Although economic growth has brought significant improvements in the standard of living in the UK over recent decades, there are still individuals living in poverty. Furthermore poverty in the UK is expected to rise. Although monetary poverty has wide ranging impacts such as poor health, low educational attainment and employability and reduced life expectancy, it does not (in the form of a poverty line at 60% of the median equivalised household income) appear to have an impact on wellbeing when the threshold was tested. Instead, multidimensional poverty – that purported by the Capabilities Approach – is a more individually relevant measure of poverty. Using a list, developed by Nussbaum, of core capabilities seen as essential for human life, capability measures were taken from the British Household Panel Survey. In analysis, some are found to be significant determinants of wellbeing, individually and in sum. Furthermore, individuals within the dataset experience loss aversion to capabilities. This thesis concludes that poverty measurement should be meaningful at the individual level, and to that aim, the Capabilities Approach provides a richer and more relevant evaluation of what poverty really means.

Adolescence is challenging time for youth with autism spectrum disorder (ASD), who generally exhibit a myriad of psychosocial difficulties. While this developmental period represents an important window for intervention, few evidence-based programs exist. Recent research suggests that interventions targeting emotion regulation (ER) skill deficits in ASD may represent a promising approach to promoting more favourable outcomes for these youth (Mazefsky et al., 2014). Nurturing mindfulness has been shown to be an effective means of improving ER and wellbeing in diverse child and adult populations, although research in ASD is limited. This pilot study evaluated the impact of a 9-week mindfulness intervention on the ER and socioemotional functioning of 14 adolescents (13-17 years) with high functioning ASD using a pre-test post-test design. Parents reported statistically significant changes of small to medium effect size in adolescents’ overall problem behaviours and social skills, ER, adaptability, hyperactivity, and withdrawal behaviours. Additionally, parents reported changes of small effect size that approached significance for adolescents’ anxiety symptoms and atypicality. Adolescents reported changes of small effect size that were statistically significant for anxiety symptoms and interpersonal functioning, and non-significant for depression and social stress symptoms. Changes in many parent-reported outcome variables showed moderate to strong correlations with home practice adherence and parent-reported changes in ER. Qualitative observations of program impact and social acceptability were positive and supported the quantitative findings. The results provide promising evidence for mindfulness training with youth with ASD. Implications for assessment, intervention, and future research are discussed. / October 2016

Objective—To explore the experience of psychological distress and wellbeing in emergency medicine (EM) consultants. Methods— A qualitative, Interpretative Phenomenological Analysis (IPA) study based on interviews with EM consultants working in emergency departments (EDs) across South West England. 18 EM consultants were interviewed, representing a response rate of 54.55% across 5 EDs. The mean (SD) age of participants was 43.17 (5.8) years. All participants worked full-time as EM consultants, with the average years-in-role being 7.64 (5.76). The personal meanings that participants attached to their experiences were inductively analysed and explored alongside their perceived psychological health. Results— The analysis formed three super-ordinate themes: systemic pressures, physical and mental strain, and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted: functioning at work, relationships, personal wellbeing and the EM profession. Sustainability was promoted by the presence of social support and through evolving with the consultant role. Conclusions— EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current socio-political demands on EM services. Recognising the psychological experience and needs of EM consultants through promoting a sustainable EM consultant role could have wide-reaching benefits for the delivery of emergency care and physician wellbeing.

This paper uses data from The Survey on Income and Living Conditions (SILC) for year 2013 to estimate the effect of family size on parent's wellbeing. To address the possible endogeneity in family size we use "multiple births" as exogenous origin of variation in family size. First finding shows insignificant effect of the additional child on parent's wellbeing. However, when we examine if the effect of number of children is significantly different for men and for women, we receive significant results. The number of children positively influences mother's wellbeing, but for fathers, there do not exist clear result. Finally, we examine if big family is poor family and our finding reveals, that number of children positively increases income of household. JEL Classification D31, I31, J13 Keywords wellbeing, family size, instrumental variable, income Author's e-mail andrea.havrilova@gmail.com Supervisor's e-mail gebicka@fsv.cuni.cz

There is a growing interest in brief, low-cost workplace health promotion interventions for wellbeing, which target increasing resilience, mindfulness and positive appraisal. One such health promotion intervention is Positive Mental Training. Three linked studies set out to investigate the efficacy of Positive Mental Training in the workplace. Study 1 used a double blind, randomised control trial design, with healthy volunteer employees randomised to intervention or control conditions. Validated questionnaires measured wellbeing, resilience, mindfulness, burnout and emotional distress at 4 time intervals, over a 6 month period. Multi-level linear modelling showed significant effects of the intervention on wellbeing and depression. ANCOVA analysis revealed these benefits were not sustained at follow up (26 weeks). Study 2 expanded on study 1, with qualitative interviews of purposefully selected participants of study 1. A grounded theory approach was used to explore individual motivations, benefits and limitations of the programme. Study 3 adopted a component research design to investigate one possible underlying aspect of this multi-component health promotion intervention (positive appraisal suggestion) in a student population and examined whether relaxation increased this effect. Positive appraisal suggestions given with or without relaxation were both able to significantly increase levels of positive affect and self-esteem compared to a control. Positive cognitive bias was found to increase in both the active conditions and the control suggesting differential cognitive and emotional processes, in that an increase in positive CB was not associated with an increase in mood. Overall these studies indicated evidence for the efficacy of Positive Mental Training in workplace health promotion, explored experience of participants undertaking the study and investigated the underlying mechanisms of an active component of Positive Mental Training. Theoretical and clinical implications are discussed.

Det övergripande syftet med avhandlingen var att beskriva och undersöka patienters - vårdade inom intensivvård - upplevelser och effekter av en cyklisk belysningsintervention utifrån hälsa, välbefinnande och återhämtning. Metod: En intervention bestående av ett automatiskt styrt belysningssystem var installerat på ett intensivvårdsrum. Belysningsinterventionens mål var att efterlikna dagsljuset i styrka, kvalitet, och lokalisation. Ett ordinarie intensivvårdsrum fungerade som kontrollmiljö. I studie I eftersöktes i en systematisk litteratursammanställning tidigare forskningsresultat rörande cykliska belysningsinterventioner inom intensivvård. Belysningsmiljöerna i intervention- och kontrollmiljön bedömdes i studie I av besökare och i studie II av patienter samt jämfördes och analyserades statistiskt. Ljus och belysningsmätningar utfördes i både forsknings- och kontrollmiljön. I studie II undersöktes patienters upplevelser av den cykliska belysningsmiljön genom kvalitativa intervjuer vilka analyserade med innehållsanalys. I studie II mättes och jämfördes patienters sömn, dygnsrytm samt fysiologiska parametrar och analyserades statistiskt. I studie IV undersöktes och jämfördes patienternas självskattade återhämtning efter sex och tolv månader. Resultat: Cykliska belysningsinterventioner exponerade för vuxna patienter var få. Resultatet visade dock att interventioner med cykliskt ljus inom neonatal intensivvård kunde inverka positivt på förtidigt födda barns hälsa. Den cykliska interventionsmiljön bedömdes som mer trivsam och mätningar av belysningen utförda i interventionsmiljön visade på samstämmighet med europeiska rekommendationer. Belysningsnivåerna i kontrolmiljön var manuellt styrda och mätningarna visade på antingen för låga eller för höga belysningsnivåer under dagtid jämfört med europeiska rekommendationer. Patienterna bedömde den cykliska belysningsmiljön som starkare dagtid och under nattetid bedömdes belysningen i kontrolmiljön som mer varierande. Patienters individuella upplevelser av den cykliska belysningsinterventionen presenterades i fyra kategorier: en dynamisk belysningsmiljö, belysningens påverkan på patientens sömn, ljus/belysnings påverkan på dygnsrytm samt en lugnande belysning. Patienternas dygnsrytm stärktes inte av den cykliska belysningsmiljön under deras sista 24-timmarsperiod. Patienternas självrapporterade återhämtning efter intensivvård var bättre efter 12-månader efter utskrivning hos de som vårdats i interventionsmiljön. Slutsatser: Genom att studera de båda forskningsområdena vårdvetenskap och ljus/belysning tillsammans skapades ny kunskap till vårdvetenskapen. Trots svår sjukdom eller skada kunde patienterna bedöma och reflektera kring belysningsmiljön. Ämnesområdet lämpar sig väl för att undersökas med både kvantitativa och kvalitativa metoder. / Aim: The overall aim of this thesis was to describe and evaluate patients’, who were cared for in the intensive care unit (ICU), experiences and effects concerning a cycled lighting intervention based on health, wellbeing and recovery. Methods: An automatically controlled cycled lighting intervention aimed to mimic natural light levels, quality and position throughout the day was evaluated. An ordinary lit room was used as a control. A multiple-method approach was used. In study I, there were three aspects: a systematic review of the previous research concerning cycled lighting interventions in the intensive care; visitor evaluations of the lighting environments in the intervention and ordinary room; and measurements of illuminance, luminance and irradiance in both conditions. In study II, the patients evaluated the lighting environment in the two rooms. Data were compared and analysed. Furthermore, patients’ experiences regarding the cycled lighting environment were investigated through qualitative interviews, which were subsequently analysed by content analysis. In study III, patients’ sleep, activity and physiological parameters were measured and compared. Study IV consisted of statistical analysis of a questionnaire concerning patients’ self-reported recovery six and 12 months after their ICU treatments. Results: The literature review on cycled lighting interventions in adult ICUs was rare but more common in the neonatal ICU (NICU). Findings showed that cycled lighting interventions improved health in preterm infants, but there were also non-significant results reported. The visitors reported the cycled lighting environment as more pleasant, and based on measurements, the lighting levels were at equivalent levels with European recommendations for hospitals. The lighting levels in the ordinary room were manually controlled and were reported as being either too low or too bright during the daytime. Patients evaluated the cycled lighting environment as brighter in daytime, and this was in coherence with the results from the measurements of illumination. Patients’ individual experiences concerning the cycled lighting environment were reported in four categories: a dynamic lighting environment, the impact of lighting on patients’ sleep, the impact of light/lighting on the circadian rhythm and the degree to which the lighting calmed them. Patients’ circadian rhythms were not further strengthened by the cycled lighting intervention during their final 24-period in the ICU. Twelve months after their ICU treatments, patients cared for in the intervention environment self-reported their recovery as significantly better than those who received treatment in the ordinary room. Conclusions: A multiple methodology was used to explore theresearch field from a wider perspective. Combining knowledge from both the lighting research field and caring science has brought new knowledge to both and especially to the practice of nursing. Despite their severe illnesses or injuries, patients were able to assess their experiences with the lighting environment and reflect on how the lighting was able to support their health. This thesis reports findings that indicate that environmental/lighting interventions may improvepatients’ health. Lighting interventions are harmless, safe, sustainable and, in comparison to technical and medical interventions, considerably cheaper. With this knowledge, we believe all vulnerable patients in the ICU should be surrounded by a lighting environment around the clock to support their health, wellbeing and recovery.

This study explored how personal strivings constructs of Goal Conflict and Complementarity and primary appraisal dimensions of Motivational Relevance and Congruence (separately and in combination), related across time to immediate and long-term effects of a stressful transaction. The study was located within the transactional model of stress and integrated aspects of motivational theory, focusing on the theoretical position that within the stressful transaction the relationship between motivational factors and the individual response to an event is mediated by cognitive processes, including appraisal. Advances in transactional theory highlight the role of motivational factors (such as personal strivings) as linked to primary appraisal in the form of Motivational Relevance and Congruence. The utility of personal strivings in exploring the role of motivational factors in the stress process were highlighted. Despite an increasing theoretical focus on motivation and appraisal, research in the area is limited. Data was collected for the study through the administration of questionnaires to university students (N=152) prior to (time 1) and into (time 2) an examination period. The questionnaires used a range of self-report measures. Correlations, partial correlations and ANOVAs were used to analyze the data. The findings indicated that Goal Complementarity and Conflict directly influenced primary appraisal processes but not affective and wellbeing outcomes. It was proposed that primary appraisal processes were the conduit through which the impact of Goal Complementarity and Conflict were expressed within the stressful transaction. The results also suggested the impact of anticipatory Motivational Relevance which seemed to imply a highly “loaded” event with negative affective and long-term consequences into the event. Subjects entering the event wit h an “optimistic” demeanour indicated by high anticipatory Congruence and positive affect had increased Congruence into the event with consequent amplified positive emotions and dampened negative effects. Subjects with high anticipatory Relevance and low Congruence across the event had relatively higher scores on negative outcomes. High anticipatory Relevance and Congruence was associated with negative immediate and long-term outcomes into the event. High Relevance Congruence was generally associated with a strong emotional response, which also elicited strong positive emotion as the event unfolded. Subjects with low Relevance did not seem to hold as strong an investment in the event and reported reduced emotions and symptomology. These findings were discussed in relation to the stress, appraisal and motivation literature and their limitations and implications were explored.

This master thesis explores the relationships between the human being and the built environment in the context of healthcare and from the perspective of aesthetics. The aim is, by identifying the aesthetic experiences the built environment evokes, to enhance the understanding of how the design of the built environment can support and sustain wellbeing. The findings from previous studies show that the aspects of the attributes of the built environment can evoke sense-based aesthetic experiences and aesthetic experiences beyond senses. Furthermore, the empirical results of this thesis, gained by applying participatory research and research through design methodologies, indicate that wellbeing is related to rich experiences connected to nature, homeliness or the lack of homeliness as well as lack of maintenance.   The tentative Aesthetic Design Framework for Atmospheresdeveloped in this thesis, based on the Affordance Theory and theTheory of Aesthetic Atmospheres, proposes that the built environment can be transformed into therapeutic aesthetic atmospheres by utilizing aesthetic affordances and applying Aesthetic Design Strategy. In order to test the framework, design proposals were created. The evaluation of the design proposals shows that the designed atmosphere is perceivable when distinct. The results also indicate that familiar aesthetic affordances are easier to perceive and relate to. Consequently, it is proposed that the Aesthetic Design Framework for Atmospheres can aid the design of atmospheres. The results of this study can enhance design processes and the design of built environments in general by clarifying aesthetic aspects, grounded both in empirical data and theory. / Denna masteruppsats utforskar förhållandet mellan människan och den byggda miljön i vårdkontext och utifrån estetik. Målet är att identifiera de estetiska upplevelser den byggda miljön framkallar och därmed öka förståelsen av hur design av byggd miljö kan stödja och bevara välmående. Tidigare forskning visar att aspekter av attribut i den byggda miljön framkallar både sinnesbaserade estetiska upplevelser och estetiska upplevelser bortom sinnena. Dessutom, indikerar empiriska resultat av denna uppsats att välmående hänger ihop med rika upplevelser relaterade till natur, hemtrevnad eller bristen på hemtrevnad samt bristen på underhåll.   Det tentativa teoretiska ramverket, Aesthetic Design Framework for Atmospheres, utvecklat i denna uppsats och baserat på Teori om Affordance och Teori om Estetiska Atmosfärer,föreslår att den byggda miljön kan förvandlas till en terapeutisk atmosfär genom att använda estetiska affordancer och tillämpa Estetisk Design Strategi. Designförslag utformades för att testa ramverket. Utvärderingen av förslagen visar att en designad atmosfär kan varseblivs när den är pregnant. Resultaten indikerar även att bekanta estetiska affordancer är lättare att varsebli och relatera till. Därmed föreslås att Aesthetic Design Framework for Atmospheres kan understödja design av atmosfärer. Resultaten av denna uppsats kan främja designprocesser och design av byggd miljö genom att identifiera estetiska aspekter grundade både i empiri och teori.

Vi upplever att vi jämt är omgivna av digitala apparater och av digitalisering. Kandidatarbetets tema är ett vågat ämne där vi undersöker hur mobiltelefonen påverkar vårt psykiska välmående och vilka möjliga lösningar det finns på hur problemen kan hanteras. Vi skriver om vad det finns för mobilapplikationer som kan terapeutiskt hjälpa användaren att utveckla och förbättra sitt välmående. Från våra kunskapsområden vill vi med vår mobilapplikation bygga upp välmående. Den ska terapeutiskt hjälpa den som är i behov och som behöver hjälp att må bättre. Vi fördjupar oss i detta ämnesområde där vi ser det från vårt perspektiv med våra ögon och hanterar det efter våra erfarenheter.   Vi tillämpar designperspektivet X for Change som tar upp samhällsfrågor, i detta fall så är det om folkhälsa. X for Change ska inte på något sätt vara upprörande eller provocerande i de frågor som besvaras, utan vara till hjälp under hela kandidatarbetet. Designprocessen delades in i två faser där ändringar av gestaltningen ägde rum. Under denna undersökning går vi in på nya gestaltningsmetoder där vi skapar färdiga prototyper från idé till hi-fi prototyper för vår mobilapplikation. Detta är ett vågat försök där vi testar oss fram och med tiden utvecklat en ny förmåga i vårt skapande som designers. / We believe that we are constantly surrounded by digital devices and by digitalization. The theme of this bachelor’s thesis is a daring subject where we investigate how the mobile phone affects a person's mental wellbeing and what possible solutions there are on how to deal with those problems. We are writing about what kind of mobile applications there are that can help users develop and improve their wellbeing. From our area of expertise, we want with our mobile application help users to improve their mental health and promote wellbeing. It is meant to work as a therapeutic tool to those who are in need of help to feel better. We immerse ourselves in this topic where we see it from our own perspective with our own eyes and manage it based on our own experiences.   We use the design perspective X for Change that brings up certain societal issues, in this case it's about the public health. X for Change is not meant to be upsetting or provoking on the topic of these questions but be of help throughout the whole thesis. The design process is split into two phases, where changes to our application took place. During the whole investigation we enter new methods to create our application where we create finished prototypes from ideas to hi-fi prototypes for our mobile application. It is a bold attempt where we test ourselves and with time we have created a new ability in our creativity as designers.

The concurrent experience of multiple health conditions (often termed multimorbidity) has become an important issue in recent years. Most research on this topic uses clinical data (e.g. GP or hospital records) that lack important socio-contextual information about the lives of people with multiple conditions. Population health surveys can help to overcome these limitations, but identifying people who have multiple conditions is problematic. Decisions need to be taken regarding what is meant by a condition, which ones should be included, and how multiple should be defined. These decisions tend to be based on what data are available, rather than on any universal inclusion criteria or theoretical underpinnings. This thesis used an approach informed by sociological theory and principles drawn from critical realist philosophy to estimate the prevalence of multiple conditions among adults (16+) in the general population, using data from the 1998 and 2008- 2011 Scottish Health Surveys. It explicitly acknowledged the multiple, contested and constructed nature of health, illness and diagnosis; the limits of empirical enquiry; and the need to approach concepts such as multiple conditions critically. To support the decision-making process, longitudinal analyses of mortality were used to examine the impact of including various contested conditions on people’s long-term chance of survival (if there was no evidence of impact then the definition was rejected). The final measure of multiple conditions arrived at suggested that 24.9% of adults had multiple conditions (compared with 17.2% using the survey’s original, unadjusted, measure). This measure was then used to explore how this status related to people’s wellbeing, which helped to highlight importance differences in experiences. Among adults with multiple conditions, 33.5% of those in the most deprived areas had low wellbeing compared with 13.5% of those in the least deprived areas. Low wellbeing was also higher among people with multiple conditions aged under 65 than those aged 65 and over, especially for those living in areas of high deprivation. There was some evidence that having multiple conditions and additional vulnerabilities (e.g. psychological distress, living in a deprived area, having activity limitations) before the age of 55 increased people’s risk of mortality, which might result in older populations appearing to have better wellbeing due to less healthy people not reaching old age. Working-age people with multiple conditions were also more likely than people of the same age with no conditions to be economically inactive, to not live in an owner-occupied property, and not have a co-resident partner. All of which suggest that poor health at younger ages limits access to the social and economic norms enjoyed by most people. The approach adopted arguably helped to avoid over-classifying largely healthy people as having multiple conditions, while still ensuring that people’s own perspectives on their health were not under-privileged with respect to more traditional biomedically-focused approaches. However, it was also clear that the experiences of adults with multiple conditions are highly varied, and in particular, socially stratified. This heterogeneity has implications for research in this field, as well as clinical practice and public health policy. Recommendations for better reflecting this diversity in future studies included collecting more measures of functional capacity, aspirations, illness experiences, and social stressors (such as financial insecurity).