4,221 research outputs found

    A Multi-level Analysis on Implementation of Low-Cost IVF in Sub-Saharan Africa: A Case Study of Uganda.

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    Introduction: Globally, infertility is a major reproductive disease that affects an estimated 186 million people worldwide. In Sub-Saharan Africa, the burden of infertility is considerably high, affecting one in every four couples of reproductive age. Furthermore, infertility in this context has severe psychosocial, emotional, economic and health consequences. Absence of affordable fertility services in Sub-Saharan Africa has been justified by overpopulation and limited resources, resulting in inequitable access to infertility treatment compared to developed countries. Therefore, low-cost IVF (LCIVF) initiatives have been developed to simplify IVF-related treatment, reduce costs, and improve access to treatment for individuals in low-resource contexts. However, there is a gap between the development of LCIVF initiatives and their implementation in Sub-Saharan Africa. Uganda is the first country in East and Central Africa to undergo implementation of LCIVF initiatives within its public health system at Mulago Women’s Hospital. Methods: This was an exploratory, qualitative, single, case study conducted at Mulago Women’s Hospital in Kampala, Uganda. The objective of this study was to explore how LCIVF initiatives have been implemented within the public health system of Uganda at the macro-, meso- and micro-level. Primary qualitative data was collected using semi-structured interviews, hospital observations informal conversations, and document review. Using purposive and snowball sampling, a total of twenty-three key informants were interviewed including government officials, clinicians (doctors, nurses, technicians), hospital management, implementers, patient advocacy representatives, private sector practitioners, international organizational representatives, educational institution, and professional medical associations. Sources of secondary data included government and non-government reports, hospital records, organizational briefs, and press outputs. Using a multi-level data analysis approach, this study undertook a hybrid inductive/deductive thematic analysis, with the deductive analysis guided by the Consolidated Framework for Implementation Research (CFIR). Findings: Factors facilitating implementation included international recognition of infertility as a reproductive disease, strong political advocacy and oversight, patient needs & advocacy, government funding, inter-organizational collaboration, tension to change, competition in the private sector, intervention adaptability & trialability, relative priority, motivation &advocacy of fertility providers and specialist training. While barriers included scarcity of embryologists, intervention complexity, insufficient knowledge, evidence strength & quality of intervention, inadequate leadership engagement & hospital autonomy, poor public knowledge, limited engagement with traditional, cultural, and religious leaders, lack of salary incentives and concerns of revenue loss associated with low-cost options. Research contributions: This study contributes to knowledge of factors salient to implementation of LCIVF initiatives in a Sub-Saharan context. Effective implementation of these initiatives requires (1) sustained political support and favourable policy & legislation, (2) public sensitization and engagement of traditional, cultural, and religious leaders (3) strengthening local innovation and capacity building of fertility health workers, in particular embryologists (4) sustained implementor leadership engagement and inter-organizational collaboration and (5) proven clinical evidence and utilization of LCIVF initiatives in innovator countries. It also adds to the literature on the applicability of the CFIR framework in explaining factors that influence successful implementation in developing countries and offer opportunities for comparisons across studies

    Modelling, Monitoring, Control and Optimization for Complex Industrial Processes

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    This reprint includes 22 research papers and an editorial, collected from the Special Issue "Modelling, Monitoring, Control and Optimization for Complex Industrial Processes", highlighting recent research advances and emerging research directions in complex industrial processes. This reprint aims to promote the research field and benefit the readers from both academic communities and industrial sectors

    Report of the International Narcotics Control Board for 2022.

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    Reframing Construction Labour Productivity in a Colonisation Context: The West Bank as an Example

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    This thesis explores the under-researched topic of defining construction labour productivity and the factors impacting it in the context of a small, volatile and dependent economy of the West Bank. The aim is to identify the impact of particular social, economic and political constraints on structural and agency factors affecting the construction sector's productivity using case studies from the West Bank. Labour productivity is studied from a broad perspective, adding political and economic conditions to reframe and evaluate the term and its determinants in the context of high uncertainty, political instability and complex geography. 'Labour productivity' comes to represent the production interplay between agency and structural factors, and construction labour is treated as complementary to the machine rather than as an extension of it. The theoretical framework is developed based on Giddens' Structuration Theory, mainly the reconciliation of the multi-layers structure and agency determinants impacting construction labour productivity in the context of colonisation. The study's philosophy validates the use of mixed methods methodology, merging positivism and constructivism under the canopy of pragmatism. Quantitative and qualitative data have been collected, with the quantitative part consisting primarily of comprehensive survey data from the PCBS and the qualitative of purposive semi-structured interviews with decision makers at macro and meso levels plus analysis of multiple case studies. The results reveal that the controversy about using hourly wage as an indication of construction productivity is resolved by including labour characteristics and context-specific variables in the model. The construction sector in Israel depends on skilled blue-collar employees from the West Bank rather than unskilled ones, with a higher rate of labour mobility for those from rural areas to Israeli construction markets than from other locations, leading to skill shortages in the West Bank. The construction labour process in the West Bank also rests on low levels of vocational education and training and a high risk of accidents due to meagre experience, lack of training and improper application of health and safety regulations. Finally, Israeli control of movement within the West Bank and the outlets to international markets impacts on labour productivity by imposing restrictions on importing and transporting construction materials and the internal mobility of workers. The research contributes to knowledge through its originality and generalisation by mapping the complexity of social factors and providing a definition of construction productivity appropriate to colonisation

    An Exploration of Academy Deans' Responsibilities in Five U15 Research-Intensive Universities in Canada: Ambiguities and Managerialism in the Academe - A Mixed Methods Research

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    This study examined the responsibilities of academic deans within five U15 research-intensive universities in Canada as they operate in an increasingly complex environment. The academic deans who are sometimes flaunted as Chief Executive Officers, were found to be consummate academics who transitioned from their academic discipline into administration as middle managers. Academic deans have a dual responsibility in that they are accountable to the senior leadership of their university while being advocates for their colleges. Significantly, the responsibilities of these academic middle managers are central to the achievement of their universities’ strategic objectives. However, the position of the deanship is described by researchers as complex, and the very nature of the duality of the role engenders ambiguities. The ambiguities and complexities of academic deans’ responsibilities are said to be influenced by public sector reforms disguised as managerialism. Some practices espoused by managerialism appear to be integral to universities’ strategies globally, whether as an ideology or through processes and practices. Universities in Canada are also adopting various strategies which are said to be driven by managerialism (Brownlee, 2015). Symptomatic of managerialism are various changes in university governance, including the professionalization of the roles of middle managers, now referred to as chief executive officers in some institutions, and the implementation of marketing techniques (Brownlee, 2015; Kolsaker, 2008; Olssen, 2002). Additionally, and as indicated in the literature, reflective of managerialism are the demands for accountability, efficiency, and effectiveness which are achieved through practices such as increased competition, a focus on marketization, and engagement of private-public partnerships. According to the literature, the practices espoused by managerialism in higher education institutions (Meek et al., 2020; Seale & Cross, 2016) have shifted the responsibilities of academic deans to a type of management that is reflective of corporate-style management practices and evidenced by various corporate terminologies. Given the tenets of managerialism, the argument obtains that some principles of this ideology are translated into practices and have contributed to the evolved roles of academic deans. They now engage in business-like practices, the processes of their institutions’ strategic planning initiatives, establishing public-private partnerships, and marketization, among others. The changes have impacted how academic deans interpret, understand, and enact their roles, which are oftentimes imbued with role conflict and ambiguity due to competing demands and unclear expectations by various constituents (Arntzen, 2016; Boyko & Jones, 2010; Hoyle & Wallace, 2005). With the evolved responsibilities of academic mid-level managers, more specifically academic deans who are at the centre of this study, there is evidence of job enlargement as well as increased complexities in their roles. As such, in examining academic deans’ responsibilities, this study gathered information on academic deans lived experiences and perceptions of the presence of managerialism in their institutions and how their responsibilities reflect practices akin to managerialism. That is, responsibilities that mirror management techniques usually employed by the private sector or corporate organizations. The study further examined academic deans’ perceptions of role conflict and role ambiguity and how their perceived self-efficacy and tolerance-intolerance of ambiguity influence how they navigate the complexities of their roles. The study’s findings were limited to the perceptions of the participants who indicated that some of their responsibilities are reflective of practices such as budgeting and fund development; strategic planning; advancement/fundraising/establishing donor relationships; advertising/marketization and human resource management, among others. According to the narratives provided by the academic deans in this study, they found themselves ill-prepared for important corporate-like responsibilities, which they indicated generally do not coalesce with their academic disciplines. Further, the findings revealed that the practices that characterize the responsibilities of these middle-level managers/chief executive officers are delineated by varying degrees of uncertainties and ambiguities which are defined by role conflict and role ambiguity. However, the academic deans in the study demonstrated that having a sense of self-efficacy and a high tolerance for ambiguity had been valuable in helping them to navigate the complexities of their roles as they engaged the corporate-like management imperatives of their responsibilities. The research was grounded in the constructivist paradigm through a qualitatively dominant cross-over (Frels & Onwuegbuzie, 2013) mixed-methods research design. This process captured the subjective experiences of academic deans to gain an in-depth understanding of the practices of academic deans as they carry out their functions in an ambiguous environment characterized by managerialism (Arntzen, 2016; Ayers, 2012; Bess, 2006). Data were collected to address the research questions using a mixed methods sequential design over two phases. Phase one of this study focused on gathering quantitative data from surveys through SurveyMonkey. Phase two concentrated on the qualitative method of collecting data by way of reviewing position descriptions of academic deans, policy documents governing deans, and elite interviews with deans. The study has implications for further research initiatives, research-into-practice, and contribution to theory. Implications for future research include comparative research with larger sample sizes across U15 research-intensive and non-research-intensive universities to garner a more comprehensive understanding of academic deans’ perceptions of managerialism, role conflict, and role ambiguity. The study findings have potential implications for institutions’ policies governing academic deans’ recruitment and professional development of academics, including the establishment of management career pathways and succession planning initiatives

    Trust, Trusting and Trustworthiness in the Words of Survivors of Child Sexual Abuse

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    Survivors of Child Sexual Abuse are known to hold silence around the abusive events and their trauma distress. Existing scholarship suggests damaged abilities to trust as one reason for this, and thus trust becomes located as an impaired propensity in the mind of the survivor. Survivors and service providers alike report trust as important when accessing mental, physical, judicial or religious services, and yet very little empirical evidence exists which interrogates the mechanism of trust building, as opposed to generalised trust propensity. Epistemology into trust is hampered by obscured and conflated definitions, and in mental health settings by the apparent dislocation of the survivor’s propensity to trust from the trustworthiness of their trustee - be that an individual, an institution or society. This study has interrogated trust for CSA survivors using a Mad Studies paradigm to address the research questions: How do survivors describe their own trusting abilities? What previous relational experiences inform survivors’ ability and/or willingness to trust? How do survivors evaluate potential trustees? How does trust influence disclosure? Seventeen participants with a range of characteristics were recruited into the study, and Interpretative Phenomenological Analysis used to analyse the data. The researcher is a CSA survivor and an autoethnographic account of her interaction with, and shaping of, the data offers a robust reflexivity to evidence the quality of the study. The findings demarcate generalised and relational trust; present a ‘trust enactment model’ of relational trust; delineate the process of building/repairing trust; and advance the utility of ‘transactional trust’. The study foregrounds the centrality of trustee trustworthiness, thus challenging survivor trust deficiency as the sole trust-component in relationality when survivors seek services. The study identifies an epistemological lacuna regarding trustee trustworthiness, and indicates the necessity of further research to establish parameters of trustworthiness when working with CSA survivors

    The goals of competition law for merger analysis in developing jurisdictions : a critical appraisal of merger analysis under Kenyan competition law

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    Thesis (LLD (Mercantile Law))--University of Pretoria, 2023.This thesis considers whether jurisdictional exigencies should influence competition law enforcement, with a specific focus on merger analysis. It examines various approaches and schools of thought regarding the goals of competition law and how these play out within jurisdictional parameters. The history of enforcement of American antitrust is scrutinised to establish the nature of the interplay between greater economic policy direction and the goals of competition law. The study also explores the issue of convergence and whether developing jurisdictions should align their competition law to that of developed jurisdictions with mature competition law.Mercantile LawLLD (Mercantile Law)wUnrestricte

    Academic integrity : a call to research and action

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    Originally published in French:L'urgence de l'intĂ©gritĂ© acadĂ©mique, Éditions EMS, Management & société, Caen, 2021 (ISBN 978-2-37687-472-0).The urgency of doing complements the urgency of knowing. Urgency here is not the inconsequential injunction of irrational immediacy. It arises in various contexts for good reasons, when there is a threat to the human existence and harms to others. Today, our knowledge based civilization is at risk both by new production models of knowledge and by the shamelessness of knowledge delinquents, exposing the greatest number to important risks. Swiftly, the editors respond to the diagnostic by setting up a reference tool for academic integrity. Across multiple dialogues between the twenty-five chapters and five major themes, the ethical response shapes pragmatic horizons for action, on a range of disciplinary competencies: from science to international diplomacy. An interdisciplinary work indispensable for teachers, students and university researchers and administrators
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