More than 3,000 malnutrition inpatients in 46 NHS foundation trusts in 2014; how to manage the health conditions of inpatients?

DSC_0537 (2) There were 3,324 malnourished inpatients in NHS hospitals managed by 46 foundation trusts in 2014. Figures have been increasing due to the increase of inpatients since 2011, and more than 40% of malnourished inpatients were in Gateshead NHS foundation trust. Figures were obtained by FOI requests from 46 trusts in England. 

In 2013, the average percentage of malnourished inpatients in 46 trusts was below 0.1%, and it had slightly increased from 2011. The proportion of malnutrition inpatients was lower than 1% in 43 trusts in 2013, but have increased in 25 trusts in comparison with the previous year.

Total number of 46 NHS foundation trusts

Year Average percentage of malnourished inpatients Total number of malnourished inpatients Total number of inpatients
2011 0.07 2,627 3,554,409
2012 0.08 2,813 3,612,338
2013 0.08 3,102 3,710,775
2014 3,324

In three trusts, the percentage of malnourished inpatients was over 2% in 2013, and highest in Gateshead Health NHS foundation trust at 2.19%.

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How many malnutrition inpatients in your local NHS foundation trusts?

Trusts with the highest percentage o malnourished patients in 2013

NHS foundation trust Percentage of malnourished inpatients Number of malnourished inpatients Number of inpatients
Gateshead Health NHS Foundation Trust 2.18 1,310 59,970
Cheshire and Wirral Partnership NHS Foundation Trust 2.15 55 2,559
Sheffield Health & Social Care NHS Foundation Trust 2.01 20 993
Yeovil District Hospital NHS Foundation Trust 0.42 169 40,265
Salford Royal NHS Foundation Trust 0.18 147 80,856

an aging POPULATION AND MENTAL PROBLEMs POSSIBLY AFFECT THE NUMBER OF MALNourished INPATIENTS

Are there any particular reasons why trusts have many malnourished inpatients? Kerri James, communications officer of QE Gateshead said;

“At the Queen Elizabeth Hospital we have two older person’s mental health inpatient wards and also two general older persons ward. Malnutrition is something that generally occurs in an older population, and as a lot of our inpatients fall into this category. It’s natural that would be reflected in a higher number”.

“Many patients come into hospital already malnourished which would need to be taken into account for these figures”.

“People with mental health problems are often at higher risk of malnutrition as they are unable to care for themselves properly at home, so are malnourished when they come to us, we have two older person’s mental health inpatient wards”.

BAPEN (British Association for Parenteral and Enteral Nutrition), released a result of a nutrition screening survey in the UK in 2014. According to the report, the prevalence of malnutrition becomes more likely in elderly people.

In Gateshead, the food budget has been increasing since 2012, and inpatients are served a meal three times daily (breakfast, lunch and tea) plus snacks for the last five years.

Year Percentage of malnourished inpatients Number of malnourished inpatients Number of inpatients Annual budget for foods for inpatients(£)
2010 2.04 970 47,596
2011 1.85 1,071 57,903 647,506
2012 1.80 1,033 57,462 598,155
2013 2.18 1,310 59,970 758,188
2014 1,362 767,868

Also, Jane Harris, communications manager of Sheffield Health & Social Care NHS Foundation Trust, explains their situation;

“We are a mental health and social care Trust. Therefore, the patients admitted into our hospitals and in-patient services are people who are experiencing a significant deterioration in their mental health and well-being or who have been diagnosed with dementia or who have a learning disability”.

“The nature of their illnesses or diagnosis may mean that they have not been regularly eating and/or drinking prior to admission”.

Food education is more important to improve the nutritional health of inpatients

According to the UK government, the average food cost per inpatient per day was £10.48 in 2013, this had increased by £0.61 from the previous year. However, the average percentage of malnourished inpatients had not decreased.

Nigel Penny, Senior Lecturer in Applied Nutrition and Physiology at Birmingham City University, said that food costs do not necessarily influence the number of malnourished inpatients.

“The catering provisions used to be outsourced. The reason of malnutrition of inpatients is more about education about what is a balanced and healthy meal”.

“Nutrition specialists should be involved with choosing the right foods for each inpatient. In the long term, choosing the right foods can prevent illnesses and reduce the costs of the NHS”.

Foundation trusts in the UK have financial problems. 77 NHS foundation trusts of 152 in England are in deficit, and the overall net deficit was £349 million in 2014, the latest statistics of the UK government have shown.

In 2013, the surplus was £126 million, and the financial situation is rapidly declining from the previous year.

how to manage the nutritious conditions of inpatients properly?

In this situation, the Queen Elizabeth Hospital focuses on care for the elderly by using a picture menu. James said;

“We have lots of initiatives such as easy to use crockery and drinks containers, and also patients who need extra help at mealtimes and with drinking are giving red crockery so that anyone involved in their care knows”.

“Our catering department has also a created a picture menu to aid with keeping people well fed, as research found people, particularly with mental health problems like dementia, responded much better to a pictorial menu”.

Harris also explained the efforts by Sheffield Health & Social Care NHS Foundation Trust;

“We have introduced an electronic based version of the malnutrition universal screening tool (MUST) and associated training is in place across most of the in-patient areas and we have reviewed our weight management care pathway during the past year”.

“We have improved the quality of diet available and the experience of dining within residential services. Advice on diet is being made readily available including improved methods for measuring and recording hydration of vulnerable individuals”.

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More than 3,000 malnutrition inpatients in 46 NHS foundation trusts in 2014; how to manage the health conditions of inpatients?

“Global food security is not an issue of production, but access” – expert says

The global population is continually increasing. According to Food and Agriculture Organization of the United Nations (FAO), the global population was 7,162 million in 2012, nearly 30% larger than 1990. Can humans produce enough food in the future? When asked what is the most serious problem associated with global food security? James Dyke, a Lecturer at University of Southampton, said;

“That 1 billion people are obese while 800 million people are malnourished. Global food security is not an issue of production, but access“.

According to FAO, the number of people undernourished has decreased slightly since the 1990’s, but over 10% of people in the world are still undernourished today.

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The number of people undernourished has decreased slightly since the 1990’s.

There is a gap in food security by country. The global food security index 2014 have revealed that the index is still low especially in some African countries. This index, released by the Economist Intelligence Unit, analyses the food security by using 4 elements; affordability, availability, quality and safety, and background variables. Why is the index still low in some countries? Dyke said;

“In order to be food secure, one must be able to access food (you must be able to afford it and get to where it is being sold) and then utilise it (cook or prepare it). Significant numbers of people are not secure in these respects. There are multiple reasons for this. It is not because the world cannot grow enough food“.

food
Global food security index in 2014
Top 10 Bottom 10
United states 89.6 Congo (Dem. Rep.) 27.1
Netherlands 86.1 Chad 28.8
Austria 85.1 Togo 28.9
Ireland 84.8 Madagascar 30.4
France 84.6 Mozambique 31.4
Canada 84.3 Tanzania 31.8
New Zealand 84.2 Burkina Faso 33.4
Denmark 83.9 Guinea 33.7
Germany 83.9 Haiti 33.9
Singapore 83.8 Sudan 34.3

more middle class mouths that will want to eat “western type diets”

Regarding the concern on the future of global food security, Dyke pointed out that the increase of consumption of animal protein. He said;

“The greatest cause of concern for future food security, is not more mouths to feed, but more middle class mouths that will want to eat “western type diets” that involve higher proportions of meat and diary“.

The consumption of animal protein has been increased nearly 30% from 1990 to 2009 in the world, while the share of dietary energy supply derived from cereals, roots and tubers had been decreased by 10%. China and India have a large population, but the average of consumption of animal protein is not high in these 2 countries so far.

  • X axis, color of circles; Average supply of protein of animal origin(gr/caput/day)
  • Y axis; Share of dietary energy supply derived from cereals, roots and tubers(%)
  • Size of circles; GDP per capita (in purchasing power equivalent, $)

The demand for increasing amounts of animal protein has led the FAO to suggest that eating more insects might improve global food security. According to the FAO website, edible insects are full of high quality protein and vitamins that are beneficial to humans. Compared to more traditional sources of animal protein (such as livestock and poultry) they also have a high food conversion. FAO released a short video on the subject.

“Global food security is not an issue of production, but access” – expert says

“Beyond technical skills it is most important to understand the true nature of the data sources used” – New media incubator in US

Stephen Larson, founder and CEO of www.our-hometown.com, talked about their online tools to be useful for journalists.

Could you explain your current position and activities briefly?

“I’m founder and CEO of http://www.our-hometown.com a software development firm specializing in web based news media. Our legacy business is content management systems, primarily in the US. Our new products include map and sidebar widgets that enhance content using natural language processing and machine learning. In addition, we provide research tools for journalists and readers”.

How do you find data for your works? 

“In our case we are creating our own data from our client’s news stories by using natural language processing to identify proper names (aka named entities) in the stories and storing information about them in our database. The three primary tables are:

  • a named entity table who’s key is the named entity;
  • a story table who’s key is the URL of the story; and
  • a table who’s key is the combination of  both named entity and URL, capturing both all the stories a given named entity appears in and all the named entities in a given story.

In the named entity table we store the type of entity it is: a person, organization, place, event, award, holiday or other named period of time. For places, we store the longitude and latitude. The story table has the date and time the story was published”.

How to find stories from data?

“We find stories for any given location with our www.newsbayou.com interface. Both location and publication date/time are used to order the stories in the default mode but there also are buttons to view a map where all stories are listed regardless of publication date and one to view more recent stories from a wider area”.

Could you tell me your best work?

“We created a map widget that automatically displays the locations mentioned for any given story. We have quite a few news websites with these maps embedded in every story. It’s described further here: www.pointsmentioned.com.

We also have a, soon to be released, feature that uses the database to add a sidebar to any given story for any named entity, typically one mentioned in the story. The sidebar feature that excites me the most is a kind of word cloud but instead of words, it’s named entities. Other features are a list of other stories that mention the named entity and a clickable timeline of stories that mention the named entity.

Future releases will list related stories based on the frequency of the occurrences of the named entities in the given story and those of other stories”.

What is the most notable feature of the work?

“As far as I can tell, it’s the largest operating real time database of stories indexed as described above. We index 3 million plus stories and over 1 million unique named entities. Thousands of stories are added daily”.

What do you think about the most important skills, knowledge, and attitudes for data journalists to create good pieces?

“Beyond technical skills it is most important to understand the true nature of the data sources used.  Just realize that all databases have varying degrees of accuracy but none are truly perfect”.

“Beyond technical skills it is most important to understand the true nature of the data sources used” – New media incubator in US

Interview with 4 journalists – what are the important things for creating good data journalism works?

As a part of my study, I subscribed a mailing list “data-driven-journalism — List about Data Driven Journalism and Open Data in Journalism“. I asked some questions on data journalism for members of this mailing list, then 4 people kindly answered my questions. I would like to introduce their experiences and opinions on data journalism. Their works describe social issues and problems by using data analyse and visualisation techniques effectively.

Adrián Blanco participated the data journalism project about the berlin wall

Adrián Blanco works as a freelance on data journalism. He tries to go deeper learning to code.

Question 1. How do you find data for your works? And how to find stories from data?

“I use open data portals like data.gov.uk in UK or data from public sources. I have also worked creating own data sets with information and data from press releases, etc”.

Question 2. Could you tell me your best work of data journalism? What is the most noticeable feature of the work?

“This one about the Berlin Wall (written in Spanish), produced when I worked as an intern for RTVE (the Spanish public broadcasting media) is one of the most complete I’ve done. I worked on a multidisplinary team to produce this project.

During the 28 years that the Wall divided Berlin in two sides, 138 people died trying to cross it; 121 men, 8 women and 9 children. This interactive project, made for the 25th anniversary of the fall of the Wall shows who these people were and how they died. The data was extracted from Berlin Wall Memorial museum and from Destatis, the Federal Statistical Office.

The noticeable feature I think is that tells the story of an obscure period in Germany with human beings and in an easy and charm way”.

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Data journalism work about the Berlin Wall

Question 3. What do you think about the most important skills, knowledge, and attitudes for data journalists to create good pieces?

“As a junior data journalist, I think the most important skill or attitude is to be open minded and learn everyday something new”.

Aleksandra Dukovska combined movies, pictures and data on air pollution issues

Aleksandra Dukovska, a multimedia journalist, used Google spreadsheet and Excel for some stories.

Question 1. How do you find data for your works? And how to find stories from data?

“When I made some stories with data, I used data that are already available on the official institutions. For example, I used data of the Ministry of Ecology on air quality, or data from State Statistical Office in Macedonia. In other case, I think I used data of OECD. I am using publicly available data”.

Question 2. Could you tell me your best work of data journalism? What is the most noticeable feature of the work?

“I was doing some video about air pollution and I combined that online with data about air quality and measurement to illustrate the difference in days and periods”.

Question 3. What do you think about the most important skills, knowledge, and attitudes for data journalists to create good pieces?

“In digital environment, every skill is valuable in computer assisted reporting”.

Andrea Nelson Mauro’s team discovered that more than 23,000 migrants are died during they was trying to reach EU

Andrea Nelson Mauro is a founder of Dataninja.it, an award winning Italian Data journalism Network. They are active since 2012 and the team is composed by 7 members (data journalist, data scientist, geo-nerd, data-researchers, social data analyst). They are developing national and cross-border investigations regarding hot topics.
For istance:
#MigrantsFiles: Awarded with Data Journalism Award in 2014
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MigrantsFiles
ConfiscatiBene.it: Focused on assets confiscated from the mafia in Italy and Europe. They are working for Italian and international newspapers.

Question 1. How do you find data for your works? And how to find stories from data?

“From online open sources, institutions. You may find stories by analyzing data sets in different ways, but the most important thing is to build a new data set by merging different data from different sources (obviously it needs a methodology and should be clear to the readers when you publish your articles)”.
Question 2. Could you tell me your best work of data journalism? What is the most noticeable feature of the work?
#MigrantsFiles: we’ve worked with Journalism++ – a French/Deutsch data journalism agency leaded by Nicolas Kayser Bril – and other freelance journalists from EU. We’ve discovered that more than 23,000 migrants are died during they was trying to reach EU. No one did count this phenomenon before”.
Question 3. What do you think about the most important skills, knowledge, and attitudes for data journalists to create good pieces?
“The better way is (imho): working in team with different skills – for instance, take a look to the skills of dataninja’s team members – being open and share a data, information and news with other journalist, being clean with methodology to give a kind of transparency”.

Michael Bauer produced a data journalism work on the election reform in Austria

Michael Bauer is a data journalists at derStandard.at, a national newspaper in Austria. He is researching stories and producing tons of hand-knit interactives.

Question 1. How do you find data for your works? And how to find stories from data?

“We do have data sources for the regular occurring stories we write. These might be transparency databases, the statistical office and reports published. The latter unfortunately mostly come in PDF but Tabula helps a great deal. Finding stories is a lot of analyzing. But most of the time you get to data with a story in mind. Often we are approached by colleagues who found an interesting story somewhere but need help teasing it out”.

Question 2. Could you tell me your best work of data journalism? What is the most noticeable feature of the work?

“My best work is still to come (I am working on a larger project). One thing I am happy about was a piece on election reform we did. The city of Vienna was debating election reform and the debate was led and communicated in an uneducated manner. We looked at the proposals and worked out what difference they made. Showing there is little difference to be expected of the reform”.

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A piece on election reform

Question 3. What do you think about the most important skills, knowledge, and attitudes for data journalists to create good pieces?

“Curiosity. Curiosity. And trying to be a critic to stuff you see. All technology can be learned”.

Interview with 4 journalists – what are the important things for creating good data journalism works?

Many knowledge on data journalism shared at media conference in US

IRE, a non-profit organization for investigative reporting, has a program called “NICAR“. NICAR particularly focuses on data journalism, and held a media conference in 5-8 march in Atlanta. Many knowledge of data journalism were shared during this term. An interview article and many presentation materials are still available in the internet.

Eva Constantaras, an American investigative data journalist, talked about her experiences and opinions on data journalism.

Mar Cabra, an editor of ICIJ, explained the method of data driven investigative journalism. She introduced a case on tax dodge of the major multinational companies, and explained how ICIJ obtain the material data on the incident.

Michael Corey, senior news applications developer for Reveal, talked about his project to detect environmental dangers in the US by analysing data.

Some people referred to technical aspects. Tisha Thompson introduced typical coding skills for data journalism. She also referred to R, a free software for data analysis.

Natalia Mazotte, introduced some online tools for data visualisation such as Timeline.js, Odyssey.js, Datawrapper, etc.

You can find materials here, and find more information on Twitter by searching with the hushtag #NICAR15.

Many knowledge on data journalism shared at media conference in US

Making a simple database of smoking rates in Britain – Practice of Javascript

Javascript enables us to make interactive contents in various ways. I obtained a data of smoking rates in Britain and created a Javascript. Users can find the rates of each region by using select box. I used a stat showing smoking rate in 2013 released by The Office for National Statistics.

1. I used switch statement to select regions as follows. “onButtonClick” defines the process when users press the button on the screen.

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2. I put the smoking rates below the switch statement, and set the names of regions correspond to each figure.

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3. Users can select regions from the list, and can find the
figures.

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Choose the name of region, and press “Exec”
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The smoking rate is displayed.

Source code is as follows.

<!DOCTYPE html>

<html>
<head>
<h1>Smoking rate in Britain by region</h1>
<script type=”text/javascript”>
function onButtonClick() {
index = document.form1.Select1.selectedIndex;
target = document.getElementById(“output”);
switch (index) {
case 0:
target.innerHTML = “22.3%<br/>”;
break;
case 1:
target.innerHTML = “20.1%<br/>”;
break;
case 2:
target.innerHTML = “20.3%<br/>”;
break;
case 3:
target.innerHTML = “19.1%<br/>”;
break;
case 4:
target.innerHTML = “17.8%<br/>”;
break;
case 5:
target.innerHTML = “17.5%<br/>”;
break;
case 6:
target.innerHTML = “17.3%<br/>”;
break;
case 7:
target.innerHTML = “17.2%<br/>”;
break;
case 8:
target.innerHTML = “17.3%<br/>”;
break;
case 9:
target.innerHTML = “19.8%<br/>”;
break;
case 10:
target.innerHTML = “21.1%<br/>”;
break;
}
}
</script>
</head>
<body>
<form name=”form1″ action=””>
<select id=”Select1″”>
<option>North East</option>
<option>North West</option>
<option>Yorkshire and The Humber</option>
<option>East Midlands</option>
<option>West Midlands</option>
<option>East of England</option>
<option>London</option>
<option>South East</option>
<option>South West</option>
<option>Wales</option>
<option>Scotland</option>
</select>

<input type=”button” value=”Exec” onclick=”onButtonClick();”/>
</form>
<div>smoking rate is</div>
<div id=”output”></div>
</body>
</html>

Making a simple database of smoking rates in Britain – Practice of Javascript

Analysing the relationship between smoking rates and life expectancy in England – Practice of correlation analysis by using R

As I mentioned in my previous post, R is a great tool for statistical analysis. Quantitative analysis is essential for data journalism, and this kind of tool is helpful. In this tern, I demonstrated how to use R by analysing the relationship between smoking rates and life expectancy in England.

1. Obtaining data

I downloaded the relevant data from the Office for National Statistics. I picked up 2 data sets showing smoking rate in 2013, and life expectancy (2011-2013), and merged them. I also converted the excel file into a CSV file.

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I picked up and arranged relevant data.

2. Importing data into R

Then, I imported the CSV file into R.

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Displayed first 6 lines by using “head”.

3. Analysing data

Users can analyse the imported data in various ways. For example, R can show the largest or smallest figure by using “summary”.

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R can show the summary of data.

Also, users can calculate a correlation coefficient by using “cor.test”. Correlation coefficient shows the similarity of 2 different variables by using the number between -1 to 1. If a correlation coefficient is close to -1, variables have negative correlation. In this case, the correlation coefficient is -0.8718264, so the smoking rates is inversely proportional to the life expectancy.

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Users can draw a distribution map and a regression line showing the relationship between 2 variables.

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Users can select colors of line.
Analysing the relationship between smoking rates and life expectancy in England – Practice of correlation analysis by using R