The impact of malnutrition and decreased food intake on length of stay, readmission, and mortality in acute care patients

Rationale: The Australasian Nutrition Care Day Survey (ANCDS) evaluated if malnutrition and decreased food intake are independent risk factors for negative outcomes in hospitalised patients. Methods: A multicentre (56 hospitals) cross-sectional survey was conducted in two phases. Phase 1 evaluated nutritional status (defined by Subjective Global Assessment) and 24-hour food intake recorded as 0, 25, 50, 75, and 100% intake. Phase 2 data, which included length of stay (LOS), readmissions and mortality, were collected 90 days post-Phase 1. Logistic regression was used to control for confounders: age, gender, disease type and severity (using Patient Clinical Complexity Level scores). Results: Of 3122 participants (53% males, mean age: 65±18 years) 32% were malnourished and 23% consumed�25% of the offered food. Median LOS for malnourished (MN) patients was higher than well-nourished (WN) patients (15 vs. 10 days, p<0.0001). Median LOS for patients consuming �25% of the food was higher than those consuming �50% (13 vs. 11 days, p<0.0001). MN patients had higher readmission rates (36% vs. 30%, p = 0.001). The odds ratios of 90-day in-hospital mortality were 1.8 times greater for MN patients (CI: 1.03 3.22, p = 0.04) and 2.7 times greater for those consuming �25% of the offered food (CI: 1.54 4.68, p = 0.001). Conclusion: The ANCDS demonstrates that malnutrition and/or decreased food intake are associated with longer LOS and readmissions. The survey also establishes that malnutrition and decreased food intake are independent risk factors for in-hospital mortality in acute care patients; and highlights the need for appropriate nutritional screening and support during hospitalisation. Disclosure of Interest: None Declared.

Freshwater sensitivity of corrensite and chlorite/smectite in hydrocarbon reservoirs - an ESEM study

An Environmental Scanning Electron Microscope (ESEM) has been used to investigate the freshwater sensitivity of secondary corrensite (regularly interstratified chlorite/smectite) and chlorite-rich chlorite/smectite in order to determine whether hydrocarbon reservoirs hosting these clays should be regarded as freshwater sensitive. ESEM experiments involved an examination and close comparison of selected clay areas in three samples at high magnification before, during and after prolonged freshwater treatments. Corrensite and chlorine/smectite in the samples did not visibly swell when immersed in fresh water. After soaking in fresh water for up to three months, these clays retained their original morphology and associated porosity. Hence, the presence of corrensite or chlorite/smectite in a hydrocarbon reservoir need not indicate that the reservoir is freshwater sensitive. © 1994.

The product of text and 'Other' statements : discourse analysis and the critical use of Foucault

Much has been written on Michel Foucault’s reluctance to clearly delineate a research method, particularly with respect to genealogy (Harwood 2000; Meadmore, Hatcher, & McWilliam 2000; Tamboukou 1999). Foucault (1994, p. 288) himself disliked prescription stating, “I take care not to dictate how things should be” and wrote provocatively to disrupt equilibrium and certainty, so that “all those who speak for others or to others” no longer know what to do. It is doubtful, however, that Foucault ever intended for researchers to be stricken by that malaise to the point of being unwilling to make an intellectual commitment to methodological possibilities. Taking criticism of “Foucauldian” discourse analysis as a convenient point of departure to discuss the objectives of poststructural analyses of language, this paper develops what might be called a discursive analytic; a methodological plan to approach the analysis of discourses through the location of statements that function with constitutive effects.

Of repetition and of song

Allyson Reynolds, for many years now, has been a keen student of nature. Nature’s forms have always been important to her work, but it would be wrong to see Reynolds as simply transcribing directly from the natural world. For this artist, nature and the natural world represents an elusive invitation and so Reynolds doesn’t so much paint from nature, although resemblance and imitation are clearly evident, as work to render visually and emotionally tangible this invitation. And for a viewer this is no small thing as the invitation is to become attuned and connect with nature as it exists in ourselves, that is to see as nature. Reynolds’ is inviting us as viewers to connect and participate with the nature of nature that is evident in ourselves through the act of perceiving. Reynolds’ work can do this because it is a work born of deep evocation. The sensibility from which it emerges or is transacted is poetic, intensely so, but more than that it works to make of viewing an act of poetry, through a celebration of seeing. Reynolds evocation is born of a deep feeling towards and contemplation of the natural world - it is as though the world lives in her and is now a seamless part of her creative vocabulary. In such personal work there is a profoundly felt and revealed sense of the intimate and like true intimacy it revels in both its dark and quiet, as well as its playful and light, aspects. What is special about Reynolds’ visual poetry is that it able to render this intimacy so accessible. It is an accessibility that is available for the viewer who is able to not only look but also surrender to that looking, accepting and working with the flow of thoughts and associations it occasions...

A comparison of calculated and experimental HRTEM images of twinned boron carbide

High resolution TEM images of boron carbide (B13C2) have been recorded and compared with images calculated using the multislice method as implemented by M. A. O'Keefe in the SHRLI programs. Images calculated for the [010] zone, using machine parameters for the JEOL 2000FX AEM operating at 200 keV, indicate that for the structure model of Will et al., the optimum defocus image can be interpreted such that white spots correspond to B12 icosahedra for thin specimens and to low density channels through the structure adjacent to the direct inter-icosahedral bonds for specimens of intermediate thickness (-40 > t > -100 nm). With this information, and from the symmetry observed in the TEM images, it is likely that the (101) twin plane passes through the center of icosahedron located at the origin. This model was tested using the method of periodic continuation. Resulting images compare favorably with experimental images, thus supporting the structural model. The introduction of a (101) twin plane through the origin creates distortions to the icosahedral linkages as well as to the intra-icosahedral bonding. This increases the inequivalence of adjacent icosahedral sites along the twin plane, and thereby increases the likelihood of bipolaron hopping.

The magic of numbers and the amazing disappearing act : the politics of counting youth homelessness

No-one wants to see young people who are no longer able to stay at home with their parents living in situations that are neither stable nor safe. Most Australians also appreciate that youth homelessness is typically a result of factors beyond the control of young people like poverty, lack of affordable housing, parental divorce or separation, family conflict and violence, sexual abuse, or mental health problems.1 Since the Burdekin Report of 1989 first put the issue on the national agenda, youth homelessness has been a point of some political sensitivity as the numbers of young homeless stayed stubbornly high through the 1990s and into the 2000s.

Abundance of Natural Riparian Forests and Tree Plantations in the Amudarya Delta of Uzbekistan and their impact on emissions of soil-borne greenhouse gases

Through a forest inventory in parts of the Amudarya river delta, Central Asia, we assessed the impact of ongoing forest degradation on the emissions of greenhouse gases (GHG) from soils. Interpretation of aerial photographs from 2001, combined with data on forest inventory in 1990 and field survey in 2003 provided comprehensive information about the extent and changes of the natural tugai riparian forests and tree plantations in the delta. The findings show an average annual deforestation rate of almost 1.3% and an even higher rate of land use change from tugai forests to land with only sparse tree cover. These annual rates of deforestation and forest degradation are higher than the global annual forest loss. By 2003, the tugai forest area had drastically decreased to about 60% compared to an inventory in 1990. Significant differences in soil GHG emissions between forest and agricultural land use underscore the impact of the ongoing land use change on the emission of soil-borne GHGs. The conversion of tugai forests into irrigated croplands will release 2.5 t CO2 equivalents per hectare per year due to elevated emissions of N2O and CH4. This demonstrates that the ongoing transformation of tugai forests into agricultural land-use systems did not only lead to a loss of biodiversity and of a unique ecosystem, but substantially impacts the biosphere-atmosphere exchange of GHG and soil C and N turnover processes.

Shut up and write! Some surprising uses of cafes and crowds in doctoral writing

This chapter discusses a ‘writing movement’, which is currently occurring in various parts of Australia through the support of social media. A concept emerging from the café scene in San Francisco, ‘Shut Up and Write!’ is a meetup group that brings writers together at a specific time and place to write side by side, thus making writing practice, social. This concept has been applied to the academic environment and our case-study explores the positive outcomes in two locations: RMIT University and Queensland University of Technology. This informal learning practice can be implemented to assist research students in developing academic skills.

Fostering wellbeing of immigrants and refugees? Evaluating the outcomes of work integration social enterprise

Work integration social enterprises (WISE) seek to create employment and pathways to employment for those highly disadvantaged in the labour market. This chapter examines the effects of WISE on the wellbeing of immigrants and refugees experiencing multiple barriers to economic and social participation. Drawing on an evaluation of a programme that supports seven such enterprises in the Australian state of Victoria, the effects of involvement for individual participants and their communities are examined. The study finds that this social enterprise model affords unique local opportunities for economic and social participation for groups experiencing significant barriers to meaningful employment. These opportunities have a positive impact on individual and community-level wellbeing. However, the financial costs of the model are high relative to other employment programmes, which is consistent with international findings on intermediate labour market programmes. The productivity costs of WISE are also disproportionately high compared to private sector competitors in some industries. This raises considerable dilemmas for social enterprise operators seeking to produce social value and achieve business sustainability while bearing high productivity costs to fulfil their mission. Further, the evaluation illuminates an ongoing need to address the systemic and structural drivers of health and labour market inequalities that characterize socio-economic participation for immigrants and refugees.

Characteristics of culturally and linguistically diverse mental health clients

The present study examined Queensland Transcultural Mental Health Centre (QTMHC) client characteristics in order to provide a better understanding for development of future health service delivery models. Archived data that was collected for 1499 clients over two years period (2007-2009) was analysed using descriptive statistics and Chi squares. The results indicated that clients were referred from a range of sources and were generally adults. There were more women than men, who sought services. At least half of the clients had language barriers and relied on bilingual workers. Most frequently expressed mental health issues were mood disorder symptoms, followed by symptoms of schizophrenia and psychosis and anxiety. Acculturation strains and stressors were described as the most common psychosocial issues. Mental health and psychosocial issues differed for age, gender and world regions from which the CALD clients originated. The findings provided an understanding of clients who seek services at QTMHC. Various ways in which transcultural services and data bases can be further improved are discussed.

The compatibility of leasehold and freehold tenure arrangements with environmental offset and trading initiatives

Environmental offsets and environmental trading initiatives are being rapidly introduced into environmental regulatory regimes. These relatively new legal mechanisms are attempting to fill in the gaps left by command and control regulation. The introduction of environmental offset and trading policy in Queensland will need to be compatible with existing land tenure regulation. Who owns and who uses natural resources are controlled by a range of legislative reservations and restrictions. Reservations give the State ownership of certain natural resources such as minerals, quarry material and, in some circumstances, forest products. Where there is a reservation in operation, the land holders rights are weakened. Restrictions in relation to uses prevent land holders from carrying out certain activities on the land. An example of a restriction of use is the operation of the Vegetation Management Act 1999(Qld), which prescribes the manner in which vegetation is to be dealt with. This article explores the nature of freehold and leasehold land tenure in Queensland and examines the effect of reservations and restrictions upon the operation of environmental offset and trading initiatives. Presently Queensland legislation does not directly address the relationship between land tenure and environmental offset and trading initiatives. The stability of tenure required for the creation of environmental offsets can be at odds with the flexibility allowed for under leasehold arrangements. This flexibility may act to undermine the permanency requirement of environmental offset creation (i.e. the guarantee that the offset is created for the long term).

Protection of Refugees and Displaced Persons in the Asia Pacific Region

The chapters in this book explore the impact of recent shifts in global and regional power and the subsequent development and enforcement of international refugee protection standards in the Asia Pacific region. Drawing on their expertise across a number of jurisdictions, the contributors assess the challenges confronting the implementation of international law in the region, as well as new opportunities for extending protection norms into national and regional dialogues. The case studies span key jurisdictions across the region and include a comparative analysis with China, Indonesia, Thailand, Myanmar, Malaysia, Bangladesh and Australia. This topical and important book raises critical questions for the Asia Pacific region and sheds light on the challenges confronting the protection of refugees and displaced persons in this area. Interdisciplinary in its approach, it will be of interest to academics, researchers, students and policy-makers concerned with the rights and protection of refugees.