20 research outputs found
Imbibition in Disordered Media
The physics of liquids in porous media gives rise to many interesting
phenomena, including imbibition where a viscous fluid displaces a less viscous
one. Here we discuss the theoretical and experimental progress made in recent
years in this field. The emphasis is on an interfacial description, akin to the
focus of a statistical physics approach. Coarse-grained equations of motion
have been recently presented in the literature. These contain terms that take
into account the pertinent features of imbibition: non-locality and the
quenched noise that arises from the random environment, fluctuations of the
fluid flow and capillary forces. The theoretical progress has highlighted the
presence of intrinsic length-scales that invalidate scale invariance often
assumed to be present in kinetic roughening processes such as that of a
two-phase boundary in liquid penetration. Another important fact is that the
macroscopic fluid flow, the kinetic roughening properties, and the effective
noise in the problem are all coupled. Many possible deviations from simple
scaling behaviour exist, and we outline the experimental evidence. Finally,
prospects for further work, both theoretical and experimental, are discussed.Comment: Review article, to appear in Advances in Physics, 53 pages LaTe
The effects of integrated care: a systematic review of UK and international evidence
BACKGROUND: Healthcare systems around the world have been responding to the demand for better integrated models of service delivery. However, there is a need for further clarity regarding the effects of these new models of integration, and exploration regarding whether models introduced in other care systems may achieve similar outcomes in a UK national health service context. METHODS: The study aimed to carry out a systematic review of the effects of integration or co-ordination between healthcare services, or between health and social care on service delivery outcomes including effectiveness, efficiency and quality of care. Electronic databases including MEDLINE; Embase; PsycINFO; CINAHL; Science and Social Science Citation Indices; and the Cochrane Library were searched for relevant literature published between 2006 to March 2017. Online sources were searched for UK grey literature, and citation searching, and manual reference list screening were also carried out. Quantitative primary studies and systematic reviews, reporting actual or perceived effects on service delivery following the introduction of models of integration or co-ordination, in healthcare or health and social care settings in developed countries were eligible for inclusion. Strength of evidence for each outcome reported was analysed and synthesised using a four point comparative rating system of stronger, weaker, inconsistent or limited evidence. RESULTS: One hundred sixty seven studies were eligible for inclusion. Analysis indicated evidence of perceived improved quality of care, evidence of increased patient satisfaction, and evidence of improved access to care. Evidence was rated as either inconsistent or limited regarding all other outcomes reported, including system-wide impacts on primary care, secondary care, and health care costs. There were limited differences between outcomes reported by UK and international studies, and overall the literature had a limited consideration of effects on service users. CONCLUSIONS: Models of integrated care may enhance patient satisfaction, increase perceived quality of care, and enable access to services, although the evidence for other outcomes including service costs remains unclear. Indications of improved access may have important implications for services struggling to cope with increasing demand. TRIAL REGISTRATION: Prospero registration number: 42016037725