The health-related quality of life of overweight and obese adolescents - a study measuring body mass index and adolescent-reported perceptions

Objective. To determine whether the health-related quality of life (HRQOL) of overweight and obese adolescents is significantly lower than that of their healthy weight counterparts, and if so, whether any demographic trends exist and the relative contribution of each HRQOL dimension.

Methods. Cross-sectional analysis of 2,890 students participating in the Pacific Obesity Prevention in Communities Project, Australia. HRQOL was measured using the Pediatric Quality of Life Inventory (PedsQL) adolescent module. Adolescent height and weight were measured by trained field workers and weight categories assigned according to the International Obesity Task Force BMI cut-off points for adolescents. Multivariate linear regression analyses were undertaken to estimate the mean differences in HRQOL scores between (i) overweight and healthy weight, and (ii) obese and healthy weight adolescents, whilst adjusting for gender, age and socioeconomic status quartile.

Results. The sample had a mean age of 14.6 years (range 11–18), 56.2% boys, 20.2% overweight and 6.3% obese. Higher weight status categories were associated with lower HRQOL scores (mean PedsQL scores: healthy weight: 79.1, overweight: 77.7 and obese: 73.7). Relative to the healthy weight group, and after adjustments, overweight and obese adolescents reported 1.44 (p = 0.005) and 5.55 (p < 0.001) lower HRQOL summary scores, respectively. Overweight adolescents reported significantly lower scores in physical and social functioning, whilst obese adolescents reported significantly lower scores in the same dimensions plus emotional functioning. Girls and younger (< 15 years) adolescents reported greater mean negative HRQOL differences associated with excess weight.

Conclusions. Overweight and obesity in adolescents are associated with significantly lower HRQOL scores.

Assessing the practice of project-based JV between local and international contractors in the UAE

This paper is about assessing the practice of Project-Based Joint Ventures formed between local and international contractors in the UAE construction industry. This common practice nowadays, provides the means for contractors to quickly add resources to enhance project acquisition. Studies indicate that JVs are among the tools that contractors will need to get together in the face of increasing market demands. Specifically, Project-Based JVs are often used in the UAE Construction industry with an exceptional growth in an attempt to diversify from Oil and Gas. The UAE is very business friendly which makes it attractive for such kind of alliance or partnership for local contractors to get the necessary experience and for international contractors to minimize the risks associated with entering new markets. In this context, studies that evaluate this alliance phenomenon in the UAE construction industry are limited. The few industry-related studies have primarily focused on large, international JVs; yet, many JVs are formed on small and medium-sized projects within the UAE. The paper aims to assess the current practices and understand the many factors involved with forming, managing, and controlling JV partnerships. The research methodology adopted a mix of quantitative and qualitative approaches. First, a closed question survey was disseminated to construction professionals in the UAE in light of the literature findings. Second, two case studies were demonstrated and analysed, then triangulated with the literature and survey findings to remove possible bias and improve the confidence in the collected data. The paper concluded that the JV in the UAE construction industry is mostly formed on project-basis rather than continuous collaboration. The management control mostly used in the UAE construction industry is shared management of activities in a venture with the operations shared between parents. The paper addressed major factors that lead to successful JV in the construction projects of the UAE which are namely trust, correct structure, communication, and partner’s commitment. Partners’ common objectives do not affect the JV success or failure. Willingness to adapt eliminates conflicts and enhances the JV success prospect.

International study of objectively measured physical activity and sedentary time with body mass index and obesity: IPEN adult study

BACKGROUND: Physical activity (PA) has been consistently implicated in the etiology of obesity, whereas recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose-response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose-response associations of accelerometer-based PA and sedentary time with body mass index (BMI) and weight status in 10 countries, and the moderating effects of study site and gender. METHODS: Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18-65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations. RESULTS: A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts per minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min per day) and higher counts per minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status. CONCLUSIONS: On the basis of these results, the current Institute of Medicine recommendation of 60 min per day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines. © 2015 Macmillan Publishers Limited All rights reserved.

International study of perceived neighbourhood environmental attributes and Body Mass Index: IPEN Adult study in 12 countries

BACKGROUND: Ecological models of health behaviour are an important conceptual framework to address the multiple correlates of obesity. Several single-country studies previously examined the relationship between the built environment and obesity in adults, but results are very diverse. An important reason for these mixed results is the limited variability in built environments in these single-country studies. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and BMI/weight status in a multi-country study including 12 environmentally and culturally diverse countries. METHODS: A multi-site cross-sectional study was conducted in 17 cities (study sites) across 12 countries (Australia, Belgium, Brazil, China, Colombia, Czech Republic, Denmark, Mexico, New Zealand, Spain, the UK and USA). Participants (n = 14222, 18-66 years) self-reported perceived neighbourhood environmental attributes. Height and weight were self-reported in eight countries, and measured in person in four countries. RESULTS: Three environmental attributes were associated with BMI or weight status in pooled data from 12 countries. Safety from traffic was the most robust correlate, suggesting that creating safe routes for walking/cycling by reducing the speed and volume of traffic might have a positive impact upon weight status/BMI across various geographical locations. Close proximity to several local destinations was associated with BMI across all countries, suggesting compact neighbourhoods with more places to walk related to lower BMI. Safety from crime showed a curvilinear relationship with BMI, with especially poor crime safety being related to higher BMI. CONCLUSIONS: Environmental interventions involving these three attributes appear to have international relevance and focusing on these might have implications for tackling overweight/obesity.

Challenges to providing work integrated learning to international business students at Australian universities

Purpose – The purpose of this paper is to report on a three-year Australian study of international business and accounting students and the transition to employment. For international students seeking to differentiate themselves in a highly competitive global labour market, foreign work experience is now an integral part of the overseas study “package”. Work-integrated learning (WIL) is seen to provide critical “employability” knowledge and skills, however, international students have low participation rates. The high value placed on WIL among international students poses challenges for Australia as well as opportunities. Understanding the issues surrounding international students and WIL is closely linked to Australia’s continued success in the international education sector which has broad, long-term, social and economic implications.Design/methodology/approach – This paper draws on 59 interviews with a range of stakeholders including international students, universities, government, employers and professional bodies. Central to the paper is an in-depth case study of WIL in the business and accounting discipline at one Australian university.Findings – Providing international students with access to discipline-related work experience has emerged as a critical issue for Australian universities. The study finds that enhancing the employability skills of internationals students via integrated career education, a focus on English language proficiency and “soft skills” development are central to success in WIL. Meeting the growing demand for WIL among international students requires a multipronged approach which hinges on cooperation between international students, universities, employers and government.Originality/value – This project aims to fill a critical knowledge gap by advancing theories in relation to international students and WIL. While there is a significant body of research in the fields of international education and WIL, there is an absence of research exploring the intersection between the two fields. The study will contribute to the advancement of knowledge in both fields by exploring the emerging issue of WIL and international students.

‘I’m not like that, why treat me the same way?’ The impact of stereotyping international students on their learning, employability and connectedness with the workplace

A significant body of literature on international education examines the experiences of international students in the host country. There is however a critical lack of empirical work that investigates the dynamic and complex positioning of international students within the current education-migration nexus that prevails international education in countries such as Australia, Canada and the UK. This paper addresses an important but under-researched area of the education-migration landscape by examining how the stereotyping of students as mere ‘migration hunters’ may impact their study and work experiences. It draws on a four-year research project funded by the Australian Research Council that includes more than 150 interviews and fieldwork in the Australian vocational education context. Positioning theory is used as a conceptual framework to analyse how generalising international students as ‘mere migration hunters’ has led to the disconnectedness, vulnerability and marginalization of the group of international students participating in this research.

Body mass index and parent-reported self-estem in elementary school children: evidence for a causal relationship.

OBJECTIVE: To clarify relationships between body mass index (BMI) and self-esteem in young children at a population level. To assess whether low self-esteem precedes or follows development of overweight/obesity in children. DESIGN: Prospective cohort study in elementary schools throughout Victoria, Australia. Child BMI and self-esteem were measured in 1997 and 2000. SUBJECTS: Random sample of 1,157 children who were in the first 4 y of elementary school (aged 5-10 y) at baseline. MEASURES: BMI was calculated from measured height and weight, then transformed to z-scores. Children were classified as nonoverweight, overweight or obese based on international cut-points. Low child self-esteem was defined as a score below the 15th percentile on the self-esteem subscale of the parent-reported Child Health Questionnaire. RESULTS: Overweight/obese children had lower median self-esteem scores than nonoverweight children at both timepoints, especially at follow-up. After accounting for baseline self-esteem, higher baseline BMI z-score predicted poorer self-esteem at follow-up (P=0.008). After accounting for baseline BMI z-score, poorer baseline self-esteem did not predict higher BMI z-score at follow-up. While nonoverweight children with low baseline self-esteem were more likely to develop overweight/obesity (OR=2.1, 95% CI=1.2, 3.6), this accounted for only a small proportion of the incidence of overweight. CONCLUSIONS: Our data show an increasingly strong association between lower self-esteem and higher body mass across the elementary school years. Overweight/obesity precedes low self-esteem in many children, suggesting a causal relationship. This indicates that prevention and management strategies for childhood overweight/obesity need to begin early to minimise the impact on self-esteem.

A hermeneutic analysis of the Denver international baggage handling system

This paper attempts to demonstrate the principles of hermeneutics in an effort to understand factors affecting Information Systems (IS) projects. As hermeneutics provides a systematic method of interpreting text from multiple information sources, thus, Information Systems being prima facie defined and documented as text documents, are eminently suited for this mode of investigation. In this paper, we illustrate hermeneutics by analysing a sample case study document describing a well known project of Denver International Airport (DIA) Automated Baggage Handling System, which was extensively reported in IS and management press and studied by Montealegre and his colleagues (Montealegre, Nelson, Knoop, & Applegate, 1999, p553-554). As a result of the hermeneutic approach to the analysis of this document, a new "flexibility" factor has been discovered to play an important, yet unreported, role in the DIA system demise. In the DIA case, the observed flexibility factor influenced the quality of the interaction between the actors, the prevailing environment and the information systems.

Project quality management for small and medium enterprises (SMEs) in trade

Managing project quality is becoming focal issue in major enterprises as popular quality programs from International Standard Organization (ISO) such as ISO9000 certification processes gain momentum. Large organizations as well as small-medium enterprises (SMEs) seem to implement this program, albeit for varied reasons. In this paper, we have reported the findings from an action research project conducted in SMEs who are implementing quality management. The findings indicate that external pressures such as regulations, competition and perceived success - defined on their own parameters, may be the drivers and the certification does not necessarily result in better performance. We are in the process of developing a cost-effective guideline/framework - based on this research, for SMEs involved in the certification process. In addition, the results are aimed at informing academia as well as certification bodies of specific concerns with SMEs.

Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies

A WHO expert consultation addressed the debate about interpretation of recommended body-mass index (BMI) cut-off points for determining overweight and obesity in Asian populations, and considered whether population-specific cut-off points for BMI are necessary. They reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (25 kg/m2). However, available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity. The cut-off point for observed risk varies from 22kg/m2 to 25kg/m2 in different Asian populations; for high risk it varies from 26kg/m2 to 31kg/m2. No attempt was made, therefore, to redefine cut-off points for each population separately. The consultation also agreed that the WHO BMI cut-off points should be retained as international classifications. The consultation identified further potential public health action points (23·0, 27·5, 32·5, and 37·5 kg/m2) along the continuum of BMI, and proposed methods by which countries could make decisions about the definitions of increased risk for their population.