Contribution of thickened drinks, food and enteral and parenteral fluids to fluid intake in hospitalised patients with dysphagia

Background Studies amongst older people with acute dysphagic stroke requiring thickened fluids have assessed fluid intakes from combinations of beverage, food, enteral and parenteral sources, but not all sources simultaneously. The study aimed to comprehensively assess total water intake from food, beverages, enteral and parenteral sources amongst dysphagic adult in-patients receiving thickened fluids. Methods Patients requiring thickened fluid following dysphagia diagnosis were recruited consecutively from a tertiary teaching hospital’s medical and neurosurgical wards. Fluid intake from food and beverages was assessed by wastage, direct observation and quantified from enteral and parenteral sources through clinical medical records. Results No patients achieved their calculated fluid requirements unless enteral or parenteral fluids were received. The mean daily fluid intake from food was greater than from beverages whether receiving diet alone (food 807±363mL, food and beverages 370±179mL, p<0.001) or diet with enteral or parenteral fluid support (food 455±408mL, food and beverages 263±232mL, p<0.001). Greater daily fluid intakes occurred when receiving enteral and parenteral fluid in addition to oral dietary intake, irrespective of age group, whether assistance was required, diagnosis and whether stage 3 or stage 2 thickened fluids were required (p<0.05). After enteral and parenteral sources, food provided the most important contribution to daily fluid intakes. Conclusions The greatest contribution to oral fluid intake was from food, not beverages. Designing menus and food services which promote and encourage the enjoyment of fluid dense foods, in contrast to thickened beverages, may present an important way to improve fluid intakes of those with dysphagia. Supplemental enteral or parenteral fluid may be necessary to achieve minimum calculated fluid requirements.

Multilevel converters in renewable energy systems

In photovoltaic, fuel cells and storage batteries, the low output DC voltage should be boosted. Therefore, a step-up converter is necessary to boost the low DC voltage for the DC link voltage of the inverter. The main contribution of this chapter is to electrical energy conversion in renewable energy systems based on multilevel inverters. Different configuration of renewable energy systems based on power converters will be discussed in detail. Finally, a new single inductor Multi-Output Boost (MOB) converter is proposed, which is compatible with the diode-clamped configuration. Steady state and dynamic analyses have been carried out in order to show the validity of the proposed topology. Then the joint circuit of the proposed DC-DC converter with a three-level diode-clamped converter is presented in order to have a series regulated voltage at the DC link voltage of the diode-clamped inverter. MOB converter can boost the low input DC voltage of the renewable energy sources and at the same time adjust the voltage across each capacitor to the desired voltage levels, thereby solving the main problem associated with capacitor voltage imbalance in this type of multilevel converter.

Distribution profiles of key weather variables in Australian capital cities : implications for energy efficient building design

Local climate is a critical element in the design of energy efficient buildings. In this paper, ten years of historical weather data in Australia's eight capital cities were profiled and analysed to characterize the variations of climatic variables in Australia. The method of descriptive statistics was employed. Either the pattern of cumulative distribution and/or the profile of percentage distribution are presented. It was found that although weather variables vary with different locations, there is often a good, nearly linear relation between a weather variable and its cumulative percentage for the majority of middle part of the cumulative curves. By comparing the slopes of these distribution profiles, it may be possible to determine the relative range of changes of the particular weather variables for a given city. The implications of these distribution profiles of key weather variables on energy efficient building design are also discussed.

Impact and energy absorption of empty and foam-filled conical tubes

Foam-filled conical tubes have recently emerged as efficient energy absorbing devices to mitigate the adverse effects of impacts. The primary aim of this thesis was to generate research and design information on the impact and energy absorption response of empty and foam-filled conical tubes, and to facilitate their application in energy absorbing systems under axial and oblique loading conditions representative of those typically encountered in crashworthiness and impact applications. Finite element techniques supported by experiments and existing results were used in the investigation. Major findings show that the energy absorption response can be effectively controlled by varying geometry and material parameters. A useful empirical formula was developed for providing engineering designers with an initial estimate of the load ratio and hence energy absorption performances of these devices. It was evident that foam-filled conical tubes enhance the energy absorption capacity and stabilise the crush response for both axial and oblique impact loading without a significant increase in the initial peak load. This is practically beneficial when higher kinetic energy needs to be absorbed, thus reducing the impact force transmitted to the protected structure and occupants. Such tubes also increase and maintain the energy absorption capacity under global bending as well as minimise the reduction of energy absorption capacity with increasing load angle. Furthermore, the results also highlight the feasibility of adding a foam-filled conical tube as a supplementary device in energy absorbing systems, since the overall energy absorption performance of such systems can be favourably enhanced by only including a relatively small energy absorbing device. Above all, the results demonstrate the superior performance of foam-filled conical tube for mitigating impact energy in impact and crashworthiness applications.

Energy polarization and popular representation: Evidence from the Russian Duma

In this article we introduce the term “energy polarization” to explain the politics of energy market reform in the Russian Duma. Our model tests the impact of regional energy production, party cohesion and ideology, and electoral mandate on the energy policy decisions of the Duma deputies (oil, gas, and electricity bills and resolution proposals) between 1994 and 2003. We find a strong divide between Single-Member District (SMD) and Proportional Representation (PR) deputies High statistical significance of gas production is demonstrated throughout the three Duma terms and shows Gazprom's key position in the post-Soviet Russian economy. Oil production is variably significant in the two first Dumas, when the main legislative debates on oil privatization occur. There is no constant left–right continuum, which is consistent with the deputies' proclaimed party ideology. The pro- and anti-reform poles observed in our Poole-based single dimensional scale are not necessarily connected with liberal and state-oriented regulatory policies, respectively. Party switching is a solid indicator of Russia's polarized legislative dynamics when it comes to energy sector reform.

Improved correlation-based modal strain energy method for global damage detection of truss bridge structures

The previous investigations have shown that the modal strain energy correlation method, MSEC, could successfully identify the damage of truss bridge structures. However, it has to incorporate the sensitivity matrix to estimate damage and is not reliable in certain damage detection cases. This paper presents an improved MSEC method where the prediction of modal strain energy change vector is differently obtained by running the eigensolutions on-line in optimisation iterations. The particular trail damage treatment group maximising the fitness function close to unity is identified as the detected damage location. This improvement is then compared with the original MSEC method along with other typical correlation-based methods on the finite element model of a simple truss bridge. The contributions to damage detection accuracy of each considered mode is also weighed and discussed. The iterative searching process is operated by using genetic algorithm. The results demonstrate that the improved MSEC method suffices the demand in detecting the damage of truss bridge structures, even when noised measurement is considered.

Public awareness of “green” and “energy efficient” residential property : an empirical survey based on data from New Zealand

Purpose – The purpose of this paper is to examine the buyer awareness and acceptance of environmental and energy efficiency measures in the New Zealand residential property markets. This study aims to provide a greater understanding of consumer behaviour in the residential property market in relation to green housing issues ---------- Design/methodology/approach – The paper is based on an extensive survey of Christchurch real estate offices and was designed to gather data on the factors that were considered important by buyers in the residential property market. The survey was designed to allow these factors to be analysed on a socio-economic basis and to compare buyer behaviour based on property values. ---------- Findings – The results show that regardless of income levels, buyers still consider that the most important factor in the house purchase decision is the location of the property and price. Although the awareness of green housing issues and energy efficiency in housing is growing in the residential property market, it is only a major consideration for young and older buyers in the high income brackets and is only of some importance for all other buyer sectors of the residential property market. Many of the voluntary measures introduced by Governments to improve the energy efficiency of residential housing are still not considered important by buyers, indicating that a more mandatory approach may have to be undertaken to improve energy efficiency in the established housing market, as these measures are not valued by the buyer. ---------- Originality/value – The paper confirms the variations in real estate buyer behaviour across the full range of residential property markets and the acceptance and awareness of green housing issues and measures. These results would be applicable to most established and transparent residential property markets.

Poster abstract : Energy-efficient rate adaptive MAC Protocol (RA-MAC) for long-lived sensor networks

This paper introduces an energy-efficient Rate Adaptive MAC (RA-MAC) protocol for long-lived Wireless Sensor Networks (WSN). Previous research shows that the dynamic and lossy nature of wireless communication is one of the major challenges to reliable data delivery in a WSN. RA-MAC achieves high link reliability in such situations by dynamically trading off radio bit rate for signal processing gain. This extra gain reduces the packet loss rate which results in lower energy expenditure by reducing the number of retransmissions. RA-MAC selects the optimal data rate based on channel conditions with the aim of minimizing energy consumption. We have implemented RA-MAC in TinyOS on an off-the-shelf sensor platform (TinyNode), and evaluated its performance by comparing RA-MAC with state-ofthe- art WSN MAC protocol (SCP-MAC) by experiments.

ERTP : Energy-efficient and reliable transport protocol for data streaming in wireless sensor networks

Emerging data streaming applications in Wireless Sensor Networks require reliable and energy-efficient Transport Protocols. Our recent Wireless Sensor Network deployment in the Burdekin delta, Australia, for water monitoring [T. Le Dinh, W. Hu, P. Sikka, P. Corke, L. Overs, S. Brosnan, Design and deployment of a remote robust sensor network: experiences from an outdoor water quality monitoring network, in: Second IEEE Workshop on Practical Issues in Building Sensor Network Applications (SenseApp 2007), Dublin, Ireland, 2007] is one such example. This application involves streaming sensed data such as pressure, water flow rate, and salinity periodically from many scattered sensors to the sink node which in turn relays them via an IP network to a remote site for archiving, processing, and presentation. While latency is not a primary concern in this class of application (the sampling rate is usually in terms of minutes or hours), energy-efficiency is. Continuous long-term operation and reliable delivery of the sensed data to the sink are also desirable. This paper proposes ERTP, an Energy-efficient and Reliable Transport Protocol for Wireless Sensor Networks. ERTP is designed for data streaming applications, in which sensor readings are transmitted from one or more sensor sources to a base station (or sink). ERTP uses a statistical reliability metric which ensures the number of data packets delivered to the sink exceeds the defined threshold. Our extensive discrete event simulations and experimental evaluations show that ERTP is significantly more energyefficient than current approaches and can reduce energy consumption by more than 45% when compared to current approaches. Consequently, sensor nodes are more energy-efficient and the lifespan of the unattended WSN is increased.

Damage detection for truss bridge structures using correlation-based structural modal strain energy

This paper presents the feasibility of using structural modal strain energy as a parameter employed in correlation- based damage detection method for truss bridge structures. It is an extension of the damage detection method adopting multiple damage location assurance criterion. In this paper, the sensitivity of modal strain energy to damage obtained from the analytical model is incorporated into the correlation objective function. Firstly, the sensitivity matrix of modal strain energy to damage is conducted offline, and for an arbitrary damage case, the correlation coefficient (objective function) is calculated by multiplying the sensitivity matrix and damage vector. Then, a genetic algorithm is used to iteratively search the damage vector maximising the correlation between the corresponding modal strain energy change (hypothesised) and its counterpart in measurement. The proposed method is simulated and compared with the conventional methods, e.g. frequency-error method, coordinate modal assurance criterion and multiple damage location assurance criterion using mode shapes on a numerical truss bridge structure. The result demonstrates the modal strain energy correlation method is able to yield acceptable damage detection outcomes with less computing efforts, even in a noise contaminated condition.

Influence of axial deformation on modal strain energy

Axial loads of load bearing elements impact on the vibration characteristics. Several methods have been developed to quantify axial loads and hence axial deformations of individual structural members using their natural frequencies. Nevertheless, these methods cannot be applied to individual members in structural framing systems as the natural frequency is a global parameter for the entire framing system. This paper proposes an innovative method which uses modal strain energy phenomenon to quantify axial deformations of load bearing elements of structural framing systems. The procedure is illustrated through examples and results confirm that the proposed method has an ability to quantify the axial deformations of individual elements of structural framing systems

Disturbed appetite and nutrient intake in peritoneal dialysis patients

OBJECTIVE Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. DESIGN Prospective, cross-sectional comparison of PD patients versus controls. SETTING Teaching hospital dialysis unit. PATIENTS 39 PD patients and 42 healthy controls. INTERVENTION Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. MAIN OUTCOME MEASURES Hunger and fullness profiles. Derived hunger and fullness scores. RESULTS Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. CONCLUSION The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.