Abstract Background Older people with dementia are regularly excluded from decision-making processes and their wishes and preferences for care are often not respected. The aim of this study was to analyze whether the use of Talking Mats® (TM) help older service recipients with mild to moderate dementia to feel more involved in and satisfied with needs assessment and planning conversations within Swedish home care services, compared to usual conversation methods. Methods This study employed a post-test only, two-armed parallel group randomized controlled trial design. The use of TM was evaluated in comparison with a control group using usual conversation methods. Inclusion criteria were service recipients from participating municipalities, ≥ 65 years scoring 12-23p on the MMSE. Randomization was conducted in blocks by site (n = 3) with allocation set at 50% per arm with concealed allocation. Once participants were randomized to study arm blinding was not possible. Post-tests were conducted with service recipients after conversations with care managers and nursing assistants. The impact of staff’s perceived acceptability, appropriateness and feasibility of TM was assessed. Results 101 older home care services recipients were recruited, 51 in the TM group and 50 in the control group. Non-response was relatively high > 10% in both groups. Total attrition showed 24% of the service recipients with dementia did not complete data collection following conversations with CMs, and 35% with NAs. High involvement and satisfaction were found in both TM and control group in conversations with care managers and nurse assistants. No difference between groups was detected. Dementia severity was significantly and positively correlated with self-perceived involvement. Conclusions There were no significant differences between TM and control groups regarding self-perceived involvement and satisfaction after conversations with care managers and nurse assistants. Trial registration ClinicalTrials.gov ID: NCT05 561,998. Registered on September 28, 2022.
BACKGROUND:The Swedish tactical police unit is a highly trained team specialized in managing complex situations and tactically demanding operations. Each tactical police group includes a designated medic who completes a 10-week basic training program in tactical medicine, followed by various forms of additional training. The medical aspects of police work are strictly regulated by medical authorities, and among other restrictions, the medics' authorizations apply only when providing care to fellow officers. The purpose of this study was to explore tactical police medics' perceptions of their work in relation to training, competencies, tactics, and the provision of practical medical care. METHOD:The study employed a qualitative design in which 13 medics from the tactical police unit were interviewed using a semi-structured interview protocol. They were asked questions about their perceived preparedness for the role, their training, and real-life situations in which they had acted as medics. All interviews were digitally recorded and transcribed verbatim. The transcripts were then coded and analysed thematically following Braun and Clarke's model of thematic analysis. RESULT:The results indicated that the medics were generally satisfied with their training and education in tactical medicine. However, there was a clear discrepancy between what they had been trained to do and the tasks they actually performed in their roles. They also expressed frustration about how their mission is defined by medical authorities, particularly the restriction that prevents them from applying their medical authorizations to injured third parties. Collaboration with civilian healthcare was described as inconsistent; cooperation with prehospital physicians was generally viewed positively, whereas the relationship with ambulance personnel was perceived as more challenging. CONCLUSIONS:The tactical police medics represent a highly trained and competent group that is not being utilized to its full potential. They could be deployed more extensively in situations requiring tactical medical care and rescue operations. Achieving this would require stronger and more effective collaboration with civilian healthcare services.
Ruminants, as an inseparable part of the food chain, will play a determining role in meeting future food demands and guaranteeing global food security for the ever-growing population. In this regard, supplying ruminants with feed material and feed additives that enhance animal health and products has attracted great research interest in the field of ruminant nutrition. Volatile fatty acids (VFAs), such as acetic, propionic and butyric acids, which are endogenously generated in the rumen, are mainly responsible for providing the animal with metabolizable energy and as precursors for animal products. In addition, VFA can be supplied to ruminants as ex situ additives. Extensive research on VFA additives has proven that VFA supplementation affects the development of ruminant gastrointestinal tract, hormone levels, milk yield and composition, adipose tissue, meat quality, weight gain, dry matter intake, etc. The current review provides a unique collection of studies on the effects of VFA additives on ruminants in addition to an in-depth overview of the ruminant digestion system and the fate of different fractions of feed material. Moreover, the potential for sustainable provision of VFA additives from organic-rich waste and residues through anaerobic digestion plus post separation and concentration is critically discussed in this review.
Interest in the link between diet, health, and sustainable nutrition has grown, driving exploration of alternative proteins. Edible filamentous fungi offer a promising high-quality protein source for meat analogues. This study explores Neurospora intermedia biomass, cultivated on grape marc and wine lees produced via submerged fermentation in a demo-scale bubble column reactor, to create clean-label, vegan, and gluten-free meat analogue balls (MABs). MABs were formulated with 21.4 % (w/w) fungal protein and compared with pea-based textured vegetable protein. Protein sources were evaluated for techno-functional properties, and MABs were assessed for cooking characteristics, nutritional value, color, texture, microstructure, and sensory attributes. Fungal proteins exhibited high water (5.92-6.51 g/g) and oil (up to 5.81 g/g) absorption capacities. Fungi-based MABs had a cooking efficiency of 86.5-87.6 % and crude protein content up to 37 % on a dry basis. Texture profile analysis showed improved cohesiveness (0.63-2.23), and springiness (0.55-2.45) compared to those made from peabased texturized proteins. Scanning electron microscopy confirmed a fibrous microstructure. Sensory evaluation under blind conditions by untrained panelists highlighted juiciness, a fibrous texture, and a fungi- or meataroma mimicry. These results support the potential of Neurospora intermedia biomass grown on oenological byproducts as a nutritious, functional protein source for next-generation meat analogues. The study has strong potential to contribute to the circular bioeconomy fields with broader sustainability implications.
The increasing global population and evolving dietary preferences demand sustainable and innovative food solutions. Edible filamentous fungi offer a promising protein source and are emerging as key ingredients in meat alternatives. This study investigates the quality and safety of Neurospora intermedia biomass (NIB), produced in a demo-scale bubble column reactor using grape marc (GM) and wine lees (WL) as cultivation media, and synthetic glucose medium (SYN) as a control. For submerged fermentation, GM and WL were used at 4% w/v and 50% v/v, respectively, whereas 1.5% w/v glucose was used for SYN. The NIB exhibited a complete amino acid profile, with notable levels of lysine (9.25-9.46%) and leucine (8.69-9.04%), and its lipid fraction was rich in unsaturated fatty acids-oleic (41.0-59.8%) and linoleic (19.7-33.9%), along with phosphorus (1097-2747 mg/100 g) and polyphenols (5.48-7.89 mg GAE/g). Overall, the proteomic analysis allowed the identification of more than 3000 proteins. Bioinformatic predictions identified potential allergens, which together accounted for only a minor fraction of the total protein mass. This study underscores NIBs grown on GM and WL as a functional and nutritious ingredient that has a rich and diverse protein profile with potentially low allergenicity. Additionally, it offers an innovative strategy that adds economic value to oenological by-products, reduces environmental impact, and promotes a circular bioeconomy.
