4,416 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

    Towards a framework for the study of ongoing socio-technical transitions: explored through the UK self-driving car paradigm

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    The UK government set out to see self-driving cars on roads by 2021. The idea of a self-driving car has been around for almost a century, and more recent technological developments have made self-driving cars a real-life possibility. While a fully self-driving automobility system is some distance away, real-life testing is bringing autonomous driving closer to consumers. Some claim this to be the biggest disruption to mobility systems since the invention of the car. Claims about the potential of self-driving mobility range from economic and social benefits to environmental improvements. A significant ambiguity however remains concerning how they will be deployed and how the technological innovation will affect mobility aims and related transport and infrastructure systems. So far, the vast majority of studies on AVs have focused on the technology aspect of this transition lacking contributions that address this from a broader socio-technical perspective. With the accelerated adoption of new technologies, Sustainability Transitions has come to prominence as a research area that seeks to understand and guide socio-technical transitions toward sustainable trajectories. Socio-technical transitions theoretical framework has been used to understand historical transitions in the majority of empirical applications. The ability to apply the same framework to ongoing transitions and to guide these towards sustainable outcomes remains unsubstantiated. To address this gap this thesis examines the foundations of multi-level perspective (MLP) – a socio-technical transitions analytical framework – and develops an analytical framework (SRPM – System Rules Pathways Mechanisms) that is appropriate for the study of ongoing transitions. The refocused framework incorporates critical realism to focus analysis on causation and causal mechanisms. It is used to analyse the ongoing socio-technical transition to self-driving cars in the UK through a four-step analytical process. The study is framed as a case-based process mechanism study. The four steps are: i) contextualisation of the ongoing transition to AVs in the UK as a socio-technical transition based on the MLP theoretical framework; ii) identification of internal and external structural relations within the transition through the notion of rules and the morphogenetic cycle; iii) aligning observed processes with transition pathways to theorise about the trajectories of the transition; iv) identification of causal mechanisms in the observed processes through identification of demi-regularities through data analysis of grey literature and theorisation about mechanisms through the development of mechanism sketches and schemata. The thesis makes two contributions to knowledge: i) methodological and ii) empirical. The methodological contribution is the development of the SRPM analytical framework to study an ongoing socio-technical transition, and the empirical contribution is the application of this framework to the study of the ongoing transition to driverless cars in the UK

    Graduate Catalog of Studies, 2022-2023

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    Mid-Late Pleistocene glacial dynamics in the Valira valleys (Principality of Andorra). Asymmetries within the Pyrenees and correlation across the westernmost European mountain ranges

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    [eng] Many sediment-covered mountain areas affected by the growth of Pleistocene glaciers are over-consolidated. Palaeoglacial conditions are deduced from glacial consolidation and site investigations. Geomorphological evidence on the glacial extent and history is in this Thesis used as a framework for hydro-mechanical flow simulations in the valley glacier of Andorra and the lower Isère glaciated valley. From the effects observed within the fossil record of ancient glaciated valleys, a reliable reconstruction of palaeo-glacier’s thickness is possible when former ice-tonges overlayed porous aquifers, because subglacial erosion was mitigated by the subglacial water pressure limiting subglacial till formation. Records of minimum preconsolidation values indicate a buoyant surging glacier. For palaeoglacier reconstruction, the glacial valley geomorphology is clue providing the palaeogeographical calibration for further hydrogeomechanical calculations, especially at successive glacial stages during the deglaciation. A modern analogue, the Hansbreen sub-polar glacier, helps to set up a conceptual model allowing a better understanding of the glaciology of the two studied former valley glaciers, comparable to a polythermal glacier type. Tills and glaciolacustrine deposits from Andorra’s main valley and its principal tributary of La Massana allow for reliable local deglaciation patterns between GS-9 (40 ka b2k) and the Holocene Optimum (9.3–5.5 b2k). However, from the palaeoenvironmental data of the Pyrenees, deglaciation started sooner, and aridity affected the size of the glaciers from GS-10, resetting the valley glacier conditions ahead of GI-7. This affected the mainly prominent glacier-ice transfluence pass in the Pyrenees and the extension of the ice tongues on both sides of the mountain belt between GI-9 and GI-7, also during GS-5.2 and GI-5.1. During and posteriorly Heinrich event H4, aridity did not favour the development of valley glaciers in Andorra until stadial GS-7; however, glaciers in the Pyrenees progressed during the following Heinrich event (H3). Using geochemical data (Al, Ti, Ca, K, P), a basic limnological study permits a palaeoenvironmental interpretation in Andorra by adding data from stable carbon isotope (δ13C) from bulk carbon samples and AMS dates. Results show four unreported inland δ13C cycles linked to low water levels in the ice-dammed lake of Andorra (La Massana palaeolake). At the beginning of each cycle, enhanced δ13C bulk carbon values are found (> -23‰), a proxy of abrupt shifting from Type-C3 to Type-C4 vegetation. The beginning of the LGM and Heinrich events H3 and H2 were marked by enhanced δ13C values interpreted as a product of strong climate change that boosted aridity. The retrieval period towards δ13C depleted values (< -23‰) spans 4,500±500 years. In Andorra, the beginnings of H3 and H2 events were relatively dry, and the second half of the climate was moist. The first evidence of sediments coming from the motion of a temperate-base glacier in the Pyrenees was from stadial GI-3. Moist conditions suddenly stopped at the beginning of Heinrich event 2 and returned at the end of H2. This moisture behaviour during H2 on the southern slopes of the Pyrenees is the opposite of the wet-to-dry conditions described in NW Iberia. Conversely, the H1 event had a wet-to-dry structure coast to coast of Iberia, including in the SE Pyrenees (Andorra). A transition from single-phase-like glacier advances (NW Iberia) to multiphase glacier advances (SE Pyrenees) was due to a change from coldbased glaciers to temperate-based glaciers. However, glacier sensibility to global changes increases through time toward NW Iberia. The Last Maximum Ice Extent and the Global LGM did not concur in places experiencing multiphase glacier advances. Indeed both extreme behaviours do not correspond to the same type of glaciers. Polar-type glaciers in NW Iberia are in this Thesis invoked, while tempered or polythermal were frequent in NE Iberia. Abrupt glacier advances and quick glacier recession in Andorra are interpreted as surges from a mass-imbalanced glacier. Two kinds of surge events are distinguished from available data in the Pyrenees, those surges produced by overfed ice tongues fed by short-lived cold spells (in GS-2b and H1) and those surges produced by buoyant melting ice tongues within the glaciated valley (between stadials GS-5/GI-4, stadials GI-3/GS-3 and stadials GS-2.1b/GS-2.1a) by a warm moist climate. The winter solar rate increase (GI-3 and GS-5.1) and the evidence of polythermal-type glaciers matched. Conversely, summer insolation increases and wet-ice type oversaturated glaciers and surges at GS-2a concurred. In Andorra the snow-overfed glacier surges correlate with the decreasing winter insolation during GS-2b. In Iberia, the LGM would be placed between 23-17.5 ka and glaciers spread, linked to both wet westerlies from the North Atlantic and moisture supply of Mediterranean influence, reaching almost the eastern side of the Central Pyrenees, leading us to suppose an NW-NE seesaw climatic relationship across Iberia almost since GS-5.1. The oscillations of the oceanic thermal front promoted wet/dry westerly winds crossing over the Pyrenees, pushing back the Mediterranean influence towards the East. By classifying glacial phases of the northern Iberian Peninsula fringe, four common glacial phases arise for the last glacial cycle: A An early LGC starting at MIS 5d having a recessional period during MIS 5c. Cold-type glaciers are expected to have existed in some of the extreme NW of the Iberian mountains until Termination 1. B The Last Maximum Ice Extent occurred mainly during MIS 5a – MIS 4. An asymmetrical glacier recession during MIS 3 was related to an increase in eastward aridity. C Significant glacier fluctuations during the MIS 3 – MIS 2 hinge, the appraisal of temperated-polythermal type of glaciers accompanied by a generalised moisture increase entailing valley glaciers to surge. D Side-to-side mountain range-scale deglaciation dissymmetry in MIS 2. The widespread expansion of tempered-polythermal type glaciers during the LGM period and Termination 1 had a proportional expansion to the available moisture. The final deglaciation is characterised by relictual cirque glaciers disappearing during GS-1. In Andorra, a general rise in local river base levels occurred until the Holocene Optimum. Unravelling the afore-cited glacial phases and unexpected research allows for a tesselated mapping of the SW continental Europe concerning part, or all of the LGC glacial phases outlined above: 1 – Areas where glaciers were prevalent during MIS 2, like the Iberian Central System, the NW and S French Massif Central, the NW Jura and the maritime Alps. 2 – Areas having a far-flung end moraine produced in a previous glacial phase (MIS 6 or posterior) showing stability until the MIS 2, as for ice caps/fields from the southern half of the Galicia mountains. 3 – Areas of pseudo-pleniglacial or apparent-pleniglacial condition, despite previous glacier recessions phases (albeit challenging to identify), as in most of the northern slope of the Pyrenees. 4 – Areas of multiphase glacier advances, like most of the southern slope of the Pyrenees, most of the Cantabrian Mountains, the half north of the Galicia mountains, the High Atlas, Sierra Nevada and the SW French Massif Central, the western Alps and the Vosges. 5 – Areas where glaciers were present from the LGM until Termination-I, like the northern Iberian range and Sanabria in Iberia. Nevertheless, other mountain ranges have a Type 5 glaciation’s scenario, like the southern Black Forest in Germany

    Mainstreaming of Nature-Based Solutions for the mitigation of hydro-meteorological hazard: governance analysis of a socio- technical change

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    The Nature-Based Solutions (NBS) concept and approach were developed to simultaneously face challenges such as risk mitigation and biodiversity conservation and restoration. NBSs have been endorsed by major International Organizations such as the EU, the FAO and World Bank that are pushing to enable a mainstreaming process. However, a shift from traditional engineering “grey” solutions to wider and standard adoption of NBS encounters technical, social, cultural, and normative barriers that have been identified with a qualitative content analysis of policy documents, reports and expert interviews. The case of the region Emilia-Romagna was studied by developing an analytical framework that brought together the social-ecological context, the governance system and the characteristics of specific NBSs

    Scientific dissemination and professional practices through digital media: The study of pragmatic strategies in the communication of international research projects

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    La investigación científica hoy en día está ligada a los procesos de globalización y a la búsqueda de la innovación y la excelencia, lo cual favorece una creciente colaboración, internacionalización y multidisciplinariedad. Para llevar a cabo estas iniciativas ambiciosas y de gran escala, los investigadores necesitan la financiación externa que distintas organizaciones, instituciones y programas pueden proporcionar. Esta reconfiguración del trabajo académico va de la mano de la ubiquidad y popularidad de Internet. Un extenso abanico de géneros, plataformas y medios digitales permiten a los científicos y académicos difundir sus investigaciones a una audiencia amplia y heterogénea. La inversión de esfuerzo en la comunicación mediada digitalmente permite a los investigadores contribuir a una diseminación más efectiva del conocimiento generado, así como cumplir con su compromiso social. Por otra parte, este esfuerzo les puede permitir reforzar su reputación como investigadores y conseguir un mayor impacto. Un ejemplo destacado de este escenario académico cambiante donde se maximiza el discurso digital para propósitos investigadores es el de los proyectos de investigación internacionales. Se trata de consorcios compuestos de miembros provenientes de entornos socioculturales y profesionales distintos que hacen uso de sitios web y redes sociales para la diseminación de sus proyectos conjuntos y utilizan las características tecnológicas y comunicativas de estos espacios digitales para ofrecer actualizaciones periódicas de su trabajo e información sobre hallazgos en progreso y resultados de investigación. De este modo, rinden cuentas a los organismos que los financian y aumentan su visibilidad entre los lectores digitales. Las intenciones comunicativas de estos equipos de investigación para cumplir dichos objetivos se codifican y transmiten discursivamente a través de diversas estrategias pragmáticas, que se encuadran en determinados parámetros contextuales y que responden a las especificidades del medio y se ven constreñidas por estas. Estas estrategias revelan cómo los investigadores comparten la información, cómo publicitan sus hallazgos y cómo se dirigen a sus potenciales lectores.Así, esta tesis doctoral tiene como objetivo investigar las estrategias pragmáticas prominentes en lengua inglesa empleadas por grupos de investigación internacionales en sus prácticas digitales discursivas, que normalmente se materializan en sitios webs y redes sociales para sus proyectos. Con este propósito, se compiló y analizó el corpus digital EUROPRO, que contiene 30 sitios web de proyectos de investigación que recibieron financiación en el marco del programa Horizonte2020 (subcorpus EUROPROwebs) y las correspondientes cuentas de Twitter de aquellos proyectos (subcorpus EUROPROtweets). Dichos subcorpus han sido extraídos de la base de datos digital EUROPRO recopilada por el grupo de investigación InterGedi. En mi tesis doctoral propongo una taxonomía derivada de los datos como resultado del análisis del corpus, que comprende 27 estrategias organizadas en torno a tres macrocategorías: informativas, promocionales e interaccionales. Incido teórica y metodológicamente en el proceso de diseñar y revisar esta herramienta analítica para así demonstrar su solidez y viabilidad. Además, analizo el rango de ocurrencia, la frecuencia y el uso específico de estas estrategias en las secciones que aparecen de manera sistemática en los sitios web incluidos en el corpus y en las páginas web donde se aloja la mayor parte de la información sobre el proyecto (Homepage, About, Partners, News & Events), en las cuentas de Twitter y, de forma comparativa, entre las secciones web y los tuits, con el fin de observar tendencias significativas y en cuanto a similitudes y diferencias en su funcionamiento en estos medios digitales. Además, adopto un enfoque etnográfico mediante la inclusión de evidencias contextuales conseguidas a través de entrevistas semi-estructuradas con investigadores de los proyectos Horizonte2020, cuyos resultados ayudan a sustentar los hallazgos procedentes del análisis textual. También tomo una perspectiva multimodal sobre cómo se emplean las estrategias pragmáticas en los sitios web de proyectos de investigación en relación a la sección Homepages. Este análisis, en concreto, permite reconocer el potencial de los recursos verbales y visuales para la construcción de significado desde una perspectiva pragmática. En general, el presente estudio busca ahondar en nuestro entendimiento de prácticas académicas digitales que están evolucionando rápidamente y que tienen gran alcance, en particular adoptadas por grupos de investigación, que pueden beneficiarse de los resultados y las implicaciones de esta investigación para la futura comunicación y diseminación de sus proyectos científicos.<br /

    LIPIcs, Volume 274, ESA 2023, Complete Volume

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    LIPIcs, Volume 274, ESA 2023, Complete Volum
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