Carrying extra pounds can impact your sexual performance, and not just by lowering your self-esteem. Obese men have lower levels of the male hormone testosterone, which is important for sexual desire and producing an erection. Being overweight is also linked to high blood pressure and hardening of the arteries, which can reduce blood flow to the penis. Some guys are asking about how to buy cialis online? Aye! Here it moves - simply click this link and get your answer. Among many recommended online pharmacies in online south africa to order cialis online south africa is my favourite. Try it out and know that buying cialis online is easy. Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Being overweight and getting too little exercise also contribute to ED. Studies indicate that men who exercise regularly have a lower risk of ED. Here is the antibiotics online is a known meds to kill infections. huge selection of generic terbinafine antibiotics are available to lamisil online price on that chemist store. they sell generic terbinafine. Majority of guys estimate the value of cost as need of good cheap antibiotics to treat various infeactions, that's why they put their belief on effectivness of antibiotics online.

Public service leaders in emerging markets often look for best-practice initiatives and guidance on their own projects, but frequently fail to achieve desired outcomes, writes By Livingstone Chilwane, MD for health and public service at Accenture.
While it makes sense to emulate excellence, attempting to copy best projects without careful planning and adaptation usually ends in disaster. Replication works best for easily quantifiable, low-complexity, discrete tasks in controllable environments.
In fast-food franchises all around the world, ingredients, uniforms, processes, standards and even interior design and architecture are replicated at low cost and with minimal adjustment. Public services, in contrast, are highly complex by nature and depend on a variety of interacting stakeholders, subject to the whims of politicians and citizens, and intimately bound up with local cultural and environmental conditions that vary within national borders, let alone across them.
City planners for Brazil’s business capital, Sao Paulo — for example, sought to emulate the successes of Chicago, Paris, Moscow and Vienna in creating an automobile-centred, radial road system. But in the process, they overlooked several local realities, like the fact that Sao Paulo’s steep, hilly terrain made the proposed geometric road patterns extremely challenging to build.
The design also required the city to straighten several naturally meandering rivers, increasing the risk of flooding and other environmental damage. Consequently, the city today suffers from frequently flooded roads and some of the world’s highest levels of traffic congestion and pollution.
South African public service leaders also look for guidance abroad and should be careful when replicating successful projects. They should consider the following traps:
* Beware of outliers that others can’t replicate – Outliers are extraordinarily difficult to replicate. These projects are typically high-profile, pet projects that aim to prove a concept. They therefore tend to have significant sponsorship and are often led by an inspirational leader and staffed by an enthusiastic workforce that is happy to commit extraordinary time and energy to the project. These conditions can propel an initial concept-proving pilot to great success. In contrast, attempts to recreate the same project elsewhere — often with overworked, low-paid and disinterested workers — will typically fail. Replications rarely receive the same enthusiastic support and resources as the initial innovative trailblazer.
* Never assume behaviour of your stakeholders – Launching a new public service project involves interaction across a range of stakeholders, including citizens, public sector workers, politicians and the media. Predicting the actions and reactions of these actors is hard enough, let alone expecting their behaviours and dynamics to be similar across different contexts. Initiatives that succeed in multiple locations can still fail in the next one because the citizens react differently to the concept or to the implementation approach. Other issues can arise because the local workforce rejects the solution in the form that worked elsewhere, or because the political establishment in the new location does not support the initiative. Usually, these failures involve a lack of communication and the consequent lack of buy-in from stakeholders who have no sense of ownership in the project or feel it has no relevance to their circumstances.
* Beware of accumulated contextual differences – The contextual environment in two separate locations will vary according to multiple differences in the political, social, cultural, infrastructural, geographical and environmental conditions. These differences accumulate to influence project delivery on the ground. Implementing identical processes in two locations is therefore likely to result in very different outcomes in each location. Projects aimed at replicating successful information and communications technology (ICT) solutions offer classic examples of this dynamic. ICT projects should scale up easily, cheaply and rapidly due to the nature of the technology. But scaling is frequently hampered by a combination of environmental factors that vary across locations. Incompatible infrastructure — such as electricity supplies or sockets, climatic conditions or weak content relevance to the local community — language or social environment — are typical examples of factors that frustrate replication attempts. A World Bank report looking at ICT for development projects between 2003 and 2010 found a 70% failure rate in projects aiming to deliver universal access to ICT. In the 2000s, India gained a reputation in this field as “a graveyard of successful pilots,” due to this struggle to replicate ICT project successes. More recently, city planners have been discussing why it is proving so difficult to replicate the success of “smart city” solutions across different locations. Experience shows that the accumulated contextual differences between locations renders exact replication across multiple locations practically impossible.
It is advisable to learn from multiple projects in different contexts. Project planners need to actively design their own unique model that’s relevant to their circumstances, while in the process learning from the wisdom and experience of multiple other instances. Specifically, our research reveals the importance of learning from the patterns and dynamics that are common across multiple successful projects.
It is also important to engage with your stakeholders from the planning process and invest in establishing formal and informal channels to connect different groups based on genuine interaction and feedback. Regular communication between stakeholders and project planners can build coalitions of shared objectives and common interest. These interactions have the added benefit of generating input to improve the local relevance of project plans.
Leaders should focus on outcomes. As Jeffrey Bradach of the Bridgespan Group, who has published, taught and advised extensively on scaling success in the non-profit sector, put it, “The objective is to reproduce a successful programme’s results, not to slavishly recreate every one of its features.” The desired outcomes must be context-specific. Furthermore, there must be mechanisms to monitor progress toward those outcomes, and to bring attention to situations where there is divergence from them. This monitoring and continual realignment makes the project a living, breathing part of its context. It ensures local relevance even as circumstances and behaviours evolve during the project’s progress.