An empirical examination of risk equalisation in a regulated community rated health insurance market

Despite universal access entitlements to the public healthcare system in Ireland, over half the population is covered by voluntary private health insurance. The market operates on the basis of community rating, open enrolment and lifetime cover. A set of minimum benefits also exists, and two risk equalisation schemes have been put in place but neither was implemented. These schemes have proved highly controversial. To date, the debate has primarily consisted of qualitative arguments. This study adds a quantitative element by analysing a number of pertinent issues. A model of a community rated insurance market is developed, which shows that community rating can only be maintained in a competitive market if all insurers in the market have the same risk profile as the market overall. This has relevance to the Irish market in the aftermath of a Supreme Court decision to set aside risk equalisation. Two reasons why insurers’ risk profiles might differ are adverse selection and risk selection. Evidence is found of the existence of both forms of selection in the Irish market. A move from single rate community rating to lifetime community rating in Australia had significant consequences for take-up rates and the age profile of the insured population. A similar move has been proposed in Ireland. It is found that, although this might improve the stability of community rating in the short term, it would not negate the need for risk equalisation. If community rating were to collapse then risk rating might result. A comparison of the Irish, Australian and UK health insurance markets suggests that community rating encourages higher take-up among older consumers than risk rating. Analysis of Irish hospital discharge figures suggests that this yields significant savings for the Irish public healthcare system. This thesis has implications for government policy towards private health insurance in Ireland.

Tudor ‘reform’ treatises and government policy in sixteenth century Ireland

During the sixteenth century hundreds of treatises, position papers and memoranda were composed on the political state of Ireland and how best to ‘reform’, ‘conquer’ or otherwise incorporate that island into the wider Tudor kingdom. These ‘reform’ treatises attempted to identify and analyse the prevailing political, social, cultural and economic problems found in the Irish polity before positing how government policy could be altered to ameliorate these same problems. Written by a broad array of New English, Old English and Gaelic Irish authors, often serving within Irish officialdom, the military, or the Church of Ireland, these papers were generally circulated amongst senior ministers and political figures throughout the Tudor dominions. As such they were written with the express purpose of influencing the direction of government policy for Ireland. Collectively these documents are one of the most significant body of sources, not just for the study of government activity in the second Tudor kingdom, but indeed for the broader history of sixteenth century Ireland. This thesis offers the first systematic study of these texts. It does so by exploring the content of the hundreds of such works and the ‘reform’ treatise as a type of text, while the interrelationship of these documents with government policy in Tudor Ireland, and their effect thereon, is also explored. In so doing it charts the developments from origin to implementation of the principal strategies employed by Tudor Englishmen to enforce English control over the whole of Ireland. Finally, it clearly demonstrates that the ‘reform’ treatises were both central to government activity in sixteenth century Ireland and to the historical developments which occurred in that time and place.

Azione destabilizzante e impegno politico. Le figure femminili tra il giallo e il nero Italiani dal 1980 a oggi

My thesis analyses female figures in Italian crime fiction since 1980, from narratological, sociological and gender-studies perspectives. It considers the narrative structure of the giallo and the noir, taking into account the difficulties, particularly in Italy, of establishing what noir fiction is and if/how it is possible to frame it in a specific narrative scheme. This discourse connects to the extraordinary success of Italian giallo and noir fiction over the past fifteen-twenty years. In this scenario, I examine the place of female writers in relation to this phenomenon, especially since the 1980s: in terms of the level of visibility/acceptance of their work, in a narrative space traditionally considered as a male territory, and with regard to their writings, which introduce different narrative perspectives. Specifically, I consider selected texts by leading female Italian writers, in which female elements (writers/characters) become destabilizing factor both on the narrative level, by undermining the schemes of ‘formulaic’ fiction, and on the political one, through their implicit potential (as women) for disrupting the rigid models inherited from processes of social conditioning and from political structures. In terms of gender identities, such texts offer scope to question conventional social constructions of the subject: by empowering the female narrative voice and by embodying it in characters (investigators/killers) traditionally personified by male figures. These texts offer themselves as a critical space where, potentially, readers can rethink static gendered relationships and stereotypical symbolical categories.

Locating the transnational: representations and aesthetics of the city in contemporary European cinemas

This thesis focuses on two Western European cinematic cities, and two unique periods of their respective nations’ histories, in a bid to “locate” the transnational within a contemporary European milieu. I argue that my geo-cinematic case studies are emblematic of broader questions of the problematics of national identity in contemporary Europe in the face of cross-national flows yet, as a result of their representations as cities both “anchored” and “in flux”, they reject a European postnational identity. Through its engagement with cinematic Rome as the “Eternal City” of Europe and cinematic Dublin as the “newly Europeanised” city, my thesis traces how representations and aesthetics of the urban spaces of these two cities correspond with the tensions at the heart of the respective eras in question. Via the figures that inhabit it, navigate it and search for it, the city is utilised to highlight fixity and mobility, centrality and dislocation, in explicit and implicit ways, amid the rapidly changing landscape of its national terrain. It is through my analyses of the filmed places and sociopolitical, socioeconomic and sociocultural spaces of these capital cities under the rubric of the transnational that this research demonstrates the “pluralities” of the construct in its cinematic manifestations. It is also my aim to evaluate the concept of cinematic transnationalism when identifying and accounting for representations of a specific national, historical timeframe, when the momentousness of the changes that occur is not bound by the national, but rather is reflective of the influence of both domestic and external forces. To this end, my thesis draws attention to instances in which the nation is shown to persist and resist dilution, arguing that it is only against the backdrop and continuity of the nation (in its evershifting guises) that the transnational can be conceived in representative and aesthetic terms.

Corporeal prisons: dynamics of body and mise-en-scène in three films by Paul Schrader

This thesis focuses on the complex relationship between representations of the human body and the formal processes of mise-en-scène in three consecutive films by the writer-director Paul Schrader: American Gigolo (1980), Cat People (1982) and Mishima: A Life in Four Chapters (1985). While Schrader’s work has typically been critiqued under the broad category of masculinity in crisis (and often as a subset of the films of his more famous long-time collaborator, Martin Scorsese), I focus on a fiveyear early period of his filmography when he sought to explore his key themes of bodily crisis, fragmentation and alienation through an unusually intense focus upon the expressive potential of film form, specifically via the combined elements of colour, lighting, camerawork and production design. By approaching these three films as corporeal character studies of troubled figures whose emotional and psychosexual neurosis is experienced in and through the body, I will locate Schrader’s filmmaking process and style within the thematic and aesthetic contexts of both his own early film criticism and the European and Japanese art cinemas that he claims as his primary influence. In doing so, I will establish Schrader’s position as a director whose literary and theological background differentiated him from his peers of the postclassical Hollywood generation, and who thus continually sought to develop his own visual literacy through his relationship with the camera and his collaborations with more overtly style-oriented film artists. But instead of merely focusing on mise-en-scène to gain a formalist appreciation of these films, I mobilise stylistic analysis as a new critical approach towards the problematic discourses of identity and embodiment that have haunted Schrader’s career from the beginning. In particular, I argue that paying closer attention to Schrader’s formal choices sheds new light on how these films – which he approached as exercises in style – repeatedly deal with the volatile and unavoidably body-oriented categories of race, gender and sexuality. In the process, I argue that a formalist attentiveness to mise-en-scène can also provide valuable cultural insights into Schrader’s oeuvre.

Micro and nanostructured impedance sensors for biological and biomedical applications

This thesis work covered the fabrication and characterisation of impedance sensors for biological applications aiming in particular to the cytotoxicity monitoring of cultured cells exposed to different kind of chemical compounds and drugs and to the identification of different types of biological tissue (fat, muscles, nerves) using a sensor fabricated on the tip of a commercially available needle during peripheral nerve block procedures. Gold impedance electrodes have been successfully fabricated for impedance measurement on cells cultured on the electrode surface which was modified with the fabrication of gold nanopillars. These nanostructures have a height of 60nm or 100nm and they have highly ordered layout as they are fabricated through the e-beam technique. The fabrication of the threedimensional structures on the interdigitated electrodes was supposed to improve the sensitivity of the ECIS (electric cell-substrate impedance sensing) measurement while monitoring the cytotoxicity effects of two different drugs (Antrodia Camphorata extract and Nicotine) on three different cell lines (HeLa, A549 and BALBc 3T3) cultured on the impedance devices and change the morphology of the cells growing on the nanostructured electrodes. The fabrication of the nanostructures was achieved combining techniques like UV lithography, metal lift-off, evaporation and e-beam lithography techniques. The electrodes were packaged using a pressure sensitive, medical grade adhesive double-sided tape. The electrodes were then characterised with the aid of AFM and SEM imaging which confirmed the success of the fabrication processes showing the nanopillars fabricated with the right layout and dimensions figures. The introduction of nanopillars on the impedance electrodes, however, did not improve much the sensitivity of the assay with the exception of tests carried out with Nicotine. HeLa and A549 cells appeared to grow in a different way on the two surfaces, while no differences where noticed on the BALBc 3T3 cells. Impedance measurements obtained with the dead cells on the negative control electrodes or the test electrodes with the drugs can be compared to those done on the electrodes containing just media in the tested volume (as no cells are attached and cover the electrode surface). The impedance figures recorded using these electrodes were between 1.5kΩ and 2.5 kΩ, while the figures recorded on confluent cell layers range between 4kΩ and 5.5kΩ with peaks of almost 7 kΩ if there was more than one layer of cells growing on each other. There was then a very clear separation between the values of living cell compared to the dead ones which was almost 2.5 - 3kΩ. In this way it was very easy to determine whether the drugs affected the cells normal life cycle on not. However, little or no differences were noticed in the impedance analysis carried out on the two different kinds of electrodes using cultured cells. An increase of sensitivity was noticed only in a couple of experiments carried out on A549 cells growing on the nanostructured electrodes and exposed to different concentration of a solution containing Nicotine. More experiments to achieve a higher number of statistical evidences will be needed to prove these findings with an absolute confidence. The smart needle project aimed to reduce the limitations of the Electrical Nerve Stimulation (ENS) and the Ultra Sound Guided peripheral nerve block techniques giving the clinicians an additional tool for performing correctly the peripheral nerve block. Bioimpedance, as measured at the needle tip, provides additional information on needle tip location, thereby facilitating detection of intraneural needle placement. Using the needle as a precision instrument and guidance tool may provide additional information as to needle tip location and enhance safety in regional anaesthesia. In the time analysis, with the frequency fixed at 10kHz and the samples kept at 12°C, the approximate range for muscle bioimpedance was 203 – 616 Ω, the approximate bioimpedance range for fat was 5.02 - 17.8 kΩ and the approximate range for connective tissue was 790 Ω – 1.55 kΩ. While when the samples were heated at 37°C and measured again at 10kHz, the approximate bioimpedance range for muscle was 100-175Ω. The approximate bioimpedance range of fat was 627 Ω - 3.2 kΩ and the range for connective tissue was 221-540Ω. In the experiments done on the fresh slaughtered lamb carcass, replicating a scenario close to the real application, the impedance values recorded for fat were around 17 kΩ, for muscle and lean tissue around 1.3 kΩ while the nervous structures had an impedance value of 2.9 kΩ. With the data collected during this research, it was possible to conclude that measurements of bioimpedance at the needle tip location can give valuable information to the clinicians performing a peripheral nerve block procedure as the separation (in terms of impedance figures) was very marked between the different type of tissues. It is then feasible to use an impedance electrode fabricated on the needle tip to differentiate several tissues from the nerve tissue. Currently, several different methods are being studied to fabricate an impedance electrode on the surface of a commercially available needle used for the peripheral nerve block procedure.

The ‘Celtic’ dimension of pre-first World War religious discourse in Britain: Wellesley Tudor Pole and the Glastonbury phenomenon

This article will explore the contribution made to the construction of discourse around religion outside of mainstream Christianity, at the turn of the twentieth century in Britain, by a Celticist movement as represented by Wellesley Tudor Pole (d.1968) and his connection to the Glastonbury phenomenon. I will detail the interconnectedness of individuals and movements occupying this discursive space and their interest in efforts to verify the authenticity of an artefact which Tudor Pole claimed was once in the possession of Jesus. Engagement with Tudor Pole’s quest to prove the provenance of the artefact, and his contention that a pre-Christian culture had existed in Ireland which had extended itself to Glastonbury and Iona creating the foundation for an authentic Western mystical tradition, is presented as one facet of a broader, contemporary discourse on alternative ideas and philosophies. In conclusion, I will juxtapose Tudor Pole’s fascination with Celtic origins and the approach of leading figures in the ‘Celtic Revival’ in Ireland, suggesting intersections and alterity in the construction of their worldview. The paper forms part of a chapter in a thesis under-preparation which examines the construction of discourse on religion outside of mainstream Christianity at the turn of the twentieth century, and in particular the role played by visiting religious reformers from Asia. The aim is to recover the (mostly forgotten) history of these engagements.

Zazen, philosophy of mind, and the practicality of realising impermanence

This dissertation involves a general overview of the meditative practice of zazen and analytic philosophy of mind while suggesting a potential bridge between them in the form of an analysis of the practicality of realising impermanence. By the end of my argument I hope to have offered up some compelling evidence in favour of the idea that analytic philosophy would benefit greatly from adopting principles which are best learned and expressed through the practice of, and scholarship around, Zen Buddhism and in particular the treatment of the concept of impermanence. I demonstrate the Western philosophical tendency to make dichotomous assumptions about the nature of mind, even when explicitly denying a dualist framework. I do so by examining the historical and philosophical precedent for dualistic thinking in the work of figures such as Plato and Descartes. I expand on this idea by examining the psychology of categorisation - i.e. creating mental categories and boundaries - and demonstrating how such categorisations feeds back into behaviour in practical ways, both positive and negative. The Zen Buddhist principle of impermanence states that all phenomena are impermanent and therefore lack essential nature; this includes intellectual concepts such as the metaphysical framework of the analytic approach to mind. Impermanence is a principle which is realised through the embodied practice of zazen. By demonstrating its application to analytic philosophy of mind I show that zazen (and mindfulness practice in general) provides an ongoing opportunity for clearing up entrenched world views, metaphysical assumptions and dogmatic thinking. This in turn may promote a more holistic and ultimately more rewarding comprehension of the role of first-person experience in understanding the world. My argument is not limited to analytic philosophy of mind but reflects broad aspects of thinking in general, and I explain its application to issues of social importance, in particular education systems.