Hospital malnutrition : prevalence, identification and impact on patients and the healthcare system

Malnutrition is a debilitating and highly prevalent condition in the acute hospital setting, with Australian and international studies reporting rates of approximately 40%. Malnutrition is associated with many adverse outcomes including depression of the immune system, impaired wound healing, muscle wasting, longer lengths of hospital stay, higher treatment costs and increased mortality. Referral rates for dietetic assessment and treatment of malnourished patients have proven to be suboptimal, thereby increasing the likelihood of developing such aforementioned complications. Nutrition risk screening using a validated tool is a simple technique to rapidly identify patients at risk of malnutrition, and provides a basis for prompt dietetic referrals. In Australia, nutrition screening upon hospital admission is not mandatory, which is of concern knowing that malnutrition remains under-reported and often poorly documented. Unidentified malnutrition not only heightens the risk of adverse complications for patients, but can potentially result in foregone reimbursements to the hospital through casemix-based funding schemes. It is strongly recommended that mandatory nutrition screening be widely adopted in line with published best-practice guidelines to effectively target and reduce the incidence of hospital malnutrition.

Implementation of the nurse practitioner role within a Victorian healthcare network : an organisational perspective

Objective
This paper presents a discussion of the development of a framework to implement and sustain the nurse practitioner (NP) role within one health service designed to strengthen the capacity of the health system and which could be readily transferable to other health services.
Setting
Eastern Health (EH) is a multi‑campus tertiary health care organisation servicing a population of approximately 800,000 people in the east and outer eastern suburbs of Melbourne, Australia. EH is committed to advancing the nursing profession and exploring innovative, research based models of practice that are responsive to the needs of the community it serves.
Primary argument
The Framework documents the processes of providing a new career pathway for advanced practice nurses that incorporates education and training, and utilises current evidenced‑based practice guidelines to define and promote the scope of practice.
Conclusion
Strong organisational support to facilitate interdisciplinary and multidisciplinary learning opportunities assists integration of the NP role into the healthcare team. Role clarity will assist interprofessional teams to understand and value the role NPs provide.

Automatic grain texture analysis using integral transforms

Tonewood for musical instruments is quarter-sawn and frequently quality-graded based on visual appearance, mechanical and acoustic properties. The assessment uses simple human (subjective) observation, and two ‘‘experts’’ can rate the same sample differently. This paper describes the application of integral transforms (Fourier and Radon) for automatic (objective) assessment of the visual appearance of 10 Sitka spruce (Picea sitchensis) sample images. This work considers surface classification on the basis of grain orientation, count, spacing, and evenness or uniformity.

Web health portal to enhance patient safety in Australian healthcare systems

The use of a web Health Portal can be employed not only for reducing health costs but also to view patient's latest medical information (e.g. clinical tests, pathology and radiology results, discharge summaries, prescription renewals, referrals, appointments) in real-time and carry out physician messaging to enhance the information exchanged, managed and shared in the Australian healthcare sector. The Health Portal connects all stakeholders (such as patients and their families, health professionals, care providers, and health regulators) to establish coordination, collaboration and a shared care approach between them to improve overall patient care safety. The paper outlines a Health Portal model for designing a real-time health prevention system. An application of the architecture is described in the area of web Health Portal.

Integral approach and numerical improvement to calculate carbon concentration profiles in carburising

The carbon diffusion in steel, where the carbon diffusivity varies with the carbon content, was solved with the integral methods under the third boundary condition. The variation of carbon diffusivity in steel with the carbon content was described with two different functions, linear dependence and exponential dependence. The integral approximation for both cases was improved with the numerical computation to more accurately predict the carbon profiles. The integral solution is more accurate than the formulation based on the assumption of a constant diffusivity or those based on the assumption of a constant diffusivity and/or constant carbon content at part surface. It is also more easily used in practice than the numerical method to describe the carburising process and predict the carbon content at steel surface and carbon profiles in treated layer.

A framework for the design of privacy preserving pervasive healthcare

Privacy is an important aspect of pervasive and ubiquitous computing systems, and, in particular, pervasive healthcare. With reference to previous approaches on developing privacy sensitive pervasive healthcare applications, we detail a framework for the design of such systems that aims to minimise the impact of privacy on such systems. In reviewing previous approaches, we extract and combine common elements in order to unify the approaches and create a more formal methodology for designing privacy mechanisms in pervasive healthcare applications. In doing so we also consider the manner in which ubiquitous technologies impact on privacy and methods for reducing this impact. We demonstrate how the framework can be applied by using examples from the previous approaches. In addressing privacy issues, the framework aims to remove a large obstacle to deployment of pervasive healthcare systems, acceptance of the technology.

A theoretical framework of entrepreneurship and innovation in healthcare organisations

This paper examines the role of entrepreneurship and innovation in the context of healthcare management by offering a number of research propositions. In recent years, hospitals have attracted ever growing commentary about rising costs and the need for improving information technology systems. Whilst there have been some service innovations introduced from other industries, particularly the manufacturing industry, there have been few service innovations originating from the healthcare sector. In the healthcare sector, there are a number of service innovations, which are discussed in this paper in terms of their relevance to managerial roles of hospital staff members. In addition, this paper examines the role of entrepreneurial managers in determining innovative technology behaviour in healthcare organisations. Literature from innovation management, corporate intrapreneurship and healthcare management is used to explain the findings of this paper and future areas of research are also proposed.

The integral child

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A fuzzy decision support method for customer preferences analysis based on Choquet integral

The explosion of the Web 2:0 platforms, with massive volume of user generated data, has presented many new opportunities as well as challenges for organizations in understanding consumer's behavior to support for business planning process. Feature based sentiment mining has been an emerging area in providing tools for automated opinion discovery and summarization to help business managers with achieving such goals. However, the current feature based sentiment mining systems were only able to provide some forms of sentiments summary with respect to product features, but impossible to provide insight into the decision making process of consumers. In this paper, we will present a relatively new decision support method based on Choquet Integral aggregation function, Shapley value and Interaction Index which is able to address such requirements of business managers. Using a study case of Hotel industry, we will demonstrate how this technique can be applied to effectively model the user's preference of (hotel) features. The presented method has potential to extend the practical capability of sentiment mining area, while, research findings and analysis are useful in helping business managers to define new target customers and to plan more effective marketing strategies.

Patient and business rules extraction and formalisation using SVN and SBVR for automated healthcare

This paper describes advances in automated health service selection and composition in the Ambient Assisted Living (AAL) domain. We apply a Service Value Network (SVN) approach to automatically match medical practice recommendations to health services based on sensor readings in a home care context. Medical practice recommendations are extracted from National Health and Medical Research Council (NHMRC) guidelines. Service networks are derived from Medicare Benefits Schedule (MBS) listings. Service provider rules are further formalised using Semantics of Business Vocabulary and Business Rules (SBVR), which allows business participants to identify and define machine-readable rules. We demonstrate our work by applying an SVN composition process to patient profiles in the context of Type 2 Diabetes Management.

Feedback reporting of survey data to healthcare aides

Background

This project occurred during the course of the Translating Research in Elder Care (TREC) program of research. TREC is a multilevel and longitudinal research program being conducted in the three Canadian Prairie Provinces of Alberta, Saskatchewan, and Manitoba. The main purpose of TREC is to increase understanding about the role of organizational context in influencing knowledge use in residential long-term care settings. The purpose of this study was to evaluate healthcare aides’ (HCAs) perceptions of a one-page poster designed to feed back aggregated data (including demographic information and perceptions about influences on best practice) from the TREC survey they had recently completed.

Methods
A convenience sample of 7 of the 15 nursing homes participating in the TREC research program in Alberta were invited to participate. Specific facility-level summary data were provided to each facility in the form of a one-page poster report. Two weeks following delivery of the report, a convenience sample of HCAs was surveyed using one-to-one structured interviews.

Results
One hundred twenty-three HCAs responded to the evaluation survey. Overall, HCAs’ opinions about presentation of the feedback report and the understandability, usability, and usefulness of the content were positive. For each report, analysis of data and production and inspection of the report took up to one hour. Information sessions to introduce and explain the reports averaged 18 minutes. Two feedback reports (minimum) were supplied to each facility at a cost of CAN$2.39 per report, for printing and laminating.

Conclusions
This study highlights not only the feasibility of producing understandable, usable, and useful feedback reports of survey data but also the value and importance of providing feedback to survey respondents. More broadly, the findings suggest that modest strategies may have a positive and desirable effect in participating sites.