Supporting delivery of the recovery package for people living with and beyond cancer

Survivorship is an important issue in cancer care in the UK. More people are being diagnosed with the disease and many more are living for longer after diagnosis. The National Cancer Survivorship Initiative recommends that patients with cancer have a package of care designed to improve outcomes and support for those living with and beyond the disease. The recovery package consists of a holistic needs assessment, treatment summary, cancer care review and health and wellbeing event. Although these interventions are recommended as a way to improve care, many people do not have access to the combined package, or even some of its components. The Cancer Nursing Partnership (CNP), a collaboration of cancer nursing organisations and communities of influence, has been established to support nurses with delivery of the recovery package in practice. This article describes the package and its components, introduces the CNP and outlines the work it has carried out to date.

Evidence Base

Natalie Doyle and Richard Henry outline the evidence around Charles Campion-Smith's article on primary care after cancer treatment.

Carotenoids and health in older people

As the proportion of older people increases, so will chronic disease incidence and the proportion of the population living with disability. Therefore, new approaches to maintain health for as long as possible in this age group are required. Carotenoids are a group of polyphenolic compounds found predominantly in fruit and vegetables that have been proposed to have anti-inflammatory and antioxidant effects. Such properties may impact on the risk diseases which predominate in older people, and also ageing-related physiological changes. Working out the effect of carotenoid intake versus fruit and vegetable intake is difficult, and the strong correlation between individual carotenoid intakes also complicates any attempt to examine individual carotenoid health effects. Similarly, research to determine whether carotenoids consumed as supplements have similar benefits to increased dietary intake through whole foods, is still required. However, reviewing the recent evidence suggests that carotenoid intake and status are relatively consistently associated with reduced CVD risk, although β-carotene supplementation does not reduce CVD risk and increases lung cancer risk. Increased lycopene intake may reduce prostate cancer progression, with a potential role for carotenoids at other cancer sites. Lutein and zeaxanthin have a plausible role in the maintenance of eye health, whilst an association between carotenoid intake and cognitive and physical health appears possible, although research is limited to date. Given this accruing evidence base to support a specific role for certain carotenoids and ageing, current dietary advice to consume a diet rich in fruit and vegetables would appear prudent, and efforts maintained to encourage increased intake.

On the use of OpenFOAM to model Oscillating wave surge converters

The Computational Fluid Dynamic (CFD) toolbox OpenFOAM is used to assess the applicability of Reynolds-Averaged Navier-Stokes (RANS) solvers to the simulation of Oscillating Wave Surge Converters (OWSC) in significant waves. Simulation of these flap type devices requires the solution of the equations of motion and the representation of the OWSC’s motion in a moving mesh. A new way to simulate the sea floor inside a section of the moving mesh with a moving dissipation zone is presented. To assess the accuracy of the new solver, experiments are conducted in regular and irregular wave traces for a full three dimensional model. Results of acceleration and flow features are presented for numerical and experimental data. It is found that the new numerical model reproduces experimental results within the bounds of experimental accuracy.

More nonlocality with less entanglement in a tripartite atom-optomechanical system

Quantum effects in hybrid atomic optomechanics in a system comprising a cloud of atoms and a mobile mirror mediated by a single-mode cavity are studied. Tripartite non-locality is observed in the atom-light-mirror system, as demonstrated by the violation of the Mermin-Klyshko (MK) inequality. It has been shown [C. Genes, et al., PRA 77, 050307 (R) (2008)] that tripartite entanglement is optimized when the cavity is resonant with the anti-Stokes sideband of the driving laser and the atomic frequency matches the Stokes one. However, we show that this is not the case for the nonlocality. The MK function achieves minima when the atoms are resonant with both the Stokes and anti-Stokes sidebands, and unexpectedly, we find violation of the MK inequality only in a parameter region where entanglement is far from being maximum. A negative relation exists between nonlocality and entanglement with consideration of the possibility of bipartite nonlocality in the violation of the MK inequality. We also study the non-classicality of the mirror by post-selected measurements, e.g. Geiger-like detection, on the cavity and/or the atoms. We show that with feasible parameters Geiger-like detection on the atoms can effectively induce mechanical non-classicality.

Understanding the practice nurse’s role in the cancer care tapestry

Background: The are currently 2 million people in the UK living with or
after cancer, and this number is expected to double by 2030 (Maddams et
al, 2012). However, many report unmet physical and psychological needs.

Aim: To determine the learning needs of practice nurses to take on an
enhanced role with people affected by cancer, particularly after primary
treatment, and to develop a course to meet these needs.

Method: The Macmillan Steering Group designed and developed a course for practice
nurses to identify their learning needs, enabling participating practice
nurses to work collaboratively with each other and the course facilitator.
There was strong patient involvement throughout. The course was
evaluated by self-assessment of knowledge, skills and confidence, patient
satisfaction questionnaires and in-depth, qualitative telephone interviews
with the participants and their supporting GPs.

Results: The practice nurses reported changed practice, with increased confidence in discussing
issues relating to cancer and its treatment with patients and relatives.
They understood the importance of supported self-management and were
able to signpost patients to appropriate sources of information and
support. Many of the practice nurses started initiating and undertaking
Cancer Care Reviews, both as planned appointments and opportunistically.
Over the past year, a further nine pilots have been completed throughout
the UK, demonstrating that these results are reproducible in other settings.

Conclusions: With appropriate support and training and protected time
to include cancer care into their everyday work, practice nurses can take
on an important role in the support and care of people affected by cancer

Planning Urban Food Production into Today's Cities

If cities are to become more sustainable and resilient to change it is likely that they will have to engage with food at increasingly localised levels, in order to reduce their dependancy on global systems. With 87 percent of developed regions estimated to be living in cities by 2050 it can be assumed that the majority of this localised production will occur in and around cities.
As part of a 12 month engagement, Queen’s University Belfast designed and implemented an elevated aquaponic food system spanning the top floor and exterior roof space of a disused mill in Manchester, England. The experimental aquaponic system was developed to explore the possibilities and difficulties associated with containing fish tanks, filtration units, vertical growing systems and roof top growing systems within and upon existing buildings, including the structural considerations needed when undertaking such transformations. Although capable of producing 4000 crops at any one time, the elevated aquaponic system utilised space within the existing building, which could otherwise be used as lettable area, and also located some crop growth within the building where light levels are reduced.
The following paper takes the research collected from the elevated aquaponic system and extrapolates the findings across a whole city. The resulting research enables the agricultural productive capacity of todays cities to be determined and a frame work of implementation to be developed for city wide food production. The research focuses specifically on facade and roof based systems, thus elevating the need to utilise lettable area within cities in addition to locating crops where light levels are highest.

Holocene climate and environmental change in north-eastern Kamchatka (Russian Far East), inferred from a multi-proxy study of lake sediments

A sediment record from a small lake in the north-eastern part of the Kamchatka Peninsula has been investigated in a multi-proxy study to gain knowledge of Holocene climatic and environmental change. Pollen, diatoms, chironomids and selected geochemical parameters were analysed and the sediment record was dated with radiocarbon. The study shows Holocene changes in the terrestrial vegetation as well as responses of the lake ecosystem to catchment maturity and multiple stressors, such as climate change and volcanic eruptions. Climate change is the major driving force resulting in the recorded environmental changes in the lake, although recurrent tephra deposition events also contributed. The sediment record has an age at the base of about 10,000 cal yrs BP, and during the first 400 years the climate was cold and the lake exhibited extensive ice-cover during winter and relatively low primary production. Soils in the catchment were poor with shrub alder and birches dominating the vegetation surrounding the lake. At about 9600–8900 cal yrs BP the climate was cold and moist, and strong seasonal wind stress resulted in reduced ice-cover and increased primary production. After ca. 8900 cal yrs BP the forest density increased around the lake, runoff decreased in a generally drier climate resulting in decreased primary production in the lake until ca. 7000 cal yrs BP. This generally dry climate was interrupted by a brief climatic perturbation, possibly attributed to the 8.2 ka event, indicating increasingly windy conditions with thick snow cover, reduced ice-cover and slightly elevated primary production in the lake. The diatom record shows maximum thermal stratification at ca. 6300–5800 cal yrs BP and indicates together with the geochemical proxies a dry and slightly warmer climate resulting in a high productive lake. The most remarkably change in the catchment vegetation occurred at ca. 4200 cal yrs BP in the form of a conspicuous increase in Siberian dwarf pine (Pinus pumila), indicating a shift to a cooler climate with a thicker and more long-lasting snow cover. This vegetational change was accompanied by marked shifts in the diatom and chironomid stratigraphies, which are also indicative of colder climate and more extensive ice-cover.