APPROACHES TO PROMOTING MORE WIDESPREAD PARTICIPATION IN PHYSICAL ACTIVITY

Exercise is associated with a reduced risk of coronary heart disease, has beneficial effects on cardiovascular risk factors, and has other health benefits. No more than 10 per cent to 20 per cent of adults in Australia and other developed countries participate in regular vigorous physical activity, while over 65 per cent of Australian adults are almost totally sedentary. Survey data from the U.S.A. suggest that levels of participation in jogging and walking have increased in the past 10 years but that the proportion of people who take no deliberate exercise has also increased. Large-scale community interventions to promote exercising have not been subject to rigorous evaluation and it is difficult to reach any firm conclusions about the effects of exercise promotion. However, it is possible to identify some of the factors which may influence exercise participation, and there is information from trials of large-scale, multifactorial interventions to reduce cardiovascular risk which provides some helpful guidelines about how it may be useful to proceed. Approaches to increasing levels of exercise participation should emphasise community-based efforts which provide appropriate settings and social support for exercising, making exercise a more appealing and accessible option for large numbers of people; the use of mass media for community education about exercising should be co-ordinated carefully with specific community activities. Personalized fitness instruction, groups and classes should place more emphasis on exercise as a pattern of behaviour to be integrated into a person's way of life and maintained over time; and there is the potential for more widespread and systematic use of self-instructional exercise materials to assist people who wish to exercise independently. Because there exist only limited local research findings and work in other countries does not yet provide conclusive information, research and development priorities for these areas are suggested.     

Comparative study of four wound dressings on epithelization of partial-thickness wounds in pigs

Sixteen shallow wounds were inflicted in each of five Yorkshire white female piglets, 18-20 kg body weight, by a 2-cm diameter, fast-rotating abrasive disc. The injury is similar to a second-degree burn. The wounds were dressed with one of four dressings: Duoderm (Squibb), Op-Site (Smith & Nephew) [corrected], and collagen sponge, covered with either occlusive or semiocclusive polyurethane film (Datascope Corp.). The last two dressings were moistened with saline before application. The rate of epithelization by planimetric quantitation after 3 to 5 days was the same regardless of the dressing used, although the epithelium layer was thicker in wounds treated with Duoderm. Wounds dressed by either of the collagen sponge materials showed a better appearance when visually scored. Wounds dressed with Duoderm or Op-Site were often macerated; Duoderm's paste-like material remained on the wound and was difficult to remove without inflicting discomfort to the patient. Duoderm, and also Op-Site, adhered much more strongly to the intact skin than either type of collagen sponge dressing.     

The use of thromboprophylaxis in total hip replacement surgery: are the attitudes of orthopaedic surgeons changing?

We conducted a survey of all 926 active members of the British Orthopaedic Association using a postal questionnaire to find out their current attitude to thromboprophylaxis in total hip replacement surgery. Previous surveys have been performed, and with all the recent literature on the subject we wanted to see if the attitude of British orthopaedic surgeons has changed. There were 676 replies, a response rate of 73%. Fifty-five replies were excluded, those from surgeons who had retired from practice or whose practice did not include total hip replacement surgery. Of the remaining 621 surgeons, 466 (75%) use some method of thromboprophylaxis, with 367 (59%) routinely using prophylactic pharmacological agents and 99 (16%) using mechanical methods of thromboprophylaxis. Twenty-five per cent (155) of surgeons used no routine method of thromboprophylaxis. Eight-six per cent (534) of surgeons used a pharmacological method of prophylaxis in those patients thought to have a high risk of developing a deep vein thrombosis (DVT) (eg previous DVT, cardiovascular disease, obesity). Thirty-two different methods of thromboprophylaxis were used. Low molecular weight heparin is now being used by 19% of surgeons routinely and by 25% of surgeons in high risk cases, whereas 3 years ago it was not used at all. Our survey shows that although there is still a great reluctance for British orthopaedic surgeons to use pharmacological agents routinely in thromboprophylaxis. Amongst those that do, low molecular weight heparin is being increasingly used. More surgeons may want to use low molecular weight heparin routinely, but in some hospitals it is not currently available.     

An investigation of the neuropsychological profile in adults with velo-cardio-facial syndrome (VCFS).

Velo-cardio-facial syndrome (VCFS) is associated with deletions on the long arm of chromosome 22, mild intellectual disability, poor social interaction and a high prevalence of psychosis. However, to date there have been no studies investigating the neuropsychological functioning of adults with VCFS. We compared 19 adults with VCFS with 19 age, gender and IQ matched controls using a comprehensive neuropsychological battery. Compared to controls, adults with VCFS had significant impairments in visuoperceptual ability (Visual Object and Space Perception Battery), problem solving and planning (Tower of London) and abstract and social thinking (Comprehension WAIS-R). It is likely that haploinsufficiency (reduced gene dosage) of a neurodevelopmental gene or genes mapping to chromosome 22q11 underlies the cognitive deficits observed in individuals with VCFS.     

Deficits in spatial coding and feature binding following damage to spatiotopic maps in the human pulvinar.

We report a patient with unilateral damage to the rostral part of the pulvinar who was impaired in localizing stimuli in the inferior visual field contralateral to the lesion and who made errors in the binding of shape and color in that quadrant. The findings demonstrate the importance of the pulvinar in spatial coding and provide support for the function of the thalamus in binding of features. They also provide evidence for a homology between the visual field maps of the inferior and lateral subdivisions of the pulvinar in monkeys and in humans, such that the inferior visual field is represented in the rostral part of the nucleus.