Modernized Tradition: Transformation of Public Transport

Due to incrementing environmental issues, the Philippine government has aimed solutions for sustainable development by pursuing the Public Utility Vehicle Modernization Program (PUVMP), which was launched in 2017 and took effect in 2020. The program included the modernization of jeepneys, which is a historical icon in the country. The modernization of jeepneys affected jeepney drivers, operators, and commuters alike; thus it is crucial to take their opinions into consideration. In this study, the researchers ought to know the thoughts and opinions of jeepney drivers and commuters concerning the PUVMP in Baguio City. The study that was executed embraced a phenomenological approach. Due to the pandemic the world is facing at present, the responses were gathered using an online survey as it was seen to be fit for the current situation. The results exhibited divided opinions towards the program as drivers and operators were against it, while commuters supported the program. The jeepney drivers and operators used their financial status as a basis for their opinion, while commuters prioritized their safety and comfort. When asked how will they cope with the PUVMP, jeepney drivers showcased a negative array of choices. Their answers varied from complying just because it is what the government wants, opting for illegal schemes to earn money, to losing their jobs completely. The results acquired can be used as a basis for adjustments and changes to produce an ameliorated program which satisfies the needs and wants of the affected groups

The Heimdall framework for supporting characterisation of learning health systems

Background: There are many proposed benefits of using learning health systems (LHSs), including improved patient outcomes. There has been little adoption of LHS in practice due to challenges and barriers that limit adoption of new data-driven technologies in healthcare. We have identified a more fundamental explanation: the majority of developments in LHS are not identified as LHS. The absence of a unifying namespace and framework brings a lack of consistency in how LHS is identified and classified. As a result, the LHS ‘community’ is fragmented, with groups working on similar systems being unaware of each other’s work. This leads to duplication and the lack of a critical mass of researchers necessary to address barriers to adoption. Objective: To find a way to support easy identification and classification of research works within the domain of LHS. Method: A qualitative meta-narrative study focusing on works that self-identified as LHS was used for two purposes. First, to find existing standard definitions and frameworks using these to create a new unifying framework. Second, seeking whether it was possible to classify those LHS solutions within the new framework. Results: The study found that with apparently limited awareness, all current LHS works fall within nine primary archetypes. These findings were used to develop a unifying framework for LHS to classify works as LHS, and reduce diversity and fragmentation within the domain. Conclusions: Our finding brings clarification where there has been limited awareness for LHS among researchers. We believe our framework is simple and may help researchers to classify works in the LHS domain. This framework may enable realisation of the critical mass necessary to bring more substantial collaboration and funding to LHS. Ongoing research will seek to establish the framework’s effect on the LHS domain

Multi-period Project Portfolio Selection under Risk considerations and Stochastic Income

This paper deals with multi-period project portfolio selection problem. In this problem, the available budget is invested on the best portfolio of projects in each period such that the net profit is maximized. We also consider more realistic assumptions to cover wider range of applications than those reported in previous studies. A novel mathematical model is presented to solve the problem, considering risks, stochastic incomes, and possibility of investing extra budget in each time period. Due to the complexity of the problem, an effective meta-heuristic method hybridized with a local search procedure is presented to solve the problem. The algorithm is based on genetic algorithm (GA), which is a prominent method to solve this type of problems. The GA is enhanced by a new solution representation and well selected operators. It also is hybridized with a local search mechanism to gain better solution in shorter time. The performance of the proposed algorithm is then compared with well-known algorithms, like basic genetic algorithm (GA), particle swarm optimization (PSO), and electromagnetism-like algorithm (EM-like) by means of some prominent indicators. The computation results show the superiority of the proposed algorithm in terms of accuracy, robustness and computation time. At last, the proposed algorithm is wisely combined with PSO to improve the computing time considerably

Crisis resolution teams for people experiencing mental health crises: the CORE mixed-methods research programme including two RCTs

Background Crisis resolution teams (CRTs) seek to avert hospital admissions by providing intensive home treatment for people experiencing a mental health crisis. The CRT model has not been highly specified. CRT care is often experienced as ending abruptly and relapse rates following CRT discharge are high. Aims The aims of CORE (Crisis resolution team Optimisation and RElapse prevention) workstream 1 were to specify a model of best practice for CRTs, develop a measure to assess adherence to this model and evaluate service improvement resources to help CRTs implement the model with high fidelity. The aim of CORE workstream 2 was to evaluate a peer-provided self-management programme aimed at reducing relapse following CRT support. Methods Workstream 1 was based on a systematic review, national CRT manager survey and stakeholder qualitative interviews to develop a CRT fidelity scale through a concept mapping process with stakeholders (n = 68). This was piloted in CRTs nationwide (n = 75). A CRT service improvement programme (SIP) was then developed and evaluated in a cluster randomised trial: 15 CRTs received the SIP over 1 year; 10 teams acted as controls. The primary outcome was service user satisfaction. Secondary outcomes included CRT model fidelity, catchment area inpatient admission rates and staff well-being. Workstream 2 was a peer-provided self-management programme that was developed through an iterative process of systematic literature reviewing, stakeholder consultation and preliminary testing. This intervention was evaluated in a randomised controlled trial: 221 participants recruited from CRTs received the intervention and 220 did not. The primary outcome was re-admission to acute care at 1 year of follow-up. Secondary outcomes included time to re-admission and number of days in acute care over 1 year of follow-up and symptoms and personal recovery measured at 4 and 18 months’ follow-up. Results Workstream 1 – a 39-item CRT fidelity scale demonstrated acceptability, face validity and promising inter-rater reliability. CRT implementation in England was highly variable. The SIP trial did not produce a positive result for patient satisfaction [median Client Satisfaction Questionnaire score of 28 in both groups at follow-up; coefficient 0.97, 95% confidence interval (CI) –1.02 to 2.97]. The programme achieved modest increases in model fidelity. Intervention teams achieved lower inpatient admission rates and less inpatient bed use. Qualitative evaluation suggested that the programme was generally well received. Workstream 2 – the trial yielded a statistically significant result for the primary outcome, in which rates of re-admission to acute care over 1 year of follow-up were lower in the intervention group than in the control group (odds ratio 0.66, 95% CI 0.43 to 0.99; p = 0.044). Time to re-admission was lower and satisfaction with care was greater in the intervention group at 4 months’ follow-up. There were no other significant differences between groups in the secondary outcomes. Limitations Limitations in workstream 1 included uncertainty regarding the representativeness of the sample for the primary outcome and lack of blinding for assessment. In workstream 2, the limitations included the complexity of the intervention, preventing clarity about which were effective elements. Conclusions The CRT SIP did not achieve all its aims but showed potential promise as a means to increase CRT model fidelity and reduce inpatient service use. The peer-provided self-management intervention is an effective means to reduce relapse rates for people leaving CRT care. Study registration The randomised controlled trials were registered as Current Controlled Trials ISRCTN47185233 and ISRCTN01027104. The systematic reviews were registered as PROSPERO CRD42013006415 and CRD42017043048. Funding The National Institute for Health Research Programme Grants for Applied Research programme

On Solving the Coronal Heating Problem

This article assesses the current state of understanding of coronal heating, outlines the key elements of a comprehensive strategy for solving the problem, and warns of obstacles that must be overcome along the way.Comment: Accepted by Solar Physics; Published by Solar Physic

Junkie love : romance and addiction on the big screen

This article investigates the filmic construction of two disparate but intertwining cultural practices: those engaging in the life-affirming rituals of romantic love and those performing the potentially self-destructive rituals of hard drug consumption. Discussing a number of key feature films from the (mini) genre “junkie love”, it aims to show what happens when elements of mainstream romantic drama merge with the horror conventions of the heroin addiction film. Drawing amongst others on Murray Smith’s theory of “levels of [spectator] engagement” and Greg Smith’s concept of the “emotion system”, the article concludes that junkie love films, using tropes of the romantic tragedy in the tradition of Romeo and Juliet, present a more complex and nuanced approach to drug addicts than the predominantly condemnatory media coverage—one that arguably invites the spectator’s understanding and compassion