In 2010, approximately two-thirds of adults and one-fifth of the adolescent population in the United States were considered either overweight or obese, resulting in the United States having the highest per capita obesity rate among all OECD countries. A considerable body of literature regarding health behavior, health outcomes, and public policy exists on what the Centers for Disease Control and Prevention considers an obesity epidemic. In response to the growing problem of childhood obesity, the Child Nutrition and WIC Reauthorization Act of 2004 (CNRA), which required that schools participating in the National School Lunch Program and/or School Breakfast Program have wellness policies on file, was passed. The purpose of this research is to provide additional insight into the origin of the geographic variation in adolescent obesity rates between the U.S. states. Previous research has looked at differences in built environments, maternal employment, food prices, agriculture policies, and technology factors in an effort to explain the variation in adolescent obesity prevalence. This dissertation contributes to the literature by examining the hypothesis that state-level school wellness policies also played a role in determining the rates of childhood obesity. Using School Health Policies and Practices Study (SHPPS) surveys from 2000 – 2012, I derived a state-level school wellness policy measure. This, together with Youth Risk Behavior Surveillance survey data on adolescent BMI was used to measure the effect of the wellness policy mandate on adolescent obesity prevalence. Several models were applied to first demonstrate that the state of residence for an adolescent is indeed related to BMI trends and then to investigate various determinants of adolescent obesity including the primary variable of interest, state school wellness policies. The results of this research provide evidence of a statistically significant, although very small positive effect of school wellness policies on adolescent BMI that is contrary to my hypothesis. Dominance analysis showed that of the four wellness policy factors considered in the principal component composition of the wellness policy measure, policy components that met state requirements rather than those meeting health screen criteria, state recommendations, and national standards were most important in explaining the overall variance of the regression model. Interestingly, the public school attendance rate itself was also associated with a substantial decrease in adolescent BMI. Understanding the determinants of adolescent obesity and how to effect change in the rising trend is a national concern. Obese adolescents are at significant risk of becoming obese adults and previous research has already shown the high economic costs associated with adult obesity and its comorbidities. Policies implemented in school, where adolescents consume a considerable portion of their daily calories and participate in physical activity, can help to build healthy habits that have the potential to lower the probability of an adolescent becoming an obese adult. Over time, a healthier adult population may result in lower economic costs associated with medical care and lost productivity.

Magister Commercii (Industrial Psychology) - MCom(IPS) / Through the Health and Safety Act, government has placed pressure on corporate organisations to exercise their duty of care and provide support to employees who may have psychological difficulties. Employee Assistance Programmes (EAP) is the one way in which organisations can fulfil their duty according to the Health and Safety Act. Human Resource is most important and valuable resource an organisation has which is often not even recognized. The effectiveness of an organisation is to a large extent dependent on the well-being of its staff. An employee assistance programme is designed to help employers manage issues of performance in the workplace. Employees manage the balance between work and personal pressures which have become increasingly part of daily life. Furthermore, the success of this programme depends on the flexibility it has according to the ever-changing needs of employees, organisations and society. The organisation in this study does not have formal assistance programmes in place to provide support to its employees who may have psychological difficulties. This study examines the need of an Employee Assistance Programme from the perception of both the employer and the employee and reveals that both groups have different needs, experience different types of problems and view the EAP in different contexts. Despite the differences in opinion, the evidence indicates that both employer and employee perceive there to be a great need for an EAP.

Philosophiae Doctor - PhD / The Wellness Leadership White Paper states that leadership is needed in a supportive environment with the purpose of guiding clients to lasting wellness. Wellness can be defined as an active process that enables an individual to become aware of all aspects of the self and to make choices in terms of a more healthy existence by means of balancing and integrating various life dimensions. Health care professionals are leaders who play an important role in creating an environment that contributes to wellness. Their leadership is, therefore, viewed as a wellness strategy. Leadership has been identified as an essential role of health care professionals with a responsibility to attend to the needs of their clients, such as youth victims of violence, with the aim of leading them towards wellness. The Provincial Nursing Strategy of the Western Cape in South Africa emphasises the need for health care professionals to demonstrate their leadership capacity in practice. In the communities of the Western Cape Province of South Africa, many youth victims of violence report for treatment at the health care facilities; it places a high burden on the health care system. Even though health care professionals provide treatment to this group of youth, it is not clear how health care professionals lead them towards wellness after an incidence of violence. The purpose of this study was to develop a conceptual framework that can be implemented by health care professionals to gain a better understanding about the important role they play in leading youth victims of violence towards wellness in a rural community in the Western Cape Province of South Africa. This research study applied a qualitative, exploratory, descriptive and contextual design. The study population who were selected by means of a purposive sampling technique consisted of youth attending a high school and who had been victims of violence and of health care professionals (professional nurses, medical doctors and social workers) working at the health care facilities in the community where the study was conducted. The study was conducted in four phases. Phase 1 of the study focused on the exploration and description of the expectations of the youth victims of violence about how health care professionals should lead them towards wellness. Focus group discussions (FGDs) were conducted at a high school at the study site. Phase 2 explored and described the experiences of health care professionals who were supporting youth victims of violence at the health care facilities in the community of study. The execution of this phase comprised of unstructured individual interviews. The total number of the FGDs and unstructured individual interviews conducted in this study was determined by data saturation. Data analysis of the data collected involved transcription of the voice recordings of the all the interviews and writing up of field notes. The steps of Tesch’s coding technique were used at the end of Phases 1 and 2. To ensure trustworthiness of the collected data, Guba and Lincoln’s strategies of credibility, transferability, dependability, confirmability and authenticity were applied. Phase 3 of this study entailed the development of a conceptual framework for health care professionals to lead youth victims of violence towards wellness. It was based on the findings from Phases 1 and 2 of the study; Phase 4 of the study involved peer debriefing and validation of the developed conceptual framework. In Phase 1 of the study, a total of nine (n = 9) FGDs were conducted among fifty eight (n = 58) youth participants between the ages of 15 and 19 years. Each group consisted of 6 to 8 participants and the interviews did not last more than an hour per session. The data analysis in this phase showed that the youth victims of violence did have expectations from the health care professionals in guiding them towards wellness. They shared their interpretation of the term wellness and were also quite aware of the challenges in their community. Four categories emerged from the data in Phase 1: Category 1 - Dimensions of wellness as it related to healthy body, mind, spirit and positive interactions: The findings of this category revealed that youth participants described wellness as a holistic concept that comprised healthy living, self-care and a healthy personality and mind (emotional, psychological) as well as spiritual well-being. They did not necessarily consider wellness as the absence of sickness or illness, Category 2 - Common problems among youth in the context of the community: They articulated that drug abuse, teenage pregnancy and violent behaviour were important issues of concern to them in their community. Category 3 – Building a sound and trusting relationship: They expressed their need for health care professionals to have a positive attitude towards them, to be respectful and to provide them with accurate information, as well as confidential and supportive services. Category 4 - Guidance of youth to wellness: The youth also proposed strategies that they believe could be used by the health care professionals while guiding them towards wellness. These strategies were: Provision of information / health education, school and community outreach programmes, provision of counselling services and role modelling. For the second phase, seven (n = 7) health care professionals were interviewed. Two (n = 2) were professional nurses, three (n = 3) medical doctors and two (n = 2) social workers. The findings of the individual interviews indicated that the health care professionals recognised the fact that wellness is very important. However, they felt that guiding youth victims of violence toward wellness was a challenging process. Three categories emerged from the data in Phase 2: Category 1 - Different points of view about the concept of wellness: The health care professionals described wellness as the holistic wellbeing of a person, an absence of illness or disease and living a healthy lifestyle. Category 2 - Barriers to leading youth victims of violence towards wellness: The health care professionals reported challenges while attempting to lead youth victims of violence towards wellness which included low socioeconomic status of families, unsupervised youth, violent behaviour, drug and substance abuse, a lack of resources in the community, negative staff attitudes, inadequate physical infrastructure and human resources as well as the absence of a process of guiding youth victims to wellness. Category 3 - Guidance to leading youth victims to wellness: The health care workers proposed strategies for guiding youth victims towards wellness. Those strategies included the provision of support in the form of counselling services, use of support groups, family and community support; recreational activities, dedicated staff to work with youth victims of violence and a multidisciplinary team approach. The findings from the first two phases were triangulated during the third phase of this study with the purpose of developing a conceptual framework. The survey list of Dickoff, James and Wiedenbach formed the foundation of the reasoning map for the development of the framework. The unique contribution of this study is the development of an original, participative leadership framework that provides health care professionals with information for leading youth victims of violence towards wellness in a rural community in the Western Cape. This study was conducted in a single rural community of the Western Cape Province of South Africa. Despite this limitation, the framework could be evaluated for use in similar settings. Finally, guidelines to implement the framework and recommendations for improving community health care practice, nursing education and nursing research were suggested based on the findings from the study.

Master of Public Health - MPH / Non-communicable diseases (NCDs) are the leading causes of deaths worldwide and are shown to be responsible for approximately 71% of deaths globally. NCDs mainly affect individuals of working age, resulting in high sick leave absences and loss of productivity in the working environment. This presents a major barrier to economic growth, particularly in low- and middle-income countries where the impact is greatest. Among the interventions identified in the South African Strategic Plan for the control of NCDs, is the implementation of wellness initiatives (i.e. diet and exercise interventions) in the workplace. This has been to improve overall productivity and decrease absenteeism. This study was therefore aimed at investigating the effect that participating in workplace wellness initiatives targeted at employees, particularly those that are overweight, hypertensive and diabetic at Nestlé, had on the number of working days lost due to sick leave from NCDs.

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The master's thesis deals with the shift from visual to multisensory perception. In this context, it works with the concept of comfort, which it applies to both physical and mental aspects of the experience of visitors to art institutions. Creating a sense of comfort is important not only at the end of the process - that is, evoking that feeling in visitors - but also in the creative process. The work uses the environment of wellness (spa) resorts and is based on the growing popularity of relaxation facilities. It uses various clichés that are associated with this environment. Galleries and spa resorts are a leisure activity. Both environments offer care, although each in a different way. In the wellness resorts, others take care of our body. In a museum or gallery, they care more about the mental side, but we still feel that we have to make some effort so that we can be cared for in this way. The diploma thesis is a real, created space, the basic layout and equipment of which are inspired by the sauna. All objects in the space, but also its other "layers" acting on the senses of visitors serve to make people feel comfortable even in an environment that is in a sense inhospitable. Sauna benches invite you to sit down, stored bathrobes offer the feeling of luxury and instantly available care that we know from wellness resorts. The space is filled with the scent released from the diffuser. The last component of the space is the "meditation" audio, which accompanies visitors both in the real space in which it is located and in the abstract space of the scent.

The success of mental health counseling partially depends on the professionals who are providing these services, also on the quality of services they provide. To maximize their efficacy, counselors must achieve and maintain their own personal wellness. However, for counselors who work with people who have experienced trauma, there is an increased chance that these counselors will experience adverse effects from this work. In fact, the impact of trauma on counseling professionals is similar to actually experiencing the traumatic event themselves. Native Americans are more likely than any other racial group in the United States to experience chronic traumatization and victimization. As a result of this, Native Americans suffer disproportionate health disparities, including mental health conditions like depression, anxiety, and addiction. The research question of this phenomenological study is, “What are the lived experiences of Native American counselors working in the trauma-intense environment of a Native American reservation?”. In this study, three participants took part in a semi-structured, open-ended, individual interview. Through data analysis, four themes were identified about the participants’ shared experiences: the worth and weight of working on a reservation, the impact of culture and community on counseling, four forms of trauma impacting the counselor and their work, and the effects of personal and professional wellness on counselors. The discussion of these findings are presented, along with implications for future research and policy change. In short, the goal of this study is to assist Native American counselors in maintaining their wellness, so they may continue providing counseling services to a population of people who experience significant trauma.

To answer the research question of "What would a conceptual framework for spirituality in an employee assistance (EAP) context entail?" an exploratory-descriptive approach was followed. A literature study was conducted to understand the construct of spirituality and the importance thereof in human functioning. Further, spirituality in practical contexts was explored, both in the workplace and in the EAP contexts. The researcher concluded that spirituality is better situated in the EAP that in the workplace setting in general. To further explore spirituality in the EAP context, a quantitative approach was followed and a survey in the form of web-based questionnaire was distributed to a list of EAP practitioners and professionals, which was obtained form EAPA-SA. Survey links were distributed to 232 (valid) email addresses of the members on the EAPA-SA list, and an additional 25 survey links were distributed to other respondents using snowball sampling. Out of the total of 257 valid survey links distributed, a total of 57 completed responses were received, a response rate of 22%. The survey aimed to explore the knowledge, attitudes and practices in respect of spirituality in their respective employee assistance practices. The respondents rated spirituality quite highly in both their own and in their clients' lives, indicating strong positive attitudes towards spirituality and that they frequently deal with spiritual matters in practice. However, respondents indicated uncertainty regarding their own knowledge levels and the training they received to enable them to deal with these matters in practice. Incorporating the results of the literature and empirical studies, a conceptual framework and recommendations for spiritual interventions in EAP practice are proposed. / Mini Dissertation (MSocSci)--University of Pretoria, 2016. / Social Work and Criminology / MSocSci / Unrestricted

Introduction: Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped and affects those who work in caring professions. Helping people in distress can traumatise the helper because of their empathetic ability. Nurses who work in ARV clinics witness the suffering of their patients when they listen to their patients' descriptions of the trauma that they have to cope with. The patients get the chance to let go of the trauma and to share their concerns. Unfortunately the nurses often absorb some of the emotional pain of their patients and not all nurses are equipped to handle the situations in such a way that they do not become secondarily affected by the trauma of their patients and therefore, become vulnerable to develop compassion fatigue. If compassion fatigue is not identified in time and addressed adequately, the affected nurses may develop feelings of hopelessness in their ability to take care of their patients with detrimental effect on the quality of nursing care to these patients. Aims: Firstly, to explore and describe the extent of the manifestation of compassion fatigue amongst nurses working in antiretroviral clinics; and secondly, to develop a wellness programme to aid in the identification and management of episodes of compassion fatigue as well as the prevention of future occurrences of such episodes of compassion fatigue amongst nurses working in antiretroviral clinics. Methodology: The researcher conducted the study in two phases. In Phase one, a single embedded case study design, with three sub-units situated within the case, namely nurses who work in the adult, ante-natal and paediatric ARV clinics in a tertiary public hospital, was used. Purposive sampling was used to select seven nurses. Data was collected using semi-structured interviews. The researcher used content analysis as described by Elo and Kyngäs (2008) to analyse the transcribed interviews. The themes identified include the risk to develop compassion fatigue, manifestation of compassion fatigue and strategies to prevent and manage compassion fatigue. For document analysis the researcher used professional and enrolled nurses' job description and the employee health and wellness programme for public service. In Phase two, the researcher developed the wellness programme to aid in the identification, prevention and management of compassion fatigue amongst nurses who work in antiretroviral clinics and the Delphi Method was used to refine the wellness programme. Findings: Nurses working in the ARV clinics are at risk of developing compassion fatigue due to work environment issues such as challenges created by the health care system, lack of support from management, and their overwhelming work load. The cost of the nurse-patient relationship also contributed to nurses being at risk of compassion fatigue. Aspects that were identified that relate to the cost of a relationship with patients who are HIV positive include caring for traumatised patients, vicarious exposure to traumatic experiences of patients, and the influence caring for patients who are HIV positive has had on nurses' personal lives and their families. Nurses can traumatise their family members by continually not being available for them through emotional withdrawal. Nurses presented with physical, psychological, spiritual symptoms and changes in their behaviour that are indicative of compassion fatigue. Various strategies to prevent and manage compassion fatigue were identified: both what nurses can do, and what they expected from management. Nurses' job description is generic and does not spell out their role and function within antiretroviral clinics. The implementation of the health and wellness programme is lacking. The findings of Phase one and related literatures formed the bases from which the researcher developed the wellness programme to aid with the identification, prevention and management of compassion fatigue. Conclusion: Nurses are at risk of developing compassion fatigue due to the cost of the nurse-patient relationship with patients who are HIV positive. The key to prevention of compassion fatigue is awareness and a number of strategies that can aid in the identification, prevention and management of compassion fatigue have been identified and included in the wellness programme. Managerial support and practicing of self-care is important to maintain the health and well-being of nurses who work in antiretroviral clinic. / Thesis (PhD)--University of Pretoria, 2016. / Nursing Science / PhD / Unrestricted