Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010

Background & aims The Australasian Nutrition Care Day Survey (ANCDS) ascertained if malnutrition and poor food intake are independent risk factors for health-related outcomes in Australian and New Zealand hospital patients. Methods Phase 1 recorded nutritional status (Subjective Global Assessment) and 24-h food intake (0, 25, 50, 75, 100% intake). Outcomes data (Phase 2) were collected 90-days post-Phase 1 and included length of hospital stay (LOS), readmissions and in-hospital mortality. Results Of 3122 participants (47% females, 65 ± 18 years) from 56 hospitals, 32% were malnourished and 23% consumed ≤ 25% of the offered food. Malnourished patients had greater median LOS (15 days vs. 10 days, p < 0.0001) and readmissions rates (36% vs. 30%, p = 0.001). Median LOS for patients consuming ≤ 25% of the food was higher than those consuming ≤ 50% (13 vs. 11 days, p < 0.0001). The odds of 90-day in-hospital mortality were twice greater for malnourished patients (CI: 1.09–3.34, p = 0.023) and those consuming ≤ 25% of the offered food (CI: 1.13–3.51, p = 0.017), respectively. Conclusion The ANCDS establishes that malnutrition and poor food intake are independently associated with in-hospital mortality in the Australian and New Zealand acute care setting.

The impact of malnutrition and decreased food intake on length of stay, readmission, and mortality in acute care patients

Rationale: The Australasian Nutrition Care Day Survey (ANCDS) evaluated if malnutrition and decreased food intake are independent risk factors for negative outcomes in hospitalised patients. Methods: A multicentre (56 hospitals) cross-sectional survey was conducted in two phases. Phase 1 evaluated nutritional status (defined by Subjective Global Assessment) and 24-hour food intake recorded as 0, 25, 50, 75, and 100% intake. Phase 2 data, which included length of stay (LOS), readmissions and mortality, were collected 90 days post-Phase 1. Logistic regression was used to control for confounders: age, gender, disease type and severity (using Patient Clinical Complexity Level scores). Results: Of 3122 participants (53% males, mean age: 65±18 years) 32% were malnourished and 23% consumed�25% of the offered food. Median LOS for malnourished (MN) patients was higher than well-nourished (WN) patients (15 vs. 10 days, p<0.0001). Median LOS for patients consuming �25% of the food was higher than those consuming �50% (13 vs. 11 days, p<0.0001). MN patients had higher readmission rates (36% vs. 30%, p = 0.001). The odds ratios of 90-day in-hospital mortality were 1.8 times greater for MN patients (CI: 1.03 3.22, p = 0.04) and 2.7 times greater for those consuming �25% of the offered food (CI: 1.54 4.68, p = 0.001). Conclusion: The ANCDS demonstrates that malnutrition and/or decreased food intake are associated with longer LOS and readmissions. The survey also establishes that malnutrition and decreased food intake are independent risk factors for in-hospital mortality in acute care patients; and highlights the need for appropriate nutritional screening and support during hospitalisation. Disclosure of Interest: None Declared.

Bouncing back : homegrown. Curated exhibition of student work and design workshop

Bouncing Back Architecture Exhibition: This exhibition showcases interpretations of urban resiliency by 2nd and 4th Year undergraduate architecture students who explore the notion of Bouncing Back from the 2011 Queensland floods, in the context of contemporary Brisbane built environment. Design solutions have been expressed in a variety of forms including emergency shelters, flood-proof housing and a range of urban designs, some of which address extreme environmental conditions. Design Process Workshop | Architecture Workshop with Queensland Academy of Creative Industries Students: In collaboration with Homegrown Facilitator Natalie Wright, Lindy Osborne and Glenda Caldwell and some of their architecture students from the QUT School of Design, extended the university design studio experience to 18 Secondary School students, who brainstormed and designed emergency food distribution shelters for those affected by floods. Designs and models created in the workshop were subsequently included in the Bouncing Back Architecture Exhibition.

A viable and sustainable key management approach for a national e-health environment

To protect the health information security, cryptography plays an important role to establish confidentiality, authentication, integrity and non-repudiation. Keys used for encryption/decryption and digital signing must be managed in a safe, secure, effective and efficient fashion. The certificate-based Public Key Infrastructure (PKI) scheme may seem to be a common way to support information security; however, so far, there is still a lack of successful large-scale certificate-based PKI deployment in the world. In addressing the limitations of the certificate-based PKI scheme, this paper proposes a non-certificate-based key management scheme for a national e-health implementation. The proposed scheme eliminates certificate management and complex certificate validation procedures while still maintaining security. It is also believed that this study will create a new dimension to the provision of security for the protection of health information in a national e-health environment.

Power system stability enhancement in a deregulated environment using FACTS devices

In deregulated versions of free-market electricity, producers will be free to send power along other utilities. The price of power strongly depends and fluctuates according to mutual benefit index of both supplier and consumer. In such a situation, strong interaction among utilities may cause instabilities in the system. As the frequency of market-based dispatch increases market forces tend to destabilize the stable system dynamics depending on the value of Ks/τλ(market dependent parameter) ratio. This tends to destabilize the coupled dynamics. The implementation of TCSC can effectively damp the inter area modes of oscillations of the coupled market system.

Nucleation experiments in a microgravity environment

A simple experimental apparatus is described in which a wide variety of vapor phase nucleation studies of refractory materials could be performed aboard NASA's KC-135 Research Aircraft. The chief advantage of a microgravity environment for these studies is the expected absence of thermally driven convective motions in the gas. The absence of convection leads to much more accurate knowledge of both the temperature distribution in the system and the time evolution of the refractory vapor concentration as a function of distance from the crucible.The evolution of the apparatus will be described as more experience is gained with the microgravity environment. Such experiments will be used to prepare for similar ones carried out aboard either the shuttle or Space Station where considerably longer duration experiments are possible.

A generic framework and runtime environment for development and evaluation of behavioral biometrics solutions

Increasing use of computerized systems in our daily lives creates new adversarial opportunities for which complex mechanisms are exploited to mend the rapid development of new attacks. Behavioral Biometrics appear as one of the promising response to these attacks. But it is a relatively new research area, specific frameworks for evaluation and development of behavioral biometrics solutions could not be found yet. In this paper we present a conception of a generic framework and runtime environment which will enable researchers to develop, evaluate and compare their behavioral biometrics solutions with repeatable experiments under the same conditions with the same data.

Impact of the internal business environment on knowledge management within construction organisations

Purpose: Recent knowledge management (KM) literature suggests that KM activities are influenced by the elements of the internal business environment (BE) of organisations. This paper attempts to provide some unique insights into the contextual input of the KM process through empirically identifying the major factors (i.e. “forces”) within the internal BE of construction organisations operating in Hong Kong, and investigating their impact on the intensity of KM activities. Design/methodology/approach: A questionnaire survey was administered to a sample of construction contractors operating in Hong Kong to elicit opinions on the internal BE and intensity of KM activities as executed by targeted organisations. A total of 149 usable responses were received from 99 organisations representing about 38 percent of the research population. In parallel, to the survey, a total of 15 semi-structured interviews were undertaken to provide more insights into the phenomenon under investigation. Findings: Supported by the empirical and qualitative evidence, this study established that firstly, both organisational and technical environments have the capacity to either positively or negatively impact the intensity of KM activities, and both environments serve as stimuli in increasing each other's dynamism; secondly, certain types of KM activities are stronger “energy receivers” and easily to be “powered up” by manipulating factors representing these two environments. Then, through interactions between KM activities, the intensity of the whole strategic KM cycle will be increased thus helping to strengthen organisational competitive advantage.

Interpersonal coupling in rowing : the mediating role of the environment

Evidence currently supports the view that intentional interpersonal coordination (IIC) is a self-organizing phenomenon facilitated by visual perception of co-actors in a coordinative coupling (Schmidt, Richardson, Arsenault, & Galantucci, 2007). The present study examines how apparent IIC is achieved in situations where visual information is limited for co-actors in a rowing boat. In paired rowing boats only one of the actors, [bow seat] gets to see the actions of the other [stroke seat]. Thus IIC appears to be facilitated despite the lack of important visual information for the control of the dyad. Adopting a mimetic approach to expert coordination, the present study qualitatively examined the experiences of expert performers (N=9) and coaches (N=4) with respect to how IIC was achieved in paired rowing boats. Themes were explored using inductive content analysis, which led to layered model of control. Rowers and coaches reported the use of multiple perceptual sources in order to achieve IIC. As expected(Kelso, 1995; Schmidt & O’Brien, 1997; Turvey, 1990), rowers in the bow of a pair boat make use of visual information provided by the partner in front of them [stroke]. However, this perceptual information is subordinate to perception Motor Learning and Control S111 of the relationship between the boat hull and water passing beside it. Stroke seat, in the absence of visual information about his/her partner, achieves coordination by picking up information about the lifting or looming of the boat’s stern along with water passage past the hull. In this case it appears that apparent or desired IIC is supported by the perception of extra-personal variables, in this case boat behavior; as this perceptual information source is used by both actors. To conclude, co-actors in two person rowing boats use multiple sources of perceptual information for apparent IIC that changes according to task constraints. Where visual information is restricted IIC is facilitated via extra-personal perceptual information and apparent IIC switches to intentional extra-personal coordination.

Effects of family environment on negative symptoms and quality of life of psychotic patients

This study tested the hypothesis that negative symptoms and quality of life for patients with functional psychoses are associated with family environment. Fifty-seven first-admission patients with functional psychoses were assessed at hospital admission for severity of psychopathology and premorbid adjustment. Relatives residing with patients rated the family environment at admission and one month after discharge on the Family Environment Scale. Patients made the same ratings after discharge. Six months later, patients were reassessed on severity of psychopathology, negative symptoms, and quality of life. Multiple regression analyses showed that higher levels of positive emotional expressiveness in the family predicted milder and fewer negative symptoms and better quality of life at follow-up. The prediction was statistically independent of the initial severity of psychopathology or premorbid adjustment

Physical characteristics of the indoor environment that affect health and wellbeing in healthcare facilities : a review

Understanding the physical characteristics of the indoor environment that affect human health and wellbeing is the key requirement underpinning the beneficial design of a healthcare facility (HCF). We reviewed and summarised physical factors of the indoor environment reported to affect human health and wellbeing in HCFs. Research materials included articles identified in a Pubmed search, guidelines, books, reports and monographs, as well as the bibliographies of review articles in the area studied. Of these, 209 publications were selected for this review. According to the literature, there is evidence that the following physical factors of the indoor environment affect the health and wellbeing of human beings in an HCF: safety, ventilation and HVAC systems, thermal environment, acoustic environment, interior layout and room type, windows (including daylight and views), nature and gardens, lighting, colour, floor covering, furniture and its placement, ergonomics, wayfinding, artworks and music. Some of these, in themselves, directly promote or hinder health and wellbeing, but the physical factors may also have numerous indirect impacts by influencing the behaviour, actions, and interactions of patients, their families and the staff members. The findings of this research enable a good understanding of the different physical factors of the indoor environment on health and wellbeing and provide a practical resource for those responsible for the design and operate the facilities as well as researchers investigating these factors. However, more studies are needed in order to inform the design of optimally beneficial indoor environments in HCFs for all user groups.