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

Numerical modelling of the lobes of radio galaxies – Paper V: universal pressure profile cluster atmospheres

© 2023 The Author(s). Published by Oxford University Press on behalf of Royal Astronomical Society. This is the final manuscript version of an article which has been published in final form at https://doi.org/10.1093/mnras/stad2933We present relativistic magnetohydrodynamic modelling of jets running into hydrostatic, spherically symmetric cluster atmospheres. For the first time in a numerical simulation, we present model cluster atmospheres based upon the universal pressure profile (UPP), incorporating a temperature profile for a ‘typical’ self-similar atmosphere described by only one parameter – M 500. We explore a comprehensive range of realistic atmospheres and jet powers and derive dynamic, energetic, and polarimetric data which provide insight into what we should expect of future high-resolution studies of AGN outflows. From the simulated synchrotron emission maps which include Doppler beaming we find sidedness distributions that agree well with observations. We replicated a number of findings from our previous work, such as higher power jets inflating larger aspect-ratio lobes, and the cluster environment impacting the distribution of energy between the lobe and shocked regions. Comparing UPP and β-profiles we find that the cluster model chosen results in a different morphology for the resultant lobes with the UPP more able to clear lobe material from the core; and that these different atmospheres influence the ratio between the various forms of energy in the fully developed lobes. This work also highlights the key role played by Kelvin–Helmholtz instabilities in the formation of realistic lobe aspect ratios. Our simulations point to the need for additional lobe-widening mechanisms at high jet powers, for example jet precession. Given that the UPP is our most representative general cluster atmosphere, these numerical simulations represent the most realistic models yet for spherically symmetric atmospheres.Peer reviewe

Primary Care Physician Assistants in Nebraska

https://digitalcommons.unmc.edu/coph_policy_reports/1022/thumbnail.jp

Exploring the views of planners and public health practitioners on integrating health evidence into spatial planning in England: A mixed-methods study

Background: This study explored barriers and facilitators to integrating health evidence into spatial planning at local authority levels and examined the awareness and use of the Public Health England Spatial Planning for Health resource. Methods: A sequential exploratory mixed methods design utilised in-depth semi-structured interviews followed by an online survey of public health, planning and other built environment professionals in England. Results: Views from 19 individuals and 162 survey responses revealed high awareness and use of the Spatial Planning for Health resource, although public health professionals reported greater awareness and use than other professionals. Key barriers to evidence implementation included: differences in interpretation and use of ‘evidence’ between public health and planning professionals; lack of practical evidence to apply locally; and lack of resource and staff capacity in local authorities. Key facilitators included: integrating health into the design of Local Plans; articulating wider benefits to multiple stakeholders, and simplifying presenting evidence (regarding language and accessibility). Conclusion: The Spatial Planning for Health resource is a useful resource at local authority level. Further work is needed to maximise its use by built environment professionals. Public health teams need support, capacity and skills to ensure that local health and wellbeing priorities are integrated into local planning documents and decisions

Adapting Medical Guidelines to Be Patient-centered Using a Patient-driven Process for Individuals With Sickle Cell Disease and Their Caregivers

Background: Evidence-based guidelines for sickle cell disease (SCD) health maintenance and management have been developed for primary health care providers, but not for individuals with SCD. To improve the quality of care delivered to individuals with SCD and their caregivers, the main purposes of this study were to: (1) understand the desire for patient-centered guidelines among the SCD community; and (2) adapt guideline material to be patient-centered using community-engagement strategies involving health care providers, community -based organizations, and individuals with the disease. Methods: From May–December 2016, a volunteer sample of 107 individuals with SCD and their caregivers gave feedback at community forums (n = 64) and community listening sessions (n = 43) about technology use for health information and desire for SCD-related guidelines. A team of community research partners consisting of community stakeholders, individuals living with SCD, and providers and researchers (experts) in SCD at nine institutions adapted guidelines to be patient-centered based on the following criteria: (1) understandable, (2) actionable, and (3) useful. Results: In community forums (n = 64), almost all participants (91%) wanted direct access to the content of the guidelines. Participants wanted guidelines in more than one format including paper (73%) and mobile devices (79%). Guidelines were adapted to be patient-centered. After multiple iterations of feedback, 100% of participants said the guidelines were understandable, most (88%) said they were actionable, and everyone (100%) would use these adapted guidelines to discuss their medical care with their health care providers. Conclusions: Individuals with SCD and their caregivers want access to guidelines through multiple channels, including technology. Guidelines written for health care providers can be adapted to be patient-centered using Community-engaged research involving providers and patients. These patient-centered guidelines provide a framework for patients to discuss their medical care with their health care providers

Time-efficient physical activity intervention for older adolescents with disability : rationale and study protocol for the Burn 2 Learn adapted (B2La) cluster randomised controlled trial

Introduction Physical activity declines during adolescence, with the lowest levels of activity observed among those with disability. Schools are ideal settings to address this issue; however, few school-based interventions have been specifically designed for older adolescents with disability. Our aim is to investigate the effects of a school-based physical activity programme, involving high-intensity interval training (HIIT), on physical, mental and cognitive health in older adolescents with disability. Methods and analysis We will evaluate the Burn 2 Learn adapted (B2La) intervention using a two-arm, parallel group, cluster randomised controlled trial with allocation occurring at the school level (treatment or waitlist control). Secondary schools will be recruited in two cohorts from New South Wales, Australia. We will aim to recruit 300 older adolescents (aged 15–19 years) with disability from 30 secondary schools (10 in cohort 1 and 20 in cohort 2). Schools allocated to the intervention group will deliver two HIIT sessions per week during scheduled specialist support classes. The sessions will include foundational aerobic and muscle strengthening exercises tailored to meet student needs. We will provide teachers with training, resources, and support to facilitate the delivery of the B2La programme. Study outcomes will be assessed at baseline, 6 months (primary endpoint), and 9 months. Our primary outcome is functional capacity assessed using the 6 min walk/push test. Secondary outcomes include physical activity, muscular fitness, body composition, cognitive function, quality of life, physical literacy, and on-task behaviour in the classroom. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation, adaptability, and sustainability in schools. Ethics and dissemination This study has received approval from the University of Newcastle (H-2021–0262) and the New South Wales Department of Education (SERAP: 2021257) human research ethics committees. Findings will be published in peer-reviewed journals, and key stakeholders will be provided with a detailed report following the study. Trial registration number Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808

The verdict geometric quality library.

Verdict is a collection of subroutines for evaluating the geometric qualities of triangles, quadrilaterals, tetrahedra, and hexahedra using a variety of metrics. A metric is a real number assigned to one of these shapes depending on its particular vertex coordinates. These metrics are used to evaluate the input to finite element, finite volume, boundary element, and other types of solvers that approximate the solution to partial differential equations defined over regions of space. The geometric qualities of these regions is usually strongly tied to the accuracy these solvers are able to obtain in their approximations. The subroutines are written in C++ and have a simple C interface. Each metric may be evaluated individually or in combination. When multiple metrics are evaluated at once, they share common calculations to lower the cost of the evaluation

Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up. Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission). Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19. Funding PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. COVIDENCE UK is supported by the UK Research and Innovation, the National Institute for Health Research, and Barts Charity. The views expressed are those of the authors and not necessarily those of the funders