This Bachelor thesis discusses the process of decision-making and the actors involved in the negotiations of the Channel Tunnel. The Channel Tunnel Fixed link is situated between France and the UK, the interconnected region forms the Transmanche region. The Channel Tunnel is an infrastructure that has not just brought and further integrated both sides of the Channel but has become an important asset for connecting the UK to the rest of Europe. In 2016 it was announced that the UK would leave the EU, the previous agreements surrounding the infrastructure of the Channel Tunnel fixed link needed to be renegotiated. This research uses the theoretical framework of Multi-Level Governance to analyse what are the decision-making process that took place during the negotiation of the Channel Tunnel fixed link. The research uses qualitative method, it focuses on the Qualitative Network Analysis to analyse the levels of governance the actors belong to. The research has determined that the decision-making process is both very structured and fixed, yet the UK influenced the outcome of the decision-making by demanding the withdrawal of the EU in the negotiations. Overall, the final policymaking process was the result of centralised decisions being taken at the level of the state in France and in the UK, which may create gaps in representing the interests of actors at the microlevel (locally or within the regions), and at the macrolevel (Other EU member states).

Peripheral blood biomarkers can inform clinical care and drug development. Establishing causality between biomarker and disease is often critical for such applications, but epidemiological studies are limited due to biases from confounding and reverse causation. Mendelian randomization analysis leverages random inheritance of genetic variants at conception to mimic properties of randomized studies and estimate unconfounded effects between biomarker and disease, or vice-versa. This thesis demonstrates the utility of Mendelian randomization as a complementary tool to elucidate observational studies, predict drug safety and repurposing opportunities, and improve diagnostic biomarkers for cardiometabolic diseases. First, we characterized the hypothesized relationship between lipoprotein(a) and atrial fibrillation. We demonstrated both observed and genetically predicted lipoprotein(a) levels were associated with higher risk of atrial fibrillation across multiple independent cohorts. Importantly, risk was partly mediated independent of atherosclerotic cardiovascular disease, a known consequence of elevated lipoprotein(a) and itself a risk factor for atrial fibrillation. Next, we explored the lifelong effects of endogenous testosterone across a comprehensive set of 461 health outcomes in 161,268 males from the UK Biobank cohort. Using Mendelian randomization analysis, we found higher testosterone had beneficial effects on body composition and bone mineral density but adverse effects on prostate cancer, androgenic alopecia, spinal stenosis, and hypertension. Finally, we applied Mendelian randomization with the intention of discovering biomarkers caused by disease, which are expected to represent markers of early disease. As a proof-of-concept, we applied this framework to identify biomarkers associated with genetic predisposition to kidney function among 238 biomarkers measured in the ORIGIN trial. We discovered reduced kidney function caused increased trefoil factor 3 and showed its addition to models with known risk factors improved discrimination of incident early-stage chronic kidney disease. Taken together, Mendelian randomization identified biomarkers that warrant further study, with promising implications for screening, prevention, and treatment of different cardiometabolic diseases. / Thesis / Doctor of Philosophy (PhD) / Biological markers associated with disease can inform novel therapeutics or diagnostics but distinguishing causation from correlation is challenging. Mendelian randomization – a technique that leverages random inheritance of genetic variation to infer causality – was used to examine the role of biomarkers in cardiometabolic diseases. First, we implicated lipoprotein(a) as a risk factor for atrial fibrillation that acts independent of atherosclerotic cardiovascular disease. Second, we comprehensively characterized the lifelong effects of testosterone on health outcomes in males, where we found evidence of both beneficial and adverse effects on disease. Finally, we discovered trefoil factor 3 as a diagnostic marker for early-stage chronic kidney disease. Altogether, this thesis demonstrated different applications of Mendelian randomization that showcase its utility as a complementary tool to reveal causal biomarkers, and served to identify biomarkers for cardiometabolic diseases that merit further studies to evaluate their potential benefit on patient care.

No / Dementia is said to be under-recognized and sub-optimally managed in primary care, but there is little information about actual processes of diagnosis and clinical care. To determine general practitioners' concordance with clinical guidelines on the diagnosis and management of patients with dementia. Design: Unblinded, cluster randomized pre-test-post-test controlled trial involving 35 practices in the UK. METHODS: Patients with a diagnosis of probable or confirmed dementia were identified in practices, and permission sought from the older person and/or their carer to study the medical records of these patients. Medical records were reviewed using a data extraction tool designed for the study and based on published guidelines, and unweighted scores for diagnostic concordance and management concordance were calculated. RESULTS: We reviewed 450 records of patients aged 75 and over with a diagnosis of dementia and found that: only 4% of cases were identified first in secondary care; two-thirds of those identified in primary care were referred immediately; about one-third identified had informant history and blood tests documented at the Index consultation and one-fifth underwent cognitive function testing. DISCUSSION: The records analysed in this study came from a period before the Quality Outcomes Framework and show that the documentation in primary care of the diagnostic process in dementia syndromes is good, although there were significant gaps, particularly around depression case-finding. Information about management processes were less evident in the records.

No / Current literature has indicated a concern about standards of maternity care experienced by pregnant women who are seeking asylum. As the next generation of midwives, it is important that students are educated in a way that prepares them to effectively care for these women. To understand how this can be achieved, it is important to explore what asylum seeking means to midwifery students. This article is the first of three parts and reports on one objective from a wider doctorate study. It identifies dominant discourses that influenced the perceptions of a group of midwifery students' about the pregnant asylum seeking woman. The study was designed from a social constructivist perspective, with contextual knowledge being constructed by groups of people, influenced by underpinning dominant discourses, depending on their social, cultural and historical positions in the world. In a United Kingdom University setting, during year two of a pre-registration midwifery programme, eleven midwifery students participated in the study. Two focus group interviews using a problem based learning scenario as a trigger for discussion were conducted. In addition, three students were individually interviewed to explore issues in more depth and two students' written reflections on practice were used to generate data. Following a critical discourse analysis, dominant discourses were identified which appeared to influence the way in which asylum seekers were perceived. The findings suggested an underpinning ideology around the asylum seeker being different and of a criminal persuasion. Although the pregnant woman seeking asylum was considered as deserving of care, the same discourses appeared to influence the way in which she was constructed. However, as the study progressed, through reading alternative sources of literature, some students appeared to question these discourses. These findings have implications for midwifery education in encouraging students to challenge negative discourses and construct positive perceptions of asylum seeking.

Yes / Objectives. Coeliac disease (CD) is an autoimmune condition managed by a lifelong therapeutic gluten-free diet. Previous research suggests that the chronicity of CD, the limitations imposed by the gluten-free diet, and the risk of other associated diseases can have a negative impact on health-related quality of life (HRQoL) and psychological well-being. The aim of this study was to explore the illness perceptions and self-efficacy beliefs of adults with CD in the United Kingdom and to report their subjective levels of HRQoL and psychological well-being. Design. The study employed a cross-sectional postal questionnaire design. Method. Participants (n= 288) were adults with CD recruited via Coeliac UK. Measures of well-being, HRQoL, self-efficacy, illness perceptions, and dietary self-management were analysed. Preliminary descriptive and univariate procedures were employed before bivariate tests of association or difference were carried out. Backward stepwise multiple regression analysis was used to investigate the predictive strength of variables on well-being, quality of life, and self-efficacy. Logistic regression was used to look at the influence of variables on adherence. Results. Results indicate that HRQoL and psychological well-being were comparable to those found in previous related studies. Participants with weak beliefs in the serious consequences of CD and poorer emotional reactions to the condition had a greater likelihood of having enhanced HRQoL, improved psychological well-being, and higher self-efficacy. Strong beliefs in personal control and a greater perceived understanding of CD were associated with greater self-efficacy. Conclusions. Perceived self-efficacy and illness perceptions could play a role in informing psychological interventions for individuals with CD.

No / This paper utilises computerised textual analysis to explore the extent to which both firm and country characteristics influence mandatory and voluntary risk reporting (MRR and VRR) variations both within and between non-financial firms across Germany, the UK and the US, over the period from 2005 to 2010. We find significant variations in MRR and VRR between firms across the three countries. Further, we find, on average, that German firms tend to disclose significantly higher (lower) levels of risk information mandatorily than UK (US) firms. German firms, on average, tend to reveal considerably higher (lower) levels of VRR than US (UK) firms. Our results document that MRR and VRR variations are significantly influenced by systematic risk, the legal system and cultural values. We also find that country and firm characteristics have higher explanatory power over the observed variations in MRR than over those in VRR.

No / Manuscript Type: Empirical Research Question/Issue: This paper examines the influence of corporate governance on risk disclosure practices in the UK and Italy and also studies the impact of those practices on market liquidity. Research Findings/Insights: We find that governance factors principally influence the decisions of UK (Italian) firms over whether to exhibit risk information voluntarily (mandatorily) in their annual report narratives. When we distinguish between firms with strong and weak governance (in terms of board efficiency) in each country, we find that the factors that affect mandatory and voluntary risk disclosure appear to be driven more by strongly governed firms in both countries. Furthermore, strongly governed firms in the UK tend to provide more meaningful risk information to their investors than weakly governed firms. In Italy, however, we find that strongly rather than weakly governed firms exhibiting risk information voluntarily rather than mandatorily improves market liquidity significantly. Theoretical/Academic Implications: This paper emphasizes the importance of distinguishing between mandatory and voluntary risk disclosure when studying the impact of corporate governance. Our findings differ across strongly and weakly governed firms, in terms of both the factors that influence risk disclosure practices and the exact informativeness of those practices. Practitioner/Policy Implications: The results support the current regulatory trend in risk reporting within the UK that emphasizes the importance of directors and encourages rather than mandates risk disclosure. However, the results generally signal a need for further improvements in the Italian context. Our evidence also supports the value of the confidence in the UK governance system, compared to that in Italy, which motivates British firms to provide highly informative risk information more often than Italian firms.

No / During the micro-excavation of the cauldrons, residues were identified which appeared different from the surrounding soil and metal corrosion products. Thirty-seven of these residues from nine cauldrons and two significant fragments of incomplete cauldrons were analysed by gas chromatography-mass spectrometry (GC-MS) along with two samples of soil from the micro-excavation for comparison. The aim of the analysis was to determine whether these residues contained any organic material related to the use of the cauldrons, specifically lipids (fats, waxes, resins etc.) from the preparation of food or drink. Two of the samples from the cauldrons were also sent for compound specific carbon stable isotope analysis by gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) to give a more precise identification of the residues.

In dieser Doktorarbeit werden zwei Konzepte der Quanteninformationsverarbeitung realisiert. Der Quantenschlüsselaustausch ist revolutionär, weil er perfekte Sicherheit gewährleistet. Zahlreiche Quantenkryptografieprotokolle wurden schon untersucht. Zwei Probleme bestehen. Zum einen ist es sehr schwer, die Bedingungen herzustellen, die in den Annahmen für perfekte Sicherheit impliziert sind. Zum anderen sind die Reichweiten auf momentan etwa 200 km begrenzt, aufgrund des abnehmenden Signals gegenüber des konstanten Rauschens. Ein Experiment dieser Doktorarbeit beschäftigt sich mit dem ersten Problem. Insbesondere der übertragene Quantenzustands ist kritisch für die Sicherheit des Verfahrens. Es werden Einzelphotonen von Stickstoff- Fehlstellen-Zentren und zum ersten Mal von Silizium-Fehlstellen-Zentren für einen Quantenschlüsselaustausch mit Hilfe des BB84-Protokolls benutzt. Die Abweichung von idealen Einzelphotonenzuständen sowie deren Bedeutung für die Sicherheit werden analysiert. Die Übertragung von Quantenzuständen via Satellit könnte das Problem der begrenzten Reichweite lösen. Das neue Frequenz-Zeit- Protokoll eignet sich dafür besonders gut. Es wird während dieser Arbeit zum ersten Mal überhaupt implementiert. Umfangreiche Untersuchungen inklusive der Variation wesentlicher experimenteller Parameter geben Aufschluss über die Leistungsfähigkeit und Sicherheit des Protokolls. Außerdem werden elementare Bestandteile eines vollautomatischen Experiments zum Quantenschlüsselaustausch über Glasfasern in der sogenannten Time-bin-Implementierung mit autonomem Sender und Empfänger realisiert. Ein anderes Konzept der Quanteninformationsverarbeitung ist die Herstellung zufälliger Bitfolgen durch den Quantenzufall. Zufällige Bitfolgen haben zahlreiche Anwendungsgebiete in der Kryptografie und der Informatik. Die Realisierung eines Quantenzufallszahlengenerators mit mathematisch beschreibbarer und getesteter Zufälligkeit und hoher Bitrate wird ebenfalls beschrieben. / In this thesis, photonic quantum states are used for experimental realisations of two different concepts of quantum information processing. Quantum key distribution (QKD) is revolutionary because it is the only cryptographic scheme offering unconditional security. Two major problems prevail: Firstly, matching the conditions for unconditional security is challenging, secondly, long distance communication beyond 200 km is very demanding because an increasingly attenuated quantum state starts to fail the competition with constant noise. One experiment accomplished in this thesis is concerned with the first problem. The realisation of the actual quantum state is critical. Single photon states from nitrogen and for the first time also silicon vacancy defect centres are used for a QKD transmission under the BB84 (Bennett and Brassard 1984). The deviation of the used single photon states from the ideal state is thoroughly investigated and the information an eavesdropper obtains due to this deviation is analysed. Transmitting quantum states via satellites is a potential solution to the limited achievable distances in QKD. A novel protocol particularly suited for this is implemented for the first time in this thesis, the frequency-time (FT) protocol. The protocol is thoroughly investigated by varying the experimental parameters over a wide range and by evaluating the impact on the performance and the security. Finally, big steps towards a fully automated fibre-based BB84 QKD experiment in the time-bin implementation with autonomous sender and receiver units are accomplished. Another important concept using quantum mechanical properties as a resource is a quantum random number generator (QRNG). Random numbers are used for various applications in computing and cryptography. A QRNG supplying bits with high and quantifiable randomness at a record-breaking rate is reported and the statistical properties of the random output is thoroughly tested.

In this thesis I explore the attitudes, arguments, and actions of British political elites in connection with the development of human rights law in Europe and the UK. I do this by examining British input into five key episodes for the development of European supranational rights and their incorporation into domestic legal orders (namely the drafting of the European Convention on Human Rights 1950, the drafting of the European Social Charter 1961, the acceptance of individual petition in 1966, the failed 1970s Bill of Rights debate, the passing of the Human Rights Act 1998, and recent developments such as the UK ‘opt-out’ to the EU Charter of Fundamental Rights, and the emergence of a new ‘British Bill of Rights’ debate). Casting light on British involvement in less examined periods in European rights development, I challenge existing, isolated, explanations for the more focal episodes (such as Simpson’s rational-choice post-colonial thesis for individual petition acceptance, and ideological accounts for New Labour’s post-1997 constitutional reform). Responding to the most recent literature in the area, central to my analysis is the question of how rights progress relates to inter-party conflict. By considering continuities and discontinuities in elite political discussion of rights I argue that while conflict is a significant underlying feature of every major episode of rights progress during the last sixty years, and is less evident in less progressive periods, other factors have had a greater influence over the form, timing, and extent of rights progress. Most significant amongst these is the constitutional ideological development of the Labour party and the critical connection between Labour’s elevation of the Convention within the UK constitutional space and revisionist shifts in party thinking.