A 12-month profile of community paediatric consultations in the Barwon region.

OBJECTIVE: To determine the profile of all consultations carried out in paediatricians offices in the Barwon region over a 12-month period. METHODOLOGY: The age, sex, category, diagnosis, and outcome of all non-hospital-based paediatric consultations carried out in the Barwon region were documented prospectively on a day by day basis. Relevant demographic data and information on Barwon children treated elsewhere were also collected. The frequency of different categories of illness, systems involved and groups of diagnoses was determined. RESULTS: A total of 14,711 consultations was carried out in the region with 10% of the childhood population having contact with the paediatricians during the year; 3135 new patients or problems were seen with 34.8% of all consultations involving behavioural problems and 76% of these relating to ADHD. The most frequent medical diagnostic group was CNS/disability being 16% of all consultations. At least 50% of the medical consultations involved chronic illness. CONCLUSIONS: Behavioural difficulty, chronic disability, and learning problems represent a significant part of the workload of community-based general paediatricians. Appropriate exposure during paediatric training should be given to these issues along with more sophisticated training in the medical, social and psychological complications of chronic illness and its effect on clients and families.

The evolving role of community-based general paediatricians: the Barwon experience.

OBJECTIVE: To detail the acute and chronic paediatric service and community-orientated activities and responsibilities of community-based general paediatricians. METHODOLOGY: Data were collected over the 12 months July 1996 to June 1997 relevant to (i) acute neonatology and paediatrics, (ii) the different community paediatric service organizations with which the paediatricians were involved, and (iii) the quantification of the amount of time spent in non-consulting paediatric work. RESULTS: Findings revealed decreasing hospital admissions, infrequent severe neonatal resuscitation requirements, extensive involvement in community organizations and a great deal of time spent in non-consulting paediatric work. CONCLUSIONS: Ongoing training and upgrading in acute paediatric diagnostic and procedural skills, rationalization of resuscitation expertise, training in management and administrative skills and models of care for the chronically ill should become part of the training of community-based general paediatricians.

A simple hospital triaging system for infants with acute illness.

OBJECTIVE: To determine the simplest combination of symptoms and signs for use as a triaging procedure in young infants presenting to hospital, and to compare this with the 'Baby Check' system. METHODOLOGY: Six hundred and eighty-two babies were assessed when presenting with acute illness to a children's hospital emergency department. Results of analysis were compared to the results of the Baby Check system, which was derived from the data on the same babies. RESULTS: The presence of at least one of the following markers: drowsiness on examination, significant chest wall recession, generalized pallor, a history of feeding less than 50% or decreased activity, had a sensitivity of 91%, a specificity of 72%, a positive predictive value of 29% and a negative predictive value of 98% when predicting the need for intervention in hospital. The 'Baby Check' system with a score of 13 or more had a sensitivity of 95%, a specificity of 70%, a positive predictive value of 28% and a negative predictive value of 99%. Less common but predictive markers such as bile-stained vomiting, respiratory grunt, apnoea and convulsions add further to the sensitivity. Based on this data set, if historical variables alone (the presence of either drowsiness, difficult breathing, being more pale than usual, feeding less than 50% or decreased activity) were used (as in telephone screening) 92% of babies needing treatment in hospital would be identified. CONCLUSION: A simple five-marker system is almost as powerful as the 19-marker Baby Check system and provides a useful basis for a triaging system and educational guidelines when assessing sick babies.

Dietary intakes and food use of groups of elite Australian male athletes.

The present study conducted dietary surveys of four groups of Australian male athletes: triathletes, marathon runners, Australian Rules football players, and Olympic weightlifters. Their training diets were assessed via a 7-day food record from which mean daily intakes of energy, macronutrients, and key micronutrients were estimated. The data were compared between groups as well as to recommendations in the literature for athlete nutrition. Results showed major differences between groups. The contribution of carbohydrate to total energy intake was greater for triathletes and marathon runners than for the other two groups. There was no difference between all four groups in the total amount of fat consumed, yet its contribution to total energy intake was significantly lower for triathletes and marathon runners. The football players and weightlifters consumed a similar fat:energy ratio as the typical Australian diet. Furthermore, the micronutrient density of the football players' diets was significantly lower than that of the other groups.

Seasonal changes in body composition in Australian Rules footballers.

Anthropometric measurements were collected from a group of Australian Rules footballers at the start and end of the competitive season. Eighty-nine players were studied, drawn from a top level professional league team, a second level association team and an A-grade amateur association team. Changes in the physical profile of these players during the season were observed. A small but significant gain in fat-free body mass in the top level players was observed (0.9 kg, p less than 0.01), but no change in body fat. The intermediate level players showed no significant change in body mass and a tendency toward a slight loss in body fat, while the lower level players showed a significant loss in body fat during the season (1.8 kg, p less than 0.001) without significant change in fat-free body mass.

Australian Rules football: an anthropometric study of participants.

Anthropometric measurements and personal data were collected from 119 Australian Rules footballers from Victoria. A top level professional league team, a second level association team, and an A-grade amateur association team were observed, representing three levels of ability. The profile of physical features of these athletes at the beginning of the season is presented. A gradation of body size was observed between teams. The players in the top level team were slightly taller and heavier than those in the other teams. They had less body fat, as shown by lesser skinfold thicknesses, a smaller percentage body fat as determined by prediction equations, and a greater fat-free mass. The intermediate level team showed an intermediate level of body fat and the lower level team had the highest proportion of fat.