Thesis advisor: Susan Shell / There are many urgent issues facing prisons in the United States today including overcrowding, inmate violence, sentencing concerns and cost. Some communities are using faith-based moral rehabilitation programs in prisons to address these issues and attempt to reform convicts in body and soul. These efforts, exemplified by Louisiana State Penitentiary’s moral rehabilitation program, have clear benefits for reducing in-prison violence and state costs, but they have also garnered ample criticism due to their use of religion in state facilities, the preferential treatment of some prisoners, unclear evidence of moral reformation and claims of abuse. This study looks at modern moral rehabilitation programs and compares them to the early 19th century American penitentiaries, which had similar goals of moral improvement. By examining the function, advantages and disadvantages of these modern moral programs and comparing them to the history of early American penitentiaries; the functions and flaws of the Pennsylvania and Auburn Systems; and Gustave de Beaumont and Alexis de Tocqueville’s analysis and criticism of the penitentiaries in their book On the Penitentiary System…; this study recommends the changes necessary to maintain the beneficial and laudable aspects of today’s moral rehabilitation programs while addressing the criticisms and questions over this form of punishment. The conclusion is the recommendation of a reformed, less religious moral program with six components: incarceration, a strong community citizenship for inmates, education and mentoring, labor, a limited component of religion with the possibility of radical moral transformation, and certain punishment through solitary confinement.

The purpose of this study is to determine the levels of burnout and role stresses among direct service providers at centers for independent living in Region V, and investigate the relationship between burnout and role stressors among the population. Results showed that the respondents have average level of emotional exhaustion, high level of depersonalization, and low level of personal accomplishment in categorization of MBI scores. When comparing with the MBI-HSS normative samples, it indicated that these providers experience higher burnout than overall samples and the sample in social services. The obtained results supported the previous view that CIL management problems including low salaries, high staff turnover, insufficient resources, excessive caseload, unsatisfactory reward, or general lack of control over job tasks and responsibilities that may effect to high burnout.

Previous researchers have identified that participation in a pulmonary rehabilitation program improves health outcomes yet, continuation in a weekly maintenance program yielded mixed results. Self-management programs have had reported use in chronic obstructive pulmonary disease (COPD). A meta analysis has identified that no self-management program had evaluated the effect of this type of intervention on the functional status of the participant with COPD. Reduced functional status is well reported as an indicator of disease progression in COPD. Adjuvant therapies for people with COPD need to demonstrate an effect in this domain. The Stanford model chronic disease self-management program (CDSMP) had been reported as a program that may optimise the health of people with chronic health conditions. However, its utility has not been formally evaluated for people with COPD. There have not been any reports of a comparison of the Stanford model CDSMP with pulmonary rehabilitation via a randomised controlled study in COPD. Aim: To compare and evaluate the health outcomes from participation in nurse ledwellness-promoting interventions conducted in the ambulatory care setting of a metropolitan hospital. Participants were randomised to either a six-week behavioural intervention: the Stanford model CDSMP or, a six-week pulmonary rehabilitation program and results compared to usual care (a historical control group). The efficacy of the interventions was measured at week seven and repeated at week 26 and 52. Following the week seven evaluation, the pulmonary rehabilitation program participants were rerandomised to usual care or, weekly maintenance pulmonary rehabilitation for 18 weeks and, followed up until the study completion at week 52.Little is reported about the costs of care for people with COPD in Australia. This study prospectively evaluated the costs of the interventions and health resource for the 52 weeks and undertook a cost utility analysis. Methods: Walking tests (The Incremental Shuttle Walking Test) and questionnaires asking participants about their health related quality of life, mood status, dyspnoea and self efficacy were assessed prior to randomisation to either six week intervention and repeated at weeks 7, 26 and 52. The implementation of these adjuvant therapies enabled all costs associated with the interventions to be prospectively examined and compared. Results: During the two years of recruitment 252 people (54% males) with a mean age 71 years (SD 11, range 39-93 years) were referred to the study. Student’s ttests identified that there were no statistically significant differences (P=0.16) between all those referred by age and gender as compared to all those admitted to Hospital A with an exacerbation of COPD. Ninety-seven people (51% male) with a mean age of 68 years (SD 9, range 39-87 years) agreed to participate in the study. Follow up in the study continued for 12 months following enrolment with only a modest level of attrition by week seven (3%) and week 52 (25%). Following the six-week interventions, both the pulmonary rehabilitation and CDSMP groups recorded statistically significant increases in functional capacity, self-efficacy and health related quality of life.Functional performance was additionally evaluated in the intervention arms with participants wearing pedometers for the six-week period of the interventions. There were no statistically significant differences between steps per week (P=0.15) and kilometres per week (P=0.17) walked between these two groups in functional performance. The Spearman rho statistic identified no statistically significant relationship between functional performance and the severity of COPD (rs (33) = 0.19, P = 0.26). No significant correlation between functional capacity and functional performance was identified (rs (32) = 0.19, P = 0.29). This suggests that other factors contribute to daily functional performance. The largest cost of care for people with COPD has been reported to be unplanned admissions due to an exacerbation of COPD.In this study there were no statistically significant differences between the three intervention groups in the prospective measurement of ambulatory care visits, Emergency Department presentations and admissions to hospital. The calculation of costs illuminated the costs of care in COPD are greater than the population norm. In addition, maintenance pulmonary rehabilitation generated a greater quality adjusted life year (QALY) than a six-week program. Despite the strength of the participants preferences (as measured by the QALY) for maintenance PRP, there were no significant differences in use of hospital resources throughout the study period by the three intervention groups, which suggests some degree of equivalence.

Concern remains regarding the efficacy of drink driving countermeasures to produce lasting change for repeat offenders, as a wide array of countermeasures have been developed that demonstrate varying levels of success in reducing re-offence rates. This thesis proposes that the collection and examination of repeat offenders' self-reported perceptions, experiences and behavioural changes that result from completing court-ordered interventions can provide valuable contributions to the development of effective sentencing strategies. As a result, the program of research implemented a mixed-method design to investigate the self-reported impact of legal sanctions, a drink driving rehabilitation program, and alcohol ignition interlocks on key outcome measures for a group of recidivist drink drivers.----- Study One incorporated a cross-sectional design to examine the deterrent effect of traditional legal sanctions (e.g., fines and licence disqualification periods), non-legal sanctions, alcohol consumption, recent offending behaviour(s), and the actual severity of sanctions on perceptual deterrence and intentions to re-offend. The study involved face-to-face and telephone interviews with 166 repeat offenders. The analysis indicated that participants perceived legal sanctions to be severe, but not entirely certain nor swift.----- In Study One, self-reported recent drink driving behaviours and alcohol consumption levels were identified as predictors of future intentions to drink and drive. The results suggest that habitual behaviours are difficult to change, and heavy alcohol consumption levels increase the probability of re-offending. At a bivariate level, three non-legal sanctions were negatively associated with intentions to re-offend but were not predictors of future intentions to drink and drive in the model. In addition, a relationship was not evident between: (a) the size of the penalties and perceptions of sanction severity or future intentions to drink and drive, and (b) the number of previous convictions and self-reported deterrence. The findings of the study confirm the popular assumption that some repeat offenders are impervious to the threat and application of legal sanctions.----- Study Two examined the stages of change and self-efficacy levels of 132 repeat offenders - who were all involved in Study One - while they completed an 11 week drink driving rehabilitation program. A repeated measures design was implemented to focus on the impact of the intervention on a number of salient program outcomes such as participants' motivations and self-efficacy levels to control and change their drinking and drink driving behaviour(s). Prior to program commencement, the majority of participants were motivated to change their drinking driving, but not their drinking. The sample also reported high self-efficacy levels to control the two behaviours, but did not have high expectations of the effectiveness of the program.----- Upon completion of the program, significant increases were evident in motivations to change drinking and drink driving behaviours, and a large percentage of participants reported a positive appraisal of the effectiveness of the intervention. Program completion also resulted in a reduction in self-reported alcohol consumption levels, yet the majority of the sample continued to consume harmful levels of alcohol. Self-efficacy levels remained high, although a notable finding was that participants reported higher levels of control over their drinking rather than drink driving behaviours. In general, Study Two provided a positive perspective of the capacity of a drink driving rehabilitation program to produce change for a group of repeat offenders.----- Study Two extended a small body of research and examined the effects that mandated program enrolment has on motivations to change, as well as expectations and appraisals of program effectiveness. Contrary to predictions, mandated participants did not report lower levels of motivation to change drinking and drink driving compared to voluntary attendees, but did indicate lower expectations of the effectiveness of the program, as well as being willing to engage in the program. Furthermore upon program completion, mandated participants also reported lower appraisals of the effectiveness of the program, but this factor was not associated with intentions to re-offend or non-program completion. Rather, not successfully completing the program appeared linked with being unwilling to change drinking behaviours.----- Study Three involved a longitudinal case-study design that utilised both quantitative and qualitative data to conduct one of the first examinations of the impact of alcohol ignition interlocks on a group of recidivist drink drivers from a users' perspective. The study investigated 12 participants' self-reported perceptions and experiences of using an interlock and the effect that the device had on key program outcomes such as drinking levels, operational performance, circumvention attempts and general beliefs regarding the effectiveness of the device in comparison to traditional legal sanctions.----- Participants reported positive appraisals regarding the effectiveness of the device as qualitative themes emerged concerning the educational and practical benefits of interlocks. However, closer examination of individual interlock performances revealed each participant had attempted to start their vehicle after consuming alcohol, and a smaller sample of three drivers were regularly attempting to start their vehicle after drinking. The combination and analysis of self-reported and downloaded interlock data revealed four main themes: (a) initial operational difficulties, (b) a general unwillingness to reduce alcohol consumption levels, (c) an unwillingness to acknowledge/recognise that interlock breath violations resulted from drinking, and (d) an overall decline in the frequency of interlock breath violations over the interlock installation period. Similar to Study Two, a notable finding was that half the sample was still consuming harmful levels of alcohol upon program completion.----- Taken together, the results of the program of research highlight that repeat offenders' entrenched behaviours, such as drinking and drink driving, are resistant to change and that multi-modal interventions are required if the drinking and driving sequence is to be broken for this population. The findings have direct implications for the sentencing and management of repeat offenders and the development of countermeasures that attempt to produce long-term behavioural change.

The rehabilitation department of the Mobile Hospital Team at Region Skåne Malmö wants to convert the current traditional training programs, given to patients on a piece of paper, into something digital. For the following purpose, an online cross-platform web application called WeeDo was implemented. This thesis researched to what extent this tool can replace traditional forms of rehabilitation, how well physiotherapists can track the improvement and engagement of their patients from a distance, and what functionalities are important to make the system effective and useful. A field study along with a semi-structured interview and questionnaires were invoked to conduct data from the users of the application. 32 patient proxy users participated in the questionnaires and 1 physiotherapist in the interview. The results from the questionnaires found that a visual representation of exercises is valuable and important. 91.3% of the patient respondents felt that WeeDo can replace the traditional form of physiotherapy. The interview results found that WeeDo will not only be similarly effective as the traditional physiotherapy but WeeDo will also let physiotherapists to track patients' improvement and engagement from a distance. However the study includes some limitations and recommendations for future research to validate similar conclusions that can be drawn from this study.

Many offenders are incarcerated in U.S prisons with the intent of rehabilitation; however, a majority of these offenders will be released with limited options for employment. Recidivism has been linked to unemployment. The purpose of this multiple case study was to examine the lived experiences of 20 offenders involved in correctional education programs while incarcerated to explore their correctional education experience within the context of postincarceration employment. The theoretical foundation of this study was based on Bandura's self-efficacy theory. Narrative data were elicited pertaining to offenders' perceptions of past education experience, correctional education experience, and their perceived impact of the experience on their future employment. Data were analyzed using inductive coding procedures to categorize the offenders' perceptions of correctional education. According to study findings, offenders' participation in and completion of correctional education programs while incarcerated provided the necessary support for them to successfully reenter society; program participation aided offenders to bridge the gap between release and securing employment by providing the necessary skills to compete for employment. This study contributes to social change by informing correctional education administrators, faculty, and staff of the viability of correctional education programs offered to offenders.

Miss Kathy is a documentary film that tells the story of Kathy Griffin-Grinan, a lead recovery coach for prostitution and human trafficking with the Harris County Sheriff’s Office. Her non-profit organization —We’ve Been There, Done That – works in conjunction with law-enforcement to offer the survivors of prostitution a chance at rehabilitation. With endless enthusiasm, she mentors survivors as they struggle to escape a destructive lifestyle. This film also explores the relationship between human trafficking and prostitution, while addressing issues of victimization and exploitation.