8,832 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

    An empirical investigation of the relationship between integration, dynamic capabilities and performance in supply chains

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    This research aimed to develop an empirical understanding of the relationships between integration, dynamic capabilities and performance in the supply chain domain, based on which, two conceptual frameworks were constructed to advance the field. The core motivation for the research was that, at the stage of writing the thesis, the combined relationship between the three concepts had not yet been examined, although their interrelationships have been studied individually. To achieve this aim, deductive and inductive reasoning logics were utilised to guide the qualitative study, which was undertaken via multiple case studies to investigate lines of enquiry that would address the research questions formulated. This is consistent with the author’s philosophical adoption of the ontology of relativism and the epistemology of constructionism, which was considered appropriate to address the research questions. Empirical data and evidence were collected, and various triangulation techniques were employed to ensure their credibility. Some key features of grounded theory coding techniques were drawn upon for data coding and analysis, generating two levels of findings. These revealed that whilst integration and dynamic capabilities were crucial in improving performance, the performance also informed the former. This reflects a cyclical and iterative approach rather than one purely based on linearity. Adopting a holistic approach towards the relationship was key in producing complementary strategies that can deliver sustainable supply chain performance. The research makes theoretical, methodological and practical contributions to the field of supply chain management. The theoretical contribution includes the development of two emerging conceptual frameworks at the micro and macro levels. The former provides greater specificity, as it allows meta-analytic evaluation of the three concepts and their dimensions, providing a detailed insight into their correlations. The latter gives a holistic view of their relationships and how they are connected, reflecting a middle-range theory that bridges theory and practice. The methodological contribution lies in presenting models that address gaps associated with the inconsistent use of terminologies in philosophical assumptions, and lack of rigor in deploying case study research methods. In terms of its practical contribution, this research offers insights that practitioners could adopt to enhance their performance. They can do so without necessarily having to forgo certain desired outcomes using targeted integrative strategies and drawing on their dynamic capabilities

    Playing with (my)self: Reconfiguring 21st century performance art as an emerging encounter amongst the becoming-stage, the becoming-actor, and the becoming-audience

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    “Playing with (my)Self: Reconfiguring 21st Century Performance Art as an Emerging Encounter amongst the Becoming-Stage, the Becoming-Actor, and the Becoming-Audience” This practice-based PhD revolves around the stage, the actor, and the audiences as three primary locations where performance emerges via an encounter between those entities: the interplay between the stage, the performer, and the audience feeds back on itself to create the conditions with which it is possible for these encounters to generate emerging performance. This PhD relocates the stage onto the surface and intensity of the performer; creates multiplicity within a single performer/space; and produces a new sense of aesthetics through techniques of improvisation, use of costume, props and constructed spaces, led by notions of becoming and immanence, as both object and action of performance itself. In the context of performance studies, theatre technique and theory are explored to contribute to new performance in its expanded field, including theatre, moving image, and live performance, and works through notions of archetype, humour, and staging to create several new works of art as research. Theatre theorists and practitioners researched include Konstantin Stanislavski, Lee Strasberg, Anne Bogart and Tina Landau, Bertolt Brecht, Richard Foreman, and Tim Etchells. The main contribution and intention of this PhD is to show how theatre theory and technique positively inform fine art performance practice,in that builds a new sense of self, in that the actor or performer becomes one part of many co-emergences amongst the stage, the actor, and the audience, and seeks to add knowledge in the field of performance studies by establishing a new condition for the stage as an encounter with the performer, who is positioned as a structure from which performance emanates, and includes practical research into the mechanics of acting including the work of Konstantin Stanislavsky along with Lee Strasberg’s ‘Method Acting’ technique, and examines the space between the audience and the performed event as a co-producers, with a particular emphasis on Bertolt Brecht’s ‘Alienation Effect’. By putting myself in the role of actor in this research, I am examining how such a role can be decoupled from the actor in question, and how it can be totally linked within the co-emergent space of stage/actor/audience; in this way performers within performance can be viewed as one element among many within the constellation of performance-making. This research situates itself among Jos de Gruyter and Harald Thys’ moving image work; Diane Torr’s “Man For a Day” workshops; Andy Kaufman’s “Foreign Man” persona; Liz Magic Laser’s “I Feel Your Pain”; Marcus Coates’ shaman practice; Keren Citter’s moving image work; Mike Kelly’s musical “Day is Done”; Tino Seghal’s performance “These Associations”; Lindsay Seers’s photographic and installation practice; Ryan Trecartin’s video “Center Jenny”; Anna Deveare Smith’s verbatim theatre; and Cindy Sherman’s character-based photographic practice, among others. Bruce Nauman and Paul McCarthy, whose physical and conceptual spaces have been important points of departure researching sculpture as stage, and thresholds as they relate to perception and audience engagement are also examined. This research is also indebted to the performance practices of New York-based theatre artists Mabou Mines, Richard Foreman, and The Wooster Group, all of whom worked towards an aesthetics in theatre which bumped into the conceptual and practical space of performance art since the 1970s. Important theoretical contributions include Lyotard’s Libidinal Economy; Sartre’s essay The Look, Bertolt Brecht’s A Short Organum for the Theatre and particularly the Alienation Effect; Deleuze and Guattari’s A Thousand Plateaus; Deleuze’s essay One Less Manifesto; Strasberg’s A Dream of Passion with particular reference to Method Acting; Stanislavski’s An Actor Prepares; Ranciere’s The Emancipated Spectator; Bogart and Landau’s Viewpoints; and Lyotard’s Libidinal Economy

    Writing Facts

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    »Fact« is one of the most crucial inventions of modern times. Susanne Knaller discusses the functions of this powerful notion in the arts and the sciences, its impact on aesthetic models and systems of knowledge. The practice of writing provides an effective procedure to realize and to understand facts. This concerns preparatory procedures, formal choices, models of argumentation, and narrative patterns. By considering »writing facts« and »writing facts«, the volume shows why and how »facts« are a result of knowledge, rules, and norms as well as of description, argumentation, and narration. This approach allows new perspectives on »fact« and its impact on modernity

    The Middle Management Leader and the Matrixed Organization

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    The purpose of this qualitative case study was to explore the pivotal and challenging role that middle management leaders have in leading and managing matrixed teams within a matrixed organizational structure. The specific problem to be addressed was the possible inability of middle management leaders to lead effectively within the information technology (IT) industry where a matrixed organizational structure has been implemented resulting in ineffective teams that do not benefit an organization in achieving its strategic objectives. The outcome of the research and study were to contribute to the body of knowledge and to reduce the gaps in the literature by expanding on the understanding of middle management leaders and their pivotal and challenging roll leading and managing teams within a matrixed organizational structure. The study included 15 one-on-one interviews resulting in seven discovered themes. The seven themes that were discovered in conjunction with the existing literature provided key insight and applicable implementation strategies that can be utilized by middle management leaders that are leading and managing matrixed teams within a matrixed organizational environment and by matrixed organizations in order to better equip their middle management leaders. The conclusion of this study suggests that the challenges faced by middle management leaders can be overcome when proper steps and actions are taken and implemented by both middle management leaders and their matrixed organization

    Affinity-Based Reinforcement Learning : A New Paradigm for Agent Interpretability

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    The steady increase in complexity of reinforcement learning (RL) algorithms is accompanied by a corresponding increase in opacity that obfuscates insights into their devised strategies. Methods in explainable artificial intelligence seek to mitigate this opacity by either creating transparent algorithms or extracting explanations post hoc. A third category exists that allows the developer to affect what agents learn: constrained RL has been used in safety-critical applications and prohibits agents from visiting certain states; preference-based RL agents have been used in robotics applications and learn state-action preferences instead of traditional reward functions. We propose a new affinity-based RL paradigm in which agents learn strategies that are partially decoupled from reward functions. Unlike entropy regularisation, we regularise the objective function with a distinct action distribution that represents a desired behaviour; we encourage the agent to act according to a prior while learning to maximise rewards. The result is an inherently interpretable agent that solves problems with an intrinsic affinity for certain actions. We demonstrate the utility of our method in a financial application: we learn continuous time-variant compositions of prototypical policies, each interpretable by its action affinities, that are globally interpretable according to customers’ financial personalities. Our method combines advantages from both constrained RL and preferencebased RL: it retains the reward function but generalises the policy to match a defined behaviour, thus avoiding problems such as reward shaping and hacking. Unlike Boolean task composition, our method is a fuzzy superposition of different prototypical strategies to arrive at a more complex, yet interpretable, strategy.publishedVersio

    Report of the International Narcotics Control Board for 2022.

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    On Curation: A Hermeneutical Approach

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    Starting point of this paper is the philosophical field of hermeneutics. Hermeneutics was established to account for different conditions of understanding and how they shape our interpretative processes. As different times constitute different conditions, the goal of the discipline essentially is to bridge the temporal gap between the creation of a work and its perception at a given point in time. Whereas traditionally, understanding was a matter of analyzing the historical tradition of author/artist and reader/viewer, nowadays, the perception and interpretation of art is shaped by another instance, the curator. Under the premise that selection and arrangement, i.e. curating, cannot be neutral, the author analyzes different contexts in which curating takes place and how different contexts account for different effects on our perception of art. After outlining the development of the curatorial practice—from institutional to independent curation—, a case study of Swiss curator Harald Szeemann serves as opportunity to examine specific phenomena and exhibitions in a detailed manner. A cultural and methodological cesura is proposed after which curators were able to execute the power and influence they have today: independent curation and the ahistorical exhibition. Ahistorical exhibitions disregard chronological display and enable curators to create individual narratives and themes by gathering artworks in a cross-temporal and geographical manner. Throughout the paper, it is assessed if and to what degree the application of hermeneutics onto the field of independent curation is fruitful. This theoretical analysis is followed by a market overview, in which various functions the curator fulfills in different institutions, e.g. museums, galleries, auction houses, are outlined and compared. Optimally, the consideration of cultural and commercial factors enables viewers to approach and see (curated) art in a differentiated way
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