Everyone's problem but nobody's job : staff perceptions and explanations for poor nutritional intake in older medical patients

Aim: Up to 60% of older medical patients are malnourished with further decline during hospital stay. There is limited evidence for effective nutrition intervention. Staff focus groups were conducted to improve understanding of potential contextual and cultural barriers to feeding older adults in hospital. Methods: Three focus groups involved 22 staff working on the acute medical wards of a large tertiary teaching hospital. Staff disciplines were nursing, dietetics, speech pathology, occupational therapy, physiotherapy, pharmacy. A semistructured topic guide was used by the same facilitator to prompt discussions on hospital nutrition care including barriers. Focus groups were tape-recorded, transcribed and analysed thematically. Results: All staff recognised malnutrition to be an important problem in older patients during hospital stay and identified patient-level barriers to nutrition care such as non-compliance to feeding plans and hospital-level barriers including nursing staff shortages. Differences between disciplines revealed a lack of a coordinated approach, including poor knowledge of nutrition care processes, poor interdisciplinary communication, and a lack of a sense of shared responsibility/coordinated approach to nutrition care. All staff talked about competing activities at meal times and felt disempowered to prioritise nutrition in the acute medical setting. Staff agreed education and ‘extra hands’ would address most barriers but did not consider organisational change. Conclusions: Redesigning the model of care to reprioritise meal-time activities and redefine multidisciplinary roles and responsibilities would support coordinated nutrition care. However, effectiveness may also depend on hospitalwide leadership and support to empower staff and increase accountability within a team-led approach.

Narrative : family trauma or challenge and resilience in the Galapagos Archipelago

The chapter is a "here and now" narration in the first person as witnessed and experienced by the author during field work in the Galapagos Islands in 1976-79. The story begins on the most remote volcanic island of Fernandina where the breeding biology of Flightless cormorants was being studied. A small selection of the many potentially life threatening situations and challenges is described including stories related to the birth of their son.

Queensland property legislation update

This article discusses the legislative changes introduced by the new Government in Queensland in 2012 and their impact on property transactions. The changes generally relate to the government’s mandate to reduce red tape in property transactions as well as election promises to reintroduce the stamp duty reduction for the purchase of a home and wind back the previous government’s changes to the lot entitlement provisions of the Body Corporate and Community Management Act 1997.

The effect of Yb addition in bi2sr2ca 1-xybxcu2oy partial melted thick films

To study the phase relations in the Bi-2212 and Yb2O3 system, Bi2Sr2Ca1-xYbxCu 2Oy thick films are prepared by partial melt processing via an intermediate reaction between Bi-2212 and Yb2O3. When Bi-2212 and Yb2O3 are partially melted and then slowly cooled, solid solutions of Bi2Sr2Ca 1-xYbxCu2Oy, form by reactions between liquid and solid phases which contain Yb. Following these reactions, Ca is partially replaced in Bi-2212 matrix and participates in the formation of secondary phases, such as Bi-free, (Ca, Sr)Ox and CaO. Variation of the Bi-2212-Yb2O3 ratios and processing parameters changes the balance between the phases and leads to different Yb:Ca ratios in the Bi-2212 matrix of processed thick films. When the partial melting process is optimized for each sample to minimize the growth of secondary phases, x = 0.42-0.46 for the samples prepared at pO2 = 0.01 atm, x = 0.24-0.29 for the samples prepared at pO2 = 0.21 atm, x = 0.18-0.23 for the samples prepared at pO2 = 0.99 atm are obtained regardless to the starting compositions. It is found that superconducting properties of Bi 2Sr2Ca1-xYbxCu2O y thick films strongly depend on the processing conditions, because the conditions result in different Yb content in the Bi-2212 matrix and the volume fraction of the secondary phases. The highest Tc(0) of 77, 90 and 91 K were obtained for the samples processed at 0.01, 0.21 and 0.99 atm of O2, respectively.

Re-melting of Bi-2212/Ag laminated tapes by partial melting process

Bi-2212 tapes are prepared by a combination of dip-coating and partial melt processing. We investigate the effect of re-melting of those tapes by partial melting followed by slow cooling on the structure and superconducting properties. Microstructural studies of re-melted samples show that they have the same overall composition as partially melted tapes. However, the fractional volumes of the secondary phases differ and the amounts and distribution of the secondary phases have a significant effect on the critical current. Critical current of Bi-2212/Ag tapes strongly depends on the maximum processing temperature. Initial J(c)'s of the tapes, which are partially melted, then slowly solidified at optimum conditions and finally post-annealed in an inert atmosphere, are up to 10.4 x 10(3) A/cm(2). It is found that the maximum processing temperature at initial partial melting has an influence on the optimum re-heat treatment conditions for the tapes. Re-melted tapes processed at optimum conditions recover superconducting properties after post-annealing in an inert atmosphere: the J(c) values of the tapes are about 80-110% of initial J(c)'s of those tapes.

Melt textured Y123 bulk and thick film

YBa2Cu3O7-δ - 25mol%Y2BaCuO5 bars and thick films have been melt textured using a stationary furnace with a temperature gradient of 3 or 6°C/cm. Samples are heated above the peritectic reaction temperature and quenched to just above the solidification temperature and then slowly cooled below the solidification temperature. All bar shaped samples consist of 2-5 mm grains though the grain orientations strongly depend on the heat treatment conditions. The bar shows the maximum Jc of above 3,000 A/cm2, whereas the maximum Jc of 200 A/cm2 and Tczero of 88K are obtained for the thick film on (100) LaAlO3 single crystal.

Binder effect on microstructure and properties of YBa2Cu3O7-x extruded wires

YBa2Cu3O7-x wires have been extruded with 2 and 5 wt.% of hydroxy propyl methylcellulose (HPMC) as binder. Both sets of wires sintered below 930°C have equiaxed grains while the wires sintered above this temperature have elongated grains. In the temperature range which gives equiaxed grains, the wires extruded with 5 wt.% HPMC have higher grain size and density. Cracks along the grain boundaries are often observed in the wires having elongated grains. Critical current density, Jc, increases initially, reaches a peak and then decreases with the sintering temperature. The sintering temperature giving a peak in Jc strongly depends on the heat treatment scheme for the wires extruded with 5 wt.% HPMC. TEM studies show that defective layers are formed along grain boundaries for the wires extruded with 5 wt.% HPMC after 5 h oxygenation. After 55 h oxygenation, the defective layers become more localised and grain boundaries adopt an overall cleaner appearance. Densification with equiaxed grains and clean grain boundaries produces the highest Jc's for polycrystalline YBa2Cu3O7 wires.

Microstructural studies of quenched partially-melted Y-123 materials and Y-123 with Y-211, PtO2 and CeO2 additions

The microstructure of YBa2Cu3O7-delta (Y-123) materials partially-melted in air and quenched from the temperature range 900-1100 degrees C, has been characterized using a combination of X-ray diffractometry, optical microscopy, scanning electron microscopy, electron microprobe analyses, transmission electron microscopy and energy and wave dispersive X-ray spectrometries. The microstructural studies reveal significant changes in the character of the quenched partial-melt as a function of temperature and time before quenching. BaCu2O2 and BaCuO2 are found to co-exist in stoichiometric samples quenched from the temperature range 920-960 degrees C. Under suitable cooling conditions, large pockets of melt cristallize as BaCuO2 with an exsolution of BaCu2O2 in the form of thin plates (approximate to 50-100 nm thick) along facets. Y2BaCuO5 (Y-211) additions are associated with the formation of BaCu2O2 at 1100 degrees C. Preliminary results on the effects of PtO2 and CeO2 additions to Y-123 (and Y-123 with Y-211 additions) show that these enhace the formation of BaCu2O2 at the melting temperature of 1100 degrees C. (C) 1998 Elsevier Science S.A. All rights reserved.

Melt-textured YBa2Cu3O7-x wires having plate-like grains

YBCO wires which consist of well oriented plate-like fine grains are fabricated using a moving furnace to achieve higher mechanical strength. Melt-texturing experiments have been undertaken on YBCO wires with two different compositions: YBa1.5Cu2.9O7-x, and YBa1.8Cu3.0O7-x. Wires are extruded from a mixture of precursor powders (formed by a coprecipitation process) then textured by firing in a moving furnace. Size of secondary phases such as barium cuprate and copper oxide, and overall composition of the sample affect the orientation of the fine grains. At zero magnetic field, the YBa1.5Cu2.9O7-x wire shows the highest critical current density of 1,450 Acm-2 and 8,770 Acm-2 at 77K and 4.2K, respectively. At 1 T, critical current densities of 30 Acm-2 and 200 Acm-2, respectively, are obtained at 77K and 4.2K. Magnetisation curves are also obtained for one sample to evaluate critical current density using the Bean model. Analysis of the microstructure indicates that the starting composition of the green body significantly affects the achievement of grain alignment via melt-texturing processes.

Bulk manufacture of YBCO powders by coprecipitation

This work presents an assessment of the coprecipitation technique for the reliable production of high-temperature superconducting (HTS) copper-oxide powders in quantities scaled up to 1 kg. This process affords precise control of cation stoichiometry (< 4% relative), occurs rapidly (almost instantaneously) and can be suitably developed for large-scale (e.g. tonne) manufacture of HTS materials. The process is based upon a simple control of the chemistry of the cation solution and precipitation with oxalic acid. This coprecipitation method is applicable to all copper-oxides and has been demonstrated in this work using over thirty separate experiments for the following compositions: YBa2Cu3O7-δ, Y2BaCuO5 and YBa2Cu4O8. The precursor powders formed via this coprecipitation process are fine-grained (∼ 5-10 nm), chemically homogeneous at the nanometer scale and reactive, Conversion to phase-pure HTS powders can therefore occur in minutes at appropriate firing temperatures. © 1995.

The formation of YBa2Cu3O7-x in melt-texture heat treatments

A study of the bulk formation of YBa2Cu3O7-x from the Y2BaCuO5 plus liquid regime reveals that phase formation occurs at appreciable rates below 950°C in air. This result has been observed for phase-pure YBa2Cu3O7-x starting material given two types of heat treatment: held at 1100°C and slow-cooled from 1030°C at 6°C/h or heat-treated isothermally. Differential thermal analysis, with a cooling rate of 10°C/min indicates that the degree of undercooling for the peritectic formation of YBa2Cu3O7-x is greater than 100°C. © 1994.

Bicyclists overestimate their own night-time conspicuity and underestimate the benefits of retroreflective markers on the moveable joints

Conspicuity limitations make bicycling at night dangerous. This experiment quantified bicyclists’ estimates of the distance at which approaching drivers would first recognize them. Twenty five participants (including 13 bicyclists who rode at least once per week, and 12 who rode once per month or less) cycled in place on a closed-road circuit at night-time and indicated when they were confident that an approaching driver would first recognize that a bicyclist was present. Participants wore black clothing alone or together with a fluorescent bicycling vest, a fluorescent bicycling vest with additional retroreflective tape, or the fluorescent retroreflective vest plus ankle and knee reflectors in a modified ‘biomotion’ configuration. The bicycle had a light mounted on the handlebars which was either static, flashing or off. Participants judged that black clothing made them least visible, retroreflective strips on the legs in addition to a retroreflective vest made them most visible and that adding retroreflective materials to a fluorescent vest provides no conspicuity benefits. Flashing bicycle lights were associated with higher conspicuity than static lights. Additionally, occasional bicyclists judged themselves to be more visible than did frequent bicyclists. Overall, bicyclists overestimated their conspicuity compared to previously collected recognition distances and underestimated the conspicuity benefits of retroreflective markings on their ankles and knees. Participants mistakenly judged that a fluorescent vest that did not include retroreflective material would enhance their night-time conspicuity. These findings suggest that bicyclists have dangerous misconceptions concerning the magnitude of the night-time conspicuity problem and the potential value of conspicuity treatments.

Femininity, mental weakness and difference : male students account for anorexia nervosa in men

The purpose of this study was to examine how men account for the diagnosis in men of anorexia nervosa (AN), a condition commonly associated with women. Male students participated in focus group discussions of topics related to AN. Discussions were tape-recorded with participants' consent, transcribed, and then analyzed using discourse analysis. The participants spontaneously constructed AN as a female-specific condition. When asked to account for AN in men, they distanced AN from hegemonic masculinities in ways that sustained both dominant masculine identities and gender-specific constructions of AN. These findings show how issues of health and gender are interlinked in everyday understandings of AN. Future researchers might usefully consider how the construction of gender-specific illness implicates wider notions of both feminine and masculine gender identities.

Interfacial microstructure in Y1Ba2Cu3O7-δ high Tc superconductors

The microstructures of YBa2Cu3O7-δ ceramics prepared from freeze dried powders and containing an excess of CuO have been studied by analytical electron microscopy. Special attention has been paid to the interfacial microstructure. It was found that a liquid phase formed during sintering between 890°C and 920°C and this promoted grain growth and densification. Both clean grain boundaries and boundaries containing an amorphous intergranular film, which was rich in Cu, have been observed. Both CuO and BaCuO2 were present as secondary phases.