11,341 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

    Approximate Computing Survey, Part I: Terminology and Software & Hardware Approximation Techniques

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    The rapid growth of demanding applications in domains applying multimedia processing and machine learning has marked a new era for edge and cloud computing. These applications involve massive data and compute-intensive tasks, and thus, typical computing paradigms in embedded systems and data centers are stressed to meet the worldwide demand for high performance. Concurrently, the landscape of the semiconductor field in the last 15 years has constituted power as a first-class design concern. As a result, the community of computing systems is forced to find alternative design approaches to facilitate high-performance and/or power-efficient computing. Among the examined solutions, Approximate Computing has attracted an ever-increasing interest, with research works applying approximations across the entire traditional computing stack, i.e., at software, hardware, and architectural levels. Over the last decade, there is a plethora of approximation techniques in software (programs, frameworks, compilers, runtimes, languages), hardware (circuits, accelerators), and architectures (processors, memories). The current article is Part I of our comprehensive survey on Approximate Computing, and it reviews its motivation, terminology and principles, as well it classifies and presents the technical details of the state-of-the-art software and hardware approximation techniques.Comment: Under Review at ACM Computing Survey

    Cyber Conflict and Just War Theory

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    Exploring the Training Factors that Influence the Role of Teaching Assistants to Teach to Students With SEND in a Mainstream Classroom in England

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    With the implementation of inclusive education having become increasingly valued over the years, the training of Teaching Assistants (TAs) is now more important than ever, given that they work alongside pupils with special educational needs and disabilities (hereinafter SEND) in mainstream education classrooms. The current study explored the training factors that influence the role of TAs when it comes to teaching SEND students in mainstream classrooms in England during their one-year training period. This work aimed to increase understanding of how the training of TAs is seen to influence the development of their personal knowledge and professional skills. The study has significance for our comprehension of the connection between the TAs’ training and the quality of education in the classroom. In addition, this work investigated whether there existed a correlation between the teaching experience of TAs and their background information, such as their gender, age, grade level taught, years of teaching experience, and qualification level. A critical realist theoretical approach was adopted for this two-phased study, which involved the mixing of adaptive and grounded theories respectively. The multi-method project featured 13 case studies, each of which involved a trainee TA, his/her college tutor, and the classroom teacher who was supervising the trainee TA. The analysis was based on using semi-structured interviews, various questionnaires, and non-participant observation methods for each of these case studies during the TA’s one-year training period. The primary analysis of the research was completed by comparing the various kinds of data collected from the participants in the first and second data collection stages of each case. Further analysis involved cross-case analysis using a grounded theory approach, which made it possible to draw conclusions and put forth several core propositions. Compared with previous research, the findings of the current study reveal many implications for the training and deployment conditions of TAs, while they also challenge the prevailing approaches in many aspects, in addition to offering more diversified, enriched, and comprehensive explanations of the critical pedagogical issues

    Data-Driven Capacity Planning for Vehicular Fog Computing

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    The strict latency constraints of emerging vehicular applications make it unfeasible to forward sensing data from vehicles to the cloud for processing. To shorten network latency, vehicular fog computing (VFC) moves computation to the edge of the Internet, with the extension to support the mobility of distributed computing entities (a.k.a fog nodes). In other words, VFC proposes to complement stationary fog nodes co-located with cellular base stations with mobile ones carried by moving vehicles (e.g., buses). Previous works on VFC mainly focus on optimizing the assignments of computing tasks among available fog nodes. However, capacity planning, which decides where and how much computing resources to deploy, remains an open and challenging issue. The complexity of this problem results from the spatio-temporal dynamics of vehicular traffic, varying computing resource demand generated by vehicular applications, and the mobility of fog nodes. To solve the above challenges, we propose a data-driven capacity planning framework that optimizes the deployment of stationary and mobile fog nodes to minimize the installation and operational costs under the quality-of-service constraints, taking into account the spatio-temporal variation in both demand and supply. Using real-world traffic data and application profiles, we analyze the cost efficiency potential of VFC in the long term. We also evaluate the impacts of traffic patterns on the capacity plans and the potential cost savings. We find that high traffic density and significant hourly variation would lead to dense deployment of mobile fog nodes and create more savings in operational costs in the long term

    CITIES: Energetic Efficiency, Sustainability; Infrastructures, Energy and the Environment; Mobility and IoT; Governance and Citizenship

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    This book collects important contributions on smart cities. This book was created in collaboration with the ICSC-CITIES2020, held in San José (Costa Rica) in 2020. This book collects articles on: energetic efficiency and sustainability; infrastructures, energy and the environment; mobility and IoT; governance and citizenship
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