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.

I sang Amazing Grace for about 3 hours that day : understanding Indigenous Australians’ experience of seclusion

Research shows that Indigenous Australians suspicion and fear of being ‘locked up’ may influence mental health service avoidance. Given this, the aim of this study was to explore, by qualitative analysis of in depth interviews (N = 3), how three Indigenous people experienced the controversial practice of seclusion Hans-Georg Gadamer’s phenomenology guided analysis of the material, and allowed narrated experiences to be understood within their cultural and historical context. Participants viewed seclusion negatively: police involvement in psychiatric care; perceptions of being punished and powerless; occasions of extreme use of force; and lack of care were prominent themes throughout the interviews. While power imbalances inherent in seclusion are problematic for all mental health clients, the distinguishing factor in the Indigenous clients’ experience is that seclusion is continuous with the discriminatory and degrading treatment by governments, police and health services that many Indigenous people have experienced since colonisation. The participants’ experiences echoed Goffman’s (1961) findings that institutional practices act to degrade and dehumanise clients whose resulting conformity eases the work of nursing staff. While some nurses perceive that seclusion reduces clients’ agitation (Meehan, Bergen & Fjeldsoe, 2004; Wynaden et al., 2001), one must ask at what cost to clients’ dignity, humanity and basic human rights.

Every One, Every Day

Creative Statement: “There are those who see Planet Earth as a gigantic living being, one that feeds and nurtures humanity and myriad other species – an entity that must be cared for. Then there are those who see it as a rock full of riches to be pilfered heedlessly in a short-term quest for over-abundance. This ‘cradle to grave’ mentality, it would seem, is taking its toll (unless you’re a virulent disbeliever in climate change). Why not, ask artists Priscilla Bracks and Gavin Sade, take a different approach? To this end they have set out on a near impossible task; to visualise the staggering quantity of carbon produced by Australia every year. Their eerie, glowing plastic cube resembles something straight out of Dr Who or The X Files. And, like the best science fiction, it has technical realities at its heart. Every One, Every Day tangibly illustrates our greenhouse gas output – its 27m3 volume is approximately the amount of green-house gas emitted per capita, daily. Every One, Every Dayis lit by an array of LED’s displaying light patterns representing energy use generated by data from the Australian Energy Market. Every One, Every Day was formed from recycled, polyethylene – used milk bottles – ‘lent’ to the artists by a Visy recycling facility. At the end of the Vivid Festival this plastic will be returned to Visy, where it will re-enter the stream of ‘technical nutrients.’ Could we make another world? One that emulates the continuing cycles of nature? One that uses our ‘technical nutrients’ such as plastic and steel in continual cycles, just like a deciduous tree dropping leaves to compost itself and keep it’s roots warm and moist?” (Ashleigh Crawford. Melbourne – April, 2013) Artistic Research Statement: The research focus of this work is on exploring how to represent complex statistics and data at a human scale, and how produce a work where a large percentage of the materials could be recycled. The surface of Every One, Every Day is clad in tiles made from polyethylene, from primarily recycled milk bottles, ‘lent’ to the artists by the Visy recycling facility in Sydney. The tiles will be returned to Visy for recycling. As such the work can be viewed as an intervention in the industrial ecology of polyethylene, and in the process demonstrates how to sustain cycles of technical materials – by taking the output of a recycling facility back to a manufacturer to produce usable materials. In terms of data visualisation, Every One, Every Day takes the form of a cube with a volume of 27 cubic meters. The annual per capita emissions figures for Australia are cited as ranging between 18 to 25 tons. Assuming the lower figure, 18tons per capital annually, the 27 cubic meters represents approximately one day per capita of CO2 emissions – where CO2 is a gas at 15C and 1 atmosphere of pressure. The work also explores real time data visualisation by using an array of 600 controllable LEDs inside the cube. Illumination patterns are derived from a real time data from the Australian Energy Market, using the dispatch interval price and demand graph for New South Wales. The two variables of demand and price are mapped to properties of the illumination - hue, brightness, movement, frequency etc. The research underpinning the project spanned industrial ecology to data visualization and public art practices. The result is that Every One, Every Day is one of the first public artworks that successfully bring together materials, physical form, and real time data representation in a unified whole.

[Book Review] Urban Maps : Instruments of Narrative and Interpretation in the City by Richard Brook and Nick Dunn, Ashgate, Farham, United Kingdom, 2011, 250pp. ISBN 978-0-754676-5-77.

Urban maps discusses new ways and tools to read and navigate the contemporary city. Each chapter investigates a possible approach to unravel the complexity of contemporary urban forms. Each tool is first defined, introducing its philosophical background, and is then discussed with case studies, showing its relevance for the navigation of the built environment. Urbanism classics such as the work of Lynch, Jacobs, Venuti and Scott-Brown, Lefebrve and Walter Benjamin are fundamental in setting the framework of the volume. In the introduction cities and mapping are first discussed, the former are illustrated as ‘a composite of invisible networks devoid of landmarks and overrun by nodes’ (p. 3), and ‘a series of unbounded spaces where mass production and mass consumption reproduce a standardised quasi-global culture’ (p. 6).

Creep and shrinkage of ultra lightweight cement composite

Creep and shrinkage behaviour of an ultra lightweight cement composite (ULCC) up to 450 days was evaluated in comparison with those of a normal weight aggregate concrete (NWAC) and a lightweight aggregate concrete (LWAC) with similar 28-day compressive strength. The ULCC is characterized by low density < 1500 kg/m3 and high compressive strength about 60 MPa. Autogenous shrinkage increased rapidly in the ULCC at early-age and almost 95% occurred prior to the start of creep test at 28 days. Hence, majority of shrinkage of the ULCC during creep test was drying shrinkage. Total shrinkage of the ULCC during the 450-day creep test was the lowest compared to the NWAC and LWAC. However, corresponding total creep in the ULCC was the highest with high proportion attributed to basic creep (≥ ~90%) and limited drying creep. The high creep of the ULCC is likely due to its low E-modulus. Specific creep of the ULCC was similar to that of the NWAC, but more than 80% higher than the LWAC. Creep coefficient of the ULCC was about 47% lower than that of the NWAC but about 18% higher than that of the LWAC. Among five creep models evaluated which tend to over-estimate the creep coefficient of the ULCC, EC2 model gives acceptable prediction within +25% deviations.

Review: "Stir" -- Stephen Wallace

Synopsis and review of the Australian prison film Stir (Stephen Wallace, 1980). Includes cast and credits. Stir was written by a former prisoner, Bob Jewson, who had witnessed first hand a notorious riot at Bathurst Gaol in New South Wales in February 1974, the second serious disturbance at the prison in four years. In 1979, prisoners at Parramatta Gaol staged a peaceful sit-in to protest against the New South Wales’ government’s decision not to pursue criminal charges against prison officers for their actions during the 1974 Bathurst riot. The bashing of China Jackson and his cellmate in the first scene of Stir follows a sit-in, with the rest of the film drawing heavily on events around the 1974 Bathurst riot. The director later claimed that he wanted to call the film ‘The Riot at Bathurst Prison’, but was persuaded by nervous bureaucrats to apply the veneer of fiction. The film was retitled Stir, and set in the fictional Gatunga Gaol. Like other films in this genre, Stir draws heavily on the experiences of former prisoners and warders. The Prisoners’ Action Group played a leading role in the planning and preparation of the film, and many former inmates and guards were employed as extras. And in common with many films in this genre, Stir is concerned to humanise the plight of prisoners. Through the depiction of the routines of punishment, violence and retribution by which order in the institution is maintained, and through careful evocation of the atmosphere of fear and intimidation that prisoners (and warders) live with every day, Stir, again like other films in this genre blames the authorities and the system itself for events like those portrayed here. As producer Richard Brennan says in an interview on the 2005 DVD release of the film, “prisons create monsters”...

Are we there yet? Early years reform in Queensland : stakeholder perspectives on the introduction of funded preschool programs in long day care services

Australian educators are currently engaging with wide-ranging, national early childhood reform that is reshaping early childhood education and care. The Australian reform agenda reflects many of the early childhood policy directions championed by bodies such as the Organisation for Economic Cooperation and Development and the United Nations Children's Education Fund, and is based on the dual discourse of (i) starting strong and (ii) investing in the early years. However, despite its traction in policy rhetoric and policy there is little empirical evidence of how reform is being played out. This paper reports on research undertaken in collaboration with the Queensland Office for Early Childhood Education and Care to generate sector feedback on one element of the reform agenda, the implementation of universal preschool in Queensland. The study aimed to determine the efficacy of the new policy in supporting the provision of 'approved preschool programs' within long day care services. Drawing together the views and experiences of a range of stakeholders, including peak organisations, service providers, directors, preschool teachers and government policy officers, it provides a situated case study of the implementation of universal preschool, and offers empirical evidence of how this policy is being played out at the local level. The paper identifies the opportunities and challenges in implementing universal preschool in Queensland that may have bearing on early childhood reform in Australia as well as other countries. Discussion of key findings is set within an overview of the ECEC policy agenda in Australia, with a particular focus on the commitment to universal preschool. Les éducateurs australiens s’engagent présentement dans une vaste réforme nationale de la petite enfance qui remodèle l'éducation et l’accueil de la petite enfance. Le programme de la réforme australienne reflète plusieurs des orientations en politique de la petite enfance soutenues par des organismes comme l'Organisation de coopération et de développement économiques (OCDE) et le Fonds des Nations Unies pour les enfants (UNICEF). Il s’appuie sur le double discours de (i) un bon départ et de (ii) l’investissement dans les premières années. Cependant, en dépit de son attrait en rhétorique de politique et en politique il y a peu de données empiriques sur la façon dont la réforme se déroule. Cet article rend compte de la recherche entreprise en collaboration avec le bureau de l'éducation et l’accueil à la petite enfance du Queensland afin d’obtenir une rétroaction du secteur sur un élément de la réforme, la mise sur pied du préscolaire universel dans le Queensland. L'étude visait à déterminer l'efficacité de la nouvelle politique pour soutenir la disposition «programmes préscolaires approuvés» dans les services de garde à temps plein. En regroupant les perspectives et les expériences d'une gamme d’intervenants, y compris d’importantes organisations, des prestataires de service, des directeurs, des enseignants du préscolaire et des fonctionnaires de politique gouvernementale, elle constitue une étude de cas localisée de l'exécution la mise sur pied du préscolaire universel, et fournit des données empiriques sur la façon dont cette politique se met en place au niveau local. L’article identifie les opportunités et les défis liés à l’implantation du préscolaire universel au Queensland, qui pourraient avoir une portée sur la réforme de petite enfance en Australie ainsi que dans d'autres pays. La discussion des principaux résultats est faite en lien avec un aperçu global de la politique d'éducation et d’accueil de la petite enfance en Australie, avec un accent particulier sur l'engagement envers le préscolaire universel. Los educadores australianos actualmente están involucrados en una amplia reforma de la educación temprana nacional que está revolucionando la educación preescolar y los servicios de cuidado. El programa de reforma Australiana refleja muchas de las direcciones políticas relacionadas con la infancia temprana incitadas por organismos como la Organización de Cooperación y Desarrollo Económicos y el Fondo Educacional Infantil de las Naciones Unidas, y se basa en el doble discurso de (i) empezando fuertemente e (ii) invertir en los primeros años. Sin embargo, a pesar de su política de tracción en retórica y política, hay pocos datos empíricos de cómo la reforma se está llevando a cabo. Este documento informa sobre las investigaciones llevadas a cabo en colaboración con la Oficina de Queensland de Educación tempana y cuidados, para generar comentarios del sector, sobre uno de los elementos de la agenda de reforma, la aplicación del preescolar universal en Queensland. El estudio tiene como objetivo determinar la eficacia de la nueva política para apoyar la prestación de "programas preescolares aprovados" dentro se los servicios de guardería y cuidado. Reuniendo los puntos de vista y las experiencias de una serie de interesados, entre ellos algunas organizaciones cumbre, proveedores de servicios, los directores, los maestros preescolares y oficiales de política y gobierno, se logra un estudio simulado de la implementación del preescolar universal, y ofrece evidencia empírica de cómo esta política se está llevando a cabo en el plano local. El documento identifica las oportunidades y desafíos en la implementación del preescolar universal en Queensland, que puede repercutir en la reforma de la indancia temprana en Australia, así como en otros países. La discusión de los resultados claves se encuentra en el interior de una visión de la agenda política de ECEC en Australia, con un enfoque particular en el compromiso con el preescolar universal.

Development and validation of a ultra performance LC-ESI/MS method for analysis of metabolic phenotypes of healthy men in day and night urine samples

Ultra-performance LC coupled to quadrupole TOF/MS (UPLC-QTOF/MS) in positive and negative ESI was developed and validated to analyze metabolite profiles for urine from healthy men during the day and at night. Data analysis using principal components analysis (PCA) revealed differences between metabolic phenotypes of urine in healthy men during the day and at night. Positive ions with mass-to-charge ratio (m/z) 310.24 (5.35 min), 286.24 (4.74 min) and 310.24 (5.63 min) were elevated in the urine from healthy men at night compared to that during the day. Negative ions elevated in day urine samples of healthy men included m/z 167.02 (0.66 min), 263.12 (2.55 min) and 191.03 (0.73 min), whilst ions m/z 212.01 (4.77 min) were at a lower concentration in urine of healthy men during the day compared to that at night. The ions m/z 212.01 (4.77 min), 191.03 (0.73 min) and 310.24 (5.35 min) preliminarily correspond to indoxyl sulfate, citric acid and N-acetylneuraminic acid, providing further support for an involvement of phenotypic difference in urine of healthy men in day and night samples, which may be associated with notably different activities of gut microbiota, velocity of tricarboxylic acid cycle and activity of sialic acid biosynthesis in healthy men as regulated by circadian rhythm of the mammalian bioclock.

Integrating early childhood teachers into long day care : building respectful relationships

Amongst the current reforms in early childhood in Australia is the requirement for four year university degree-qualified teachers to be employed to provide a kindergarten program for four-year-old children in the year prior to school entry. The possibility for long day care to provide a funded kindergarten program, with an early childhood teacher (ECT) presents a change for the field. With this change come challenges, though also opportunities to think in new and different ways about what long day care and working in long day care might look like.

Control, shift, insert : living and enacting policy in teachers' day/night work

This thesis investigates the experiences of teachers who trialled an electronic curriculum and assessment tool in the wider context of text-mediated ruling relations organising their work. Problematised as policy and text, this tool is interrogated as a 'solution' to problems perceived in teachers' work in an era of increased accountability. It provides evidence that teachers' work is shaped by forces operating outside their control and mediated by the policy discourses and subjectivities available to them.

Validating a novel, low cost, automated malnutrition screening system as a predictor of nutritional risk in the Oncology Day Care Unit

Background Cancer-related malnutrition is associated with increased morbidity, poorer tolerance of treatment, decreased quality of life, increased hospital admissions, and increased health care costs (Isenring et al., 2013). This study’s aim was to determine whether a novel, automated screening system was a useful tool for nutrition screening when compared against a full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA) tool. Methods A single site, observational, cross-sectional study was conducted in an outpatient oncology day care unit within a Queensland tertiary facility, with three hundred outpatients (51.7% male, mean age 58.6 ± 13.3 years). Eligibility criteria: ≥18 years, receiving anticancer treatment, able to provide written consent. Patients completed the Malnutrition Screening Tool (MST). Nutritional status was assessed using the PG-SGA. Data for the automated screening system was extracted from the pharmacy software program Charm. This included body mass index (BMI) and weight records dating back up to six months. Results The prevalence of malnutrition was 17%. Any weight loss over three to six weeks prior to the most recent weight record as identified by the automated screening system relative to malnutrition resulted in 56.52% sensitivity, 35.43% specificity, 13.68% positive predictive value, 81.82% negative predictive value. MST score 2 or greater was a stronger predictor of nutritional risk relative to PG-SGA classified malnutrition (70.59% sensitivity, 69.48% specificity, 32.14% positive predictive value, 92.02% negative predictive value). Conclusions Both the automated screening system and the MST fell short of the accepted professional standard for sensitivity (80%) or specificity (60%) when compared to the PG-SGA. However, although the MST remains a better predictor of malnutrition in this setting, uptake of this tool in the Oncology Day Care Unit remains challenging.

The incidence and predictors of lower limb split skin graft failure and primary closure dehiscence in day case surgical patients

This project was an observational study of outpatients following lower limb surgical procedures for removal of skin cancers. Findings highlight a previously unreported high surgical site failure rate. Results also identified four potential risk factors (increasing age, presence of leg pain, split skin graft and haematoma) which negatively impact on surgical site healing in this population.

Phase III study of matrix metalloproteinase inhibitor prinomastat in non-small-cell lung cancer

Purpose: Matrix metalloproteinases (MMPs) degrade extracellular proteins and facilitate tumor growth, invasion, metastasis, and angiogenesis. This trial was undertaken to determine the effect of prinomastat, an inhibitor of selected MMPs, on the survival of patients with advanced non-small-cell lung cancer (NSCLC), when given in combination with gemcitabine-cisplatin chemotherapy. Patients and Methods: Chemotherapy-naive patients were randomly assigned to receive prinomastat 15 mg or placebo twice daily orally continuously, in combination with gemcitabine 1,250 mg/m2 days 1 and 8 plus cisplatin 75 mg/m2 day 1, every 21 days for up to six cycles. The planned sample size was 420 patients. Results: Study results at an interim analysis and lack of efficacy in another phase III trial prompted early closure of this study. There were 362 patients randomized (181 on prinomastat and 181 on placebo). One hundred thirty-four patients had stage IIIB disease with T4 primary tumor, 193 had stage IV disease, and 34 had recurrent disease (one enrolled patient was ineligible with stage IIIA disease). Overall response rates for the two treatment arms were similar (27% for prinomastat v 26% for placebo; P = .81). There was no difference in overall survival or time to progression; for prinomastat versus placebo patients, the median overall survival times were 11.5 versus 10.8 months (P = .82), 1-year survival rates were 43% v 38% (P = .45), and progression-free survival times were 6.1 v 5.5 months (P = .11), respectively. The toxicities of prinomastat were arthralgia, stiffness, and joint swelling. Treatment interruption was required in 38% of prinomastat patients and 12% of placebo patients. Conclusion: Prinomastat does not improve the outcome of chemotherapy in advanced NSCLC. © 2005 by American Society of Clinical Oncology.

Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma

Background: There is currently no early predictive marker of survival for patients receiving chemotherapy for malignant pleural mesothelioma (MPM). Tumour response may be predictive for overall survival (OS), though this has not been explored. We have thus undertaken a combined-analysis of OS, from a 42 day landmark, of 526 patients receiving systemic therapy for MPM. We also validate published progression-free survival rates (PFSRs) and a progression-free survival (PFS) prognostic-index model. Methods: Analyses included nine MPM clinical trials incorporating six European Organisation for Research and Treatment of Cancer (EORTC) studies. Analysis of OS from landmark (from day 42 post-treatment) was considered regarding tumour response. PFSR analysis data included six non-EORTC MPM clinical trials. Prognostic index validation was performed on one non-EORTC data-set, with available survival data. Results: Median OS, from landmark, of patients with partial response (PR) was 12·8 months, stable disease (SD), 9·4 months and progressive disease (PD), 3·4 months. Both PR and SD were associated with longer OS from landmark compared with disease progression (both p < 0·0001). PFSRs for platinum-based combination therapies were consistent with published significant clinical activity ranges. Effective separation between PFS and OS curves provided a validation of the EORTC prognostic model, based on histology, stage and performance status. Conclusion: Response to chemotherapy is associated with significantly longer OS from landmark in patients with MPM. © 2012 Elsevier Ltd. All rights reserved.

Towards an authentically assessed science curriculum

The intentions of the science curriculum are very often constrained by the forms of student learning that are required by, or are currently available within, the system of education. Furthermore, little attention is given to developing new approaches to assessment that would encourage these good intentions. In this chapter, we argue that achieving this broadening of the intentions of science education will require a diversity of assessment techniques and that only a profile of each student’s achievement will capture the range of intended learnings. We explore a variety of assessment modes that match some of these new aspects of science learning and that also provide students with both formative information and a more comprehensive and authentic summative profile of their performances. Our discussion is illustrated with research-based examples of assessment practice in relation to three aspects of science education that are increasingly referred to in curriculum statements as desirable human dimensions of science: context-based science education, decision-making processes and socioscientific issues and integrated science education. We conclude with some notes on what these broader kinds of assessment mean for teachers and the support they would need to include them in their day-to-day practices in the science classrooms if, and when, the mainstream of science teaching and learning takes these curricular intentions seriously.