Gynaecological Illness after Sterilization

A total of 374 patients were followed up for at least 10 years after tubal ligation, and 43% required further gynaecological treatment. Major gynaecological surgery was needed by 25%. There seems a good case for the selective use of hysterectomy as a method of sterilization.     

Illness after measles-mumps-rubella vaccination.

OBJECTIVES: To provide accurate information on the common sequelae of measles-mumps-rubella (MMR) vaccination and to compare post-vaccine symptoms in children vaccinated at 13 and 15 months. DESIGN: Prospective cluster randomized controlled trial. SETTING: Twenty-two family practices in southwestern Ontario. PATIENTS: All 376 infants who were due to receive MMR vaccine in the next year, 253 (67.3%) successfully completed the study. INTERVENTION: MMR vaccine administered at 13 months by half of the family physicians and at 15 months by the remaining half. OUTCOME MEASURES: Family physician''s physical findings in children 7 days and 30 days after vaccine; reported illnesses by mothers in a daily diary in the month before and after vaccination and medical records of visits to family physicians and hospital admissions in the month before and after vaccination. RESULTS: Compared with the incidence rates in the corresponding weeks before vaccination, the rates of lymphadenopathy (23.8%) and fever (16.8%) were higher 1 week afterward and the rate of rash (26.9%) was higher 7 to 14 days afterward. Fewer health problems were reported in the third and fourth weeks after vaccination than in the corresponding weeks beforehand. Hospital admissions after vaccination were no more frequent than those before once cause and time of admission were taken into account. The two age groups did not differ in any of the outcomes. CONCLUSIONS: Mothers should be informed about the possibility of increased physical findings in the weeks after MMR vaccination, especially lymphadenopathy, nasal discharge and rash. Since the occurrence of sequelae does not seem to differ significantly between 13-month-old recipients and 15-month-old recipients, it should not influence the decision of when to administer the vaccine.     

Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation

Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activity for at least two years following the cardiac rehabilitation programme. Participants were recruited from circuit training classes in East Sussex in the UK. Thematic content analysis revealed seven main themes: fear of death and ill health avoidance, critical incidents, overcoming aging, social influences, being able to enjoy life, provision of routine and structure, enjoyment and psychological well-being. Fear of death, illness avoidance, overcoming aging, and being able to enjoy life were powerful motives for continued participation in exercise. The social nature of the exercise class was also identified as a key facilitator of continued participation. Group-based exercise suited those that continued exercise participation post cardiac rehabilitation and fostered adherence.