Measurement of energy expenditure of daily tasks among mothers of young children

There is currently some debate about whether the energy expenditure of domestic tasks is sufficient to confer health benefits. The aim of this study was therefore to measure the energy cost of five activities commonly undertaken by mothers of young children. Seven women with at least one child younger than five years of age spent 15 minutes in each of the following activities: sitting quietly, vacuum cleaning, washing windows, walking at moderate pace (approx 5km/hour), walking with a stroller and grocery shopping in a super-market. Each of the six 'trials' was completed on the same day, in random order. A carefully calibrated portable gas analyser was used to measure oxygen uptake during each activity, and data were converted to units of energy expenditure (METS). Vacuum cleaning, washing windows and walking with and without a stroller were found to be 'moderate intensity activities' (3 to 6 METs), but supermarket shopping did not reach this criterion. The MET values for these activities were similar to those reported in the Compendium of Physical Activities (Ainsworth et al., 2000). However, the energy expenditures of walking, both with and without a stroller, were higher than those reported in the Compendium. The findings suggest that some of the tasks associated with domestic caring duties are conducted at an intensity which is sufficient to confer some health benefit. Such benefits will only accrue however if the daily duration of these activities is sufficient to meet current guidelines.

The pharmacokinetics of once-daily dosing of ceftriaxone in critically ill patients

The aim of this study was to determine the pharmacokinetic profile of the normal recommended dose of ceftriaxone in critically ill patients and to establish whether the current daily dosing recommendation maintains plasma concentrations adequate for antibacterial efficacy. Ceftriaxone at a recommended dose of 2 g iv was administered od to 12 critically ill patients with severe sepsis and normal serum creatinine concentrations. Blood samples were taken at predetermined intervals over the first 24 h and on day 3 for measurement of ceftriaxone concentrations. There was wide variability in drug disposition, explained by the presence of variable renal function and identified by the measurement of creatinine clearance. In nine patients with normal renal function, there was a high level of creatinine clearance(mean +/- S.D., 41 +/- 12 mL/min) and volume of distribution (20 +/- 3.3 L), which resulted in an elimination half-life of 6.4 +/- 1.1 h. In comparison with normal subjects, ceftriaxone clearance was increased 100%, volume of distribution increased 90% and the elimination half-life was similar. Three patients had substantially suboptimal plasma ceftriaxone concentrations. We confirm previous findings that ceftriaxone clearance in critically ill patients correlates with renal clearance by glomerular filtration. The elimination half-life is prolonged (21.4 +/- 9.8 h) in critically ill patients with renal failure when compared with previously published data in non-critically ill patients with renal failure. We conclude that in critically ill patients with normal renal function, inadequate plasma concentrations may result following od bolus dosing of ceftriaxone. Drug accumulation may occur in critically ill patients with renal failure.

The potential of telemedicine for home nursing in Queensland

The potential for telemedicine in home nursing was examined by retrospectively reviewing the case-notes relating to home visits made by nurses in Queensland. The case-notes of 166 clients were randomly selected from 10 domiciliary nursing centres run by the Blue Care nursing organization in south-east Queensland. Two experienced community registered nurses independently undertook a retrospective review of the case-notes. Each reviewer made an independent judgement as to whether any of the home nursing visits in the episode of care could have been conducted by telemedicine. Visits requiring hands-on care were deemed to be unsuitable for telemedicine. A total of 12,630 home visits were reviewed. The median number of visits per client was 27 (range 1-722). The mean age of the clients was 72 years (range 2-93 years). A total of 1521 home visits (12%) were judged suitable for telemedicine. There was no significant difference in suitability between males (13%) and females (12%). Care interventions suitable for telemedicine were more likely to be those of a supportive, educational or review nature. Forty per cent of clients lived up to 5 km from the home nursing centre, 33% lived 5-10 km from the centre and 27% lived over 10 km from the centre. The results of the present study confirm the potential for telemedicine in home nursing in Australia.

Nocturnal activity in the green sea turtle alters daily profiles of melatonin and corticosterone

In nature, green turtles (Chelonia mydas) can exhibit nocturnal activity in addition to their typically diurnal activity cycle. We examined whether nocturnal activity in captive and free-living green turtles altered daily plasma profiles of melatonin (MEL) and corticosterone (CORT). In captivity, diurnally active green turtles expressed distinct diel cycles in MEL and CORT; a nocturnal rise was observed in MEL and a diurnal rise was observed in CORT. However, when induced to perform both low- and high-intensity nocturnal activity, captive green turtles exhibited a significant decrease in MEL, compared to inactive controls. In contrast, plasma CORT increased significantly with nocturnal activity, and further, the relative increase in CORT was correlated with the intensity of the nocturnal behavior. In free-living green turtles that performed nocturnal activity including: nesting, mate searching, and feeding/swimming behaviors, plasma profiles in MEL and CORT exhibited relatively little, or no, daily fluctuation. Our findings demonstrate that nocturnal activity in green turtles is often associated with MEL and CORT profiles that resemble those measured during the day. We speculate that these conspicuous changes in MEL and CORT during nocturnal activity could either support or promote behaviors that enable acquisition of transient resources important to the survival and reproductive success of green turtles. (C) 2002 Elsevier Science (USA).

Total Daily Energy Expenditure and Incidence of Upper Respiratory Tract Infection Symptoms in Young Females

A group of 31 young females, tennis players and non-athletes, aged 16 2 years (range: 14 - 21 years), with a wide range of physical activity levels was used to investigate the relationship between total daily energy expenditure and the incidence of upper respiratory tract infection symptoms. Methods: During a 12 week winter period, habitual daily activity (excluding training) was evaluated using a 3-day physical activity record. Tennis training was quantified using a validated method of estimating energy expenditure during play. Total daily energy expenditure was calculated from the sum of daily training plus mean habitual daily activity energy expenditures. The total group of subjects was divided in quartiles for total daily energy expenditure. A validated symptom checklist was used to assess the incidence and severity of upper respiratory tract infections, on a daily basis. Results: The girls in the highest quartile of total daily energy expenditure (greater than or equal to 17322 kJ/day) and in the lowest quartile (less than or equal to 10 047 kJ/day) had the greatest incidence of URTI symptomatology, although the moderately active girls in quartile three (12290-16410 kJ/day) presented the lowest incidence. Significant differences in number of upper respiratory tract infection episodes, sickness days and symptomatology index were found between quartiles three and one (p < 0.05) and quartiles three and four (p < 0.01). Peak severity of symptoms was significantly lower in quartile three compared with all other quartiles (p < 0.05).

Effects of paternal drinking, conduct disorder and childhood home environment on the development of alcohol use disorders in a Thai population

Aims To identify influences on the development of alcohol use disorders in a Thai population, particularly parental drinking and childhood environment. Design Case-control study. Setting A university hospital, a regional hospital and a community hospital in southern Thailand. Participants Ninety-one alcohol-dependents and 177 hazardous/harmful drinkers were recruited as cases and 144 non-or infrequent drinkers as controls. Measurements Data on parental drinking, family demographic characteristics, family activities, parental disciplinary practice, early religious life and conduct disorder were obtained using a structured interview questionnaire. The main outcome measure was the subject's classification as alcohol-dependent, hazardous/harmful drinker or non-/infrequent drinker. Findings A significant relationship was found between having a drinking father and the occurrence of hazardous/harmful drinking or alcohol dependence in the subjects. Childhood factors (conduct disorder and having been a temple boy, relative probability ratios, RPRs and 95% CI: 6.39, 2.81-14.55 and 2.21, 1.19-4.08, respectively) also significantly predicted alcohol dependence, while perceived poverty and ethnic alienation was reported less frequently by hazardous/harmful drinkers and alcohol-dependents (RPRS and 95% CIs = 0.34, 0.19-0.62 and 0.59, 0.38-0.93, respectively) than the controls. The relative probability ratio for the effect of the father's infrequent drinking on the son's alcohol dependence was 2.92 (95% CI = 1.42-6.02) and for the father's heavy or dependent drinking 2.84 (95% CI=1.31-6.15). Conclusions Being exposed to a light-drinking, father increases the risk of a son's alcohol use disorders exhibited either as hazardous-harmful or dependent drinking. However, exposure to a heavy- or dependent-drinking father is associated more uniquely with an increased risk of his son being alcohol-dependent. The extent to which this is seen in other cultures is worthy of exploration.

Cost comparison of hospital- and home-based treatment models for acute chronic obstructive pulmonary disease

This trial compared the cost of an integrated home-based care model with traditional inpatient care for acute chronic obstructive pulmonary disease (COPD). 25 patients with acute COPD were randomised to either home or hospital management following request for hospital admission. The acute care at home group costs per separation ($745, CI95% $595-$895, n = 13) were significantly lower (p < 0.01) than the hospital group ($2543, CI95% $1766-$3321, n = 12). There was an improvement in lung function in the hospital-managed group at the Outpatient Department review, decreased anxiety in the Emergency Department in the home-managed group and equal patient satisfaction with care delivery. Acute care at home schemes can substitute for usual hospital care for some patients without adverse effects, and potentially release resources. A funding model that allows adequate resource delivery to the community will be needed if there is a move to devolve acute care to community providers.

Composition and energy density of eggs from two species of freshwater turtle with twofold ranges in egg size

Lipid, protein, ash, carbohydrate and water content and energy density of eggs were measured from different clutches over a range of egg size in two species of freshwater turtle. Dry egg contents consisted of protein (54-60%), lipid (25-31%) and ash (5-6%) while carbohydrate was found to be negligible (