A dissertation submitted to the Faculty of Medicine in part fulfilment of the requirements for the Degree of Master of Medicine in Psychiatry at the University of the Witwatersrand. Johannesburg / This dissertation consists of a review of the literature, past and present, pertaining to the metal lithium. An overview is presented of its actions, its adverse effects, and its use in medicine particularly in psychiatry. As it is not irregular for many patients to receive two or more drugs concomitantly and often in a combination which has the potential to interact adversely, an overview of these interactions is also presented. / IT2018

Abstract Working memory has been identified as an area in which children diagnosed with ADHD experience difficulty (Carnoldi, Marzocchi, Belotti, Caroli, De Meo & Braga, 2001). However, there are conflicting findings regarding the nature of working memory deficits in children diagnosed with ADHD and some researchers believe that working memory deficits may differ between the two ADHD subtypes (Diamond, 2005; Douglas, 2005; Knouse 2007; Milich , Balentine & Lynam, 2001). In addition, it is also thought that working memory may be one of the main contributing factors of this disorder (Rapport, Chung, Shore & Isaacs, 2001). Thus, there is clearly a need for additional and more detailed investigation into the way individuals with ADHD test with regard to their working memory functioning. This study attempted to examine the working memory functioning in children diagnosed with ADHD, in particular, the Predominantly Inattentive subtype and Predominantly Hyperactive/impulsive subtype in comparison to a control group. A sample of seventy-two participants was tested using the Ravens Progressive Coloured Matrices (RPCM) and the Automated Working Memory Assessment (AMWA) to assess their nonverbal intelligence and working memory. The primary motivating factor for the choice of participants was that they had to have been diagnosed by a professional as having ADHD (either subtype) and they had to be in Grades one or two. None of the children in the control group met the DSM-IV-TR (APA, 2000) criteria for ADHD. Repeated measures Abstract Working memory has been identified as an area in which children diagnosed with ADHD experience difficulty (Carnoldi, Marzocchi, Belotti, Caroli, De Meo & Braga, 2001). However, there are conflicting findings regarding the nature of working memory deficits in children diagnosed with ADHD and some researchers believe that working memory deficits may differ between the two ADHD subtypes (Diamond, 2005; Douglas, 2005; Knouse 2007; Milich , Balentine & Lynam, 2001). In addition, it is also thought that working memory may be one of the main contributing factors of this disorder (Rapport, Chung, Shore & Isaacs, 2001). Thus, there is clearly a need for additional and more detailed investigation into the way individuals with ADHD test with regard to their working memory functioning. This study attempted to examine the working memory functioning in children diagnosed with ADHD, in particular, the Predominantly Inattentive subtype and Predominantly Hyperactive/impulsive subtype in comparison to a control group. A sample of seventy-two participants was tested using the Ravens Progressive Coloured Matrices (RPCM) and the Automated Working Memory Assessment (AMWA) to assess their nonverbal intelligence and working memory. The primary motivating factor for the choice of participants was that they had to have been diagnosed by a professional as having ADHD (either subtype) and they had to be in Grades one or two. None of the children in the control group met the DSM-IV-TR (APA, 2000) criteria for ADHD. Repeated measures Abstract Working memory has been identified as an area in which children diagnosed with ADHD experience difficulty (Carnoldi, Marzocchi, Belotti, Caroli, De Meo & Braga, 2001). However, there are conflicting findings regarding the nature of working memory deficits in children diagnosed with ADHD and some researchers believe that working memory deficits may differ between the two ADHD subtypes (Diamond, 2005; Douglas, 2005; Knouse 2007; Milich , Balentine & Lynam, 2001). In addition, it is also thought that working memory may be one of the main contributing factors of this disorder (Rapport, Chung, Shore & Isaacs, 2001). Thus, there is clearly a need for additional and more detailed investigation into the way individuals with ADHD test with regard to their working memory functioning. This study attempted to examine the working memory functioning in children diagnosed with ADHD, in particular, the Predominantly Inattentive subtype and Predominantly Hyperactive/impulsive subtype in comparison to a control group. A sample of seventy-two participants was tested using the Ravens Progressive Coloured Matrices (RPCM) and the Automated Working Memory Assessment (AMWA) to assess their nonverbal intelligence and working memory. The primary motivating factor for the choice of participants was that they had to have been diagnosed by a professional as having ADHD (either subtype) and they had to be in Grades one or two. None of the children in the control group met the DSM-IV-TR (APA, 2000) criteria for ADHD. Repeated measures of Mann-Whitney and post-hoc analysis revealed that there were significant differences in the verbal short term memory, verbal working memory and visuospatial working memory between the three groups. Test results revealed no significant differences between the test scores of the Inattentive group and the control group in these areas. However, scores obtained by the Hyperactive/impulsive group differed significantly from those of the control and Inattentive groups. Score differences related specifically to verbal short term memory, verbal working memory and visuospatial working memory. This implies that children diagnosed with ADHD, (the Hyperactive/impulsive subtype) may need specific strategies in the classroom to enable them to encode, access and retrieve information to ensure optimal performance. The implications of these findings are discussed further in the thesis.

Background: Emigration of health-care workers is a problem within global health systems which affects many countries, including Peru. Several factors have caused health-care workers to emigrate, including burnout syndrome (BS). This study aims to identify the association between BS and its dimensions with the intention of physicians and nurses to emigrate from Peru in 2014. Methods: A cross-sectional study, based on a secondary analysis of the National Survey of Health Users (ENSUSALUD - 2014) was conducted. Sampling was probabilistic, considering the 24 departments of Peru. We include the questionnaire for physicians and nurses, accounting for 5062 workers. BS was measured by the Maslach Burnout Inventory-Human Services Survey. Adjusted odds ratio (OR) was calculated using multiple logistic regression. Results: Of the study population, 44.1% were physicians, 37.7% males, and 23.1% were working in Lima. It was found that 2.8% [95% confidence interval (CI): 2.19–3.45] of health-care workers had BS. The overall prevalence of intention to emigrate among health-care workers was 7.4% (95% CI: 6.36–8.40). Association was found between BS and intention to emigrate in Peruvian health-care workers (OR = 2.15; 95% CI: 1.05–4.40). Emotional exhaustion was the BS dimension most associated with intention to emigrate (OR = 1.80; 95% CI: 1.16–2.78). Conclusion: Physicians and nurses from Peru who suffered from BS were more likely to have intention to emigrate. Policies should be established to reduce BS as a strategy to control “brain drain” from health-care workers of Peru. / Revisión por pares

MSc (Physiotherapy), Faculty of Health Sciences, University of the Witwatersrand / In South Africa, the concept of Developmental Co-ordination Disorder (DCD) is relatively unfamiliar and not well understood. The exact epidemiology is unknown, but the Diagnostic and Statistical Manual of Mental Disorders (DSM IV, 2000) indicate that the value could be between five and ten percent of the American population. Many studies on DCD have been conducted and most highlight the immense difficulties these children experience with motor activities, both in sport and daily tasks. However, few studies specifically investigated endurance and the impact it has on the child’s ability to function normally without too much effort and fatigue due to the condition. The main aim of this study was to determine the difference in submaximal endurance levels between children diagnosed with DCD and normally developing children. Children between the ages of seven and ten years were included in the study. The Six Minute Walk Test (6MWT) was employed to determine the average distance covered by each of two groups that were selected to participate in the study and thus, the submaximal endurance levels of each group. The first group of participants consisted of children having a diagnosis of DCD (n=31) and the second comparative group consisted of normally developing children (n=17). The results were analysed and compared using the Student t-test. Anthropometric data of height, age, gender and weight as well as baseline data of breathing rate, heart rate and peak flow were taken. These were compared to normative data as determined by the growth charts of the Centre for Disease Control and Prevention (CDC) as well as previous research on the various topics. The average distance covered by the DCD group was 375.89 metres with a standard deviation of ±73.33 and the mean distance covered by the normal comparative group was 430.48 metres with a standard deviation of ±60.85. When the two groups were compared it produced a p-value of 0.0086 which was a statistically significant difference. The normally developing group covered on average 54.6 metres more distance than the group with co-ordination difficulties. In comparison to studies that determined normal age (Lammers et al, 2008) and height (Li et al, 2007) reference values, the children within the eight-year age band for the normally developing group fell within the determined values. The other age bands fell below average for both the DCD and normally developing groups. The finding of the current study is important as it highlights the discrepancy in the submaximal endurance levels of children with DCD when compared to normally developing children of the same age. This is important when considering that most of the activities of daily living are performed at submaximal endurance levels and it is particularly important to note that these are the activities that children with DCD find challenging. The 6MWT can be performed by children as young as four years of age, with explanation and encouragement. This is particularly helpful in the clinical setting, as other tests of physical fitness require more time, equipment and generally good co-ordination in the individual being tested. The 6MWT is easy to apply and requires few tools, making it a cost and time effective means of testing submaximal fitness in children. It is thus a useful measure to determine whether therapeutic intervention has impacted endurance for activities of daily living.

There is a higher prevalence of hearing loss in children with diagnosed neurological disorders than the general paediatric population. It is therefore essential that these children have their hearing assessed. Conventional behavioural audiometry requires participation from the child, and in a majority of this population with neurological pathology this is not always possible owing to their neurocompromised state. These children will have to undergo objective testing, such as the Auditory Brainstem Response (ABR) in order to obtain estimated hearing thresholds, as this requires no active involvement from the patient. This study therefore aims to describe the audiological ABR findings in order to determine hearing function in this group and to establish a relationship between audiological ABR findings to behavioural audiometry findings where these exist in a group of neurologically disordered children in a tertiary hospital in South Africa. Methods: A retrospective review was conducted on 40 ABR patient records of children between the ages of 5 months and 10 years diagnosed with a neurological disorder. Behavioural audiometry results were then sought for these children, where these existed. Hearing status was described for each child per ear for both objective and behavioural results, and descriptive statistics were conducted. Results: 56.25 % (n=45) of ears in this study presented with normal hearing on ABR testing. No behavioural audiometry results were obtained in 72.5 % (n=58) of ears in this study. Results correlated between ABR and behavioural testing for only 7.5% (n=8) of ears tested and in all eight of these ears the hearing result was within normal hearing limits. Twelve and a half percent (n=10) of ears were misdiagnosed on behavioural testing. More premature infants were able to be tested behaviourally when compared to other pathologies. Cerebral palsy, Down’s Syndrome, prematurity and RVD were the pathologies in which the most hearing losses were diagnosed. Conclusions: Behavioural audiometry appears a largely unreliable method of hearing testing in children diagnosed with neurological disorders as results were obtained in only 27.5 % of the study sample; however it remains the gold standard in paediatric hearing testing in order to evaluate the entire auditory system and provides information on how a child processes sound, unlike ABR testing which only provides hearing information up to the auditory brainstem. This study highlights the high prevalence of hearing problems in children with neurological disorders and therefore the importance of hearing testing in this population. Hearing thresholds should be established for subsequent remediation via objective testing. Conditioning should continue simultaneously for a behavioural audiological test battery with adaptations for the child’s developmental ability.

M.Sc. (Physiotherapy), Faculty of Haelth Sciences, University of the Witwatersrand, 2008. / Children with Developmental Coordination Disorder (DCD) are a heterogeneous group who have a marked impairment in the performance of functional motor skills. DCD affects 5-8 % of children in the mainstream educational system, with twice as many boys than girls being affected. DCD often co-occurs with other developmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit (ADD), severe learning disabilities and reading disabilities and is often associated with educational, social and emotional problems that often persist beyond adolescence. Current research has shown that children with DCD do not outgrow their motor problems and without intervention they do not improve (Zoia et al, 2006; Barnhart et al, 2003; Peters and Wright, 1999). The aim of this study was to investigate the effect of an eight week group gross motor intervention programme on 26 children with Developmental Coordination Disorder (DCD) at Forest Town School, which is a special-needs school for children with learning disabilities. The intervention programme consisted of gross motor activities commonly used by the physiotherapists at the school for their DCD groups. The children attended a thirty-minute physiotherapy session a week, in groups of up to 6, for eight weeks. The children’s motor performance was assessed using the Bruininks-Oseretsky Test for Motor Proficiency (BOTMP) pre- intervention, post- intervention and then eight weeks after the intervention had ceased. The children were used as their own controls. The results of the statistical analysis revealed that the mean group gross motor and fine motor scores significantly improved after the intervention. It was found that the gross motor scores improved by a larger percentage than the fine motor, which may be because the intervention consisted purely of gross motor activities. The fine motor scores also significantly improved, implying that there was a transfer or generalisation of skills to the fine motor tasks. The improvement in the motor performance was found to be maintained eight weeks after the intervention was stopped. It was concluded in the study that the eight week group physiotherapy programme at Forest Town School improved the motor skills of children with DCD and learning difficulties. Physiotherapy in a small group may therefore be a cost effective solution for the treatment of children with DCD in government-funded schools and hospitals that have a limited number of physiotherapists available to treat these children.

This thesis is part of a creative arts PhD which explores the possibilities of constructed images and the memory of the South African Border War. It was presented together with an exhibition of constructed photographic images entitled BOS. In the thesis I argue that the memory of the war, an event now almost three decades past, continues to be problematic. I also argue that photographs are themselves complex and constructed objects that do not provide a simple truth about either history or memory. Photographs can supplement or support memories but they are always to be viewed with suspicion. In Chapter One I explore the limitations imposed on the speech of conscripts, both during the conflict and in the years following the conclusion of hostilities. In Chapter Two I examine the recent appearance of several ‘anti-­‐ heroic’ memoirs of the conflict written by conscripts. The use of the medical diagnosis of post-­‐traumatic stress syndrome (PTSD) in these writings is critically examined. Chapter Three focuses on a development in the ideas of the two most influential figures in the field of Anglophone photographic theory, Susan Sontag and Roland Barthes. I argue that their initial hostility to the photographic image on ethical/political grounds has been replaced by a more nuanced engagement with the power of the image. I then examine the views of two contemporary writers on photography, both deeply involved with the analysis of traumatic images: Ariella Azoulay and Susie Linfield. In Chapter Four, I engage with the artistic practice of the American photographer, David Levinthal, an important reference point for this project because of his photographic work with miniatures and toys and his place within what I describe as ‘critical postmodernism’. In Chapter Five, I examine the themes of silence and censorship as these pertain to the photography of the Border War using Susan Sontag’s notion of the “ecology of images”. I analyze the types of images which have been produced from the war, looking at the “limited photojournalism” of John Liebenberg and the role of iconic images in the propaganda war. Finally, in Chapter Six, I present an account of the process of creating the work for the BOS exhibition in which I employed a combination of strategies involving appropriation, miniaturization, and re-­‐staging.

Thesis advisor: William Stanwood / This research study seeks to answer the question of whether or not televisions advertisements’ depictions of female body image influences eating disorders in the young women who view such advertisements. The role of the cognitive processes social comparison theory and thin-ideal internalization was also explored as mediators in this relationship, as well as the efficiency of various programs aimed at correcting the problem of eating disorders in young women. Results were obtained by coding and observing the advertisements of various television programs popular among such a demographic. Messages encouraging thinness were recorded, as well as the percentage of thin actresses viewed. After analyzing the results and reviewing recent research on the problem, the conclusion was made there is likely a relationship between eating disorders and the depiction of the thin-ideal in advertising, however such a relationship is largely dependent on the female viewer herself, andmany other factors. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Communication Honors Program. / Discipline: Communication.

Thesis advisor: Paul Kline / This three paper dissertation considers whether yoga--a popular mind-body practice combining physical postures and movement, mindfulness, and breath exercises--may be a useful component of treatment for adult trauma survivors. The first paper involves a systematic review and meta-analyses of the current evidence base for yoga in the treatment of anxiety, depression, and PTSD among trauma survivors. The second and third papers are grounded in a single, mixed-methods multi-wave data source aimed at examining yoga's contribution to recovery for adult women who have complex trauma histories (i.e., sustained and/or multiple traumatic experiences such as recurring physical or sexual abuse). The second paper is a quantitative study employing hierarchical linear and logistic regression to examine associations between yoga practice and reductions in traumatic symptomology over time. The third paper is a hermeneutic phenomenological study exploring how women with complex trauma histories experience practicing yoga and its potential role in their coping and healing processes over time. Taken together, these three papers offer insights into the complex healing needs of adult survivors suffering from the effects of traumatization, and the promising role of yoga within their recovery processes. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

by Cheung Kei Wai. / Parallel title in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves 119-123). / Acknowledgement --- p.ii / Abstract --- p.iii / List of Abbreviations --- p.vii / List of Figure and Table Captions --- p.viii / List of Publication --- p.xiii / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- Normal Diffusion --- p.4 / Chapter 1.2 --- Statistical Origin of Anomalous Diffusion --- p.10 / Chapter 1.3 --- Various Models of Diffusion --- p.15 / Chapter 2. --- Scaling Theory of Hopping Transport in One Dimension --- p.21 / Chapter 2.1 --- "Scaling Exponents, the Models and their Solutions" --- p.22 / Chapter 2.2 --- Numerical Simulations --- p.32 / Chapter 2.3 --- Relations to Diffusion on Fractals and Hierarchical Structures --- p.37 / Chapter 2.4 --- Non-Markovian Nature of Results and Quasi-localization Effect --- p.42 / Chapter 3. --- Renormalization Group (RG) Analysis of the Problem --- p.43 / Chapter 3.1 --- The Length Scale Renormalization (LSR) --- p.45 / Chapter 3.2 --- Application of the LSR to Random Barrier Model --- p.52 / Chapter 3.2.1 --- The distribution of the renormalized coupling constants / Chapter 3.2.2 --- Behaviour of W and V under the LSR transformation / Chapter 3.3.3 --- The scaling exponents from LSR / Chapter 3.3 --- Scaling Form of Diffusion Front --- p.66 / Chapter 4. --- Diffusion in Hierarchical Systems --- p.72 / Chapter 4.1 --- Scaling and Probability Densities --- p.75 / Chapter 4.2 --- Exact Renormalization and Lattice Green Function --- p.82 / Chapter 4.3 --- The Range of Diffusion --- p.89 / Chapter 5. --- Biased Diffusion --- p.95 / Chapter 5.1 --- Scaling Theory --- p.98 / Chapter 5.1.1 --- Linear Response / Chapter 5.1.2 --- Diffusion-Drift Crossover / Chapter 5.2 --- Crossover Behaviour under an Additional Bias --- p.103 / Chapter 6. --- Physical Realizations and Related Problems --- p.108 / Chapter 6.1 --- Physical Realizations --- p.109 / Chapter 6.2 --- Equivalence with Random Resistor Network (RRN) Problems --- p.113 / Chapter 7. --- Discussion and Conclusion --- p.116 / References --- p.119 / Chapter Appendix A --- Derivation of Eq. (1.3.8) --- p.124 / Chapter Appendix B --- Derivation of Eq. (1.3.10) --- p.126 / Chapter Appendix C --- Sampling from a Distribution --- p.129 / Chapter Appendix D --- Scaling Form of P (s) in Ordered System --- p.130 / Chapter Appendix E --- Explicit Form of the Lattice Green Function --- p.132