13,553 research outputs found
Implementing Health Impact Assessment as a Required Component of Government Policymaking: A Multi-Level Exploration of the Determinants of Healthy Public Policy
It is widely understood that the public policies of ‘non-health’ government sectors have greater impacts on population health than those of the traditional healthcare realm. Health Impact Assessment (HIA) is a decision support tool that identifies and promotes the health benefits of policies while also mitigating their unintended negative consequences. Despite numerous calls to do so, the Ontario government has yet to implement HIA as a required component of policy development. This dissertation therefore sought to identify the contexts and factors that may both enable and impede HIA use at the sub-national (i.e., provincial, territorial, or state) government level.
The three integrated articles of this dissertation provide insights into specific aspects of the policy process as they relate to HIA. Chapter one details a case study of purposive information-seeking among public servants within Ontario’s Ministry of Education (MOE). Situated within Ontario’s Ministry of Health (MOH), chapter two presents a case study of policy collaboration between health and ‘non-health’ ministries. Finally, chapter three details a framework analysis of the political factors supporting health impact tool use in two sub-national jurisdictions – namely, Québec and South Australia.
MOE respondents (N=9) identified four components of policymaking ‘due diligence’, including evidence retrieval, consultation and collaboration, referencing, and risk analysis. As prospective HIA users, they also confirmed that information is not routinely sought to mitigate the potential negative health impacts of education-based policies. MOH respondents (N=8) identified the bureaucratic hierarchy as the brokering mechanism for inter-ministerial policy development. As prospective HIA stewards, they also confirmed that the ministry does not proactively flag the potential negative health impacts of non-health sector policies. Finally, ‘lessons learned’ from case articles specific to Québec (n=12) and South Australia (n=17) identified the political factors supporting tool use at different stages of the policy cycle, including agenda setting (‘policy elites’ and ‘political culture’), implementation (‘jurisdiction’), and sustained implementation (‘institutional power’).
This work provides important insights into ‘real life’ policymaking. By highlighting existing facilitators of and barriers to HIA use, the findings offer a useful starting point from which proponents may tailor context-specific strategies to sustainably implement HIA at the sub-national government level
The Genetics of Pain: An exploration of gene-by-environment interactions and their effects on pain
The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood experience (ACE) reported significantly higher scores than minor allele carriers with at least one ACE. For pain interference, minor allele carriers (G/G) of CNR2 rs2501431 scored significantly higher than major allele carriers (A/A and G/A). Chapter 3 presents a cluster analysis that combines genotypes of FKBP5 rs9394314 and CNR2 rs2501431 to explore meaningful relationships with pain and trauma-related distress. ACE was also explored as a moderator of these relationships. Three clusters were identified where the second cluster characterized by major allele carriers of rs9394314 and minor allele carriers of rs2501431 reported significantly higher pain-related functional interference scores. Participants in the second cluster with at least one ACE reported higher pain interference and traumatic distress scores compared to the third cluster, while participants in the first cluster with at least one ACE reported higher pain severity compared to the first cluster. Chapter 4 presents genomic structural equation models (SEM) that explore the relationships of genotypes with trauma-related distress using the traumatic injuries distress scale (TIDS), ACE, and recovery outcomes. The results demonstrate a relationship between TIDS and recovery outcomes, and an indirect relationship between FKBP5 rs9394314 and recovery outcomes exist which is mediated by TIDS. Major allele carriers of FKBP5 rs9394314 reported higher TIDS scores, which was also demonstrated for participants that had at least one ACE. Major allele carriers that scored higher on the TIDS were predicted to be in the none-recovered category. These results support the notion that gene-x-environment interactions may play an important role in pain and recovery
Coloniality and the Courtroom: Understanding Pre-trial Judicial Decision Making in Brazil
This thesis focuses on judicial decision making during custody hearings in Rio de Janeiro, Brazil. The impetus for the study is that while national and international protocols mandate the use of pre-trial detention only as a last resort, judges continue to detain people pre-trial in large numbers. Custody hearings were introduced in 2015, but the initiative has not produced the reduction in pre-trial detention that was hoped. This study aims to understand what informs judicial decision making at this stage. The research is approached through a decolonial lens to foreground legacies of colonialism, overlooked in mainstream criminological scholarship. This is an interview-based study, where key court actors (judges, prosecutors, and public defenders) and subject matter specialists were asked about influences on judicial decision making. Interview data is complemented by non-participatory observation of custody hearings. The research responds directly to Aliverti et al.'s (2021) call to ‘decolonize the criminal question’ by exposing and explaining how colonialism informs criminal justice practices. Answering the call in relation to judicial decision making, findings provide evidence that colonial-era assumptions, dynamics, and hierarchies were evident in the practice of custody hearings and continue to inform judges’ decisions, thus demonstrating the coloniality of justice. This study is significant for the new empirical data presented and theoretical innovation is also offered via the introduction of the ‘anticitizen’. The concept builds on Souza’s (2007) ‘subcitizen’ to account for the active pursuit of dangerous Others by judges casting themselves as crime fighters in a modern moral crusade. The findings point to the limited utility of human rights discourse – the normative approach to influencing judicial decision making around pre-trial detention – as a plurality of conceptualisations compete for dominance. This study has important implications for all actors aiming to reduce pre-trial detention in Brazil because unless underpinning colonial logics are addressed, every innovation risks becoming the next lei para inglês ver (law [just] for the English to see)
Image classification over unknown and anomalous domains
A longstanding goal in computer vision research is to develop methods that are simultaneously applicable to a broad range of prediction problems. In contrast to this, models often perform best when they are specialized to some task or data type. This thesis investigates the challenges of learning models that generalize well over multiple unknown or anomalous modes and domains in data, and presents new solutions for learning robustly in this setting.
Initial investigations focus on normalization for distributions that contain multiple sources (e.g. images in different styles like cartoons or photos). Experiments demonstrate the extent to which existing modules, batch normalization in particular, struggle with such heterogeneous data, and a new solution is proposed that can better handle data from multiple visual modes, using differing sample statistics for each.
While ideas to counter the overspecialization of models have been formulated in sub-disciplines of transfer learning, e.g. multi-domain and multi-task learning, these usually rely on the existence of meta information, such as task or domain labels. Relaxing this assumption gives rise to a new transfer learning setting, called latent domain learning in this thesis, in which training and inference are carried out over data from multiple visual domains, without domain-level annotations. Customized solutions are required for this, as the performance of standard models degrades: a new data augmentation technique that interpolates between latent domains in an unsupervised way is presented, alongside a dedicated module that sparsely accounts for hidden domains in data, without requiring domain labels to do so.
In addition, the thesis studies the problem of classifying previously unseen or anomalous modes in data, a fundamental problem in one-class learning, and anomaly detection in particular. While recent ideas have been focused on developing self-supervised solutions for the one-class setting, in this thesis new methods based on transfer learning are formulated. Extensive experimental evidence demonstrates that a transfer-based perspective benefits new problems that have recently been proposed in anomaly detection literature, in particular challenging semantic detection tasks
Sexual violence as a form of social control : the role of hostile and benevolent sexism
This thesis examines the feminist hypothesis that rape functions as a tool of social control through which women are kept in subordinate social positions (Brownmiller, 1975). In examining this hypothesis, the current thesis explores the role of benevolent and hostile sexism in accounting for people's responses to different types of rape (i.e. stranger vs. acquaintance rape). An examination of the literature suggests that there are general societal beliefs in the distinction between "good" and "bad" rape victims (Pollard, 1992). Interestingly, researchers have observed that benevolent sexism (BS) is related to the idealisation of women in traditional gender roles (i.e. "good" women; Glick et aI., 2000). It is, therefore, argued that individuals who idealise women in traditional roles (i.e. high BS individuals) are more likely to negatively evaluate rape victims who can be perceived as violating these norms. Nine empirical studies are presented in this thesis. Study 1 examines the potential role of BS in accounting for previously observed differences in the amount of blame attributed to stranger and acquaintance rape victims (e.g. Pollard, 1992). Studies 2 and 3 examine the psychological mechanisms that underlie the relationship between BS and victim blame in acquaintance rape situations. Studies 2 and 4 also explore the psychological mechanisms that underlie the relationship between hostile sexism (HS) and self reported rape proclivity in acquaintance rape situations (c.f. Viki, 2000). In Study 5, the relationship between BS and paternalistic chivalry (attitudes that are simultaneously courteous and restrictive to women) is examined. Studies 6 and 7 examine the role of BS in accounting for participants' responses to stranger vs. acquaintance rape perpetrators. The last two studies (Studies 8 and 9) examine the potential role of legal verdicts in moderating the relationship between BS and victim blame in acquaintance rape cases. Taken together, the results support the argument that BS provides a psychological mechanism through which differences in the amount of blame attributed to stranger and acquaintance rape victims can be explained. In contrast, HS provides a mechanism for explaining differences in self-reported proclivity to commit stranger and acquaintance rape. The thesis concludes with a summary of the findings, a discussion of the methodological limitations of the studies and suggestions of directions for future research
Examination of a Brief, Self-Paced Online Self-Compassion Intervention Targeting Intuitive Eating and Body Image Outcomes among Men and Women
Ideals for appearance and body image are pervasive in Western culture in which men and women are portrayed with unrealistic and often unattainable standards (Ferguson, 2013; Martin, 2010). Exposure and reinforcement have created a culture of social acceptance and internalization of these ideals, contributing to pervasive body image disturbance (i.e., body dissatisfaction; Fallon et al., 2014; Stice, 2001; Thompson & Stice, 2001; Thompson et al., 1999). Research has suggested that body dissatisfaction is expressed differently across sexes (Grossbard et al., 2008), with attention to thin ideals among women and muscular ideals among men. Body dissatisfaction has been linked to numerous poor outcomes, including dieting, unhealthy weight control behaviors, disordered eating, and increased psychopathology. Although dieting is one of the primary mechanisms employed to reduce body dissatisfaction (Thompson & Stice, 2001), research has shown that such efforts are contraindicated as dieting predicts weight gain over time (Pietiläinen et al., 2012) as well as preoccupation with food, disordered eating, eating disorders, emotional distress, and higher body dissatisfaction (Grabe et al., 2007; Johnson & Wardle, 2005; Neumark- Sztianer et al., 2006; Paxton et al., 2006; Tiggemann, 2005). Restrictive dietary behaviors suppress physiological cues to eat (e.g., hunger) that presents a vulnerability to eating in response to alternative cues, both internal (e.g., emotions) and external (e.g., availability of food).
Intuitive eating is a non-restrictive approach to eating that encourages adherence to internal physiological cues to indicate when, what, and how much to eat (Tylka, 2006) and has demonstrated an inverse relationship with disordered eating, restrained eating, food preoccupation, dieting, body dissatisfaction, and negative affect (Bruce & Ricciardelli, 2016). Self-compassion, relating to oneself in a caring and supportive manner (Neff, 2003a), has been proposed as a pathway to increase intuitive eating and reduce body dissatisfaction (Neff & Knox, 2017; Schoenefeld & Webb, 2013; Webb & Hardin, 2016). Research has highlighted the efficacy of self-compassion interventions in addressing weight-related concerns (Rahimi-Ardabili et al., 2018) as well as brief experiential exercises for reducing body dissatisfaction (Moffitt et al., 2018). Additionally, there is a growing body of evidence supporting the efficacy of internet-based self-compassion interventions (Mak et al., 2018; Kelman et al., 2018; Nadeau et al., 2020). The purpose of the current study was to examine the effectiveness of a brief, self-paced online self-compassion intervention targeting body image and adaptive eating behaviors and potential mechanisms of change (e.g., self-compassion and psychological flexibility) among undergraduate men and women. This study also examined outcomes among men and women in the area of self-compassion, body dissatisfaction, and intuitive eating as research has highlighted the need to determine who benefits more from self-compassion interventions (Rahimi-Ardabili et al., 2018).
The study compared a one-hour, self-guided online self-compassion intervention to an active control condition. The intervention was comprised of psychoeducation, experiential exercises, and mindfulness practice designed to increase self-compassion surrounding body image and eating behaviors. In contrast, the active control condition consisted of self-care recommendations and self-assessments for nutrition, exercise, and sleep. The study was administered over three parts (e.g., baseline, intervention, and follow-up) in which variables of interest were assessed at each time point. Outcome variables included self-compassion, intuitive eating, disordered eating, body appreciation, muscle dysmorphia, internalized weight bias, fear of self-compassion, and psychological inflexibility. Participants were randomized on a 2:1 intervention to control ratio at the second time point in order to make comparisons between groups while simultaneously having sufficient power for examining mediation and moderation within the treatment condition. Overall, 1023 individuals (64% women, Mage = 18.9, 67.4% white) signed informed consent and participated in at least one part of the study whereas 101 participants (71% women, Mage = 19.3, 71% white) completed all three study portions.
As predicted, self-compassion was correlated with all variables of interest, and all study variables were correlated with each other (p < .01). In contrast to hypothesized outcomes, the self-compassion condition failed to demonstrate improvements across time or between conditions on all study outcomes. These results persisted when participants were screened for levels of intuitive eating as well. Contrary to prediction, internalized weight bias, muscle dysmorphia, and fear of self-compassion demonstrated increased levels within the intervention condition and decreases in the control condition. There were significant gender differences on multiple outcome variables, with men demonstrating higher levels of self-compassion and body appreciation whereas women endorsed higher levels of disordered eating, internalized weight bias, muscle dysmorphia, and psychological inflexibility. Additionally, there were significant gender interactions for internalized weight bias, body appreciation, and muscle dysmorphia. The interactions existed such that men demonstrated increased internalized weight bias and muscle dysmorphia across time whereas women displayed decreased weight bias and muscle dysmorphia. The opposite pattern was found within body appreciation; women demonstrated increased body appreciation across time while men reported decreased levels of body appreciation.
Despite this study’s intent to examine underlying mechanisms of change, the condition in which participants were randomly selected did not have any relationship, positive or negative, with the outcome variables of interest. As such, mediation within the current study was not conducted as it would violate statistical assumptions required to examine this hypothesis. Finally, upon examining the moderating relationship of fear of self-compassion between self-compassion and outcome variables, there were main effects for self-compassion on intuitive eating, emotional eating, internalized weight bias, body appreciation, and psychological inflexibility as well as main effects of fear of self-compassion on psychological inflexibility. There were significant interactions for intuitive eating and emotional eating, such that as fear of self-compassion increased, the effect of self-compassion on intuitive eating decreased, and the effect of self-compassion on reducing emotional eating behaviors decreased.
Overall, the brief, self-paced online intervention delivered in the current study did not prove to be an effective means for improving self-compassion, intuitive eating, body appreciation, disordered eating, muscle dysmorphia, and psychological inflexibility. Nevertheless, the relationships between self-compassion and outcome variables of interest throughout the study mirror that of the existing literature. Findings from this study, in general, were also consistent with differences between men and women despite a gap in the research for intervention outcomes. Although fear of self-compassion demonstrated a moderating effect on the relationship between self-compassion and intuitive eating as well as emotional eating, this does not account for the lack of significant findings. The context surrounding this study, such as the COVID-19 pandemic, provided a considerable challenge to examining the efficacy of the current intervention. However, the findings of this study suggest future research will likely need to identify ways to enhance the delivery of experiential exercises that encourage engagement, provide a safe and warm environment for participants, and create flexibility and willingness surrounding painful and difficult experiences in order to undermine internalized and socially accepted beliefs about body image and eating behaviors
In her own words: exploring the subjectivity of Freud’s ‘teacher’ Anna von Lieben
This project is inspired by Roy Porter (1985), who draws attention to the patient-shaped gap in medical history, and Rita Charon (2006), who emphasises the need to bring the patient’s narrative to the fore in the practice of medicine. The principal aim was to devise a means of accessing the lived experience of a patient who is no longer alive in order to gain an understanding of her narrative. Anna von Lieben was identified as a suitable subject as she wrote a substantial quantity of autopathographical poetry suitable for analysis and her status as Freud’s patient makes her a person of significant interest to the history of medicine.
The poems were analysed using Interpretative Phenomenological Analysis (IPA), an idiographic and inductive method of qualitative research, based on Heideggerian hermeneutic phenomenology, which explores the lived experience of individuals and is committed to understanding the first-person perspective from the third-person position.
The main findings from the IPA study reveal that Anna experienced a prolonged period of malaise, starting in late adolescence which she believed to result, at least partly, from a traumatic experience which occurred at that time. The analysis also indicates that Anna suffered from deep and lasting feelings of guilt and shame. The discovery of additional family documentation enabled me to contextualise and add substance to the findings of the IPA study. Anna’s husband’s diaries in particular reveal that Anna:
• had a severe and longstanding gynaecological disorder
• suffered from severe morphinism
• did not benefit from Freud’s treatment which seemed neither to ease her symptoms nor identify any cause
• was treated in Paris, not by Jean-Martin Charcot as previously supposed, but by a French hydrotherapist, Theodore Keller, who appears to have become a person of considerable significance in her life.
The above findings led me to investigate Anna’s comorbidities (gynaecological disease and morphinism) and to show how those could be responsible for much of the symptomatology identified by Freud as ‘hysteria’. I then explore the possibility that her psychotic-like experiences could have been iatrogenically induced by her treatment first by Keller and then by Freud. Finally, I propose a fourfold set of hypotheses as an alternative to Freud’s diagnosis of hysteria
How to Be a God
When it comes to questions concerning the nature of Reality, Philosophers and Theologians have the answers.
Philosophers have the answers that can’t be proven right. Theologians have the answers that can’t be proven wrong.
Today’s designers of Massively-Multiplayer Online Role-Playing Games create realities for a living. They can’t spend centuries mulling over the issues: they have to face them head-on. Their practical experiences can indicate which theoretical proposals actually work in practice.
That’s today’s designers. Tomorrow’s will have a whole new set of questions to answer.
The designers of virtual worlds are the literal gods of those realities. Suppose Artificial Intelligence comes through and allows us to create non-player characters as smart as us. What are our responsibilities as gods? How should we, as gods, conduct ourselves?
How should we be gods
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Reliable Decision-Making with Imprecise Models
The rapid growth in the deployment of autonomous systems across various sectors has generated considerable interest in how these systems can operate reliably in large, stochastic, and unstructured environments. Despite recent advances in artificial intelligence and machine learning, it is challenging to assure that autonomous systems will operate reliably in the open world. One of the causes of unreliable behavior is the impreciseness of the model used for decision-making. Due to the practical challenges in data collection and precise model specification, autonomous systems often operate based on models that do not represent all the details in the environment. Even if the system has access to a comprehensive decision-making model that accounts for all the details in the environment and all possible scenarios the agent may encounter, it may be intractable to solve this complex model optimally. Consequently, this complex, high fidelity model may be simplified to accelerate planning, introducing imprecision. Reasoning with such imprecise models affects the reliability of autonomous systems. A system\u27s actions may sometimes produce unexpected, undesirable consequences, which are often identified after deployment. How can we design autonomous systems that can operate reliably in the presence of uncertainty and model imprecision?
This dissertation presents solutions to address three classes of model imprecision in a Markov decision process, along with an analysis of the conditions under which bounded-performance can be guaranteed. First, an adaptive outcome selection approach is introduced to devise risk-aware reduced models of the environment that efficiently balance the trade-off between model simplicity and fidelity, to accelerate planning in resource-constrained settings. Second, a framework that extends stochastic shortest path framework to problems with imperfect information about the goal state during planning is introduced, along with two solution approaches to solve this problem. Finally, two complementary solution approaches are presented to minimize the negative side effects of agent actions. The techniques presented in this dissertation enable an autonomous system to detect and mitigate undesirable behavior, without redesigning the model entirely
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Evaluation of a Remote Implementation of the Well-Being Promotion Program with Middle School Students during COVID-19
The COVID-19 pandemic and pivot to emergency remote teaching changed the way in which many students access school-based mental health interventions. Furthermore, the effects of the pandemic heightened distress and decreased life satisfaction amongst many youth, increasing the need for schools to provide targeted mental health supports (Lazarus et al, 2021; Magson et al., 2021). Empirically supported Tier 2 mental health interventions exist (i.e., the Well-Being Promotion Program; Suldo, 2016), but little is known about how these interventions can be adapted and feasibly implemented in remote school contexts. This retrospective case study evaluated the implementation of a remote version of the Well-Being Promotion Program, a targeted positive psychology intervention, with eighth grade students during the COVID-19 pandemic. The study aimed to (1) to describe the co-design process through which a research-practice partnership modified the WBPP for remote delivery and (2) to explore the implementation strategies that influenced the feasibility of implementing the resulting digital version of the WBPP. The study used qualitative data (e.g., meeting notes, interviews and written feedback from providers, students, and caregivers) and quantitative data (e.g., pre-/post-measures, intervention integrity, attendance) to evaluate the co-design process and the feasibility of the adapted WBPP. Through co-design, the intervention was modified to be facilitated via videoconference, to use digital versions of WBPP materials, to use email to share with caregivers the handouts and a recorded version of the information session, to add additional sessions for data collection, and to adapt language to align with school vernacular. Using reflexive thematic analysis (Braun & Clarke, 2006; Braun et al., 2019), themes were constructed from the data to provide insight into the implementation strategies used by the research-practice partnership to influence feasibility. Findings suggest that (a) maintaining the structure of the WBPP, (b) using technology for remote implementation, (c) collaborating through the research-practice partnership, and (d) recognizing the effectiveness of intervention efforts influenced the feasibility of the remote implementation. Lessons learned from this case study suggest that research-practice partnerships can be critical for influencing the feasibility of intervention implementation in local school contexts, especially during novel situations such as the COVID-19 pandemic
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