Print versus website physical activity programs: a randomized trial.

Background: Mediated physical activity interventions can reach large numbers of people at low cost. Programs delivered through the mail that target the stage of motivational readiness have been shown to increase activity. Communication technology (websites and e-mail) might provide a means for delivering similar programs. Methods: Randomized trial conducted between August and October 2001. Participants included staff at an Australian university (n=655; mean AGE=43, standard deviation, 10 years). Participants were randomized to either an 8-week, stage-targeted print program (Print) or 8-week, stage-targeted website (Web) program. The main outcome was change in self-reported physical activity. Results: There was no significant increase in total reported physical activity within or between groups when analyzed by intention to treat (F [1,653]=0.41, p=0.52). There was a significant increase in total physical activity reported by the Print participants who were inactive at baseline (t [1,173]=−2.21, p=0.04), and a significant decrease in the average time spent sitting on a weekday in the Web group (t [1,326]=2.2, p=0.03). Conclusions: There were no differences between the Print and Web program effects on reported physical activity. The Print group demonstrated slightly larger effects and a higher level of recognition of program materials.

A usability instrument for evaluating websites-navigation elements

Many small businesses websites have become an important advertising medium. However little consideration is given to how these websites might be made more effective. Many factors impact on website effectiveness, including navigation. Research here describes a usability instrument developed for evaluating small business websites and uses navigation as an example of its application. The research found that the quality of navigation does have an impact on ease-of-use of a site, user's emotional response and frustration levels and a user's intention to return to that website. The research also established the statistically significant elements that contribute to navigation.

Contract Law

Each title in the Butterworths Casebook Companions series provides a basic coverage of the principles of that area of law. Students are then directed to read specific cases and materials and are provided with pertinent questions designed to enhance their knowledge and understanding and ensure that they can apply the principles. Charts, diagrams and suggested tasks are included where appropriate to encourage active participation and learning and further explain and simplify material. Contract Law is designed for students who have no previous knowledge of contract law. The book covers all aspects of contract law, including: the nature and development of contract law; agreement; consideration; intention to create legal relations; capacities and formalities; terms and their construction; matters rendering a contract void, voidable or unenforceable; performance and termination; remedies; and solving contract problems. Preface Glossary of terms Table of cases Table of statutes Part 1 — Introduction Part 2 — Formation Part 3 — Scope and content Part 4 — Destruction Part 5 — Performance and termination Part 6 — RemediesIndex

Low-intensity pulsed ultrasound for chronic patellar tendinopathy : a randomized, double-blind, placebo-controlled trial

Objective. Patellar tendinopathy (PT) is a common and significant clinical condition for which there are few established interventions. One intervention that is currently being used clinically to manage PT symptoms is the introduction of low-intensity pulsed ultrasound (LIPUS). The aim of this study was to investigate the clinical efficacy of LIPUS in the management of PT symptoms.

Methods. A randomized, double-blind, placebo-controlled study was conducted. Volunteers with clinically and radiologically confirmed PT were randomly allocated to either an active-LIPUS (treatment) or inactive-LIPUS (placebo) group. LIPUS was self-administered by participants for 20 min/day, 7 days/week for 12 weeks. All participants also completed a daily, standardized eccentric exercise programme based on best practice. Primary outcomes were change in pain during the participant's most aggravating activity in the preceding week, measured on 10 cm visual analogue scales for both usual (VAS-U) and worst (VAS-W) tendon pain.

Results. Out of 156 individuals who volunteered, 37 met the eligibility criteria and were randomized to either active-LIPUS (n = 17) or inactive-LIPUS (n = 20). Using an intention-to-treat analysis, VAS-U and VAS-W for the entire cohort decreased by 1.6 ± 1.9 cm (P < 0.01) and 2.5 ± 2.4 cm (P < 0.01), respectively. There were no differences between the active- and inactive-LIPUS groups for change in VAS-U (–0.2 cm; 95% CI, –1.5, 1.1 cm) (P = 0.74) or VAS-W (–0.5 cm; 95% CI, –2.1, 1.1 cm) (P = 0.57). A per-protocol analysis provided similar results.

Conclusions. These findings suggest that LIPUS does not provide any additional benefit over and above placebo in the management of symptoms associated with PT.

Multimedia campaign on a shoestring : promoting 'Stay Active - Stay Independent' among seniors

Issue addressed: This paper describes a multimedia campaign implemented in rural New South Wales on a budget smaller than that typical of many published campaigns. The 'To Be Young at Heart- Stay Active Stay Independent' (SASI) campaign was one arm of a multi- strategic program to reduce falls among seniors by promoting physical activity. Methods: This 18-month campaign used social marketing techniques. Central to this campaign was strong formative research, significant use of corporate, community and media partnerships and a detailed, strategic distribution plan. Campaign reach was evaluated by a community intercept survey. Results: A variety of high quality information, education and communication (IEC) resources were developed. Overall, the campaign cost was calculated at $191,000. The actual cost of $42,000 (excluding staff time) was used to generate almost double this amount in sponsorship ($82,000). In the mid-campaign reach survey, 36% recognised the campaign and attributed this to television (58%), newspaper (33%), poster (13%) and bus-back advertising (8%). Of these respondents, 21% reported seeking information about physical activity, 33% reported increased intention to be more active, and 22% reported becoming more active as a result of the campaign. Conclusions: It is possible to develop and deliver a well designed, multimedia campaign on a limited budget by using sound formative research and engaging community and corporate partners to generate sponsorship. An effective distribution strategy is crucial and may require additional partnerships at State or national level.

Battlefield tourism in Turkey : an empirical analysis of British ex-colonial event attendance

This paper explores the influence of visitor satisfaction on intention to recommend event attendance. The Anzac Day commemoration at Gallipoli, Turkey, an event that has become increasingly popular in recent years and provides the backdrop for the current study. Some 20,000 people travel to attend this event. Data was collected from 331 attendees while they were in transit from Gallipoli to Istanbul on 25 April 2007. The analysis of this data was undertaken using factor analysis as a basis for identifying model constructs to be tested using structural equation modelling. Findings suggest that the constructs relating to the ceremonies held at Anzac Cove and Lone Pine and the experiential and emotional aspects of the event were significant predictors of event satisfaction and subsequent recommending behaviour. The implications of these findings for events in general and the success of the Anzac Day commemorations at Gallipoli are discussed.

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

Background: Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA), there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA.

Methods/Design: Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics.

Discussion: Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA.

Trial registration: ACTR12605000503628; NCT00415259.

Quality of reporting of randomized clinical trials in abstracts of the 2005 annual meeting of the American College of Rheumatology.

Objective: To determine the quality of abstracts reporting randomized clinical trials (RCT) at the 2005 Annual Scientific Meeting of the American College of Rheumatology.

Methods: All 2005 abstracts including late-breaking abstracts were assessed. An abstract was deemed to be reporting an RCT if it indicated that participants were randomized in the title or body of the abstract. RCT were excluded if they included only pharmacokinetic data. The CONSORT checklist was applied and relevant data extracted. We defined manufacturer support as acknowledgment of industry support or industry employee as co-author.

Results: Of 2146 abstracts, 143 (6.7%) reported RCT. Of these, 78.3% were drug trials, and 63.6% indicated manufacturer support. Only 30.8% of abstracts used "randomized" in the title, 44.1% did not explicitly state whether blinding was undertaken, and only 7.0% clearly stated who was blinded. Thirty percent of studies did not give an explicit definition of eligibility criteria of participants. While 84.6% explicitly described the experimental intervention, only 37.1% explicitly described the comparator intervention. Only 21% explicitly stated that an intention to treat analysis was performed. Baseline demographic and clinical characteristics were reported in 48.3%. While most abstracts reported summary results for each treatment group, only 35.7% reported effect size with its precision.

Conclusion: The quality of reporting is suboptimal in many RCT abstracts. Abstracts reporting RCT would benefit from a structured approach that ensures more detailed reporting of eligibility criteria, active and comparator interventions, flow of participants, and adequate summary and precision of results.

Detection of depression in patients with low vision

Purpose. Depression is common in people with vision impairment and further reduces levels of functioning independent of vision loss. However, depression most often remains undetected and untreated this group. Eye health  professionals (EHPs) (ophthalmic nurses, ophthalmologists, optometrists, and orthoptists) and rehabilitation workers (RWs) may be able to play a role in detecting depression. This study aimed to identify current practice and investigate factors associated with depression management strategies.
Methods. A self-administered cross-sectional survey of EHPs and RWs assessed current practice including confidence in working with depressed people with vision impairment; barriers to recognition, assessment, and management of depression; beliefs about the consequences, duration, and efficacy of treatment for depression in individuals with vision impariment.
Results. Ninety-four participants aged 23 to 69 years took part. Thirty-seven participants (39.8%) stated that they attempted to identify depression as part of patient management, with RWs significantly more likely to do so (n = 17, 60.7%) than EHPs (n = 20, 30.8%; p = 0.007). Intention to identify depression was not associated with sociodemographic factors, professional experience in eye care services, or the length and number of patient consultations, but a significant relationship was found for confidence, barriers, and beliefs about depression (p < 0.05). No consistent depression management strategy emerged and a range of barriers were highlighted.
Conclusions. Training programs are needed to provide EHPs and RWs with the skills and resources to address depression in people with vision loss under their care and to support the development of procedures by which concerns about depression can be identified objectively, documented, and included as part of a referral to appropriate services.

Marketing competencies : a cross-cultural study in a multinational company

Most research into international marketing focuses on the differences in markets across countries and cultures in terms of the variation in customers and products involved. Arguably, if different products are developed and offered to different customers, then the roles and requirements of marketing employees may reflect these differences also. This research study used self-report measures by marketing employees in a large multinational automotive company in Australia and Britain. Using structural equation modelling, the study found that the relationship between individual marketing competencies and marketing performance varied across countries, suggesting that there may be cultural differences that influence both the role of managers in improving performance, and the degree to which a marketing employee’s intention to perform results in actual performance.

Evaluation of a decision aid for prenatal testing of fetal abnormalities : a cluster randomised trial [ISRCTN22532458]

Background: By providing information on the relative merits and potential harms of the options available and a framework to clarify preferences, decision aids can improve knowledge and realistic expectations and decrease decisional conflict in individuals facing decisions between alternative forms of action. Decision-making about prenatal testing for fetal abnormalities is often confusing and difficult for women and the effectiveness of decision aids in this field has not been established. This study aims to test whether a decision aid for prenatal testing of fetal abnormalities, when compared to a pamphlet, improves women's informed decision-making and decreases decisional conflict.

Methods/design: A cluster designed randomised controlled trial is being conducted in Victoria, Australia. Fifty General Practitioners (GPs) have been randomised to one of two arms: providing women with either a decision aid or a pamphlet. The two primary outcomes will be measured by comparing the difference in percentages of women identified as making an informed choice and the difference in mean decisional conflict scores between the two groups. Data will be collected from women using questionnaires at 14 weeks and 24 weeks gestation.

The sample size of 159 women in both arms of the trial has been calculated to detect a difference of 18% (50 to 68%) in informed choice between the two groups. The required numbers have been adjusted to accommodate the cluster design, miscarriage and participant lost – to – follow up.

Baseline characteristics of women will be summarised for both arms of the trial. Similarly, characteristics of GPs will be compared between arms.

Differences in the primary outcomes will be analysed using 'intention-to-treat' principles. Appropriate regression techniques will adjust for the effects of clustering and include covariates to adjust for the stratifying variable and major potential confounding factors.

Discussion: The findings from this trial will make a significant contribution to improving women's experience of prenatal testing and will have application to a variety of maternity care settings. The evaluation of a tailored decision aid will also have implications for pregnancy care providers by identifying whether or not such a resource will support their role in providing prenatal testing information.

An empirical analysis of Australian and Portuguese consumers within the context of CSR and environmentalism

This cross country study examines the potential environmental predictors of consumers' green behaviour. It uses consumer’s self reported environmental behavioural intentions and examines its potential influence on corporate practice of social responsibility (CSR). A conceptual model was developed and was subjected to empirical verification using survey research design. It was hypothesised that CSR improves green behavioural purchase intension. PLS was used to estimate the measure of respondents’ overall perception of green products and their intention to purchase. It was found that in both countries, Australia and Portugal, CSR influenced purchase intentions. In both cases there was evidence of association between CSR and the consumers’ intention to purchase environmentally safe products.

An exploration of motives for attending Australian ecotourism locations and their influence on future intentions

This paper sought to explore the push [internal] motivations of eco-tourists and the influence of these motivational drives on their future ecotourism intentions. Findings from this exploratory study identified five key internal motivations, namely, 'self-esteem', 'relaxation', 'social interaction', 'self-fulfilment' and 'thrill and excitement'. Further analysis identified that 'self-esteem', elaxation' and 'self-fulfilment' motives were significantly related to ecotourist's intention to volunteer as well as their intention to donate money to an eco-tourism destination. Additionally, 'self-fulfilment' and 'thrill and excitement' motives were identified as impacting upon eco-tourists’ future attendance intentions. Consequently, findings from this research provide eco-tourism operators with insight into eco-tourist motivations to inform product and brand development and promotional activities and assist in the ongoing development effective eco-tourist retention strategies.

Condom use

The thesis is based upon tests of a model for predicting condom use. Anticipation of negative emotions following unprotected intercourse was the strongest predictor of intention to use condoms. Interventions which encourage people to consider the emotions they would experience following unprotected intercourse may prove valuable in promoting condom use.

A randomised trial of surgical, medical and expectant management of first trimester spontaneous miscarriage

Background: Medical management and expectant care have been considered possible alternatives to surgical evacuation of the uterus for first trimester spontaneous miscarriage in recent years.

Aim: To compare the effectiveness and safety of medical and expectant management with surgical management for first trimester incomplete or inevitable miscarriage.

Methods: Forty women were recruited following diagnosis of incomplete or inevitable miscarriage, and randomised to surgical, medical or expectant care via an off-site, computerised enrolment system. The primary outcome was the effectiveness of medical (vaginal misoprostol) and expectant management relative to surgical evacuation, assessed at 10–14 days and 8 weeks post-recruitment. Infection, pain, bleeding, anxiety, depression, physical and emotional recovery were assessed also. Analysis was by intention-to-treat.

Results: Effectiveness at 8 weeks was lower for medical (80.0%) and expectant (78.6%) than for surgical management (100.0%). Two women in the medical group had confirmed infections. Bleeding lasted longer in the expectant group than in the surgical group. There were no significant differences in pain, physical recovery, anxiety or depression between the groups. 54.6%, 42.9% and 57.1% of the surgical, medical and expectant groups respectively would opt for the same treatment again.

Conclusion: Expectant care appears to be sufficiently safe and effective to be offered as an option for women. Medical management might carry a higher risk of infection than surgical or expectant care.