research dealt with perceived stressors, coping mechanisms and outcomes in a medical school environment. Outcome was assessed using self-report instruments which examined stress symptoms and psychological distress. Both bivariate and multivariate correlational analyses were performed to investigate correlations and the predictive value of risk factors for psychological distress. The findings indicate that there are no significant differences in the perception of stressors in the medical school environment between the Pre-clinical and Clinical groups. Maladaptive coping strategies, perceived stressors and female gender have important roles to play in predicting psychological distress. High self-esteem and good social support for both groups, as well as optimism in the Clinical group protects against psychological distress. Strengths and limitations of this study as well as implications for intervention strategies among undergraduate medical students are also discussed. / Thesis (Ph.D.)-University of KwaZulu-Natal, 2003.

Psychosocial oncology is well established in Europe and in America. Similar initiatives are, however, rare in Africa. On the African continent, psychosocial services are scarce and often a luxury although the importance of psychosocial variables as mediators in the paediatric cancer outcomes have been widely recognised. The apartheid system in South Africa was instrumental in causing major disparities in health, education and socioeconomic status. In order to provide a more holistic service it becomes imperative to assess not only the psychosocial needs and resources of both children and parents who endure the disease but also the influence of socio-demographic variables such as race, educational level and socioeconomic status. This research was limited to collecting baseline information on how parents and children communicate about the illness, emotional responses and the psychological resources that they utilise to deal with the childhood cancer trajectory. The study group consisted of 100 children between the ages of 5 and 16 years who had been diagnosed with cancer and one or both parents of those children. Data was collected through semi-structured interviews and standardised self-report measures. The results of the study indicate that both parents and children did not suffer disabling psychopathology, but certainly evidenced symptoms of depression and anxiety indicative of adjustment difficulties. Communicating about the illness was generally limited to physiological aspects of the disease and medically related matters, while emotional issues were rarely articulated. Children, parents and their siblings relied heavily on medical staff for their information needs. The age of the child was a significant factor with reference to amount and complexity of information imparted to children: adolescents were given more information about the treatment and prognosis; while younger children were given a limited amount of information. Race, socioeconomic status and educational levels of parents not only influenced the meanings and beliefs families developed around the cancer experience, but also the manner in which they expressed their emotions and the coping strategies that they employed. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.

In the absence of a cure and/or vaccine, the best approach to HIV is to focus on prevention. However, preventative measures that are presently available in Nigeria do not target persons with intellectual disability despite their vulnerability to HIV infection. This study sought to compare the HIV knowledge, attitudes, and sexual practices of mildly/moderately intellectually impaired learners (IIL) and mainstream learners (ML) in Nigeria; to explore the contextual factors informing these, as well as both groups‗ exposure to HIV education. It also tested the relevance of the I-Change Model in predicting sexual abstinence among learners with intellectual disability. Findings can assist in developing tailored HIV prevention education for Nigerian learners with intellectual impairment. This cross-sectional, comparative study utilised mixed methods to investigate HIV knowledge, attitudes, and sexual practices among mildly/moderately IIL and ML in Nigeria. Mildly/moderately IIL (300) and ML (300) within the age range of 12-19 years in special and regular schools completed a questionnaire based on the I-Change Model. Focus group discussions and in-depth interviews were used with learners to explore contextual factors informing their HIV knowledge, risk perception, sexual behaviours and access to HIV education and services. Key informant interviews were used as independent sources of the same information with their teachers. Learners with intellectual impairment were less aware of HIV/AIDS than their non-disabled peers (p < 0.001), had lower HIV knowledge scores (p < 0.001) and lower HIV risk perception scores (p < 0.001). Sexual experience was reported by 79 (26.3%) of the IIL sample compared to 48 (16.0%) of the ML sample (p = 0.002). Girls with intellectual disability were 3.71 times more likely to report a history of sexual abuse than non-disabled girls (p = 0.041). Inconsistent condom use with casual partners (p < 0.001) and non-use of condoms during the last sexual activity (p < 0.001) was higher in IIL. The I-Change Model was most effective in predicting sexual abstinence among IIL, particularly regarding factors related to motivation and intention. Intellectually impaired learners were more vulnerable to HIV infection due to neglect, poverty, sexual abuse/exploitation, stigmatisation, pressure from non-disabled peers, denial of HIV education, and inaccessible HIV-related services. Teachers only provided them with sexuality and HIV education when sexual activity was suspected and/or from age 18. The content of such education comprised mainly warnings, misinformation and corporal punishment to instil fear and desexualise them. Thus, this group of learners was limited in the way they experienced and expressed their sexuality. Unlike with their non-disabled peers, teachers attributed sexual activity among IIL solely to natural urges without emotional involvement. Contrary to teachers‘ opinions, some IIL were involved in symbiotic, loving relationships with their II peers. In addition, those that were not yet in such relationships expressed the desire to find non-discriminatory partners in the future. They explored their sexuality through intimate relationships, sexual intercourse, peeping at the opposite sex, pornography, and masturbation. Condoms were less available to IIL than ML, and they lacked the self-efficacy to use them. They were also less available to II girls than II boys. Female learners with intellectual impairment often had older sexual partners due to sexual abuse/exploitation, unlike their non-disabled peers, who embarked on such relationships for financial/material gains. The findings of this study indicated that IIL were sexual beings, just like their non-disabled peers, and at higher risk of HIV infection than the latter. Stigma and discrimination are the root causes of all the disadvantages/barriers that IIL experience in accessing HIV information, education and related services. Therefore, there is the need to put stigma reduction strategies in HIV response to safeguard the health of IIL. In addition, there is a need for the development of a gender-sensitive, tailored sexuality and HIV/AIDS educational format for learners with intellectual disability in Nigeria. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.