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    Establishing a research partnership for delivering palliative and end-of-life care for older people in rural and remote areas: a formative mixed-methods study.

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    BackgroundMany older people live in rural and remote areas. As the ageing population grows, conditions such as cancer, dementia and stroke will become more prevalent, causing a huge demand for palliative and end-of-life care. However, evidence regarding models of care and interventions in rural and remote areas is limited.AimA new United Kingdom rural palliative care partnership was funded for 12 months. It aimed to understand the models of palliative and end-of-life care for older people with cancer, dementia and stroke in rural/remote areas across all four nations of the United Kingdom. It also aimed to identify the core priorities for research into rurality and palliative care for older people.MethodsThe project consisted of three integrated components, including: (1) a scoping review of relevant literature on rural palliative care for older people with cancer, dementia and stroke; (2) stakeholder engagement workshops using a modified Nominal Groups Technique and (3) qualitative interviews with family carers who supported rural-/remote-dwelling older adults towards the end of life.ResultsOur scoping review was undertaken in 2022. The search identified 1128 unique citations, of which five papers were included. There were no United Kingdom studies on models of palliative and end-of-life care delivered to older people with cancer, dementia or stroke within rural/remote locations. However, international models of care were identified. Models included technological interventions to reach those in remote locations, the role of palliative care nurses and the use of volunteers. Articles highlighted the importance of not replacing face-to-face care with technology for ease of reaching more people and emphasised the importance of effective interdisciplinary working in rural and remote palliative care. Additionally, three online workshops to develop research capacity, identify models of care, understand issues of rurality and determine research priorities were attended by 15-20 stakeholders. Qualitative interviews were also undertaken with 20 family carers who had supported rural-/remote-dwelling older adults at their end of life. Data identified that rural/remote communities face challenges in accessing palliative and end-of-life care due to issues such as transport to and distance from services, poor broadband coverage and problems with workforce recruitment and retention. Synthesising the data from these methods helped to identify some interventions and models of care for palliative and end-of-life care for older people in rural and remote areas. It also helped us to jointly shape and develop research priorities, which included workforce planning and service composition, facilitating preferred place of death and the role of technology. However, there are gaps in our understanding about how to improve the family carer support as well as digital literacy among older people to help them benefit from technological interventions.ConclusionsOverall, there is a lack of research on palliative and end-of-life care models and interventions provided to older adults with cancer, dementia and stroke in rural and remote settings, especially in the United Kingdom. There is an urgent need to co-design community-based models of palliative and end-of-life care in rural and remote locations, considering the unique challenges of living in these areas.FundingThis article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135350

    Integrating Fluid Dynamics: Leveraging Simscape for Modelling and Real-Time Control of Continuous Flow Ohmic Heater

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    Ohmic heating (OH) is an innovative thermal processing technology known for its rapid and uniform heating capabilities. It presents several challenges due to its complex multi-physics nature, involving electrical, thermal, and fluid dynamics phenomena. The nonlinearity of OH systems, influenced by variations in electrical conductivity and temperature, makes physical modelling a necessity to capture these dynamics accurately. To address this, we developed a MATLAB model using the Simscape toolbox, designed to investigate the effects of OH technology under various physical conditions of food products. This model was validated against both an established mathematical model and a pilot scale continuous flow ohmic heater (CFOH), achieving a normalised mean square error (NRMSE) of ± 0.005 and a mean absolute percentage error (MAPE) of ± 5%. It effectively simulates temperature variations in response to changes in the thermophysical properties of food, facilitating real-time system dynamics evaluations. Additionally, the model explores significant factors such as electrical conductivity, product temperature, density, flow rate, and electric field strength. The successful application of this physical model underscores its potential in designing model-based control systems to enhance the efficiency and performance of the CFOH processes

    Studio Properties : a Field Guide to Design Education

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    There is something special about a studio as a place of practice and learning. Studio is a complex form of teaching and learning. If you have not experienced studio, it may seem mysterious, even chaotic. If you have experienced studio, you may want to know more about how and why it works. Either way, Studio Properties will deepen your understanding of studio to help you teach, research, or administer design education more effectively and with greater confidence and creativity. Use Studio Properties like a field guide. You will discover the components of studio broken down into individual properties. You will find clear descriptions and a wealth of research references that illuminate studio. You will be guided in understanding the relationships between properties without being limited to one model or approach. In this innovative and non-linear book, available in print, ebook and open access, six internationally renowned and award-winning educators and researchers from various studio disciplines invite you to explore familiar and less-familiar aspects of studio. The ebook editions of this book are available open access under a CC BY-NC-ND 4.0 licence on bloomsburycollections.com. Open access was funded by the Open University

    Community, Courage, Culture and Care: A Qualitative Study Exploring the Experiences of Planetary Health Leadership in the UK Health Context.

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    Background Planetary health and the delivery of planetary healthcare are growing concerns for health and health institutions globally. While the leadership required to navigate this evolving arena is an area of increasing study, little research exists exploring the experience and perceptions of leaders in this field. Aim This study aimed to explore the experiences and perceptions of leaders working towards planetary health in the UK health context, with a view to making recommendations on leadership and leadership development in this field. Methods A qualitative study with 25 participants with experience of planetary health and/or planetary healthcare leadership. Virtual semistructured interviews were used for data collection and thematically analysed. Results Six themes were identified: creating community; managing the scale of the challenge; morality; creating consensus; shaping culture and identity (as leader and/or as activist). Conclusions This study highlights the relational, collaborative and moral aspects of leadership as central to the experience of planetary health leadership, offering recommendations for leadership educators to strengthen leadership development in this field. It also identified the critical need for the well-being needs of leaders navigating this emotive and uncharted territory to be appreciated and responded to, along with the importance of legitimising and professionalising action and leadership in this field

    Environmental wellbeing: a concept and principles for research, policy and action

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    Environmental wellbeing is often referred to in academic literature but seldom defined. This article provides two contributions to knowledge: (1) developing an integrated concept of environmental wellbeing, positioning it as a locally situated counterpart to notions of ‘planetary health’ and ‘human wellbeing’, and (2) outlining practical principles for its operationalisation. Building on concepts of environmental justice, this article begins with novel theorisation of environmental wellbeing as a (natural and social) state in which humans and non-humans, both as individuals and as parts of larger ecosystems, can thrive within an equitable balancing of resources and uses. Nevertheless, such balancing needs to account for, and counter, the uneven causation of harms as well as the uneven distribution of benefits, while recognising that advances towards environmental wellbeing should be pragmatically achievable within an already severely damaged natural world. The article addresses these challenges by offering practical principles for operationalising environmental wellbeing within local decision-making. Environmental wellbeing is thus articulated here not only as a theorised desirable state but also as a practical tool for advocacy and policy development

    Preservation of temporal organisation of tennis service following ageing in recreational players

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    Background: Ageing leads to functional changes in body systems. Purpose: This study sought to examine the age-based differences in temporal patterning, temporal variability and temporal regularity of tennis service in older adults. Research design: cross-sectional study. Study sample: Participants of this study were volunteers from young (n = 10) and older (n = 11) adults who were self-defined as non-competitive, participating in tennis at a recreational (sub-elite) level for 2–3 days per week regularly. Data collection: They were asked to perform 20 trials of the same serves (flat, slice or top-spin) on a regular size court. The timing (duration) of the serve action was recorded and analysed, using a high-speed digital camera. Participants performed the tennis serves during their routine training sessions on a tennis court. They undertook a structured general (10min) and a specific warm-up routine (10min) before performing services. There was a 30-second rest period between trials. Results: Findings showed that there were no statistically significant differences between the two groups in temporal patterning, whereas the younger group performed the serves with higher variability and regularity/consistency than the older adults in some phases of the action. Conclusion: Older adults who participate recreationally in sports are able to preserve some functional organisation of perceptual-motor capacities, such as timing, due to long-term practice effects. The findings illustrate how sport participation may help maintain functional movement organisation following ageing to mitigate age-related declines in perception and action in late adulthood

    The effect of run duration, gait variable and Lyapunov exponent algorithm on the inter-session reliability of local dynamic stability in healthy young people

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    Local dynamic stability (LDS) of gait has been used to differentiate between healthy and injured populations, establishing its potential as an indicator of healthy gait and a new objective measure to assess gait function following injury. For LDS to be a reliable assessment tool of healthy gait progression during rehabilitation, it must provide consistent and sensitive inter-session measures. Methodological factors such as trial duration, gait variable, and Lyapunov Exponent (LyE) algorithm can influence LDS estimation and its reliability. Young people are a high-risk population for sport-related injuries, and running is a key activity during rehabilitation and is regularly assessed. Therefore, the effects of run duration, gait variable, and LyE algorithm choice on the reliability and sensitivity of inter-session LDS measures in young people were investigated. Sixteen healthy participants ran on a treadmill on two separate sessions (difference of 7 ± 5 days). LDS was calculated using both the Rosenstein and Wolf algorithm for durations of 1-, 2-, 3-, 4- and 5-min of knee flexion angle and medio-lateral acceleration of the pelvis and thorax from each session. The relative and absolute reliability between sessions was calculated using the intraclass correlation coefficient and standard error of measurement. The sensitivity of inter-session LDS change was quantified by the minimal detectable change. Results showed that longer run durations produced higher relative reliability and a minimum run duration of 4 min is recommended to achieve moderate-to-good inter-session reliability across all gait variables and LyE algorithms. However, shorter durations of 2-3 min may still be sufficient when using medio-lateral pelvis acceleration or knee flexion angle, particularly with the Rosenstein algorithm, which also improves sensitivity to change. These findings provide practical guidance for methodological choices when calculating LDS in young people during running and support their potential use as reliable tools for monitoring gait function and tracking rehabilitation progress in young people following injury

    (Hetero)sex, 'fun' and university life: the discursive construction of women students' experiences of sexual violence at university

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    There is growing recognition of the issue of sexual violence experienced by women university students in the UK. Despite increased attention, problems with prevalence, reporting, support and institutional responses persist. There is, therefore, a need to better understand students’ experiences and perceptions of sexual violence and the context in which these incidents occur in order to develop effective, theoretically informed responses which follow from students’ experiences. This article presents findings from research which explored the nature and extent of women students’ experiences of sexual violence at one university in England. Reporting on semi-structured interviews with students, the article addresses a gap in evidence by using a poststructuralist framework to understand the dominant gendered and heterosexed discourses which shape the nature, extent and understanding of sexual violence and construct a ‘truth’ about expectations of university life. It applies and extends Gavey’s (2005) concept of the cultural scaffolding of rape to consider students’ experiences in the university context in which they took place. It is argued that these discourses produce contextually contingent gendered subjectivities which are at times resisted but are also amplified in the space of the university, further limiting the ways in which students can make sense of their experiences

    Tourism-driven inclusive growth – insights from Brazil’s Northeast

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    The concept of inclusive growth focuses on the relationship between economic growth, poverty and inequality and has started to receive greater attention in tourism research. Bakker, presents a Tourism-driven Inclusive Growth Diagnostic Framework (T-DIGD) to systematically analyse factors that constrain tourism’s ability to drive inclusive growth and identify policy priorities at national level. Using a mixed-methods approach, this study applies the T-DIGD to a local destination in the Northeast of Brazil to assess its practical applicability, identify any gaps, and enhance its value as a diagnostic tool for tourism-driven inclusive growth. Findings confirm the framework’s strength in analysing constraints for tourism-driven inclusive growth in a systematic manner. It is argued that governance, power in terms of access to networks and connections, as well as the political economy should be more explicitly incorporated into the T-DIGD, and further attention should be given to equality in non-monetary outcomes of tourism opportunities

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