Best Guess method for age-based weight estimation in paediatric emergencies: validation and comparison with current methods

Background: During paediatric resuscitation, drug doses are calculated based upon weight. Age‐based weight estimates are used when weighing children is impractical. The average weight of Australian children has increased, and widely used paediatric age‐based formulae might underestimate weight. A modified age‐based method for paediatric weight calculation, the ‘Best Guess’, has been described. Objective: To validate the Best Guess formulae on a new population of paediatric emergency patients, and to compare the accuracy of this method with Advanced Paediatric Life Support (APLS) and Australian Resuscitation Council (ARC) formulae for age‐based weight calculations. Methods: A retrospective study was performed of Australasian Triage Scale (ATS) category 1 or 2 patients presenting to a tertiary paediatric ED over a 12 month period. Calculated weights using each method (APLS, ARC and Best Guess) were compared with true weights for infants (<1 year), preschool‐aged (1–4 years) and school‐aged (5–14 years) children. Mean actual error and mean percentage error for each was calculated. Results: A total of 1843 patient weights were included in the study. The Best Guess Infant formula accurately estimated weight (mean percentage error +4.2%). The Best Guess formulae more accurately estimated weight than both APLS and ARC formulae for both preschool‐aged children (mean percentage error +2.6% vs?12.1% vs?12.1%) and school‐aged children (mean percentage error +7.7% vs?19.9% vs?12.4%). Conclusion: The Best Guess formulae is a valid method for age‐based weight estimation in acutely unwell or injured children presenting to the ED and more accurately predicts mean weight than either APLS or ARC formulae.     

Physical Activity,Dietary Behavior,and Body Weight Changes during the COVID-19 Nationwide Level 3 Alert in Taiwan: Results of a Taiwanese Online Survey

This cross-sectional study aimed to explore the influence of the COVID-19 pandemic on physical activity (PA) and dietary habits, and their impact on body weight changes during the Level 3 alert period that resulted in the lockdown in Taiwan. The study was conducted between 1 July 2021 and 15 July 2021, using a Google Forms online survey platform. Personal data, anthropometric information, PA information, and dietary habit information were collected before and during the alert period. Exactly 374 respondents, aged between 20 and 66, were included in the study. The results indicate that the lockdown during the alert period negatively impacted all levels of PA, including vigorous and moderate activities and walking. Additionally, respondents showed a sedentary lifestyle, with an increased daily sitting time of 22%. However, body weight and dietary behavior were not significantly affected, and some dietary questions achieved significant differences, including eating three meals less regularly, among others. During the pandemic, exercise was still one of the most important ways to maintain health; therefore, we hope to bring more attention to the prevention of sedentary lifestyles and dietary abnormalities in Taiwan during a pandemic.     

Bread consumption in the UK: what are the main attitudinal factors affecting current intake and its place in a healthy diet?

Despite efforts to promote the consumption of starchy foods, UK consumers are not meeting the recommended proportion of energy from starch for the population. Awareness of the nutritional benefits of starchy foods is poor and consumers tend to have highly divergent attitudes to, and beliefs about, these foods – although starchy foods are generally viewed as good for health, they are also often described as ‘fattening’ and avoided by those trying to lose weight. Concern about wheat allergy and other gastrointestinal problems commonly associated with bread in particular are also barriers to it being perceived as a ‘healthy food’. There is therefore clearly a mismatch between consumers' perceptions of starchy foods and current nutritional guidelines. This paper considers the evidence for and against the most common consumer perceptions around the health effects of bread and the possible impact of reduced levels of consumption on the nutrient intake of individuals.     

A 28-day oral toxicity study of echimidine and lasiocarpine in Wistar rats

Pyrrolizidine alkaloids (PAs) are a class of naturally-occurring plant toxins. Echimidine is one of the predominant PAs found in honeys produced in Australia and New Zealand. There is a lack of information on the oral toxicity of echimidine on which to base regulatory decisions concerning the risk to humans of these honeys. This GLP study was conducted to assess the subchronic dietary toxicity of echimidine to rats compared to that of lasiocarpine as a positive control. Wistar rats, 10/sex, were fed diets containing 0, 0.6, 1.2 or 2.5 mg/kg bw echimidine. Positive control groups, 10/sex, were fed diets containing 0.6, 1.2 or 2.5 mg/kg bw lasiocarpine.Neither PA had any effect on survival, food consumption, clinical signs, gross lesions, or histopathology. Consumption of lasiocarpine, but not echimidine, decreased bodyweight gain in males at ≥ 1.2 mg/kg bw, and in females at 2.5 mg/kg bw. Slight alterations in white cell counts and serum ALT concentrations at 2.5 mg/kg bw of both PAs were not clinically significant, had no histological correlates, and were considered to be of equivocal relevance.In conclusion, the subchronic No Observed Adverse Effect Level (NOAEL) for echimidine is 2.5 mg/kg bw/day, whereas, on the basis of a treatment-related decrease in bodyweight gain in males at 1.2 mg/kg bodyweight, the NOAEL for lasiocarpine is 0.6 mg/kg bw/day.