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The aim of this study was to assess whether our online closed community heart care support group and information resource could sustain changes in health behaviour after the moderators withdrew their support. Heart patients (n = 108) living in a deprived area of Greater Manchester were recruited from general practitioners' coronary heart disease registries. The sample for this randomized controlled trial was divided in half at random where half of the participants received password-protected access to our health portal and the other half did not. At 6 months follow-up (based on the moderated phase), there was a significant difference between the experimental group and the controls in terms of self-reported diet (eating bad foods less often). This change in behaviour was not sustained during the 3-month unmoderated phase. During this unmoderated phase of the intervention, the experimental group had significantly more health care visits compared with the controls. There was no significant difference between the two phases for either group in terms of exercise, smoking or social support. This study offers insight into the potential implications for health changes of moderating arrangements for online health communities.

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The synthesis of evidence from trials and medical studies using meta-analysis is essential for Evidence Based Medicine. However, problematical outlying results often occur even under the random-effects model. We propose a model that allows a long-tailed distribution for the random effect, which removes the necessity for an arbitrary decision to include or exclude outliers. In this approach, they are included, but with a reduced weight. We also introduce a modification of the forest plot to show the downweighting of outliers. We illustrate the methodology and its usefulness by carrying out both frequentist and Bayesian meta-analyses using data sets from the Cochrane Collaboration.

a b s t r a c t The White Paper Choosing health acknowledges that there is no lack of information in the system about healthy lifestyles, but the manner of communication of risk and the level of support for lifestyle change need improvement. Action also has to be taken to address inequalities in health and to focus on securing better access to healthier choices for people in disadvantaged groups or areas. Accordingly, this randomized controlled trial examined whether access to a purpose-built health portal for heart disease could enable patients to manage better their heart conditions. We recruited 108 men and women aged 50-74 from coronary heart disease registries from a deprived area of Greater Manchester. Every participant received a new computer and one-year broadband subscription; however, only the experimental group received access to the Hearts of Salford health portal. Our results indicate that the experimental group changed their diet significantly. Specifi cally, they reported eating 'bad foods' (such as chips, sweets, crisps, fried foods, ready meals and cakes/biscuits) signifi cantly less often compared to the controls.

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Severe burns induce pathophysiologic problems, among them catabolism of lean mass, leading to protracted hospitalization and prolonged recovery. Oxandrolone is an anabolic agent shown to decrease lean mass catabolism and improve wound healing in the severely burned patients. We enrolled 81 adult subjects with burns 20% to 60% TBSA in a multicenter trial testing the effects of oxandrolone on length of hospital stay. Subjects were randomized between oxandrolone 10 mg every 12 hours or placebo. The study was stopped halfway through projected enrollment because of a significant difference between groups found on planned interim analysis. We found that length of stay was shorter in the oxandrolone group (31.6 +/- 3.1 days) than placebo (43.3 +/- 5.3 days; P < .05). This difference strengthened when deaths were excluded and hospital stay was indexed to burn size (1.24 +/- 0.15 days/% TBSA burned vs 0.87 +/- 0.05 days/% TBSA burned, P < .05). We conclude that treatment using oxandrolone should be considered for use in the severely burned while hepatic transaminases are monitored.