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Background: Rates of psychological distress are rising, pressure on mental health services is increasing and currently there is a section of the population who experience psychological distress but are not accessing traditional mental health services. It has been proposed that nature-based interventions can play a role in mental health care. Aims: This thesis firstly aimed to conduct a systematic review to identify, and review randomised controlled trials that measured the effect of a virtual nature intervention on attention and distress. The second part of the thesis consisted of an empirical study that investigated the association between watching a virtual nature video and changes in positive and negative affect, anxiety, and mindfulness in older adults. The study aimed to see if this association could be further enhanced with mindfulness instruction. A correlational relationship between improvements in positive and negative affect, anxiety and nature connectedness aimed to be investigated, as was state mindfulness as a potential mediator in the relationship between contact with virtual nature and improvements in affect and anxiety. METHOD: The systematic review searched four databases using relevant key words for research papers and judged these against inclusion and exclusion criteria. The quality of the final papers was assessed. A three-arm randomised empirical study was conducted recruiting older adults from the general population. Results: The systematic review revealed twenty papers relevant to the research question. A narrative synthesis found evidence for associations between virtual nature contact and improvements in attention and psychological distress. The evidence for attention appeared to be stronger for certain measures. The quality of papers was good however limited by unclear reporting. Findings from the empirical study found support for an association between negative affect and watching a nature video, with no association with any other variables. Mindfulness instruction did not enhance any changes, neither was nature connectedness correlated with benefits. No mediation analysis was conducted as the data did not meet the assumptions of a mediation. Conclusions: The systematic review suggests that virtual nature is associated with improvements in psychological distress and attention in the general population. When it comes to attention this association seems to vary depending on the measurement used. This association of improvements in psychological distress was not replicated in the empirical project which used an older adult sample. Previous established associations seen in the general population using real nature did not extend to this older adult population and virtual nature, suggesting that virtual nature may not hold the same benefits as real nature.

Families, broadly conceived, are multiply determined and determining systems whose functioning and well-being are sensitive to a range of contexts, including the dynamic policy context across the full range of policy domains. Particular political attention with strong normative overtones is often given to families with particular characteristics experiencing social exclusion in particular ways and associated with particular (undesirable) policy outcomes. Debatably, one important role of the 'public' academic is to contribute to the policy process by providing expert commentary on the assumptions and evidence-base on which policy is founded, and on the evaluation of its tangible products. This thesis reflects on the candidate's experience of over a decade's worth of engagement with policy and evidence that either relates, or is argued should better relate, to the functioning of families in contexts of extreme social exclusion and experiencing significant family stress. Prima facie, the three substantive areas cover by the selected papers: early years support, youth gang policy, and bereaved family activism, might seem unconnected, however, they represent a strongly linked narrative arc of research and writing that offer common themes and intellectual progression. At the heart of both early years and youth gang work are questions of how best to frame and configure interventionist policy aimed at preventing negative outcomes (health, behaviour, life-chances) for socially-excluded children and adolescents while, at the same time, avoiding policy misdirection, stigmatisation and coercion. In a late modern, austere Britain, how can the State credibly claim to reduce harms of these kinds when policy is often a net contributor to/creator of them? At the heart of youth gang and bereaved family papers are questions of how best to support the sometimes-blamed, often-overlooked secondary victims of serious violence. How is (often extreme) stress experienced by affected families, what vulnerabilities does it express and create, and to what extent can it be used as a motivator of defiant action? The thesis concludes with a discussion of the various modes of academic engagement displayed across the work, specifically, the developmental progression of the author from 'professional', to 'policy', to 'critical', to 'public' modes of doing research on family stress. The personal rewards and costs of persistence in the face of limited policy impact are stressed.

Background: Parents of children with epilepsy have been shown to have higher rates of depression, anxiety and stress in comparison to parents of children without epilepsy due to the impact of caring for a child with a chronic condition. A systematic review of existing literature aimed to identify qualitative research that examined parents' experiences of caring for their children with epilepsy. Methods: The systematic review explored the experiences that parents have in caring for their child with epilepsy. A search of electronic databases for qualitative literature was completed. The quality of all eligible articles papers was assessed, and findings from studies were synthesised. Results: Twelve studies met inclusion criteria for the review; findings suggest that parents need time to process their child's diagnosis of epilepsy; they cope with this in differing ways and are motivated to learn how to adapt and cope with parenting their child with epilepsy. Conclusions: Parents of children with epilepsy may experience symptoms of stress, this may motivate them to learn how best to care for their child. Empirical Paper Abstract Background: Parents' experiences of being told about sudden unexpected death in epilepsy (SUDEP) may be particularly challenging to cope with. As little is known about how mothers understand and make sense of SUDEP, a qualitative research project aimed to explore mothers' experiences. It was hoped this would be helpful for clinicians to understand in order to assist them in providing information to parents in a way that minimises distress. Methods: The empirical article explored mother's experiences of being told about SUDEP and the subsequent impact of this for 11 mothers of children with epilepsy. Interpretative Phenomenological Analysis methodology was utilised, with themes derived from interpretation of interview transcripts, in order to describe the experiences of the participants. Results: Within the empirical study, five themes emerged. The way in which mothers found out about SUDEP seemed to have a link to their perception of risk and how they subsequently managed feelings of uncertainty and the psychological impact of knowing about SUDEP. Mothers' recommendations to clinicians included when, how and what to tell other parents, and were based on their own helpful and unhelpful experiences of being informed about SUDEP. Conclusions: In being told about SUDEP, mothers may struggle to make sense of it and this can be associated with an increase in anxiety. However, clinicians can reduce potential distress by carefully timing when and how they tell parents, and by making sure information is clear and relevant for the child in question.

This thesis is comprised of three papers. Paper 1 presents a systematic review on the evidence for the relationship between appraisals of auditory verbal hallucinations and voice-related distress in psychosis. A literature search was conducted using the following electronic databases: Web of Science, PsycINFO, Embase and Pubmed. Twenty-four studies were identified that satisfied inclusion criteria for the review. Several types of appraisals were found to be associated with distress in voice-hearers: malevolence, control, power, origin of voices and benevolence beliefs. Evidence for an association was particularly strong for malevolence and control appraisals, indicating that these may be important to target in interventions. Overall findings generally supported that modification of voice appraisals, particularly malevolence, power and control appraisals, in cognitive therapy is associated with a reduction in voice-related distress. Paper 2 presents an experimental study which explored whether people who are exposed to stressful material are more likely to report hearing voices when they are not present (i.e. false alarms). Factors that may predict or moderate voice-hearing were also explored. A non-clinical sample (N = 130) completed measures of trauma history, hallucination proneness, dissociation, affect and attachment styles, before being allocated to view pictures depicting stressful interpersonal scenarios or pictures with neutral interpersonal scenarios. Participants then completed a voice detection task. False alarms were recorded as a proxy measure of voice-hearing. Participants in the stressful group reported significantly higher levels of stress than in the neutral group. No differences were found in false alarms. Physical abuse history and depersonalisation significantly correlated with false alarms. This study indicates that people with physical abuse history and dissociative tendencies may be more vulnerable to hearing voices; clinically, these factors should therefore be assessed. However, findings of this study should be interpreted tentatively due to lack of diversity within the sample. Paper 3 is a critical reflection of the systematic review, the empirical paper and the research process as a whole. Strengths and limitations of the presented research are discussed as well as directions for future research.

Literature review: Doctoral and Doctor of Philosophy (PhD) students experience various challenges. This literature review explored stressors and coping in doctoral students. Four databases were searched, nine papers met the inclusion criteria and were included in the review. The review included qualitative studies and thematic synthesis was conducted to analyse findings. Four themes were identified under stressors: 1) Social disconnect 2) Institutional support and Academic Factors, 3) Individual factors and View of Self, and 4) Challenges and Uncertainty. Themes identified under coping included: 1) Seeking and feeling supported, 2) University resources, 3) Personal strategies, 4) Organisational factors. Findings suggest the importance of social support for doctoral/PhD students and opportunities for this whilst studying, as well as support in developing organisational and practical skills. Empirical study: This study aimed to explore the wellbeing, symptoms of depression, anxiety and stress including COVID-related stress in a sample of postgraduate students (n=290), to explore possible relationships of these variables with demographic factors and assess any differences in scores between home-based and international students, and between those who had and had not accessed services. A cross-sectional survey was used. Home students scored significantly higher stress and covid-related stress levels than international students with small effect sizes, so may not be of great clinical relevance. Those who reported accessing services scored significantly higher in depression, anxiety and stress scores and lower wellbeing when compared to those who reported they did not access services ,with medium to large effect sizes. Older age and being a Master's student were associated with higher wellbeing, lower stress and COVID-19 related stress. Conclusions should be interpreted cautiously due to limitations. Clinical implications include the possible need for support for both home and international students. Further research is required on understanding reasons for not accessing support.

Reduced water availability and salinity are two major environmental factors influencing crop establishment in semi-arid environments. Therefore the effect of reduced water availability using polyethylene glycol (PEG) 4000 solutions and of salinity (NaCl) on the germination of six soybean cultivars was examined. Cultivars differed in their response to reduced water availability and salinity and in their ability to recover from the stresses. A large increase in germination during a recovery period at 0 MPa following water stress suggested that PEG was not toxic whilst the failure of seeds to recover from high salinity revealed the toxic effects of NaCl. At the same water potential, germination in saline conditions was higher than that in PEG and the rate of water uptake by individual seeds was more rapid in NaCl solutions than in PEG. The most plausible explanation for the greater water uptake and germination in NaCl is that seeds accumulated salts which lowered their osmotic potential. The effects of NaCl on seedling growth were much greater when experiments were conducted in a hydroponic system compared with a paper towel method. However, analysis of the solutions soaking the paper towels revealed that 4.25 mMolal Ca2+ was available to the seeds in this system in saline conditions. This may have reduced Na+ uptake or provided a protective effect against Na+ toxicity. Germination (40%) was possible at a tissue Na+ concentration in the embryonic axis of 9.3mg g-1 FW whilst seedling growth was completely inhibited at a tissue Na+ concentration of 6.1 mg g-1 FW. Germination at higher tissue Na+ concentrations was associated with higher K++Ca2+ concentrations, suggesting that these ions may protect the seeds in the pregermination phase against salinity. A reduction in seed vigour due to ageing resulted in reduced germination under saline conditions compared to the germination of unaged seeds, but there was no significant interaction between salinity and seed ageing. However, unaged seeds showed a greater increase in germination after transfer to 0 MPa than did the aged seeds. Since both the site of ageing and the toxic effect of NaCl is the cell membrane, there may be additive effects of NaCl toxicity on cell membrane in aged seeds.

This thesis empirically assesses the associations between socioeconomic status, acute and chronic stressors and stress related biomarkers during the working life-course for men and women living in England aged over 50 years. Specifically, this thesis seeks to understand the extent to which, acute and chronic stressors over the working life-course, help to explain socioeconomic differences in stress related biomarkers among older adults. To rigorously undertake this research, the basis of the thesis is comprised by three empirical papers: 1. Socioeconomic status and Perceived stress differences in diurnal cortisol: Longitudinal evidence from the Whitehall II Study. 2. Are socioeconomic differences in diurnal cortisol profiles underestimated by missing values? Compensating for Missing Data in the Whitehall II Study. 3. Allostatic Load and Effort-Reward Imbalance: Associations over the Working-Career. The contribution of this thesis to the research literature is unique in its treatment and modelling of the determinants of stress related biomarkers. Firstly, I explored the role that acute stress (perceived stress) and chronic stress (socioeconomic status) have in explaining the levels of stress (cortisol) throughout the day. I found that there were socioeconomic differences in diurnal cortisol profiles, which persisted even after controlling for perceived stress. However, perceived stress did not help to explain why the poorest civil servants had flatter diurnal cortisol slopes. Secondly, due to the amount of missing data, I analysed if missing data could lead to an underestimation of the socioeconomic differences in the diurnal cortisol slope. Using multiple imputation, and I found that imputed estimates of cortisol tended to be a bit higher at awakening for the middle and high socioeconomic groups, while the estimates for the low-grade jobs group diverged at bedtime, showing a flatter diurnal slope for the multiple imputation estimates. This suggests that the presence of missing data could lead to an underestimation in socioeconomic differences in biomarker of the stress response. Thirdly, using allostatic load, I explored if work stress (measured by effort-reward imbalance) over the working career predicts higher levels of allostatic load. Repeated exposure to effort-reward imbalance towards the end of the working career predicted higher levels of allostatic load, with employees working in semi-routine and routine jobs reporting more accumulated effort-reward imbalance. We now have a better understanding of the association between socioeconomic status and biomarker of the stress response. Through the analysis of acute (perceived stress) and chronic stressors, the former may not be as important in understanding socioeconomic differences in stress compared to chronic stressors like work related stressors over the working life-course.

Psychological distress is common during pregnancy. The objective of this thesis was to evaluate the effectiveness of antenatal cognitive behavioural based treatments in reducing psychological distress in pregnant women. A systematic review was undertaken of randomised controlled studies utilizing antenatal cognitive behavioural based treatment in reducing anxiety and stress compared to treatment as usual. Eleven papers were identified through a systematic search of databases using predefined criteria comparing intervention groups to treatment as usual in pregnant women with anxiety or stress. The systematic review revealed preliminary evidence for the effectiveness of cognitive behavioural based treatment with several studies noting changes over time in anxiety and stress; however, only a few studies reported intervention effects when compared to control. While the systematic review results suggest that a small number of cognitive behavioural based interventions may be effective in reducing anxiety and stress during pregnancy compared to treatment as usual, confidence in these findings is limited due to methodological limitations such as lack of follow-up, high attrition rates and difficulties with generalisability. The evidence base is currently insufficient and further research which utilises a robust methodology is needed before any reliable conclusions can be drawn. An empirical study was conducted to examine the effectiveness of a brief, single-session stress reduction programme introducing cognitive behavioural techniques aimed at reducing general anxiety, other pregnancy related distress and improving general well-being and pregnancy outcomes. Twenty-nine participants with clinically significant levels of anxiety were recruited to the empirical study from the local maternity hospital. Participants completed measures of general anxiety, pregnancy related anxiety, general well-being and childbirth experience. The control was derived from a historical dataset where 37 participants were matched for baseline anxiety levels. The empirical study demonstrated significant reductions in general anxiety; however, similar findings were also observed in the control group. Significant reductions were observed with pregnancy related anxiety and women also reported their childbirth experience similarly regardless of delivery type. Although our findings were not significant when compared to control, our recruitment design resulted in good return rates following birth. Further studies using sophisticated study design with use of robust control group are required.

Aims: Parents of children with intellectual and developmental disabilities tend to illustrate and report higher levels of stress and lower wellbeing than parents of typically developing children. This thesis aimed to explore the aspects of this relationship between parental wellbeing and raising a child with heterogeneous intellectual and developmental disability. Firstly, the thesis aimed to review the current literature and evidence base for mindfulness-based group and individual interventions and their effect on psychological outcomes for parents of children with intellectual and developmental disabilities. Secondly, a research study aimed to explore the role of overall parental locus of control and particular sub-domains of locus of control on parent reported wellbeing. Furthermore, the role of child compliant and social behaviour, child problem behaviour, diagnostic groups, level of functioning, and demographic variables were explored. Method: A systematic review of the literature was conducted to address the first aim of this thesis. Within the research study, a single sample of parents and family carers (n = 114) completed an online anonymous survey consisting of demographic information and three self-report measures; a modified version of the Parental Locus of Control Scale, the Warwick-Edinburgh Mental Wellbeing Scale, and the Nisonger Child Behaviour Rating Form. Results: The systematic review illustrated that mindfulness-based interventions appear to have a significant effect on a number of parent psychological outcomes; such as wellbeing, stress, mental health, compassion, and mindfulness. A further four papers indicated a significant impact on child behavioural outcomes from parental mindfulness interventions. The research study indicated parental locus of control, in particular the two sub-domains of child control, and parent efficacy significantly mediated the relationship between child problem behaviour and parental wellbeing. Conclusions: There is a need to further explore the effectiveness of mindfulness interventions on parental distress and child behaviour, in particular in comparison to well-established interventions and groups. The research study results highlight the importance of parental attributions in influencing the wellbeing of parents of children with intellectual and developmental disabilities. However, it is clear from these findings that there is a complex relationship between parent cognitive attributions and broader social and societal factors. These findings may inform future practice with these families, although further research to explore these complex relationships is required.

The present work has been produced as part of an on-going collaboration between the University of Manchester and Amec, with the primary aim of furthering mechanistic understanding of corrosion processes in zirconium alloys out-of-reactor. Zirconium alloys are used as cladding material for nuclear fuel pellets, and correct understanding of the corrosion process in autoclave is essential to predicting material behaviour in-reactor. This EngD thesis is composed of five proposed papers that investigate observations and hypotheses under the theme of mechanical degradation in oxides formed on zirconium alloys in autoclave. First investigations concern observed stress relaxation in zirconium oxide. Finite element analysis is used to capture mechanical aspects of the corrosion process and apply this to stress behaviour determined previously using synchrotron x-ray diffraction. The results indicate that a mechanism other than creep or hydrogen induced lattice strain must be present to account for the observed stress relaxation. One such potential mechanism is crack formation; statistical analysis of scanning electron microscopy images has been used to identify a link between the development of roughness at the metal-oxide interface, crack formation in the oxide and transition points or acceleration in the corrosion kinetics. Parameters such as the median radius of curvature and profile slope (Rdq) have been applied, as these parameters do not require the definition of a periodic wavelength or amplitude. These and other parameters are related to information in literature to indicate that for samples of Zircaloy-4 and ZIRLOTM, which go through transition, the interface roughness changes in a way that would increase localised stress concentrations. The third material is an experimental low tin alloy, which under the same oxidation conditions, and during the same time period, does not appear to go through transition and does not develop an interface roughness in the same way. A critical assessment of finite element analysis applied to oxidising non-planar interfaces shows the significant limitations in the existing mechanism for representing oxidation expansion and stress formation. Autoclave oxidation experiments of artificially roughened samples of Zircaloy-4 were carried out to further understand the impact of out-of-plane stress generation. The results indicate a divergence based on surface roughness after ~86 days oxidation. SEM examination of images in cross section highlighted accelerated oxidation above surface roughness peaks, and an increased crack area in rougher samples. Finally, finite element analysis of the tetragonal to monoclinic phase transformation showed that biaxial compressive stress relaxation, or the tri-axial tensile stress associated with an advancing crack tip, could reduce the transformation strain energy and destabilise the tetragonal phase. The volumetric expansion and shear strain associated with the phase transformation produces stress in the surrounding oxide sufficient to generate nano-scale cracks perpendicular to the metal-oxide interface. This would allow fast ingress routes for oxygen containing species, and therefore acceleration in the corrosion kinetics.