Aims: The aims of this thesis were to investigate the risk of severe maternal morbidity amongst women from different socioeconomic groups in the UK, explore why these differences exist and compare these findings to the setting in Australia. Methods: Three separate analyses were conducted. The first used UK Obstetric Surveillance System (UKOSS) data to assess the incidence and independent odds of severe maternal morbidity by socioeconomic group in the UK. The second analysis used quantitative and qualitative data from the 2010 UK National Maternity Survey (NMS) to explore the possible reasons for the difference in odds of morbidity between socioeconomic groups in the UK. The third analysis used data from the Victorian Perinatal Data Collection (VPDC) unit in Austra lia to assess the incidence and odds of severe maternal morbidity by socioeconomic group in Victoria. Results: The UKOSS analysis showed that compared with women from the highest socioeconomic group, women in the lowest 'unemployed' group had 1.22 (95%CI: 0.92 - 1.61) times greater odds associated with severe maternal morbidity. The NMS analysis demonstrated that independent of ethnicity, age and parity, women from the lowest socioeconomic quintiJe were 60% less likely to have had any antenatal care (aOR 0.40; 95%CI 0.18 - 0.87), 40% less likely to have been seen by a health professional prior to 12 weeks gestation (aOR 0.62; 95%CI 0.45 - 0.85) and 45% less likely to have had a postnatal check with their doctor (aOR 0.55; 95%CI 0.42 - 0.70) compared to women from the highest quintile. The Victorian analysis showed that women from the lowest socioeconomic group were 21% (aOR 1.21 ; 95% CI 1.00 - 1.47) more likely and that Aboriginal and Torres Strait Islander women were twice (aOR 2.02; 95%CI 1.32 - 3.09) as likely to experience severe morbidity. Discussion: The resu lts suggest that women from the lowest socioeconomic group in the UK and in Victoria have increased odds of severe maternal morbidity. Further research is needed into why these differences exist and efforts must be made to ensure that these women are appropriately prioritised in the future planning of maternity services provisio n in the UK and Australia.

This thesis explores employment among people who inject drugs (IDU). It seeks identify what differentiates IDU who work from those who do not, barriers to labour market participation, and how employment is perceived and experienced by IDU. Using longitudinal data from the Vancouver Injection Drug User Study (VIDUS), it conducts this research through a detailed examination of the implications of missing data, quantitative analyses of transitions into employment and qualitative, in-depth interviews. Missing data analyses identified differences between those that those that do and do not have missing data, as well as predictors of observation gaps and how individuals end their study participation (either right-hand censorship, attrition, or death). Differences were observed along individual, behavioural and contextual dimensions. Analytical approaches to the relationship between data structure and content gleaned useful information for longitudinal studies with marginalized populations. Discrete time event history analyses of work transitions revealed complex relationships between drug use, drug-related activities, situational risk factors, and transitions into employment. While most IDU did not make transitions into employment, some did, and while some statistical relationships were expected, others were surprising. Novel findings included mode-specific addiction treatment impacts on employment (methadone vs. non-methadone) and the importance of the broader risk environment over and above even high-intensity substance use. Finally, qualitative interviews identified heterogeneity in individual motivations toward and experiences of work. Those who maintained concurrent drug use and formal labour market involvement utilized strategies to spatially and temporally separate the two activities. Individual capacities to employ these strategies were facilitated by material, vocational and temporal motivations, and interfered with by health conditions, catastrophic events and institutional relationships that operated as barriers to employment. This study provides insight into what is a known social determinant of health in the general population among injection drug users.

La prématurité, définie par un accouchement avant 37 semaines d'aménorrhée, ne cesse de croître en France. Elle a des facteurs de risque médicaux et socio-économiques. Elle se trouve au coeur des enjeux de la sécurité de la naissance et de l'efficience du système de santé, au nom desquelles les maternités de proximité sont fermées progressivement depuis 1998, sans égard pour une équité spatiale des populations. L'étude de l'impact de ces restructurations sur un vaste territoire comme la Bourgogne est d'autant plus intéressante que cette dernière cumule des facteurs de dispersion avec un peuplement en périphérie de ses limites régionales, une moyenne montagne centrale difficile à franchir, le Morvan, et une faible densité de population et de professionnels de santé. Notre travail a permis de confirmer la répartition hétérogène du taux d'accouchement prématuré en Bourgogne. Pour expliquer cette disparité, et à l'aide principalement de données individuelles du PMSI (Programme de Médicalisation des Systèmes d'Information) et contextuelles de l'INSEE (Institut National de la Statistique et des Études Economiques), nous avons étudié séparément ses relations avec l'accessibilité physique, la distance socio‐économique et l'organisation des soins, avec un accent sur les réseaux de santé périnatale qui caractérisent cette région. Nous avons enfin réuni tous les facteurs explicatifs pertinents dans une analyse multi niveaux dont les modèles hiérarchiques linéaires sont les plus adaptés pour prendre en compte simultanément des données individuelles et des données contextuelles agrégées. Les résultats identifient des clusters de prématurité et montrent que la disparité de la prématurité repose essentiellement sur la disparité spatiale du désavantage socio‐économique et sur la situation d'isolement du Morvan central. Ce travail devrait permettre d'intervenir auprès de ces territoires pour améliorer ou compenser leurs facteurs de risque de prématurité / Prematurity, defined as a birth occurring before 37 weeks of gestation, is increasing in France. It has medical and socio‐economic risk factors. It is of concern to issues about birth security and healthcare efficiency, according to which the local maternity units have been gradually closed since 1998, regardless of spatial equity for the population. The study of the impact of the restructuring on such a vast area as Burgundy is all the more interesting that Burgundy combines factors of dispersion such as its settlement on the edge of its regional boundaries, a central mountain Morvan difficult to drive through, and the low density of its population and of its health professionals. Our work has confirmed the heterogeneous distribution of the rate of preterm delivery in Burgundy. To explain this disparity, in mainly using individual data from PMSI (Programme de Medicalization of Information Systems) and contextual data from INSEE (National Institute for Statistics and Economic Studies), we studied separately the prematurity relationships with physical accessibility, with socio‐economic distance and with perinatal care organization, with a special focus on perinatal health networks that characterize this region. We finally gathered all the relevant explanatory factors in a multilevel analysis with hierarchical linear models that are best suited to take into account both individual and aggregate contextual data. The results identify prematurity clusters and show that prematurity disparity is mainly based on spatial disparity of socio‐economic disadvantage and on the situation of isolation of central Morvan. This work should cause interventions to be carried out within these areas to improve or compensate their risk factors

This is the story of a project to connect the resources of a university to the struggles of a group of Congolese asylum seekers in the city of Derby. It represents a case study of a whole process: this includes a specific project established to explore how a university might fulfil its stated goals of being closely anchored in the local and regional community; and how it might engage and marshal its resources to provide educational and maybe research opportunities, while giving priority to community-based projects that tackle social disadvantage. The thesis is made up of a number of overlapping elements: there is the story of the project itself, of why the University became involved, and the nature of the interaction with a particular community, as seen through the eyes of some of the Congolese and me the project coordinator/researcher. It includes my struggles to establish a steering committee with the Congolese and the creation of a range of educational/recreational resources to help members of a community manage the difficult, stressful and even traumatic processes of asylum. The project led to the establishment of a community association and various initiatives to dialogically engage with the community and gather diverse narratives. Finally it led to various outcomes leading to what might be a ‘Reconnecting the hearts and minds’ project, that created spaces for story telling for a number of women and men migrants. The project also included an evaluation, which developed at its core, into a collection of narratives chronicling the difficult processes of forced migration, where people experience the pain of family separation, the dislocation of landing in a foreign country. A country whose language was different, whose customs were strange and where the processes of claiming asylum could be alienating, and where racism is experienced. We can call this project and its evaluation a piece of action research with a series of narratives at its heart. The project and evaluation together raise questions about the role of creative activity and narrative in managing painful transitions. There is another story within the bigger one, however, a story of a project coordinator and his relationship with the community and the University of Derby ... of initial enthusiasm followed by marginalisation and the closure of a supportive community development unit in the University; and of the placement of this role, for want of a better home, in the marketing department. This is also a narrative of registering for a doctorate, of being rejected, and of seeking to think through, with the help of others, what a good enough doctorate might entail. The end product has become a process of auto/biographical narrative reflexive research in which the narratives of the migrants intertwine with the researcher’s own; around the themes of dislocation, and of the struggles for voice and agency. The basic threads of the study are of a dislocating experience, and of how resources of hope can be found in creative activity – whether a sewing class, telling stories, fashion shows or engaging in auto/biographical narrative reflexivity. The basic argument has to do with tokenism and the disrespect that can surround university civic engagement as well as how asylum seekers are treated callously more generally; but also how resources of hope can make a difference. There is also the troubling issue of voice in research and whose story really counts; of a white, middle class male engaging with distressed women migrants, and of what might have been a silencing of the women concerned. But through values of commitment, and of learning to listen, the project became more dialogical, as evidenced in the women’s stories.

This thesis explores the experiences, encounters, responses and reactions to Islamophobia through a narrative study of forty female Pakistani and British students with a Pakistani heritage in universities across England. In exploring Islamophobia as a ‘racialised’ phenomenon, the participant narratives locate the experiences and encounters of Islamophobia within their ‘intersubjective’ realities, across various ‘communities’ of ‘discourse.’ These realities are informed by the wider socio-political milieu of a war against Al Qa’ida and its affiliates that ‘securitizes’ the Muslim and Pakistani identity(s) particularly in Britain. The university is also implicated in the counter terrorism agenda of the state, depicted as a ‘vulnerable’ space for radicalizing students. However, females in this discussion are predominantly absent within the academic and public narratives. Therefore, this research will explore the experience of Islamophobia, the way it is perceived by the British/Pakistani/Muslim/female student, and the way students respond and react to it within the university. The research employs a narrative method of inquiry. The narrative analysis is informed by a Bakhtinian notion of ‘dialogics’ to explore the multiplicity of ‘meanings’ that emerge through individual accounts of Islamophobia located within their public and private realms. In exploring these narratives the thesis illustrates how ‘degrees of religiosity’ influences encounters and experiences of Islamophobia, and highlights responses and reactions of students to such experiences, that include individual and group activism to challenge Islamophobia and the insecure meta-narrative about Muslims and terrorism. The research further focuses on both the religious identity of the Muslim student, and their problematic ethnic identity, Pakistani demonstrating how in a securitized socio-political milieu Muslim students are further vulnerable to experiences of Islamophobia, in the form of Pakophobia, where both their religious and ethnic identities are held suspect. These narratives have implications for the emerging understanding of Islamophobia as a ‘racialised’ phenomenon. They further have implications for universities that are encouraged to participate in the government’s counter-terrorism agenda. The narratives by locating the research within the particularities of a wider socio-political milieu that ‘racialises’ and ‘securitizes’ Muslims raises critical questions about the nature of discrimination in a post 9/11, 7/7 era that may have repercussions for other Muslim minority groups.

This thesis is primarily concerned with the distribution of quotas in higher education and public employment within identified beneficiary groups. In a system of quotas based on preferential treatment of groups, the question about which members of the group must benefit over others is a crucial one. One of the main themes in the thesis is to critically analyse the judicial understanding about the nature of these groups. The homogeneity (in backwardness) that is attached to beneficiary groups in differing degrees is challenged in the thesis using the examples of Scheduled Castes and Muslims within the Other Backward Classes category. The differences within beneficiary groups have great significance for the fairness of India’s reservation policies. By ignoring internal differences, the most marginalised groups are left behind in terms of accessing the benefits of reservations. I have argued that any attempt to address the issue of sub-classification must begin by recognising multiple axis of marginalisation within the framework of intersectionality. This lack of sufficient engagement with the issue of sub-classification highlights the failure of the Supreme Court of India to develop a normative framework within which reservations might be viewed. This lack of normative clarity informs spheres of reservations like higher education and public employment along with according homogenous treatment to beneficiary groups internally. The Supreme Court has viewed reservations in higher education and public employment as essentially performing the same function. I have argued that reservations in these spheres perform different functions and the resulting obligations on the state in terms of constitutional justifications must also differ. While the demands for sub-classification present an opportunity to make distribution of reservations fairer, it also exposes the limitation of reservations as a tool of social transformation.

Across the world, women constitute the bottom segments of the informal labour market hierarchy, and the story is no different for Turkish women, except they are further constrained by a patriarchal family culture and corporatist welfare state structure which favours high-skilled workers in full-time employment. A reading of the literature on the reasons for participating in the informal sector suggested that workers either end up in the informal sector as a result of structural factors, such as high unemployment, horizontal and vertical labour market discrimination and limited job opportunities for the low-skilled and low-educated, or they actively chose to participate in the labour market to seize the opportunities it provides, such as evading tax and/or bureaucratic costs, or testing out business ideas. However, this dichotomous understanding provided little scope, if any, to understand why women also entered the informal sector, in ever growing numbers and what the gender-specific constraints and opportunities in the informal sector are. Against this background, this thesis aims to show that this dichotomous theorisation of the informal sector is an exaggeration of reality, and that women workers position presents a middle ground, in which they recognise the constraints on their ability to improve their lives but they are also not powerless. Hence, by focusing on the variety of survival strategies used by women workers in the informal sector, the thesis attempts to show the choice among these strategies, including the conditions in which these strategies can be adopted and the barriers to do so.

This thesis focuses on the education of secondary school pupils who are socially disadvantaged. It presents the phenomenon of social disadvantage in the context of education and current legislation. It also describes the current situation and the causes of social disadvantage, particularly the role of the family, and also focuses on pupils and their families from socially excluded localities. A significant amount of space is dedicated to descriptions of the manifestations of social disadvantage in school, the diagnosis of social disadvantage, and the specific education of socially disadvantaged pupils, especially the principles of such education. The goals of this thesis are to demonstrate the effect of social disadvantage on secondary school pupils and to highlight possible solutions to this phenomenon within the education system, the possibilities for support in education, and the role of the school social worker in eliminating the impacts of social disadvantage in education. The thesis also contains case histories of socially disadvantaged female pupils as a demonstration of the professional and important work of the school social worker. KEYWORDS education, social disadvantage, socially disadvantaged pupils, secondary school, social exclusion, school social worker

The diploma thesis "Issue of integrating children from socially disadvantaged ambience to nursery school" deals with the inclusive process of children from the socio-economically disadvantaged environment placed to nursery schools. The thesis describes the legislative framework of inclusion and the social environment of the Czech society. This work also deals with the Roma community, which makes up a large proportion of people with socio-economic disadvantage. It defines the role of the teacher in the inclusion of children from a socially disadvantaged environment and the position of the teacher assistant. The research part deals with the inclusive process of specific children at nursery school in the city with high unemployment. It also monitors the approach of individuals involved in the inclusive process and suggests possible changes that could lead to its improvement.

This thesis deals with the possibilities of development of partial functions in socially disadvantaged children of younger school age. The theoretical part introduces basic characteristics of children of younger school age, social disadvantage, and impacts of environment on education; partial functions, their diagnostics, and deficits in such functions. It also presents specific learning disorders and behaviour disorders as well as selected options of support for socially disadvantaged children. The practical part presents the results of the research focused on the situation of socially disadvantaged children of younger school age within the context of possibilities of development of their partial functions. The qualitative research was processed using the grounded theory method, while the methods of data collection included interview, observation, and analysis of document. The key elements found were the exhaustion of parents of socially disadvantaged children and transferring of responsibility for the education process to the child. The conclusion of the thesis contains practical recommendations for work with families with children in connection with the education of socially disadvantaged children and the possibilities of supporting their development.