Assessment of Knowledge and Practices of Referring Private Practitioners Regarding Revised National Tuberculosis Control Programme in Nagpur City - A Cross Sectional Study

Objectives: To assess knowledge, diagnostic and treatment practices of the referring private practitioners of Nagpur city regarding Revised National Tuberculosis Control Programme (RNTCP). Methods: The study involved interview of 103 Private Practitioners (PPs) of Nagpur city. Knowledge of private practitioners was assessed based on questions related to diagnosis, categorization, treatment regimens & follow up. Practices of private practitioners were assessed based on which investigations and treatment regimen they advise & whether they offer supervised treatment. Their willingness to get involved in the programme was also recorded. Results: Only 49 (47.6%) private practitioners knew sputum smear examination as primary tool of diagnosis of TB. Only half, 52 (50.5%) of the private practitioners knew number of categories of tuberculosis correctly and 64 (62.1%) private practitioners did know how to categorize TB patients. Chest X-ray and Mantoux test (38.5%) was mainly used by the PPs for TB diagnosis. 42.7% of PPs were prescribing treatment for TB and among them only 8 were prescribing as per RNTCP guidelines and just one provided treatment under direct observation. Different combination of HRZE and HRZES was prescribed for variable period ranges from 2-8 months. And only 12 (11.6%) private practitioners expressed their willingness to get involved in RNTCP for TB control. Conclusion: There is lack of adequate knowledge, diagnostic and treatment practice among PPs as per RNTCP guidelines and further encouragement is required for their participation in the programme

Development of a fixed firefighting system selection tool for improved outcomes

The UK along with the European Union has experienced a recent proliferation in design approaches for potential fixed firefighting systems. Such systems are installed to mitigate fire hazards in buildings and equipment. In the UK, for example there were five general design approaches to fixed firefighting systems protection in 1986. This had increased to eleven in 2011. This is against the backdrop of the current non-prescriptive regulatory frameworks including the Building Regulations, the repeal of so-called ‘local acts’, the Regulatory (fire) Reform Order and associated guidance (Approved Documents, standards, codes of practice and guides). In response to this trend, as was intended, the market place is becoming increasingly competitive. However, the capability of each technology remains limited to protection against certain hazards, rather than offering a solution to guard against all possible scenarios. When selecting a fixed firefighting system, fire hazards and interactions can be difficult to assess and describe and the inequality or absence of satisfactory methods is notable in many recently published guidance documents. The absence of good quality guidance for non-expert practitioners (specifiers) and regulatory changes means a good quality source of impartial and expert knowledge is increasingly desirable. The challenge is to amass this knowledge and render it in an accessible format to the non-expert user. This paper reports on progress to-date; understanding the problem, amassing and structuring the knowledge base and developing a suitable knowledge management tool

Integrated multisectoral strategy to improve girls' and women's nutrition before conception, during pregnancy and after birth in India (Swabhimaan): protocol for a prospective, non-randomised controlled evaluation

INTRODUCTION: Swabhimaan is a community-based programme to improve adolescent girls’ and women’s nutrition in the rural areas of three Indian states—Bihar, Chhattisgarh and Odisha with high prevalence of undernutrition. METHODS AND ANALYSIS: Swabhimaan has a nested prospective, non-randomised controlled evaluation. Since 2017, five intervention sites receive community-led interventions through national government’s livelihood mission supported women’s self-help group federations and five control sites will initiate these activities 36 months later, in 2020. Community-led activities aim to improve coverage of 18 interventions including adequacy of food consumed, prevention of micronutrient deficiencies, access to basic health services and special care of nutritionally ‘at risk’ girls and women, improving hygiene and access to water and sanitation services and access to family planning services. The evaluation includes baseline (2016–2017), midline (2018–2019) and endline (2020–2021) surveys covering 6638 adolescent girls, 2992 pregnant women and 8755 mothers of children under 2. The final impact analysis will be by intention to treat, comparing primary and secondary outcomes in five intervention areas and five control areas. The primary outcomes are: (1) a 15% reduction in the proportion of adolescent girls with a body mass index (BMI) <18.5 kg/m2; (2) a 15% reduction in the proportion of mothers of children under two with a BMI <18.5 kg/m2 and (3) and a 0.4 cm improvement in mean mid-upper arm circumference among pregnant women. ETHICS AND DISSEMINATION: All procedures involving human subjects were approved by the Institutional Ethics Committee of the All India Institute of Medical Sciences, Bihar, Chhattisgarh and Odisha and in compliance with guidelines laid down in the Declaration of Helsinki. Evidence will inform maternal and preconception nutrition policy at national and state level. TRIAL REGISTRATION NUMBER: 58261b2f46876 and CTRI/2016/11/007482; Pre-results

Communities of practice in construction case study organisations: questions and insights

Purpose – At the heart of knowledge management (KM) are the people – an organisation's important knowledge asset. Although this is widely acknowledged, businesses seldom understand this axiom in terms of the communities through which individuals develop and share the capacity to create and use knowledge. It is the collective learning that takes place within the social systems, i.e. communities of practice (CoP) that are of particular significance to an organisation from a KM perspective. This paper aims to review, critique, and raise some pertinent questions on the role of CoPs; and with the help of case studies shed light on the “goings-on” in construction practices. Design/methodology/approach – After critically reviewing the literature on CoPs and querying some underlying assertions, this research investigates how these issues are addressed in practice. A case study approach is adopted. Three organisations operating in the construction sector are interviewed for the purpose of this paper. Findings – Case study findings highlight the potential challenges and benefits of CoPs to a construction organisation, the role they play in generating and delivering value to the organisation and their contribution towards the collective organisational intelligence. From the findings, it is clear that the question is not whether communities exist within organisations, but how they deliver value to the organisation. From an organisational perspective, the key challenge is to provide an environment that is conducive to developing and nurturing such communities as opposed to merely creating them. Practical implications – Challenges and benefits demonstrated through the case studies should be taken in context. The findings are not intended to be prescriptive in nature, but are intentionally descriptive to provide contextual data that allow readers to draw their own inferences in the context of their organisations. They should be applied taking into account an organisation's unique characteristics and differentiators, the dynamics of the environment in which it operates and the culture it harbours within. Originality/value – Investigating the role of CoPs in the context of case study construction organisations forms the prime focus of this paper

Critical Success Factors of Water and Power Public–Private Partnerships in Developing Countries: A Systematic Review

Public–private partnerships (PPP) have evolved as a choice of infrastructure procurement for numerous developing countries, particularly in the water and power sectors, thereby capturing the interest of researchers. A rich body of literature exists in the field of PPPs, as well as their critical success factors (CSF). Despite the valuable insights garnered from individual studies, a research gap exists in conducting a meta-synthesis of the findings from multiple developing countries and investigating the broader elements and themes of power and water PPP CSF research. This systematic review employed the PRISMA protocol and identified 30 records. We explored the regions, sectors, yearly output, adopted research methods, key authors, and themes of the corpus reviewed. The review recognised four emerging trends in the records, which are identifying, ranking, exploring the interrelationship, or utilising CSFs. The review identified the top 30 frequent CSFs in the corpus, as well as their ranking by importance across multiple settings. The review concludes by addressing geographic and methodological limitations and proposing directions for future research

Tribal population in India: A public health challenge and road to future

India with 8.6% of tribal population is finding it difficult to bridge the gap that exists between tribal and non-tribal population in regards to healthcare. Tribal population suffers triple burden of disease; in fact it is quadruple, namely, communicable diseases, non-communicable diseases, malnutrition, mental health, and addictions complicated by poor health seeking behavior. With increasing needs, an Expert committee on Tribal health has given recommendations with the goal to bridge the current gap in the health status of tribal people latest by the year 2027. An entirely parallel health system has been proposed with key focus areas, governance, and financing. To summarize and report the present scenario in terms of disease burden, health-seeking behavior, healthcare delivery system, and a roadmap for the future along the importance of primary healthcare in achieving it. Mere establishment of more health facilities cannot overcome the poor health of tribal population and so the role of trained manpower to deliver quality healthcare, in which case the role of traditional healers, local Tribal boys and girls comes in handy. It is high time and states should act swiftly to assess the needs, priorities of their own tribal population and set goals, targets to achieve the same through proven public health strategies

Critical success factors of water and power public–private partnerships in developing countries: A systematic review

Public–private partnerships (PPP) have evolved as a choice of infrastructure procurement for numerous developing countries, particularly in the water and power sectors, thereby capturing the interest of researchers. A rich body of literature exists in the field of PPPs, as well as their critical success factors (CSF). Despite the valuable insights garnered from individual studies, a research gap exists in conducting a meta-synthesis of the findings from multiple developing countries and inves-tigating the broader elements and themes of power and water PPP CSF research. This systematic review employed the PRISMA protocol and identified 30 records. We explored the regions, sectors, yearly output, adopted research methods, key authors, and themes of the corpus reviewed. The review recognised four emerging trends in the records, which are identifying, ranking, exploring the interrelationship, or utilising CSFs. The review identified the top 30 frequent CSFs in the corpus, as well as their ranking by importance across multiple settings. The review concludes by addressing geographic and methodological limitations and proposing directions for future research.</p