Coronary angiography observations: evidence-based or ritualistic practice?

Objective: The purposes of this study were to describe the incidence and occurrence of femoral artery bleeding during the first 6 hours after coronary angiography and to determine whether there is a relationship between  current postangiogram observation protocols and the detection of  complications.

Design: This was a prospective descriptive study.

Setting: The study was conducted in 3 university hospitals in Melbourne, Australia.

Patients: Subjects included 55 patients representing the complication rate of 1075 patients, mean age 61 years (SD, 12), 69% male.

Results: About 5.1% of patients had 1 or more incidents of bleeding  requiring manual compression. In 4.2% of patients, bleeding occurred within 6 hours of angiography. Bleeding occurred a median of 2.02 hours (Q1 = 45 minutes, Q3 = 4.31 hours) after angiography. Patients without pressure bandaging bled a median of 1.32 hours (Q1 = 36.50 minutes, Q3 = 2.59 hours) after angiography. Patients with pressure bandaging bled a median of 4.75 hours (Q1 = 2.25 hours, Q3 = 7.28 hours) after angiography. In 40.6% of cases, bleeding was detected through the patient’s call for assistance, and in 59.4% of cases nurses noted bleeding while checking the puncture site. Postcatheter observations were recorded 23.70 (SD, 14.60) minutes before the bleeding incident. There were no significant changes in vital signs, systolic blood pressure (P > .05), diastolic blood pressure (P > .05), or pulse (P > .05) before or during a bleeding episode. All were within normal parameters. No neurovascular assessment anomalies were detected.

Conclusion: The use of pressure bandaging has a significant effect on the incidence and pattern of bleeding. Routine vital sign measurement has no relevance in detecting local complications after angiography. The most significant complication is bleeding that requires manual compression. Detection is through frequent puncture site observation and patient recognition and communication.

The effect of 5, 10, and 20 repetition maximums on the recovery of voluntary and evoked contractile properties

Maximal strength training has been reported to emphasize neural adaptations. The main objective of this study was to detect differences in muscle activation between 5, 10, and 20 repetition maximum (RM) sets. Fourteen subjects performed elbow flexion with 5, 10, and 20RM. Subjects were tested for maximum isometric force (maximal voluntary contraction [MVC]), twitch amplitude (peak twitch [Pt]), time to peak twitch (TPT), half relaxation time (1/2 RT), electromyography (EMG), and muscle activation (interpolated twitch). Subjects were tested preexercise and 30 seconds, 1, 2, and 3 minutes postexercise. There were no significant differences in MVC, muscle activation, or antagonist/agonist EMG after 5, 10, or 20RM. However, greater RM did have a greater detrimental effect on twitch properties than fewer RM. Peak twitch was significantly (p = 0.004) less (32.08%) for the 20 than for the 5RM, whereas TPT shortened (p < 0.05) by 7.3 and 11.1% with 10 and 20RM vs. 5RM, respectively. Half relaxation time at 20RM was shortened (p < 0.05) by 20.6 and 25.4% compared with that at 5 and 10RM, respectively. MVC, muscle activation, and temporal twitch properties did not recover within 3 minutes of recovery. In conclusion, whereas 5RM did not produce greater muscle inactivation, twitch contractile properties were affected to a greater degree by a higher number of RM.

Weaning of Australian shortfin glass eels (Anguilla Australis): a comparison on the effectiveness of four types of fish roe

Eel culture is solely dependent on wild seed stock, caught in estuaries during the freshwater migratory phase as glass eels. The methods used for weaning glass eels are very variable, and range from the use of live zooplankton to fish roe to fines of commercial fish feeds. The present experiments were conducted on glass eels of the Australian shortfin eel, when the effectiveness of four types of readily available fish roe (European carp, mirror dory, orange roughy and warehou) were evaluated over a 42-day period, in the laboratory.

After 28 days the eels did not show an interest in orange roughy and mirror dory roe, and these two treatments were discontinued to avoid mortality. In all treatments there was a decrease in mean weight during this period, but the survival was over 99%. In the 28th to 42nd day period the mean weight and specific growth rate of glass eels reared on European carp and warehou roe increased, but the differences between these two treatments were not significant.

The physical features of the roe and the oocytes thereof, the proximate composition, amino acid and fatty acid composition indicated major differences amongst the roe types, particularly with regard to the amount of n−6 polyunsaturated fatty acids (PUFA) and the ratio of n−3 to n−6. European carp and warehou roe (and oocytes) had a significantly higher arachidonic acid (AA-20:4n−6; over 60% of PUFA) content and a considerably lower n−3 to n−6 ratio (n−3 to n−6 ratio being 1.32, 5.92, 3.77 and 2.67 for roe types, and 1.25, 4.83, 2.91 and 2.42 for oocytes, of European carp, mirror dory, orange roughy and warehou, respectively), than in the other two roe types. The fatty acid profiles of European carp and warehou roe were similar to that of metamorphosing glass eels.

A preliminary examination of the diet and feeding of sea sweep Scorpis aequipinnis (Pisces: Scorpididae) from coastal waters of south-western Victoria, Australia

The diet and feeding of sea sweep (Scorpis aequipinnis) was investigated from 230 specimens collected from the south-western Victorian coastline between January and July, 2002. Stomach content analysis indicated that S. aequipinnis are browsing omnivores (55.6% algae, 25.4% animal, by dry weight), with rhodophytes found to be the most important component of their diet (93.5% frequency of occurrence; 42.6% dry weight; 45.5% prey-specific abundance). However, the relative proportions of the major dietary components differed significantly between size classes. The dietary composition of small individuals ( < 150 mm total length) was significantly different to larger individuals, primarily due to a higher degree of carnivory exhibited by the smaller fish. S. aequipinnis were found to be highly flexible feeders exploiting both benthic and pelagic food resources, characterised by irregular periods of selective carnivorous feeding.

Effect of crude oil extracts from trout offal as a replacement for fish oil in the diets of the Australian native fish Murray cod Maccullochella peelii peelii

The efficacy of trout oil (TO), extracted from trout offal from the aquaculture industry, was evaluated in juvenile Murray cod Maccullochella peelii peelii (25.4-0.81 g) diets in an experiment conducted over 60 days at 23.7-0.8 °C. Five isonitrogenous (48% protein), isolipidic (16%) and isoenergetic (21.8 kJ gm1) diets, in which the fish oil fraction was replaced in increments of 25% (0-100%), were used. The best growth and feed efficiency was observed in fish fed diets containing 50-75% TO. The relationship of specific growth rate (SGR), food conversion ratio (FCR) and protein efficiency ratio (PER) to the amount of TO in the diets was described in each case by second-order polynomial equations (P<0.05), which were: SGR=-0.44TO2+0.52TO+1.23 (r2=0.90, P<0.05); FCR=0.53TO2-0.64TO+1.21 (r2=0.95, P<0.05); and PER=-0.73TO2+0.90TO+1.54 (r2=0.90, P<0.05). Significant differences in carcass and muscle proximate compositions were noted among the different dietary treatments. Less lipid was found in muscle than in carcass. The fatty acids found in highest amounts in Murray cod, irrespective of the dietary treatment, were palmitic acid (16:0), oleic acid (18:1n-9), linoleic acid (18:2n-6) and eicosapentaenoic acid (20:5n-3). The fatty acid composition of the muscle reflected that of the diets. Both the n-6 fatty acid content and the n-3 to n-6 ratio were significantly (P<0.05) related to growth parameters, the relationships being as follows. Percentage of n-6 in diet (X) to SGR and FCR: SGR=-0.12X2+3.96X-32.51 (r2=0.96) and FCR=0.13X2-4.47X+39.39 (r2=0.98); and n-3:n-6 ratio (Z) to SGR, FCR, PER: SGR=-2.02Z2+5.01Z-1.74 (r2=0.88), FCR=2.31Z2-5.70Z+4.54 (r2=0.93) and PER=-3.12Z2-7.56Z+2.80 (r2=0.88) respectively. It is evident from this study that TO could be used effectively in Murray cod diets, and that an n-3:n-6 ratio of 1.2 results in the best growth performance in Murray cod.

Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability

Lateral ankle sprain (LAS) is one of the most common injuries incurred during sporting activities, and effective rehabilitation programs for this condition are challenging to develop. The purpose of this research was to compare the effect of 6 weeks of balance training on either a mini-trampoline or a dura disc on postural sway and to determine if the mini-trampoline or the dura disc is more effective in improving postural sway. Twenty subjects (11 men, 9 women) with a mean age of 25.4 ± 4.2 years were randomly allocated into a control group, a dura disc training (DT) group, or a mini-trampoline (MT) group. Subjects completed 6 weeks of balance training. Postural sway was measured by subjects performing a single limb stance on a force plate. The disbursement of the center of pressure was obtained from the force plate in the medial-lateral and the anterior-posterior sway path and was subsequently used for pretest and posttest analysis. After the 6-week training intervention, there was a significant (p < 0.05) difference in postural sway between pre- and posttesting for both the MT (pretest = 56.8 ± 20.5 mm, posttest = 33.3 ± 8.5 mm) and DT (pretest = 41.3 ± 2.6 mm, posttest = 27.2 ± 4.8 mm) groups. There was no significant (p > 0.05) difference detected for improvements between the MT and DT groups. These results indicate that not only is the mini-trampoline an effective tool for improving balance after LAS, but it is equally as effective as the dura disc.

The metabolic syndrome in Australia : prevalence using four definitions

Objective : To compare the prevalence of the Metabolic Syndrome (MetS) defined by four definitions and to determine which definition best identifies those at high cardiovascular disease (CVD) risk and with insulin resistance.

Methods : AusDiab is a population-based survey of 11,247 Australians. Participants had anthropometry, blood pressure, and fasting biochemistry. Ten-year CVD risk was calculated.

Results : The prevalence of the MetS using the ATPIII, WHO, IDF, and EGIR definitions was 22.1% (95%Cl: 18.8, 25.4), 21.7% (19.0, 24.3), 30.7% (27.1, 34.3), and 13.4% (11.8, 14.9), respectively. Comparing those with to those without the MetS, the odds ratios (95%CI) for having a 10 year CVD risk ≥15% were 6.6 (5.4, 8.2), 5.5 (4.7, 6.5), 5.6 (4.8, 6.6), and 3.5 (3.0, 4.1), for the WHO, ATPIII, IDF, and EGIR definitions, respectively. The population attributable risk (PAR) of high CVD risk due to the MetS was highest for the IDF (23.4%). Insulin resistance was detected in 56.1, 69.7, 50.9, and 91.1% of those meeting the ATPIII, WHO, IDF, and EGIR definitions, respectively.

Conclusion : The WHO definition was associated with the greatest CVD risk, but is not practical for clinical use. The higher PAR due to the IDF definition, with only slightly lower CVD risk than WHO, and clinical utility of the IDF definition, indicates that it may be a useful tool for CVD prevention.

Estimating the impact of mandatory folic acid fortification on the folic acid intake of Australian women of childbearing age

Objective: The primary aim of this study was to estimate the impact of mandatory folic acid (FA) fortification of bread-making flour on the FA intake of Australian women of childbearing age (16-44 years). The secondary objective was to investigate the relationship between estimated FA intake and socio-economic status (SES) and age.

Method: Dietary modelling was used to estimate FA intake under four mandatory fortification scenarios – no supplement use, supplement use unrelated to FA intake, supplement use only among the highest consumers of bread, and increased supplement use. Data were obtained from the 1995 National Nutrition Survey for food intake patterns, the 2007 Victorian Population Health Survey for FA supplement use, and a marketplace survey.

Results: It is estimated that the National Health and Medical Research Council (NHMRC) recommendation for an additional 400 mg/day FA will be achieved by a minimum of 3.9, 25.4, 21.7 and 30% of the target population under scenarios 1-4, respectively. The FA upper level of intake is exceeded by a maximum of 0.1, 1.7, 6.1 and 4.1% of the target population for scenarios 1-4, respectively.

Conclusions: Mandatory FA fortification is not sufficient for the NHMRC recommendations for minimum and maximum intakes to be met by all of the target population under a number of plausible behaviour scenarios.

Implications: Targeted nutrition education campaigns are needed for SES and age sub-groups and research of this nature should be extended to other population groups. Monitoring and evaluation of this policy will be important to ensure appropriate FA intake.

Feasibility of repeated 24-h dietary recalls combined with a food-recording booklet, using EPIC-Soft, among preschoolers

Background/Objectives: This study evaluates the feasibility among preschoolers of the 224-h dietary recalls (24-HDRs) method combined with a food-recording booklet (FRB), using EPIC-Soft pc-program for the 24-HDR (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study).
Subjects/Methods: A total of 20 and 25 (4- to 5-year-old) children were recruited, as a convenience sample, through worksites or day or healthcare in Denmark and Spain, respectively. One parent (or both parents together) completed two face-to-face 24- HDR, combined with an optional use of a FRB. Feasibility was evaluated by evaluation questionnaires completed by parents and interviewers.
Results: The face-to-face interviews were primarily conducted with the mothers. The FRB was used by 90% of the participants, and proxy persons, other than the parent, were also involved; involvement of proxy persons seems necessary in a majority of the recalls in both the countries.
Conclusions: The results suggest that 224-HDR with one parent combined with a FRB is feasible for registering preschoolers’ diet. An FRB and/or information from proxy persons, other than the parent, is needed for a majority of the parents. In future studies, it may be beneficial to develop the FRB more like a structured food record (FR), which might, in principle, change the method to a one-day FR method from more than a 24-HDR method. It is recommended then to further investigate the use of EPIC-Soft as a data-entry tool.

Underpricing of infrastructure of IPOs: evidence from India

This paper explores the underpricing of initial public offerings (IPOs) made by infrastructure companies in India from 2004 to 2010, and follows Dimovski who reported that in the Australian market, infrastructure IPOs did not produce underpricing returns that were statistically significantly different to zero. The objective of this paper is to investigate the underpricing of infrastructure IPOs in the emerging market of India and to explore factors that may influence the underpricing of infrastructure IPOs in India. The results show that, on average, the underpricing returns were 25.4% and statistically significantly different to zero, while money left on the table, in aggregate is not. In contrast to Australian evidence, significant underpricing in Indian infrastructure IPOs indicates greater risk of these investments. We find that oversubscription, government ownership and issue size are significant variables in explaining underpricing in Indian infrastructure IPOs.

Psychiatric disorders and unmet needs in Australian police cells

To determine the prevalence of current psychiatric disorders and unmet needs in a sample of police cell detainees in Victoria. A cross-sectional descriptive study was conducted, including data linkage with the Victoria Police database and the Victorian Psychiatric Case Register. In Melbourne, Australia, 150 detainees were recruited from two busy metropolitan police stations. Outcome measures included estimated rates of psychiatric disorders, using the Structured Clinical Interview for DSM-IV-TR, and individual needs, using the Camberwell Assessment of Need – Forensic Version. One quarter (n = 32, 25.4%) of detainees had a prior admission to a psychiatric hospital, and three quarters met current criteria for a diagnosable mental disorder. The most common disorders were substance dependence (n = 81, 54%) and mood disorders (n = 60, 40%). A third met diagnostic criteria for both a mental illness and a substance use disorder. The odds of being classified with mood (OR = 10.1), anxiety (OR = 2.2), psychotic (OR = 15.4) and substance use disorders (OR = 26.3) were all significantly higher in the current sample as compared with the general population. Detainees with a mental illness identified significantly more needs and significantly more unmet needs (e.g. psychological distress) than those who did not rate as having a current mental illness. There remains a pressing need to evaluate standardized screening tools for mental illnesses in police cells to provide timely access to assessment and treatment services. The need for functional interagency collaborations are highlighted and discussed.

The underpricing of infrastructure IPOs: Evidence from China

This study investigates the underpricing of 135 infrastructure IPOs in China from 1996 to 2012. It follows infrastructure IPO studies in Australia and India which report average underpricing returns to subscribers of 3.5% and 25.4%, respectively. The average underpricing return for Chinese infrastructure IPOs is substantially higher at 86.3%, but interestingly substantially lower than the underpricing of Chinese IPOs generally. The issue size, government ownership and the pre-IPO earnings per share are helpful in explaining the underpricing of Chinese infrastructure IPOs while the underwriter reputation does not appear to have much explanatory power. In addition, we find the underpricing of infrastructure IPOs in China is also affected by its local GDP levels.