This thesis tests one of the major propositions of deterrence theory: that increases in the severity of punishment can reduce the likelihood of offending. To this end, a case study in which the statutory penalties were doubled for almost all drink-driving offences in New South Wales, Australia, is examined. Two quasi-experimental studies were undertaken to assess the impact of these legislative changes: an interrupted time-series analysis of road crash rates (Study 1) and an analysis of drink-driving reoffending rates before and after the penalty changes were implemented (Study 2). Study 1 showed a significant increase in a surrogate measure of alcohol-related road crashes after the tougher drink-driving penalties were introduced. Further analyses suggested that this increase was driven primarily by a secular rise in non alcohol-related crashes that coincided with the policy???s implementation. Two possible conclusions about the deterrent effect of the policy are drawn from these findings: (1) that there was a reduction in alcohol-related road crashes which was overwhelmed by the rise in non alcohol-related crashes occurring around the same time or (2) that there was no change in crash rates. Study 2 found that drink-drivers who were convicted under the new penalty regime were less likely, and took longer, to reoffend than drink-drivers convicted before the introduction of the new penalties. This reduction in reoffending was only apparent for drink-drivers residing in country and regional areas and was small in magnitude.These latter findings are consistent with the possibility that the penalty changes coincided with a reduction in alcohol-related crashes but suggest that any decrease is likely to have been relatively small. A third study using a scenario-based survey methodology was also undertaken to examine the relationship between legal sanctions and willingness to drink-drive, controlling for other factors. The results of this study showed that participants who were more knowledgeable about drink-driving penalties were less likely to state that they would offend in the drink-driving scenario than participants who were less knowledgeable about the law. The implications of these findings for deterrence theory and criminal justice policy are discussed.

Previous research has shown that humankind is not becoming happier, and that in fact symptoms of depression continue to rise, despite the belief of many that happiness is the ultimate purpose of human life. The purpose of this study was to investigate whether happiness can be taught through an intervention programme aimed at increasing levels of subjective wellbeing as measured by scales of self-reported happiness and depression. Participants attending a course based on research into Positive Psychology that included the practice of multiple validated interventions made up the experimental group (N=33), and participants in other community education courses made up the control group (N=41). A pre-intervention, post-intervention and follow-up design was used, with participants completing sets of questionnaires designed to test levels of happiness and depression, and additional questionnaires capturing demographic information and signature character strengths. The results of this study suggested that the intervention had a positive effect on increasing happiness and reducing symptoms of depression. The non-randomised groups resulted in a more depressed experimental than control group prior to the intervention. Generally speaking, it was not true that any subgroup benefited more from the intervention than others, nor were happier or more depressed than others. This study appears to support earlier research that found that subjective wellbeing could be increased through education and volitional behaviour. Implications for the findings are discussed in relation to group education and therapeutic intervention both for increasing happiness as well as reducing symptoms of depression.

Fibromyalgia Syndrome (FMS) is a disease of unknown etiology that affects up to 3 million Canadians, or 2-10% of the general population (Carruthers & van de Sande, 2005). Acceptance-based behavioural therapy (ABBT) is a relatively recent approach to treating human suffering in general and chronic pain in particular (Hayes, Strosahl, & Wilson, 1999; McCracken, 2005). ABBT treatments have been shown to effectively treat pain, pain-related anxiety, depression, and other behavioural measures of disability (McCracken, 2005; McCracken, Vowles, Gregg, & Almada, 2010; Pear & Simister, 2016, p. 160). In-person treatments can place significant burden on patients and the overall health-care system. Outcomes for online programs can be similar to those for in-person treatment while allowing for increased flexibility for both patients and professionals (Ritterband & Tate, 2009; Strecher, 2007). The current study extended a pilot study (Shay, Tkachuk, Simister, Bailly, & Skrabek, 2011), modifying the previous treatment to a 6 unit program that could be delivered online. Sixty-one participants completed the study, being randomly assigned to an online ABBT plus treatment-as-usual (online ABBT + TAU) group or a treatment-as-usual alone (TAU) group. All participants completed a series of self-report measures at baseline, at post-treatment, and at a 3-month follow-up. Linear mixed modelling supported significant differences between the groups in favour of the ABBT + TAU treatment group on the primary outcome measure (Fibromyalgia Impact Questionnaire-Revised (FIQ-R); F (2, 52.82) = 20.10, p < .0001) following treatment. The online ABBT + TAU group also had significantly greater improvements in depression, pain, acceptance, perceived helplessness, and kinesiophobia. Increased acceptance mediated the effects of treatment on improvements in FMS quality of life and FMS impact, while reduced helplessness mediated the effects of treatment on improvements in level of reported pain. Comments and subjective ratings of improvement were consistent with the quantitative results. Participants rated mindfulness (contact with present moment experience) as the most useful treatment unit. / February 2016

abstract: An ever expanding body of research has shown that children of divorce are at increased risk for a range of maladaptive outcomes including academic failure, behavior problems, poor psychological adjustment, reduced self-concept, and reduced social competence (Amato, 2001). Furthermore, the widespread prevalence of divorce makes preventing these poor outcomes a pressing public health concern. The Children of Divorce-Coping with Divorce (CoD-CoD) program is an internet-based selective prevention that was derived from recent research identifying modifiable protective factors in children of divorce including active and avoidant coping, divorce appraisals, and coping efficacy. CoD-CoD addresses these putative mediators through careful adaptation of intervention components previously demonstrated to be effective for children from disrupted families (Pedro-Carroll & Alpert-Gillis, 1997; Stolberg & Mahler, 1994; Sandler, et al., 2003). In the CoD-CoD efficacy trial, 147 children ages 11-16 whose family had received a divorce decree within 48 months of the intervention start date served as participants. Participants were assessed in two waves in order to test the small theory of the intervention as well as the interventions effects on internalizing and externalizing behaviors. Analyses indicated that the program effectively reduced the participants total mental health problems and emotional problems as reported on the Strengths and Difficulties Questionnaire (SDQ) (d = .37) and for total mental health problems this effect was stronger for children with greater baseline mental health problems (d = .46). The program also had mediated effects on both child and parent-reported total mental health problems whereby the program improved coping efficacy for children with low baseline coping efficacy which led to reduced parent-reported mental health problems. To the author's knowledge this is the first randomized controlled trail of internet-based mental health program for children or adolescents which utilizes an active control condition. / Dissertation/Thesis / Ph.D. Psychology 2011

<b>Background:</b> The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach offers a transparent framework for rating the certainty of evidence in systematic reviews. Concerns, however, have been raised that use of GRADE beyond biomedical interventions frequently downgrades the 'best evidence possible' for many complex interventions. This DPhil thesis aims to (1) further investigate the challenges of using GRADE in systematic reviews of complex interventions, (2) explore how the GRADE approach can be advanced to address these challenges, and (3) inform the write-up and dissemination of a new GRADE guidance for complex interventions. <b>Methods:</b> To address the broad aims of this thesis a range of methodological approaches were employed, primarily drawing on the best-practice techniques for developing research reporting guidelines (see Chapter 2). First, a systematic literature review method was used to establish whether an adequate system already exists for rating the certainty of evidence for complex interventions and informing the need for a new guidance (Chapter 3). Further consultation with experts, including semi-structured interviews with review authors and GRADE methodologists, provided a nuanced understanding of the challenges of applying GRADE in reviews of complex interventions and suggestions for advancing the guidance on GRADE (Chapter 4). Agreement around these suggestions was explored in a Delphi-based online expert panel (Chapter 5), and the content of the new GRADE guidance for complex interventions was discussed indepth in a three-day expert meeting held in Oxford in May 2017 (Chapter 6). <b>Results:</b> The systematic literature review identified a few systems attempting to modify GRADE for public health interventions; however, there was little reporting of rigorous procedures in the development and dissemination of these systems. Qualitative interviews captured differences in views on GRADE use between review authors and GRADE methodologists. Specifically, GRADE methodologists found it critical to consider GRADE from the beginning of the review process and exercise judgment in GRADE ratings. Review authors, on the other hand, often thought of GRADE as an 'annoying add-on' at the end of the review process and felt challenged by the need to be more interpretative with evidence and sift through many publications on GRADE. Suggestions were made to enhance the GRADE guidance. No significant disagreement was found in the online expert panel on any domain of evidence, and the expert meeting provided further insights into the content of the new GRADE guidance for complex interventions. Participants agreed that the new guidance should specify the meaning of the construct of 'certainty of evidence' for complex interventions, consider revisions of the initial categorisation of evidence based on study design, and better assess the coherence of the causal pathway of complex interventions. <b>Conclusion:</b> This thesis work consolidates up-to-date methodological knowledge on reviewing complex interventions by providing critical examination of the existing approaches and new insights. In transparent reporting of the research phases, it informs development of a new GRADE guidance on rating the certainty of evidence in systematic reviews of complex interventions.

Midwives experience both occupational and organisation episodes of work-related psychologicl distress. As the wellbeing of health professionals is linked with the safety and quality of care, these episodes of distress should be met with adequate support. Midwives can be reluctant to speak openly about episodes of work-related distress. Additionally, they may not be able, or prefer not to access, face-to-face support. As such, an online intervention may be one option that midwives turn to when seeking support, as it can provide confidential and flexible access to support. This research makes a case for the development of an online interevention, designed to effectively support midwives in work-related psychological distress. Firstly, a narrative literature review integrates contemporary research to build an overview of the nature, prevalence, and origin, of work-related psychological distress in midwifery populations. A critical literature review then explores some of the ethical considerations in relation to providing midwives with anonymous and confidential online support. This review concludes that the provision of anonymity and confidentiality online would ensure the greatest benefit overall to the greatest number of people using and working within maternity services. A systematic mixed-methods literature review then concludes that there are currently very few targeted interventions designed to support midwives in work-related distress, none of which are currently delivered online. Moreover, this review identifies insufficient high-quality research to comprehensively understand which particular interventions or techniques could deliver effective support to midwives in work-related psychological distress. Lastly, a multi-stakeholder Delphi study is presented to establish consensus in relation to the content development, design and delivery of an online intervention to support midwives and/or student midwives in work-related psychological distress. In this case, an expert panel prioritised confidentiality and anonymity, along with 24-hour mobile access, effective moderation, an online discussion forum, and additional legal, educational, and therapeutic components. Consensus also supported the inclusion of a simple user assessment to identify people at risk of either causing harm to others or experiencing harm themselves, in order to direct them to appropriate support. The impact of any future intervention of this type will be optimised by utilising the findings from this Delphi study throughout the intervention development process. Furthermore, as the ethical, practical and evidence based arguments for the development of an online intervention designed to support midwives in work-related psychological distress have now been formed, it will be important to build and rigorously test this intervention in response to the identified gaps in research. This thesis demonstrates that there is a case for the development of an online intervention designed to support midwives in work-related psychological distress. Future research will require feasibility studies, pilot studies and adequately powered randomised controlled trials in order to sercure the evidence base for any new online support for this professional population.

Utilizing a well-established manualized alcohol-focused intervention, the Brief Alcohol Screening for College Students (BASICS), this study explored the efficacy of implementing BASICS in a small group setting for mandated college students. The study assessed pretest and posttest data over a two month period to explore whether participation in the small group implementation of BASICS was associated with changes in substance use and related risk factors (i.e., alcohol use, marijuana use, typical blood alcohol concentration, peak blood alcohol concentration, hazardous drinking, alcohol consequences, risky sexual behavior, and depression and anxiety), pro-social change factors (i.e., harm reduction, readiness for change, and student engagement), and coping behaviors. Repeated measures multivariate analyses of variance and covariance were conducted with a final sample of 52 participants. Multivariate analyses were examined with and without the use of covariates (baseline alcohol use and alcohol consequences scores) for substance use and related risk factors and pro-social change factors. Further exploration of substance use and related risk factors were conducted with the addition of marijuana condition. A final set of analyses explored fourteen subscales of coping behaviors. Given limitations surrounding small and homogenous sampling, results should be interpreted with caution. The main analyses revealed no significant differences between the intervention and waitlist control group for substance use and related risk factors outcomes. This study is unable to make a definitive judgment on the effectiveness of BASICS implemented in small group setting for mandated students; however, findings suggest that in a small group setting BASICS may facilitate a reduction in engagement with substance use behaviors and associated consequences but does not promote lower risk practices. The examination of the marijuana condition revealed that participants who endorsed marijuana use demonstrated higher baseline scores for alcohol use, hazardous drinking, alcohol consequences, and risky sexual behavior. Overall, further analyses need to be conducted to determine the effectiveness of BASICS implemented in a small group setting for mandated students. These future research endeavors may benefit from collaborative efforts to increase sample size and implement the intervention with more diverse student populations.

Les inégalités sociales de santé sont particulièrement élevées en France. Si leur réduction est reconnue comme un enjeu de santé publique majeur, les politiques sanitaires restent centrées sur le système de soins et la modification des comportements " individuels ". Les travaux en épidémiologie sociale permettent de mieux comprendre comment ces inégalités se construisent et s'enchaînent tout au long de la vie. Cependant, l'absence de connaissances solides sur les moyens d'agir sur ces déterminants limite le passage à l'intervention. De nombreuses interventions locales sont mises en œuvre mais restent souvent peu décrites, peu évaluées et peu transférées. La thèse s'inscrit dans le champ de la recherche interventionnelle en santé des populations. Dans la première partie, la vision classique séquentielle des programmes de santé publique est déconstruite au profit d'une approche plus systémique. Différents niveaux d'intervention sont présentés, des programmes d'éducation à la santé individuels aux évaluations d'impacts sur la santé (EIS) qui permettent d'agir sur les déterminants sociaux de la santé. A partir d'une critique de l'essai expérimental, d'autres approches évaluatives sont présentées, basées sur une revue de la littérature sur l'" évaluation de programme ", domaine peu développé en France. La seconde partie décrit les résultats d'une recherche sur la transférabilité des interventions, menées à partir du programme AAPRISS (Apprendre et Agir Pour réduire les Inégalités Sociales de Santé). Un modèle visant à décrire les interventions en distinguant leurs " fonctions clés " (potentiellement standardisables et transférables) et leur implémentation, pouvant varier selon les contextes, a été développé à partir de différents projets de prévention inclus dans le méta-programme AAPRISS. Il repose sur l'hypothèse qu'une meilleure description des interventions, basées sur une distinction entre éléments transférables et éléments adaptatifs, constitue un prérequis à son évaluation et son potentiel transfert, et repose sur une co-construction entre professionnels et chercheurs. Dans une troisième partie, ce modèle est utilisé pour le programme AAPRISS lui-même. Les dynamiques d'échange de connaissance et de co-construction intersectorielle et interdisciplinaire sur lesquelles il repose sont analysées. La complexité des déterminants conduisant aux ISS plaide pour des programmes qui revisitant les projets existants plutôt que la création d'une nouvelle intervention visant à les réduire. Mieux comprendre comment fonctionnent ces projets et pouvoir reproduire des processus à même d'agir sur les ISS est essentiel. / Social inequalities in health are particularly elevated in France. Decreasing these inequalities has been on the political agenda since 2009. However, knowledge is sparse regarding possible interventions which would contribute to their decrease. Many local-level interventions are implemented, but most often they are not described, not evaluated, nor transferred. This thesis is embedded within the field of population health intervention research. The first part of the thesis focusses on deconstructing the archetypal vision of the intervention within the field of public health, wherein it is considered to be a sequential, technical programme. A systemic approach to interventions is then described. Different levels of intervention are described, from individual health education to Health Impact Assessment (HIA), aiming at addressing social determinants of health. By relying on a critique of the randomised controlled trial, alternative evaluation approaches are detailed, based on a literature review in the field of " programme evaluation " still relatively under developed in France. The second part of the thesis is centred on the results of research on intervention transferability, based on the AAPRISS (Apprendre et Agir Pour réduire les Inégalités Sociales de Santé) programme. A description model has been developed, based on a distinction between the " key functions " of an intervention (that is standardisable and transferable key elements), and their implementation, that can vary across contexts. It has been developed from different prevention projects included within the AAPRISS programme. It relies on the hypothesis that a better description of interventions, relying on a distinction between transferable and adaptive elements, constitutes a useful step to the evaluation and potential transfer of an intervention. The model is built on a knowledge co-construction between project leaders and researchers. In the last part of the thesis, the model is applied to the AAPRISS meta-programme itself. Knowledge exchange and co-construction dynamics on which it relies are analysed. The complexity and multiplicity of the determinants of health and SIH call for revisiting existing programmes more than for the creation of a new programme to reduce SIH.

abstract: The lack of healthy behaviors - such as physical activity and balanced diet - in modern society is responsible for a large number of diseases and high mortality rates in the world. Adaptive behavioral interventions have been suggested as a way to promote sustained behavioral changes to address these issues. These adaptive interventions can be modeled as closed-loop control systems, and thus applying control systems engineering and system identification principles to behavioral settings might provide a novel way of improving the quality of such interventions. Good understanding of the dynamic processes involved in behavioral experiments is a fundamental step in order to design such interventions with control systems ideas. In the present work, two different behavioral experiments were analyzed under the light of system identification principles and modelled as dynamic systems. In the first study, data gathered over the course of four days served as the basis for ARX modeling of the relationship between psychological constructs (negative affect and self-efficacy) and the intensity of physical activity. The identified models suggest that this behavioral process happens with self-regulation, and that the relationship between negative affect and self-efficacy is represented by a second order underdamped system with negative gain, while the relationship between self-efficacy and physical activity level is an overdamped second order system with positive gain. In the second study, which consisted of single-bouts of intense physical activity, the relation between a more complex set of behavioral variables was identified as a semi-physical model, with a theoretical set of system equations derived from behavioral theory. With a prescribed set of physical activity intensities, it was found that less fit participants were able to get higher increases in affective state, and that self-regulation processes are also involved in the system. / Dissertation/Thesis / Masters Thesis Chemical Engineering 2016

Children with behaviour problems tend to be more unengaged and low-achieving at school than children without behaviour difficulties. This systematic literature review is highlighting the meaning of intervention to support children towards the school engagement.  The interventions for decreasing behaviour problems, is seen as a facilitator to be engaged. The school engagement will lead to an academic achievement at school. Early engagement has impact for longer in future in child’s life. The engagement in kindergarten has influence in primary school engagement and achievement. Therefore, intervening in early age to support children at-risk, will lead to better possibilities in learning. The risk factors can be child’s socioeconomical status, race, disability and parent’s low involvement in the school settings. Behaviour problem has pointed out to be hindering factor for the school engagement and this means missed opportunities in learning. This might lead even more disruptive behaviour. That kind of behaviour is challenging for the whole classroom, since it affects on everyone’s learning. Teacher’s attitudes manifest the self-worthiness in students. Supportive and friendly environment at school embraces the participation to the school settings. Especially, children from low socioeconomical families tend to score lower at school. These children need more intervening from the teacher to cultivate the school engagement. This systematic review analysed the data from 14 different articles from Europe, USA and Australia.