Health Care and Change Management in the Context of Prisons: Rapid reviews of the literature in two parts

First paragraph: The literature review of factors promoting or inhibiting change finds that there is no unified science of change management and that there is a general lack of empirical evidence across the board about change management in all domains of human industry. - We have proposed a general five-level evidence framework that can be used to categorise broadly the quality of evidence for and commission research into prison management. - We argue that proposals for change should be subjected to a formal decision making process in keeping with good practice in decision making in which alternatives to the proposed change are also evaluated. - We find that change can occur to structures, processes, outcomes and people (table 6) in planned or unintended ways, gradually or radically. - Despite the lack of empirical evidence we find that there is a broad consensus on the features of successful change management approaches

Internal affairs: tenascin-C as a clinically relevant, endogenous driver of innate

To protect against danger, the innate immune system must promptly and accurately sense alarm signals, and mount an appropriate response to restore homeostasis. One endogenous trigger of immunity is tenascin-C, a large hexameric protein of the extracellular matrix. Upregulated upon tissue injury and cellular stress, tenascin-C is expressed during inflammation and tissue remodeling, where it influences cellular behavior by interacting with a multitude of molecular targets, including other matrix components, cell surface proteins, and growth factors. Here, we discuss how these interactions confer upon tenascin-C distinct immunomodulatory capabilities that make this matrix molecule necessary for efficient tissue repair. We also highlight in vivo studies that provide insight into the consequences of misregulated tenascin-C expression on inflammation and fibrosis during a wide range of inflammatory diseases. Finally, we examine how its unique expression pattern and inflammatory actions make tenascin-C a viable target for clinical exploitation in both diagnostic and therapeutic arenas