Economic Evaluation of a Primary Care Trial to Reduce Weight Gain in Overweight/Obese Children: The LEAP Trial

Background:- A common policy response to the childhood obesity epidemic is to recommend that primary care physicians screen for and offer counseling to the overweight/obese. As the literature suggests, this approach may be ineffective; it is important to document the opportunity costs incurred by brief primary care obesity interventions that ultimately may not alter body mass index (BMI) trajectory.

Methods:- Live, Eat and Play (LEAP) was a randomized controlled trial of a brief secondary prevention intervention delivered by family physicians in 2002-2003 that targeted overweight/ mildly obese children aged 5 to 9 years. Primary care utilization was prospectively audited via medical records, and parents reported family resource use by written questionnaire. Outcome measures were BMI (primary) and parent-reported physical activity and dietary habits (secondary) in intervention compared with control children.

Results:- The cost of LEAP per intervention family was AU $4094 greater than for control families, mainly due to increased family resources devoted to child physical activity. Total health sector costs were AU $873 per intervention family and AU $64 per control, a difference of AU $809 {P < .001). At 15 months, intervention children did not differ significantly in adjusted BMI or daily physical activity scores compared with the control group, but dietary habits had improved.

Conclusions:- This brief intervention resulted in higher costs to families and the health care sector, which could have been devoted to other uses that do create benefits to health and/or family well-being. This has implications for countries such as the United States, the United Kingdom, and Australia, whose current guidelines recommend routine surveillance and counseling for high child BMI in the primary care sector.

Reducing unhealthy weight gain in children through community capacity−building: results of a quasi−experimental intervention program, Be Active Eat Well

Background:
Be Active Eat Well (BAEW) was a multifaceted community capacity-building program promoting healthy eating and physical activity for children (aged 4–12 years) in the Australian town of Colac.
Objective:
To evaluate the effects of BAEW on reducing children's unhealthy weight gain.
Methods:
BAEW had a quasi-experimental, longitudinal design with anthropometric and demographic data collected on Colac children in four preschools and six primary schools at baseline (2003, n=1001, response rate: 58%) and follow-up (2006, n=839, follow-up rate: 84%). The comparison sample was a stratified random selection of preschools (n=4) and primary schools (n=12) from the rest of the Barwon South Western region of Victoria, with baseline assessment in 2003–2004 (n=1183, response rate: 44%) and follow-up in 2006 (n=979, follow-up rate: 83%).
Results:
Colac children had significantly lower increases in body weight (mean: -0.92 kg, 95% CI: -1.74 to -0.11), waist (-3.14 cm, -5.07 to -1.22), waist/height (-0.02, -0.03 to -0.004), and body mass index z-score (-0.11, -0.21 to -0.01) than comparison children, adjusted for baseline variable, age, height, gender, duration between measurements and clustering by school. In Colac, the anthropometric changes were not related to four indicators of socioeconomic status (SES), whereas in the comparison group 19/20 such analyses showed significantly greater gains in anthropometry in children from lower SES families. Changes in underweight and attempted weight loss were no different between the groups.
Conclusions:
Building community capacity to promote healthy eating and physical activity appears to be a safe and effective way to reduce unhealthy weight gain in children without increasing health inequalities.

Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children : switch-play

Objectives : To evaluate the effectiveness of an intervention to prevent excess weight gain, reduce time spent in screen behaviours, promote participation in and enjoyment of physical activity (PA), and improve fundamental movement skills among children.

Participants : In 2002, 311 children (78% response; 49% boys), average age 10 years 8 months, were recruited from three government schools in low socioeconomic areas of Melbourne, Australia.

Design : Group-randomized controlled trial. Children were randomized by class to one of the four conditions: a behavioural modification group (BM; n=66); a fundamental movement skills group (FMS; n=74); a combined BM/FMS group (BM/FMS; n=93); and a control (usual curriculum) group (n=62). Data were collected at baseline, post intervention, 6- and 12-month follow-up periods.

Results : BMI data were available for 295 children at baseline and 268 at 12-month follow-up. After adjusting for food intake and PA, there was a significant intervention effect from baseline to post intervention on age- and sex-adjusted BMI in the BM/FMS group compared with controls (-1.88 kg m-2, P<0.01), which was maintained at 6- and 12-month follow-up periods (-1.53 kg m-2, P<0.05). Children in the BM/FMS group were less likely than controls to be overweight/obese between baseline and post intervention (adjusted odds ratio (AOR)=0.36, P<0.05); also maintained at 12-month follow-up (AOR=0.38, P<0.05). Compared with controls, FMS group children recorded higher levels and greater enjoyment of PA; and BM children recorded higher levels of PA and TV viewing across all four time points. Gender moderated the intervention effects for participation in and enjoyment of PA, and fundamental movement skills.

Conclusion : This programme represents a promising approach to preventing excess weight gain and promoting participation in and enjoyment of PA. Examination of the mediators of this intervention and further tailoring of the programme to suit both genders is required.

Fragmentation ; disjunction and unity : the lie of the land

The works presented interrogate a world in which lies have given us a set of metaphysical problems. The works deal with time, space and surfaces working together yet disrupted.

Television viewing time and weight gain in colorectal cancer survivors : a prospective population-based study

Objective To investigate the prospective relationships between television viewing time and weight gain in the 3 years following colorectal cancer diagnosis for 1,867 colorectal cancer survivors (body mass index (BMI) ≥ 18.5 kg/m2).

Methods BMI, television viewing time, physical activity, and socio-demographic and clinical covariates were assessed at baseline (5 months), 24 months and 36 months post-diagnosis. Multiple linear regression was used to study independent associations between baseline television viewing time and BMI at 24 and 36 months post-diagnosis.

Results At both follow-up time points, there was a significant increase in mean BMI for participants reporting ≥5 h/day of television viewing compared to those watching <3 h/day at baseline (24 months: 0.72 kg/m2 (0.31, 1.12), p < 0.001; 36 months: 0.61 kg/m2 (0.14, 1.07), p = 0.01), independent of baseline BMI, gender, age, education, marital status, smoking, cancer site, cancer disease stage, treatment mode and co-morbidities. Additional adjustment for baseline physical activity did not change results.

Conclusions These findings suggest that a greater emphasis on decreasing television viewing time could help reduce weight gain among colorectal cancer survivors. This, in turn, could contribute to a risk reduction for co-morbid conditions such as type 2 diabetes and cardiovascular disease.

Is sex-specific mass gain in Cory's shearwaters Calonectris diomedea related to begging and steroid hormone expression?

Mass differences between the sexes of dimorphic bird species often appear early in the nestling development. But how do adults know how much to feed a chick in a sexually dimorphic species? Do chicks of the heavier sex beg more? We studied begging in Cory’s shearwaters Calonectris diomedea, a species with heavier adult and juvenile males than females. We found that begging rates and call numbers were not different between male and female chicks, but parameters of begging intensity differed between the sexes in their relationship to chick body condition. For the same body condition, males had significantly higher begging call numbers and rates. Acoustical parameters, which were analysed semi-automatically, included the lengths of call and silence intervals, the minimum, mean and maximum frequency in a call and the number of frequency peaks within a call. We found no consistent differences of acoustic begging call elements between the sexes. Male and female chicks did not differ in the levels of the steroid hormones testosterone or corticosterone in the second quarter of the nestling period, and the mechanism leading to sex-related differences in begging rates for a given body condition remains unknown.

Deakin University Library website 2.0 : iterative change for maximum gain

The purpose of library websites is evolving. Deakin University Library originally undertook to redevelop its website to provide improved access to information, resources and services and to better meet clients in their space. The first phase redeveloped the library homepage and top level link pages. During this time, social networking applications were becoming part of higher education. There were new choices: the Library website and search tools could undergo significant metamorphosis; adopt Web2.0 functionality and move from being the public face of the online library to the public space of its online community, with students and staff as active partners in its development.

Teachers’ ethics : education international and the forging of professional unity

The paper maintains that the current era, marked by a new global economy transforming economic and social development, has created the need for a reorganisation of teachers’ representation. This paper discusses a key development in teacher organisation, namely the emergence of Education International as a global hub for teacher unionism from across the world. This unique organisation, formulated in response to the emergence of global economies and supra-national figures, represents teachers’ response to globalised institutions and has instigated projects, such as the Professional Code of Ethics, which aim to create a sense of professional identity and unity amongst teachers. The organisation presents the political voice of teachers as a global collective that seeks to embed teachers’ interests in education reform and in the public debates concerning the direction of educational change in the era of globalisation. The paper concludes by outlining an ongoing issue that jeopardizes the collective voice of teachers and stresses how this needs to be further addressed in the ethical frameworks of what it means to be a teacher in the 21st century.

Metabolic adaptations to short-term high-intensity interval training : a little pain for a lot of gain?

High-intensity interval training (HIT) is a potent time-efficient strategy to induce numerous metabolic adaptations usually associated with traditional endurance training. As little as six sessions of HIT over 2 wk or a total of only approximately 15 min of very intense exercise (~600 kJ), can increase skeletal muscle oxidative capacity and endurance performance and alter metabolic control during aerobic-based exercise.

Education to gain sustainability : analysis and approach from the experience obtained from two high school systems in mexican rural communities

The decade “Education for Sustainability” is just emerging and one of its goals emphasized the importance of considering the currícula in a transdisciplinary and community based programs. This includes recognizing local and regional interests as relevant topics into the currícula. “Education for sustainability” does not appear to have a strong basis on their actions as its theoretical discourse does. The study we present here about content analysis in the curricula of two high schools systems in rural Mexican communities is an example. In this research we analyzed: 1) how the curricula is oriented towards forest management and the way is connected to the social reality of the communities; 2) how does the learning process develops in the classroom and its dynamics with teachers and students and 3) how does the environmental learning take place. Results revealed that more research is needed with adolescents in order to change the educational structure in rural Mexican high schools.