Although it seems clear that coaches become effective practitioners through idiosyncratic combinations of learning experiences (Werthner & Trudel, 2009), little is known about how and why this occurs and impacts on coaching knowledge and practice (Cushion et al., 2010). This research sought to understand the processes and impact of coaches learning in the context of UK youth football coaching, specifically centring on a formal education course. The research process utilised a pragmatic and integrated perspective, influenced by impact evaluation frameworks (e.g. Coldwell & Simkins, 2011). A group of 25 coaches were investigated at different points over a period of a year and a half, using a mixture of semi-structured interviews, systematic observations, video-based stimulated recall interviews and course observations, to build up increasingly in-depth levels of data. Using the principles of grounded theory methodology (Strauss & Corbin, 1998) as well as mixed analyses of variance (ANOVA), changes in the knowledge use and practice behaviours of course candidates, and equivalent coaches not undertaking formal education, were compared. The course had subtle impacts on coaches knowledge conceptions in interaction with wider knowledge sources, yet impact on practice was generally demonstrated only in the areas of questioning content and individually directed coaching interventions. Mismatches between the espoused theory of the course and what the candidates actually perceived, as well as a lack of individualised support to overcome disjuncture (Jarvis, 2006) created barriers to learning, preventing integration of theoretical conceptions into altered coaching practice. A substantive grounded theory was generated to explain the underpinning double-loop cognitive filter and reflective feedback processes involved in coaches learning. The model demonstrated that practitioners learning, guided by existing biography and driven by a practical focus on what works , was heavily influenced by context. Meaningful learning connected knowledge with implementation in practice through reflection. These processes help explain uneven learning across individuals; addressing for the first time questions of what works , how , 'why', and for whom in coach learning (McCullick et al., 2009). Thus the results generate an understanding of coaches learning which can be practically relevant in fostering better opportunities to enhance the development of capable and creative coaches.

Decentralization is a key governance reform which many developing countries have embarked on. Local governments are expected to use their informational advantage to improve the delivery of public goods. This result implied by Tiebout’s (1956) model requires fully informed citizens who “vote with their feet.” The model’s application to developing countries has been limited, since local decisions may not be responsive to local demands. Practitioners are shifting to innovations that minimize institutional constraints so that decentralized programs can lead to improved outcomes. Examples of such innovative ways include decentralized agricultural extension programs, which embrace farmers’ empowerment, local government, and private sector participation. Few impact evaluation studies on agricultural extension have combined qualitative and quantitative methods. This dissertation contributes to the literature by applying these methods and survey data to study the impact of a decentralized extension program in Uganda, known as the National Agricultural Advisory Services (NAADS) on the value of farm production per acre. The program is non-randomly assigned to local governments and farmers self-select in or out within participating sub-counties. Using a sample of 305 participating and non-participating farmers and local government assessment indicators as instruments, we cannot reject the null that the NAADS program has had an impact. The 2SLS results show no program impact; however, the OLS results show that the program had a positive impact on the value of farm production per acre of about 20 percent. Qualitative results show that NAADS farmers: participate in local decision making processes through farmers’ institutions; have increased knowledge on farming; and practice enterprise diversification. The quantitative finding must be treated with caution; for example, the study did not account for spillover effects. The NAADS program faces challenges inherent in Uganda’s decentralized structure; particularly the low financial and human capacity, and the weak monitoring at the local level. The policy implications include: the need to strengthen farmers’ institutions; development of a marketing strategy; clear policy guidelines for local government support to NAADS; improved coordination of NAADS activities among line ministries; need for additional resources for NAADS activities; and improved capacity of service providers.

Aim of the study: The aim of this study was to measure the effects of a specific technique used when assisting vaginal delivery and intended to decrease anal sphincter ruptures. After measuring the effects, the direct costs of a rupture were calculated and finally the cost impact of the intervention was evaluated. Data and model: Data from deliveries before the intervention, from 2004, and after the intervention, from 2008, were used and a pre-test – post-test evaluation design was applied. The dependent variable was the presence or absence of a rupture and because the variable is binary a logit model was used. The independent variables consisted of twelve different factors considered to affect the number of ruptures. When only accounting for ruptures alone 123 of 2900 deliveries resulted in a sphincter ruptures which equals 4.24% of the total amount of deliveries. Results: When not controlling for any of the independent variables, the risk of getting a rupture decreased by 3.8 percentage points when using the method while assisting a delivery. On the other hand, when controlling for all of the independent variables and the use of the method, the risk of getting a rupture decreased by 2.5 percentage points, from 4.24% to 1.74%. Two different models were tested, one with the variable weeks and one without the same variable, due to the presence of correlation in the model. The total cost of ruptures for a year was calculated as $84,429,254 without the implementation of the method and $34,647,854 with the implementation. Total cost savings for society with the implementation of the method would then be $49,677,045. Conclusions: Implementation of the method is highly recommendable for both society and the women involved. Not only does the number of ruptures decrease due to the method but also the costs for society decreases dramatically.

Impact evaluation (IE) has become a major focus of Extension program evaluation during the past three decades, yet Extension professionals continue to struggle to produce well-documented evidence of program impacts (Lamm, 2011; Workman, 2010). This research was primarily a quantitative, non-experimental correlational study of factors associated with Extension educators’ IE behaviors and practices in the North Central Region of the Cooperative Extension service. The study employed a comprehensive, systems approach to explore interrelated individual and organizational factors that affect IE in Extension. A major feature of this research design was the use Structural Equation Modeling (SEM) statistical analysis methodology. The use of SEM to organize and implement this study facilitated simultaneous exploration of many constructs theorized to be involved in IE behaviors in the context of Extension educational program evaluation. Specification of a theoretical, conceptual model to be used to frame the potential relationships among the many constructs and factors was necessary prior to data collection in order to be able to use SEM for data analysis. Data were analyzed using SEM path analysis to determine relationships among the factors. Significant findings included the identification of the most influential factors on the dependent variable of actual IE behaviors. These were: competency by perceived skill level, behavioral intention, number of roles in IE, education level, and attitude. Factors exhibiting noteworthy influence on factors other than the dependent variable within the model included training, culture, and proportion of teamwork. Qualitative data themes most frequently mentioned by participants included: the need to know how to measure change; a need for training in general; a need for better planning of programs to achieve impact; conflicting priorities, lack of time and timing/coordination concerns; changing expectations (“moving target”) regarding IE practices and goals; and diverseness in contexts, competencies, and schedules. Study findings identified a number of influential factors not previously cited in literature, including number of roles in IE; proportion of teamwork employed in IE; a lack of understanding of how to measure change; and issues of diverseness regarding competencies, context (including stakeholder expectations), and scheduling within the Extension organization.

Injuries have emerged as one of the biggest public health issues of the 21th century. Yet, the causal effects of injury control strategies are often questioned due to a lack of randomized experiments. In this thesis, a set of quasi-experimental methods are applied and discussed in the light of causal inference theory and the type of data commonly available in injury surveillance systems. I begin by defining the interrupted time series design as a special case of the regression-discontinuity design, and the method is applied to two empirical cases. The first is a ban on the sale and production of non-reduced ignition propensity (RIP) cigarettes, and the second is a tightening of the licensing rules for mopeds. A two-way fixed effects model is then applied to a case with time-varying starting dates, attempting to identify the causal effects of municipality-provided home help services for the elderly. Lastly, the effect of the Swedish bicycle helmet law is evaluated using the comparative interrupted time series and synthetic control methods. The results from the empirical studies suggest that the stricter licensing rules and the bicycle helmet law were effective in reducing injury rates, while the home help services and RIP cigarette interventions have had limited or no impact on safety as measured by fatalities and hospital admissions. I conclude that identification of the impact of injury control interventions is possible using low cost means. However, the ability to infer causality varies greatly by empirical case and method, which highlights the important role of causal inference theory in applied intervention research. While existing methods can be used with data from injury surveillance systems, additional improvements and development of new estimators specifically tailored for injury data will likely further enhance the ability to draw causal conclusions in natural settings. Implications for future research and recommendations for practice are also discussed. / Injuries have emerged as one of the biggest public health issues of the 21th century. Yet, the causal effects of injury control strategies are rarely known due to a lack of randomized experiments. In this thesis, a set of quasi-experimental methods are discussed in the light of causal inference theory and the type of data commonly available in injury surveillance systems. I begin by defining the identifying assumptions of the interrupted time series design as a special case of the regression-discontinuity design, and the method is applied to two empirical cases. The first is a ban on the sale and production of non-fire safe cigarettes and the second is a tightening of the licensing rules for mopeds. A fixed effects panel regression analysis is then applied to a case with time-varying starting dates, attempting to identify the causal effects of municipality-provided home help services for the elderly. Lastly, the causal effect of the Swedish bicycle helmet law is evaluated using a comparative interrupted time series design and a synthetic control design. I conclude that credible identification of the impact of injury control interventions is possible using simple and cost-effective means. Implications for future research and recommendations for practice are discussed.

Rotavirus is the most common cause of severe gastroenteritis among children <5 years of age worldwide and is responsible for 453,000 deaths among children in this age group. More than half of these deaths occur in sub-Saharan Africa. Because of the tremendous global burden of rotavirus, vaccine development and introduction has been a high priority for several international agencies, including the World Health Organization (WHO) and GAVI. Two live, attenuated, orally administered rotavirus vaccines, a pentavalent bovine-human reassortant vaccine (RV5; RotaTeq® (Merck and Co, Inc, Pennsylvania)) and a monovalent vaccine (RV1; Rotarix™ (GSK Biologicals, Rixensart, Belgium)) based on a human rotavirus strain, are licensed and available for use in many countries worldwide. Pre-licensure clinical trials of each of these vaccines in high and middle-income countries demonstrated high efficacy (85-98%) against severe rotavirus disease. Further studies conducted in low-income countries of Asia and Africa found modest efficacy (50%-70%) of these vaccines against severe rotavirus disease. However, the public health impact of vaccination (in terms of burden of severe rotavirus disease prevented by vaccinating a given number of children) is greater in developing countries because of the substantially higher baseline rotavirus disease burden in these settings. In 2009, the World Health Organization recommended the inclusion of rotavirus vaccine in the national immunization programs of all countries globally and particularly in those countries with high child mortality due to diarrhea. Of the 16 countries recently approved by GAVI for rotavirus vaccine introduction, 12 countries are located in Africa. As rotavirus vaccines are introduced into national immunization programs, monitoring their impact is a high priority for several reasons. There is a need to assess the effectiveness of these vaccines in routine use to ensure it parallels that of pre-licensure trials, particularly when used in developing countries. Assessing the impact of vaccination on disease burden in countries such as Rwanda will be vital to understanding the full public health benefit of the vaccine. The primary purpose of this program evaluation is to determine the impact of pentavalent rotavirus vaccine on rotavirus and all-cause diarrhea morbidity following introduction into the national immunization program in Rwanda in May 2012. Additionally, this evaluation will document changes in circulating strains over time pre- and post-vaccine introduction. It will also strengthen support for economic evaluation of treating diarrhea versus introduction of new vaccine in routine immunization. Methodology Various studies have been implemented since 2011 in the health sector in Rwanda to reach the goal of this thesis. First, we analyzed data for all-cause, non-bloody diarrheal disease among children <5 years of age from the routine health management information system (HMIS) in Rwanda from January 2008 through December 2011, The objective of this analysis was to determine whether routinely collected health information on national diarrhea hospitalizations, in-hospital deaths, and outpatient visits can be used to monitor the impact of rotavirus vaccine. We used data from the health management information system (HMIS) in Rwanda to describe trends in all-cause, non-bloody diarrhea hospitalizations and outpatient visits among children <5 years of age from 2008 to 2011 prior to vaccine introduction. Second, we evaluated the economic burden attributable to hospitalization for diarrhea among children aged less than 5 years in Rwanda. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at 3 hospitals were collected to estimate costs. Interviews with the child’s caregivers provided medical costs incurred before and after hospitalization and the household costs. Third, we analyzed and tried to understand the introduction and delivery cost per dose or per child of the three new vaccines in Rwanda including the rotavirus vaccine for domestic and external financial resource mobilization. Fourth, we determined the rotavirus prevalence rates and circulating genotypes directly pre- and post-introduction of the RotaTeq rotavirus vaccine in May 2012. Stool samples were collected from 1,847 children <5 admitted to 8 surveillance sites for acute gastroenteritis (AGE) and tested for rotavirus antigens by enzyme immunoassay. Fifth, to monitor the effect of rotavirus vaccine in Rwanda, we studied trends in the number of hospital admissions for diarrhea and rotavirus before and after the introduction of the rotavirus vaccine. We conducted a time-series analysis to examine trends in admissions to hospital for non-bloody diarrhea in children younger than 5 years in Rwanda between Jan 1, 2009, and Dec 31, 2014, using monthly discharge data from the HMIS.Result All-cause, non bloody diarrheal hospitalizations and outpatient visits among children <5 years of age in Rwanda from 2008 to 2011 peaked during the June to August dry season, coinciding with the rotavirus season. The bulk of the diarrheal disease burden occurred in children <1 year of age. Average medical costs for each child for the hospitalization were $44.22 ± $23.74 and the total economic burden per hospitalization was $101, of which 65% was borne by the household. The unit cost of introducing rotavirus vaccines 2012 was 22.69 US. Among the 397 stool samples that were genotyped, 5 G types (G1, G4, G8, G9, and G12) and 3 P types (P[4], P[6], and P[8]) were identified. G8 (30.3%), G9 (28.0%), and G1 (19.7%) were the most prevalent G types, while P[8] (52.0%) and P[4] (32.6%) were the most prevalent P types. There was a significant amount of mixed G genotypes (12.1%), while mixed P types were less common (5.1%). G8P[4], G9P[8], and G1P[8] were the most prevalent strains, accounting for 27.8%, 24.3%, and 15.3% of all specimens, respectively.Compared with the 2009–11 pre vaccine baseline, hospital admissions for non-bloody diarrhea captured by the HMIS fell by 17–29% from a pre-vaccine median of 4051 to 2881 in 2013 and 3371 in 2014, admissions for AGE captured in pediatric ward registries decreased by 48–49%, and admissions specific to rotavirus captured by active surveillance fell by 61–70%. The greatest effect was recorded in children age-eligible to be vaccinated, but we noted a decrease in the proportion of children with diarrhea testing positive for rotavirus in almost every age group.ConclusionGiven the stable and consistent trends and the prominent seasonality consistent with that of rotavirus, HMIS data should provide a useful baseline to monitor rotavirus vaccine impact on the overall diarrheal disease burden in Rwanda. Active, sentinel surveillance for rotavirus diarrhea will help interpret changes in diarrheal disease trends following vaccine introduction. Other countries planning rotavirus vaccine introduction should explore the availability and quality of their HMIS data.Households often bear the largest share of the economic burden attributable to diarrhea hospitalization and the burden can be substantial, especially for households in the lowest income quintile.The cost of introduction of new vaccines (rotavirus) is less than the cost of treating the diarrhea diseases. The number of admissions to hospital for diarrhea and rotavirus in Rwanda fell substantially after rotavirus vaccine implementation, including among older children age-ineligible for vaccination, suggesting indirect protection through reduced transmission of rotavirus. These data highlight the benefits of routine vaccination against rotavirus in low-income settings. / Doctorat en Santé Publique / info:eu-repo/semantics/nonPublished

We address the questions on what determines local government proliferation, specifically on the impact of intergovernmental transfers on proliferation. On exploring the determinants of proliferation, we provide a more elaborate empirical technique than exists in the literature by employing panel binary outcome, survival regression, as well as count analysis to capture the time varying effect from intergovernmental transfers. We also examine the impact of proliferation on service delivery outcomes and construct channels by which the policy may affect the outcomes in the education and health sectors. We apply panel difference-in-difference estimation and we uniquely identify the different treatment group and thus control for the plausible differential impact on outcomes in regards to changes in intergovernmental transfers. On the determinants of local government formation, there are likely competing effects across transfers on the decision to proliferate as well as on the extent of fragmentation given that we find (1) the lump-sum conditional grants positively influence the probability of proliferation, (2) a province with higher median share of equalization grants associates with higher number of local governments, (3) higher equalization grants implies a longer duration to the proliferation event, and (4) higher tax sharing in the proliferated local governments reflects higher stability where stability refers to the longer duration to the sequential proliferation event. The findings suggest the tactical central-local behavior may be present, however, the support of rent-seeking hypothesis on proliferation should not be generalized to overall system of transfers. On the impact from the proliferation policy, the education and health outcomes estimations provide mixed results within the treatment group. The findings shed light on the current practice of administrative or political decentralization, specifically on the competing local-central preferences within each sector on measured service delivery outcomes. The results from difference-in-difference (DID) estimations show support on attainment of education outcome in new local governments represented by a reduction in the dropout rate but not on the quality of education in terms of higher students’ tests scores even though there is a relatively higher conditional grants allocated to the proliferated local governments. Meanwhile, in terms of infant mortality rate, we only find evidence of improvement in infant mortality on the originating local government but not on the new local governments. Controlling for selectivity and production function covariates have not changed the pattern of the impact.

This research paper explores the impact of Government Procurement Law on the activities of Research and Development in Taiwan. The Empirical Study focus on the Technological Research Projects. After collecting relevant literature regarding R&D in foreign countries, this study conducted an in-depth interview to derive a questionnaire. Later, based on a questionnaire mailed to 46 officials in Taiwan area, of which 37 replies were received (a 80.44 percent response rate). The study proposed a comprehensive and innovative program on establishing the R&D management in Taiwan.

<p>Developing countries often hoard the largest number of species, but also experience very high poverty levels. This dissertation reviews the evidence of the performance common conservation interventions. I find that despite the billions of dollars channeled towards conservation efforts annually, there is still very limited evidence whether or not conservation policies work. The evidence has been limited to exceptional countries like Costa Rica and Thailand and outlines like deforestation, without considering ecosystem function and ecosystem services. Furthermore, I find that the conservation impact evaluation literature has currently not highlighted the channels through which conservation policies effect change and how the effectiveness varies with the baseline characteristics of the area. </p><p>This dissertation aims to address some of the gaps in current conservation literature. Focusing on Indonesia between 2000 and 2006, I evaluate the performance of protected areas in terms of stalling deforestation as well as providing a wide range of ecosystem services and benefits (Chapter 2). In Chapter 3 I examine the role of context in which protected areas operate and show significant heterogeneity in their performance. In Chapter 4 I develop a static spatially explicit model of household fuelwood extraction that allows me to predict the location and magnitude of spillovers when a protected area is introduced. I find that depending on the characteristics of the areas, it may be optimal for households to buy fuelwood than collect it.</p> / Dissertation

This thesis is a collection of essays on the relevance of property right reforms on the wellbeing of poor households in developing countries; specifically titling programmes in urban Peru. The first essay assesses the effects of titling on housing investment. The availability of a unique dataset permits us to trace households' investment behaviour. This allows us to investigate if tenure security induces households to make sizeable investments, the evolution of this effect over time, and whether heterogeneous expectations about future tenure security matter for the estimated impact. Evidence reveals significant effects, especially on large investment; however, the response on this type of investment may take several years to become effective. The second essay contributes to the debate on the sustainability of property rights reforms by emphasising the importance of strong registration systems. Policymakers have focused on the process of granting titles but the conditions needed to maintain the formality of future plot transactions have been left unattended. The analysis exploits an exogenous variation in legislation to examine the impact of a change in the registration process on the registration rate of plot transactions. Evidence suggests a large negative effect, implying that a weak registration system could threaten the reform. The third essay explores the impact of titling on the risk preferences of slum dwellers. The analysis provides evidence that titled dwellers reported lower values of the risk aversion measure than their non-treated counterparts. Results also suggest that tenure security can influence slum dwellers' preference formation process. Evidence shows that beneficiaries who were exposed to tenure security during their youth report on average lower values of the risk aversion indicator than individuals titled at an older age.