Liposomal bupivacaine peripheral nerve block for the management of postoperative pain.

statement The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes by increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: nursingcare.cochrane.org/evidence-transfer-program-review-summaries. This is a Cochrane review summary of: Hamilton TW, Athanassoglou V, Trivella M et al ( 2016 ) Liposomal bupivacaine peripheral nerve block for the management of postoperative pain. Cochrane Database of Systematic Reviews. Issue 8. CD011476. doi: 10.1002/14651858.CD011476.pub2

Championing mental health at work: emerging practice from innovative projects in the UK.

This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments

Evidence of Erosional Self-Channelization of Pyroclastic Density Currents Revealed by Ground-Penetrating Radar Imaging at Mount St. Helens, Washington (USA)

The causes and effects of erosion are among the least understood aspects of pyroclastic density current (PDC) dynamics. Evidence is especially limited for erosional self-channelization, a process whereby PDCs erode a channel that confines the body of the eroding flow or subsequent flows. We use ground-penetrating radar imaging to trace a large PDC scour and fill from outcrop to its point of inception and discover a second, larger PDC scour and fill. The scours are among the largest PDC erosional features on record, at \u3e200 m wide and at least 500 m long; estimated eroded volumes are on the order of 106 m3. The scours are morphologically similar to incipient channels carved by turbidity currents. Erosion may be promoted by a moderate slope (5–15°), substrate pore pressure retention, and pulses of increased flow energy. These findings are the first direct evidence of erosional self-channelization by PDCs, a phenomenon that may increase flow velocity and runout distance through confinement and substrate erosion

Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

Background The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Methods Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy volunteers matched for age and gender, recruited August 2011 to April 2013. The resultant angle was measured using ‘Image J’ digital geometric software. The intra-observer repeatability (measurement error and reliability) and intra-subject repeatability (minimum detectable change (MDC) over 4 weeks) were determined in healthy volunteers. A comparison of cervical lordosis was made between patients and healthy volunteers at baseline. Change in lordosis between baseline and 4-week follow-up was determined in patients receiving spinal manipulation. Results Intra-observer measurement error for cervical lordosis was acceptable (SEM 3.6°) and reliability was substantial ICC 0.98, 95 % CI 0.962–0991). The intra-subject MDC however, was large (13.5°). There was no significant difference between lordotic angles in patients and healthy volunteers (p = 0.16). The mean cervical lordotic increase over 4 weeks in patients was 2.1° (9.2) which was not significant (p = 0.12). Conclusions This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation

Applying the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) Framework to evaluate automated evidence synthesis in health behaviour change

YesAutomated tools to speed up the process of evidence synthesis are increasingly apparent within health behaviour research, however, frameworks to evaluate the development and implementation of such tools are not routinely used. This commentary explores the potential of the Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework (NASSS; Greenhalgh et al., 2017) for supporting automated evidence synthesis in health behaviour change by applying it to the ongoing Human Behaviour-Change Project, which aims to revolutionise evidence synthesis within behaviour change intervention research. To increase the relevance of NASSS for health behaviour change, we recommend i) terminology changes (‘condition’ to ‘behaviour’ and ‘patient’ to ‘end user’) and ii) a that it is used prospectively so that complexities can be addressed iteratively. We draw three conclusions about i) the need to specify the organisations that will use the technology, ii) identifying what to do if interdependencies fail and iii) even though we have focused on automated evidence synthesis, NASSS would arguably be beneficial for technology developments in health behaviour change more generally, particularly for invention development (e.g. for a behaviour change app)

Engaging the public in delivering health improvement: Research Briefing

Involving members of the public in delivering public health programmes offers a way to utilise the knowledge, skills and resources within communities. Many health promotion projects involve volunteers or lay health workers; they carry out activities such as peer support and peer education, signposting to services and running community groups. Engaging citizens in co-producing health and wellbeing can help services tackle health inequalities by improving connections with less advantaged groups and by shaping provision to better meet community needs. This research briefing considers what active citizens can do for services and how services can best engage, support and sustain a community or volunteer workforce in order to improve health outcomes. It provides practical guidance on the steps that need to be taken to redesign services and maximise the long term benefits: • deciding what people can contribute to health improvement • choosing a service model • recruiting, training and supporting people in their roles • changing systems to support citizen engagement. This research briefing is based on the findings of the ‘People in Public Health’ study, independent research conducted by Leeds Metropolitan University and funded though the National Institute for Health Research Service Delivery and Organisation Programme. The research examined approaches to support members of the public who take on public health roles, with a focus on the Choosing Health priorities

The geological history of Nili Patera, Mars

Nili Patera is a 50 km diameter caldera at the center of the Syrtis Major Planum volcanic province. The caldera is unique among Martian volcanic terrains in hosting: (i) evidence of both effusive and explosive volcanism, (ii) hydrothermal silica, and (iii) compositional diversity from olivine-rich basalts to silica-enriched units. We have produced a new geological map using three mosaicked 18 m/pixel Context Camera digital elevation models, supplemented by Compact Remote Imaging Spectrometer for Mars Hyperspectral data. The map contextualizes these discoveries, formulating a stratigraphy in which Nili Patera formed by trapdoor collapse into a volcanotectonic depression. The distinctive bright floor of Nili Patera formed either as part of a felsic pluton, exposed during caldera formation, or as remnants of welded ignimbrite(s) associated with caldera formation—both scenarios deriving from melting in the Noachian highland basement. After caldera collapse, there were five magmatic episodes: (1) a basaltic unit in the caldera's north, (2) a silica-enriched unit and the associated Nili Tholus cone, (3) an intrusive event, forming a ~300 m high elliptical dome; (4) an extrusive basaltic unit, emplaced from small cones in the east; and (5) an extreme olivine-bearing unit, formed on the western caldera ring fault. The mapping, together with evidence for hydrated materials, implies magmatic interaction with subsurface volatiles. This, in an area of elevated geothermal gradient, presents a possible habitable environment (sampled by the hydrothermal deposits). Additionally, similarities to other highland volcanoes imply similar mechanisms and thus astrobiological potential within those edifices

Designing expert hearings: how to use deliberative research methods for public health evidence

Ye

People in Public Health – A Study of Approaches to Develop and Support People in Public Health Roles

‘People in Public Health’ is a study about approaches to develop and support lay people in public health roles. The use of participatory approaches in public health programmes, both in national and international contexts, is well established and seen as necessary to deliver sustainable improvements in public health (Bracht and Tsouros, 1990; Rifkin et al., 2000; World Health Organization, 2002). Indeed a central argument in the Wanless reviews was that a ‘fully engaged scenario’ with high levels of public engagement in health would result in lower levels of public expenditure and better health outcomes (Wanless, 2002; Wanless, 2004). Government policy supports greater community engagement in health as a means of addressing public health priorities and tackling health inequalities (Department of Health, 2003). The health agenda on community involvement resonates with arguments for citizen empowerment and greater democratisation of services, not only in the NHS but across the public sector, in national agencies and local authorities (Campbell et al., 2008). Recent national guidance on community engagement noted the wide variety of approaches, indicating that those approaches based on higher levels of participation and greater community control were more likely to lead to increased health and social outcomes1 (National Institute for Health and Clinical Effectiveness, 2008). There was a recommendation to recruit what were termed ‘agents of change’ in communities who become involved ‘to plan, design and deliver health promotion activities and to help address the wider social determinants of health’ by taking on roles such as peer educators, health champions or neighbourhood wardens (National Institute for Health and Clinical Effectiveness, 2008:28). The concept of empowerment, the process of individuals and communities being enabled to undertake local action to effect change, is seen as core to health promotion (Tones and Tilford, 2001; World Health Organization, 1986; Wallerstein, 2006). Government policy on community empowerment advocates increased citizen involvement in planning and running services (Secretary of State for Communities and Local Government, 2008) and this agenda is linked to the personalisation of health and social services and patient and public involvement (Department of Health, 2005b; Department of Health, 2006; Secretary of State for Health, 2006). More evidence is required, however, about effective mechanisms for lay engagement and how public services can best enhance, support and sustain community involvement