4,342 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

    Ab Initio Language Teaching in British Higher Education

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    Drawing extensively on the expertise of teachers of German in universities across the UK, this volume offers an overview of recent trends, new pedagogical approaches and practical guidance for teaching at beginners level in the higher education classroom. At a time when entries for UK school exams in modern foreign languages are decreasing, this book serves the urgent need for research and guidance on ab initio learning and teaching in HE. Using the example of teaching German, it offers theoretical reflections on teaching ab initio and practice-oriented approaches that will be useful for teachers of both German and other languages in higher education. The first chapters assess the role of ab initio provision within the wider context of modern languages departments and language centres. They are followed by sections on teaching methods and innovative approaches in the ab initio classroom that include chapters on the use of music, textbook evaluation, the effective use of a flipped classroom and the contribution of language apps. Finally, the book focuses on the learner in the ab initio context and explores issues around autonomy and learner strengths. The whole builds into a theoretically grounded guide that sketches out perspectives for teaching and learning ab initio languages that will benefit current and future generations of students

    Developing mHealth interventions:Using dual process theories to reduce cardiovascular disease risk

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    The sugars content of parental and new perspective descendant strawberry genotypes potential approach for the future selection process

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    Besides being one of the most commercially grown berry fruits, strawberries (Fragaria x annanassa Duch.) are known for their nutritional value, richness in polyphenols, and antioxidant capacity. New directions of strawberry breeding and selection are set towards premium fruit quality, high sugars content, and desirable sugars/total acids ratio (sweet index, SI), which represent some of the main prerequisites for selecting new breeding materials [1]. With this intention, a set of 24 strawberry genotypes was cultivated, including 12 parental varieties and 12 of their descendants - perspective candidates obtained by crossing the parental varieties mentioned above. A total of eleven sugars were quantified using High-Performance Anion-Exchange Chromatography with Pulsed Amperometric Detection (HPAEC-PAD). Results implied that glucose, sorbitol, sucrose, and melibiose content were the most important sugars in separating the fruits of parental varieties and their progeny [2]. Results showed that old, parental varieties had a significantly higher content of glucose and sucrose, while new perspective genotypes had higher sorbitol and melibiose content (Fig.2). PCA analysis confirmed that parental (samples 1-12) and descendant genotypes (samples 13-24), could be discriminated according to sugars profile i.e. that these four sugars have an effect on their differentiation (Fig.1). This was in accordance with Mann-Whitney U test results (Fig.2). Fig.1. Principal Component Analysis - The difference between parental and descendant genotypes; score plot (A) – parental samples (PS) 1-12, descendant (DS) samples 13-24, and loading plot (B) – sugar components. Acknowledgments: This work has been supported by the Ministry of Education, Science, Technological Development and Innovation of Republic of Serbia, Contract number: 451-03-47/2023-01/200168 and 451-03-47/2023-01/200288., as well as company “Zeleni hit d.o.o.” from Belgrade, Serbia and “BerryLab” breeding consortium from Italy. References: [1] L. Mazzoni, L. di Vittori, F. Balducci, T.Y. Forbes-Hernandez, F. Giamperi, M. Battino, B. Mezzeti, F. Capocasa, Scientia Horticulturae, 261: 108945 (2019). [2] M. Fotirić Akšić, T. Tosti, M. Sredojević, J. Milivojević, M. Meland, M. Natić, Plants, 8: 205 (2019).Poster: [https://cherry.chem.bg.ac.rs/handle/123456789/5975

    Accidental awareness during general anaesthesia in obstetric surgery

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    Accidental awareness during general anaesthesia (AAGA) occurs when a patient becomes unintentionally conscious during general anaesthesia, which may involve unpleasant memories of experiences during surgery. Contributory factors that may increase risk of AAGA coincide in pregnant women undergoing general anaesthesia for childbirth related surgery. Whilst obstetric general anaesthesia has largely been substituted by spinal and epidural (termed neuraxial) anaesthetic techniques, in which a mother can be awake and pain free during childbirth, general anaesthesia is still necessary to facilitate surgery rapidly in emergency situations or for mothers with certain medical conditions. In this thesis I investigate the distinct characteristics of general anaesthesia for pregnant women undergoing surgery for childbirth, whether these characteristics increase risk of AAGA, and changes to obstetric anaesthetic technique occurring in the context of wider anaesthetic developments over time. I provide evidence on the incidence, experiences, risk factors and psychological consequences of AAGA in peripartum women. Challenges to large scale clinical study of AAGA are explored and addressed in the design of a multi-centre, prospective, cross-sectional cohort study of women receiving general anaesthesia for obstetric surgery in 72 hospitals in England. A four-stage process for screening patients using direct questioning, verifying with corroborative detail, adjudicating and classifying descriptions of experiences is described. The interactional nature of research interviews, statistical modelling, psychological factors and the neurophysiology of memory are considered during development of study methodology. Psychological morbidity was assessed for 12 months after surgery. As part of an embedded study, descriptive epidemiology of obstetric patients and general anaesthesia techniques were identified, alongside risk factors for airway complications. A total of 3,115 patients were recruited, 12 of whom had certain/probable or possible AAGA: a prevalence of 0.39% or 1 in 256 (95%CI 149–500) for all obstetric surgery. Distressing experiences were reported by seven (0.22%) patients, paralysis by five (0.16%) and paralysis with pain by two (0.06%). Associations were identified between AAGA and patient risk factors (abnormal body mass index), organisational factors (out-of-hours surgery) and pharmacological factors (use of thiopental during induction of anaesthesia). Contextual factors relating anaesthesia for obstetric patients with AAGA and other anaesthesia complications, including difficult airway management, were evaluated. My study methodology and it’s context, in English public sector hospitals, identified a higher risk of AAGA in obstetric patients than previously detected using other methods and locations. These results have implications for healthcare policy of obstetric anaesthesia, informed consent of patients receiving general anaesthesia and post-natal screening care. I conclude on recommendations to minimise awareness risk for future patients and address the challenge of implementing systemic improvements in obstetric general anaesthesia care and patient safety

    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 /

    A Qualitative and Quantitative Analysis of the Impact of Eco-Cultural Background on Investment Decision Making by Professional Fund Managers

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    Theories of cultural psychology, cultural finance, and sociology provided the foundation for a cross-cultural model of investment decision making. Using a combination of interviews and self-report questionnaires with fund managers from China and the West (72 interviews and 187 questionnaires respectively) it was found that five key investment behaviours differed between Chinese and Western fund managers. These included preference towards macroeconomic information, top-down stock selection, utilising contextual information in management evaluation, choice of average holding period, and holding time for a losing stock. It was further found that individualistic cultural values and holistic thinking, which in the research of cross-cultural behavioural differences have traditionally been observed as influential, were not mediating factors in investment decision making. In contrast, the economic context of a fund manager’s domestic country was identified as an influential factor in the development of a mindset supportive of investment decision making. Similarly, cross-cultural differences in the use of intuition during the investment decision making process were found to relate more to contextual factors (i.e., Chinese or Western market) rather than individuals’ cognitive style. On the other hand, personal cognitive style are expected to impact the association between one investment behavioural difference - the choice of average holding period, and investment returns. In other words, opting for a longer holding period is only detrimental in the case of fund managers who display a greater than average preference for holistic thinking, regardless of cultural background. These findings both support and extend the current financial literature and have implications for investment practice, investors’ education, and policy making

    Exploring curriculum policy-practice gaps in Jamaica: learning from policymakers, principals and teachers

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    This study highlights the relationship between curriculum policy intention and enactment. It considered the gap between the design of the National Standards Curriculum (NSC) in Jamaica and its enactment in a sample of twenty schools. The aim is to inform a real-world understanding of the expectations of curriculum policymakers and principals, and teachers as curriculum enactors. The study utilises a qualitative methodology with thematic analysis. Data were collected using secondary and primary sources. Secondary sources included published and unpublished reports, desk reviews and my professional knowledge of Jamaica's public education system. Primary sources were lesson observations and policymaker and practitioner interviews. The participants were seven key Ministry of Education and Youth Policymakers, twenty school principals and twenty classroom teachers who implemented the NSC. The theoretical framework includes Blumer's symbolic interactionism, globalisation and education reform, learner-centred pedagogy, social and sociocultural constructivism, Freire's critical pedagogy, curriculum enactment and Elbaz's theory of teachers' practical knowledge. The research provides a means for the participants to contribute a contextual understanding of the possible pitfalls of implementing a globally inspired curriculum policy in a small developing state with post-colonial antecedents and significant resource constraints. Generally, policymakers were unsophisticated in their policy expectations for the NSC. The principals view themselves as extensions of the MOEY, diminishing their role in enacting the NSC. Both policymakers and principals failed to recognise teachers' practical knowledge and support for the NSC. Their failure creates further dissonance between the NSC as a policy and its enactment in the classroom. However, teachers bear some responsibility for the inertia in enacting the NSC. This failure is partially due to a skill and knowledge deficit, which policymakers and principals should work together to address. Finally, this study adds to the available literature on education policy-practice gaps, illustrates this phenomenon of global curriculum reform movements in a small Caribbean state and reinforces the intrinsic value of engaging in real-world research to understand and solve complex problems
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