Fighting covid-19 outbreaks in prisons

Improving prison health services is critical for fighting epidemics such as covid-19. Prisoners are at much higher risk of infectious diseases than communities outside. Eruption of covid-19 in prisons emphasises the need to improve prison healthcare. Health education for inmates and prison staff must be intensified, and better treatment and prevention measures require increased funding. More non-custodial sentences would decongest prisons, reducing the potential for the outbreaks. Links between prison and national health services should be strengthened

Stability of a liquid thread and stability and nonlinear evolution of multi-layer fluid flow

This thesis is concerned with stability and existence of waves in interfacial and free surface problems. Considered is the curtain coating problem, with specific emphasis on trilayer and bilayer flows, and the breakup of a viscous thread with a solid core. Experiments on curtain coating and sheet breakup are mostly conducted by industry and as such are hidden in patents or kept secret by companies trying to gain an edge in a competitive market. Experiments on curtain breakup concentrating on the effect that surfactants have upon the stability and the effect of differing fluid properties are discussed. It is shown that multiple layers of different fluid are more stable when reducing the flow rate of the lowest layer. Single and multi-layer fluid flow down an inclined plane is studied with the emphasis on the effect of an insoluble surfactant. Bilayer and trilayer flow down an inclined plane is considered. The main point of interest here is the existence of multiple unstable modes for a single set of parameters. A long wave model describing the multi-layer flow is discussed. Time-dependent solutions to this model system lead to the discovery of travelling wave solutions present in the dynamics. The travelling wave solutions are further investigated through Fourier analysis leading to the discovery of branches of solutions emerging from wavenumbers for which the flow is neutrally stable. The normal mode stability of annular Stokes flow of a viscous thread with a solid core is discussed which extends work done for negligible viscosity and small wavenumbers

A comparative study on the clinical decision making processes of nurse practitioners versus medical doctors using scenarios within a secondary care environment

Subjects This study was conducted from May 2012 to January 2013.Aim To investigate the decision-making skills of secondary care nurse practitioners compared to those of medical doctors.Background A literature review was conducted, searching for articles published from 1990 to 2012. The review found that nurse practitioners are key to the modernisation of the National Health Service. Studies have shown that compared to doctors, nurse practitioners can be efficient and cost-effective in consultations.Design Qualitative research design. Methods The information processing theory and think-aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality, and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment.Results The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took three minutes longer to complete the scenarios. Conclusion This study suggests that nurse practitioner consultations are comparable to those of medical doctors within a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes.NH

Hydroecological impacts of climate change modelled for a lowland UK wetland

Conservation management of wetlands often rests on modifying hydrological functions to establish or maintain desired flora and fauna. Hence the ability to predict the impacts of climate change is highly beneficial. Here, the physically based, distributed model MIKE SHE was used to simulate hydrology for the Lambourn Observatory at Boxford, UK. This comprises a 10 ha lowland riparian wetland protected for conservation, where the degree of variability in the peat, gravel and chalk geology has clouded hydrological understanding. Notably, a weathered layer on the chalk aquifer surface seals it from overlying deposits, yet is highly spatially heterogeneous. Long-term monitoring yielded observations of groundwater and surface water levels for model calibration and validation. Simulated results were consistent with observed data and reproduced the effects of seasonal fluctuations and in-channel macrophyte growth. The adjacent river and subsidiary channel were found to act as head boundaries, exerting a general control on water levels across the site. Discrete areas of groundwater upwellings caused raised water levels at distinct locations within the wetland. These were concurrent to regions where the weathered chalk layer is absent. To assess impacts of climate change, outputs from the UK Climate Projections 2009 ensemble of global climate models for the 2080s are used to obtain monthly percentage changes in climate variables. Changes in groundwater levels were taken from a regional model of the Chalk aquifer. Values of precipitation and evapotranspiration were seen to increase, whilst groundwater levels decreased, resulting in the greater dominance of precipitation. The discrete areas of groundwater upwelling were seen to diminish or disappear. Simulated water levels were linked to specific requirements of wetland plants using water table depth zone diagrams. Increasing depth of winter and summer groundwater levels leads to a loss of Glyceria maxima and Phragmites australis, principal habitat for the endangered Vertigo moulinsiana. Further, the reduced influx of base-rich groundwater and increased dominance of high pH rain-fed waters alters the acidity of the soil. This leads to changes in species composition, with potential reductions in Carex paniculata, Caltha palustris and Typha latifolia

Protect the giant ibis through the pandemic

The giant ibis (Thaumatibis gigantea), Cambodia’s national bird, is edging toward extinction. The ibis’s historical range stretched across Southeast Asia, but only 194 critically endangered individuals remain, constrained to the northeastern region of Cambodia. The small population suffers from habitat loss and disturbance caused by human activities, and tensions between humans and wildlife have escalated during the coronavirus disease 2019 (COVID-19) pandemic. In April, 3 giant ibises and more than 100 other birds were poached in Cambodia’s Chhep Wildlife Sanctuary. To save the giant ibis, conservation efforts must continue, even during the pandemic

Therapeutic alliance in parent-focussed interventions for youth depression

The aim of this thesis was to investigate the role of therapeutic alliance in group-based parent-focussed interventions for youth depression. Results suggested that while therapist alliance ratings are likely not clinically important in parent-focussed interventions for youth depression, alliance plays an essential role in parents benefitting therapeutically from parent-focussed interventions

Waste management, informal recycling, environmental pollution and public health

With rapid population growth, especially in low-income and middle-income countries, the generation of waste is increasing at an unprecedented rate. For example, annual global waste arising from waste electrical and electronic equipment alone will have increased from 33.8 to 49.8 million tonnes between 2010 and 2018. Despite incineration and other waste treatment techniques, landfill still dominates waste disposal in low-income and middle-income countries. There is usually insufficient funding for adequate waste management in these countries and uptake of more advanced waste treatment technologies is poor. Without proper management, many landfills represent serious hazards as typified by the landslide in Shenzhen, China on 20 December 2015. In addition to formal waste recycling systems, approximately 15 million people around the world are involved in informal waste recycling, mainly for plastics, metals, glass and paper. This review examines emerging public health challenges, in particular within low-income and middle-income countries, associated with the informal sector. While informal recyclers contribute to waste recycling and reuse, the relatively primitive techniques they employ, combined with improper management of secondary pollutants, exacerbate environmental pollution of air, soil and water. Even worse, insufficient occupational health measures expose informal waste workers to a range of pollutants, injuries, respiratory and dermatological problems, infections and other serious health issues that contribute to low life expectancy. Integration of the informal sector with its formal counterparts could improve waste management while addressing these serious health and livelihood issues. Progress in this direction has already been made notably in several Latin American countries where integrating the informal and formal sectors has had a positive influence on both waste management and poverty alleviation