Tine Louise Launholt

Background: Malnutrition is prevalent among community-dwelling older adults (OAs), particularly those using healthcare services, and the number of affected individuals is expected to increase with ongoing population ageing. Early and systematic identification of OAs at risk of malnutrition is recommended as a key first step in prevention and management. However, a significant gap exists between recommended nutritional practices and their implementation in routine care. Aim: This article aims to describe the development process of a complex intervention for early detection of malnutrition risk among community-dwelling OAs (≥65 years) in a Danish homecare setting. Methods: The development process was overall framed by the Medical Research Council (MRC) framework and guided by the IdentifyiNg and assessing different approaches to DEveloping compleX intervention framework. Eleven iterative actions were undertaken, including systematic consideration of contextual conditions, key uncertainties, stakeholder engagement, review of published evidence, and development of the intervention’s programme theory. Findings: The development process resulted in an intervention comprising four activities: A. An interprofessional workgroup. B. Learning activities for homecare staff. C. Conversations with OAs and their informal caregivers. D. Systematic and continuous screening followed by an action guide. Activities C and D covered the screening procedure, and activities A and B the implementation strategy for this procedure. The developed intervention was designed to support nutritional self-care among OAs and facilitate early identification of malnutrition risk in homecare settings. Subsequent feasibility testing of the intervention was conducted between August 2024 and December 2025. It is reported elsewhere.

Background: Malnutrition is prevalent among older adults (OAs), ≥65 years, receiving home care services. Despite recommendations for early detection and multifactorial interventions, a gap remains between routine practice and evidence. We therefore developed a complex intervention for early detection of malnutrition risk in a Danish home care setting, comprising an implementation strategy with staff learning activities and a screening procedure with a start-up conversation and follow-up screenings. This article outlines the feasibility test and process evaluation of the intervention. Methods: Guided by the Medical Research Council (MRC/NIHR) framework for complex interventions and MRC process evaluation guidance, the evaluation was conducted in two parts. Part 1 focused on case-level feasibility, while Part 2 examined implementation feasibility within routine home care practice. Qualitative data were collected through participant observations, informal interviews, semi-structured individual interviews, focus group interviews, and a participatory workshop. Quantitative data were extracted from the electronic patient record (NEXUS, Systematic A/S, Aarhus, Denmark). Qualitative data were analysed using qualitative content analysis, and quantitative data using descriptive statistics. Results: All eligible OAs (12/12) received a start-up conversation in Part 1 compared with 5/16 (31%) in Part 2, while follow-up screenings declined from 61/71 (86%) to 37/50 (74%). Overall, staff perceived the learning activities as useful and were able to deliver the screening procedure. However, delivery and implementation were influenced by time constraints, leadership support, workplace culture, and organisational infrastructures. OAs showed willingness to participate, yet their prerequisites for engagement were more limited than anticipated. Conclusion: The intervention could be delivered in a real-world home care setting, but delivery, implementation, and activation of proposed mechanisms were constrained by resource limitations, competing priorities, workplace culture, and organisational infrastructures. To improve uptake, intervention adaptations and a stepwise implementation approach are recommended.

Malnutrition among community‐dwelling older adults (OAs) is prevalent, particularly in groups using healthcare services. Malnutrition burdens health, social, and aged‐care systems in terms of expenses for hospital admissions and care in nursing homes and home care settings. Effective management requires early identification and multimodal interventions; however, studies report a significant gap between recommended nutrition interventions and current healthcare practices. Therefore, this study aimed to identify, present, and map existing evidence on barriers and facilitators in the implementation of nutrition interventions among OAs living in noninstitutional municipal healthcare settings. A scoping review following the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) extension for Scoping Reviews checklist were conducted. The study included evidence from bibliographic databases and gray‐evidence sources that identify barriers and/or facilitators from stakeholder perspectives that influence the implementation of nutrition interventions for malnutrition prevention or treatment among OAs (≥65 years) in noninstitutional municipal healthcare settings. Stakeholders were OAs, informal caregivers, or healthcare professionals (HCPs). Thirty‐seven articles were included and 10 categories identified. Barriers were (1) lack of knowledge and awareness among HCPs, (2) lack of resources, (3) lack of collaboration and communication, (4) missing links between healthcare settings, and (5) poor insight among OAs and caregivers. Facilitators were (1) education and training of HCPs, (2) self‐care, (3) person‐centered care, (4) technology in nutrition care, and (5) social and psychological factors. Findings from this review indicate an imperative need for targeted implementation strategies for developing evidence‐based nutrition home care practice.

Introduction Apple vinegar (AV) has been proclaimed to have different health benefits, such as a weight loss, the ability to lower blood glucose levels, and reducing the risk of heart diseases. Studies on animals have demonstrated effects of AV consumption, deepening our knowledge of the beneficial effects and side effects. Aim The aims of this study were to evaluate the evidence of the effect of AV on metabolic parameters and body weight in humans, furthermore, to evaluate the safety and side effects of ingesting AV, and additionally to evaluate the evidence of the effect of AV on metabolic parameters, safety, and side effects of AV from studies performed on animals (mammals). Methods A systematic literature search was performed. The databases PubMed (MEDLINE), PsycInfo (Ebsco), CINAHL (Ebsco), and Embase (Ovid) were searched for relevant articles. Primary outcomes were glycated hemoglobin, postprandial glucose, and synonyms for blood glucose. Secondary outcomes were waist circumference, visceral fat, high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol. Studies performed on humans and animals were included. The included studies performed on humans were quality assessed for risk of bias using a version of the Cochrane Collaboration’s tool. Results A total of 487 papers were identified in the literature search. Of these, 13 studies performed on humans and 12 studies performed on animals were included. There may be beneficial health effects from the consumption of AV. The risk of side effects when ingested in recommended quantities and in recommended ways seems inconsiderable. Conclusion Due to inadequate research of high quality, the evidence for the health effects of AV is insufficient. Therefore, more large-scale, long-term clinical studies with a low risk of bias are needed before definitive conclusions can be made.