A review of the first year's experience with an automatic message-routing system for low-cost telemedicine

The Swinfen Charitable Trust has used email for some years as a low-cost telemedicine medium to provide consultant support for doctors in developing countries. A scalable, automatic message-routing system was constructed which automates many of the tasks involved in message handling. During the first 12 months of its use, 1510 messages were processed automatically. There were 128 referrals from 18 hospitals in nine countries. Of these 128 queries, 89 (70%) were replied to within 72 h; the median delay was 1.1 day. The 39 unanswered queries were sent to backup specialists for reply and 36 of them (92%) were replied to within 72 h. In the remaining three cases, a second-line (backup) specialist was required. The referrals were handled by 54 volunteer specialists from a panel of over 70. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 0.2 days (interquartile range, IQR, 0.1-0.8). The median interval between receipt of a new referral and first reply was 2.6 days (IQR 0.8-5.9). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.

Initiation of fungal epizootics in diamondback moth populations within a large field cage: proof of concept for auto-dissemination

Adult diamondback moths (DBM), Plutella xylostella L. (Lepidoptera: Plutellidae), inoculated with the fungus Zoophthora radicans, were released within a large field cage containing DBM-infested potted broccoli plants. Larvae and pupae on exposed and caged control plants were examined on five occasions over the next 48 days for evidence of Z. radicans infection. Infected larvae were first detected on exposed plants 4 days after the initial release of adults, and after 48 days the infection level reached 79%. Aerially borne conidia were a factor in transmission of the fungus. Infection had no effect on possible losses of larval and adult cadavers due to scavengers in field crops. In a trial to measure the influence of infection on dispersal, twice as many non-infected as infected males were recaptured in pheromone traps, although the difference in cumulative catch only became significant 3 days after release of the males. In a separate experiment, when adult moths were inoculated with Beauveria bassiana conidia and released into the field cage, DBM larvae collected from 37 of 96 plants sampled 4 days later subsequently died from B. bassiana infection. The distribution of plants from which the infected larvae were collected was random, but the distribution of infected larvae was clustered within the cage. These findings suggest that the auto-dissemination of fungal pathogens may be a feasible strategy for DBM control, provided that epizootics can be established and maintained when DBM population densities are low.

Automatic message handling for a national counselling service

An automatic email handling system (AutoRouter) was introduced at a national counselling service in Australia. In 2003, counsellors responded to a total of 7421 email messages. Over nine days in early May 2004 the administrator responsible for the management of the manual email counselling service recorded the time spent on managing email messages. The AutoRouter was then introduced. Since the implementation of the AutoRouter the administrator's management role has become redundant, an average of 12 h 5 min per week of staff time has been saved. There have been further savings in supervisor time. Counsellors were taking an average of 6.2 days to respond to email messages (n=4307), with an average delay of 1.2 days from the time counsellors wrote the email to when the email was sent. Thus the response was sent on average 7.4 days after receipt of the original client email message. A significant decrease in response time has been noted since implementation of the AutoRouter, with client responses now taking an average of 5.4 days, a decrease of 2.0 days. Automatic message handling appears to be a promising method of managing the administration of a steadily increasing email counselling service.

Mobile message services and communications policy

Something of a design after-thought, mobile phone SMS (Short-Message Services) have been enthusiastically adopted by consumers worldwide, who have created a new text culture. SMS is now being deployed to provide a range of services and transactions, as well as playing a critical role in offering an interactive path for television broadcasting. In this paper we offer a case study of a lucrative, new industry developing internationally at the intersection of telecommunications, broadcasting, and information services—namely, premium rate SMS/MMS. To explore the issues at stake we focus on an Australian case study of policy responses to the development of premium rate mobile messaging services in the 2002-2005 period. In the first part, we give a brief history of premium rate telecommunications. Secondly, we characterise premium rate mobile message services and examine their emergence. Thirdly, we discuss the responses of Australian policy-makers and industry to these services. Fourthly, we place the Australian experience in international context, and indicate common issues. Finally, we draw some conclusions from the peregrinations of mobile message services for regulators grappling with communications policy frameworks.

Rumors denials as persuasive messages: Effects of personal relevance, source, and message characteristics

Denial is a commonly used strategy to rebut a false rumor. However, there is a dearth of empirical research on the effectiveness of denials in combating rumors. Treating denials as persuasive messages, we conducted 3 laboratory-based simulation studies testing the overall effectiveness of denials in reducing belief and anxiety associated with an e-mail virus rumor. Under the framework of the elaboration likelihood model, we also tested the effects of denial message quality and source credibility, and the moderating effects of personal relevance. Overall, the results provided some support for the effectiveness of denials with strong arguments and an anxiety-alleviating tone in reducing rumor-related belief and anxiety. The effects of denial wording and source credibility were visible for participants who perceived high personal relevance of the topic. Limitations of the current research and future research directions are discussed.

Group-directed criticism in Indonesia: Role of message source and audience

Research in individualist cultures has shown that group members are more likely to agree with criticisms of their group when the criticisms are made by another ingroup member as opposed to an outgroup member (the intergroup sensitivity effect). However, evaluations of ingroup critics are often harsher when they take their comments to an outgroup audience. In light of research on facework and tolerance for dissent, it seems important to test whether these effects are generalizable to a collectivist culture. Indonesian Muslims (N = 191) received a criticism of their religion stemming either from another Muslim or a Christian, and published in either a Muslim or a Christian newspaper. Participants agreed with the comments more when they were made by an ingroup as opposed to an outgroup member. Furthermore, consistent with previous research in Australia, the effects of audience on agreement were moderated by levels of group identification. Results are discussed in relation to theory about the functional role internal critics can play in group life.

An extensive repertoire of type III secretion effectors in Escherichia coli O157 and the role of lambdoid phages in their dissemination

Several pathogenic strains of Escherichia coli exploit type III secretion to inject effector proteins into human cells, which then subvert eukaryotic cell biology to the bacterium's advantage. We have exploited bioinformatics and experimental approaches to establish that the effector repertoire in the Sakai strain of enterohemorrhagic E. coli (EHEC) O157:H7 is much larger than previously thought. Homology searches led to the identification of > 60 putative effector genes. Thirteen of these were judged to be likely pseudogenes, whereas 49 were judged to be potentially functional. In total, 39 proteins were confirmed experimentally as effectors: 31 through proteomics and 28 through translocation assays. At the protein level, the EHEC effector sequences fall into > 20 families. The largest family, the NleG family, contains 14 members in the Sakai strain alone. EHEC also harbors functional homologs of effectors from plant pathogens (HopPtoH, HopW, AvrA) and from Shigella (OspD, OspE, OspG), and two additional members of the Map/IpgB family. Genes encoding proven or predicted effectors occur in > 20 exchangeable effector loci scattered throughout the chromosome. Crucially, the majority of functional effector genes are encoded by nine exchangeable effector loci that lie within lambdoid prophages. Thus, type III secretion in E. coli is linked to a vast phage metagenome, acting as a crucible for the evolution of pathogenicity.

Axillary bud outgrowth: sending a message

Mutants that branch profusely in the presence of a growing shoot tip have highlighted the role of graft-transmissible signals that are produced in roots and stem. Orthologous genes in Arabidopsis, pea and petunia are involved in the transmission of a novel long-distance message. These genes show varying degrees of regulation by auxin and an auxin-independent feedback system, and encode enzymes that might act on carotenoid-like substrates. Axillary bud outgrowth is under homeostatic control, involving developmental stages or checkpoints. Perturbation of the long-range messaging and auxin depletion does not guarantee that bud outgrowth will ensue at a particular node.

Dissemination of a community-based physical activity project: The case of 10,000 steps

This paper describes the use of a web-site for the dissemination of the community-based '10,000 steps' program which was originally developed and evaluated in Rockhampton, Queensland in 2001-2003. The website provides information and interactive activities for individuals, and promotes resources and programs for health promotion professionals. The dissemination activity was assessed in terms of program adoption and implementation. In a 2-year period (May 2004-March 2006) more than 18,000 people registered as users of the web-site (togging more than 8.5 billion steps) and almost 100 workplaces and 13 communities implemented aspects of the 10,000 steps program. These data support the use of the internet as an effective means of disseminating ideas and resources beyond the geographical borders of the original project. Following this preliminary dissemination, there remains a need for the systematic study of different dissemination strategies, so that evidence-based physical activity programs can be translated into more widespread public health practice. (c) 2006 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Evidence-based approaches to dissemination and diffusion of physical activity interventions

With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

The Populist Message of Australian Country Music

Australian country music is influenced by American country music and Australian bush ballads. This music idealises genuine true blue inhabitants of an idealised rural heartland and fuses nationalism with agrarian mythology. The lyrics of a number of country songs contain a populist political message, which is frequently nationalistic but is a form of nationalism.