Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/ tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved out.. comes for all concerned.

Early-Middle Jurassic stratigraphy of the Fortrose-Chaslands region, southernmost South Island, New Zealand

The 40 km of coastline from Fortrose to Chaslands Mistake (southeastern South Island, New Zealand) comprises sediments that are part of the Early-Middle Jurassic of the Murihiku Terrane. The sediments are dominantly fluvial with some marine beds and alluvial fan deposition, and display an evolution of fluvial style which progresses from perennial flow to seasonal flow. The McPhee Cove Conglomerate is a prominent unit to the north. It has been used to separate two formations which would otherwise, on inherent lithological grounds, be difficult to distinguish. This paper discusses several similar conglomerates which occur in the south, but which are separated from the type area of the McPhee Conglomerate by major tectonic disruption. Hence, the existing lithostratigraphic nomenclature to the north, including the McPhee Cove Conglomerate, cannot be simply extended southwards. The Fortrose-Chaslands area appears to consist of two tectonic blocks, the Slope Point Block and the Brothers Block, which are separated from each other and from the adjacent Papatowai Block by major strike faults (or fault zones). A change is proposed to the existing stratigraphy which involves recognising all terrestrial sediments as part of the False Island Formation. Four prominent clast-supported conglomerate horizons are named as members of the False Islet Formation: the White Head Conglomerate, Black Bluff Conglomerate. Hoiho Conglomerate, and Slope Point Conglomerate Members. The latter contains five named conglomerate beds.

Phenolic acids and abscisic acid in Australian Eucalyptus honeys and their potential for floral authentication

Seven phenolic acids related to the botanical origins of nine monofloral Eucalyptus honeys from Australia, along with two abscisic isomers, have been analyzed. The mean content of total phenolic acids ranges from 2.14 mg/100 g honey of black box (Eucalyptus largiflorens) honey to 10.3 mg/100 g honey of bloodwood (Eucalyptus intermedia) honey, confirming an early finding that species-specific differences of phytochemical compositions occur quantitatively among these Eucalyptus honeys. A common profile of phenolic acids, comprising gallic, chlorogenic, coumaric and caffeic acids, can be found in all the Eucalyptus honeys, which could be floral markers for Australian Eucalyptus honeys. Thus, the analysis of phenolic acids could also be used as an objective method for the authentication of botanical origin of Eucalyptus honeys. Moreover, all the honey samples analyzed in this study contain gallic acid as the main phenolic acid, except for stringybox (Eucalyptus globoidia) honey which has ellagic acid as the main phenolic acid. This result indicates that the species-specific differences can also be found in the honey profiles of phenolic acids. Further-more, the analysis of abscisic acid in honey shows that the content of abscisic acid varies from 0.55 mg/100 g honey of black box honey to 4.68 mg/ 100 g honey of bloodwood honey, corresponding to the contents of phenolic acids measured in these honeys. These results have further revealed that the HPLC analysis of honey phytochemical constituents could be used individually and/or jointly for the authentication of the botanical origins of Australian Eucalyptus honeys. (C) 2003 Elsevier Ltd. All rights reserved.

Flavonoids in Australian Melaleuca, Guioa, Lophostemon, Banksia and Helianthus honeys and their potential for floral authentication

Flavonoids in Australian honeys from five botanical species (Melaleuca, Guioa, Lophostemon, Banksia and Helianthus) have been analyzed in relation to their floral origins. Tea tree (Melaleuca quinquenervia) and heath (Banksia ericifolia) honeys show a common flavonoid profile comprising myricetin (3,5,7,3',4',5'-hexahydroxyflavone), tricetin (5,7,3',4,5'-pentahydroxyflavone), querectin (3,5,7,3',4'-pentahydroxyflavone) and luteolin (5,7,3',4'-tetrahydroxyflavone), which was previously suggested as a floral marker for an Australian Eucalyptus honey (bloodwood or Eucalyptus intermedia honey). These honeys of various floral species can be differentiated by their levels of total flavonoids, being 2.12 mg/100 g for heath honey and 6.35 m/100 g for tea tree honey. In brush box (Lophostemon conferta) honey, the flavonoid profile comprising mainly tricetin, luteolin and quercetin is similar to that of another Eucalyptus honey (yellow box or Eucalyptus melliodora honey). These results indicate that the flavonoid profiles in some of the Australian non-Eucalyptus honeys may contain more or less certain flavonoids from Eucalyptus floral sources because of the diversity and extensive availability of Eucalyptus nectars for honeybee foraging yearly around or a possible cross contamination of the monofloral honeys during collection, transportation and/or storage. Further analyses are required to differentiate and/or verify the botanical sources of the flavonoids that contribute to the flavonoid profiles of these honeys, by restricting honey sampling areas and procedures, employing other complementary analytical methods (e.g. pollen analysis, sugar profile) and using materials (e.g. nectar) directly sourced from the flowering plant for comparative studies. In Australian crow ash (Guioa semiglauca) honey, myricetin, tricetin, quercetin, luteolin and an unknown flavonoid have been found to be the main flavonoids, which is characteristic only to this type of honey, and could thus be used as the floral marker, while in Australian sunflower (Helianthus annuus) honey, the content of total flavonoids is the smallest amount comparing to those in the other honeys analysed in this study. However, the flavonoid quercetin and the flavonoid profile mainly consisting of quercetin, quercetin 3,3'-dimethyl ether (5,7,4'-trihydroxy3,3'-dimethoxyflavone), myricetin and luteolin are characteristic only to this sunflower honey and could thus be used for the authentication.

Adult-population incidence of severe sepsis in Australian and New Zealand intensive care units

Objective. To determine the population incidence and outcome of severe sepsis occurring in adult patients treated in Australian and New Zealand intensive care units (ICUs), and compare with recent retrospective estimates from the USA and UK. Design. Inception cohort study. Setting. Twenty-three closed multi-disciplinary ICUs of 21 hospitals (16 tertiary and 5 university affiliated) in Australia and New Zealand. Patients. A total of 5878 consecutive ICU admission episodes. Measurements and results. Main outcome measures were population-based incidence of severe sepsis, mortality at ICU discharge, mortality at 28 days after onset of severe sepsis, and mortality at hospital discharge. A total of 691 patients, 11.8 (95% confidence intervals 10.9-12.6) per 100 ICU admissions, were diagnosed with 752 episodes of severe sepsis. Site of infection was pulmonary in 50.3% of episodes and abdominal in 19.3% of episodes. The calculated incidence of severe sepsis in adults treated in Australian and New Zealand ICUs is 0.77 (0.76-0.79) per 1000 of population. 26.5% of patients with severe sepsis died in ICU, 32.4% died within 28 days of the diagnosis of severe sepsis and 37.5% died in hospital. Conclusion. In this prospective study, 11.8 patients per 100 ICU admissions were diagnosed with severe sepsis and the calculated annual incidence of severe sepsis in adult patients treated in Australian and New Zealand ICUs is 0.77 per 1000 of population. This figure for the population incidence falls in the lower range of recent estimates from retrospective studies in the U.S. and the U.K.

Australia and New Zealand applied linguistics (ANZAL): Taking stock

This paper reviews some emerging trends in applied linguistics in both Australia and New Zealand. It sketches the current scene of (selected) postgraduate applied linguistics programs in higher education and considers how various university programs define applied linguistics through the classes (titles) they have postgraduate students complete to be awarded a degree. Evidence of program requirements and topics reveal not only what applied linguistics generally entails, but offers insights into how applied linguistics is defined and practiced. Additionally, some of the salient research topics (titles) being published in the journals from the two countries' applied linguistics associations are sketched.

Speleothem master chronologies: combined Holocene O-18 and C-13 records from the North Island of New Zealand and their palaeoenvironmental interpretation

The stable isotope records of four stalagmites dated by 19 TIMS uranium series ages are combined to produce master chronologies for delta(18)O and delta(13)C The delta(18)O records display good overall coherence, but considerable variation in detail. Variability in the delta(13)C records is greater, but general trends can still be discerned. This implies that too fine an interpretation of the structure of individual isotopic records can be unreliable. Speleothem delta(18)O values are demonstrated to show a positive relationship with temperature by comparing trends with other proxy records, but also to respond negatively to rainfall amount. Speleothem delta(13)C is considered to be most influenced by rainfall. The postglacial thermal optimum occur-red around 10.8 ka BP, which is similar in timing to Antarctica but up to 2000 years earlier than most Northern Hemisphere sites. Increasingly negative delta(18)O values after 7.5 ka BP indicate that temperatures declined to a late mid-Holocene minimum centred around 3 ka BP, but more positive values followed to mark a warm peak about 750 years ago which coincided with the 'Mediaeval Warm Period' of Europe. Low 5110 values at 325 years BP suggest cooling coincident with the 'Little Ice Age'. A marked feature of the delta(13)C record is an asymmetric periodicity averaging c. 2250 years and amplitude of c. 1.9parts per thousand. It is concluded that this is mainly driven by waterbalance variations with negative swings representing particularly wet intervals. The 5110 record shows a higher-frequency cyclicity with a period of c. 500 years and an amplitude of c. 0.25 parts per thousand. This is most likely to be temperature-driven, but some swings may have been amplified by precipitation.

Classification of perinatal deaths: Development of the Australian and New Zealand classifications

Classifications of perinatal deaths have been undertaken for surveillance of causes of death, but also for auditing individual deaths to identify suboptimal care at any level, so that preventive strategies may be implemented. This paper describes the history and development of the paired obstetric and neonatal Perinatal Society of Australia and New Zealand (PSANZ) classifications in the context of other classifications. The PSANZ Perinatal Death Classification is based on obstetric antecedent factors that initiated the sequence of events leading to the death, and was developed largely from the Aberdeen and Whitfield classifications. The PSANZ Neonatal Death Classification is based on fetal and neonatal factors associated with the death. The classifications, accessible on the PSANZ website (http://www.psanz.org), have definitions and guidelines for use, a high level of agreement between classifiers, and are now being used in nearly all Australian states and New Zealand.

Comparison of the R-70 self-heating rate of New Zealand and Australian coals to Suggate rank parameter

Samples from New Zealand and Australia have been tested in an adiabatic oven to assess the effect of rank on the R-70 selfheating rate of coal. A non-linear relationship can be defined for coals from both countries using the revised Suggate rank (S-r) parameter. Subbituminous coals have the highest R-70 self-heating rate values, which are 20 times that of high volatile A bituminous coals on a dry mineral matter free basis (similar to 1 cf. 20 degrees C h(-1)). However, the moderating effects of moisture and mineral matter can reduce this difference to only 2-3 times for coal in-situ. (c) 2005 Elsevier B.V All rights reserved.

Phenolic acids in Australian Melaleuca, Guioa, Lophostemon, Banksia and Helianthus honeys and their potential for floral authentication

Eight phenolic acids and two abscisic acid isomers in Australian honeys from five botanical species (Melaleuca, Guioa, Lophostemon, Banksia and Helianthus) have been analyzed in relation to their botanical origins. Total phenolic acids present in these honeys range from 2.13 mg/100 g sunflower (Helianthus annuus) honey to 12.11 mg/100 g tea tree (Melaleuca quinquenervia) honey, with amounts of individual acids being various. Tea tree honey shows a phenolic profile of gallic, ellagic, chlorogenic and coumaric acids, which is similar to the phenolic profile of an Australian Eucalyptus honey (bloodwood or Eucalyptus intermedia honey). The main difference between tea tree and bloodwood honeys is the contribution of chlorogenic acid to their total phenolic profiles. In Australian crow ash (Guioa semiglauca) honey, a characteristic phenolic profile mainly consisting of gallic acid and abscisic acid could be used as the floral marker. In brush box (Lophostemon conferta) honey, the phenolic profile, comprising mainly gallic acid and ellagic acid, could be used to differentiate this honey not only from the other Australian non-Eucalyptus honeys but also from a Eucalyptus honey (yellow box or Eucalyptus melliodora honey). However, this Eucalyptus honey could not be differentiated from brush box honey based only on their flavonoid profiles. Similarly, the phenolic profile of heath (Banksia ericifolia) honey, comprising mainly gallic acid, an unknown phenolic acid (Phl) and coumaric acid, could also be used to differentiate this honey from tea tree and bloodwood honeys, which have similar flavonoid profiles. Coumaric acid is a principal phenolic acid in Australian sunflower honey and it could thus be used together with gallic acid for the authentication. These results show that the HPLC analysis of phenolic acids and abscisic acids in Australian floral honeys Could assist the differentiation and authentication of the honeys. © 2005 Elsevier Ltd. All rights reserved.

Australian and New Zealand practice in intensive care (ANZPIC II): Predictors of physician confidence to diagnose pneumonia and determine illness severity in ventilated patients

The manner in which elements of clinical history, physical examination and investigations influence subjectively assessed illness severity and outcome prediction is poorly understood. This study investigates the relationship between clinician and objectively assessed illness severity and the factors influencing clinician's diagnostic confidence and illness severity rating for ventilated patients with suspected pneumonia in the intensive care unit (ICU). A prospective study of fourteen ICUs included all ventilated admissions with a clinical diagnosis of pneumonia. Data collection included pneumonia type - community-acquired (CAP), hospital-acquired (HAP) and ventilator-associated (VAP), clinician determined illness severity (CDIS), diagnostic methods, clinical diagnostic confidence (CDC), microbiological isolates and antibiotic use. For 476 episodes of pneumonia (48% CAP, 24% HAP, 28% VAP), CDC was greatest for CAP (64% CAP, 50% HAP and 49% VAP, P < 0.01) or when pneumonia was considered life-threatening (84% high CDC, 13% medium CDC and 3% low CDC, P < 0.001). Life-threatening pneumonia was predicted by worsening gas exchange (OR 4.8, CI 95% 2.3-10.2, P < 0.001), clinical signs of consolidation (OR 2.0, CI 95% 1.2-3.2, P < 0.01) and the Sepsis-Related Organ Failure Assessment (SOFA) Score (OR 1.1, CI 95% 1.1-1.2, P < 0.001). Diagnostic confidence increased with CDIS (OR 163, CI 95% 8.4-31.4, P < 0.001), definite pathogen isolation (OR 3.3, CI 95% 2.0-5.6) and clinical signs of consolidation (OR 2.1, CI 95% 1.3-3.3, P = 0.001). Although the CDIS, SOFA Score and the Simplified Acute Physiologic Score (SAPS II) were all associated with mortality, the SAPS II Score was the best predictor of mortality (P = 0.02). Diagnostic confidence for pneumonia is moderate but increases with more classical presentations. A small set of clinical parameters influence subjective assessment. Objective assessment using SAPS II Scoring is a better predictor of mortality.