A process for developing a sustainable and scalable approach to community engagement : community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh

BACKGROUND: Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example. METHODS: The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey - which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level. RESULTS: A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable. CONCLUSIONS: This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context

Policies to Regulate Distributed Data Exchange

This research is partially sponsored by the EPSRC grant EP/P011829/1, funded under the UK Engineering and Physical Sciences Council Human Dimensions of Cyber Security call (2016).Postprin

Using A Normative Framework to Explore the Prototyping of Wireless Grids

The capacity for normative frameworks to capture the essential features of interactions between components in open architectures suggests they might also be of assistance in an early, rapid prototyping phase of system development, helping to refine concepts, identify actors, explore policies and evaluate feasibility. As an exercise to examine this thesis, we investigate the concept of the wireless grid. Wireless grids have been proposed to address the energy issues arising from a new generation of mobile phones, the idea being that local communication with other mobile phones, being cheaper, can be used in combination with network communication to achieve common goals while at the same time extending the battery duty cycle. This results in a social dilemma, as it is advantageous for rational users to benefit from the energy savings without any contribution to the cooperation, as every commitment has its price. We present a necessarily simplified model, whose purpose is to provide us with the foundation to explore issues in the management of such a framework, policies to encourage collaborative behaviour, and the means to evaluate the effects on energy consumption