In a randomised controlled trial, the internet-based ResilienceOnline (ROL) program was evaluated among sales managers from an Australian industrial organisation. This program is designed to enhance resilience by teaching seven skills to help improve ability to cope with challenges and setbacks and maximise potential achievements. Sales managers were allocated to complete the ROL program (n = 26) or to be in a waitlist-control condition (n = 27) and were compared on pre-and post-intervention measures of happiness, quality of life, depression, anxiety, stress and work performance. Sales managers found the resilience training very enjoyable and believed it would improve their work performance and life skills. However, a high proportion of sales managers did not complete the ROL program and it was not found to significantly reduce distress or improve quality of life or work performance.

Emphysematous pyelonephritis is a life-threatening necrotizing renal infection characterized by the production of gas. Of 8,105 admissions to our diabetes service during the last 5 years we identified 13 cases. The patients were managed aggressively with fluids and antibiotics, followed by immediate nephrectomy. The mortality rate is 40 to 50 per cent, primarily owing to sudden septic complications.

The effectiveness of a therapist-supported Internet intervention program for tinnitus distress in an industrial setting was evaluated using a cluster randomised design. Fifty-six Australian employees of two industrial organisations were randomly assigned, based on their work site (18 work sites from BP Australia and five from BHP Billiton), to either a cognitive behavioural therapy (CBT) program or an information-only control program. Participants were assessed at pre- and post-program, measuring tinnitus distress, depression, anxiety, stress, quality of life, and occupational health. The CBT program was not found to be superior to the information program for treating tinnitus distress. A high attrition rate and small sample size limit the generalisability of the findings, and further developments of the program and assessment process are needed to enhance engagement and compliance.

Epidural catheters moved a clinically significant amount with reference to the skin in all BMI groups as patients changed position. If catheters had been secured to the skin before position change, many would have been pulled partially out of the epidural space. To minimize the risk of catheter displacement, particularly in obese patients, we recommend that multiorificed catheters be inserted at least 4 cm into the epidural space and that patients assume the sitting upright or lateral position before securing the catheter to the skin.

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