Malnutrition in community-dwelling older people: lessons learnt using a new procedure

This article reports the implementation of a new procedure for screening and treatment of malnutrition in a community NHS trust in England. The barriers and facilitators to implementation were assessed with staff from Integrated Community and Older People's Mental Health teams. Data from interviews and surveys were collected at baseline, 2 months after initial training and 16 months after initial training as well as following deployment of a nutrition lead to embed new developments for nutritional care. The adoption of the procedure made screening and treatment of malnutrition simpler and more likely to be actioned. The benefit of a nutrition lead and local nutrition champions to support and empower staff (avoiding reliance on training alone) was shown to drive change for nutritional care across the community. Prioritisation and commitment of leadership at the organisational level are needed to embed and sustain malnutrition screening and treatment in routine practice

Numerical models to predict the performance of tidal stream turbines working under off-design conditions

As previously experienced by the wind industry, it is envisaged that tidal stream turbine blades will presentmisalignments or blade deformations over time as they are constantly working under harsh and highlyunsteady environments. Blade misalignment will affect the power capture of a tidal stream turbine andif not detected in time could affect other components of the drive train. Therefore, the aim of this paperis to compare the use of two numerical modelling techniques to predict the performance of a tidal streamturbine working under off-design conditions, in this case, the misalignment of one or more blades. Thetechniques used in this study are Blade Element Momentum Theory and Computational Fluid Dynamics.The numerical models simulate the performance of a three-bladed horizontal axis tidal stream turbine withone or two blades offset from the optimum pitch setting. The simulations were undertaken at 1.0 m/s flowspeeds. The results demonstrated that both unsteady BEMT and steady or transient CFD are able topredict power coefficients when there is a certain level of misalignment in one or even two blades. However,both techniques failed to accurately predict a loss of power performance at high rotational speeds

Evaluating public involvement in research design and grant development: Using a qualitative document analysis method to analyse an award scheme for researchers

Background A regional Research Design Service, funded by the National Institute for Health Research, introduced a small grant in 2008, to support public involvement (often known as patient and public involvement [PPI]) activities during the development of applications for research funding. Successful applicants are requested to submit a report detailing how the grant money was used, including a description of the aims and outcomes of the public involvement activities. The purpose of this study was to analyse the content of these reports. We aimed to find out what researcher views and experiences of public involvement activities were, and what lessons might be learned. Methods We used an innovative method of data analysis, drawing on group participatory approaches, qualitative content analysis, and Framework Analysis to sort and label the content of the reports. We developed a framework of categories and sub-categories (or themes and sub-themes) from this process. Results Twenty five documents were analysed. Four main themes were identified in the data: the added value of public involvement; planning and designing involvement; the role of public members; and valuing public member contributions. Within these themes, sub-themes related to the timing of involvement (prior to the research study/intended during the research study), and also specific benefits of public involvement such as: validating ideas; ensuring appropriate outcomes; ensuring the acceptability of data collection methods/tools and advice regarding research processes. Other sub-themes related to: finding and approaching public members; timing of events; training/support; the format of sessions; setting up public involvement panels: use of public contributors in analysis and interpretation of data; and using public members to assist with dissemination and translation into practice. Conclusions The analysis of reports submitted by researchers following involvement events provides evidence of the value of public involvement during the development of applications for research funding, and details a method for involving members of the public in data analysis which could be of value to other researchers The findings of the analysis indicate recognition amongst researchers of the variety in potential roles for public members in research, and also an acknowledgement of how involvement adds value to studies

The care and support needs of residential care home residents with comorbid cancer and dementia: A qualitative review and ethnographic study.

Background: Prevalence of cancer and dementia are strongly related to age. In the UK, 70% of care home residents have dementia. By 2040, older people (aged 65+) will account for 77% of all people living with cancer. Residents with only one of these conditions may have complex care needs. Having comorbid cancer and dementia (CCD) is likely to bring further challenges. This is the first research project to examine the care and support needs of people with CCD living in residential care homes and areas for improvement. Aims: To explore: (1) The care and support needs of people with CCD living in residential care homes. (2) What constitutes good care for people with CCD, their family/supporters, and residential care home staff. (3) Potential barriers and facilitators to providing good care for people with CCD. Methods: (1) Literature review to examine implications for cancerrelated care for people with dementia living in residential care homes. (2) Interviews with 5‐10 men and women with CCD, their family members/ supporters, and residential care home staff. (3) Ethnographic observations of 5‐10 people with CCD to further explore barriers and facilitators to good care. Results: Emergent findings from the literature review will be presented, and their implications for supporting people with CCD living in residential care homes discussed. Conclusions: Findings from this study will help improve the care and support of people with CCD and will contribute to a wider programme of research exploring the cancer care needs of people with dementia across a variety of care settings

Technology-facilitated abuse in intimate relationships : a scoping review

Technology-facilitated abuse (TFA) is a significant, harmful phenomenon and emerging trend in intimate partner violence. TFA encompasses a range of behaviours and is facilitated in online spaces (on social media and networking platforms) and through the misuse of everyday technology (e.g. mobile phone misuse, surveillance apps, spyware, surveillance via video cameras and so on). The body of work on TFA in intimate relationships is emerging, and so this scoping review set out to establish what types of abuse, impacts and forms of resistance are reported in current studies. The scoping review examined studies between 2000 and 2020 that focused on TFA within intimate partnerships (adults aged 18+) within the setting of any of these countries: the UK and Ireland, USA, Canada, New Zealand and Australia. The databases MEDLINE, CINAHL and Scopus were searched in December 2020. A total of 22 studies were included in the review. The main findings were that TFA is diverse in its presentation and tactics, but can be typed according to the eight domains of the Duluth Power & Control Wheel. Impacts are not routinely reported across studies but broadly fall into the categories of social, mental health and financial impacts and omnipresence. Similarly, modes of resistance are infrequently reported in studies. In the few studies that described victim/survivor resistance, this was in the context of direct action, access to legal or professional support or in the identification of barriers to resistance

A Practical Guide for Maintaining High Activity Levels in Physical Education

This article present nine strategies that have been used successfully to improve activity levels in PE classes. These strategies comprise small-sided games, school warm-ups, rule adaptations, quick transitions, rewards, resources, teacher challenges, teaching by invitation and technology

An argument for the use of Aristotelian method in bioethics

The main claim of this paper is that the method outlined and used in Aristotle's Ethics is an appropriate and credible one to use in bioethics. Here “appropriate” means that the method is capable of establishing claims and developing concepts in bioethics and “credible” that the method has some plausibility, it is not open to obvious and immediate objection. It begins by suggesting why this claim matters and then gives a brief outline of Aristotle's method. The main argument is made in three stages. First, it is argued that Aristotelian method is credible because it compares favourably with alternatives. In this section it is shown that Aristotelian method is not vulnerable to criticisms that are made both of methods that give a primary place to moral theory (such as utilitarianism) and those that eschew moral theory (such as casuistry and social science approaches). As such, it compares favourably with these other approaches that are vulnerable to at least some of these criticisms. Second, the appropriateness of Aristotelian method is indicated through outlining how it would deal with a particular case. Finally, it is argued that the success of Aristotle's philosophy is suggestive of both the credibility and appropriateness of his method.</p

CFD modelling of a tidal stream turbine subjected to profiled flow and surface gravity waves

This study used computational fluid dynamics to investigate the effect of waves and a velocity profile on the performance of a tidal stream turbine (TST). A full scale TST was transiently modelled operating near its maximum power point, and then subjected to waves both in and out of phase with its period of rotation. A profile was then added to one of the wave models. For this set of conditions it was found that the longer period and in-phase wave had a significant effect on the power range fluctuations, with more modest variations for thrust and the average values, although this is dependent on the turbine tip speed ratio. The addition of the profile had a strong effect on the bending moment. It has been concluded that a naturally varying sea state may yield a smoothing effect in this turbine response, but that with further structural investigation it may be that some measuring and mitigation techniques are required in the event of a predominantly single long period, in-phase wave