A curious fact in the estimation of metabolic rate by indirect calorimetry is that the normal 'exact' method of calculation is so cumbersome that the effect of protein metabolism is commonly ignored. Moreover, the total respiratory quotient is used to assign to the oxygen consumed a calorie value which is appropriate only to the non-protein respiratory quotient. This paper describes several ways in which the calculation can be simplified and shows how the effect of protein metabolism can be included with a minimum of trouble. The derivation of the calorie value of 1 litre of oxygen is the first step.

The framework has been developed using national and international documents and the input of experienced practitioners across Australia. It represents a set of key competencies for the pharmaceutical delivery of cancer care. The next essential step of the competency framework is to implement and integrate the framework into practice and to develop accompanying training tools.

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