Evaluation of an internet-based physical activity intervention: A preliminary investigation

The Internet has the potential for delivering innovative, interactive physical activity (PA) interventions to large numbers of people. This study was designed to test the efficacy. of ant Internet intervention that consisted of a Web site plus 12 weekly e-mail tip sheets, compared with a waiting list control group. The Internet intervention was theory based and emphasized clear, graphical presentation of PA information. Sixty-five (30 intervention and 35 control) sedentary adult employees of several large hospitals (9 men and 56 women) were randomly assigned to 1 of the 2 study arms. Of the 65 participants, 57 completed the 1-month follow-up, and 52 completed the 3-month follow-up. At both 1 and 3 months, those in the intervention group were significantly more likely to have progressed, in stage of motivational readiness for PA than participants in the control group: 1 month, chi(2)(1, N = 52) = 4.05, p

The late effects of poliomyelitis in Queensland

This paper reports an investigation of new health problems reported by Queensland residents with a prior history of poliomyelitis. 126 people with a past history of paralytic poliomyelitis were recruited from the waiting list for the trial Post Polio Clinic at Queen Elizabeth II Hospital, Brisbane. A self-administered postal questionnaire was used to examine a number of variables including acute poliomyelitis histories; presence, duration and severity of new symptoms consistent with the late effects of poliomyelitis; changes in functional status between the maximal recovery period and the time of the survey and the impact of post-polio symptoms on lifestyle and employment. The most frequent new symptoms reported were muscle weakness (87 per cent), unusual tiredness (79 per cent), joint pain (79 per cent), muscle pain (61 per cent) and muscle cramps (71 per cent). Subjects reported an increased reliance on assistive devices and a decreased level of independence with activities of daily living, particularly with mobility-related tasks. Eight three per cent of subjects had made lifestyle changes as a result of post-polio symptoms and 67 per cent of those subjects in the workforce reported making changes to their employment, such as reduced hours of work. (author abstract)

Realtime telemedicine for paediatric otolaryngology pre-admission screening

We conducted a feasibility study to examine whether a paediatric patient at a regional hospital could be assessed by an ear, nose and throat (ENT) specialist via videoconference, therefore saving at least one journey to the tertiary hospital for a pre-admission appointment. A video-otoscope was used with standard videoconference equipment, and realtime images were transmitted at a bandwidth of 384 kbit/s. In all, 13 telepaediatric ENT clinics were conducted between November 2003 and April 2005, and 98 consultations were facilitated for 64 patients. The main reasons for referral were recurrent tonsillitis (25%) and obstructive sleep apnoea (23%). Of the 64 patients examined by telemedicine, 42 (66%) were recommended for surgery and placed on the surgical waiting list. About 12 patients (19%) required travel to the tertiary centre for further investigations and tests not available locally, while four patients (6%) were reviewed via videoconference during a scheduled clinic. Six patients (9%) required no further follow-up after their initial telepaedliatric consultation. Videoconferencing is an effective method of assessing ENT conditions of paediatric patients and for pre-screening potential surgical admissions to a tertiary hospital. Careful consideration of a number of economic and logistical factors needs to be made before large investments are made to expand the service.

Should watchful waiting be used more often for acute otitis media?

RECENT ANXIETY about the treatment of acute otitis media has been precipitated by a resistance to antibiotics by the common pathogens that can cause this infection.1, 2 The medical profession is facing an increasingly impotent option in the form of antibiotics, prompting physicians around the world to consider alternatives. In this issue of the ARCHIVES, Pichichero and Poole3 have undertaken a comprehensive study involving pediatricians and otorhinologists. The objectives were to assess their recognition of the physical findings of acute otitis media and their ability to perform myringotomy. The principal issue is the safety of performing myringotomy in children with acute otitis media. Because this is an office procedure in which a general anesthetic is not administered, the child is strapped to a papoose board and held down. Myringotomy is not without potential serious complications. The superior part of the middle ear cavity contains the ossicles and the chorda tympani branch . . . [Full Text of this Article]

A randomised controlled trial of methadone maintenance treatment versus wait list control in an Australian prison system

Objectives: The aim was to determine whether methadone maintenance treatment reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners. Methods: All eligible prisoners seeking drug treatment were randomised to methadone or a waitlist control group from 1997 to 1998 and followed up after 4 months. Heroin use was measured by hair analysis and self report; drugs used and injected and syringe sharing were measured by self report. Hepatitis C and HIV incidence was measured by serology. Results: Of 593 eligible prisoners, 382 (64%) were randomised to MMT (n = 191) or control (n = 191). 129 treated and 124 control subjects were followed up at 5 months. Heroin use was significantly lower among treated than control subjects at follow up. Treated subjects reported lower levels of drug injection and syringe sharing at follow up. There was no difference in HIV or hepatitis C incidence. Conclusions: Consideration should be given to the introduction of prison methadone programs particular where community based programs exist. (C) 2003 Elsevier Ireland Ltd. All rights reserved.