Prevalence and socio-economic distribution of eating, physical activity and sedentary behaviour among South Australian children in urban and rural communities: baseline findings from the OPAL evaluation.

OBJECTIVE: To identify current prevalence and sociodemographic distribution of adherence to national diet and physical activity and sedentary behaviour guidelines among Australian primary school children. STUDY DESIGN: Cross-sectional survey of children (n = 4637, 9-11 years) participating at baseline in the South Australian Obesity Prevention and Lifestyle (OPAL) programme evaluation. METHODS: Self-reported diet, physical activity (PA) and screen time (ST) behaviours were assessed via questionnaire. Children were classified as meeting or not meeting each guideline (two or more serves of fruit, five or more serves of vegetables, two or less serves of discretionary food, ≥60 min of PA, and ≤2 h of ST per day). RESULTS: Although 65% of children met fruit recommendations, only 22% met vegetable recommendations (17% consumed no vegetables). Approximately one-quarter (28%) of children met discretionary food recommendations. Only 17% of children met the ST recommendations and 33% met PA recommendations. Less than 1% of children met all five recommendations. Rural children were more likely to meet both PA (OR = 1.45, 95% CI: 1.21-1.74, P < 0.001) and ST (OR = 1.37, 95% CI: 1.14-1.66, P < 0.01) recommendations than urban counterparts. Children at least socio-economic disadvantage performed better than those at greatest disadvantage for most behaviours. CONCLUSION: Improvement in Australian children's diet and physical activity and sedentary behaviours, particularly urban children and those at greatest socio-economic disadvantage, is urgently warranted.

Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies.

PURPOSE: Indwelling central venous catheters (CVCs) have been increasingly used to enable delivery of intravenous chemotherapy. We aimed to compare the safety and cost of two commonly used CVCs, peripherally inserted central venous catheter (PICCs) and ports, in the delivery of chemotherapy in patients with non-haematological malignancies. METHODS: Seventy patients were randomly assigned to receive either a PICC or a port. The primary endpoint was occurrence of major complications, which required removal of the CVC and secondary endpoints included occurrence of any complications. RESULTS: Port devices were associated with fewer complications compared with PICC lines (hazard ratio of 0.25, CI, 0.09-0.86, P = 0.038). Major complication rate was lower in the port arm compared to the PICC arm (0.047 versus 0.193 major complications/100 catheter days, P = 0.034) with 6 versus 20 % of patients experiencing major complications, respectively. Thrombosis, the most common complication, was significantly higher in the PICC arm compared to the port arm (25 versus 0 %, P = 0.013). Quality of life and cost estimates did not differ significantly between the two arms. CONCLUSIONS: Port devices are associated with a lower risk of complications, with no difference in cost, compared to PICC lines in patients with non-haematological malignancies receiving intravenous chemotherapy.

Accuracy of prediction equations for calculating resting energy expenditure in morbidly obese patients.

INTRODUCTION: The accuracy of prediction equations for estimating resting energy expenditure (REE) in morbidly obese patients is unclear. The aim of this study was to compare the REE measured using bedside indirect calorimetry with commonly used prediction equations. METHODS: A total of 31 morbidly obese patients were studied. Pre-operative REE was measured with indirect calorimetry and compared with estimated REE using the Harris-Benedict and Schofield equations. All patients subsequently underwent a Roux-en-Y gastric bypass and measurements were repeated at six weeks and three months following surgery. RESULTS: The mean age of the patients was 47 years. The mean pre-operative body mass index was 46 kg/m(2). The mean REE measured using indirect calorimetry was 1,980 kcal/day. The estimated REE using the Harris-Benedict and Schofield formulae was 2,195 and 2,129 kcal/day respectively. The equations overestimated REE by 10% and 7%. Body weight and body mass index reduced significantly following Roux-en-Y gastric bypass. There was no significant change in measured REE over the three-month period. After weight loss the difference between the estimated and measured REE reduced to 1-3%. CONCLUSIONS: Prediction equations overestimate REE in morbidly obese patients. Their accuracy improved after surgery induced weight loss, confirming their validity for the normal weight population. Indirect calorimetry should be used in morbid obesity.