The uneven effects of EU membership conditionality on Eastern European reforms continue to puzzle the research community. Sometimes, the research focus has been too large, considering EU membership conditionality as a policy implemented uniformly across policy areas. Other efforts take a too narrow approach by trying to explain the effects of EU membership conditionality in single sectors. I suggest studying this phenomenon through a set of mid-level theories in a cross-country, cross-sectorial approach. I argue that both the intensity of EU membership conditionality and reform outcomes are contingent upon the policy sector context; hence, we should take a sectorial contextual approach in studying them. Reform outcomes result from the interplay between EU’s and domestic leaders’ interests in a particular sectorial reform. I assume domestic leaders to be rational, power driven actors. I argue that, since they act in some weakly institutionalized political environments such as Eastern European societies, they represent the principal actors in the power game. I assume the EU to be a rational actor as well; yet, differently from Eastern Europe, the role of individual leaders is less distinguishable in the highly institutionalized EU political theatre. In this case, EU institutions are the primary political agents. They are interested in maintaining and enlarging the Union as a stable democracy. Expanding an earlier argument that views the EU as established through consociational practices, I argue that EU membership conditionality is a tool to impose institutional reforms in the EU aspirant countries, so their institutions can be receptive to the EU consociational practices once they join the Union. In these countries, the consociational character of conditionality is more visible, since it seeks to impose in aspirant countries the same practices that have brought democratic stability in some member states. The EU does not impose consociational practices on unified societies, but simply seeks to make their institutions receptive to the EU consociational practices. I test these arguments with the cases of institutional reforms in postcommunist Albanian and Macedonia. I conclude that, generally, EU membership manages to change Eastern European leaders’ interests in institutional reforms, but when it cannot, the reforms are almost impossible.

Mitt examensarbete innefattar en fönsterutredning för radhusområdet Skeppsvägen i Bålsta. Fastighetsägare är Håbohus AB och examensarbetet har skrivits för Skanska Sverige AB. Arbetet har skrivits på plats i Bålsta där Skanska Direkt AB har eget kontor och erhåller idag totalentreprenaden för renovering av Skeppsvägen. Arbetets syfte är att klart och tydligt redovisa eventuell effekt och energibesparing vid byte av befintliga fönster och altandörrar. Undersökning av fönster och altandörrar har gjorts okulärt, med värmekamera och med fuktkvotsmätare. Vid den okulära besiktningen noterades färgsläpp på fönster. Fotografierna med värmekamera visar att fönstren och altandörrarna tätar väldigt dåligt mellan båge och karm och risk för drag finns. Fuktkvotsmätaren gav ett högsta utslag på 14 % i bågen trä vilket är anmärkningsvärt. Effekt och energiberäkningar har gjorts för att jämföra de befintliga värdena med de nya efter ett eventuellt byte. Beräkningarna visar att Håbohus kan minska sin energiförbrukning med 15400- 16707 kWh/år beroende på vilka fönster och altandörrar de vill montera. De skulle även sänka effektbehovet med 16,5- 18,4%. / My graduate work is an evaluation of exchanging the existing windows for terrace houses on Skeppsvägen in Bålsta. Property owner is Håbohus AB and the assigner is written for Skanska Sweden AB. I’ve been working in Bålsta were Skanska Direct AB has their own office, Skanska also have the turnkey contract on the renovation job on Skeppsvägen. The intention of the work is to clearly report any power and energy savings when replacing existing windows and patio doors. Investigation of windows and patio doors has been made visually, with an infrared camera and a moisture meter. When the visual examination was made I recorded color release. The photograph of infrared camera shows that the windows and patio doors seals badly between sash and frame. Moisture content meter gave a maximum response of 14 % which is remarkable. Power and energy calculations have been done to compare the existing values with the new values after a possible replacement. The calculations shows that Håbohus can reduce their energy consumption by 15400-16707 kWh/year depending on which windows and patio doors they want to mount. They would also reduce the power requirement about 16,5 to 18,4 %.

<p>Functional<strong> </strong>magnetic resonance imaging (fMRI) is a popular technique to study brain function and neural networks. Functional MRI studies are often characterized by small sample sizes and rarely consider statistical power when setting a sample size. This could lead to data dredging, and hence false positive findings. With the widespread use of fMRI studies in clinical disorders, the vulnerability of participants points to an ethical imperative for reliable results so as to uphold promises typically made to participants that the study results will help understand their conditions. While important, power-based sample size calculations can be challenging. The majority of fMRI studies are observational, i.e., are not designed to randomize participants to test efficacy and safety of any therapeutic intervention. My PhD thesis therefore addresses two objectives: firstly, to identify potential obstacles to implementing sample size calculations, and secondly to provide solutions to these obstacles in observational clinical fMRI studies. This thesis contains three projects.</p> <p>Implementing a power-based sample size calculation requires specifications of effect sizes and variances. Typically in health research, these input parameters for the calculation are estimated from results of previous studies, however these often seem to be lacking in the fMRI literature. Project 1 addresses the first objective through a systematic review of 100 fMRI studies with clinical participants, examining how often observed input parameters were reported in the results section so as to help design a new well-powered study. Results confirmed that both input estimates and sample size calculations were rarely reported. The omission of observed inputs in the results section is an impediment to carrying out sample size calculations for future studies.</p> <p>Uncertainty in input parameters is typically dealt with using sensitivity analysis; however this can result in a wide range of candidate sample sizes, leading to difficulty in setting a sample size. Project 2 suggests a cost-efficiency approach as a short-term strategy to deal with the uncertainty in input data and, through an example, illustrates how it narrowed the range to choose a sample size on the basis of maximizing return on investment.</p> <p>Routine reporting of the input estimates can thus facilitate sample size calculations for future studies. Moreover, increasing the overall quality of reporting in fMRI studies helps reduce bias in reported input estimates and hence helps ensure a rigorous sample size calculation in the long run. Project 3 is a systematic review of overall reporting quality of observational clinical fMRI studies, highlighting under-reported areas for improvement and suggesting creating a shortened version of the checklist which contains essential details adapted from the guidelines proposed by Poldrack et al. (2008) to accommodate strict word limits for reporting observational clinical fMRI studies.</p> <p>In conclusion, this PhD thesis facilitates future sample size and power calculations in the fMRI literature by identifying impediments, by providing a short-term solution to overcome the impediments using a cost-efficiency approach in conjunction with conventional methods, and by suggesting a long-term strategy to ensure a rigorous sample size calculation through improving the overall quality of reporting.</p> / Doctor of Philosophy (PhD)

Malaria is the most important parasitic disease in man and it kills approximately 2,000 people each day. Pregnant women are especially vulnerable to malaria with increased incidence and mortality rates. There are indications that pregnancy alters the pharmacokinetic properties of many antimalarial drugs. This is worrisome as lower drug exposures might result in lowered efficacy and lower drug exposures can also accelerate the development and spread of resistant parasites. The aim of this research was to study the pharmacokinetics and pharmacodynamics of the most commonly used drugs for the treatment of uncomplicated Plasmodium falciparum malaria during the second and third trimester of pregnancy using a pharmacometric approach. This thesis presents a number of important findings that increase the current knowledge of antimalarial drug pharmacology and that may have an impact in terms of drug efficacy and resistance. (1) Lower lumefantrine plasma concentrations at day 7 were evident in pregnant women compared to that in non-pregnant patients. Subsequent in-silico simulations with the final pharmacokinetic-pharmacodynamic lumefantrine/desbutyl-lumefantrine model showed a decreased treatment failure rate after a proposed extended artemether-lumefantrine treatment. (2) Dihydroartemisinin exposure (after intravenous and oral administration of artesunate) was lower during pregnancy compared to that in women 3 months post-partum (same women without malaria). Consecutive in-silico simulations with the final model showed that the underexposure of dihydroartemisinin during pregnancy could be compensated by a 25% dose increase. (3) Artemether/dihydroartemisinin exposure in pregnant women was also lower compared to literature values in non-pregnant patients. This further supports the urgent need for a study in pregnant women with a non-pregnant control group. (4) Quinine pharmacokinetics was not affected by pregnancy trimester within the study population and a study with a non-pregnant control group is needed to evaluate the absolute effects of pregnancy. (5) Finally, a data-dependent power calculation methodology using the log likelihood ratio test was successfully used for sample size calculations of mixed pharmacokinetic study designs (i.e. sparsely and densely sampled patients). Such sample size calculations can contribute to a better design of future pharmacokinetic studies. In conclusion, this thesis showed lower exposures for drugs used to treat uncomplicated Plasmodium falciparum malaria during the second and third trimester of pregnancy. More pharmacokinetic studies in pregnant women with a non-pregnant control group are urgently needed to confirm the current findings and to enable an evidence-based dose optimisation. The data-dependent power calculation methodology using the log likelihood ratio test can contribute to an effective design of these future pharmacokinetic studies.