Contemporary English health policy is saturated with claims about what the world is like and how it might be otherwise. These claims span the wide range of subject matters covered by health policy, from hospital waiting times to our preparedness for major disease outbreaks; from structures for the planning and purchasing of healthcare to requirements around the sharing of patient records. Despite this, empirical studies of health policymakers working at the national level in the UK suggest that research evidence plays only a very limited role in policy development (Lavis et al. 2005; Dash 2003; Dash et al. 2003; Innvær et al. 2002; Petticrew et al. 2008). This apparent contradiction was the starting-­‐point for this project. If civil servants are not drawing on research knowledge in their work, how is it that they are able to devise policy about such complex and technical policy issues? Policy-­‐making requires knowing the world in some way in order to act upon it. My research asks, what kinds of knowledge are civil servants in England’s Department of Health using in their work, and what forms does this use take? This thesis is situated in an emerging field of interpretive policy analysis which treats policymaking as realised in the daily work practices of communities of individuals (Wagenaar & Cook 2003; Wagenaar 2004; Colebatch 2006; Colebatch et al. 2010; Freeman et al. 2011). I have adopted an ethnographic approach, conducting 60 hours of original data collection in the form of interviews and meeting observations among mostly mid-­‐ranking civil servants working on various high-­‐profile health policies in 2010-­‐11. By analysing my fieldwork experiences and the resulting data, and by relating these to insights from theoretical resources in sociology, psychology and philosophy, I offer an account of the different forms of knowing and knowledge entailed in the practice of policy-­‐making. I identify three forms of knowledge and knowing that were integral to the work of the civil servants I studied: the ‘practices of knowing’ by which they came to understand the objects of their policies and think through the possibilities for their reform; the ‘pragmatic use of knowledge claims’ in which facts, figures and stories were invoked to generate support for policies and to defend decisions taken; and the ‘know-­‐how of policymaking’, which was the most important form of knowledge for the civil servants’ professional identities. In the conclusion, I reflect on the aspects of knowledge and knowing which are shared by the civil servants’ practices and my own work in producing this thesis.

Systematic reviews and meta-analyses have been a central pillar of evidence-based practice and policy-making in healthcare over recent years. Traditionally, this has focused on effectiveness evidence from trials.. There is increasing understanding, however, that other study designs also provide essential information and this has led to interest in developing ways to review and synthesis such evidence. Qualitative research has unique potential to illuminate the patient experience. This research has three aims: 1) To review and compare the proposed methods of systematic review and synthesis of qualitative research. 2) To develop and assess two methods of systematic review and synthesis of qualitative research. 3) To compare these two methods and suggest how they might be used in a policy-making context. In addressing these aims, this thesis substantially contributes to debates about the purpose and practice of systematic review and synthesis of qualitative research, particularly in the context of health technology assessment and related pOlicy-making. I undertake a unique critical comparison of the methods suggested for reviewing and synthesising qualitative research, based on their approach to key stages of systematic review. This is used to produce a comprehensive framework for good practice~ I use the framework in two systematic reviews, one about heavy menstrual bleeding using meta-ethnography, and one about hysterectomy using meta-study. These two reviews allow a comparison of the two methods, and in particular explore the impact of expanding the meta-ethnography approach through meta-study, which adds explicit steps to assess the impact of study methodology and theory on findings. The ability of meta-study to unpack the procedures and theories that produce particular findings is key and illuminates the importance of theory in systematic reviews of qualitative research. Through the two systematic reviews, my thesis also contributes to understanding of these reproductive health topic areas through the creation of new insights and concepts from the synthesis. The synthesis of heavy menstrual bleeding studies produced a detailed patient illness model based on women's experiences. In addition, it allowed an understanding of elements that contribute to women's certainty or uncertainty about whether or not their periods could be seen as problematic and requiring medical help. This helps to establish the limitations of the medical model for doctors, as well as women who suffer from heavy menstrual bleeding. The synthesis of hysterectomy studies produced a detailed description of the journey that women make to, and through, hysterectomy, based on their experiences. I also created a theoretical framework, which shows that hysterectomy needs to be understood in the context of personal, physical experiences, together with sociocultural forces that affect the way in which hysterectomy is experienced, and that the interaction of these micro- and macro-concerns mediate through, and affect, relationships with key other people. Methodology affected the research questions posed and the conclusions of research. Comparing the two methods of review and synthesis showed the importance of taking account of the methods and theories that produce research findings. However this additional detail may be at the expense of certainty and requires additional resources.

It is conventional to argue that the autonomy and reputation of regulatory agencies depend on their expertise. Yet the studies on how independent regulatory agencies (IRAs) create and deploy their knowledge capacity are few and far apart. Normatively, the justification for delegating decision-making powers to IRAs is that they operate by using technical analysis and expertise rather than political considerations. But yet again, although delegation has been discussed as a design principle, systematic evidence on the conditions under which IRAs make use of knowledge and how is still scarce. The literature on knowledge utilization portrays a rather complex link between expertise and policy, where relevant knowledge is not always reflected in policy outcomes and plays several functions besides facilitating the solution of policy problems. Unfortunately, scholars of IRAs have not exploited the insights of this literature yet. This dissertation addresses the under-explored question of the usage of economic knowledge by IRAs. We identify four possible uses of expertise: instrumental (i.e., to solve problems); strategic (e.g. to advocate a position); symbolic (e.g., to gain legitimacy), and non-use. Our aim is to explain under which conditions a certain usage is more likely to occur. To do so, we draw on the methodological device of explanatory typologies (Elman 2005). Specifically, we select two explanatory dimensions that reflect both the context and the content of policy: the level of conflict in the policy arena, and the degree problem tractability. We use different combinations of these two dimensions to derive four hypotheses on the possible uses of expertise mentioned above. The elusive nature of knowledge utilization makes the identification and measurement of these different usages highly dependent on an in-depth understanding of the institutional, organisational, and political context in which a regulatory decision is taken. We have thus opted for a qualitative approach based on case studies and process tracing (Bennett 2010; Brady 2010; Freedman 2010) to appraise the four hypotheses. Empirically, we performed three case studies on regulatory policy decisions taken by the UK Office of Communications (Ofcom) between 2005 and 2010. We find that, given certain scope conditions, the prevalent use of economic analysis is instrumental - a finding that contradicts previous research that labelled instrumental learning as extremely rare, if not a sort of technocratic utopia. Other uses still exist however, and given other scope conditions regulators can be strategic and symbolic in their approach to knowledge and expertise. This is not surprising if we accept the notion that regulators operate in a policy environment that is eminently but not exclusively technical: to survive in a (at least partially) political environment, regulators have to deploy usages of knowledge that deviate from the instrumental type.

Ce travail explore le rôle des enjeux environnementaux dans les transformations de l'action publique urbaine.Basé sur quatre études de cas (Nantes et Saint-Étienne en France, Leicester et Manchester au Royaume Uni),il analyse l'émergence des questions environnementales sur les agendas urbains et leur influence sur latransformation des politiques urbaines et des modalités de gouvernement des villes. En croisant lesperspectives théoriques de la sociologie de l'action publique et des travaux portant sur le gouvernement desvilles et l'économie politique urbaine, cette thèse montre que trois emblèmes se sont succédé dans la gestionurbaine de l'environnement : l'emblème "écologie urbaine" avec son cadrage militant dans les années 1970et 1980, l'emblème "développement durable" avec son cadrage entrepreneurial dans les années 1990 et2000 et, enfin, l'emblème « changement climatique » avec son cadrage néo-managérial depuis 2005. Cettepériodisation de la gestion de l'environnement en ville et de ses transformations souligne l'importancecroissante des villes en tant qu'échelles de régulation et de construction de la problématiqueenvironnementale. Toutefois, cette montée en puissance des villes ne s'accompagne pas du renforcementdes espaces publics locaux dans le domaine de l'environnement. Si on assiste bien à une recomposition desrapports politique/société, elle prend plus la forme d'une distanciation des liens entre élites politiques etsociétés urbaines. En participant au recentrement des activités des élus urbains sur la production despolitiques urbaines et au filtrage des acteurs considérés comme n'étant pas« responsables», les politiquesurbaines d'environnement accompagnent la mise en place de formes oligarchiques et post-démocratiques degouvernement des villes. / This dissertation provides an analysis of the influence of environ mental issues on the transformation of urbanpolicy-making. Based on four case studies (Nantes and Saint-Etienne in France, Leicester and Manchesterin the United Kingdom), it examines the rise of environ mental issues on urban agendas and its influence inthe transformation of urban policies and urban governance. Built around three main theoretical perspectives- public policy analysis, urban political science and urban political economy -, this work shows that urbanenviron mental management has been shaped by three different emblems : the emblem of« urban ecology »with its grass roots frame in the 1970s and 1980s, the emblem of « sustainable development » with itsentrepreneurial frame in the 1990s and 2000s, and, finally, the emblem of « climate change » with its newmanagerial and control frame since 2005. This periodisation of urban environmental management stressesthe rise of cities as prominent scales of environ mental regulation and construction. However, this rise has notbeen synonymous of a strengthening of local public spaces around environ mental issues. It is argued thatthe reshaping of state/society relationships has led ta a gap between urban political elites and urbansocieties. By helping ta reshape political elites' activities towards the production of urban policies and tamarginalise actors who are not considered as «responsible», urban environmental policies have supportedthe roll out of oligarchie and post-democratie patterns of urban governance.

M.A. / The central problem this research addresses is to establish if the Presidential Public Participation Programme (izimbizo/imbizo) constitutes a form of participatory policy analysis and policy evaluation as proposed in the general policy literature. The izimbizo programme is uniquely suited to meet the requirements of the (South) African context. Post-positivism provides a different approach through policy analysis, especially in relation to valuative and normative approaches. The research is furthermore applied, as it seeks to improve the application and existing practice around organising the izimbizo. The research proposes the extension of the use of the programme beyond that of merely a communication tool, into the realm of the policy process. The objectives of this dissertation were to provide an overview of the concept of izimbizo as a deliberative approach to policy making, focusing particularly on the evaluation process. The research systematically explores how the izimbizo is operationalised. It provides an overview of the international trends and international examples of successful participatory methods. Consideration is given as to how information at different stages of the policy cycle may be used for improving policy making. The research further explores existing research on public participation as well as the theory regarding deliberative approaches as a more recent mechanism for policy analysis in a democratic milieu. The benefits as well as limitations to using the izimbizo as a deliberative approach in the policy process as well as in policy monitoring and evaluation in general are explored. The study also provided a strong case for developing a clear social contract through the use of participatory programmes such as the izimbizo in order to develop citizenship and to create a positive role for sophisticated accountability.

Emotional labor is the unpaid and often unnoticed emotion work that foremost women carry out, not only in the home life but at the workplace as well. Emotional labor is highly associated with femininity according to previous research and often involves being attentive to others, creating a good ambiance, and to be warm and caring. From previous studies, it is implied that emotional labor creates stress as women often have to manage other people’s emotions as well as their own and that there is an expectancy on women to do so. What is implied from those circumstances in relation to work life is that the opportunities for women to climb the work ladder decreases, as women perform emotional labor in addition to, or instead of, their regular work tasks. There is no previous research to be found on what type of impact emotional labor has on women in leading positions, or on female leaders in the private sector in Sweden. The main purpose of the thesis is to find how emotional labor impacts female leaders in their leadership role and to find how widespread emotional labor is amongst companies in the Swedish private sector. We aim to shed light on the often unnoticed, or invisible, emotion work foremost women perform in their workplaces, which leads to the research question: What impact does emotional labor have on women in their leadership role? The theoretical framework is mainly based on previous research on emotional labor and leadership theories. Carefully chosen theories on expectations in male and female leadership are added to broaden the background. Further, facts on gender equality are provided as support. The chosen research method for the thesis is qualitative with an exploratory research design and an inductive approach. In line with the chosen method, semi-structured interviews were conducted with 12 participants from a purposive, homogeneous sampling. The interviews were further transcribed, analyzed and presented through a thematic analysis. The key findings imply that emotional labor is highly present among women in leadership positions. The findings imply that emotional labor is expected from women to perform, although not outspoken. Further, the findings imply that there is different expectations on leadership and leadership style from the employees, the board and the leaders themselves. With an expectancy from employees to lead with an emotional leadership, an expectancy from the board to lead to make results and a confusion in their own leadership, it will lead to stress in the leaders too. The conclusion of the thesis is: Women are affected by emotional labor in their leadership role as they feel an obligation to perform it, while still not doing it too much since that would, according to expectations from society, present them as poor leaders. If they, on the other hand, do not perform any emotional labor at all, they are not considered to be team players.

The current welfare-to-work reform in Britain is activating lone parents with older children and marks a step-change in the treatment of lone parents. While there has been some support for using age of child as selection criterion for the activation of lone parents, it is not clear whether this equates to selecting by ‘ability to work’ if interpreted as ability to obtain a job. The commitment of the current government to evidence-based-policy-making and the large amount of research available in this area form the justification for carrying out a policy appraisal of this aspect of the current welfare-to-work reform. The potential and likelihood to make substantial progress towards the lone parent employment and the child poverty target of the selection criteria will be assessed and compared to alternative approaches. Five selection models are identified in the international policy review: selection by age of child, transition status, employability or by caseworkers and finally, a voluntary model. The analysis is based on a critical discussion of the available evidence, an international policy review and secondary analysis of the Families and Children Study. I argue that the current approach of selecting lone parents by the age of child is unlikely to result in substantial progress towards the lone parent employment target and instead likely to create a substantial group of long-term unemployed lone parents. Alternative approaches, such as using different selection criteria that take into account the employability of lone parents are more likely to make progress towards the employment and child poverty target.

Made available in DSpace on 2017-07-21T20:31:52Z (GMT). No. of bitstreams: 1 Silvana Stremel.pdf: 989270 bytes, checksum: 8ac8adbfa7750f0b2bd33a8ddc118cdf (MD5) Previous issue date: 2011-02-08 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work presents an analysis of the process whereby the policy called as Cycles of Learning (a kind of non-retention policy for Primary Education) was recontextualised and formulated in Brazil. The aims of the research can be described as follows: a) to analyse how the Cycles of Learning policy has been recontextualised and justified in Brazilian state schools that have adopted it; b) to explain historical aspects as well as the bases of the policy known as Cycles of Learning; and c) to analyse to what extent the proposals of the Cycles of Learning are related to the building of a truly inclusive and democratic education system. The theoretical basis of the research includes: contributions from Bernstein (1996, 1998) on the concept of recontextualisation of the pedagogical discourse; authors who provide the basis for the role of school and the building of an inclusive and democratic education system (APPLE, 2001; BELLONI, 2003; CAMINI, 2001; YOUNG, 2007); and authors who discuss the policy of cycles (BARRETTO; MITRULIS, 1999; BARRETTO; SOUSA, 2005; FREITAS, 2003; MAINARDES, 2007, 2009; PERRENOUD, 2004). The research consisted of the analysis of official documents from seven teaching networks (municipal education systems) that have adopted the Learning Cycles method (Curitiba-PR, Ponta Grossa-PR, Recife-PE, Salvador- BA, São Luís-MA, Telêmaco Borba-PR and Vitória da Conquista-BA). The results indicate that: a) teaching networks have been recontextualising the Cycles of Learning policy according to local contexts, political and ideological contexts, concepts and experiences from cycles of other networks etc.; b) in all networks studied the implementation of Cycles of learning aimed to provide an inclusive and democratic education system; c) the implementation of the Cycles of Learning resulted in a process whereby curriculum was restructured, and the networks analysed opted for a common curriculum; d) in general the investigated proposals were formulated without any participation or involvement of teachers and other education professionals. Furthermore, it was concluded that the analysis of initial documents of the referred networks provides elements for understanding the concept of cycle that was adopted and the general guidelines for its implementation. Nevertheless, it should be noted that in practice such guidelines are modified, reinterpreted, and recontextualised. Although the research aimed to provide a deeper look into aspects related to the origin,characteristics and bases of the Cycles of Learning, it led to the conclusion that there are still aspects in need of further investigations, namely: the bases of the Cycles of Learning policy,the variety of options and decisions taken by teaching networks to shape the policy of cycles, the impact of such cycles in the changes of pedagogical practices and in the students’ performance, and the curriculum implications of implementing schooling organised in Cycles of Learning. / Este trabalho apresenta uma análise do processo de recontextualização e formulação dos Ciclos de Aprendizagem no Brasil. Os objetivos da pesquisa foram: a) analisar como a modalidade Ciclos de Aprendizagem vem sendo recontextualizada e justificada nas redes de ensino públicas brasileiras que a adotam; b) explicitar aspectos históricos e os fundamentos da modalidade chamada Ciclos de Aprendizagem; c) analisar em que medida as propostas de Ciclos de Aprendizagem estão articuladas à construção de um sistema educacional efetivamente inclusivo e democrático. Utilizou-se como fundamentação teórica as contribuições de Bernstein (1996, 1998) sobre o conceito de recontextualização do discurso pedagógico, de autores que fundamentam o papel da escola e a construção de um sistema educacional inclusivo e democrático (APPLE, 2001; BELLONI, 2003; CAMINI, 2001; YOUNG, 2007), bem como de autores que discutem sobre a política de ciclos (BARRETTO;MITRULIS, 1999; BARRETTO; SOUSA, 2005; FREITAS, 2003; MAINARDES, 2007,2009; PERRENOUD, 2004). A pesquisa envolveu a análise de documentos oficiais de sete redes de ensino que adotam os Ciclos de Aprendizagem (Curitiba-PR, Ponta Grossa-PR, Recife-PE, Salvador-BA, São Luís-MA, Telêmaco Borba-PR e Vitória da Conquista-BA). Os resultados da pesquisa indicam que: a) as políticas de Ciclos de Aprendizagem vêm sendo recontextualizadas pelas redes de ensino, de acordo com os contextos locais, contexto político-ideológico, concepções e experiências de ciclos de outras redes, etc.; b) em todas as redes pesquisadas a implantação dos Ciclos de Aprendizagem objetivava a construção de um sistema inclusivo e democrático; c) a implantação dos Ciclos de Aprendizagem desencadeou um processo de reestruturação curricular, sendo que as redes analisadas optaram pela proposição de um currículo comum; d) em geral, as propostas de ciclos investigadas foram formuladas sem a participação e envolvimento dos professores e demais profissionais da educação. Concluiu-se também que a análise de documentos iniciais das redes de ensino oferece elementos para a compreensão da concepção de ciclo adotada e das diretrizes gerais para sua implementação. Apesar disso, deve-se levar em consideração que, no contexto da prática, essas diretrizes são modificadas, reinterpretadas e recontextualizadas. Embora a pesquisa realizada tenha buscado aprofundar aspectos relacionados à origem, características e fundamentos dos Ciclos de Aprendizagem, concluiu-se que há ainda aspectos dessa modalidade de ciclos que necessitam ser aprofundados, tais como: os fundamentos dos Ciclos de Aprendizagem, a multiplicidade de opções e decisões que as redes de ensino utilizam na configuração da política de ciclos, o impacto dos Ciclos de Aprendizagem nas mudanças da prática pedagógica e no desempenho dos alunos e as implicações curriculares decorrentes da implantação de ciclos.

This thesis adopts a governance theoretical framework to analyse and explain the complex and non-linear nature of water governance arrangements in Egypt. Drawing on empirical data collected from fieldwork with key water stakeholders in Egypt, and using a documentary analysis of the major water policy documents, the thesis examines the interplay dynamics between water agents and structures at national, regional and international levels. The work rests on the observation that water governance arrangements in Egypt have changed over the last two decades to denote an ever-growing role for non-state actors. The historic domination and monopoly of state actors in water policy decisions is no longer suitable for addressing the emerging water challenges. Consequently, the water crisis in Egypt is perceived as a governance issue that calls for the collaboration of state and non-state actors. In order to inform the ontological, epistemological and methodological basis of the thesis, the governance analytic framework is combined with theoretical insights from structure-agency accounts. By combining theoretical and empirical enquiry, this work attempts to contribute to and advance beyond the existing literature in three ways. First, it offers one of the first attempts to organise an empirical in-depth case study analysis of the water governance arrangements in Egypt using a multi-level structure-agency framework. Second, it provides a systematic examination and mapping-out of the new water governance systems in Egypt. Third, it presents a rigorous evaluation of the impact of water governance regimes at the regional and international levels on water policy decisions at the national level. Following on from the case study analysis, and guided by the developed theoretical framework, this research has concluded that the Egyptian water governance is dominated by powerful and influential government water bodies. Therefore, any attempt to change existing governance arrangements has to be very carefully planned, taking into account the interaction between water policy agents and the existing water structure. Thus, this thesis will appeal to a diverse audience, including public policy and water governance scholars as well as water experts and policy makers.

The European Union (EU) has long strived to act collectively in the face of international challenges such as poverty, hunger and state fragility beyond its borders. While the EU member states and institutions seek coherent responses to these challenges, they also have partly competing agendas. Yet there has been increasing agreement on collective action. To understand this agreement, this thesis asks how policy professionals contribute to the advocacy of policy norms for collective action between the EU institutions and the member states. The research analyses policy processes in EU development cooperation since the early 2000s. In development cooperation the EU's effectiveness has been particularly contested because of the combination of competing ideas about the EU's role and about how to achieve effective and sustainable development. The research finds that, while formal decisions about collective action remain in the hands of member states, transnational networks of policy professionals in the EU institutions, member state bureaucracies and civil society contribute to shaping the terms of debate regarding the EU's role in effective development cooperation. These network interactions, which form around institutional decision-making centres, transcend the organisational boundaries of member state bureaucracies, EU institutions and civil society organisations. These findings fill a gap in our understanding of how EU norms governing collective external action are advocated as existing research has tended to focus on how institutional structure facilitate state coordination. By concentrating on the cases of Germany and the United Kingdom and their engagement with the EU institutions, the research revises existing, dominant views on norm advocacy in EU external action: It links the previously little related concepts of norm advocacy and discursive networks to analyse the agency and scope of policy professionals in the advocacy of EU policy norms; and it provides new empirical insights into the role of these policy professionals for collective action between the EU institutions and the member states in development cooperation.