How do Australasian hospitals identify and manage malnutrition in their acute care wards?

One aim of the Australasian Nutrition Care Day Survey was to explore nutrition care practices in acute care hospital wards across Australia and New Zealand. Managers of Dietetic departments completed a questionnaire regarding ward nutrition care practices. Overall, 370 wards from 56 hospitals participated. The median ward size was 28 beds (range: 8–60 beds). Although there was a wide variation in full-time equivalent availability of dietitians (median: 0.3; range: 0–1.4), their involvement in providing nutrition care across ward specialities was signifi cantly higher than other staff members (χ2, p < 0.01). Feeding assistance, available in 89% of the wards, was provided mainly by nursing staff and family members (χ2, p < 0.01). Protected meal times were implemented in 5% (n = 18) of the wards. Fifty-three percent of the wards (n = 192) weighed patients on request and 40% (n = 148) on admission. Routine malnutrition screening was conducted in 63% (n = 232) of the wards and 79% (n = 184) of these wards used the Malnutrition Screening Tool, 16% (n = 37) the Malnutrition Universal Screening Tool, and 5% (n = 11) other tools. Nutrition rescreening was routinely conducted in 20% of the wards. Among wards that implemented nutrition screening, 41% (n = 100) routinely referred patients “at risk” of malnutrition to dietitians as part of their standard protocol for malnutrition management. Results of this study provide new knowledge regarding current nutrition care practice, highlight gaps in existing practice, and can be used to inform improved nutrition care in acute care wards across Australia and New Zealand.

Characteristics of culturally and linguistically diverse mental health clients

The present study examined Queensland Transcultural Mental Health Centre (QTMHC) client characteristics in order to provide a better understanding for development of future health service delivery models. Archived data that was collected for 1499 clients over two years period (2007-2009) was analysed using descriptive statistics and Chi squares. The results indicated that clients were referred from a range of sources and were generally adults. There were more women than men, who sought services. At least half of the clients had language barriers and relied on bilingual workers. Most frequently expressed mental health issues were mood disorder symptoms, followed by symptoms of schizophrenia and psychosis and anxiety. Acculturation strains and stressors were described as the most common psychosocial issues. Mental health and psychosocial issues differed for age, gender and world regions from which the CALD clients originated. The findings provided an understanding of clients who seek services at QTMHC. Various ways in which transcultural services and data bases can be further improved are discussed.

Enhanced photocatalytic activity of titanium oxide nanotubes after heating treatment

Titanium oxide nanotubes were obtained by an electrochemical anodization method. Scanning electron microscope results demonstrate that the diameter of the tubes is about 120 nm and the length of the tubes is around 13 μm. Transmission electron microscope results indicate that the nanotubes are assembled by numerous nanoparticles and tube-like structure remains well after heat treatment at 400-600 °C. The photocatalysis performance of the nanotubes was evaluated in terms of the decomposition rate of methyl orange under UV irradiation. The results show that the photocatalytic activity was enhanced through the heating treatment of the nanotubes, and the nanotubes heated at 600 °C exhibits the best photocatalytic activity. X-ray diffraction patterns indicate that there is no phase transformation during the heat treatment. Therefore, the enhanced activity can be attributed to the improvement of nanotubes crystallinity, which may provide more insights about the effect of the crystallinity on the photocatalytic performance.

Pulling apart the mid to late Cenozoic magmatic record of the Gulf of California : is there a Comondú arc?

The composition of the lithosphere can be fundamentally altered by long-lived subduction processes such that subduction-modified lithosphere can survive for 100's Myrs. Incorrect petrotectonic interpretations result when spatial-temporal-compositional trends of, and source contributions to, magmatism are not properly considered. Western Mexico has had protracted Cenozoic magmatism developed mostly in-board of active oceanic plate subduction beneath western North America. A broad range of igneous compositions from basalt to high-silica rhyolite were erupted with intermediate to silicic compositions in particular, showing calc-alkaline and other typical subduction-related geochemical signatures. A major Oligocene rhyolitic ignimbrite “flare-up” (>300,000 km3) switched to a bimodal volcanic phase in the Early Miocene (~100,000 km3), associated with distributed extension and opening of numerous grabens. Extension became more focussed ~18 Ma resulting in localised volcanic activity along the future site of the Gulf of California. This localised volcanism (known as the Comondú “arc”) was dominantly effusive and andesite-dacite in composition. Past tectonic interpretations of Comondú-age volcanism may have been incorrect as these regional temporal-compositional changes are alternatively interpreted as a result of increased mixing of mantle-derived basaltic and crust-derived rhyolitic magmas in an active rift environment rather than fluid flux melting of the mantle wedge above the subducting Guadalupe Plate.

A hydrogen/methane sensor based on niobium tungsten oxide nanorods synthesised by hydrothermal method

An investigation on hydrogen and methane sensing performance of hydrothermally formed niobium tungsten oxide nanorods employed in a Schottky diode structure is presented herein. By implementing tungsten into the surface of the niobium lattice, we create Nb5+ and W5+ oxide states and an abundant number of surface traps, which can collect and hold the adsorbate charge to reinforce a greater bending of the energy bands at the metal/oxide interface. We show experimentally, that extremely large voltage shifts can be achieved by these nanorods under exposure to gas at both room and high temperatures and attribute this to the strong accumulation of the dipolar charges at the interface via the surface traps. Thus, our results demonstrate that niobium tungsten oxide nanorods can be implemented for gas sensing applications, showing ultra-high sensitivities.

Compaction control of topography and fault network structure along strike-slip faults in sedimentary basins

Strike-slip faults commonly display structurally complex areas of positive or negative topography. Understanding the development of such areas has important implications for earthquake studies and hydrocarbon exploration. Previous workers identified the key factors controlling the occurrence of both topographic modes and the related structural styles. Kinematic and stress boundary conditions are of first-order relevance. Surface mass transport and material properties affect fault network structure. Experiments demonstrate that dilatancy can generate positive topography even under simple-shear boundary conditions. Here, we use physical models with sand to show that the degree of compaction of the deformed rocks alone can determine the type of topography and related surface fault network structure in simple-shear settings. In our experiments, volume changes of ∼5% are sufficient to generate localized uplift or subsidence. We discuss scalability of model volume changes and fault network structure and show that our model fault zones satisfy geometrical similarity with natural flower structures. Our results imply that compaction may be an important factor in the development of topography and fault network structure along strike-slip faults in sedimentary basins.

PCV13 Perceptions of health during pregnancy increase the risk of cardiovascular disease

OBJECTIVES: To examine the prospective association between perception of health during pregnancy and cardiovascular risk factor of mothers 21 years after the index pregnancy. METHODS: Data used were from the Mater University Study of Pregnancy (MUSP), a community- based prospective birth ohort study begun in Brisbane, Australia, in 1983. Logistic regression analyses were conducted. RESULTS: Data were available for 3692 women. Women who perceived themselves as not having a straight forward pregnancy had twice the odds (adjusted OR 2.0, 95% CI 1.1-3.8) of being diagnosed with heart disease 21 years after the indexpregnancyascomparedtowomenwith a straight forward pregnancy. Apart from that, women who had complications (other than serious pregnancy complications) during the pregnancy were also at30%increased odds (adjustedOR 1.3, 95% CI 1.0-1.6) of having hypertension 21 years later. CONCLUSIONS: As a whole, our study suggests that pregnant women who perceived that they had complications and did not have a straight forward pregnancy are likely to experience poorer cardiovascular outcomes 21 years after the pregnancy.

Racial/ethnic variations in violence against women : Urban, suburban and rural differences

A large literature shows that violence against women in intimate relationships varies across racial/ethnic groups. However, it is unclear whether such variations differ across urban, suburban, and rural areas. The main objective of this article is to examine this issue using 1992 to 2009 National Crime Victimization Survey data. We also test the hypothesis that racial/ethnic minority women living in rural areas are more likely to be assaulted by their current and former intimate partners than are their urban and suburban counterparts. Contrary to expectations, results indicated virtually no differences in the rates at which urban, suburban, and rural racial/ethnic minority females were victims of intimate violence. The results indicate the great need of additional research into this important topic.

Genome-wide association study identifies new multiple sclerosis susceptibility loci on chromosomes 12 and 20

To identify multiple sclerosis (MS) susceptibility loci, we conducted a genome-wide association study (GWAS) in 1,618 cases and used shared data for 3,413 controls. We performed replication in an independent set of 2,256 cases and 2,310 controls, for a total of 3,874 cases and 5,723 controls. We identified risk-associated SNPs on chromosome 12q13-14 (rs703842, P = 5.4 x 10(-11); rs10876994, P = 2.7 x 10(-10); rs12368653, P = 1.0 x 10(-7)) and upstream of CD40 on chromosome 20q13 (rs6074022, P = 1.3 x 10(-7); rs1569723, P = 2.9 x 10(-7)). Both loci are also associated with other autoimmune diseases. We also replicated several known MS associations (HLA-DR15, P = 7.0 x 10(-184); CD58, P = 9.6 x 10(-8); EVI5-RPL5, P = 2.5 x 10(-6); IL2RA, P = 7.4 x 10(-6); CLEC16A, P = 1.1 x 10(-4); IL7R, P = 1.3 x 10(-3); TYK2, P = 3.5 x 10(-3)) and observed a statistical interaction between SNPs in EVI5-RPL5 and HLA-DR15 (P = 0.001).

BoP and MNCs: where is the market and where the source of innovation?

ln 2004 Prahalad made managers aware of the great economic opportunity that the population at the BoP (Base of the Pyramid) could represent for business in the tom of new potential consumers. However, MNCs (Multi-National Corporations) have continued to fail in penetrating low income markets, arguably because applied strategies are often the same adopted at the top of the pyramid. Even in those few cases where products get re-envisioned, theie introduction in contexts of extreme poverty only induces new needs and develops new dependencies. At best the rearrangement of business models by MNCs has meant the realization of CSR (Corporate Social Responsibly) schemes that have validity from a marketing perspective, but still lack the crucial element of social embeddedness (London & Hart, 2004). Today the challenge is lo reach the lowest population tier with reinvented business models based on principles of value co-creation. Starting from a view of the potential consumer at the BoP as a ring of continuity in the value chain process – a resource that can itself produce value - this paper concludes proposing an alternative innovative approach to operate in developing markets that overturns the roles of MNCs and the BoP. The proposed perspective of ‘reversed' source of innovation and primary target market builds on two fundamental tenets: traditional knowledge is rich and greatly unexploded, and markets at the lop of the pyramid are saturated with unnecessary products / practices that have lost contact with the natural environment.

BoP and MNCs: where is the market and where the source of innovation?

ln 2004 Prahalad made managers aware of the great economic opportunity that the population at the BoP (Base of the Pyramid) could represent for business in the tom of new potential consumers. However, MNCs (Multi-National Corporations) have continued to fail in penetrating low income markets, arguably because applied strategies are often the same adopted at the top of the pyramid. Even in those few cases where products get re-envisioned, theie introduction in contexts of extreme poverty only induces new needs and develops new dependencies. At best the rearrangement of business models by MNCs has meant the realization of CSR (Corporate Social Responsibly) schemes that have validity from a marketing perspective, but still lack the crucial element of social embeddedness (London & Hart, 2004). Today the challenge is lo reach the lowest population tier with reinvented business models based on principles of value co-creation. Starting from a view of the potential consumer at the BoP as a ring of continuity in the value chain process – a resource that can itself produce value - this paper concludes proposing an alternative innovative approach to operate in developing markets that overturns the roles of MNCs and the BoP. The proposed perspective of ‘reversed' source of innovation and primary target market builds on two fundamental tenets: traditional knowledge is rich and greatly unexploded, and markets at the lop of the pyramid are saturated with unnecessary products / practices that have lost contact with the natural environment.

First measurements of source apportionment of organic aerosols in the Southern Hemisphere

An Aerodyne Aerosol Mass Spectrometer was deployed at five urban schools to examine spatial and temporal variability of organic aerosols (OA) and positive matrix factorization (PMF) used for the first time in the Southern Hemisphere to apportion the sources of the OA across an urban area. The sources identified included hydrocarbon-like OA (HOA), biomass burning OA (BBOA) and oxygenated OA (OOA). At all sites, the main source was OOA, which accounted for 62–73% of the total OA mass and was generally more oxidized compared to those reported in the Northern Hemisphere. This suggests that there are differences in aging processes or regional sources in the two hemispheres. Unlike HOA and BBOA, OOA demonstrated instructive temporal variations but not spatial variation across the urban area. Application of cluster analysis to the PMF-derived sources offered a simple and effective method for qualitative comparison of PMF sources that can be used in other studies.

Association of a polymorphism of the angiotensin I-converting enzyme gene with essential hypertension

A polymorphism of the angiotensin I converting enzyme (ACE) gene has recently been reported and analysis of this polymorphism has indicated that it is associated with several cardiovascular diseases. However, the results are still controversial and such association has not yet been established conclusively. To determine whether the ACE gene may be responsible for essential hypertension in a Japanese population, we also compared the distribution of genotypes and the allele frequency of this polymorphism in our findings of a Japanese population with these features in other countries. Eighty-seven hypertensive patients with a family history of essential hypertension and 95 normotensive patients whose parents had no such history were enrolled in the study. Polymorphism of the ACE gene was determined by using the polymerase chain reaction. Homozygotes for this polymorphism had either a 490-bp band (II) or a 190-bp band (DD) and heterozygotes had both bands (ID). In hypertensive subjects, the numbers and frequency of the ACE genotypes were: II, 44 (0.51); ID, 26 (0.30); DD, 17 (0.19). In normotensive subjects these were: II, 35 (0.37); ID, 43 (0.45); DD, 17 (0.18). There were no significant differences between the two groups in derived allele frequencies (chi 2 = 1.41). The difference between the overall allelic frequency in Japan and that reported in several other countries was significant. We did not find any association between ACE gene polymorphism and essential hypertension in Japan. However, there were significant differences in derived allele frequencies between our findings in a Japanese population and those reported from Europe and Australia.

Exploring the challenges to industrialized residential building in China

Industrialised building (IB) is considered by many to have an important role to play in China's residential construction industry due to its potential for improved quality, productivity, efficiency, safety and sustainability. It is surprising, therefore, that although a large number of construction programmes have been completed in the country in recent years, very few have been built in this manner. Quite why this situation exists is unknown. The well-known problems with IB, such as the constraints placed on designer freedom, may be the cause. It is equally possible that, as is typical with developing countries such as China, cost or government issues dominate. On the other hand, in comparison with other countries, the construction industry in China has been widely criticised for its lack of modernity. Either way, there is an urgent need to assess and understand the hindrances to the adoption of IB in residential construction in order to identify what corrective measures, if any, need to be taken. Towards this end, we first identify a set of critical factors (CFs) for assessing the hindrances to IB adoption in China. This involves the analysis of research data collected by a questionnaire survey of experienced housing developers and professionals working in China's construction industry sector. Fuzzy set theory is used in the selection of the CFs. These CFs comprise, in rank order: higher initial cost; lack of skilled labour in IB; manufacturing capability and involvement issues and product quality problems; lack of supply chain; lack of codes and standards; and lack of government incentives, directives and promotion. The establishment of the CFs provides a basis for local construction sectors to better equip themselves for future implementation of IB. The findings also indicate a current need for formulating improved policies and strategies to encourage the further development of IB in China at present.

Medical nutrition therapy and simple interventions can improve intake in patients who eat poorly in hospital

The Australasian Nutrition Care Day Survey (ANCDS) reported two-in-five patients in Australian and New Zealand hospitals consume ≤50% of the offered food. The ANCDS found a significant association between poor food intake and increased in-hospital mortality after controlling for confounders (nutritional status, age, disease type and severity)1. Evidence for the effectiveness of medical nutrition therapy (MNT) in hospital patients eating poorly is lacking. An exploratory study was conducted in respiratory, neurology and orthopaedic wards of an Australian hospital. At baseline, 24-hour food intake (0%, 25%, 50%, 75%, 100% of offered meals) was evaluated for patients hospitalised for ≥2 days and not under dietetic review. Patients consuming ≤50% of offered meals due to nutrition-impact symptoms were referred to ward dietitians for MNT with food intake re-evaluated on day-7. 184 patients were observed over four weeks. Sixty-two patients (34%) consumed ≤50% of the offered meals. Simple interventions (feeding/menu assistance, diet texture modifications) improved intake to ≥75% in 30 patients who did not require further MNT. Of the 32 patients referred for MNT, baseline and day-7 data were available for 20 patients (68±17years, 65% females, BMI: 22±5kg/m2, median energy, protein intake: 2250kJ, 25g respectively). On day-7, 17 participants (85%) demonstrated significantly higher consumption (4300kJ, 53g; p<0.01). Three participants demonstrated no improvement due to ongoing nutrition-impact symptoms. “Percentage food intake” was a quick tool to identify patients in whom simple interventions could enhance intake. MNT was associated with improved dietary intake in hospital patients. Further research is needed to establish a causal relationship.