An adult social care compendium of approaches and tools for organisational change

The purpose of this compendium is to support managers working in adult social care to be more knowledgeable about and confident in the application of different approaches and tools relevant to managing change in their organisations. In the compendium an ‘approach to change’ is used to denote an ‘overarching framework that can guide a change process’ and ‘change management tools’ as ‘techniques or templates to understand or support a specific aspect of the change process’. Examples of the latter would be stakeholder mapping exercises, organisational diagnostic methodologies, engagement processes, and direct team based interventions. The compendium does not provide detailed guidance on how to apply each approach and tool, but presents an accessible overview of what each entails, the thinking that lies behind them, and (where available) a reflection on the empirical evidence of their application in practice. Having access to this information will help to demystify the often confusing and intimidating terminology that surrounds change approaches, and in doing so will enable managers to identify the approaches most relevant to a change they are leading and explore in more depth. Understanding the method being followed will also support individuals who access services and their families to engage on a more equal playing field within a change process. This includes people who access services and their families. While potentially relevant to social care managers working at all levels of an organisation, the compendium is specifically designed for those responsible for a single service (e.g. home care team, residential care home) or team (e.g. care management team), and those who directly manage service and team managers

ON THE SECOND-LARGEST SYLOW SUBGROUP OF A FINITE SIMPLE GROUP OF LIE TYPE

DOI: 10.1017/S000497271800092

Augmented Reality for Enhanced Visualization of MOF Adsorbents

Augmented reality (AR) is an emerging technique used to improve visualization and comprehension of complex 3D materials. This approach has been applied not only in the field of chemistry but also in real estate, physics, mechanical engineering, and many other areas. Here, we demonstrate the workflow for an app-free AR technique for visualization of metal–organic frameworks (MOFs) and other porous materials to investigate their crystal structures, topology, and gas adsorption sites. We think this workflow will serve as an additional tool for computational and experimental scientists working in the field for both research and educational purposes

New horizons: Reablement - supporting older people towards independence

As the overwhelming majority of older people prefer to remain in their own homes and communities, innovative service provision aims to promote independence of older people despite incremental age associated frailty. Reablement is one such service intervention that is rapidly being adopted across high-income countries and projected to result in significant cost-savings in public health expenditure by decreasing premature admission to acute care settings and long-term institutionalisation. It is an intensive, time-limited intervention provided in people's homes or in community settings, often multi-disciplinary in nature, focussing on supporting people to regain skills around daily activities. It is goal-orientated, holistic and person-centred irrespective of diagnosis, age and individual capacities. Reablement is an inclusive approach that seeks to work with all kinds of frail people but requires skilled professionals who are willing to adapt their practise, as well as receptive older people, families and care staff. Although reablement may just seem the right thing to do, studies on the outcomes of this knowledge-based practice are inconsistent-yet there is an emerging evidence and practice base that suggests that reablement improves performance in daily activities. This innovative service however may lead to hidden side effects such as social isolation and a paradoxical increase in hospital admissions. Some of the necessary evaluative research is already underway, the results of which will help fill some of the evidence gaps outlined here

DigiMOF: A Database of Metal–Organic Framework Synthesis Information Generated via Text Mining

The vastness of materials space, particularly that which is concerned with metal–organic frameworks (MOFs), creates the critical problem of performing efficient identification of promising materials for specific applications. Although high-throughput computational approaches, including the use of machine learning, have been useful in rapid screening and rational design of MOFs, they tend to neglect descriptors related to their synthesis. One way to improve the efficiency of MOF discovery is to data-mine published MOF papers to extract the materials informatics knowledge contained within journal articles. Here, by adapting the chemistry-aware natural language processing tool, ChemDataExtractor (CDE), we generated an open-source database of MOFs focused on their synthetic properties: the DigiMOF database. Using the CDE web scraping package alongside the Cambridge Structural Database (CSD) MOF subset, we automatically downloaded 43,281 unique MOF journal articles, extracted 15,501 unique MOF materials, and text-mined over 52,680 associated properties including the synthesis method, solvent, organic linker, metal precursor, and topology. Additionally, we developed an alternative data extraction technique to obtain and transform the chemical names assigned to each CSD entry in order to determine linker types for each structure in the CSD MOF subset. This data enabled us to match MOFs to a list of known linkers provided by Tokyo Chemical Industry UK Ltd. (TCI) and analyze the cost of these important chemicals. This centralized, structured database reveals the MOF synthetic data embedded within thousands of MOF publications and contains further topology, metal type, accessible surface area, largest cavity diameter, pore limiting diameter, open metal sites, and density calculations for all 3D MOFs in the CSD MOF subset. The DigiMOF database and associated software are publicly available for other researchers to rapidly search for MOFs with specific properties, conduct further analysis of alternative MOF production pathways, and create additional parsers to search for additional desirable properties

Analysis of the profile, characteristics, patient experience and community value of community hospitals : a multimethod study

Background: Community hospitals have been part of England’s health-care landscape since the mid-nineteenth century. Evidence on them has not kept pace with their development. Aim: To provide a comprehensive analysis of the profile, characteristics, patient experience and community value of community hospitals. Design: A multimethod study with three phases. Phase one involved national mapping and the construction of a new database of community hospitals through data set reconciliation and verification. Phase two involved nine case studies, including interviews and focus groups with patients (n = 60), carers (n = 28), staff (n = 132), volunteers (n = 68), community stakeholders (n = 74) and managers and commissioners (n = 9). Phase three involved analysis of Charity Commission data on voluntary support. Setting: Community hospitals in England. Results: The study identified 296 community hospitals with beds in England. Typically, the hospitals were small (<30 beds), in rural communities, led by doctors/general practitioners (GPs) and nurses, without 24/7 on-site medical cover, providing step-down and step-up inpatient care, with an average length of stay of <30 days and a variable range of intermediate care services. Key to patients’ and carers’ experiences of community hospitals was their closeness to ‘home’ through their physical location, environment and atmosphere and the relationships that they support; their provision of personalised, holistic care; and their role in supporting patients through difficult psychological transitions. Communities engage with and support their hospitals through giving time (average = 24 volunteers), raising money (median voluntary income = £15,632), providing services (voluntary and community groups) and giving voice (e.g. communication and consultation). This can contribute to hospital utilisation and sustainability, patient experience, staff morale and volunteer well-being. Engagement varies between and within communities and over time. Community hospitals are important community assets, representing direct and indirect value: instrumental (e.g. health care), economic (e.g. employment), human (e.g. skills development), social (e.g. networks), cultural (e.g. identity and belonging) and symbolic (e.g. vitality and security). Value varies depending on place and time. Limitations: There were limitations to the secondary data available for mapping community hospitals and tracking charitable funds and to our sample of case study respondents, which concentrated on people with a connection to the hospitals. Conclusions: Community hospitals are diverse but are united by a set of common characteristics. Patients and carers experience community hospitals as qualitatively different from other settings. Their accounts highlight the importance of considering the functional, interpersonal, social and psychological dimensions of experience. Community hospitals are highly valued by their local communities, as demonstrated through their active involvement as volunteers and donors. Community hospitals enable the provision of local intermediate care services, delivered through an embedded, relational model of care, which generates deep feelings of reassurance. However, current developments, including the withdrawal of GPs, shifts towards step-down care for non-local patients and changing configurations of services, providers and ownership may undermine this. Future work: Comparative studies of patient experience in different settings, longitudinal studies of community support and value, studies into the implications of changes in community hospital function, GP involvement, provider-mix and ownership and international comparative studies could all be undertaken

A qualitative examination of inappropriate hospital admissions and lengths of stay

<p>Abstract</p> <p>Background</p> <p>Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions). We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group.</p> <p>Methods</p> <p>Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach.</p> <p>Results</p> <p>The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS), including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations.</p> <p>Conclusion</p> <p>Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.</p

Trying to end the war on the world: the campaign to proscribe military ecocide

Military ecocide, the destruction of the natural environment in the course of fighting or preparing for war, has a long history and remains a regular feature of contemporary conflicts. Efforts to prohibit this in international law were initiated after the US’ notorious defoliation campaign in the Vietnam War in the 1960s and have advanced since then. Legal ambiguities and the defence of military necessity have limited the application of this body of law but the proscription of ecocide has, nonetheless, progressed and looks set to develop further. Normative change driven by scientists, environmentalists and legal experts has raised awareness of and stigmatised such practises to the extent that recourse to the worst excesses of ecocide now appears to have lessened and some recompense for past crimes has been made. Military activities, though, still inflict a heavy cost on the environment

Mechanisms and ecological role of carbon transfer within coastal seascapes

Worldwide, coastal systems provide some of the most productive habitats, which potentially influence a range of marine and terrestrial ecosystems through the transfer of nutrients and energy. Several reviews have examined aspects of connectivity within coastal seascapes, but the scope of those reviews has been limited to single systems or single vectors. We use the transfer of carbon to examine the processes of connectivity through multiple vectors in multiple ecosystems using four coastal seascapes as case studies. We discuss and compare the main vectors of carbon connecting different ecosystems, and then the natural and human-induced factors that influence the magnitude of effect for those vectors on recipient systems. Vectors of carbon transfer can be grouped into two main categories: detrital particulate organic carbon (POC) and its associated dissolved organic and inorganic carbon (DOC/DIC) that are transported passively; and mobile consumers that transport carbon actively. High proportions of net primary production can be exported over meters to hundreds of kilometers from seagrass beds, algal reefs and mangroves as POC, with its export dependent on wind-generated currents in the first two of these systems and tidal currents for the last. By contrast, saltmarshes export large quantities of DOC through tidal movement, while land run-off plays a critical role in the transport of terrestrial POC and DOC into temperate fjords. Nekton actively transfers carbon across ecosystem boundaries through foraging movements, ontogenetic migrations, or ‘trophic relays’, into and out of seagrass beds, mangroves or saltmarshes. The magnitude of these vectors is influenced by: the hydrodynamics and geomorphology of the region; the characteristics of the carbon vector, such as their particle size and buoyancy; and for nekton, the extent and frequency of migrations between ecosystems. Through a risk-assessment process, we have identified the most significant human disturbances that affect the integrity of connectivity among ecosystems. Loss of habitat, net primary production (NPP) and overfishing pose the greatest risks to carbon transfer in temperate saltmarsh and tropical estuaries, particularly through their effects on nekton abundance and movement. In comparison, habitat/NPP loss and climate change are likely to be the major risks to carbon transfer in temperate fjords and temperate open coasts through alteration in the amount of POC and/or DOC/DIC being transported. While we have highlighted the importance of these vectors in coastal seascapes, there is limited quantitative data on the effects of these vectors on recipient systems. It is only through quantifying those subsidies that we can effectively incorporate complex interactions into the management of the marine environment and its resources