7,832 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

    Digital endpoints in clinical trials of Alzheimer’s disease and other neurodegenerative diseases: challenges and opportunities

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    Alzheimer’s disease (AD) and other neurodegenerative diseases such as Parkinson’s disease (PD) and Huntington’s disease (HD) are associated with progressive cognitive, motor, affective and consequently functional decline considerably affecting Activities of Daily Living (ADL) and quality of life. Standard assessments, such as questionnaires and interviews, cognitive testing, and mobility assessments, lack sensitivity, especially in early stages of neurodegenerative diseases and in the disease progression, and have therefore a limited utility as outcome measurements in clinical trials. Major advances in the last decade in digital technologies have opened a window of opportunity to introduce digital endpoints into clinical trials that can reform the assessment and tracking of neurodegenerative symptoms. The Innovative Health Initiative (IMI)-funded projects RADAR-AD (Remote assessment of disease and relapse—Alzheimer’s disease), IDEA-FAST (Identifying digital endpoints to assess fatigue, sleep and ADL in neurodegenerative disorders and immune-mediated inflammatory diseases) and Mobilise-D (Connecting digital mobility assessment to clinical outcomes for regulatory and clinical endorsement) aim to identify digital endpoints relevant for neurodegenerative diseases that provide reliable, objective, and sensitive evaluation of disability and health-related quality of life. In this article, we will draw from the findings and experiences of the different IMI projects in discussing (1) the value of remote technologies to assess neurodegenerative diseases; (2) feasibility, acceptability and usability of digital assessments; (3) challenges related to the use of digital tools; (4) public involvement and the implementation of patient advisory boards; (5) regulatory learnings; and (6) the significance of inter-project exchange and data- and algorithm-sharing

    Facilitating prosociality through technology: Design to promote digital volunteerism

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    Volunteerism covers many activities involving no financial rewards for volunteers but which contribute to the common good. There is existing work in designing technology for volunteerism in HumanComputer Interaction (HCI) and related disciplines that focuses on motivation to improve performance, but it does not account for volunteer wellbeing. Here, I investigate digital volunteerism in three case studies with a focus on volunteer motivation, engagement, and wellbeing. My research involved volunteers and others in the volunteering context to generate recommendations for a volunteer-centric design for digital volunteerism. The thesis has three aims: 1. To investigate motivational aspects critical for enhancing digital volunteers’ experiences 2. To identify digital platform attributes linked to volunteer wellbeing 3. To create guidelines for effectively supporting volunteer engagement in digital volunteering platforms In the first case study I investigate the design of a chat widget for volunteers working in an organisation with a view to develop a design that improves their workflow and wellbeing. The second case study investigates the needs, motivations, and wellbeing of volunteers who help medical students improve their medical communication skills. An initial mixed-methods study was followed by an experiment comparing two design strategies to improve volunteer relatedness; an important indicator of wellbeing. The third case study looks into volunteer needs, experiences, motivations, and wellbeing with a focus on volunteer identity and meaning-making on a science-based research platform. I then analyse my findings from these case studies using the lens of care ethics to derive critical insights for design. The key contributions of this thesis are design strategies and critical insights, and a volunteer-centric design framework to enhance the motivation, wellbeing and engagement of digital volunteers

    Safe food through better labelling: A robust method for the rapid determination of caprine and bovine milk allergens

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    Accidental milk cross-contamination is one of the most common causes for costly food recalls. Yet, quantifying trace-levels of allergen is time-consuming and current methods are not adapted for routine analyses making quality control for trace-level allergen content impractical. This perpetuates voluntary “may-contain” statements that are unhelpful for people suffering from food allergies. Here, we developed a rapid LC-MS method enabling milk allergen quantification by comparing all tryptic-peptides of major milk allergens. The bovine-specific αS-2 casein peptide and allergen-epitope NAVPITPTLNR provided excellent performance in sensitivity (LOD 1 mg.kg − 1; LOQ 2 mg.kg − 1) across various dairy products, good recovery rates in baked croissants (77 % with a 10 % inter-day RSD) and a linear range of 2 – 2,000 mg.kg − 1. The method can be used for routine determination of trace-contamination with bovine milk allergen and the adulteration of high-value caprine dairy products with lower-value bovine milk products, protecting consumer trust and the growing population suffering from food allergies

    Identity, Power, and Prestige in Switzerland's Multilingual Education

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    Switzerland is known for its multilingualism, yet not all languages are represented equally in society. The situation is exacerbated by the influx of heritage languages and English through migration and globalization processes which challenge the traditional education system. This study is the first to investigate how schools in Grisons, Fribourg, and Zurich negotiate neoliberal forces leading to a growing necessity of English, a romanticized view on national languages, and the social justice perspective of institutionalizing heritage languages. It uncovers power and legitimacy issues and showcases students' and teachers' complex identities to advocate equitable multilingual education

    Bildung in der digitalen Transformation

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    Die Coronapandemie und der durch sie erzwungene zeitweise Übergang von PrĂ€senz- zu Distanzlehre haben die Digitalisierung des Bildungswesens enorm vorangetrieben. Noch deutlicher als vorher traten dabei positive wie negative Aspekte dieser Entwicklung zum Vorschein. WĂ€hrend den Hochschulen der Wechsel mit vergleichsweise geringen Reibungsverlusten gelang, offenbarten sich diese an Schulen weitaus deutlicher. Trotz aller Widrigkeiten erscheint eines klar: Die zeitweisen VerĂ€nderungen werden Nachwirkungen zeigen. Eine völlige RĂŒckkehr zum Status quo ante ist kaum noch vorstellbar. Zwei Fragen bestimmen vor diesem Hintergrund die Doppelgesichtigkeit des Themas der 29. Jahrestagung der Gesellschaft fĂŒr Medien in der Wissenschaft (GMW). Erstens: Wie ‚funktioniert‘ Bildung in der sich derzeit ereignenden digitalen Transformation und welche Herausforderungen gibt es? Und zweitens: Befindet sich möglicherweise Bildung selbst in der Transformation? BeitrĂ€ge zu diesen und weiteren Fragen vereint der vorliegende Tagungsband

    The Role of Knowledge and Penetration of Fintech Services in Improving MSMEs of Fishermen and Marine Farmers in Remote Small Islands Region

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    Objective: This study aims to investigate the impact of knowledge and current penetration of fintech services on the overall performance of micro, small, and medium-sized enterprises (MSMEs), which in this case were fishermen and marine farmers. Design/Methods/Approach: This study utilized data from nine fishing villages with two hundred respondents. The data was collected using a questionnaire based on the purposive sampling technique, then analyzed using SmartPLS and path analysis. Findings: Knowledge had direct and indirect positive and significant effects on the overall managerial performance of fishermen and marine farmers. In addition, the user experience might increase the rapid adoption of fintech, improving the performance of MSMEs in small island regions. Originality/Value: This study highlights the importance of fintech knowledge for increasing the uptake and impact of fintech among MSMEs in remote small island areas, which has escaped the attention of scientific research. Practical/Policy implication: Given the results, more effort is needed to increase the knowledge of MSMEs in small islands region regarding services and risk to increase the participation of MSMEs in fintech

    History, Features, Challenges, and Critical Success Factors of Enterprise Resource Planning (ERP) in The Era of Industry 4.0

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    ERP has been adopting newer features over the last several decades and shaping global businesses with the advent of newer technologies. This research article uses a state-of-the-art review method with the purpose to review and synthesize the latest information on the possible integration of potential Industry 4.0 technologies into the future development of ERP. Different software that contributed to the development of the existing ERP is found to be Material Requirement Planning (MRP), Manufacturing Resource Planning (MRPII), and Computer Integrated Manufacturing (CIM). Potential disruptive Industry 4.0 technologies that are featured to be integrated into future ERP are artificial intelligence, business intelligence, the internet of things, big data, blockchain technology, and omnichannel strategy. Notable Critical Success Factors of ERP have been reported to be top management support, project team, IT infrastructure, communication, skilled staff, training & education, and monitoring & evaluation. Moreover, cybersecurity has been found to be the most challenging issue to overcome in future versions of ERP. This review article could help future ERP researchers and respective stakeholders contribute to integrating newer features in future versions of ERP
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