A role delineation study for the SME

The purpose of this research was to perform a role delineation study to validate and prioritize the competency areas included in the body of knowledge developed by SME/AME/Shingo for their three levels of certification examinations in lean manufacturing. A modified Delphi technique was used to gather data and describe what experts in the field consider important for candidates to know and become certified in the discipline of lean manufacturing. Seventy-six Delphi panel experts were selected to serve on the Delphi panel, based on their experience, expertise, and commitment. The study incorporated a Web-based pre-Delphi study followed by three rounds of Delphi questionnaire iterations in both mail and electronic format. A hybrid quantitative and qualitative research design was used for this study in which the Delphi experts were asked to rate the importance of competency areas for testing at each level of lean certification using a 5-point Likert scale and provide additional comments. A convergence of opinion on the competency areas obtained from the Delphi study provided a basis for validating the body of knowledge. A combined grand average of the mean rating of importance and yes percent rating for inclusion was utilized to determine the number of items to be included under each major domain for the Bronze, Silver, and Gold levels of lean certification examinations. The results of the study indicated a need for modifications in the body of knowledge, change in percentage of importance to five major domains under each certification level, and inclusion of a few additional competency areas

Which Is the Best Parametric Statistical Method For Analyzing Delphi Data?

This study compares the three parametric statistical methods: coefficient of variation, Pearson correlation coefficient, and F-test to obtain reliability in a Delphi study that involved more than 100 participants. The results of this study indicated that coefficient of variation was the best procedure to obtain reliability in such a study

A community based study to determine incidence of cervical cancer and willingness of women to participate in cervical cancer screening program in Navsari, Gujarat, India

Background: Carcinoma of the uterine cervix is a major health problem faced by the Indian women. Regular cervical cytological examination by all sexually active women can prevent the occurrence of carcinoma cervix. Early detection of cervical cancer is possible with Pap smear tests. Methods: Women above 25 years of age, living in study area and want to participate in study were included. Total 2352 women were enrolled in study. House to house visits were conducted in all the village area by using simple random sampling method. Information about cervical cancer was given. Pap test for cervical cancer screening was carried out by gynaecologist. Cytological examination and confirmation was done by pathologists.Results: A total of 3001 women had attended village level IEC session and out that, 2352 (78.4%) women took part in the screening program. Out of these 2352 women, 2007 women (85.3% compliance) had given consent for physical cervical examination and Pap smear. The incidence of cervical cancer was 0.2% on the basis of clinical examination and biopsy.Conclusions: Higher compliance for undergoing vaginal examination and Pap test shows the positive health seeking behaviour of the women but for that, strong IEC and sensitization about the disease must be done to improve the participation. Sensitivity of Pap test was poor and couldn’t find true positive cases

Evaluation of the effect of topical cefadroxil on bacterial load of pathogenic staphylococci in anterior nares in human volunteers, comparative study between oral vs. topical cefadroxil and evaluation of effect of combination of oral plus topical cefadroxil in patients with staphylococcal superficial skin infections

Background: Cefadroxil has good tissue penetration & exerts more sustained action at the site of infection after oral absorption. Our aim of the study was to check topical cefadroxil has any efficacy over staphylococcal superficial skin infection or not.Methods: Pre-treatment nasal swabs were obtained from 25 healthy human volunteers and bacterial load was recorded. After single application of topical cefadroxil 3% in left anterior nare and placebo (vehicle) in right anterior nare nasal swabs were obtained and results were compared. 150 patients with staphylococcal superficial skin infections were distributed in 4 groups: Group A - oral cefadroxil 500 mg twice daily for 5 days, Group B - topical cefadroxil (0.5 % to 5%) twice daily, Group C - cefadroxil 500 mg orally plus placebo (vehicle) topically twice daily and Group D -cefadroxil 500 mg orally plus cefadroxil preparation topically twice daily. Bacterial load was measured before treatment, on follow up &after clinical cure and results were compared.Results: Topical cefadroxil significantly reduced bacterial load after single application in anterior nare. Topical cefadroxil cured and significantly reduced bacterial load in staphylococcal superficial skin infections within 3 days of treatment. Oral plus topical cefadroxil combination therapy significantly reduced bacterial load and cured infection within 3 days of treatment in patients with moderate to heavy bacterial growth. No any adverse effect was observed during entire study period in any of groups.Conclusions: Topical preparation of cefadroxil is safe and effective in treating staphylococcal superficial skin infections. Combination of oral plus topical cefadroxil showed synergistic effect in infections with moderate to heavy growth. This study is registered at CTRI [REG ID: CTRI/2013/02/003433 REF: REF/2013/02/004576]

A rare case of retroperitoneal leiomyosarcoma

Leiomyosarcoma, a rare malignancy of smooth muscle may arise from the retroperitoneum. They often reach a large size before diagnosis is made. Patient presents with vague symptoms, as such retroperitoneal malignancies are related to displacement of organs and obstructive phenomenon. The present paper is one of the very few case reports of retroperitoneal leiomyosarcoma which illustrates the presenting symptoms, gross and microscopic findings, treatment modalities and prognostic indicators of a 70 years old male seen at Government medical college, New Civil Hospital, Surat

Agricultural land-uses consistently exacerbate infectious disease risks in Southeast Asia.

Agriculture has been implicated as a potential driver of human infectious diseases. However, the generality of disease-agriculture relationships has not been systematically assessed, hindering efforts to incorporate human health considerations into land-use and development policies. Here we perform a meta-analysis with 34 eligible studies and show that people who live or work in agricultural land in Southeast Asia are on average 1.74 (CI 1.47-2.07) times as likely to be infected with a pathogen than those unexposed. Effect sizes are greatest for exposure to oil palm, rubber, and non-poultry based livestock farming and for hookworm (OR 2.42, CI 1.56-3.75), malaria (OR 2.00, CI 1.46-2.73), scrub typhus (OR 2.37, CI 1.41-3.96) and spotted fever group diseases (OR 3.91, CI 2.61-5.85). In contrast, no change in infection risk is detected for faecal-oral route diseases. Although responses vary by land-use and disease types, results suggest that agricultural land-uses exacerbate many infectious diseases in Southeast Asia

Resource availability, utilisation and cost in the provision of critical care in Tanzania: a protocol for a systematic review

INTRODUCTION: Critical care is essential in saving lives of those that are critically ill, however, provision of critical care can be costly and heterogeneous across lower-resource settings. This paper describes the protocol for a systematic review of the literature that aims to identify the reported costs and resources available for the provision of critical care and the forms of critical care provision in Tanzania. METHODS AND ANALYSIS: The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (MEDLINE, Embase and Global Health) will be searched to identify articles that report the forms of critical care, resources used in the provision of critical care in Tanzania, their availability and the associated costs. The search strategy will be developed from four key concepts; critical care provision, critical illness, resource use, Tanzania. The articles that fulfil the inclusion and exclusion criteria will be assessed for quality using the Reference Case for Estimating the Costs of Global Health Services and Interventions checklist. The extracted data will be summarised using descriptive statistics including frequencies, mean and median of the quantity and costs of resources used in the components of critical care services, depending on the data availability. This study will be carried out between February and November 2021. ETHICS AND DISSEMINATION: This study is a review of secondary data and ethical clearance was sought from and granted by the Tanzanian National Institute of Medical Research (reference: NIMR/HQ/R.8a/Vol. IX/3537) and London School of Hygiene and Tropical Medicine (ethics ref: 22866). We will publish the review in a peer-reviewed journal as an open access article in addition to presenting the findings at conferences and public scientific gatherings. PROSPERO REGISTRATION NUMBER: The protocol was registered with PROSPERO; registration number: CRD42020221923