7,881 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

    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

    Victims' Access to Justice in Trinidad and Tobago: An exploratory study of experiences and challenges of accessing criminal justice in a post-colonial society

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    This thesis investigates victims' access to justice in Trinidad and Tobago, using their own narratives. It seeks to capture how their experiences affected their identities as victims and citizens, alongside their perceptions of legitimacy regarding the criminal justice system. While there have been some reforms in the administration of criminal justice in Trinidad and Tobago, such reforms have not focused on victims' accessibility to the justice system. Using grounded theory methodology, qualitative data was collected through 31 in-depth interviews with victims and victim advocates. The analysis found that victims experienced interpersonal, structural, and systemic barriers at varying levels throughout the criminal justice system, which manifested as institutionalized secondary victimization, silencing and inequality. This thesis argues that such experiences not only served to appropriate conflict but demonstrates that access is often given in a very narrow sense. Furthermore, it shows a failure to encompass access to justice as appropriated conflicts are left to stagnate in the system as there is often very little resolution. Adopting a postcolonial lens to analyse victims' experiences, the analysis identified othering practices that served to institutionalize the vulnerability and powerlessness associated with victim identities. Here, it is argued that these othering practices also affected the rights consciousness of victims, delegitimating their identities as citizens. Moreover, as a result of their experiences, victims had mixed perceptions of the justice system. It is argued that while the system is a legitimate authority victims' endorsement of the system is questionable, therefore victims' experiences suggest that there is a reinforcement of the system's legal hegemony. The findings suggest that within the legal system of Trinidad and Tobago, legacies of colonialism shape the postcolonial present as the psychology and inequalities of the past are present in the interactions and processes of justice. These findings are relevant for policymakers in Trinidad and Tobago and other regions. From this study it is recognized that, to improve access to justice for victims, there needs to be a move towards victim empowerment that promotes resilience and enhances social capital. Going forward it is noted that there is a need for further research

    The place where curses are manufactured : four poets of the Vietnam War

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    The Vietnam War was unique among American wars. To pinpoint its uniqueness, it was necessary to look for a non-American voice that would enable me to articulate its distinctiveness and explore the American character as observed by an Asian. Takeshi Kaiko proved to be most helpful. From his novel, Into a Black Sun, I was able to establish a working pair of 'bookends' from which to approach the poetry of Walter McDonald, Bruce Weigl, Basil T. Paquet and Steve Mason. Chapter One is devoted to those seemingly mismatched 'bookends,' Walt Whitman and General William C. Westmoreland, and their respective anthropocentric and technocentric visions of progress and the peculiarly American concept of the "open road" as they manifest themselves in Vietnam. In Chapter, Two, I analyze the war poems of Walter McDonald. As a pilot, writing primarily about flying, his poetry manifests General Westmoreland's technocentric vision of the 'road' as determined by and manifest through technology. Chapter Three focuses on the poems of Bruce Weigl. The poems analyzed portray the literal and metaphorical descent from the technocentric, 'numbed' distance of aerial warfare to the world of ground warfare, and the initiation of a 'fucking new guy,' who discovers the contours of the self's interior through a set of experiences that lead from from aerial insertion into the jungle to the degradation of burning human feces. Chapter Four, devoted to the thirteen poems of Basil T. Paquet, focuses on the continuation of the descent begun in Chapter Two. In his capacity as a medic, Paquet's entire body of poems details his quotidian tasks which entail tending the maimed, the mortally wounded and the dead. The final chapter deals with Steve Mason's JohnnY's Song, and his depiction of the plight of Vietnam veterans back in "The World" who are still trapped inside the interior landscape of their individual "ghettoes" of the soul created by their war-time experiences

    The determinants of value addition: a crtitical analysis of global software engineering industry in Sri Lanka

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    It was evident through the literature that the perceived value delivery of the global software engineering industry is low due to various facts. Therefore, this research concerns global software product companies in Sri Lanka to explore the software engineering methods and practices in increasing the value addition. The overall aim of the study is to identify the key determinants for value addition in the global software engineering industry and critically evaluate the impact of them for the software product companies to help maximise the value addition to ultimately assure the sustainability of the industry. An exploratory research approach was used initially since findings would emerge while the study unfolds. Mixed method was employed as the literature itself was inadequate to investigate the problem effectively to formulate the research framework. Twenty-three face-to-face online interviews were conducted with the subject matter experts covering all the disciplines from the targeted organisations which was combined with the literature findings as well as the outcomes of the market research outcomes conducted by both government and nongovernment institutes. Data from the interviews were analysed using NVivo 12. The findings of the existing literature were verified through the exploratory study and the outcomes were used to formulate the questionnaire for the public survey. 371 responses were considered after cleansing the total responses received for the data analysis through SPSS 21 with alpha level 0.05. Internal consistency test was done before the descriptive analysis. After assuring the reliability of the dataset, the correlation test, multiple regression test and analysis of variance (ANOVA) test were carried out to fulfil the requirements of meeting the research objectives. Five determinants for value addition were identified along with the key themes for each area. They are staffing, delivery process, use of tools, governance, and technology infrastructure. The cross-functional and self-organised teams built around the value streams, employing a properly interconnected software delivery process with the right governance in the delivery pipelines, selection of tools and providing the right infrastructure increases the value delivery. Moreover, the constraints for value addition are poor interconnection in the internal processes, rigid functional hierarchies, inaccurate selections and uses of tools, inflexible team arrangements and inadequate focus for the technology infrastructure. The findings add to the existing body of knowledge on increasing the value addition by employing effective processes, practices and tools and the impacts of inaccurate applications the same in the global software engineering industry

    The Disputation: The Enduring Representations in William Holman Hunt's “The Finding of the Saviour in the Temple,” 1860

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    This interdisciplinary thesis problematizes the Jewish presence in the painting The Finding of the Saviour in the Temple (1860) by William Holman Hunt. This “Jewish presence” refers to characters within the painting, Jews who posed for the picture and the painting’s portrayal of Judaism. The thesis takes a phenomenological and hermeneutical approach to The Finding providing careful description and interpretation of what appears in the painting. It situates the painting within a newly configured genre of disputation paintings depicting the Temple scene from the Gospel of Luke (2:47 – 52). It asks two questions. Why does The Finding look the way it does? And how did Holman Hunt know how to create the picture? Under the rubric of the first question, it explores and challenges customary accounts of the painting, explicitly challenging the over reliance upon F.G. Stephens’s pamphlet. Additionally, it examines Pre-Raphaelite and Victorian religious contexts and bringing hitherto unacknowledged artistic contexts to the fore. The second question examines less apparent influences through an analysis of the originary Lukan narrative in conjunction with the under-examined genre of Temple “disputation” paintings, and a legacy of scholarly and religious disputation. This demonstrates a discourse of disputation informing The Finding over and above the biblical narrative. In showing that this discourse strongly correlates with the painting’s objectifying and spectacular properties, this thesis provides a new way to understand The Finding’s orientalism which is further revealed in its typological critical reworking of two Christian medieval and renaissance paintings. As a demonstration of the discourse, the thesis includes an examination of Jewish artists who addressed the theme of disputation overtly or obliquely thereby engaging with and challenging the assumptions upon which the disputation rests

    Changing society: pioneering women entrepreneurs in Saudi Arabia.

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    The research examines the role of institutions influencing Saudi female entrepreneurs, and how they became enabled to be social agents and institutional entrepreneurs in a very traditional, family-orientated society - albeit facing pressures to change. In acknowledging the uniqueness of the social-cultural context in Saudi Arabia, this study adopts a qualitative design. Specifically, purposive and snowball sampling techniques were implemented to gather primary qualitative data. The data draw on 31 interviews with female entrepreneurs residing in Jeddah, capturing the practical experiences of these entrepreneurs, and their engagement with the informal and formal institutions of their immediate societal surroundings. The analysis relies on the constant-comparative method (Anderson and Jack 2015) to illicit the meanings and implications taken from context, and also how this informs the day-to-day activities of the entrepreneur (Anderson et al. 2012). This study has found that existing institutions both constrain and enable Saudi women's entrepreneurship. In particular, the obligations and responsibility of Arab families are turned into an advantage, in the form of a patient resource base or networks of knowledge development. We saw too how pioneering efforts, in conjunction with other change, have begun to modestly alter the opportunity structure in Saudi Arabia, with the entrepreneur acting as an agent of change. Saudi women's entrepreneurship is thus best characterised as a recursive process between these entrepreneurs and the social system, which is an essential resource for - and product of - situated actions. This research makes a modest contribution to the long-running discussions on women's entrepreneurship in the context of the Arab world. The findings cannot suggest that it is going to be easy or smooth for future women entrepreneurs; traditions continue and there are also vested patriarchal interests. Nonetheless, increasing numbers of Saudi women are involved in growing their businesses. These pioneers have changed society; a modest, but progressive change for the better. This study has several implications. First, the produced empirical findings have highlighted certain areas for further improvement of female entrepreneurship in Saudi Arabia, which goes in keeping with Saudi Vision 2030 and the expected role of women in the social and economic development of Saudi Arabia. Second, this study has contributed to the existing body of knowledge and understanding of what institutional barriers and challenges Saudi female entrepreneurs face and how they could be overcome at a national level

    Building body identities - exploring the world of female bodybuilders

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    This thesis explores how female bodybuilders seek to develop and maintain a viable sense of self despite being stigmatized by the gendered foundations of what Erving Goffman (1983) refers to as the 'interaction order'; the unavoidable presentational context in which identities are forged during the course of social life. Placed in the context of an overview of the historical treatment of women's bodies, and a concern with the development of bodybuilding as a specific form of body modification, the research draws upon a unique two year ethnographic study based in the South of England, complemented by interviews with twenty-six female bodybuilders, all of whom live in the U.K. By mapping these extraordinary women's lives, the research illuminates the pivotal spaces and essential lived experiences that make up the female bodybuilder. Whilst the women appear to be embarking on an 'empowering' radical body project for themselves, the consequences of their activity remains culturally ambivalent. This research exposes the 'Janus-faced' nature of female bodybuilding, exploring the ways in which the women negotiate, accommodate and resist pressures to engage in more orthodox and feminine activities and appearances
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