Exploring residents' experiences of mealtimes in care homes: A qualitative interview study.

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents' health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents' experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents' enjoyment of meals, and resulting health and wellbeing. METHODS: Semi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. Interviews were supplemented by researcher observations of mealtimes. RESULTS: The dining experience was a focal point for participants' broader experiences of residing in a care home. Three themes pertaining to residents' experiences were identified: (1) Emotional and psychological connections with other residents; (2) managing competing interests with limited resources; and (3) familiarity and routine. CONCLUSION: Mealtimes are a mainstay of life in a care home through which residents' experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. It may also help to ease the transition from independent-living to life in care, which can be particularly stressful for some residents, and improve health and wellbeing over the long-term.This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula

Traces of volcanic ash from the Mediterranean, Iceland and North America in a Holocene record from South Wales, UK

A tephra record is presented for a sediment core from Llyn Llech Owain, south Wales, spanning the early‐ to mid‐Holocene. Seven cryptotephra deposits are discovered with three thought to correlate with known eruptions and the remaining four considered to represent previously undocumented events. One deposit is suggested to correlate with the ~6.9 cal ka bp Lairg A tephra from Iceland, whereas more distant sources are proposed as the origin for two of the tephra deposits. A peak of colourless shards in early‐Holocene sediments is thought to tentatively correlate with the ~9.6 cal ka bp Fondi di Baia tephra (Campi Flegrei) and a second cryptotephra is tentatively correlated with the ~3.6 cal ka bp Aniakchak (CFE) II tephra (Alaska). The Fondi di Baia tephra has never been recorded beyond proximal sites and its discovery in south Wales significantly extends the geographical distribution of ash from this eruption. The remaining four cryptotephra deposits are yet to be correlated with known eruptions, demonstrating that our current understanding of widespread tephra deposits is incomplete. This new tephra record highlights the potential for sites at more southerly and westerly locations in northwest Europe to act as repositories for ash from several volcanic regions

Physical rehabilitation for people with advanced dementia who fracture their hip - expert consensus process

This is the final version. Available on open access from Taylor & Francis via the DOI in this recordPURPOSE: Hip fracture is common in older people - with prevalence even higher for people with dementia. Research often excludes people with dementia - especially those in the more advanced stages. Therefore, the most appropriate interventions remain unknown. The main aim of this study was to gain consensus about the core considerations needed to deliver a physical intervention for people with advanced dementia who fracture their hip. Materials and Methods: An expert consensus process was undertaken, using Nominal Group Technique, to explore the key considerations when delivering rehabilitation. Data collection was undertaken in January 2023 and involved an online group discussion followed by voting and off-line rating. Qualitative content analysis and quantitative analysis of consensus scoring was undertaken. An international group of seven highly specialised physiotherapists took part. RESULTS: 59 statements were agreed following the process. Content analysis was used to categorise these statements according to the International Classification of Functioning, Disability and Health. Although consensus levels were high, there was disagreement in several areas. CONCLUSION: The statements provide an overarching understanding of the multidisciplinary expertise that is needed to effectively deliver rehabilitation interventions to this population. People with dementia require highly skilled and trained professionals, providing holistic and person-centred approaches to deliver rehabilitation interventions.IMPLICATIONS FOR REHABILITATIONThe expert consensus provides an overarching understanding of the multidisciplinary expertise that is needed to effectively deliver rehabilitation interventions to this population.Physiotherapy - or other interventions - cannot be used in isolation.People with dementia require highly skilled and trained professionals, providing holistic and person-centred approaches to deliver rehabilitation interventions.While our focus was on hip fracture, we suggest these statements can be used for people with advanced dementia with a variety of other conditions.National Institute for Health and Care Research (NIHR

Key Considerations When Providing Physical Rehabilitation for People with Advanced Dementia

This is the final version. Available on open access from MDPI via the DOI in this recordData Availability Statement: The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.Dementia is a growing global challenge with numbers set to increase rapidly in the coming years. Evidence suggests that exercise can be effective in improving cognitive functioning, but the evidence does not yet support improvements in other key domains such as quality of life or physical ability. The aim of this study was to explore the key components that needed to be considered when providing physical rehabilitation to people with advanced dementia. The study used a qualitative approach involving semi-structured focus groups with health care professionals who are experts in delivering interventions to people with advanced dementia. As a pragmatic study seeking to inform the development of interventions, a thematic coding approach was used to make sense of the data. We collected data from 20 healthcare professionals who reported that key considerations needed to be considered from both an assessment and an intervention perspective. The assessment needed to be person centred and, with the right people engaged and using outcome measures that were meaningful to the patient. The actual intervention also needed to follow the principles of person-centred care, with emphasis placed on the importance of taking time to build a rapport with the person, but also reducing any of the barriers that would prevent effective engagement, such as unsuitable environments. Our study suggests that while there are barriers and challenges to providing interventions and rehabilitation to people with advanced dementia, appropriate person-centred, tailored interventions can be effective and therefore should be offered.National Institute for Health and Care Research (NIHR

A New Constructive Heuristic for the Fm|block|ST

This paper deals with the blocking flow shop problem and proposes new constructive procedures for the total tardiness minimization of jobs. The heuristic has three-phases to build the sequence; the first phase selects the first job to be scheduled, the second phase arranges the remaining jobs and the third phase uses the insertion procedure of NEH to improve the sequence. The proposed procedures evaluate the tardiness associated to the sequence obtained before and after the third phase in order to keep the best of both because the insertion phase can worsen the result. The computational evaluation of these procedures against the benchmark constructive procedures from the literature reveals their good performance.Postprint (published version

Volcanic impacts on the Holocene vegetation history of Britain and Ireland? A review and meta-analysis of the pollen evidence

Volcanic ash layers show that the products of Icelandic volcanism reached Britain and Ireland many times during the Holocene. Historical records suggest that at least one eruption, that of Laki in a.d. 1783, was associated with impacts on vegetation. These results raise the question: did Icelandic volcanism affect the Holocene vegetation history of Britain and Ireland? Several studies have used pollen data to address this issue but no clear consensus has been reached. We re-analyse the palynological data using constrained ordination with various representations of potential volcanic impacts. We find that the palynological evidence for volcanic impacts on vegetation is weak but suggest that this is a case of absence of evidence and is not necessarily evidence of absence of impact. To increase the chances of identifying volcanic impacts, future studies need to maximise temporal resolution, replicate results, and investigate a greater number of tephras in a broader range of locations, including more studies from lake sediments