Paper one is a systematic review aimed at improving our understanding of the culturally determined risk factors of postnatal depression (PND) within 'Sub-Saharan Africa', by integrating evidence from quantitative and qualitative studies. A mixed-method systematic review approach was employed, nine quantitative and three qualitative studies were quality assessed, synthesised, and integrated. Stressful life events, adhering to cultural values and traditions, the effects of negative cultural perceptions and difficulties within the African extended family system were found to be risk factors for the development and maintenance of PND in Sub-Saharan Africa. The objective of paper two was to explore the lived experience of postnatal depression in West African mothers living in the UK. A qualitative design using semi-structured interviews with six West African mothers (Nigeria = 3; Ghana = 3) who were experiencing low mood in the postnatal period was undertaken. Participants were recruited from mother and baby groups within the National Health Service. Interpretative Phenomenological Analysis was used to explore and analyse the data. Five overarching themes emerged: (1) conceptualiszing PND, (2) isolation, (3) loss of identity, (4) issues of trust and (5) relationships as a protective factor. Each theme consisted of a number of subthemes. Women exhibited symptoms of PND but did not regard it as an illness, with the name 'depression'. They viewed their emotional distress as a result of social stress, and described feelings of isolation, loss of identity and relationship difficulties. Women's cultural background influenced their help-seeking behaviour; participants often avoided talking about their feelings and kept their distress to themselves. The findings have clinical implications in how services should be designed to meet the needs of African communities. Paper three reflects on the process of developing culturally competent research through the development of the current thesis. Suggestions for future research and reflections on the strengths and limitations of the research process are embedded throughout. Clinical implications are discussed with reference to a community psychology model.

A solid understanding of basic mathematics is essential for many practical, everyday tasks and good mathematical skills are increasingly necessary in the workplace. For some, however, mathematics can evoke an adverse emotional reaction, increasingly recognised in both psychology and education as 'Mathematics Anxiety' (MA); nationally funded projects are currently undertaking research in this area. Studies show that MA can develop in early childhood and increase in intensity with age; this emphasises the importance of early intervention and educational psychologists are well-placed to promote and support this. Paper One details a systematic literature review evaluating the impact and effectiveness of interventions on the reduction of MA in school-aged children. Nine studies, published between 2010 and 2017, met inclusion criteria and were assessed using quality frameworks. Findings indicated that MA might be amenable to intervention in children aged between seven and eighteen years; potential factors contributing to effective amelioration were identified and discussed. In Paper Two, the relationship between MA and working memory (WM) is highlighted and explored. Having established a possible bi-directional relationship, a quasi-experimental, empirical study aimed to assess the potential benefits of WM training for reducing MA. A comparison group completed activities encompassing many of the potentially effective factors identified in Paper One. 50 children, aged between eight and nine years, participated in six-week long interventions. MA was measured through self-report and qualitative questionnaires; data were analysed quantitatively (using descriptive and inferential statistics) or qualitatively (using content analysis) respectively. Findings question the validity of self-report measures of MA in this age group and implications for effective intervention are considered. Paper Three provides an overview of the concepts of evidence-based practice and practice-based research in addition to considering current literature in relation to effective dissemination of research. Implications resulting from the current research are discussed alongside the proposed dissemination strategy.

European competition law originated after the end of the Second World War as a part of treaties instrumental to the European integration process and it evolved through secondary law and jurisprudence of the European Court of Justice from an international trade provision into its modern and truly general form. European Commission in it its endeavor to modernize competition law presents a review of the application of Article 82. The goal of the review is to base the policy on a sound economic framework, to aim on effects of abusive conduct rather than on its form and finally to focus mainly on the most important competition problems. This thesis advocates the necessity of an economic analysis while assessing the possible abuse of dominant position in concrete cases and therefore welcomes proclaimed goals of the review. Conversely it criticizes the insufficient fulfillment of these goals, which is in our view, mainly due to misunderstanding of the operation of market mechanism. Economics is in its most generalized form a complex science of purposeful human action. It is therefore not a toolbox, from which one could ad hoc take models or theories in order to assess the abuse of dominant position in real-world cases. This naive approach often leads authorities to make unsound or paradox rulings. We demonstrate the indispensability of correctly understanding the market mechanism in referencing the famous Microsoft case. Industries of the New Economy are characterized by strong network effects and a high portion of fixed costs, which makes the firms often compete "for the market" instead of "on the market". The corollary high market share is not in our view a manifestation of a monopoly position, which could be exploited using monopoly price. Modern economy explains how potential competition forces these highly efficient firms to continuously invest into new technologies and how it pushes down the price of final products. On the other hand, recourse to ad hoc doctrines or non adequate economic models may lead to erroneous assessment of abuse of dominant position.

A partir de estudo do histórico da indústria de energia elétrica no Brasil, de revisão de conceitos de Direito Administrativo, teoria geral de concessões de serviços públicos e política de preço aplicada a monopólios naturais, o trabalho apresenta o estudo de caso de duas empresas de fornecimento de energia elétrica privatizadas a partir da regulamentação do art. 175 dispositivos da Constituição Federal de 1988, através da publicação da Lei nº 8.985/1995, conhecida como Lei de Concessões. A Lei em referência possibilitou que serviços de utilidade pública cuja atividade era altamente controlada pelo governo, a exemplo do fornecimento de energia, telecomunicações, entre outros, tivessem sua prestação delegada à iniciativa privada, passando o Estado a exercer apenas as tarefas de fiscalizador e regulador dos serviços, na figura de autarquias de regime especial: as agências reguladoras. As condições da prestação dos serviços públicos, como a forma de reajuste e revisão das tarifas, foram estabelecidas em contratos de concessão assinados entre a União e os novos concessionários. No segmento de distribuição de energia elétrica, entretanto, as condições contratualmente pactuadas para preservação das tarifas não têm sido devidamente observadas, provocando distorções nos mercados das concessionárias, conseqüentemente sobre os seus respectivos consumidores. / ABSTRACT Beginning from the study of the history of Brazils electric energy industry, the review of Administrative rights and obligations concepts, general theory of public utility concessions, to the price policy applied to Natural Monopolies, this Dissertation presents the case study of two electric energy distribution companies, which were privatized by means of Law nº 8.987/1995, know as Law of Concessions, that guides Article nº 175 of the Federal Constitution of 1988. The Law made it possible for public utilities whose activities were highly regulated by the Government, such as the distribution of electric energy, telecommunications, among others, to be granted to the entrepreneurial initiative, where the State would only act as a regulating and inspecting agent, through regulatory agencies. The terms of rendering the service of public utilities, such as tariff policies, were established in concession contracts signed between the Union and the new concessionaires. In the electric energy distribution sector, however, these contractual conditions to establish and preserve tariffs have not been dully observed, causing distortions in the markets served by the concessionaires and consequently on their respective consumers.

Mentalising is an "imaginative mental activity that enables us to perceive and interpret human behaviour in terms of internal mental states (e.g. needs, desires, feelings, beliefs, goals, purposes and reasons)" (Bateman & Fonagy, 2012; page 4). While this has been studied within an adult population, there has been a lack of research in understanding this construct in adolescence and its associations with mental health. This thesis aimed to systematically review the literature to establish if there was an association between mentalising difficulties and mental health disorders in adolescence. It further aimed to empirically investigate using a questionnaire-based study with adolescents, the constructs of mentalising and their associations with mental wellbeing. The review found a negative association, indicating that low mentalising skills were a risk factor for mental health difficulties. However, there was a lack of research in this area and methodological and conceptual concerns about the measurement of mentalising. The empirical study found that the theoretical model of mentalising did not fit for adolescents. This was discussed in relation to the need for further adolescent specific research to understand this developing construct. In addition, a refined model that was hypothesised to be 'self-awareness' was suggested that was found to predict the mental wellbeing outcomes, indicating a potential risk factor for mental health difficulties in adolescence.

INTRODUCTION: In psychosis, low engagement with mental health services is both prevalent and frequently associated with negative outcome. The overarching objective of this thesis was to investigate the role of psychological variables in service engagement in people with psychosis. A systematic review was conducted to examine the evidence for clinical and psychological correlates of engagement. An empirical study sought to investigate the association between engagement and psychological variables of a relational nature (i.e. mentalizing and interpersonal functioning). METHODS: A systematic search strategy across four electronic databases yielded seventeen journal articles. For the empirical study, forty-two people with multiple-episode psychosis completed self-report measures of service engagement, symptoms, mentalizing and interpersonal functioning, within a cross-sectional design. RESULTS: The review found relatively robust evidence supporting the association between engagement and numerous clinical variables. Eleven psychological variables were revealed as significant correlates of service engagement, encompassing developmental, individual and relational factors. Assessment of quality and risk of bias highlighted a number of limitations within included studies. In the empirical study, greater cognitive/disorganization symptomology was predictive of lower service engagement. Service engagement was significantly correlated with mentalizing, but not with interpersonal functioning. The relationship between cognitive/disorganized symptomology and engagement was not mediated by mentalizing performance. CONCLUSION: Numerous psychological variables are associated with service engagement, which has the potential to inform clinical practice in view of enhancing engagement. Qualitative and longitudinal studies with both service user and provider samples are required to capture the contextual information surrounding fluctuations in levels of engagement.

Thesis Portfolio Abstract Background Whilst the role of Psychological Flexibility on psychosocial outcomes has been assessed in some chronic health conditions and cancers, its role in psychosocial outcomes in men with prostate cancer has not been established. Fear of cancer recurrence has been shown to be associated with poorer psychosocial outcomes. The relationship of Psychological Flexibility on the impact of fear of cancer recurrence has not be evaluated. Research into the measurement of Psychological Flexibility in individuals with chronic ill health has not revealed a definitive measure. Methods A systematic review of the reliability and validity of measures of Psychological Flexibility in individuals with chronic health conditions was conducted. A quality assessment of the included studies was conducted and relevant results were synthesised. A cross-sectional study utilising a survey methodology was conducted to establish the role of Psychological Flexibility and fear of cancer recurrence in psychological distress and quality of life in men with prostate cancer. Regression analyses were used to establish whether fear of cancer recurrence or Psychological Flexibility significantly predicted any variance in distress or quality of life. Whether Psychological Flexibility mediated or moderated the relationship between fear of cancer recurrence and psychosocial outcomes was assessed with conditional process analysis. Results The systematic review revealed no single definitive measure of Psychological Flexibility, and that many measures currently in use within research and clinical settings have not been fully validated in individuals with chronic ill health conditions. The cross-sectional study found that Psychological Flexibility and fear of cancer recurrence each significantly predict variance in psychological distress and quality of life. Psychological Flexibility mediated and moderated the relationship between fear of cancer recurrence and psychological distress and mediated the relationship between fear of cancer recurrence and quality of life. Conclusions In the absence of a definitive measure of Psychological Flexibility, information on the measures identified were provided to allow clinicians and researchers to choose the most appropriate measure for their use. Future research might focus on further validation of existing measures of Psychological Flexibility rather than the development of additional measures. The challenges underlying using a psychometric approach to measure contextual science concepts was discussed. Due to the role of Psychological Flexibility within psychosocial outcomes in prostate cancer, it was suggested as a potential treatment target. The relevance of treatments such as Acceptance and Commitment Therapy, which aim to increase Psychological Flexibility, for men with prostate cancer was discussed. Future research avenues to further assess the role of Psychological Flexibility in psychosocial outcomes was discussed.

Background An increasing body of research is suggesting that childhood trauma and adversity may be associated with various adverse mental health outcomes, including psychosis. Cognitive functioning is often compromised in psychosis, and research has shown that there may be a link between early trauma and cognitive impairment in people with psychosis. No systematic review of the literature of this link has been undertaken, and very few studies have examined samples of individuals at high clinical risk for psychosis, to assess whether the potential link between adversity and cognitive functioning exists, without the confounding factors of length of illness, antipsychotic medication and chronicity of symptoms. Method The systematic review of all relevant electronic databases investigates the research to date on the association between childhood adverse experiences and cognitive ability in psychosis, and the conclusions that can be drawn from the existing literature, taking into account relevant considerations regarding sample, methodology and statistical analysis. The subsequent empirical study utilizes a sample at clinical high risk of developing psychosis, and a healthy control group to investigate whether any putative association in specific domains of cognitive functioning, or global cognitive ability and childhood adversity exist in those at clinical high risk, compared to controls. Results The systematic review indicated that at present, the literature looking into childhood adversity and cognitive ability in relation to psychosis is heterogeneous, with some studies finding that this association only occurs in patients, whilst others suggest it only occurs in the control groups. Some studies found it to be specific to certain cognitive domains, whilst others suggest it was a more global impairment. Methodology, samples and analysis differed considerably across studies, and likely contribute to the heterogeneity of the literature. The empirical paper showed a significant interaction effect between group (high risk versus controls) in the high childhood adversity group, in relation to global cognitive ability. Interestingly, this was not related to psychotic symptom severity or distress. Conclusion Several limitations of the existing studies limit the conclusions that can be drawn from the existing evidence regarding the link between childhood adversity and cognitive ability, and future research in prodromal samples is essential. The empirical study showed that there is a link between childhood adversity and cognitive ability in those at clinical high risk of developing psychosis, before disorder onset, that is not present in controls. This suggests that this may form a vulnerability in those at high risk for psychosis, rather than a more general mechanism present in the typical population.

This thesis is an exploration of two interconnected areas: Acceptance and Commitment Therapy (ACT) training for helping professionals (HPs) and psychological flexibility in helping professionals. The ACT model holds that HPs need to be psychologically flexible (or, herein, flexible) in order to be effective ACT practitioners, and thus a primary goal of ACT training is to enhance participant flexibility. The first chapter is a systematic review of studies that have evaluated the effectiveness of ACT training. It focused on ACT training practices and outcomes related to knowledge, skills, and psychological flexibility in HPs. The results of this review suggested that ACT training can be effective in providing HPs from a range of occupational background with the necessary knowledge and competency to deliver ACT interventions. Furthermore, ACT training can increase HP flexibility. However, confidence in these findings is limited due to methodological weaknesses, particularly variability in ACT training practices, inconsistent use of available measures, a lack of psychometrically robust measures to assess ACT knowledge, and the absence of a flexibility measure designed for use with HP populations. Recommendations were made regarding future research needs in this area, including the development of a HP-specific measure of flexibility. The second chapter reports on the development and initial validation of a measure designed to assess flexibility in the specific context of professional helping, called the Mindful Healthcare Scale (MHS). The results of two studies employing two separates samples of HPs provided good preliminary evidence of the MHS's factor structure and internal validity. The MHS was also found to converge in theoretically-consistent ways with other measures of flexibility and constructs related to the occupational functioning of HPs including burnout syndrome, self-compassion, and empathy. These findings suggest that the MHS may have considerable utility in relation to ACT training for HPs and may also advance our understanding of flexibility's role in HP occupational well-being and functioning.

In order to examine the literature on acceptance and mindfulness in parents of children with developmental disabilities a systematic review was conducted. Twelve studies were included in the review and provided some support for the relevance of these concepts in helping to support parents of children with developmental disabilities. However, general study quality was poor and methodological limitations hampered confidence in these findings. Research considerations are discussed. An empirical study was conducted to examine the relationship between psychological acceptance and family quality of life in parents of children with intellectual disabilities. One-hundred and twenty-nine parents of children with intellectual disabilities participated in a questionnaire based study. Participants completed measures of family quality of life, psychological acceptance, emotional adjustment, mental well-being and impact of the child. Parental psychological acceptance was positively associated with family quality of life and was found to account for around 1.9 per cent of its variance. Parental emotional adjustment was also positively associated with family quality of life, however, when parental psychological acceptance was added to the regression model emotional adjustment was no longer a statistically significant variable. The results of this study suggest that parental psychological acceptance may explain some of the variance in family quality of life. Further research is needed to ascertain whether interventions that improve parents' psychological acceptance also improve family quality of life.