Issues concerning the on-going care of patients with comorbidities in acute care and post-discharge in Australia: a literature review

Issues concerning the on-going care of patients with comorbidities in acute care and post-discharge in Australia: a literature review

Background. Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most western countries. This has resulted in an ageing population with a concomitant growth in the number of people who are living with chronic illnesses. Indeed a significant number of younger people experience more than one chronic illness. Large numbers of these may require repeated admissions to hospital for acute or episodic care that is superimposed upon the needs of their chronic conditions.

Aim. To explore the issues that circumscribe the complexities of caring for people with concurrent chronic illnesses, or comorbidities, in the acute care setting and postdischarge.

Methods. A literature review to examine the issues that impact upon the provision of comprehensive care to patients with comorbidities in the acute care setting and postdischarge.

Findings. Few studies have investigated this subject. From an Australian perspective, it is evident that the structure of the current health care environment has made it difficult to meet the needs of patients with comorbidities in the acute care setting and postdischarge. This is of major concern for nurses attempting to provide comprehensive care to an increasingly prevalent group of chronically ill people.

Conclusion. Further research is necessary to explore how episodic care is integrated into the on-going management of patients with comorbidities and how nurse clinicians can better use an episode of acute illness as an opportunity to review their overall management.

A calibration for surface analysis on aluminium alloys by RF-Glow-Discharge Optical Emission Spectrometry

Glow-Discharge Optical Emission Spectrometry (GD-OES) is a powerful technique for the rapid analysis of elements in a solid surface as a function of depth. DC-GD-OES allows depth profiling on electrically conductive surfaces only, and has proven to be difficult for the analysis of insulating layers, such as oxides. However, the technique of radio-frequency (RF) GD-OES has the advantage of being able to depth profile through multiple layers, both conducting and insulating. In this work, a LECO GDS- 850A spectrometer was calibrated for aluminium, oxygen, and other elements, with the RF source installed. A quantitative depth profile for a sample of tempered aluminium alloy 7475 is presented and compared with earlier work[1,2].

Depth-profile analysis of elements by glow discharge optical emmission specrometry

Glow-discharge optical emission spectrometry (GD-OES) is a powerful tool for the rapid analysis of elements in the surface of solids. One may employ GD-OES to determine quantitatively the bulk concentration of elements in a sample. With further calibration, one may also obtain elemental concentrations as a function of depth into the sample. This allows depth profiling on a host of advanced materials: treated metals, coated metals and other materials, multi-layers, painted surfaces, hard samples coated with polymers, thin films, and many others.

A consortium of institutions in Victoria, led by Deakin University, has purchased a new glow-discharge optical emission spectrometer. This instrument has the ability to perform elemental depth profiling on a wide range of materials. This technique, the first of its kind in Australia, is of particular interest to those working on metals, ceramics, glasses, coatings, semi-conductors, and multi-layers. We present here an overview of depth profiling by GD-OES and some examples of its use.

Deterministic versus stochastic quantitative microbial Risk Assessment models for wastewater irrigation of food crops

Reuse of wastewater to irrigate food crops is being practiced in many parts of the world and is becoming more commonplace as the competition for, and stresses on, freshwater resources intensify. But there are risks associated with wastewater irrigation, including the possibility of transmission of pathogens causing infectious disease, to both workers in the field and to consumers buying and eating produce irrigated with wastewater. To manage these risks appropriately we need objective and quantitative estimates of them. This is typically achieved through one of two modelling approaches: deterministic or stochastic. Each parameter in a deterministic model is represented by a single value, whereas in stochastic models probability functions are used. Stochastic models are theoretically superior because they account for variability and uncertainty, but they are computationally demanding and not readily accessible to water resource and public health managers. We constructed models to estimate risk of enteric virus infection arising from the consumption of wastewater-irrigated horticultural crops (broccoli, cucumber and lettuce), and compared the resultant levels of risk between the deterministic and stochastic approaches. Several scenarios were tested for each crop, accounting for different concentrations of enteric viruses and different lengths of environmental exposure (i.e. the time between the last irrigation event and harvest, when the viruses are liable to decay or inactivation). In most situations modelled the two approaches yielded similar estimates of risk (within 1 order-of-magnitude). The two methods diverged most markedly, up to around 2 orders-of-magnitude, when there was large uncertainty associated with the estimate of virus concentration and the exposure period was short (1 day). Therefore, in some circumstances deterministic modelling may offer water resource managers a pragmatic alternative to stochastic modelling, but its usefulness as a surrogate will depend upon the level of uncertainty in the model parameters.

Rapid synthesis of TiC–Fe3C composite by electric discharge assisted mechanical milling of ilmenite (FeTiO3) with graphite

Carbo-thermic reduction of ilmenite (FeTiO₃) to TiO₂ and/or TiC is traditionally carried out by a high temperature annealing treatment at  _~1500 °C. In this work, electric discharge assisted mechanical milling (EDAMM) has been used to synthesise TiC + Fe₃C from FeTiO₃ in 5 min. In this study we report of the reduction of FeTiO₃ with C that does not require an additional high temperature annealing treatment.