Suchergebnisse

This thesis aims to understand the political sociology of Maoist insurgency in India using a combination of disaggregated statistics and qualitative data. The vast majority of insurgent leaders are from dominant or upper caste, middle class backgrounds. Their participation in the insurgency can be understood in terms of ideology and short-term processes of mobilization. The Maoist insurgents provide a unified organizational structure for two separate sections of society. On the one hand, are untouchable or dalit landless laborers who suffer economic exploitation at the hands of higher caste landowners. On the hand are tribal or adivasi landowning cultivators whose relative autonomy has come under increasing pressure over the past two centuries as the state has established control over natural resources in their area. Their support for the insurgents does not just manifest itself from exploited untouchables' and oppressed tribals' positions in the social structure as structural theories would assume. Rather, the insurgents provide them with collective incentives in order to encourage their support. The actors at the macro and micro levels have very different reasons for participating in the insurgency. The insurgent leaders aim to capture state power through a Protracted People's War, while the objectives of supporters at the micro-level tend to be more concerned with local and short-term issues. The insurgency should be conceptualised as a state building enterprise in which the interests of supporters at all levels are served by seizing local political power and the building of a base area. The thesis demonstrates that the insurgency is expanding most rapidly in the central Indian tribal belt. I use a case study to show that not all tribal communities support the insurgents. Some oppose them, either because their interests have been harmed by the presence of the insurgents, or as a result of a variety of endogenous mechanisms. This indicates that insurgency is a more dynamic and complex process than structural and rational actor theories allow for. The thesis finishes by placing the subject of indigenous communities and insurgency in the global context. It demonstrates that, while so-called indigenous communities listed by the Minorities at Risk project amount to 4.8% of the world's population, they were involved in 43% of the intra-state conflict years listed by the Uppsala Conflict Data Program Armed Conflict Dataset between 1946 and 2010. ; This work was supported by the Economic and Social Research Council.

AbstractThis paper demonstrates that there have been three distinct waves of Maoist insurgency in India since 1947. We construct an ideal typical model of Maoist insurgency that is used to compare the roles played by local populations, insurgents, and state counterinsurgency measures across space and time. This allows us to demonstrate that the commonly accepted narrative of Indian Maoist insurgency must be fundamentally rethought. The Naxalbari outbreak in 1967 and the subsequent insurgency in West Bengal is generally agreed to be the central point in the history of Maoist insurgency in India. But our analysis demonstrates that it was comparatively short-lived and atypical. We instead trace the genealogy of Indian Maoism to Telengana in the late 1940s. The common feature linking all three waves is the persistence of insurgent activity among various tribal oradivasicommunities in the central Indian "tribal belt." Their overriding grievances are the historically iniquitous relationships produced by the processes of state and market expansion that have incorporated and subordinatedadivasipopulations who previously had a large degree of socioeconomic and political autonomy. The state's counterinsurgency strategy has consisted of violence combined with developmental and governance interventions. This has pushed Maoist insurgency to the margins of Indian political life but has been unable to eliminate insurgent activity or address the fundamental grievances ofadivasis. We conclude by arguing that Maoist insurgency in India should not be considered as crime to be resolved by state violence, or as an economic problem requiring the intensification of developmental measures, but as a matter of politics.

ABSTRACTObjectivesThe Welsh Health Survey (WHS) has been carried out annually since 2003. Approximately 15000 adults and 3000 children are interviewed each year on a wide range of health related questions. From 2013, adult participants were asked to consent to their data being linked and incorporated into the SAIL databank, allowing linkage to the SAIL datasets. Here we focus on linkage to primary care, General Practitioner (GP), data.
This provides a unique opportunity to compare some clinical concepts which are represented in both datasets. The questionnaires in the WHS are taken at a set moment in time and are standardised for everyone questioned, and are more complete. In comparison the GP data collects responses over the patients' interactions with the GP, but the information may have been elicited in different ways and data are much more likely to be missing.
ApproachWe have chosen a small number of variables scored in both datasets for comparison. BMI and its core variables height and weight are the principal numeric variables found in both datasets. Smoking behaviour is coded for 96% of people in the GP data, alcohol consumption for 79% and exercise for 62%. In contrast, in the WHS data, coding is for 99% (smoking), 99% (alcohol) and 97% (exercise).
ResultsThe 2013 WHS had 4362 participants linked to the SAIL databank, and 7332 from the 2014 WHS. Of these, 95 % had either an exact match or a probabilistic match of 0.9 or above, with 6869 people (63 %) of the combined WHS dataset having linked GP data.
Of those with GP data, 5997 (87%) have weights in the GP data at any date. But only 2429 (35%) have weights within 1 year before and 1 year after the questionnaire date. Of the 2429, 135 have no weight in the WHS data.
ConclusionsFor those using WHS data, the data can be enhanced with a temporal dimension, while the GP data user can augment missing values from the WHS. Both the GP and WHS can gain confirmation from each other. This allows the non-randomness of missingness in the GP dataset to be assessed.

BACKGROUND: There is widespread agreement that civil war obstructs efforts to eradicate polio. It is suggested that Islamist insurgents have a particularly negative effect on vaccination programmes, but this claim is controversial. METHODS: We analyse cross-national data for the period 2003-14 using negative binomial regressions to investigate the relationship between Islamist and non-Islamist insurgency and the global distribution of polio. The dependent variable is the annual number of polio cases in a country according to the WHO. Insurgency is operationalized as armed conflict between the state and an insurgent organization resulting in ≥25 battle deaths per year according to the Uppsala Conflict Data Programme. Insurgencies are divided into Islamist and non-Islamist insurgencies. We control for other possible explanatory variables. RESULTS: Islamist insurgency did not have a significant positive relationship with polio throughout the whole period. But in the past few years - since the assassination of Osama bin Laden in 2011- Islamist insurgency has had a strong effect on where polio cases occur. The evidence for a relationship between non-Islamist insurgency and polio is less compelling and where there is a relationship it is either spurious or driven by ecological fallacy. CONCLUSIONS: Only particular forms of internal armed conflict - those prosecuted by Islamist insurgents - explain the current global distribution of polio. The variation over time in the relationship between Islamist insurgency and polio suggests that Islamist insurgent's hostility to polio vaccinations programmes is not the result of their theology, as the core tenets of Islam have not changed over the period of the study. Rather, our analysis indicates that it is a plausibly a reaction to the counterinsurgency strategies used against Islamist insurgents. The assassination of Osama bin Laden and the use of drone strikes seemingly vindicated Islamist insurgents' suspicions that immunization drives are a cover for espionage activities.

ABSTRACTObjectiveTo examine the impact of mindfulness-based stress reduction (MBSR) for people with ankylosing spondylitis (AS). Methods193 People with AS were invited to take part in an MBSR 8 week course. The data linkage component of this study examined number of visits to the general practitioner before and after the course in participants and non-participants of the course (500 people taking part in a cohort study but not invited to the course). ResultsOf 193 people invited, 43 (22%) consented and took part in the course, GP records were available for 41 (95%) of MBSR participants and 457 (91%) of the 500 comparison group. There was a mean of 7.6 (median 3) visits to the GP in the 12 month period before the course for those undertaking MBSR and 4.6 (median 0) visits in the 12 month period after the course. This compared with 5.5 (median 0) visits (12 months before a random date) and 4.1 (median 0) visits (12 months after a random date) in the comparison group. Using Wilcoxon rank-sum (Mann-Whitney) test showed a significant reduction in GP visits in the MBSR group after the course compared to the comparison group. ConclusionsThose who chose to attend an MBSR course had a higher number of visits to the GP before attending the course, than the comparison group. However, after attending the stress reduction course the number of visits to the GP reduced to levels equivalent to the comparison group. This study suggests that mindfulness based stress reduction could be effective in reducing the number of visits to the GP for people with arthritis who regularly see their GP. The findings from this study suggest a full RCT and cost effectiveness analysis is warranted.

Inequities in the provision of accessible primary health care contribute to poor health outcomes and health inequity. This study evaluated inequities in the prevalence and consequences of barriers that children face in seeing a general practitioner (GP) in Aotearoa New Zealand. We analysed data on 5,947 children from the Growing Up in New Zealand longitudinal study cohort on barriers to seeing a GP in the previous year, reported by mothers when their children were aged 24 months and 54 months (in 2011/12 and 2013/14 respectively); and maternal-reported hospitalisations in the year prior to age 54 months. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for consequences of these barriers. Overall, 4.7% (n = 279) of children experienced barriers to seeing a GP in the year to 24 months and 5.5% (n = 325) in the year to 54 months. At each age, and for each specific barrier studied, barriers were more prevalent among Māori (the indigenous people of Aotearoa New Zealand), and among Pacific, compared to New Zealand European, children. Children facing barriers in the year to age 24 months were twice as likely to be hospitalised in the year to 54 months (OR 2.18, 95%CI: 1.38 to 3.44). When this relationship was analysed by ethnicity, the association was strongest for Māori (OR: 2.92, 95%CI: 1.60 to 5.30), less strong for Pacific (OR 2.01, 95%CI: 0.92 to 4.37) and not present for New Zealand European (OR 1.27, 95%CI 0.39 to 4.12) families. Barriers that children face to seeing a GP have social and cost implications for families and the health system. Changes to the health system, and future health policy, must align with the New Zealand government's obligations under Te Tiriti o [The Treaty of] Waitangi, to ensure that health equity becomes a reality for Māori.

ABSTRACTObjectivesTo examine the characteristics of children who are prescribed antipsychotic medication.
ApproachA cohort study using routine data from general practitioner and hospital records linked with education records. All children in Wales between the years 1999 to 2014 were included in the analysis, demographic characteristics and outcomes of children were stratified by intellectual disability/autism (identified using education records and GP records) and antipsychotic use. All data were linked and held in the Secure Anonymised Information Linkage (SAIL) Databank in Wales
ResultsOf children with intellectual disability 2.4 % (360/14428) have been prescribed an antipsychotic and 75 % of these have a diagnosis of autism. This compares with 0.19% (1126/602320) of children without intellectual disability who are prescribed an antipsychotic. Children, predominantly boys (78.1% (281/360) of those with intellectual disability prescribed an antipsychotic were boys compared to 67.12% (9442/14068) of those not prescribed antipsychotics), with aggression codes (17.5% of those on an antipsychotic had aggression codes compared to 1.36% of those without antipsychotic) were more likely to be prescribed antipsychotics. Those with intellectual disabilities were prescribed antipsychotics at a younger age (58 % of those with intellectual disability started the drug before the age of 14 compared to 29 % of those without intellectual disability) but were less likely to be from a deprived area compared to those prescribed antipsychotics but without intellectual disability/autism (22.5 % and 28.4 %, were in the lowest fifth of deprivation, intellectual disability and non- intellectual disability, respectively). Antipsychotic use was associated with more visits to the GP for epilepsy, diabetes and injury (post drug compared to prior to drug) and higher deaths in childhood (compared to those not give antipsychotics).
ConclusionsThe linkage of the education records allowed intellectual disability to be used as an explanatory factor in analysis looking at drug prescriptions. The majority of children prescribed antipsychotics do not have psychotic or mental disorder diagnosis codes but have a diagnosis of behavioural problems, attend special schools and have intellectual difficulties. In the group with intellectual disability/autism there is evidence that the use of antipsychotics may be associated with more visits to the GP for epilepsy, diabetes, injury (post drug compared to prior to drug) and is associated with more deaths in childhood. These findings support concerns that antipsychotics may be over used for managing predominately behavioural problems.