Susan Furber

Effects of a pedometer-based intervention on physical activity levels after cardiac rehabilitation: a randomized controlled trial.

PURPOSE In Australia, patient adherence to physical activity after a cardiac rehabilitation program (CRP) is poor. This study evaluated the efficacy of a pedometer-based intervention to increase physical activity after CRP. METHODS Patients (n = 110) who had attended a CRP were randomized into an intervention or a control group. The 6-week intervention included self-monitored physical activity using a pedometer and step calendar and 2 behavioral counseling and goal-setting sessions. Self-reported physical activity and psychosocial status were collected at baseline, 6 weeks, and 6 months. Participant exercise capacity was measured using a gas exchange analysis system. RESULTS Study groups were not significantly different at baseline, except for occupation. At 6 weeks and 6 months, improvements in total physical activity sessions (P = .002 and P = .016, respectively), walking minutes (P = .013, 6 weeks only), and walking sessions (P < .001 and P = .035) in the intervention group were significantly greater than those in the control group after adjusting for baseline differences. At 6 months, total physical activity minutes in the intervention group also increased significantly more than those in the control group (P = .044). These self-reported behavioral changes were corroborated by improvements in cardiorespiratory fitness at 6 months in the intervention group (P = .01). There were also significant improvements in psychosocial health at 6 weeks and 6 months in the intervention group. CONCLUSION The pedometer-based intervention was successful in increasing physical activity in cardiac patients after a CRP. This intervention could be given to patients to promote adherence to physical activity guidelines after a CRP, particularly in centers where maintenance programs are not available.

Organization of the olivocerebellar projection in the rat.

The olivocerebellar projection has been studied in the rat using the horseradish peroxidase (HRP) retrograde tracing technique. All regions of the cerebellum, except for the flocculonodular lobe, were

Randomised controlled trial of a pedometer-based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation

OBJECTIVE To determine the effectiveness of a pedometer-based telephone intervention on the physical activity levels of cardiac patients who did not attend a CRP. METHODS A randomised controlled trial was conducted with 215 patients referred to a CRP but who could not or chose not to attend. The 6-week intervention included self-monitoring of physical activity using a pedometer and step calendar; and behavioural counselling and goal setting sessions. Data were collected at baseline, 6 weeks and 6 months. RESULTS Study groups did not differ significantly at baseline. After 6 weeks, improvements in total physical activity time (p=0.027), total physical activity sessions (p=0.003), walking time (p=0.013) and walking sessions (p=0.002) in the intervention group were significantly greater than the control group after adjusting for baseline differences, and remained significant at 6 months. CONCLUSION The findings that the pedometer-based telephone intervention was successful in increasing physical activity levels in cardiac patients who did not attend a CRP could result in major health benefits for this group of people. PRACTICAL IMPLICATIONS The pedometer-based telephone intervention could be offered as an effective and accessible option for patients not attending a CRP to increase and maintain their physical activity levels after hospitalisation.

The organization of the olivocerebellar projection in the chicken.

The olivocerebellar pathway in the chicken was studied, using the horseradish peroxidase retrograde tracing technique. The inferior olivary nuclear complex (IOC) of the chicken comprises a dorsal and a ventral lamella and projects to the contralateral cerebellar hemisphere. In this paper the organization of the olivocerebellar pathways in the chicken is compared with the mammalian olivocerebellar pathway. The present results, taken in conjunction with data on the embryogenesis of the rat IOC, suggest that the avian dorsal lamella represents, from lateral to medial, the dorsal olivary nucleus, the principal olivary nucleus, and the rostral and a small part of the caudal medial nucleus (MO) of mammals, while the ventral lamella represents a larger part of the caudal MO of mammals.

Asthma Knowledge and Medication Compliance Among Parents of Asthmatic Children in Nanjing, China

Asthma knowledge and medication compliance among parents of 150 asthmatic children in Nanjing were assessed using a self-administered questionnaire. The results showed that 54.7% of parents had poor knowledge of asthma and its management. Parental compliance with medication was also suboptimal as only 43.3% of parents reported adherence with prescribed anti-asthmatic medication for their children. Reasons for non-compliance included fear of medication side-effects and tolerance, and forgetting to give the childs medication. Education and occupation were found to be associated with asthma knowledge, however there was no association between age or income with knowledge. Income was associated with compliance with asthma medication, however no association was found between parents’ age, education, occupation, or asthma knowledge with compliance. This study has identified the need for accurate and up-to-date information on asthma for parents of asthmatic children as well as programs aimed at teaching parents skills in managing their childs asthma. There is also the need for strategies aimed at improving communication between the health provider and parents of asthmatic children.

A population-based lifestyle intervention to promote healthy weight and physical activity in people with cardiac disease: The PANACHE (Physical Activity, Nutrition And Cardiac HEalth) study protocol

BackgroundMaintaining a healthy weight and undertaking regular physical activity are important for the secondary prevention of cardiovascular disease (CVD). However, many people with CVD are overweight and insufficiently active. In addition, in Australia only 20-30% of people requiring cardiac rehabilitation (CR) for CVD actually attend. To improve outcomes of and access to CR the efficacy, effectiveness and cost-effectiveness of alternative approaches to CR need to be established.This research will determine the efficacy of a telephone-delivered lifestyle intervention, promoting healthy weight and physical activity, in people with CVD in urban and rural settings. The control group will also act as a replication study of a previously proven physical activity intervention, to establish whether those findings can be repeated in different urban and rural locations. The cost-effectiveness and acceptability of the intervention to CR staff and participants will also be determined.Methods/DesignThis study is a randomised controlled trial. People referred for CR at two urban and two rural Australian hospitals will be invited to participate. The intervention (healthy weight) group will participate in four telephone delivered behavioural coaching and goal setting sessions over eight weeks. The coaching sessions will be on weight, nutrition and physical activity and will be supported by written materials, a pedometer and two follow-up booster telephone calls. The control (physical activity) group will participate in a six week intervention previously shown to increase physical activity, consisting of two telephone delivered behavioural coaching and goal setting sessions on physical activity, supported by written materials, a pedometer and two booster phone calls. Data will be collected at baseline, eight weeks and eight months for the intervention group (baseline, six weeks and six months for the control group). The primary outcome is weight change. Secondary outcomes include physical activity, sedentary time and nutrition habits. Costs will be compared with outcomes to determine the relative cost-effectiveness of the healthy weight and physical activity interventions.DiscussionThis study addresses a significant gap in public health practice by providing evidence for the efficacy and cost-effectiveness of a low cost, low contact, high reach intervention promoting healthy weight and physical activity among people with CVD in rural and urban areas in Australia. The replication arm of the study, undertaken by the control group, will demonstrate whether the findings of the previously proven physical activity intervention can be generalised to new settings. This population-based approach could potentially improve access to and outcomes of secondary prevention programs, particularly for rural or disadvantaged communities.Trial RegistrationACTRN12610000102077

Progression and Regression of Low‐grade Epithelial Abnormalities of the Cervix

Summary: The records of 738 women with low‐grade cervical epithelial abnormalities were examined for changes in degree of cervical disease and lesion size, as well as sociodemographic and behavioural factors which influence the development of invasive cancer of the cervix. Survival analysis was used to determine the predictors and rates of progression and regression. The results suggest that about 80% of low‐grade epithelial abnormalities of the cervix will not progress within 2 years. The only predictors of progression were a biopsy diagnosis of CIN 1 and die size of the lesion. Predictors of regression were older age, older age at first intercourse, greater parity, fewer sexual partners, and absence of a past history of genital herpes. Although progression rates of low‐grade abnormalities of the cervix were very low, CIN 1 lesions were 2.4 times (95% CI: 1.6 to 3.7) more likely to progress than lower‐grade lesions and large lesions (>l/2 ectocervix) were 2.0 times (95% CI: 1.2 to 3.3) more likely to progress than small ones (

People’s experiences of using outdoor gym equipment in parks

Studies show that parks provide people with the opportunity to participate in physical activity and encourage social interactions. However, there are few studies on the role of outdoor gym equipment on physical activity and social interactions, despite the increasing trend of installing gym equipment in parks in Australia and overseas. This study aims to determine peoples experiences of using outdoor gym equipment in relation to physical activity and social interactions.

Effectiveness of a Pedometer-based Telephone Coaching Program on Weight and Physical Activity for People Referred to a Cardiac Rehabilitation Program: a randomised controlled trial.

PURPOSE: To determine the effectiveness of a pedometer-based telephone lifestyle coaching intervention on weight and physical activity. METHODS: A randomized controlled trial was conducted with 313 patients referred to cardiac rehabilitation in rural and urban Australia. Participants were allocated to a healthy weight (HW) (4 telephone coaching sessions on weight and physical activity) or a physical activity (PA) intervention (2 telephone coaching sessions on physical activity). Weight and physical activity were assessed by self-report at baseline, short-term (6-8 weeks), and medium-term (6-8 months). RESULTS: More than 90% of participants completed the trial. Over the medium-term, participants in the HW group decreased their weight compared with participants in the PA group (P = .005). Participants in the HW group with a body mass index of ≥25 kg/m2 had a mean weight loss of 1.6 kg compared with participants in the PA-only group who lost a mean of 0.4 kg (P = .015). Short-term, both groups increased their physical activity time, and the PA group maintained this increase at the medium-term. CONCLUSIONS: Participants in the HW group achieved modest improvements in weight, and those in the PA group demonstrated increased physical activity. Low-contact, telephone-based interventions are a feasible means of delivering lifestyle interventions for underserved rural communities, for those not attending cardiac rehabilitation, or as an adjunct to cardiac rehabilitation.

Rapid versus intermediate health impact assessment of foreshore development plans

OBJECTIVE To describe the main differences between conducting a rapid health impact assessment (HIA) and an intermediate HIA on foreshore development plans and their feasibility from a health service perspective. METHODS A rapid HIA and an intermediate HIA were undertaken on two foreshore development plans. RESULTS The main differences between the two HIAs were in the identification, assessment and decision-making stages of the HIA. CONCLUSION While the rapid HIA was less resource intensive than the intermediate HIA, there are several factors that affect the feasibility of conducting this type of HIA within a short time period.