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This research considers how gender and power are implicated in the making of prostitution policy. Prostitution in England and Wales is patterned by gender: sex buyers are overwhelmingly men, and most of those who sell sex are women. Yet asking how and why this patterning prevails rarely provides the starting point for the development of prostitution policy. In addition, while there is an established literature on feminist or gender analysis of public policy, it is less often considered whether and how gender and power operate within the policy-making process itself. Using the proposal to criminalise the purchase of sex in England and Wales as a case study, and Clause 13/14 of the Policing and Crime Bill 2008-2009 in particular, I analyse almost 60 UK Parliament documents to explore how gender and power are implicated in who speaks on prostitution policy; in what they say; and in how prostitution policy is translated from its initial proposal to its enactment in law. This documentary analysis draws on Mazur (2002) in exploring the relationship between gender representation in Parliament and the gendered content of policy; on Connell's work (1987, 2002) on 'gender regimes' and 'hegemonic masculinity'; and on Freeman's proposal for 'policy translation' (2009). This work offers careful and comprehensive evidence that the making of English prostitution policy is consistent with hegemonic masculinity. This is demonstrated in particular in how criminalisation is discursively contested by policy makers and in how its potential application is narrowed significantly during its translation through the policy process. The analysis also highlights some of the methodological and conceptual difficulties in identifying - and therefore challenging - gender and power in action.

Alcohol is an important economic and cultural commodity. It also represents a significant public health problem. Alcohol is the third greatest risk factor for the global disease burden even though half of the global population abstain. Currently alcohol control strategies are inadequate and unable to combat the health, social and economic problems caused by a legal drug that has become more widely available, more affordable and promoted aggressively. This thesis considers how alcohol control policy is governed, developed and implemented at global, European, UK and Scottish policy levels with specific focus on the role of the alcohol industry in this area. Contemporary modes of governance are increasingly characterised by a multi-agency partnership approach where unelected stakeholders, including corporate partners, contribute to the development and implementation of policy and of action out with policy. The research investigates the role of the alcohol industry within discourses and action in efforts to reduce alcohol related harm. It aims to identify alcohol industry action at global, European, UK and Scottish levels of authority in order to offer an overview of the extent of action and in turn its influence on policy discourses. The research provides an analysis of the alcohol industry as a political operator. The alcohol industry engages with, and in some respects is, a stakeholder active within public health policy circles in relation to alcohol control. This engagement spans science, research, corporate social responsibility, philanthropy, lobbying and direct engagement within official policy circles. The thesis uses the alcohol industry as a case study that highlights a need for research on how influence is wielded by corporate interests within policy circles. There is acknowledgement in various theoretical accounts on governance that changing modes of governance have resulted in the creation of a space for non-state actors within policy circles. However, thereafter, the role of corporate actors is habitually underestimated and even overlooked all together. The argument presented here is that the role of powerful economic interests is rapidly gaining significance as a factor in policy making. This must be explored further in order to ascertain the extent of the influence and the ways in which economic actors exert influence. Methodologically the research examines policy documents, and industry communications as well as adopting an investigative approach to the strategies and agendas of a variety of policy stakeholders. The outcome is a narrative derived from a synthesis of existing sources that explores the area of alcohol control policy which focuses on the involvement of corporate stakeholders with a clear conflict of interest within the process of developing health policy in relation to alcohol. The results indicate that the influence of corporate actors represents a significant and growing threat to the development and implementation of effective evidence based alcohol control policy. Overall the research is intended to make a contribution to academic and public debates on governance and to support public health efforts to reduce alcohol related harm. It attempts to explore the accumulation of corporate action over multiple levels of authority and to describe and evaluate the effects of this accumulative action on public health policy in relation to alcohol.

This study is aimed at exploring how female partners experience their male partners’ use of pornography. It is reported that therapists are increasingly being called upon to support female partners presenting with difficulties relating to their male partners’ porn use (Hall, 2015), but that clinicians feel under-prepared to work effectively with these clients due to a lack of training and the limited availability of empirically based literature (Ayres & Haddock, 2009). Consequently, there appears to be a growing need for research in this area that can provide insight and guidance for clinicians. The phenomenological epistemology and relativist ontology that underpin this study place an emphasis on understanding the subjective lived experiences of the participants; a focus which seems congruent with the philosophical underpinnings of counselling psychology. Using a qualitative approach, semi-structured interviews were conducted with six female participants. The interviews were transcribed and analyzed using Interpretative Phenomenological Analysis through which four master themes were identified: ‘Pushing her limits of acceptance: The ongoing discoveries’; ‘The female partner’s meaning-making’; ‘A lonely experience’; and ‘The layers of loss’. New insights regarding the interplay between the female partners’ meaning-making and their responses highlight the multi-layered and complex experiences of these participants. A number of implications for practice are discussed including the importance of clinicians moving away from a model of pathology to one of promoting well-being and validating female partners’ emotions and experiences regardless of whether a diagnosis (of porn or sexual addiction, for example) is present. The findings may serve to inform individual and group work with both female partners and male users, as well as couple work. Finally, it is hoped that providing insight into the lived experiences of female partners may encourage a more empathetic and understanding response from male porn users and society when female partners seek their support. The limitations of the study are discussed as well as further areas for research.

This thesis is the end product of an action research project, which has consisted in fighting for sex workers' control and ownership of their own industry. The starting point of the research was rather different from that of most recent work on this topic. In fact, the impetus to embark in this project stemmed from the intellectual environment I experienced as an undergraduate Anthropology student at the University of East London, and in particular from Chris Knight's and Camilla Power's theories of the origins of culture and art. Their model argues that around 100 000 years ago, in order to guarantee cooperation by males, females found a way to prevent them from identifying and targeting menstruating females, that is, those who were approaching the peak of fertility (Knight 1991). Menstruation is a woman's best advertisement of fertility and a big attraction for males. If males were able to identify and target those most fertile (sexier) females, others would indeed have a problem, as they would not receive much needed help to meet the costs of reproduction. Thus, according to this theory, women synchronised their reproductive cycles and formed coalitions at the time of menstruation to force men to hunt and bring meat (Power 1999) - Knight (1991) sees this initiative as a "sex strike".

Gambling is a complex social behaviour. How behaviour is shaped can vary within different historical and cultural contexts: to date, it is rare for the impact of these different contexts to be examined. The study of gambling has been (largely) entrenched within a bio-medical paradigm, where problematic gambling is viewed as an innate characteristic of the individual. This focus limits understanding about the ways in which gambling behaviour is shaped and also limits the range of policy responses to intervention with ‘problematic’ individuals. Specific examination of the way different contexts and mechanisms, both proximate and distal, shape behaviour has not been undertaken. The term ‘prisoners of the proximate’ (Hanlon et al, 2012) is an apt description of much contemporary gambling research. This thesis seeks to explore alternative ways to frame the study of gambling behaviour and argues that a focus on contexts and how behaviour varies for whom and under what circumstances is appropriate. This builds on Pawson and Tilley’s (1997) principles of realist evaluation and Pawson’s (2006) work on realist review to consider what realist description might look like as a form of empirical investigation. This includes recognition of the inherent subjectivity of all research and advocates an expansive analytical approach whereby many different types of evidence are brought together to examine a particular issue. To do this, this thesis draws on secondary analysis of existing data, historical evidence and theoretical review. This approach is applied to the study of female gambling behaviour. By drawing together data generated from the 1940s to the present day, it demonstrates how patterns of gambling behaviour are gendered and how gambling preferences vary based on prevailing social and political norms and legislation. This thesis argues that a process of ‘re-”feminisation”’ of gambling is evident in Britain today. In addition, the diversity of female gambling behaviour among different groups of women is explored, as is variation based on individual, social and spatial characteristics. This is achieved by using many different sources of data (mainly large-scale government surveys such as the Health Survey for England, the British Gambling Prevalence Survey series, the Taking Part survey) but also by supplementing these datasets with administrative information about the spatial patterning of gambling venues to broaden the scope of investigation. A number of different analytic techniques are used (factor analysis, latent class analysis, survival analysis and more standard descriptive methods) to explore how behaviour varies for different women in different circumstances. Using an expansive approach to secondary data analysis, whereby information from different studies is used to explore female patterns of behaviour from different viewpoints, creates a more nuanced understanding of female gambling behaviour. This is the purpose of realist description. It is an approach which recognises that not everything is the same for all people in all circumstances. Recognising this diversity at the outset of investigation provides a platform to explore this in depth. This thesis argues that this recognition should underpin the design and analysis of primary survey research to provide a more solid basis upon which to consider why behaviour varies. Doing so creates a solid foundation for a more considered examination of what type of policy interventions are most appropriate, for whom, and under what circumstances.

This thesis comprises 12 publications from two decades of research into sex work and health. The papers report on the risks and determinants of HIV and other sexually transmitted infections (STI) in women selling sex in London. The research combined clinical, epidemiological and anthropological methods in a programme that aimed to inform policies and interventions to reduce STI and HIV risks and improve the health and well-being of sex workers. In the accompanying commentary, chapter 1 places the papers in a broad narrative by describing the context of the work which began with the early days of the AIDS epidemic and continued through new challenges including the impact of globalisation and migration. Chapter 2 is a critical review of the major findings in relation to HIV and STI risk, and includes new tables summarising estimates of effect sizes from across the studies. I then discuss major risk factors, placing the findings in the context of the wider literature, and suggest a conceptual framework linking the determinants. Chapter 3 provides a more detailed description of the ways that different research methods were used to test specific hypotheses. In particular, I show how qualitative work uncovers the importance of structural factors, such as the organisation of flats and the distribution and consumption of drugs, in determining individual and group level behaviours and risks. I provide a brief critique of the use of mixed methods in biomedical research, and stress the importance of grounding both qualitative and quantitative work in appropriate theoretical frameworks. Chapter 4 summarises the thesis and re-asserts the need for a model of causation that incorporates social, economic, behavioural and structural factors. The development of interventions requires a synthesis of evidence from many disciplines, together with the perspective of participants whose agency will be the key to successful implementation.

Catastrophic disaster represents a vital issue in emergency management for many countries in the European Union (EU) and around the world. Given the damage to human lives that different hazards represent, evacuation operations can be the only option available to emergency managers to mitigate the loss of life from catastrophic disaster. However, due to the amount of time needed to effectively evacuate a large area, the decision to evacuate must occur when there is a relatively low probability of the event. An explicit understanding of the evacuation decision can lead to better organisational preparedness in advance of catastrophic disaster events. This research represents work performed with 159 emergency experts and professionals across ten countries. The goal of this research was to create decision-making aids for evacuations in advance of a variety of catastrophic disaster scenarios. Traditional Decision Theory (DT) provides a rational approach to decision-making that emphasizes the optimization of subjective preferences combined with uncertainty. Within evacuation decision-making, DT and its respective outputs are appealing; however the analytical process can be difficult due to the lack of observed data to support quantitative assessments from catastrophic events and relative infrequency of evacuation operations. This research explored the traditional use of DT applied to catastrophic evacuation scenarios. Theoretical contributions to DT and emergency management include: 1) identification of evacuation decision criteria, 2) inter-model analysis between decision structures called Influence Diagrams (IDs), 3) complete application of quantitative decision analysis to support evacuation decision-making and 4) multi-criteria analysis for evacuation vulnerability using spatial data. Important contributions from this work include:1) An analysis of evacuation criteria for a variety of catastrophic disaster scenarios2) Inter-model analysis of evacuation scenarios (flooding, nuclear dispersion and terrorist attack) to identify common probabilistic structures to support multi-hazard strategy planning3) Quantitative decision models to support evacuation strategies, identify key uncertainties and policy analysis 4) Process to use spatial data to support multi-criteria evacuation vulnerability analysis 5) Organisational self-assessment for evacuation decision-making and spatial data use based on findings across all participating countries.

This thesis mainly consists of three empirical chapters related to understanding the characteristics, economic impact and the demand for gambling in Thailand. Beginning with a review of the theoretical and empirical literature, this confirms that socio-economic and demographic data are important determinants of the level of gambling participation and gambling expenditure. A Logit model is then used to estimate the participation of gambling. The results suggest that the number games, such as the government lottery, the underground lottery, are popular among old gamblers whereas football betting is popular for adolescents. In the past, most casino customers were old gamblers, but at present the number of young gamblers who participate in casino has considerably increased. A Tobit model is employed to estimate the level of gambling frequency and gambling expenditure. The estimations reveal that there is a “supplementation effect” of casino on other gambling types and the effect also appears among the number games. The gambling expenditures on the number games are high in the group of gamblers who have undergraduate degree or lower while the expenditures on casino and football betting are high in the group of gamblers who have undergraduate degree. However, a higher education level leads to a lower level of gambling expenditures. The focus is then centred on the 2-3 digit lottery. The rational addiction model is tested for the case of the 2-3 digit lottery. In the addiction framework, the 2-3 digit lottery is found to be an addictive goods and the addiction is “myopic addiction”. This finding is confirmed by Instrumental Variable estimation.

The association of violence with sex work has been widely documented within research and policy. This thesis provides a critique and development of such perspectives. Framed from a qualitative approach, it extends current research which has offered limited insight into the realities of how violence is experienced and responded to by sex workers and agencies involved in the provision of support to sex workers. In this way, the research develops beyond a presumption and narrow understanding of violence/harm in sex work to consider how sex workers and service providers experience, define, and thus construct their responses to harm. Findings from the data indicate variation amongst participants in their responses to harm associated with sex work, with experiences of violence or supporting violence and relationships and interactions between sex workers and service providers being important factors in how these responses are constructed. Both sex workers and service providers, however, recognised and understood associations of sex work with violence and victimisation, and related attempts to encourage individuals to cease or limit involvement in sex work, although this may not apply or be appropriate to all experiences of sex work and sex workers. The thesis contends that in order to gain an informed understanding of, and develop responses to, harm associated with sex work, it is important to consider the diversity of existing experiences of sex work. This should include alternative understandings and experiences of harm that are not limited to, or focused on, violence within sex work, as informed by the experiences of different sex workers. In doing so, there is the potential to better understand and accommodate a range of sex workers’ experiences, needs and interests in ways that do not impact on sex workers’ safety, or contribute to continued stigmatisation or exclusion, where some sex workers do not identify with a view of their work as harmful, or wish to exit sex work. Consequently this could aid the provision and development of services that respect and offer support where required, for different experiences of sex work amongst sex workers.