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In 2006 the avian influenza A (H5N1) virus received considerable media coverage in Australia, as it did in many other countries. It is often argued that the media sensationalizes health crises, and experts cautioned about the risk of panic as a result of fear of avian influenza. The purpose of the present study was to systematically analyze Australian print media coverage of avian influenza in 2006 and to examine whether this coverage served the purpose of informing, rather than alarming, the general public. For the period January 1, 2006 to December 31, 2006, 20 Australian newspaper titles were monitored for coverage of avian influenza. The identified articles were analyzed using aspects of protection motivation theory for theoretical direction to determine whether there were any consistent themes or perspectives in the coverage. A total of 850 articles were identified for analysis. Concerning vulnerability, 46% of articles reported the incidence of human cases, with 24% noting that avian influenza was a potential threat to Australia. The most common severity theme was “deadly” with over 50% of mentions, followed by “pandemic” with 35%. Only 11% of articles referred to any form of self-protection. We found that a considerable proportion of the articles reporting on avian influenza were framed in a way that had the potential to incite fear and panic amongst the public; the intensity of media coverage reduced over time; and, of particular concern, that there was little media coverage that focused on protective or preventative issues. Whether an influenza pandemic eventuates or not, it is prudent for governments and health authorities to continually develop appropriate resources and strategies to prepare the health system and the general public to respond to current, and future, infectious disease risks.

Leading medical experts have cautioned about the risk of inappropriate behavioural responses as a result of fear of avian influenza (bird flu) even before a pandemic emerges, and have emphasised the need for appropriate risk communication strategies. There is a paucity of in-depth qualitative research into the general public's understanding of, and reactions to, such potential health crises. Four focus groups were conducted in April 2006 and a further eight focus groups in July 2006, to examine people's knowledge, beliefs and behaviours in relation to avian influenza, with the primary aim being to inform the development of future communication strategies. It was clear from the focus groups that avian influenza is not a disease the participants perceive they are likely to acquire; it was not simply that Australia was far from mind when thinking of avian influenza, but that they also saw Australia as a haven protected from avian influenza. We found that, in general, participants see avian influenza as yet another example of media sensationalism—not as a disease that poses any real risk to Australia—and are clearly unprepared for a potential outbreak. Governments and health authorities should conduct further research to understand consumer perceptions of avian (or other pandemic) influenza, and attitudes towards the recommended protective behaviours, in order to pro-actively develop communication strategies to rapidly inform the public and encourage appropriate behavioural responses in the event that the potential risk is realised. Copyright © 2009 John Wiley & Sons, Ltd.

Issue addressed: To evaluate the effectiveness of a brief intervention using a pedometer and step-recording diary on promoting physical activity in people with type 2 diabetes or impaired glucose tolerance (IGT). Methods: People with type 2 diabetes or IGT who attended the Illawarra Diabetes Service were invited to participate. Participants in the intervention group received a pedometer and a diary to record their daily steps for a two-week period. Both the intervention and comparison group received advice on physical activity. Physical activity levels were measured using the Active Australia Survey at baseline, and at two and 20 weeks. Results: A total of 226 participants were recruited. At two-week follow-up the mean self-reported minutes of walking was significantly higher in the intervention group than the comparison group (223 minutes versus 164 minutes; p=0.01), as was the percentage of intervention participants achieving recommended levels of moderate-intensity physical activity (63.5% versus 41.8%, p=0.02) and the percentage of intervention participants achieving adequate levels of total physical activity (68.9% versus 48.0%, p=0.04). There were no differences between study groups for any physical activity measure at 20-week follow-up. Conclusions: A pedometer and a step-recording diary were useful tools to promote short-term increase in physical activity in people diagnosed with type 2 diabetes or IGT. Future studies need to examine whether a longer intervention, individualised physical activity counselling and support for achieving step goals could result in increasing physical activity over the long term.

Background Cognitive behavioural therapy (CBT) is recommended for the treatment of depression and anxiety. However, access is limited. Low-intensity approaches such as guided CBT self-help (bibliotherapy) can increase access to treatment and is recommended by UK guidelines. No previous research has explored the provision of group-based guidance/support for a bibliotherapy approach for depression and anxiety in community settings. The objective was to carry out a pilot study of a group guided self-help intervention, using community based recruitment methods. Method A randomised controlled trial comparing an 8 week CBT group guided self-help intervention to usual care. Recruitment and the delivery of the intervention were carried out in Glasgow and Derry/Londonderry in partnership with national depression charities. Fifty-three people were randomised, however we refer only to the forty-six participants who provided baseline data: 16 males and 30 females, aged 16 or over, with a PHQ-9 score of ≥ 5, were recruited from the community. The mean age of the sample was 43.7 (sd = 13) and 93.5% of participants had suffered from low mood for a year or more. Results There was effective recruitment, randomisation, uptake and adherence with 21 Immediate Access (IA) and 25 Delayed Access Control (DAC) participants. The intervention was highly acceptable to participants attending on average 4.46 of the 8 sessions (sd 3.06), 65.2% attended more than half of all sessions. The mean satisfaction on the Client Satisfaction Questionnaire was 28 out of 32 (sd 4.8). The provisional results in the pilot suggest the intervention may improve both anxiety and depression. At three months, data collection was achieved from 74% of participants. The trial successfully provided estimates of the sample size needed for the future planned trial. Conclusions Low-intensity group-based classes may offer an alternative method of managing depression and anxiety and warrant further research. Trial registration Current Controlled Trials ISRCTN84893887. Registered 3 November 2011.

BackgroundCognitive behavioral therapy is recommended in the National Institute for Clinical Excellence guidelines for the treatment of bulimia nervosa. In order to make this treatment option more accessible to patients, interactive online CBT programs have been developed that can be used in the user’s own home, in privacy, and at their convenience. Studies investigating online CBT for bulimic type eating disorders have provided promising results and indicate that, with regular support from a clinician or trained support worker, online CBT can be effective in reducing bulimic symptoms. Two main factors distinguish this study from previous research in this area. First, the current study recruited a wide range of adults with bulimic type symptoms from the community. Second, the participants in the current study had used cCBT with support from a nonclinical support worker rather than a specialist eating disorder clinician. ObjectiveTo investigate participants’ experiences of using an online self-help cognitive behavioral therapy (CBT) package (Overcoming Bulimia Online) for bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS). MethodsEight participants with a mean age of 33.9 years took part in semi-structured interviews. Interviews were transcribed and analyzed using a 6-step thematic analysis process. ResultsSaturation was achieved, and 7 themes were identified in the dataset. These were: (1) conceptualizing eating disorders, (2) help-seeking behavior, (3) aspects of the intervention, (4) motivation to use the online package, (5) privacy and secrecy with regard to their eating problems, (6) recovery and the future, and (7) participant engagement describing individuals’ thoughts on taking part in the online research study. ConclusionsParticipants suggested that online CBT self-help represented a generally desirable and acceptable treatment option for those with bulimic type eating problems, despite some difficulties with motivation and implementation of some elements of the package. Trial RegistrationInternational Standard Randomized Controlled Trial Number of the original RCT that this study is based on: ISRCTN41034162; http://www.controlled-trials.com/ISRCTN41034162 (Archived by WebCite at http://www.webcitation.org/6Ey9sBWTV)

Introduction Pancreatic cancer (PC) is the sixth leading cause of cancer death in Australia and the fourth in the United States, yet research in PC is lagging behind that in other cancers associated with a high disease burden. In the absence of agreed processes to reliably identify research areas which can deliver significant advances in PC research, the Cancer Council NSW established a strategic partnership with the NSW Pancreatic Cancer Network to define critical research issues and opportunities that could accelerate progress in this field in Australia. Materials and methods The process consisted of five distinct stages: a literature review on recent progress in PC research, semi-structured expert interviews, a Delphi process, consumer focus groups, and a nominal group process. Information collected at each step informed the development of subsequent stages. Results The results from these steps were refined by the nominal group into a set of seven specific pancreatic cancer research goals. The goals were disseminated and led to a new funding scheme for key PC research priorities. Discussion This prioritisation exercise provided a much needed “road map” for research prioritisation in PC and served as a checklist to researchers applying for PC research grants to confirm how their research can contribute towards accelerating progress in PC research in Australia.