Aim
Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric
A
ustralian hospitals. The current study is the first to measure the prevalence of ...malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout
A
ustralia.
Methods
Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across
A
ustralia on a single day. Malnutrition and obesity prevalence was determined using
z
‐scores and body mass index (
BMI
) percentiles. High nutritional risk was determined as a
P
aediatric
Y
orkhill
M
alnutrition
S
core of 2 or more.
Results
The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as
A
boriginal and
T
orres
S
trait
I
slander were more likely to have lower height‐for‐age
z
‐scores (
P
< 0.01); however,
BMI
and weight‐for‐age
z
‐scores were not significantly different. Children who were younger, from regional hospitals or with a primary diagnosis of cardiac disease or cystic fibrosis had significantly lower anthropometric
z
‐scores (
P
= 0.05). Forty‐four per cent of patients were identified as at high nutritional risk and requiring further nutritional assessment.
Conclusions
The prevalence of malnutrition and nutritional risk of
A
ustralian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less.
We investigated the visual scanning strategy employed by a group of individuals with a severe traumatic brain injury (TBI) during a facial affect recognition task. Four males with a severe TBI were ...matched for age and gender with 4 healthy controls. Eye movements were recorded while pictures of static emotional faces were viewed (i.e., sad, happy, angry, disgusted, anxious, surprised). Groups were compared with respect to accuracy in labelling the emotional facial expression, reaction time, number and duration of fixations to internal (i.e., eyes + nose + mouth), and external (i.e., all remaining) regions of the stimulus. TBI participants demonstrated significantly reduced accuracy and increased latency in facial affect recognition. Further, they demonstrated no significant difference in the number or duration of fixations to internal versus external facial regions. Control participants, however, fixated more frequently and for longer periods of time upon internal facial features. Impaired visual scanning can contribute to inaccurate interpretation of facial expression and this can disrupt interpersonal communication. The scanning strategy demonstrated by our TBI group appears more ‘widespread’ than that employed by their normal counterparts. Further work is required to elucidate the nature of the scanning strategy used and its potential variance in TBI.
Although high-dose chemotherapy supported by autologous peripheral-blood progenitor-cell (PBPC) transplantation improves response rates and survival for patients with multiple myeloma, all patients ...eventually develop progressive disease after transplantation. It has been hypothesized that depletion of malignant plasma cells from autografts may improve outcome by reducing infused cells contributing to relapse.
A randomized phase III study using the CEPRATE SC System (Cellpro, Bothell, WA) to enrich CD34(+) autograft cells and passively purge malignant plasma cells was completed in 190 myeloma patients randomized to receive an autograft of CD34-selected or unselected PBPCs.
After CD34 selection, tumor burden was reduced by 1.6 to 6.0 logs (median, 3.1), with 54% of CD34-enriched products having no detectable tumor. Median time to count recovery, number of transfusions, transplantation-related mortality, and days in hospital were equivalent between the two transplantation arms. With a median follow-up of 37 months, 33 patients (36%) in the selected and 34 patients (35%) in the unselected arm had died (P =.784). Median overall survival in the selected arm was reached at 50 months and is not reached at this time in the unselected arm (P =.78). Median disease-free survival was 100 versus 104 weeks (P =.82), with 67% of patients in the selected arm and 66% of patients in the unselected arm relapsing.
This phase III trial demonstrates that although CD34 selection significantly reduces myeloma cell contamination in PBPC collections, no improvement in disease-free or overall survival was achieved.
This handbook shows how local police organizations in the United States have been the focus of reform efforts, especially due to a new crisis in the policing environment—terrorism. The problem of ...terrorism has raised a host of questions about how police should respond to this new threat, and this handbook aims to address these questions. It also discusses the social ill that is the drug market, which is often associated with violence and often occurs in disadvantaged urban communities. Alternative approaches are presented that can be used to address drug crime in these areas, such as problem-oriented policing, which calls for the identification of recurring crime problems; order maintenance policing, which defines and regulates the fair use of public spaces; and community policing, which is considered “a philosophy, not a program.” The rise of zero-tolerance policies in policing has shifted the focus from the problem-solving model to aggressive order-maintenance enforcement. This has led to a call for anti-authoritarian policing; police are urged to use discretion to support their own longstanding institutional interest in plural governance.
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