Malnutrition screening tools : comparison against two validated nutrition assessment methods in older medical inpatients

Objective Although several validated nutritional screening tools have been developed to “triage” inpatients for malnutrition diagnosis and intervention, there continues to be debate in the literature as to which tool/tools clinicians should use in practice. This study compared the accuracy of seven validated screening tools in older medical inpatients against two validated nutritional assessment methods. Methods This was a prospective cohort study of medical inpatients at least 65 y old. Malnutrition screening was conducted using seven tools recommended in evidence-based guidelines. Nutritional status was assessed by an accredited practicing dietitian using the Subjective Global Assessment (SGA) and the Mini-Nutritional Assessment (MNA). Energy intake was observed on a single day during first week of hospitalization. Results In this sample of 134 participants (80 ± 8 y old, 50% women), there was fair agreement between the SGA and MNA (κ = 0.53), with MNA identifying more “at-risk” patients and the SGA better identifying existing malnutrition. Most tools were accurate in identifying patients with malnutrition as determined by the SGA, in particular the Malnutrition Screening Tool and the Nutritional Risk Screening 2002. The MNA Short Form was most accurate at identifying nutritional risk according to the MNA. No tool accurately predicted patients with inadequate energy intake in the hospital. Conclusion Because all tools generally performed well, clinicians should consider choosing a screening tool that best aligns with their chosen nutritional assessment and is easiest to implement in practice. This study confirmed the importance of rescreening and monitoring food intake to allow the early identification and prevention of nutritional decline in patients with a poor intake during hospitalization.

The future of sustainable building assessment tools : a case study in Australia

Sustainability issues in built environment have attracted an increasingly level of attention from both the general public and the industry. As a result, a number of green building assessment tools have been developed such as the Leadership in Energy and Environmental Design (LEED) and the BRE Environmental Assessment Method (BREEAM), etc. This paper critically reviewed the assessment tools developed in Australian context, i.e. the Green Star rating tools developed by the Green Building Council of Australia. A particular focus is given to the recent developments of these assessment tools. The results showed that the office buildings take the biggest share of Green Star rated buildings. Similarly, sustainable building assessments seem to be more performance oriented which focuses on the operation stage of buildings. In addition, stakeholder engagement during the decision making process is encouraged. These findings provide useful references to the development of next generation of sustainable building assessment tools.

Designing online assessment tools for disengaged youth

This article reports on the development of online assessment tools for disengaged youth in flexible learning environments. Sociocultural theories of learning and assessment and Bourdieu’s sociological concepts of capital and exchange were used to design a purpose-built content management system. This design experiment engaged participants in assessment that led to the exchange of self, peer and teacher judgements for credentialing. This collaborative approach required students and teachers to adapt and amend social networking practices for students to submit and judge their own and others’ work using comments, ratings, keywords and tags. Students and teachers refined their evaluative expertise across contexts, and negotiated meanings and values of digital works, which gave rise to revised versions and emergent assessment criteria. By combining social networking tools with sociological models of capital, assessment activities related to students’ digital productions were understood as valuations and judgements within an emergent, negotiable social field of exchange.

Assessment of functional forms of crop yield loss models of invasive plant species applied in decision support tools and bioeconomic modelling

AbstractObjectives Decision support tools (DSTs) for invasive species management have had limited success in producing convincing results and meeting users' expectations. The problems could be linked to the functional form of model which represents the dynamic relationship between the invasive species and crop yield loss in the DSTs. The objectives of this study were: a) to compile and review the models tested on field experiments and applied to DSTs; and b) to do an empirical evaluation of some popular models and alternatives. Design and methods This study surveyed the literature and documented strengths and weaknesses of the functional forms of yield loss models. Some widely used models (linear, relative yield and hyperbolic models) and two potentially useful models (the double-scaled and density-scaled models) were evaluated for a wide range of weed densities, maximum potential yield loss and maximum yield loss per weed. Results Popular functional forms include hyperbolic, sigmoid, linear, quadratic and inverse models. Many basic models were modified to account for the effect of important factors (weather, tillage and growth stage of crop at weed emergence) influencing weed–crop interaction and to improve prediction accuracy. This limited their applicability for use in DSTs as they became less generalized in nature and often were applicable to a much narrower range of conditions than would be encountered in the use of DSTs. These factors' effects could be better accounted by using other techniques. Among the model empirically assessed, the linear model is a very simple model which appears to work well at sparse weed densities, but it produces unrealistic behaviour at high densities. The relative-yield model exhibits expected behaviour at high densities and high levels of maximum yield loss per weed but probably underestimates yield loss at low to intermediate densities. The hyperbolic model demonstrated reasonable behaviour at lower weed densities, but produced biologically unreasonable behaviour at low rates of loss per weed and high yield loss at the maximum weed density. The density-scaled model is not sensitive to the yield loss at maximum weed density in terms of the number of weeds that will produce a certain proportion of that maximum yield loss. The double-scaled model appeared to produce more robust estimates of the impact of weeds under a wide range of conditions. Conclusions Previously tested functional forms exhibit problems for use in DSTs for crop yield loss modelling. Of the models evaluated, the double-scaled model exhibits desirable qualitative behaviour under most circumstances.

Validating adult and paediatric nutrition screening and assessment tools in Vietnamese language in two acute hospital in Ho Chi Minh City, Vietnam

Despite being commonly prevalent in acute care hospitals worldwide, malnutrition often goes unidentified and untreated due to a lack in the implementation of a nutrition care pathway. The aim of this study was to validate nutrition screening and assessment tools in Vietnamese language. After converting into Vietnamese, Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) were used to identify malnutrition in the adult setting; and the Paediatric Nutrition Screening Tool (PNST) and paediatric Subjective Global Nutritional Assessment (SGNA) were used in the paediatric setting in two acute care hospitals in Vietnam. This cross-sectional observational study sampled 123 adults (median age 78 years [39–96 years], 63% males) and 105 children (median age 20 months [2–100 months], 66% males). In adults, nutrition risk and malnutrition were identified in 29% and 45% of the cohort respectively. Nutrition risk and malnutrition were identified in 71% and 43% of the paediatric cohort respectively. The sensitivity and specificity of the screening tools were: 62% and 99% for the MST compared to the SGA; 89% and 42% for the PNST compared to the SGNA. This study provides a stepping stone to the potential use of evidence-based nutrition screening and assessment tools in Vietnamese language within the adult and paediatric Vietnamese acute care setting. Further work is required into integrating a complete nutrition care pathway within the acute care setting in Vietnamese hospitals.

Towed vehicles: undulating platforms as tools for maping coastal processes and water quality assessment, Seaside, California, February 5-7,2007. Workshop proceedings

The Alliance for Coastal Technologies (ACT) Workshop on Towed Vehicles: Undulating Platforms As Tools for Mapping Coastal Processes and Water Quality Assessment was convened February 5-7,2007 at The Embassy Suites Hotel, Seaside, California and sponsored by the ACT-Pacific Coast partnership at the Moss Landing Marine Laboratories (MLML). The TUV workshop was co-chaired by Richard Burt (Chelsea Technology Group) and Stewart Lamerdin (MLML Marine Operations). Invited participants were selected to provide a uniform representation of the academic researchers, private sector product developers, and existing and potential data product users from the resource management community to enable development of broad consensus opinions on the application of TUV platforms in coastal resource assessment and management. The workshop was organized to address recognized limitations of point-based monitoring programs, which, while providing valuable data, are incapable of describing the spatial heterogeneity and the extent of features distributed in the bulk solution. This is particularly true as surveys approach the coastal zone where tidal and estuarine influences result in spatially and temporally heterogeneous water masses and entrained biological components. Aerial or satellite based remote sensing can provide an assessment of the aerial extent of plumes and blooms, yet provide no information regarding the third dimension of these features. Towed vehicles offer a cost-effective solution to this problem by providing platforms, which can sample in the horizontal, vertical, and time-based domains. Towed undulating vehicles (henceforth TUVs) represent useful platforms for event-response characterization. This workshop reviewed the current status of towed vehicle technology focusing on limitations of depth, data telemetry, instrument power demands, and ship requirements in an attempt to identify means to incorporate such technology more routinely in monitoring and event-response programs. Specifically, the participants were charged to address the following: (1) Summarize the state of the art in TUV technologies; (2) Identify how TUV platforms are used and how they can assist coastal managers in fulfilling their regulatory and management responsibilities; (3) Identify barriers and challenges to the application of TUV technologies in management and research activities, and (4) Recommend a series of community actions to overcome identified barriers and challenges. A series of plenary presentation were provided to enhance subsequent breakout discussions by the participants. Dave Nelson (University of Rhode Island) provided extensive summaries and real-world assessment of the operational features of a variety of TUV platforms available in the UNOLs scientific fleet. Dr. Burke Hales (Oregon State University) described the modification of TUV to provide a novel sampling platform for high resolution mapping of chemical distributions in near real time. Dr. Sonia Batten (Sir Alister Hardy Foundation for Ocean Sciences) provided an overview on the deployment of specialized towed vehicles equipped with rugged continuous plankton recorders on ships of opportunity to obtain long-term, basin wide surveys of zooplankton community structure, enhancing our understanding of trends in secondary production in the upper ocean. [PDF contains 32 pages]

Methods and tools for the assessment of daylight transmittance through expanded metal meshes

306 p.

Assessment of existing information on Atlantic coastal fish habitats: development of a web-based spatial bibliography, query tools, and data summaries

The primary objective of this project, “the Assessment of Existing Information on Atlantic Coastal Fish Habitat”, is to inform conservation planning for the Atlantic Coastal Fish Habitat Partnership (ACFHP). ACFHP is recognized as a Partnership by the National Fish Habitat Action Plan (NFHAP), whose overall mission is to protect, restore, and enhance the nation’s fish and aquatic communities through partnerships that foster fish habitat conservation. This project is a cooperative effort of NOAA/NOS Center for Coastal Monitoring and Assessment (CCMA) Biogeography Branch and ACFHP. The Assessment includes three components; 1. a representative bibliographic and assessment database, 2. a Geographical Information System (GIS) spatial framework, and 3. a summary document with description of methods, analyses of habitat assessment information, and recommendations for further work. The spatial bibliography was created by linking the bibliographic table developed in Microsoft Excel and exported to SQL Server, with the spatial framework developed in ArcGIS and exported to GoogleMaps. The bibliography is a comprehensive, searchable database of over 500 selected documents and data sources on Atlantic coastal fish species and habitats. Key information captured for each entry includes basic bibliographic data, spatial footprint (e.g. waterbody or watershed), species and habitats covered, and electronic availability. Information on habitat condition indicators, threats, and conservation recommendations are extracted from each entry and recorded in a separate linked table. The spatial framework is a functional digital map based on polygon layers of watersheds, estuarine and marine waterbodies derived from NOAA’s Coastal Assessment Framework, MMS/NOAA’s Multipurpose Marine Cadastre, and other sources, providing spatial reference for all of the documents cited in the bibliography. Together, the bibliography and assessment tables and their spatial framework provide a powerful tool to query and assess available information through a publicly available web interface. They were designed to support the development of priorities for ACFHP’s conservation efforts within a geographic area extending from Maine to Florida, and from coastal watersheds seaward to the edge of the continental shelf. The Atlantic Coastal Fish Habitat Partnership has made initial use of the Assessment of Existing Information. Though it has not yet applied the AEI in a systematic or structured manner, it expects to find further uses as the draft conservation strategic plan is refined, and as regional action plans are developed. It also provides a means to move beyond an “assessment of existing information” towards an “assessment of fish habitat”, and is being applied towards the National Fish Habitat Action Plan (NFHAP) 2010 Assessment. Beyond the scope of the current project, there may be application to broader initiatives such as Integrated Ecosystem Assessments (IEAs), Ecosystem Based Management (EBM), and Marine Spatial Planning (MSP).

Computer vision tools for the non-invasive assessment of autism-related behavioral markers

The early detection of developmental disorders is key to child outcome, allowing interventions to be initiated that promote development and improve prognosis. Research on autism spectrum disorder (ASD) suggests behavioral markers can be observed late in the first year of life. Many of these studies involved extensive frame-by-frame video observation and analysis of a child's natural behavior. Although non-intrusive, these methods are extremely time-intensive and require a high level of observer training; thus, they are impractical for clinical and large population research purposes. Diagnostic measures for ASD are available for infants but are only accurate when used by specialists experienced in early diagnosis. This work is a first milestone in a long-term multidisciplinary project that aims at helping clinicians and general practitioners accomplish this early detection/measurement task automatically. We focus on providing computer vision tools to measure and identify ASD behavioral markers based on components of the Autism Observation Scale for Infants (AOSI). In particular, we develop algorithms to measure three critical AOSI activities that assess visual attention. We augment these AOSI activities with an additional test that analyzes asymmetrical patterns in unsupported gait. The first set of algorithms involves assessing head motion by tracking facial features, while the gait analysis relies on joint foreground segmentation and 2D body pose estimation in video. We show results that provide insightful knowledge to augment the clinician's behavioral observations obtained from real in-clinic assessments.