The psychosocial and cultural predictors of cigarette smoking were examined among a sample of 175 African-American adults. Participants completed a self-report inventory containing the Beck Depression Inventory, the Perceived Stress Scale, the Speilberger State-Trait Anxiety, the African-American Acculturation Scale, and questions regarding their smoking, demographics, and risk-taking tendencies.

Background: Puerto Ricans experience high prevalence of type 2 diabetes (diabetes). Stress is a risk factor for diabetes. The allostatic load (AL) model explains how stress influences disease through a chain of physiological changes. Puerto Ricans experience psychological and physiological (obesity and high glycemic load (GL)) stressors linked with diabetes, yet how these stressors impact the AL chain and how their interplay affects glucose metabolism remains unknown. Methods: Using data from the Boston Puerto Rican Health Study, this thesis sought to examine: 1) the relationship between GL and primary AL markers, 2) the interaction between perceived stress and GL on HbA1c, and if primary AL markers mediate this interaction, and 3) the interaction between change in weight and in perceived stress on HbA1c. Results: 1) GL change over 2 years was associated with increases in primary AL markers in women. 2) Women with high perceived stress and high GL had higher HbA1c and primary AL markers did not mediate this interaction. 3) In women, there was an interaction between change in weight and perceived stress on HbA1c over 2 years, with the effect of weight change on HbA1c being greater with increases in perceived stress. None of these associations were observed in men. Conclusion: This study partially confirms the AL model in Puerto Rican women but not in men. It provides data to inform intervention targets to prevent and manage diabetes in Puerto Rican women and identifies women at high risk of diabetes in this minority group.

The ETSU dental hygiene program is very competitive and rigorous for those admitted. Student dental hygienists may experience higher levels of anxiety and more stressors while completing their course work and clinical hours than they have previously experienced in general education and prerequisite courses. These increased number of stressors and higher levels of anxiety may have negative impacts on students’ academic performance and success in clinical learning environments. A better understanding of the actual need for a stress reduction and anxiety management curriculum will facilitate creating and implementing this type of curriculum. A total of 44 current ETSU dental hygiene students were included in the study, juniors (55%) and (45%) seniors. Nearly all respondents reported their current stress and anxiety levels are affecting their lives (97.5%). Consistently over a third of students who completed surveys from the ETSU dental hygiene program are experiencing physical symptoms of stress and anxiety including headaches, gastrointestinal distress, trouble sleeping, eating too much or too little daily, tense muscles, worry or phobias, anger or hostility, irritability or hostility, and nervousness 2-3 times a week. The average stress level of the 44 ETSU dental hygiene students reported on a 1-10 scale was a 7.65. Nearly half (40%) of all ETSU dental hygiene students currently enrolled reported their stress level as 8 out of 10 with 10 defined as “I can only think of my stress and anxiety”. Further research including an educational intervention to help teach students skills and coping mechanisms to manage and reduce stress and anxiety was recommended.

Background: Physical activity and perceived stress affect college- and university students health.  Aim: The aim is to study the association between physical activity and perceived stress among college- and university students in Sweden, and to investigate whether gender, age, and BMI are confounding factors regarding the association between physical activity and perceived stress.   Method: A cross-sectional online survey was conducted among the study population students. The analytical approaches chosen were descriptive analysis, Pearson’s correlation coefficient, and multiple linear regression. Results: According to the correlation analysis, there was a small negative significant association between physical activity and perceived stress. According to the regression analysis, there was a small negative significant association between physical activity and perceived stress, which remained after considering gender, age, and BMI. Discussion: The association between high physical activity and low perceived stress can be explained by the protective impact physical activity has on health. Conclusions: There was an association between physical activity and perceived stress among college- and university students. The association between physical activity and perceived stress among college- and university students remained after controlling for gender, age, and BMI.

Researchers have neglected to focus on understanding the relationships between stress, coping, and social support among single mothers versus mothers who are not single. Knowledge regarding how single mothers' lives are affected by stress, social support, and coping is important, and such information can help readers better understand how effectively single mothers raise children compared with mothers who are not single. A convenience sample of 173 mothers completed this study. Participants in this study consisted of mothers who were (a) raising at least one child ages 18 and under who lives in the home and (b) who were between the ages 20 to 55 years old with a 12th-grade education or greater. Participants were classified into single mothers (those who reported their status as single, to include never married, separated, divorced, in a committed relationship, and widowed; n = 75) and those who were not single (those who reported their status as married, n = 98). Data were scored based on 3 measurement scales: (a) the Perceived Stress Scale, (b) the Ways of Coping Questionnaire, (c) and the Social Support Scale. An independent samples t test determined that mothers who were not single had higher social support than did single mothers, whereas single mothers had higher perceived stress than mothers who were not single. There were no significant differences on measures of coping. An analysis of covariance revealed no significant difference between stress and coping strategies among the mothers when social support was held constant. This study contributes to social change by providing awareness of the importance of social support to professionals and for single mothers. The findings of this quantitative study can thus guide single parenting research and interventions.

Cognitive failures (CF) refers to the experience of daily attentional lapses or workingmemory mishaps; for example, reading something and instantly forgetting what you haveread, or experiencing missing out on obvious information from street signs. Relationsbetween CF and psychological stress have been found, where higher levels of stress indicatea higher risk of experiencing CF, and the other way around. Psychological stress is proven tobe moderated by physical activity. However, there are scarce findings on the directrelationship between physical activity and CF. This thesis investigates by a cross-sectionalobservational design if there is a relationship between cognitive failures and physical activityin the middle-aged population. All data were collected by a web-based survey with thequestionnaires CFQ, IPAQ and PSS-10 followed by the short task Digit Span. The sampleconsisted of 78 participants between the ages of 50-65 (M = 56). A two-stage hierarchicallinear regression was performed. The results showed no association between CF and physicalactivity, however CF was associated with stress and sex. The results are confirming previousfindings in terms of the relationship between CF and stress, as well as the small, yetsignificant, sex difference where women tend to report higher levels of stress and higherlevels of CF. Further research is of need, to investigate the direct interventional effectphysical activity could have on CF in the general population. / “Cognitive failures” (CF) syftar på de dagliga hjärnsläpp man upplever relaterade tilluppmärksamhet, arbetsminne och perception; till exempel att läsa något och omedelbartglömma vad du har läst, eller att missa att notera uppenbara gatuskyltar. Samband mellan CFoch psykologisk stress har hittats, där högre nivåer av stress indikerar högre risk för CF, ochvice versa. Psykologisk stress har visats minskas av fysisk aktivitet. Det finns dock få fyndom det direkta sambandet mellan fysisk aktivitet och CF. Den här uppsatsen undersökergenom en tvärsnittsdesign om det finns ett samband mellan CF och fysisk aktivitet i dengenerella medelålders befolkningen. Studien genomfördes genom en webbaseradundersökning med enkäterna CFQ, IPAQ och PSS-10 följt av en kort objektiv övning.Urvalet bestod av 78 deltagare mellan 50-65 år (M = 56). En tvåstegs-hierarkisk linjärregression genomfördes. Resultaten visade inget signifikant samband mellan CF och fysiskaktivitet, dock fanns samband mellan CF och stress samt kön. Denna studie bekräftar tidigarefynd både gällande sambandet mellan CF och stress såväl som en mindre, men signifikant,könsskillnad, där kvinnor tenderar att rapportera högre nivåer av stress samt högre nivåer avCF. Framtida studier i ämnet behövs för att undersöka den direkta interventionella effektenfysisk aktivitet kan ha på CF i den generella befolkningen.

Background: The COVID-19 pandemic has been affecting everyone’s daily life in unknown measures since its outbreak. Nearly all Universities around the globe were affected. Further, young people and University students in particular, are known to be vulnerable for developing mental disorders. This study aims to examine the mental health social and emotional well-being and perceived burdens of University students during COVID-19 pandemic lockdown in Germany. Materials and Methods: This cross-sectional and anonymous online survey among University students assessed mental health status with standardized measures (depressive symptoms, alcohol and drug consumption, and eating disorder symptoms), attitudes toward the COVID-19 pandemic and perceived burdens, and social and emotional aspects of the pandemic (social support, perceived stress, loneliness, and self-efficacy). Results: In total, N = 3,382 German University students participated. Nearly half of the students (49%) reported that they are worried or very much worried about the COVID-19 pandemic. The majority supports the governmental lockdown measures (85%). A Patient Health Questionnaire-9 (PHQ-9) sum score of 10 or above, indicating clinically relevant depressive symptoms, was reported by 37% (n = 1,249). The PHQ-9 sum score was on average 8.66 (SD = 5.46). Suicidal thoughts were indicated by 14.5%of the participants. Levels of depressive symptoms differed significantly for the different self-rated income changes during the pandemic (increase, decrease, no change in income). Further, levels of depressive symptoms and suicidal ideation differed significantly for students from different faculties. Multiple regression analyses revealed that not being a parent, having no indirect social contact one or two times a week, higher perceived stress, higher experienced loneliness, lower social support, and lower self-efficacy significantly predicted higher scores of depressive symptoms, also higher hazardous alcohol use, and higher levels of eating disorder symptoms. Other aspects of lifestyle such as social and cultural activities, dating, and hobbies were reported to be negatively affected during the pandemic. Conclusion: The present study implies that University students are vulnerable and due to elevated depressive symptoms at risk, being hit hard by the pandemic, but are in general coping adaptively. Low-threshold online interventions promoting help-seeking and also targeting various mental health conditions might bridge the gap the COVID-19 pandemic opened up recently.

The purpose of this research was to examine rural middle school teacher’s perceptions of stressful factors present in their current position. Data was gathered from 5th, 6th, 7th, and 8th grade teachers in the city and county schools located in O County, Mississippi. Two instruments were used for the study. The first survey instrument identified three stress factors (teacher workload, student discipline, and No Child Left Behind) and their relationship with teachers. The second instrument measured the degree to which the three stress factors were appraised as stressful. The data gathered in this study provided an awareness of factors that can increase understanding of teacher stress levels. The discussion of stress emphasized that what is perceived as stressful for one person may not be perceived as stressful for another. Results revealed that these teachers face some difficulties at their schools and in the classroom dealing with their emotional perspective or from the perspective of the children they teach. Furthermore, results indicated that rural schools offer a less stressful learning environment than urban schools. Just knowing some of the common stress factors can assist school systems and administrators in developing interventions to alleviate stress that may at some point lead to burnout.

The dose-response relationship between physical activity (PA), disease and mortality has primarily been obtained from self-report questionnaires in Western populations. A major limitation of self-reported PA is the likelihood of measurement error and these recordings cannot account for all 24-h activities, thus negating the influence of sedentary time and daily light intensity activity. Modern-day studies using objective measures of PA are highly controversial in the description of PA, as well as reliable wear time of these objective devices to accurately assess PA behaviour. The aim of the research presented in this thesis was to ascertain the associations between seven-day objectively measured PA (expressed as time spent in four different metabolic equivalent of task (MET) categories), cardiovascular disease risk factors (24-h ambulatory blood pressure and central obesity), chronic stress (General Health Questionnaire total score and serum cortisol) and DNA damage (leukocyte telomere length) in a cohort of African and Caucasian school teachers recruited from the Dr Kenneth Kaunda Education District in the North West Province of South Africa. All parameters were objectively measured (the GHQ was only added for thoroughness on measures of cognitive perceived stress) in the study population. The Africans (n=96) were younger than the Caucasians (n=107) (48.33 versus 51.06 years, p=0.024), but presented with slightly higher waist circumferences, significantly higher 24-h ambulatory systolic blood pressure (SBP, p≤0.000), diastolic blood pressure (DBP, p≤0.000) and mean arterial pressure (MAP, p≤0.000); significantly higher perceived stress scores (GHQ total scores, p=0.001) and significantly shorter telomeres (p≤0.000). The hypertensive participants in the total group (Africans and Caucasians combined) recorded 2.2 hours (12.4%) more daily awake sedentary time than the normotensive participants (p=0.004) and sedentary time was also a slightly better predictor of hypertension than moderate and vigorous activity time (Odds ratio=1.00, p=0.006). Irrespective of race and sex, 24-h SBP and DBP measurements were respectively associated with daily awake sedentary time (ß=0.17, p=0.018 and ß=0.18, p=0.020), light activity time (ß=-0.15, p=0.043 and ß=-0.16, p=0.041), waist circumference (ß=0.45, p≤0.000 and ß=0.33, p≤0.000) and log serum gamma glutamyl transferase (γ-GT, alcohol use) (ß=0.18, p=0.018 and ß=0.24, p=0.004). An older age (ß=-0.28, p≤0.000), higher alcohol consumption (ß=-0.21, p=0.003) and increased central obesity (ß=-0.17, p=0.017) were associated with shorter telomeres. Attenuated cortisol levels (ß=-0.12, p=0.068) showed a tendency towards associations with longer telomeres that may indicate possible cortisol down regulation to protect against DNA damage. Time spent in the different MET-categories showed no direct associations with either cortisol or telomere length. However, a sensitivity analysis indicated that daily light intensity activity time was significantly correlated with lower waist circumference (r=-0.21, p=0.004); a parameter associated with both cortisol (ß=-0.22, p=0.003) and telomere length (ß=-0.17, p=0.017). The thorough recording of PA during the true awake time of 24-h cycles over a period of seven days ensured that the beneficial effect of light intensity activities, as well as the detrimental effect of sedentary time, was highlighted by this study. The average awake time of all ethnic and sex groups were around 17 hours per day, which was more than most previous studies using objective measures of PA. The exclusion of participants who did not comply through wearing the Actiheart for a full seven days (n=143, 40%) did, however, have a negative impact on sample size that may have affected the statistical power for uncovering some significant associations and the high participant burden of the Actiheart device became clear. Therefore, the researchers used the data of the full seven-day recordings to also determine the minimum number of consecutive days the Actiheart device could be worn to accurately estimate energy expenditure and PA. The two-day combination of Wednesday-to-Thursday did not differ from the weekly average TEE, as well as for all MET-categories in all ethnic and sex groups. This two-day combination is practically convenient and would lessen participant burden. Future researchers are urged to test this combination in other populations to standardize Actiheart wear time. It can be concluded from the findings in this study that less daily awake sedentary time, more light intensity activity time, as well as lower alcohol consumption favour improved health as it is beneficial to 24-h ambulatory blood pressure and helps to maintain a healthy waist circumference, which ultimately influence telomere shortening. Furthermore, the two-day combination of Wednesday-to-Thursday seems to be sufficient to accurately estimate weekly energy expenditure and habitual PA with the Actiheart apparatus. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2015

The dose-response relationship between physical activity (PA), disease and mortality has primarily been obtained from self-report questionnaires in Western populations. A major limitation of self-reported PA is the likelihood of measurement error and these recordings cannot account for all 24-h activities, thus negating the influence of sedentary time and daily light intensity activity. Modern-day studies using objective measures of PA are highly controversial in the description of PA, as well as reliable wear time of these objective devices to accurately assess PA behaviour. The aim of the research presented in this thesis was to ascertain the associations between seven-day objectively measured PA (expressed as time spent in four different metabolic equivalent of task (MET) categories), cardiovascular disease risk factors (24-h ambulatory blood pressure and central obesity), chronic stress (General Health Questionnaire total score and serum cortisol) and DNA damage (leukocyte telomere length) in a cohort of African and Caucasian school teachers recruited from the Dr Kenneth Kaunda Education District in the North West Province of South Africa. All parameters were objectively measured (the GHQ was only added for thoroughness on measures of cognitive perceived stress) in the study population. The Africans (n=96) were younger than the Caucasians (n=107) (48.33 versus 51.06 years, p=0.024), but presented with slightly higher waist circumferences, significantly higher 24-h ambulatory systolic blood pressure (SBP, p≤0.000), diastolic blood pressure (DBP, p≤0.000) and mean arterial pressure (MAP, p≤0.000); significantly higher perceived stress scores (GHQ total scores, p=0.001) and significantly shorter telomeres (p≤0.000). The hypertensive participants in the total group (Africans and Caucasians combined) recorded 2.2 hours (12.4%) more daily awake sedentary time than the normotensive participants (p=0.004) and sedentary time was also a slightly better predictor of hypertension than moderate and vigorous activity time (Odds ratio=1.00, p=0.006). Irrespective of race and sex, 24-h SBP and DBP measurements were respectively associated with daily awake sedentary time (ß=0.17, p=0.018 and ß=0.18, p=0.020), light activity time (ß=-0.15, p=0.043 and ß=-0.16, p=0.041), waist circumference (ß=0.45, p≤0.000 and ß=0.33, p≤0.000) and log serum gamma glutamyl transferase (γ-GT, alcohol use) (ß=0.18, p=0.018 and ß=0.24, p=0.004). An older age (ß=-0.28, p≤0.000), higher alcohol consumption (ß=-0.21, p=0.003) and increased central obesity (ß=-0.17, p=0.017) were associated with shorter telomeres. Attenuated cortisol levels (ß=-0.12, p=0.068) showed a tendency towards associations with longer telomeres that may indicate possible cortisol down regulation to protect against DNA damage. Time spent in the different MET-categories showed no direct associations with either cortisol or telomere length. However, a sensitivity analysis indicated that daily light intensity activity time was significantly correlated with lower waist circumference (r=-0.21, p=0.004); a parameter associated with both cortisol (ß=-0.22, p=0.003) and telomere length (ß=-0.17, p=0.017). The thorough recording of PA during the true awake time of 24-h cycles over a period of seven days ensured that the beneficial effect of light intensity activities, as well as the detrimental effect of sedentary time, was highlighted by this study. The average awake time of all ethnic and sex groups were around 17 hours per day, which was more than most previous studies using objective measures of PA. The exclusion of participants who did not comply through wearing the Actiheart for a full seven days (n=143, 40%) did, however, have a negative impact on sample size that may have affected the statistical power for uncovering some significant associations and the high participant burden of the Actiheart device became clear. Therefore, the researchers used the data of the full seven-day recordings to also determine the minimum number of consecutive days the Actiheart device could be worn to accurately estimate energy expenditure and PA. The two-day combination of Wednesday-to-Thursday did not differ from the weekly average TEE, as well as for all MET-categories in all ethnic and sex groups. This two-day combination is practically convenient and would lessen participant burden. Future researchers are urged to test this combination in other populations to standardize Actiheart wear time. It can be concluded from the findings in this study that less daily awake sedentary time, more light intensity activity time, as well as lower alcohol consumption favour improved health as it is beneficial to 24-h ambulatory blood pressure and helps to maintain a healthy waist circumference, which ultimately influence telomere shortening. Furthermore, the two-day combination of Wednesday-to-Thursday seems to be sufficient to accurately estimate weekly energy expenditure and habitual PA with the Actiheart apparatus. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2015