This work contains 18 publications exploring evidence based strategies to enable health promoting housing and communities in the private sector. It examines housing’s contribution to health in the public health agenda; policy priorities and arrangements to deliver healthier housing; partnership working and health outcomes in housing; and measuring evidence of health gain in housing from practitioner interventions and has required a multi-method research programme of theory and practice including case studies, focus groups, comparative studies, telephone and face-to-face interviews/semi-structured discussion in a variety of settings. The work consolidates housing and public health policies, exploring their wider ideological shaping. It particularly focuses on New Labour policies since the launch of the current public health agenda in delivering new evidence-based interventions. These rely on a new relationship between government (as governance) and communities to deliver health improvement and to address health inequalities through partnership working, although barriers remain. Simultaneously, policy developments in private sector housing renewal have emphasised personal responsibility in the sector, and focus more closely on meeting individual and community need. The current situation can present something of a dilemma between seeing housing as a health determinant or as a commercial asset for both owner-occupiers and private sector landlords. The work brings together different sets of literature and fields of research which link housing and health in the private sector, and also different elements of policy as part of the government’s emphasis on joined up government, finding that although the strategic public health frameworks are in place, there remains pressure for organisations to revert to core activities.

This thesis investigates the impact of international organizations on the making of international law by applying insights on how international organizations work—or fail to work—to the process of institutionalized treaty making. Specifically, I probe the relationship between the World Health Organization (“WHO”) and international infectious disease law, focusing in particular on the 2005 International Health Regulations (“2005 IHR”), which was negotiated, adopted, and is now being implemented under WHO’s auspices. The 2005 IHR is the most recent development in international infectious disease law, the history of which extends back to the beginning of international health cooperation in the mid-nineteenth century, before any international health organization was formed. Relying on secondary sources, WHO documents, archival materials, and personal interviews, I chronologically trace the evolution of international infectious disease law across changing institutional settings. I first examine the incremental growth of the older “barrier” approach to infectious disease regulation, initially developed in the absence of any international health organization and then with the aid of one of WHO’s predecessor organizations. I then analyze the decline of the barrier approach and the rise of the new “epidemiological” approach embodied by the 2005 IHR, with the aid of WHO. Based on my empirical analysis, I conclude that WHO has radically changed the process of making international infectious disease law as well as its content. On its own initiative and without member state demand, WHO’s permanent staff experimented with novel practices that subsequently became the basis for the 2005 IHR. WHO’s work reduced the length of formal negotiation needed to arrive at a new agreement and the uncertainty associated with adopting a novel regulatory system. Its influence also raises normative questions about the proper role of international organizations in making international law—questions that require further exploration.

It is becoming increasingly evident that the major challenges affecting organisations today and in the years ahead will emanate from the rapid and unrelenting pace of changes in the external environment and, the often, unpredictable ways in which such changes can affect organisations. The need to respond flexibly and in an agile manner to a vast array of requirements, pressures and demands, has never been more pressing. As a result, Wright et al. (1999) among many others, have argued that the traditional bureaucratic organisation paradigm clearly suffers as a guiding paradigm for organisations operating in turbulent and fluid environments characterised by constant change. Calls have been voiced time and again for replacing such an outmoded organisational paradigm, towards realising the desired agile organisation state, reflected in the organisational agility paradigm. In response to these calls, this study explores the concept of Organisational Agility in the National Health Service (NHS), through adopting a case study approach to investigating and exploring three major themes identified by the researcher as characterising the literature on organisational agility. These are concerned with: a) the perception and understanding of the concept of organisational agility, b) the need for organisational agility as essentially being driven by the nature of changes in the environment affecting the organisation, and c) the main factors / capabilities that underpin an organisation’s ability to attain agility. As a result, a major contribution emanating from this study is the consideration that it is the first known study investigating organisational agility in the NHS. Two NHS Hospital Trusts were designated as case study organisations for the purposes of this research: Trust A, which is a one star, lower performing Trust, and Trust B, which is a three star, higher performing Trust, according to the NHS Performance Ratings published by the Commission for Health Improvement (CHI) (2003). This can well provide useful and interesting insights that seek to explain such a difference in performance between the Trusts, from an organisational agility perspective/point of view, which is considered in its own right a major contribution of the study. Both: face-to-face in-depth interviews, as well as self-completion questionnaires, were employed for gathering primary data in each of the case Trusts. This provided rich triangulation between qualitative and quantitative data, which contributed to better understanding the current situation regarding the phenomenon of organisational agility in a healthcare setting. Findings emerging from exploring the nature of the environment affecting the Trusts, as well as their perceived need for organisational agility, strongly indicate that they both perceive that there is a clear need for a higher level of agile response on their parts, in dealing with the requirements placed on them by an environment that is characterised by: a highly important overall effect on the well-being of these Trusts in managing and delivering their healthcare services, as well as by reasonably dynamic and uncertain changes in its requirements and expectations. However, interestingly, the one star, lower performing Trust perceived that it requires a significantly higher level of agility to respond to changes. Also, fourteen “agility-enabling” capabilities were conceptually developed and empirically validated in this study. The role of such capabilities in facilitating the shift towards the agile organisation paradigm was found by both Trusts to be highly important. However, Operational Flexibility emerged as the only critical factor in explaining the agility of the Trusts. Ironically, Operational Flexibility was also found to be one of the least practised “agility-enabling” capabilities on the part of the NHS Trusts. Another interesting finding is that the three star, higher performing Trust, has emerged as being significantly more advanced in terms of its practise of a number of agility-enabling dimensions. Based on these results emerging from comparing the two differently performing case Trusts, it can be concluded that the ranking of Hospital Trusts according to the NHS Performance Ratings published by the Commission for Health Improvement (CHI), may well provide an insight into the overall ability of a Hospital Trust in effectively responding to and dealing with the various pressures, demands, and requirements placed on it by different environmental parties. This conclusion emerging from such a finding is considered a contribution on the part of this study, towards providing new knowledge concerning the usefulness of the Hospital League Tables.

This research project sets out to explore, analyse and theorise the way district nurses and social care workers construe their identity, and their relationships within the changing context of collaborative projects. Unlike previous research in this field, this project offers an alternative, relational view of exploring professional identities and inter-professional relationships. The research adopted a constructivist phenomenological approach drawing upon the theories of personal construct psychology (Kelly, 1955) and existential phenomenology (Merleau Ponty, 1962), as elaborated by Butt (2004, 1998). The project consists of three studies. The first empirical work is a preliminary study using individual interviews of students undertaking degree courses in community nursing or social work. This study is concerned with examining the students' concepts of what it means to belong to a particular occupational group and the influences that shape their ideas. Using focus groups and individual interviews, the second study explores how district nurses and social care workers negotiate their identity as a result of national changes and service developments. The final study explores interprofessional relationships of individual district nurses and social care workers, using reflective interview techniques (Hargreave, 1979, Salmon, 2003). In keeping with phenomenological methodology, data was analysed using template analysis (King, 2004). A number of emerging constructs were identified that highlight the personal, historical and contextual influences upon professional role construction and inter-professional relationships, notably: visibility and recognition, role flexibility and rigidity. In particular the findings illustrate how professional identity is constructed, challenged, and reconstructed, through on-going interaction. To facilitate role re-construction and sociality, the reflective interview techniques were adapted and extended to encourage practitioners to reflect upon their every-day practice and relationships when working in a multi-disciplinary setting.

A growing interest in urban food production has prompted many North American cities to revise their municipal policies regarding agricultural activities. In March 2011, the City Council of Burlington, VT, created the Urban Agriculture Task Force to investigate and recommend policies to provide city officials with tools to effectively govern urban agriculture. In coordination with the Task Force as a community partner, I used a governance framework and participatory action research (PAR) to analyze: (1) the needs of local stakeholders, including urban agriculture practitioners, the general Burlington community, and government officials; (2) the policy tools available to the City of Burlington, including the direct provision of services, regulation, public information, and partnerships with other organizations; (3) the actors and relationships present in Burlington’s urban agriculture governance network; and (4) policy approaches used in other cities. Based on this analysis, over 50 policy recommendations were developed for the City of Burlington, ranging from ordinance revisions to the development of new urban agriculture initiatives. Key findings include that (1) a balance must be struck between stakeholder needs (e.g. practitioners desire that regulations be minimal, while municipal officials need measurable standards to ease implementation); (2) a legal basis for governing some aspects of urban agriculture, such as the humane treatment of livestock, is needed, but other aspects, such as managing neighbor conflicts or connecting people to available land, are not easily regulated and require innovative programming; and (3) the City has an opportunity to partner with other organizations that are better suited to provide technical expertise to practitioners. These recommendations lay the groundwork for the City to better govern and support current and future urban agriculture activities.

During the past few decades, decentralization efforts in México have coincided with efforts to democratize the administrative decision-making process. Adopted in 1988, the Programa Nacional de Solidaridad (National Solidarity Program; PRONASOL) required citizen participation in decisions involving the use of federal resources for regional development and poverty alleviation projects. In 1998, Section 33 of the Ley de Coordinación Fiscal (Fiscal Coordination Law; LCF) placed Social Infrastructure Funds (SIF) directly under the supervision of municipalities and retained the requirement that citizens participate in decisions involving the allocation of funds. The present study seeks to understand the factors that affect the participation of citizen committees (composed of community members; organized to address a particular cause) in SIF allocation decisions and assess the impact of this form of citizen participation on government performance. To pursue this objective, the study analyzes the implementation of LCF with respect to the role of citizen committees in SIF allocation decisions at two different locations: the township of Santa Maria Tonantzintla, located in the municipality of San Andrés Cholula, in the state of Puebla, and the rural municipality of Tenango Del Aire, located in El Estado de México (the State of México). The study finds that gender, church participation, and personal economy play major roles in the formation of citizen committees. Although the citizen committees have been instrumental in getting their SIF projects prioritized, they have had little effect on the quality or efficiency with which the projects were carried out. In general, the municipal decision-making process in both municipalities lack mechanisms to guarantee citizen participation and thus to ensure consideration of the broader public interest beyond the interest of organized groups. Because SIF can be used for various economic development projects, such as water, sewage, electrification, emergency clinics, and schools, it was of particular importance to determine whether the participatory mechanism was functioning correctly. Given the nature of the projects carried out by municipalities, flaws in the implementation process, including failures to include the broader public, could hinder not only local economic development, but also the economic growth of the nation.

Political corruption in the Caribbean Basin retards state economic growth and development, undermines government legitimacy, and threatens state security. In spite of recent anti-corruption efforts of intergovernmental and nongovernmental organizations (IGO/NGOs), Caribbean political corruption problems appear to be worsening in the post-Cold War period. This dissertation discovers why IGO/NGO efforts to arrest corruption are failing by investigating the domestic and international causes of political corruption in the Caribbean. The dissertation’s theoretical framework centers on an interdisciplinary model of the causes of political corruption built within the rule-oriented constructivist approach to social science. The model first employs a rational choice analysis that broadly explains the varying levels of political corruption found across the region. The constructivist theory of social rules is then used to develop the structural mechanisms that further explain the region’s levels of political corruption. The dissertation advances its theory of the causes of political corruption through qualitative disciplined-configurative case studies of political corruption in Jamaica and Costa Rica. The dissertation finds that IGO/NGO sponsored anti-corruption programs are failing because they employ only technical measures (issuing anti-corruption laws and regulations, providing transparency in accounting procedures, improving freedom of the press, establishing electoral reforms, etc.). While these IGO/NGO technical measures are necessary, they are not sufficient to arrest the Caribbean’s political corruption problems. This dissertation concludes that to be successful, IGO/NGO anti-corruption programs must also include social measures, e.g., building civil societies and modernizing political cultures, for there to be any hope of lowering political corruption levels and improving Caribbean social conditions. The dissertation also highlights the key role of Caribbean governing elite in constructing the political and economic structures that cause their states’ political corruption problems.

This dissertation is a comparative case study of regional cooperation in the field of economic development. In the 21st century global economy, proponents of regionalism have put forth fresh arguments for collective action. A regional approach to economic development activity presents a classic social dilemma: How can local officials collectively improve the economic prospects of a region, and remain autonomous to act in the best interest of the local community? This research examines the role of social capital in overcoming this social dilemma. Three (3) comparable Metropolitan Statistical Areas (MSAs) form the empirical basis of this research. The Houston MSA, the Atlanta MSA and the Miami MSA present distinct variations of regionalized economic development activity. This dissertation seeks to explain this disparity in the dependent variable. The hypothesis is that accrued social capital is crucial to obtaining economic development cooperative agreements. This qualitative research utilized secondary demographic and economic databases, survey instruments, interviews, field observations, and a review of legislative and administrative decisions to formulate a clear understanding of the factors influencing the current state of regional economic development cooperation within each region. The study concludes that the legislative and executive decisions of state government exert inordinate influence on the capacity of local officials to cooperate regionally for economic development purposes.

The purpose of this research is to examine the factors that have influenced political decentralization in Paraguay and Colombia and how the new intergovernmental relations that result in political, fiscal and policy decentralization impact local governments and their capacity to deliver public services. The research, building on institutional theory, places particular emphasis on trying to explain and understand how intergovernmental relations shape the decentralization—and effectiveness—of public service delivery to local and regional governments, particularly in the areas of health and education. The research method is principally a path-dependent within-cases analysis. The analysis traces how the processes of decentralization evolved from 1990 to 2010. Special attention is given to critical junctures, or special political or social circumstances, that have significantly changed the process of decentralization. Data was collected mainly through reviews of documents, journals and newspapers, and most significantly through elite interviews “tailored to the purposes of the study” (Aberbach & Rockman, 2002). Leaders of political parties, unions, non-governmental-organizations and civic movements were interviewed in both countries. The research shows that political parties play a very important role, not only in the design and implementation of decentralization of public service delivery, but also in sustaining and furthering the process. The analysis is based on the assumption that increased decentralization of health and education to local and regional levels should positively impact basic health and education indicators. If decentralization, as argued, helps governments to be more responsive to local needs, and if more health and education programs are decentralized to the local and regional level in response to the demands of many communities, it is predicted that health and education indicators would improve, as people would have easier access to these services. Analysis of health and education indicators in the form of infant mortality rates (deaths of children under one year old, live births) and school enrollment show mixed results for both Colombia and Paraguay.

This thesis inquires into the problems of funding businesses by means of so called alternative financing arrangements, i.e. by Private Equity and Public Stock and Bond Offerings. The first section involves basic ideas and characteristics of the Czech capital market and its structure. The following three sections deal, in sequence, with particular means of financing. They comprise theoretic aspects of particular financing arrangements as well as analysis of advantages and disadvantages to businesses, resulting from their application. Furthermore these sections provide for characteristics of situation in sectors of these particular financing arrangements within the scope of the Czech capital market and detect potentials to improve it.