Is television viewing time a marker of a broader pattern of sedentary behavior?

Background: Television (TV) viewing time is associated with abnormal glucose metabolism, the metabolic syndrome, and risk of type 2 diabetes; associations are stronger and more consistent in women. One explanation of this difference may be that TV viewing is a marker of an overall pattern of sedentary behavior in women.

Purpose: We sought to examine associations of TV viewing time with other sedentary behaviors and with leisure-time physical activity in a large sample of Australian adults.

Methods: Adults aged between 20 and 65 years (n=2,046) completed a  self-administered questionnaire on TV viewing, five other leisure-time sedentary behaviors, and leisure-time physical activity. Mean adjusted time spent in other sedentary behaviors and in physical activity was compared across TV-time  categories previously shown to be associated with abnormal glucose  metabolism.

Results: After adjustment for body mass index and sociodemographic variables, women’s time spent watching TV was associated positively with time in other sedentary behaviors and negatively with leisure-time physical activity, but no such associations were observed in men.

Conclusions: TV viewing time may be a robust marker of a sedentary lifestyle in women but not in men. Gender differences in the pattern of sedentary behaviors may explain at least in part the gender differences in the previously reported associations of TV viewing time with biological attributes related to type 2   diabetes.

Survival analysis of time-to-event data in respiratory health research studies

This article provides a review of techniques for the analysis of survival data arising from respiratory health studies. Popular techniques such as the Kaplan–Meier survival plot and the Cox proportional hazards model are presented and illustrated using data from a lung cancer study. Advanced issues are also discussed, including parametric proportional hazards models, accelerated failure time models, time-varying explanatory variables, simultaneous analysis of multiple types of outcome events and the restricted mean survival time, a novel measure of the effect of treatment.

Dietary assimilation and the digestive strategy of the omnivorous anomuran land crab Birgus latro (Coenobitidae).

On Christmas Island, Indian Ocean, the diet of robber crabs, Birgus latro (Linnaeus) was generally high in fat, storage polysaccharides or protein and largely comprised fruits, seeds, nuts and animal material. The plant items also contained significant amounts of hemicellulose and cellulose. In laboratory feeding trials, crabs had similar intakes of dry matter when fed artificial diets high in either fat or storage polysaccharide, but intake was lower on a high protein diet. Assimilation coefficients of dry matter (69–74%), carbon (72–81%), nitrogen (76–100%), lipid (71–96%) and storage polysaccharide (89–99%) were high on all three diets. B. latro also assimilated significant amounts of the chitin ingested in the high protein diet ( 93%) and hemicellulose (49.6–65%) and cellulose (16–53%) from the high carbohydrate and high fat diets. This is consistent with the presence of chitinase, hemicellulase and cellulase enzymes in the digestive tract of B. latro. The mean retention time (27.2 h) for a dietary particle marker (⁵⁷Co-labelled microspheres) was longer than measured in leaf-eating land crabs. The feeding strategy of B. latro involves the selection of highly digestible and nutrient-rich plant and animal material and retention of the digesta for a period long enough to allow extensive exploitation of storage carbohydrates, lipids, protein and significant amounts of structural carbohydrates (hemicellulose, cellulose and chitin).

The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

Background : Acute respiratory illnesses (ARIs) during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children.
Methods : We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs.
Results : Impact diaries were available for 72% (523/725) of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95% confidence interval $263 to $354). Influenza illnesses had a mean cost of $904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories.
Conclusion : From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options.

Initial experience in 115 patients with the retrievable Cook Celect vena cava filter

The aim of this study was to evaluate our experience with the retrievable Cook Celect inferior vena cava (IVC) filter (William Cook, Europe) with regard to insertion, efficiency, ease of retrieval, and any associated complications. A retrospective review was performed of 115 patients (41 female, 74 male, mean age 47.97 years) who underwent Cook Celect IVC filter insertion between December 2005 and October 2007. Filter insertion was successful in all patients. Of the 115 filters inserted, 57 have been successfully retrieved (49.6%) to date. The successful retrieval rate from attempted retrieval was 93.4%. The mean dwell time of successfully retrieved filters was 114.9 days (range 14–267 days). Failed retrievals were due to a thrombosed vena cava ( n = 1) and endothelialisation of the filter ( n = 3). In the failed retrieval group the mean implantation time was 142 days (range 78–211 days). While this is the first retrospective clinical study on the Cook Celect filter, results to date are promising. We demonstrated an efficacious filter with a high successful retrieval rate of 93.4% and a low complication rate. The filter was assessed with extended dwell times (range 14–267 days). Failed retrieval secondary to hook endothelialisation continues to be an issue with this filter. We recognize that a limitation of our study was the lack of systematic follow-up for clinically silent complications. Further studies to evaluate longer term outcomes and effectiveness of this filter are warranted.

Effect of an arginine-containing nutritional supplement on pressure ulcer healing in community spinal patients

Objective: To determine whether or not the use of an arginine-containing nutritional supplement could result in signifi cantly shorter pressure ulcer (PU) healing times in people with spinal cord injuries living in the community, compared with a comparative historical control group. Method: Eighteen spinal-cord-injured patients (all part of a hospital spinal outreach service) received 9g of a commercial powdered arginine supplement per day until full PU healing occurred. Healing rates were compared against 17 historical control patients (as assessed by medical history audit). 
Results: Baseline characteristics (age, gender, injury level and time) were similar between groups. Mean ulcer healing times were 10.5 ± 1.3 weeks versus 21 ± 3.7 weeks (p<0.05) in the intervention and control groups respectively. Comparison of healing rates in the intervention group against expected healing rates derived from the medical literature showed that intervention patients had a signifi cantly shorter mean healing time (category 2 PU: 5.5±1.3 weeks versus 13.4 weeks; category 3 PU: 12.5 ± 1.9 weeks versus 18.2 weeks; category 4 PU: 14.4 ± 4.8 weeks versus 22.1 weeks). A diagnosis of diabetes did not significantly alter healing rates in either group. Conclusion: Results from this observational study show a promising benefit of arginine supplementation on PU healing for individuals with spinal cord injury living in the community.

Cardiac structure and function in young endurance athletes and nonathletes

The purpose of this study was to examine, in male adolescents, the effects of long-term endurance training on cardiac structure and function, by adopting a cross-sectional comparison with a nonathletic control group. A total of 13 endurance-trained (EX) and seven untrained (CON) male adolescents (mean ± SE, age = 15.3 ± 0.3 and 15.2 ± 0.28 yrs, respectively) underwent echocardiography at rest to determine left ventricular enddiastolic dimension (LVD_d), left ventricular end-systolic dimension (LVD_s), left ventricular posterior wall thickness (LVPW), stroke volume (SV), and cardiac output (CO). On separate days, incremental exercise tests were conducted on a cycle ergometer to measure peak oxygen uptake (VO_2max) and anaerobic power. VO_2max was greater in the endurance group (54.4 ± 1.8 mL min^–1 kg^–1) than in the control group (45.8 ± 1.6 mL min^–1 kg^–1; p < 0.05). Mean exercise time was longer in EX (12.9 ± 0.7 min) than CON (10.4 ± 0.8 min; p < 0.05). No significant differences were noted between the two groups in resting heart rate, maximal heart rate, LVD_d, LVD_s, LVPW, SV, SV indexed, CO, and CO indexed, or in the anaerobic strength. These data provide evidence that endurance-trained adolescent males develop superior exercise performance before the cardiac remodeling that is evident in trained adult athletes.

Parent initiated prednisolone for acute asthma in children of school age : randomised controlled crossover trial

Objective To evaluate the efficacy of a short course of parent initiated oral prednisolone for acute asthma in children of school age.

Design Double blind, randomised, placebo controlled, crossover trial in which episodes of asthma, rather than participants, were randomised to treatment.

Setting The Barwon region of Victoria, Australia.

Participants Children aged 5-12 years with a history of recurrent episodes of acute asthma.

Intervention A short course of parent initiated treatment with prednisolone (1 mg/kg a day) or placebo.

Main outcome measures The primary outcome measure was the mean daytime symptom score over seven days. Secondary outcome measures were mean night time symptom score over seven days, use of health resources, and school absenteeism.

Results 230 children were enrolled in the study. Over a three year period, 131 (57%) of the participants contributed a total of 308 episodes of asthma that required parent initiated treatment: 155 episodes were treated with parent initiated prednisolone and 153 with placebo. The mean daytime symptom score was 15% lower in episodes treated with prednisolone than in those treated with placebo (geometric mean ratio 0.85, 95% CI 0.74 to 0.98; P=0.023). Treatment with prednisolone was also associated with a 16% reduction in the night time symptom score (geometric mean ratio 0.84, 95% CI 0.70 to 1.00; P=0.050), a reduced risk of health resource use (odds ratio 0.54, 95% CI 0.34 to 0.86; P=0.010), and reduced school absenteeism (mean difference −0.4 days, 95% CI −0.8 to 0.0 days; P=0.045).

Conclusion A short course of oral prednisolone initiated by parents when their child experiences an episode of acute asthma may reduce asthma symptoms, health resource use, and school absenteeism. However, the modest benefits of this strategy must be balanced against potential side effects of repeated short courses of an oral corticosteroid.

The ideal Ileal-Pouch design : a long-term randomized control trial of J- vs W-pouch construction

BACKGROUND: The IPAA has become established as the preferred technique for restoring intestinal continuity postproctocolectomy. The ideal pouch design has not been established. W-pouches may give better functional results owing to increased volume, whereas the J-pouch’s advantage is its straightforward construction. We report short- and long-term results of an randomized control trial designed to establish the ideal pouch.

DESIGN: Ninety-four patients were randomly assigned to J- and W-pouches (49:45) and assessed at 1 and 8.7 years postoperatively. Assessment was questionnaire based and designed to assess pouch function and patient quality of life.

RESULTS: Eighty-five percent of patients were followed up at 1 year, and 68% were followed up at 8.7 years. At 1 year, there was a significant difference in 24-hour bowel movement frequency J- vs W-pouches 7 vs 5(p < 0.001) and in daytime frequency J- vs W-pouches 6 vs 4 (p < 0.001), with no difference in nocturnal function. At 9-year follow-up, function had equilibrated between the 2 groups: 24-hour bowel movement frequency J- vs W-pouches 6.5 vs 6 (p = 0.36), daytime frequency 5.5 vs 5 (p = 0.233), and nocturnal function 1 vs 1 (p = 0.987). Mean operating time of J- and W-pouches was 195 and 215 minutes (p < 0.05). All other parameters, pad usage, urgency, incontinence, and quality of life, did not differ significantly between groups.

CONCLUSION: These data demonstrate that the theoretical functional advantage conferred on the W-pouch by its greater volume exists only in the short term and is of little consequence to patients’ long-term quality of life. This advantage is attenuated as the pouches mature, resulting in no disparity in pouch function. This, combined with the more consistent, efficient, and easily taught construction of the J-pouch, should conclusively establish it as the optimum ileal-pouch design.

Small-sample improved seasonal unit root tests for trending and breaking series

In this article three unit root tests that allow for a break in both the seasonal mean and linear trend of the data are proposed. The tests, which can be seen as small-sample corrected versions of already known asymptotic tests, are shown to perform very well in simulations, and much better than their asymptotic counterparts.

Contact lens fitting and training in a child and youth population

PURPOSE: To determine the ease with which children and youths without previous soft contact lens (SCL) experience were able to handle, care for, adapt and be fitted with SCLs. METHODS: 179 children aged 8-16 were recruited. Study visits included: screening and training visits, 1-week and 3-month follow-ups. During the training visit, the time taken to demonstrate proficiency in lens insertion and removal and care was recorded. A second training visit was scheduled if necessary. RESULTS: Nine children did not complete the screening visit and eight discontinued during the study. Of those eight, seven discontinued during the first week and one before the 3-month visit. Of those recruited, 90.5% (162/179) were successfully fitted and completed the study. A majority of children were dispensed with lenses at the first training visit (94.6%, 162/171). The mean training time for all children was 30min. There were no statistically significant differences in the number of lenses required to fit or instruction time by age group (p>0.05) or gender (p>0.05). Nine participants (5.3%, 9/171) required a second training visit with four still unable to handle lenses (2.3%, 4/171). By the 1-week visit 13.2% (22/167) of participants either lost or tore lenses, no subsequent lost or torn lenses occurred. No serious adverse events occurred during the study. CONCLUSION: Children and youths with no previous contact lens experience were easily fitted, able to successfully wear and care for lenses. The results of this study should encourage practitioners to recommend SCLs as a vision correction option.

The sexual motivation of boars housed adjacent to ovariectomised gilts did not affect the efficiency of detecting hormonally induced oestrus using the back pressure test

This study tested the hypothesis that the efficiency of detecting oestrus in gilts, using the back pressure test (BPT), will be reduced when gilts are housed adjacent to a boar of high sexual motivation compared to when gilts are housed adjacent to a boar of low sexual motivation. The experiment was a 2 x 2 Latin square design with three replicates. Boars of high and low sexual motivation were selected on the basis of the total number of copulations and the mean reaction time to first mount during three mating tests. Twelve boars were observed in mating tests and the three highest and lowest ranking boars were assigned to three palm, each pair containing a boar of high and a boar of low sexual motivation. One pair was used in each replicate. In each replicate, two groups of six ovariectomised gilts were housed for 14 days, commencing 7 days prior to hormonally induced destrus, adjacent to a boar of either high or low sexual motivation. All gilts were checked twice daily for oestrus using the BPT. In the first replicate, the level of proceptive behaviour of the gilts was quantified immediately after checking for oestrus in a 3-rain test in which the amount of time that the gilts spent within 0.5 m of a pen containing a sexually mature boar was recorded. There were no effects of housing gilts adjacent to boars of high or low sexual motivation on the percentage of gilts detected in oestrus, the percentage of gilts detected in oestrus for more than I day, the duration of oestrus or the level of proceptive behaviour of gilts. These data suggest that the level of sexual motivation of boars does not influence the efficiency of detecting hormonally induced oestrus, using the BPT, in ovariectomised gilts housed adjacent to boars.

MMSE precoder for unitary space–time codes in correlated time-varying channels

This letter addresses the problem of the design of a precoder for multiple transmit antenna communication systems with spatially and temporally correlated fading channels. By using the asymptotic (high signal-to-noise ratio) mean-square error of the channel estimates, the letter derives a precoder for unitary space-time codes that can exploit the spatiotemporal correlation in the time-varying fading channels. Simulation results illustrate that significant performance gains can be achieved by using the new precoder.

Ageing effects on visual reaction time in a single task condition and when treadmill walking

Visual reaction time (RT) was measured in 10 older men (mean age, 71.1 years) and gender-matched controls (mean age, 26.3 years) when standing (single task) and when walking on a motor-driven treadmill (dual task). There were 90 quasirandomly presented trials over 15 min in each condition. Longer mean and median RTs were observed in the dual task compared to the single task. Older males had significantly slower mean and median RTs (315 and 304 ms, respectively) than the younger group (273 and 266 ms, respectively) in both task conditions. There were no age or condition effects on with in-subject variability. Both groups showed a trend of increasing RT over the 90 single task trials but when walking only the younger group slowed. These novel findings demonstrate high but sustained attention by older adults when walking. It is proposed that the motor task's attentional demands might contribute to their slower preferred walking speed.