3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item A multilevel model of self-rated health in Gauteng: a comorbidity study(2019) Bhat, IshwariThe report reviewed the self-rated health of Gauteng’s comorbid health in 2015. The outcome variable of this report was defined as the self-rated comorbid health of Gauteng. A multilevel approach examined factors closely associated with comorbid health using both individual and community-level variables. The report addresses the symbiotic relationship between comorbidity prevalence and Gauteng’s socioeconomic conditions that foster poor health. South African healthcare has been characterised by its increasing comorbidity of communicable diseases. As the prevalence of comorbidity varies between spaces, it becomes increasingly important to examine social environments. The aim of this study estimated the prevalence of comorbidity, and determined the factors associated with self-reported comorbidity in the Gauteng province of South Africa. A multilevel model approach was used in this cross-sectional study. Primary data was provided by the Gauteng City-Region Observatory from the Quality of Live survey (QoL) in 2015, it comprised 30 002 participants above the ages of 18 years, who were selected through numerous sampling stages. enumeration areas (EA) were drawn using probability proportional to size as the primary sampling unit. Comorbidity was illustrated as classes of two, three and four-or-more. Prevalence was estimated as a proportion of comorbid health conditions from the health section of the survey. Spatial autocorrelation was used to detect spatial patterns of comorbidity. Regression models were used to determine factors closely associated with comorbidity in Gauteng. The estimated prevalence of self-reported two comorbidities (hypertension and diabetes) was 8.97%, three comorbidities (hypertension, diabetes and influenza/pneumonia) was 3.01% and four-or-more comorbidities (hypertension, heart disease/stroke, diabetes and asthma) was 0.96%. Ordinary Least Squares (OLS) models provided the first step for regression analysis, wherein only two comorbidities illustrated spatial dependence among the residual errors. The spatial error model of two comorbidities was interpreted as the most accurate model owing to the high Hausman test p-value. Three comorbidities and four-or-more comorbidities indicated no spatial dependence among the residuals, reiterating the OLS model as the most appropriate regression model for each class. Conventional multilevel models illustrated that self-rated comorbidity prevalence was more likely to report two comorbidities (n=829,8.97%) for quality of property, child malnutrition, low exercise frequency, high stress and The report reviewed the self-rated health of Gauteng’s comorbid health in 2015. The outcome variable of this report was defined as the self-rated comorbid health of Gauteng. A multilevel approach examined factors closely associated with comorbid health using both individual and community-level variables. The report addresses the symbiotic relationship between comorbidity prevalence and Gauteng’s socioeconomic conditions that foster poor health. South African healthcare has been characterised by its increasing comorbidity of communicable diseases. As the prevalence of comorbidity varies between spaces, it becomes increasingly important to examine social environments. The aim of this study estimated the prevalence of comorbidity, and determined the factors associated with self-reported comorbidity in the Gauteng province of South Africa. A multilevel model approach was used in this cross-sectional study. Primary data was provided by the Gauteng City-Region Observatory from the Quality of Live survey (QoL) in 2015, it comprised 30 002 participants above the ages of 18 years, who were selected through numerous sampling stages. enumeration areas (EA) were drawn using probability proportional to size as the primary sampling unit. Comorbidity was illustrated as classes of two, three and four-or-more. Prevalence was estimated as a proportion of comorbid health conditions from the health section of the survey. Spatial autocorrelation was used to detect spatial patterns of comorbidity. Regression models were used to determine factors closely associated with comorbidity in Gauteng. The estimated prevalence of self-reported two comorbidities (hypertension and diabetes) was 8.97%, three comorbidities (hypertension, diabetes and influenza/pneumonia) was 3.01% and four-or-more comorbidities (hypertension, heart disease/stroke, diabetes and asthma) was 0.96%. Ordinary Least Squares (OLS) models provided the first step for regression analysis, wherein only two comorbidities illustrated spatial dependence among the residual errors. The spatial error model of two comorbidities was interpreted as the most accurate model owing to the high Hausman test p-value. Three comorbidities and four-or-more comorbidities indicated no spatial dependence among the residuals, reiterating the OLS model as the most appropriate regression model for each class. Conventional multilevel models illustrated that self-rated comorbidity prevalence was more likely to report two comorbidities (n=829,8.97%) for quality of property, child malnutrition, low exercise frequency, high stress and low-income bracket in Gauteng. Self-rated comorbidity prevalence was more likely to report three comorbidities (n=76, 3.017%) for migrated from another province, family living nearby, adult malnutrition, medium to high stress, low-income bracket and female in Gauteng. Results of four-or-more comorbidities were defined by the limitation that data set was too small for regression analysis. Comorbidity has a complexity in nature, in that it both influenced by Gauteng socioeconomic environments as well as influenced Gauteng health. Comorbidity became a challenge for Gauteng in addressing complexity, accessibility and cost-effectiveness. It was anticipated that these findings may advise policy interventions in mitigating health disparities in the broader context of South Africa.Item Job search anxiety, transition resources and wellbeing(2019) Britton, ThomasMultiple researchers have noted the impact of job search anxiety on the psychological wellbeing of individuals. This study sought to investigate whether the effects of job search anxiety are mitigated by the extent to which individuals possess particular transition resources. These resources, namely generalised self-efficacy, perceived control over finding employment, perceived social support, as well as the coping style a person finds most desirable to engage in when faced with a stress-inducing situation were utilised in accordance with Nancy Schlossberg’s transition model. The outcome variable, namely psychological wellbeing, looked at symptoms of generalised anxiety as well as depression. The sample within the current study included (n = 218) exit level students from the University of the Witwatersrand, Johannesburg, South Africa. Pearson’s Product Moment Correlations, multiple moderated regressions and Two-Way ANOVA’s were executed to assess the primary research questions within the study. A significant positive relationship was found between job search anxiety and psychological wellbeing. However, despite the assertions that the theorist Nancy Schlossberg made within her transition theory as well as the theoretical connections illustrated within previous research, the transition resources highlighted within this study did not significantly moderate the relationship between job search anxiety and psychological wellbeing. Significant main effects were found between a portion of the moderator variables and the psychological wellbeing variables. The findings within the study have suggested that more work is needed to completely support Schlossberg’s transition model.Item Sensory modulation deficits and anxiety symptoms in children receiving occupational therapy(2016-10-12) Tauby, Michal ChavaThis study aimed to identify the association between observable sensory behaviours and anxiety symptoms in school-aged children. The children were between the ages of 8-10 years and attended Remedial Schools. The participants were receiving occupational therapy and were identified as having a Sensory Modulation Disorder (SMD). Parents rated their children on the Sensory Profile, and scores were correlated to the Spence Children’s Anxiety Scale, completed by the children. Participants showed high quadrant scores indicating “low registration” and sensory “over-responsivity” (avoidance and sensitivity to sensory input). Further, the participants were identified to be an “at risk” population for anxiety disorders, as scores of elevated anxiety exceeded normal populations. Although total anxiety scores correlated with only avoidance quadrant scores (and not sensitive scores as predicted,) other scores indicating emotional behaviours correlated moderately with total anxiety scores. It is concluded that children with SMD are at risk of presenting with anxiety disorder symptoms, and must thus be monitored for these.Item Is postoperative hypernociception associated with anxiety-like behaviour in rats?(2014-02-19) Ferreira, Stephanie BentoExisting animal models of postoperative pain have focused on the sensory aspects of postoperative nociception and have ignored the affective components of pain, such as anxiety, which in human studies have been shown to be important determinants of the overall pain experience and pain outcomes. Therefore, I investigated whether anxiety-like behaviour in rats was a feature of an established animal model of postoperative pain. Postoperative hypernociception was assessed on a daily basis prior to surgery and nine days after surgery in 10 male Sprague-Dawley rats, that had had an incision made through the abdominal wall. Nociceptive thresholds were tested using an anaesthesiometer, which was applied to the wound until the rat showed aversive responses. Anxiety-like behaviour was assessed in a separate group of 50 experimental and 50 control rats that had undergone the same surgical intervention or sham surgery (anaesthesia only). The open field paradigm was used to test anxiety-like behaviour and involved placing rats in a 1 m2 arena and measuring their exploratory behaviour; behaviour that is reduced in anxious rats. Additional 40 experimental and 40 control rats were decapitated and trunk blood was collected for corticosterone measurement, and the prefrontal cortices and hippocampi were excised for measurement of monoamines, including serotonin, noradrenaline and dopamine, as well as the neurotransmitters GABA and glutamate on postoperative days one, two, four and nine. Surgery produced a significant decrease in nociceptive thresholds for up to six days, however there was no significant decrease in exploratory behaviours between control and surgery rats at any stage after surgery. There was also no significant difference between the monoamines, GABA, glutamate or corticosterone levels between the surgery and control groups, on any of the postoperative days I assessed. However, a significant increase in dopamine concentrations in sham surgery rats compared to control and surgery groups was found. It therefore appears that, in an established model of postoperative pain, rats do not display anxiety-like behaviour, or express circulating or brain biomarkers of stress.