A review of telemedicine and asthma

The literature contains a number of reports of early work involving telemedicine and chronic disease; however, there are comparatively few studies in asthma. Most of the telemedicine studies in asthma have investigated the use of remote monitoring of patients in the home, e.g. transmitting spirometry data via a telephone modem to a central server. The primary objective of these studies was to improve management. A secondary benefit was that patient adherence to prescribed treatment is also likely to be improved. Early results are encouraging; home monitoring in a randomized controlled trial in Japan significantly reduced the number of emergency room visits by patients with poorly controlled asthma. Other studies have described the cost-benefits of a specialist asthma nurse who can manage patients by telephone contact, as well as deliver asthma education. Many web-based systems are available for the general public or healthcare professionals to improve education in asthma, although their quality is highly variable. The work on telemedicine in asthma clearly shows that the technique holds promise in a number of areas. Unfortunately - as in telemedicine generally - most of the literature in patients with asthma refers to pilot trials and feasibility studies, with short-term outcomes. Large-scale, formal research trials are required to establish the cost effectiveness of telemedicine in asthma.

A potential role for isothermal calorimetry in studies of the effects of thermodynamic non-ideality in enzyme-catalyzed reactions

Attention is drawn to the feasibility of using isothermal calorimetry for the characterization of enzyme reactions under conditions bearing greater relevance to the crowded biological environment, where kinetic parameters are likely to differ significantly from those obtained by classical enzyme kinetic studies in dilute solution. An outline of the application of isothermal calorimetry to the determination of enzyme kinetic parameters is followed by considerations of the nature and consequences of crowding effects in enzyme catalysis. Some of those effects of thermodynamic non-ideality are then illustrated by means of experimental results from calorimetric studies of the effect of molecular crowding on the kinetics of catalysis by rabbit muscle pyruvate kinase. This review concludes with a discussion of the potential of isothermal calorimetry for the experimental determination of kinetic parameters for enzymes either in biological environments or at least in media that should provide reasonable approximations of the crowded conditions encountered in vivo. Copyright (C) 2004 John Wiley Sons, Ltd.

Feasibility of controlling nitrification in predenitrification plants using DO, pH and ORP sensors

Experimental studies were carried out on a bench-scale nitrogen removal system with a predenitrification configuration to gain insights into the spatial and temporal variations of DO, pH and ORP in such systems. It is demonstrated that these signals correlate strongly with the operational states of the system, and could therefore be used as system performance indicators. The DO concentration in the first aerobic zone, when receiving constant aeration, and the net pH change between the last and first aerobic zones display strong correlations with the influent ammonia concentration for the domestic wastewater used in this study. The pH profile along the aerobic zones gives good indication on the extent of nitrification. The experimental results also showed a good correlation between ORP values in the last aerobic zone and effluent ammonia and nitrate concentrations, provided that DO in this zone is controlled at a constant level. These results suggest that the DO, pH and ORP sensors could potentially be used as alternatives to the on-line nutrient sensors for the control of continuous systems. An idea of using a fuzzy inference system to make an integrated use of these signals for on-line aeration control is presented and demonstrated on the bench-scale system with promising results. The use of these sensors has to date only been demonstrated in intermittent systems, such as sequencing batch reactor systems.

Using the Internet for Physical Activity Promotion in a Regional Community: Feasibility Study Findings

New communication technologies (websites and email) are believed to hold promise for delivering population health interventions. However, studies on internet-delivered physical activity (PA) programs have encountered difficulties in engaging and retaining participants. Recent PA research has focused on peoples’ perceptions of the local environment and how this relates to PA participation. This study investigated the potential of: 1) reaching people living in a regional community via a locally-based Internet Service Provider (ISP), and 2) using data on the local environment to design a PA intervention relevant to the individual. An online survey was conducted via the ISP’s website over 12 days. ISP clients (approximately 9,000) were invited to participate in the survey via electronic newsletter and direct email. Data on motivational readiness and environmental correlates of PA were collected. 820 surveys were completed, of which 797 were valid (response rate = 9%). Participants had a mean BMI 27.6±8.3, were 55% male, 56% aged >45 years, 57% worked fulltime, and 36% were in the early stages of motivational readiness for PA. Most reported positive perceptions of the local environment in terms of aesthetics, convenience, access, traffic and safety. However, over half did not know about or use local PA facilities. Over 70% were somewhat to extremely interested in having access to a PA promotion website. These data suggest that promoting PA via a locally based ISP is feasible and appealing to some people living in a regional community, but also highlight some of the challenges of using this technology to deliver population health interventions.