In most mature welfare states, policy evaluations are sponsored by the very organisations that designed and implemented the intervention in the first place. Research in the area of clinical trials has consistently shown that this type of arrangement creates a moral hazard and may lead to overestimates of the effect of the treatment. Yet, no one so far has investigated whether social interventions were subject to such ‘confirmation bias’. The objective of this study was twofold. Firstly, it assessed the scientific credibility of a sample of government-sponsored pilot evaluations. Three common research prescriptions were considered: (a) the proportionality of timescales, (b) the representativeness of pilot sites; and (c) the completeness of outcome reporting. Secondly, it examined whether the known commitment of the government to a reform was associated with less credible evaluations. These questions were answered using a ‘meta-research’ methodology, which departs from the traditional interviews and surveys of agents that have dominated the literature so far. I developed the new PILOT dataset for that specific purpose. PILOT includes data systematically collected from over 230 pilot and experimental evaluations spanning 13 years of government-commissioned research in the UK (1997-2010) and four government departments (Department for Work and Pensions, Department for Education, Home Office and Ministry of Justice). PILOT was instrumental in (a) modeling pilot duration using event history analysis; (b) modeling pilot site selection using logistic regression; and (c) the systematic selection of six evaluation reports for qualitative content analysis. A total of 17 interviews with policy researchers were also conducted to inform the case study and the overall research design. The results show little overt evidence of crude bias or ‘bad’ design. On average, government-sponsored pilots (a) were based on timescales that were proportional to the scope of the research; (b) were not primarily designed with the aim of warranting representativeness; and (c) were rather comprehensively analysed in evaluation reports. In addition, the results indicate that the known commitment of the government to a reform had no significant effect on the selection of pilot sites and on the reporting of outcomes. However, it was associated with significantly shorter pilots. In conclusion, there is some evidence that the known commitment of a government to a reform is associated with less credible evaluations; however this effect is only tangible in the earlier stages of the research cycle. In this respect, sponsorship bias would appear to be more limited than in the context of industry-sponsored clinical trials. Policy recommendations are provided, as this project was severely hindered by important ‘black box’ issues and by the poor quality of evaluation reports.

This research project investigates whether the empowerment of Israel’s population — and in particular those who suffer multiple disadvantages — is achievable through housing policies and whether successive Israeli administrations have helped or hindered this process. The research focuses on communities in publicly-subsidised areas during social housing programmes. The housing programmes analysed in this research were: The Demolish and Rebuild Programme, which represents a top-down process, implemented with little residents’ involvement. Neighbourhood Renewal, which was a programme that formally offered partnership, giving residents partial share in decision-making. Finally, Right to Buy represented a resident-led partnership, in which residents felt empowered to overcome their own disadvantaged conditions by taking a leading role in transforming housing policy. The database complementing this research was compiled, in part, from 91 in-depth interviews with residents, policy makers and officials representing these three programmes. It is a unique aspect of this research, as it draws on perspectives about participation from those who have not necessarily had an opportunity to express an opinion before, and communicates a variety of views regarding the projects and residents’ participation in them. This study focuses on how it actually affects people and can even create behavioural change among those who are normally considered dependent. Another exceptional and distinctive factor provided by this research is its analysis of empowerment in the social and political context of Israel. By analysing the Israeli case, this research will contribute both to international knowledge and academic scholarship, highlight the conditions of an individual state and generate an original and provocative narrative. The issue of participation and empowerment in a society so riven with political, social, religious and ethnic tensions is particularly important. Learning from the Israeli experience has the potential to promote understanding of empowerment under pressure. Empowerment related to social housing policy is distinctive in Israel because housing is synonymous with security. Housing is more than a cultural issue, since in Israel owning a property is a matter of security. Another key feature is the focal role of central government which determines almost every aspect in the shaping of social and housing policy. Also critical is the influence of national politics on local decision-making. In Israel the political agenda is based upon bilateralism and the demographic dispersal of population across the state’s formal and informal borders. Empowerment is a complex term. This research, however, explores examined and evidenced empowerment using just two main features: examination of residents’ participation; and evaluation of public policy towards resident participation. This research offers a unique view on empowerment within social housing policies that are subject to multiple pressures, and offers interpretations that could be usefully applied to issues of empowerment in other pressure scenarios.

No description available.

Universal coverage is a core health system goal which can be met through a variety of health financing mechanisms. The focus of this PhD is on one of these mechanisms, community-based health insurance (CBHI). CBHI aims to provide financial protection from the cost of seeking health care through voluntary prepayment by community members; typically it is not-for-profit and aims to be community owned and controlled. Despite its popularity with international policymakers and donors, CBHI has performed poorly in most low and middle income countries. The overarching objective of this PhD is therefore to understand the determinants of low enrolment and high drop-out in CBHI. The PhD builds on the existing literature, which employs mainly economic and health system frameworks, by critically applying social capital theory to the analysis of CBHI. A mixed-methods multiple case study research design is used to investigate the relationship between CBHI, bonding and bridging social capital at micro and macro levels and active community participation. The study focuses on Senegal, where CBHI is a component of national health financing policy. The results suggest that CBHI enrolment is determined by having broader social networks which provide solidarity, risk pooling, financial protection and financial credit. Active participation in CBHI may prevent drop-out and increase levels of social capital. Overall, it seems CBHI is likely to favour individuals who already possess social, economic, cultural and other forms of capital and social power. At the macro level, values (such as voluntarism, trust and solidarity) and power relations inhering in social networks of CBHI stakeholders are also found to help explain low levels of CBHI enrolment at the micro level. The results imply the need for a fundamental overhaul of the current CBHI model. It is possible that the needed reforms would require local institutions to develop new capacities and resources that are so demanding that alternative public sector policies such as national social health insurance might emerge as a preferable alternative.

Today, researchers and policy makers alike are increasingly concerned about the “double burden of malnutrition” in low and middle income countries (LMICs). This ‘double burden’ is understood to be the coexistence of under- and overnutrition within one population. The definition of a ‘double burden’ relies upon the existence of chronic undernutrition among children (indicated by stunting – where children are shorter than expected for their age) and the existence of overnutrition in children or adults (child overweightness as indicated by a greater weight than expected for a given height and adult overweightness/obesity as indicated by a greater weight than height). However, research has failed to consider that children can be concurrently stunted and overweight – known here as ‘stuntingoverweightness’. In failing to consider stuntingoverweightness, the prevalence of stunting and overweightness among children has been overestimated at the population level. Stuntedoverweight children have been ‘double counted’ – once as stunted and once as overweight. This has severe implications for our understanding of malnutrition in LMICs today. The polarisation of malnutrition among children of under- and overnutrition has been exaggerated and a whole group of children have become hidden – the stuntedoverweight. This research addresses this issue. Recalculating stunting and overweightness prevalence accounting for stuntingoverweightness this research shows that, today in LMICs, up to 10.42% of children under-five are stuntedoverweight – yet no policies or programmes exist to understand the determinants of stuntingoverweightness, its effects or how to alleviate them. An individual level analysis of Albania shows stuntedoverweight children are a separate socioeconomic group and should thus be targeted for interventions separately from their stunted and overweight peers. Furthermore, failing to recognise stuntingoverweightness has led to overestimations of the burden of stunting by up to 88.54% (in Albania) and of overweight by up to 295.26% (in Benin) and skewing our understanding of the ‘burden of malnutrition’ in LMICs. The thesis shows that for nutritional strategies to be effective – research needs to consider the diverse burden of malnutrition observed in LMICs today.

This thesis proposes a reconstructed, critical cosmopolitanism that uses the identified core components of the normative branch of cosmopolitanism rooted in (Kantian) moral philosophy and the works of a wide variety of critical theorists that include feminist, postcolonial, and queer perspectives. I pay particular attention to those theorists influenced by poststructuralist deconstructions of the stable subject who focus either on the normative theory directly or on components essential to it. Normative theorists, exemplified by Thomas Pogge, Simon Caney and others, usually focus on global distributive justice, taking as a given, for example, who counts as human. Critical theorists, such as Judith Butler, question that premise. This postmodern turn has implications for what I argue are the three necessary components of cosmopolitanism: autonomy, universality, and its anti-nationalist position. However, the first two have been problematised because of their liberal conceptualisations, which then has implications for cosmopolitanism’s anti-nationalist position as well. I propose a reconfiguration of cosmopolitanism that retains the core normative concepts, but rejects their more liberal interpretations. I argue that the atomistic individual as the basis for liberal autonomy is flawed, and that liberal cosmopolitan conceptualisations of univeralism do not recognise its particularity. I also argue that that the normative theory does not fully take into account nationalism’s dependence on the marginalisations of non-normative populations within the nation state, and how those dependencies might be complicit with nationalism’s othering of those across borders. In addition to a number of normative theorists, the thesis references such multidisciplinary thinkers as Butler, Linda Zerilli and Hannah Arendt. I examine the works of different theorists to develop a reformulation of each of these concepts and integrate an intersubjective approach into these reformulations in order to assemble a feminist, intersubjective, critical cosmopolitan theory. I suggest the adoption of a ‘cosmopolitan intersubjectivity’ in order to show how these concepts can be reconfigured to work together more cohesively and give cosmopolitan theory greater internal consistency.

This thesis addresses the training needs, experiences and aspirations of a group of young Black and White women on the One Year Youth Training Scheme (YTS) in the mid-1980s. The thesis takes as its starting point the role of the State and the Manpower Services Commission in fostering a new training scheme, based on social market principles and a deficiency-centred model of young people. In turn this process of labelling young people as deficient is subjected to a critical analysis, especially in relation to the youth labour market and the rise in youth unemployment from the late 1970s up to the beginning of the research period in 1984. Thereafter, the issue of training in the context of the sample's past experiences of schooling and the labour market is examined in order to identify the most salient factors involved in their selection of the Youth Training Scheme. A focus on two case study training schemes is undertaken, where the main objective is to explore the nature of relationships between the various actors involved, ie. Black and White female trainees and staff. In doing so the central argument pursued by this thesis is that the nature of such relations determined the quality of the training received by the sample group on the two schemes in an area of West London between the summer of 1984 and 1985. In conclusion the thesis argues that based on the research evidence, the labelling of young people as deficient in employment skills is misleading, because it fails to take into account the complexity surrounding the transition from school to work.

Half of health care in sub-Saharan Africa is privately provided, however, for mental health, the literature is all but absent on these services. Kenya provides a useful case-study, as it has a wellorganized non-state sector and data are readily available. My thesis asks what contribution do non-state actors make to coverage for mental disorders in Kenya? Non-state mental health care is conceived along two axes: for-profit vs. not-for-profit and formal vs. informal. Four empirical chapters use mixed-methods to examine: 1) not-forprofit NGO care; 2) for-profit inpatient care; 3) for-profit outpatient care; and 4) traditional and faith healing. Data were collected on 774 service users and 120 service providers from four primary sources, and two secondary sources, as well as from a wide range of key-informant interviews. The first two chapters set the research question within the context of existing knowledge in the fields of health economics and health services research. The third chapter provides an overview of methods, focusing on cost-effectiveness analysis, case study method, and crosscultural psychiatric epidemiology. The first empirical chapter presents an NGO intervention called the model for Mental Health and Development, evaluated qualitatively and quantitatively, using cost-effectiveness analysis. The second empirical chapter offers a case study of a growing private psychiatric hospital, using regression analysis on the effects of insurance on charge and service use. The third chapter is a short descriptive analysis of a questionnaire completed by psychiatric nurses about their participation in mental health care, and structured interviews with specialist outpatient providers. The final empirical chapter contains qualitative and quantitative data on traditional and faith healing, analysed for similarities and differences. The conclusion ties together findings thematically according to capacity, access and cost, estimating the degree of mental health care coverage offered by non-state actors in Kenya, and offering lessons for policy and research.

We define instance compressibility ([13, 17]) for parametric problems in the classes PH and PSPACE.We observe that the problem ƩiCIRCUITSAT of deciding satisfiability of a quantified Boolean circuit with i-1 alternations of quantifiers starting with an existential quantifier is complete for parametric problems in the class Ʃp/i with respect to w-reductions, and that analogously the problem QBCSAT (Quantified Boolean Circuit Satisfiability) is complete for parametric problems in PSPACE with respect to w-reductions. We show the following results about these problems: 1. If CIRCUITSAT is non-uniformly compressible within NP, then ƩiCIRCUITSAT is non-uniformly compressible within NP, for any i≥1. 2. If QBCSAT is non-uniformly compressible (or even if satisfiability of quantified Boolean CNF formulae is non-uniformly compressible), then PSPACE ⊆ NP/poly and PH collapses to the third level. Next, we define Succinct Interactive Proof (Succinct IP) and by adapting the proof of IP = PSPACE ([11, 6]) , we show that QBCNFSAT (Quantified Boolean Formula (in CNF) Satisfiability) is in Succinct IP. On the contrary if QBCNFSAT has Succinct PCPs ([32]) , Polynomial Hierarchy (PH) collapses. After extending the notion of instance compression to higher classes, we study the hierarchical structure of the parametric problems with respect to compressibility. For that purpose, we extend the existing definition of VC-hierarchy ([13]) to parametric problems. After that, we have considered a long list of natural NP problems and tried to classify them into some level of VC-hierarchy. We have shown some of the new w-reductions in this context and pointed out a few interesting results including the ones as follows. 1. CLIQUE is VC1-complete (using the results in [14]). 2. SET SPLITTING and NAE-SAT are VC2-complete. We have also introduced a new complexity class VCE in this context and showed some hardness and completeness results for this class. We have done a comparison of VC-hierarchy with other related hierarchies in parameterized complexity domain as well. Next, we define the compression of counting problems and the analogous classification of them with respect to the notion of instance compression. We define #VC-hierarchy for this purpose and similarly classify a large number of natural counting problems with respect to this hierarchy, by showing some interesting hardness and completeness results. We have considered some of the interesting practical problems as well other than popular NP problems (e.g., #MULTICOLOURED CLIQUE, #SELECTED DOMINATING SET etc.) and studied their complexity for both decision and counting version. We have also considered a large variety of circuit satisfiability problems (e.g., #MONOTONE WEIGHTED-CNFSAT, #EXACT DNF-SAT etc.) and proved some interesting results about them with respect to the theory of instance compressibility.

In this project, problems related to loss of free flow in central venous catheter and implanted subcutaneous ports have been investigated. The catheters investigated in this project are intended for children with cancer diseases. The initial hypothesis was that the length, radius and curvature of the catheter would affect the flow. Two other things that can have a negative impact on the flow are if the catheter is squashed or kinked. Experiments and simulations have been performed in order to test the hypothesis and investigate how a deformation of the catheter affects the flow. The results from the experiments and simulations show that the length and radius of the catheter have major impact on the pressure drop, and hence the flow. The curvature of the catheter has less impact on the flow as long as the catheter is not kinked. Experiments with squashed catheters show a decrease in outlet pressure with a decrease of the catheter lumen. / Denna projektrapport ämnar undersöka problem relaterade till fritt flöde i centrala venkatetrar och inopererade subkutana portar. Katetrarna som testats i detta projekt är till för barn med cancersjukdomar. Den ursprungliga hypotesen var att längden, radien och krökningen hos katetern påverkar flödet. Ytterligare två saker som skulle kunna ha negativ effekt på flödet är om katetern är klämd eller veckad. För att testa hypotesen om hur deformationer av katetern påverkar flödet har experiment och simuleringar utförts. Resultaten från experiment och simuleringar visar att kateterns längd och radie har störst effekt på tryckfallet och därmed flödet. Krökningen på katetern har mindre betydelse, så länge katetern inte är veckad. Experiment med klämd kateter visar att utloppstrycket minskar med minskad kateterlumen.