Performance indicator as the main and the only goal: a “dark side” of the intervention aims to accelerate HIV treatment entry among people who inject drugs in Kyiv, Ukraine

Abstract Background To improve healthcare entry and antiretroviral therapy (ART) initiation for HIV-positive people who inject drugs (PWID) in Ukraine, an intervention built upon a successful community-based harm reduction project and the existing best practices was developed. In this article, we present the results of the study conducted in collaboration with one of the recipient organizations of the intervention in Kyiv. The research question was formulated as follows: how does the interaction between different actors work to lead it to a positive outcome (initiation PWIDs into ART) within the limited period of the intervention implementation? Methods The central focus of the study was on the work activities of case managers. Their daily routines as well as their interactions with their clients and medical workers were observed and analyzed. Using the institutional ethnography approach, we explore the institutional orders, power imbalances, and social factors that play different roles in coordinating the process of PWIDs entry into healthcare and HIV treatment. Results The most intriguing result of the study is that the performance indicator that must be completed in order to receive a full salary—as a way to manage the activities of case managers—produces conditions for them to develop their cooperation with medical workers but leaves the clients and their needs out of this “boat” because interaction with them, in fact, does not help to meet case managers’ goals. Conclusions Accountability of case managers’ work assumes the primacy of the result over the process, which makes the process itself less important and the need to achieve the goal becomes the main and the only goal. This can be identified as an unintended consequence of the intervention implementation on the ground, or wider—an unintended consequence of the payment by results practice as a part of the general number-based policy

Research on the properties of Co-TiC and Ni-TiC HiP-sintered alloys

Three types of sintered alloys were fabricated based on cobalt, nickel and high-temperature alloy ZhS32-VI matrix with titanium carbide strengthening phase. TiC content was in a range of 30–50 vol. %. The melting temperatures of alloys are higher than 1320°C, and they may undergo undamaged through all technological procedures together with turbine blades, including soldering and outgassing. DSC analyses indicates no additional thermal effects until melting, which confirms their structural stability. The examinations of microstructure revealed three types of constituents – TiC particles, matrix solid solution and blow outs – structural defects having negative effects on all the studied properties. It was found that heat resistance of nickel based sintered alloys at the temperature of 1100°C is superior as compared with the alloys based on cobalt and alloy ZhS32-VI. It has been established that wear resistance in conditions of fretting wear at temperatures of 20, 850, 950 and 1050°C of sintered alloy with ZhS32-VI matrix is mostly superior as compared with the other alloys. The properties of produced alloys allow to use them for manufacturing of components of friction couples operating in conditions of high temperature fretting wear, including protective pads of turbine blades top shrouds contact faces