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PURPOSE: To develop and establish expert consensus on essential elements of optimal dietary and exercise referral practices for cancer survivors. METHODS: A four-round modified, Delphi method (face-to-face and electronic). In round 1, initial statements were drafted based on Cancer Australia's Principles of Cancer Survivorship and input from key stakeholders through a cancer preconference workshop. In round 2, the initial statements were distributed to a panel (round 1 participants) to establish consensus by rating the importance of each statement using a five-point Likert scale. Statements that required significant changes in wording were redistributed to panel members in round 3 for voting. Round 4 was for consumers, requiring them to rate their level of agreement of final statements. RESULTS: In total, 82 stakeholders participated in round 1. Response rates for survey rounds 2 and 3 were 59% (n = 54) and 39% (n = 36). Panel members included nurses (22%), dietitians (19%), exercise professionals (16%), medical practitioners (8%), and consumers (4%). The mean "importance" rating for all essential elements was 4.28 or higher (i.e., fairly important, or very important). Round 4's consumer-only engagement received responses from 58 consumers. Overall, 24 elements reached consensus following some revised wording, including the development of three new statements based on panel feedback. CONCLUSION: Our developed essential elements of optimal dietary and exercise referral practices can help provide guidance to medical and nursing health professionals relevant to dietary and exercise referral practices. Future research should conduct an implementation intervention and evaluation of these essential elements to optimise dietary and exercise care in cancer survivors.

INTRODUCTION: Cancer-related fatigue (CRF) is one of the most common and debilitating adverse effects of cancer and its treatment reported by cancer survivors. Physical activity, psychological interventions and management of concurrent symptoms have been shown to be effective in alleviating CRF. This pilot randomised controlled trial (RCT) will determine the feasibility of a telehealth CRF clinic intervention (T-CRF) to implement evidence-based strategies and assess the impact of the intervention on CRF and other clinical factors in comparison to usual care. METHODS AND ANALYSIS: A parallel-arm (intervention vs usual care) pilot RCT will be conducted at the Princess Alexandra Hospital in Queensland, Australia. Sixty cancer survivors aged 18 years and over, who report moderate or severe fatigue on the Brief Fatigue Inventory and meet other study criteria will be recruited. Participants will be randomised (1:1) to receive the T-CRF intervention or usual care (ie, specialist-led care, with a fatigue information booklet). The intervention is a 24-week programme of three telehealth nurse-led consultations and a personalised CRF management plan. The primary objective of this pilot RCT is to determine intervention feasibility, with a secondary objective to determine preliminary clinical efficacy. Feasibility outcomes include the identification of recruitment methods; recruitment rate and uptake; attrition; adherence; fidelity; apathy; and intervention functionality, acceptability and satisfaction. Clinical and resource use outcomes include cancer survivor fatigue, symptom burden, level of physical activity, productivity loss, hospital resource utilisation and carer's fatigue and productivity loss. Descriptive statistics will be used to report on feasibility and process-related elements additional to clinical and resource outcomes. ETHICS AND DISSEMINATION: This trial is prospectively registered (ACTRN12620001334998). The study protocol has been approved by the Metro South

AIM: Cancer and its treatment produce significant acute and long-term adverse effects in cancer survivors, resulting in a range of supportive cancer care needs across the disease trajectory. To enhance supportive cancer care in Australia, this study sought to understand and describe conventional services offered nationwide, specific to their structure (ownership, setting, duration), process (participants, delivery mode, referral pathways), and outcomes (evaluation). METHODS: A survey canvassing 13 conventional supportive cancer care interventions was electronically distributed to 265 cancer organizations in all Australian states and territories over 2019 and 2020. Cancer organizations were invited to participate if they provided at least one cancer-directed treatment (ie, surgery, radiation therapy, or systemic therapies); or clinical cancer care to adults, adolescents, or children; or conventional supportive care interventions to cancer survivors. RESULTS: A response rate of 46% (n = 123/265) was achieved, with 72% of cancer organizations (n = 88) delivering at least one intervention. Most were provided as outpatient or inpatient services, with few at home (<13%) or via telehealth (<10%). Psychological therapy (90%), self-care (82%), exercise (77%), healthy eating (69%), and lymphedema (69%) services were most common. Fatigue management (51%) and pelvic health (32%) were less common. Services offering massage, return-to-work, cognitive therapy, sleep hygiene, and leisure were underrepresented (<31%). CONCLUSION: Provision of conventional supportive cancer care services continues to evolve in Australia. Multiple areas of care require development of dedicated services to address supportive cancer care intervention shortfalls across the country. Online resources and telemedicine are currently underutilized modalities that are available for further development.

In this study, a multi-element aerofoil including NACA2415 aerofoil with NACA22 leading-edge slat is experimentally and computationally investigated at a transitional Reynolds number of 2 x 10(5). In the experiment, the single-element aerofoil experiences a laminar separation bubble, and a maximum lift coefficient of 1.3 at a stall angle of attack of 12 degrees is obtained. This flow has been numerically simulated by FLUENT, employing the recently developed, k-k(L)-omega and k-omega shear-stress transport (SST) transition models. Both transition models are shown to accurately predict the location of the experimentally determined separation bubble. Experimental measurements also illustrate that the leading-edge slat significantly delays the stall up to an angle of attack of 20 degrees, with a maximum lift coefficient of 1.9. The fluid dynamics governing this improvement is the elimination of the separation bubble by the injection of high momentum fluid through the slat over the main aerofoil - an efficient means of flow control. Numerical simulations using k-k(L)-omega are shown to accurately predict the lift curve, including stall, but not the complete elimination of the separation bubble. Conversely, the lift curve prediction using the k-omega SST transition model is less successful, but the separation bubble is shown to fully vanish in agreement with the experiment., Foundation of Erciyes UniversityErciyes University, M. S. Genc thanks the Foundation of Erciyes University for funding of visiting to the Bath University as academic visitor.

In this study, a multi-element aerofoil including NACA2415 aerofoil with NACA22 leading edge slat is experimentally and computationally investigated at a transitional Reynolds number of 2×105. In the experiment, the single-element aerofoil experiences a laminar separation bubble, and a maximum lift coefficient of 1.3 at a stall angle of attack of 12°. This flow has been numerically simulated by FLUENT, employing the recently developed, k-k L-? and k-? SST transition models. Both transition models are shown to accurately predict the location of the experimentally determined separation bubble. Experimental measurements illustrate that the leading-edge slat significantly delays the stall to an angle of attack of 20°, with a maximum lift coefficient of 1.9. The fluid dynamics governing this improvement is the elimination of the separation bubble by the injection of high momentum fluid through the slat over the main aerofoil - an efficient means of flow control. Numerical simulations using the k-kL-? transition model are shown to accurately predict the lift curve, including stall, but not the complete elimination of the separation bubble. Conversely, the lift curve prediction using the k-? SST transition model is less successful, but the separation bubble is shown to fully vanish in agreement with the experiment. Copyright © 2008 by the American Institute of Aeronautics and Astronautics, Inc. All rights reserved.

In this study, a multi-element aerofoil including NACA2415 aerofoil with NACA22 leading-edge slat is experimentally and computationally investigated at a transitional Reynolds number of 2 x 10(5). In the experiment, the single-element aerofoil experiences a laminar separation bubble, and a maximum lift coefficient of 1.3 at a stall angle of attack of 12 degrees is obtained. This flow has been numerically simulated by FLUENT, employing the recently developed, k-k(L)-omega and k-omega shear-stress transport (SST) transition models. Both transition models are shown to accurately predict the location of the experimentally determined separation bubble. Experimental measurements also illustrate that the leading-edge slat significantly delays the stall up to an angle of attack of 20 degrees, with a maximum lift coefficient of 1.9. The fluid dynamics governing this improvement is the elimination of the separation bubble by the injection of high momentum fluid through the slat over the main aerofoil - an efficient means of flow control. Numerical simulations using k-k(L)-omega are shown to accurately predict the lift curve, including stall, but not the complete elimination of the separation bubble. Conversely, the lift curve prediction using the k-omega SST transition model is less successful, but the separation bubble is shown to fully vanish in agreement with the experiment., Foundation of Erciyes UniversityErciyes University, M. S. Genc thanks the Foundation of Erciyes University for funding of visiting to the Bath University as academic visitor.

In this study, a multi-element aerofoil including NACA2415 aerofoil with NACA22 leading edge slat is experimentally and computationally investigated at a transitional Reynolds number of 2×105. In the experiment, the single-element aerofoil experiences a laminar separation bubble, and a maximum lift coefficient of 1.3 at a stall angle of attack of 12°. This flow has been numerically simulated by FLUENT, employing the recently developed, k-k L-? and k-? SST transition models. Both transition models are shown to accurately predict the location of the experimentally determined separation bubble. Experimental measurements illustrate that the leading-edge slat significantly delays the stall to an angle of attack of 20°, with a maximum lift coefficient of 1.9. The fluid dynamics governing this improvement is the elimination of the separation bubble by the injection of high momentum fluid through the slat over the main aerofoil - an efficient means of flow control. Numerical simulations using the k-kL-? transition model are shown to accurately predict the lift curve, including stall, but not the complete elimination of the separation bubble. Conversely, the lift curve prediction using the k-? SST transition model is less successful, but the separation bubble is shown to fully vanish in agreement with the experiment. Copyright © 2008 by the American Institute of Aeronautics and Astronautics, Inc. All rights reserved.