Early fertility remains a public health concern in South Africa, with teenage pregnancy rates remaining high, and more significantly among black adolescent girls of low socioeconomic status. This indicates the unmet need of contraception for adolescent girls. Contraceptive use and non-use by young women of low socioeconomic status is a complex issue that reveals a range of political and socio-economic injustices. Barriers to contraceptive access and use have been identified to include: health care access, interaction with healthcare providers, genders norms, knowledge gaps, reproductive choices, socio-cultural attitudes and policing, intimate partner relationship dynamics, parental judgement, and side effects. To address this public health concern there has been an increase in the provision of contraceptives through the introduction of long-acting reversible contraceptive (LARC) methods. However, young women's response to LARC methods has been characterized by low and declining uptake and early removals. A tension exists between the way public health practitioners imagine meeting the contraceptive needs of young women of low-socio economic status and what it is acceptable as contraception by young women. This mini-dissertation aims to examine young women's perceptions of long-term contraception and LARC methods; specifically, the implant and intrauterine device (IUD) contraceptive methods in how they reveal young women's fertility attitudes and how it shapes their contraceptive decision-making. This examination foregrounds the individual, interpersonal relationships and social contexts that shape sexual and reproductive choices of young women. The mini dissertation is structured in two parts: the research protocol (Part A) and a manuscript for a journal article prepared for publication (Part B). Part A explores the factors that influence young women's contraceptive decision-making at three different levels, namely: the individual level, interpersonal relationship level and social and structural context level. For the aim of further understanding young women's contraceptive decision-making, PART B focusses on examining the tensions in the acceptability and uptake of LARC methods and long-term contraception use to explain low and ineffective contraceptive use by young women, which often result in unwanted pregnancies. The findings from this mini dissertation can add to the existing literature that examines why current contraceptive provision has been inadequate in meeting the contraceptive needs of young women of low socioeconomic status and significantly curbing early fertility. Additionally, they can provide valuable information to public health practitioners on how particular factors influence the acceptability of contraceptive methods and as well as the root causes of behaviors that result in ineffective contraceptive use resulting in early fertility. Therefore, providing clear points for public health intervention.

Insomnia disorder is a debilitating sleep disorder that impacts nearly 10% of Canadian adults. Cognitive Behavioural Therapy for insomnia (CBT-I) is a psychological treatment that targets cognitions and behaviours to improve sleep outcomes. CBT-I has been shown to be an effective treatment for insomnia symptoms; however, little is known about the cognitive and physiological underpinnings of the treatment response. This thesis examines correlates of cognitive, clinical, and biological markers of change across group CBT-I treatment. Specifically, we evaluated: (1) objective and subjective cognitive and psychosocial functioning, (2) discrepancies between objective and subjective measures of sleep, and (3) the relationship between a biological marker of stress and sleep parameters. The first study in this thesis investigated how objective and self-report measures of cognitive functioning, and psychosocial functioning changed across CBT-I. Findings illustrated that changes in self-report cognitive ability and psychosocial functioning were related to the improvements in insomnia symptom severity across treatment. The second study investigated the discrepancy between objectively measured sleep with actigraphy and self-reported sleep variables. Findings showed that the mismatch between objective and subjective sleep parameters decreased early on during the implementation of CBT-I. Additionally, improvement of clinical symptoms was related to a decrease in sleep discrepancies across treatment. In the third study, we examined if there was a relationship between a biological marker of oxidative stress across CBT-I. Results showed that following CBT-I, the biological marker was related to both objective sleep parameters and self-reported symptom improvement. Overall, this thesis demonstrates that in our well-characterized sample of adults with insomnia disorder, group CBT-I was associated with significant post-group changes in cognitive, clinical, and biological factors. This has important implications for the factors that may influence an individual’s treatment response to CBT-I, and thus lead to improvements in tailoring treatments to optimize outcomes for treatment of insomnia disorder. / Dissertation / Doctor of Philosophy (PhD) / Insomnia disorder is a sleep disorder that negatively affects day-to-day-functioning and is associated with poorer mental and health outcomes. Cognitive Behavioural Therapy for insomnia (CBT-I) is an established psychological treatment that focuses on changing sleep behaviours and thinking patterns for improving sleep. This thesis aimed to examine factors that may be related to how CBT-I works to improve sleep with both self-reported and objective measures. We investigated whether cognition (e.g., memory and attention), different measures of sleep, clinical symptoms, and biological factors associated with sleep changed across treatment with CBT-I. Results indicated that several self-reported measures of cognition and sleep improved across CBT-I. Our findings suggest that these variables were related to improvements in sleep following CBT-I. By understanding what factors may be contributing to sleep difficulties and change across CBT-I, we can improve treatment outcomes and better adapt treatment strategies to those struggling with insomnia disorder.

This thesis outlines the notion of '<i>Disruptive Futuring'</i> as a new design methodology to addressing climate change. It is founded on making a connection between our behaviour as individuals and the environment. Since the publishing of 'Our Common Future' (Brundtland Commission.1987) major bodies have been publicly documenting the damage that climate change is having on the planet. This has been followed by the creation of United Nations Climate Change Conference international incentives including the Kyoto Protocol and national attempts including government departments and NGO projects. All have been directed to address the issue of climate change but have seen minimal success. Psychology plays a significant role in understanding and promoting human behavioural change and how we prioritise particular decisions or actions. However, until recently it has carried less weight in a design approach to solving behavioural problems in climate change. The primary issue is that climate change isn't a normal behavioural problem, and numerous psychologists including Stoknes (2015) highlight its incompatibility with innate human motivation. Newly explored areas within psychology and behavioural economics expose some of the reasons we may react to climate change with lower importance then other less damaging problems. <i>Disruptive Futuring</i> provides a new methodology based on thinkers such as Fogg (2002), Gilbert (2015), Dubner and Levitt. (2009), Marshall(2014), Pink(2009) and Stoknes (2015) to improve quantitative and qualitative adoption of designed interventions aimed at changing behaviours in order to accelerate human actions affecting climate change. This thesis takes a research through design approach that incorporates reflective practice. The research builds upon a literature review evaluating our connection with climate change, resulting in combining behavioural psychology with mapping and lens methods. <i>Disruptive Futuring</i> is presented as anew design methodology that develops new types of behavioural change using what Thaler & Sunstein (2009) describe as "Nudge" as a process to reroute people to new actions and flows in their everyday lives. These behavioural changes are achieved through framing climate change in ways humans are motivated by. Three practice-based projects pilot the methodology of <i>Disruptive Futuring</i> by exploring the topics of energy, water and food. These areas were selected because of their significance to our physiological requirements as highlighted by Maslow (1943). The projects result in three systems-based interventions aimed at changing behaviours that negatively impact climate change. It is observed through reflection that this methodology provides a context for designers to work in an oblique way; it has a preference to influence thinking and designing in systems; and that complex psychological concepts can be applied through designed interventions that reduce the conflict between our psychological composition and the human perception of climate change. This research explores the capability and capacity for <i>Disruptive Futuring </i>to bring climate change psychology into a unified way for designers to use during the conception and research stages of designing interventions, technology or services that target behavioural change, decisions making and create new ways of living to have less impact on climate change.

No description available.

No description available.

No description available.

Theory and research supports the implementation of cognitive and behavioural interventions (CBI’s) to address social, emotional and behavioural difficulties (SEBD) in children. The literature argues that schools are an ideal place in which to implement such interventions. As part of a county initiative, school staff were trained and offered follow up support by 2 Educational Psychologists (EPs) around the use of school-based CBI to support children who have SEBD. The 10 participants (from 5 schools) in this research were part of this initiative: they received 4 sessions of training followed by either monthly individual supervision, or group supervision, around their use of CBI. Training and supervision targeted implementation of key CB competences, selected from a competency framework recommended by ‘Improving Access to Psychological Therapies’ (IAPT, 2011). The research explored staff perceptions around the CB competences that they implemented, their methods of implementation and the barriers and facilitators to their implementation. The research used a mixed methodology design. Qualitative data was analysed using thematic analysis and quantitative data was analysed using descriptive statistics. Data was gathered through interviews, supervision sessions, intervention diaries and training evaluations. Exploration of facilitators and barriers to implementation was based on Durlak and DuPre’s (2008) model of intervention implementation. Facilitators/barriers discrete from this model were also identified. Identification and exploration of such factors can assist in ensuring quality implementation of school-based interventions in the future. This study demonstrates how school staff can implement a range of CB competences and through multi-levels of intervention in schools. The potential role of the EP in supporting school staff to implement CBI is also discussed.

No description available.

No description available.

No description available.