Reflections on tomorrow���s menu : evidence for inpatient meal preferences at a large tertiary public hospital

There are limited studies that describe patient meal preferences in hospital; however this data is critical to develop menus that address satisfaction and nutrition whilst balancing resources. This quality study aimed to determine preferences for meals and snacks to inform a comprehensive menu revision in a large (929 bed) tertiary public hospital. The method was based on Vivanti et al. (2008) with data collected by two final year dietetic students. The first survey comprised 72 questions, achieved a response rate of 68% (n = 192), with the second more focused at 47 questions achieving a higher response rate of 93% (n = 212). Findings showed over half the patients reporting poor or less than normal appetite, 20% describing taste issues, over a third with a LOS >7 days, a third with a MST _ 2 and less than half eating only from the general menu. Soup then toast was most frequently reported as eaten at home when unwell, and whilst most reported not missing any foods when in hospital (25%), steak was most commonly missed. Hot breakfasts were desired by the majority (63%), with over half preferring toast (even if cold). In relation to snacks, nearly half (48%) wanted something more substantial than tea/coffee/biscuits, with sandwiches (54%) and soup (33%) being suggested. Sandwiches at the evening meal were not popular (6%). Difficulties with using cutlery and meal size selection were identified as issues. Findings from this study had high utility and supported a collaborative and evidenced based approach to a successful major menu change for the hospital.

Let them eat steak : food preferences of patients in a tertiary public hospital

Information on foods patients like and dislike is the essential basis for planning menus which are acceptable to patients and promote adequate consumption. The aim of this study was to obtain quantitative data on the food preferences of inpatients at a large metropolitan public hospital for use in menu planning. Methodology was based on a study by Williams et al (1988), and included additional questions about appetite and taste changes. The survey used a 9 point hedonic scale to rate foods listed in random order and was modified to incorporate more contemporary foods than those used in the originalWilliams study. Surveys were conducted by final year University of Queensland dietetics students on Food Service Practicum at the Royal Brisbane and Women���s Hospital (929 beds) in 2012. The first survey (220 questions, n = 157) had a response rate of 61%. The second included more sandwich fillings and salads (231 questions, n = 219, response rate 67%). Total number surveyed was 376. Results showed the most preferred foods were roast potato, grilled steak, ice cream, fresh strawberries, roast lamb, roast beef, grapes and banana. The least preferred foods were grapefruit, soybeans, lentils, sardines, prune juice and grapefruit juice. Patients who reported taste changes (10%) had similar food preferences to those who didn���t report taste changes. Patients who reported poor/very poor appetite (10%) generally scored foods lower than those who reported OK (22%), good/very good appetite (65%). The results of this study informed planning for a new patient menu at the RBWH in December 2012.

Innovations in dietetic training in foodservice management : can early exposure to practice enhance final year competency development?

Student engagement in the delivery of theoretical course materials is a current challenge in the tertiary sector including for dietetic training. In 2011 with the creation of a new nutritionist position for Queensland Meals on Wheels (QMOW), a service learning approach to support this organisation was used with third year dietetic students undertaking two days of structured activities at various QMOW sites in South East Queensland, aligned with coursework in Foodservice Management (FSM). This cohort of students was then followed in their final year post successful completion of five weeks professional practice in FSM to see if this experience supported readiness for placement and competency development. Evaluation was undertaken of eligible students (n = 50) via paper based survey (response rate 94%) with all participating in targeted focus groups. Findings showed that students acknowledged the QMOW experience (on reflection 14 months later) providing opportunity for participation and/or observation in 5 of 12 FSM areas taught in third year, including food safety, meal production, assembly, delivery and dishwashing. Over half the students identified good exposure to FSM competency areas during the QMOW experience, with 83% satisfied with their competency exposure and subsequent practice during final year placements. A consistent theme emerged from focus groups supporting inclusion of practical opportunities with the theoretical component of the FSM subject to highlight relevance to learning. These findings highlight the importance of such teaching initiatives to met student learning preferences, linking theory with practice and supporting competency development in the final year of training programs.

Pushing cultural competence boundaries in nutrition and dietetics training

A health workforce ready for safe practice is a government priority, and particularly critical to support indigenous communities closing ���the gap���. Increased pressure exists on dietetic training programs for quality placements, with fewer opportunities for immersion in Aboriginal and Torres Strait Islander communities to demonstrate cultural competence. In 2012, Queensland University of Technology established a partnership with Apunipima Cape York Health Council with 56 weeks of dietetic placement for 8 students provided to achieve these aims. Clinical practice in Community Public Health Nutrition (CPHN) was structured in a standard 6 week placement, with Individual Case Management (ICM) and Foodservice Management (FSM) integrated across 8 weeks (4 each), with an additional 2 weeks ICM prior in a metropolitan indigenous health service. Students transitioned from urban to rural then remote sites, with new web-based technologies used for support. Strong learning opportunities were provided, with CPHN projects in antenatal and child health, FSM on standardisation of procedures in a 22 bed health facility, and ICM exposing students to a variety of cases via hospital in/outpatients, general clinics and remote community outreach. Supervisor focus group evaluation was positive, with CPHN and FSM enhancing capacity of service. Student focus group evaluation revealed placements exceeded expectations, with rating high, and strong confidence in cultural competence described. Students debriefed final and third year cohorts on their experiences, with increased awareness and enthusiasm for work with indigenous communities indicated by groups. With the success of this partnership, placements are continuing 2013, and new boundaries in dietetic training established.

Sharpening our tools ��� translating research into practice

Providing culturally appropriate health communication tools at a community level, whilst meeting funding objectives set by Government led initiatives, can be challenging. Literature states that a translational research framework fostering community communication can encourage the development of appropriate communication tools to facilitate transfer of health information between community and researchers. Reflections from initial Need for Feed cooking and nutrition education program trials in remote Indigenous communities across Cape York indicated program resources were neither meeting community nor researchers needs. In response, a translational research framework was modelled with collaborative partnerships formed between researchers and community with the aim of modifying current resources. Local working groups were established to facilitate communication and guide continual remodelling and retrial of resources for successive programs. Feedback from working groups indicated community members wanted resources with more pictures and less words. Partnership with Chronic Disease Resources Online (CDRO) led to the development of pictorial resources including 3 evaluation tools, 27 recipe sets and 10 education support materials. Between June to December 2012 resources were trialled across 4 Cape York communities with 69 school aged children and 4 community elders. Qualitative data has indicated high satisfaction with modified pictorial resources, proving pictorial resources to be an effective and culturally appropriate method to both communicate health messages to community and facilitate flow of evaluation data to researchers. A translational research framework fostering communication between community and researchers can potentially enhance the quality of health communication tools.

Entrepreneurship in the public sector : new possibilities?

Previous research has described potential roles for entrepreneurs in public sector organisations as either closely related to corporate entrepreneurship, or as normative prescriptions regarding the importance of entrepreneurship in the public sector (Ireland, Covin & Kuratko, 2009: Morris & Jones, 1999). While some might argue that entrepreneurship in the public sector context is an oxymoron, recent studies have demonstrated that entrepreneurship in the public sector is alive and well (Currie, Humphreys, Ucbasaran & McManus 2008; Kim, 2010). Entrepreneurship in the public sector can take many forms and generate a range of benefits but to date less attention has been given to the potential to generate new public value (Moore, 1995). The purpose of this paper is to increase our knowledge and understanding of the types of strategies and activities the public sector is using to capture initiative, create new public value, and generate new economic activity for the benefit of multiple stakeholders. This paper explores entrepreneurship in one public sector context. Findings indicate that entrepreneurship and commercialisation is more likely to be encouraged in contexts where contestability in develop and exploit capabilities.

Phenotypic changes associated with RNA interference silencing of chalcone synthase in apple (Malus �� domestica)

We have identified in apple (Malus �� domestica) three chalcone synthase (CHS) genes. In order to understand the functional redundancy of this gene family RNA interference knockout lines were generated where all three of these genes were down-regulated. These lines had no detectable anthocyanins and radically reduced concentrations of dihydrochalcones and flavonoids. Surprisingly, down-regulation of CHS also led to major changes in plant development, resulting in plants with shortened internode lengths, smaller leaves and a greatly reduced growth rate. Microscopic analysis revealed that these phenotypic changes extended down to the cellular level, with CHS-silenced lines showing aberrant cellular organisation in the leaves. Fruit collected from one CHS-silenced line was smaller than the 'Royal Gala' controls, lacked flavonoids in the skin and flesh and also had changes in cell morphology. Auxin transport experiments showed increased rates of auxin transport in a CHS-silenced line compared with the 'Royal Gala' control. As flavonoids are well known to be key modulators of auxin transport, we hypothesise that the removal of almost all flavonoids from the plant by CHS silencing creates a vastly altered environment for auxin transport to occur and results in the observed changes in growth and development.

Psychometric properties of the modified RESIDE physical activity questionnaire among low-income overweight women

Objectives This study explored the criterion-related validity and test-retest reliability of the modified RESIDential Environment physical activity questionnaire and whether the instrument's validity varied by body mass index, education, race/ethnicity, or employment status. Design Validation study using baseline data collected for randomized trial of a weight loss intervention. Methods Participants recruited from health departments wore an ActiGraph accelerometer and self-reported non-occupational walking, moderate and vigorous physical activity on the modified RESIDential Environment questionnaire. We assessed validity (n = 152) using Spearman correlation coefficients, and reliability (n = 57) using intraclass correlation coefficients. Results When compared to steps, moderate physical activity, and bouts of moderate/vigorous physical activity measured by accelerometer, these questionnaire measures showed fair evidence for validity: recreational walking (Spearman correlation coefficients 0.23���0.36), total walking (Spearman correlation coefficients 0.24���0.37), and total moderate physical activity (Spearman correlation coefficients 0.18���0.36). Correlations for self-reported walking and moderate physical activity were higher among unemployed participants and women with lower body mass indices. Generally no other variability in the validity of the instrument was found. Evidence for reliability of RESIDential Environment measures of recreational walking, total walking, and total moderate physical activity was substantial (intraclass correlation coefficients 0.56���0.68). Conclusions Evidence for questionnaire validity and reliability varied by activity domain and was strongest for walking measures. The questionnaire may capture physical activity less accurately among women with higher body mass indices and employed participants. Capturing occupational activity, specifically walking at work, may improve questionnaire validity.

The hard facts : a brilliant memoir about ancestral silence

A review of A History of Silence by Lloyd Jones (Text Publishing, 2013).

Loss of epithelial markers and acquisition of vimentin expression in adriamycin- and vinblastine-resistant human breast cancer cell lines

We have previously observed that breast cancer cell lines could exhibit either epithelial or fibroblastic phenotypes as reflected by their morphologies and intermediate filament protein expression (C. L. Sommers, D. Walker-Jones, S. E. Heckford, P. Worland, E. Valverius, R. Clark, M. Stampfer, and E. P. Gelmann, Cancer Res., 49: 4258-4263, 1989). Fibroblastoid, vimentin-expressing breast cancer cell lines are more invasive in vitro and in vivo (E. W. Thompson, S. Paik, N. Brunner, C. L. Sommers, G. Zugmaier, R. Clarke, T. B. Shima, J. Torri, S. Donahue, M. E. Lippman, G. R. Martin, and R. B. Dickson, J. Cell. Physiol., 150: 534-544, 1992). We hypothesized that a breast cancer cell with an epithelial phenotype could undergo a transition to a fibroblastic phenotype, possibly resulting in more invasive capacity. We now show that two Adriamycin-resistant MCF-7 cell lines and a vinblastine-resistant ZR-75-B cell line have undergone such a transition. Adriamycin-resistant MCF-7 cells express vimentin, have diminished keratin 19 expression, have lost cell adhesion molecule uvomorulin expression, and have reduced formation of desmosomes and tight junctions as determined by reduced immunodetection of their components desmoplakins I and II and zonula occludens (ZO)-1. Other MCF-7 cell lines selected for resistance to vinblastine and to Adriamycin and verapamil did not have these characteristics, indicating that drug selection does not invariably cause these phenotypic changes. In addition, to determine if vimentin expression in MCF-7 cells alone could manifest a fibroblastic phenotype, we transfected the full-length human vimentin complementary DNA into MCF-7 cells. Although vimentin expression was achieved in MCF-7 cells, it did not affect the phenotype of the cells in terms of the distribution of keratins, desmoplakins I and II, ZO-1, or uvomorulin or in terms of in vitro invasiveness. We conclude that vimentin expression is a marker for a fibroblastic and invasive phenotype in breast cancer cells but does not by itself give rise to this phenotype.

On display : Ravensthorpe Wildflower Show and the assembly of place

Each September since 1983 in the rural Shire of Ravensthorpe, Western Australia, volunteers collect samples of up to 700 wildfl ower species which are then displayed in the Ravensthorpe Senior Citizens Centre from 9.00 am to 4.00 pm daily over a two-week period. This chapter offers an ethnographic interpretation of this enduring annual event focusing on the 25th show held in 2007. The study contributes to understanding the complex and nuanced role of local wildflower shows in shaping and supporting rural senses of place and of community. Importantly, this particular type of festival, and more specifically this local instance, foregrounds a less-remarked aspect of festivals, namely the (re)production and celebration of place-specific knowledge through validations of, and interconnections between, scientific flower classification and emotive experience. This feature, encapsulated in Laurel Lamperd���s poem above, invites consideration of the ways in which local place knowledge and the simultaneous (re)production of ���place��� are constituted by a complex layering of rational, objective ways of knowing and those which emphasize emotions, aesthetics and memories. This rural wildflower show not only mobilises both the rational and the emotional in ���making sense of the world��� for local residents and for tourists, but also offers insights into the production of place as constituted in and through relations between humans and non-human life forms (Cloke & Jones, 2001; Conradson, 2005; see also Chapter 6).

Information systems success research : the ���20-year update?��� panel report from PACIS, 2011

This article summarizes a panel held at the 15th Pacific Asia Conference on Information Systems (PACIS) in Brisbane, Austrailia, in 2011. The panelists proposed a new research agenda for information systems success research. The DeLone and McLean IS Success Model has been one of the most influential models in Information Systems research. However, the nature of information systems continues to change. Information systems are increasingly implemented across layers of infrastructure and application architecture. The diffusion of information systems into many spheres of life means that information systems success needs to be considered in multiple contexts. Services play a much more prominent role in the economies of countries, making the ���service��� context of information systems increasingly important. Further, improved understandings of theory and measurement offer new opportunities for novel approaches and new research questions about information systems success.

Never too old : engaging retired people inventing the future with MaKey MaKey

Within HCI, aging is often viewed in terms of designing assistive technologies to improve the lives of older people, such as those who are suffering from frailty or memory loss. Our research adopts a very different approach, reframing the relationship in terms of wisdom, creativity and invention. We ran a series of workshops where groups of retirees, aged between early 60s and late 80s, used the MaKey MaKey inventor's toolkit. We asked them to think about inventing the future and suggest ideas for new technologies. Our findings showed that they not only rose to the challenge but also mastered the technology, collaborated intensely together while using it and freely and at length discussed their own, their family's and others' relationship with technology. We discuss the value of empowering people in this way and consider what else could be invented to enable more people to be involved in the design and use of creative technologies.

Beyond ethnography: Engagement and reciprocity as foundations for design research out here

This paper explores an emerging paradigm for HCI design research based primarily upon engagement, reciprocity and doing. Much HCI research begins with an investigatory and analytic ethnographic approach before translating to design. Design may come much later in the process and may never benefit the community that is researched. However in many settings it is difficult for researchers to access the privileged ethnographer position of observer and investigator. Moreover rapid ethnographic research often does not seem the best or most appropriate course of action. We draw upon a project working with a remote Australian Aboriginal community to illustrate an alternative approach in Indigenous research, where the notion of reciprocity is first and foremost. We argue that this can lead to sustainable designs, valid research and profound innovation. This paper received the ACM CHI Best Paper Award, which is awarded to the top 1% of papers submitted to the ACM CHI conference.

Editorial

The Scientific Social Planning Committee was in a fantastic position to design this programme, with over 270 abstracts representing a broad range of nutrition and dietetics areas, translating evidence to practice. When reviewing the abstract submissions, clear themes emerged, including those related to the nutrition and dietetics workforce and how to deliver effective outcomes that make meaningful differences to people's lives, while also equitable and sustainable. These papers challenge us to reflect on ourselves as health professionals, including our knowledge, how confident we are in what we do and what bias we may bring to the table when dealing with health issues, for example, in relation to weight management...