Blood pressure change with weight loss is affected by diet type in men

Background: Weight loss reduces blood pressure, and the Dietary Approaches to Stop Hypertension (DASH) diet has also been shown to lower blood pressure.

Objective: Our goal was to assess the effect on blood pressure of 2 weight-reduction diets: a low-fat diet (LF diet) and a moderate-sodium, high-potassium, high-calcium, low-fat DASH diet (WELL diet).

Design: After baseline measurements, 63 men were randomly assigned to either the WELL or the LF diet for 12 wk, and both diet groups undertook 0.5 h of moderate physical activity on most days of the week.

Results: Fifty-four men completed the study. Their mean (±SD) age was 47.9 ± 9.3 y (WELL diet, n = 27; LF diet, n = 27), and their mean baseline home systolic and diastolic blood pressures were 129.4 ± 11.3 and 80.6 ± 8.6 mm Hg, respectively. Body weight decreased by 4.9 ± 0.6 kg (±SEM) in the WELL group and by 4.6 ± 0.6 kg in the LF group (P < 0.001 for both). There was a greater decrease in blood pressure in the WELL group than in the LF group [between-group difference (week 12 –baseline) in both SBP (5.5 ± 1.9 mm Hg; P = 0.006) and DBP (4.4 ± 1.2 mm Hg; P = 0.001)].

Conclusions: For a comparable 5-kg weight loss, a diet high in low-fat dairy products, vegetables, and fruit (the WELL diet) resulted in a greater decrease in blood pressure than did the LF diet. This dietary approach to achieving weight reduction may confer an additional benefit in reducing blood pressure in those who are overweight.

A novel data replication and management protocol for mobile computing systems

Mobile computing has enabled users to seamlessly access databases even when they are on the move. Mobile computing environments require data management approaches that are able to provide complete and highly available access to shared data at any time from any where. In this paper, we propose a novel replicated data protocol for achieving such goal. The proposed scheme replicates data synchronously over stationary sites based on three dimensional grid structure while objects in mobile sites are asynchronously replicated based on commonly visited sites for each user. This combination allows the proposed protocol to operate with less than full connectivity, to easily adapt to changes in group membership and not require all sites to agree to update data objects at any given time, thus giving the technique flexibility in mobile environments. The proposed replication technique is compared with a baseline replication technique and shown to exhibit high availability, fault tolerance and minimal access times of the data and services, which are very important in an environment with low-quality communication links.

Health impact assessment : environmental management vs healthy public policy perspective - exploring the nexus between the two

This paper will explore the links between the traditional role of HIA in an environmental management context and the new and emerging trend internationally to subject government policy to prospective HIA.  The goal of this new iteration of HIA is to develop healthy public policy across all sectors of government creating a more inclusive and evidence-based approach to public policy formation.  The risk-based, health protection approach is more widely understood, as it draws on existing health protection experience and is allied with risk assessment theory.  The new model is based on the health promotion perspective, and emphasizes social determinants of public health.  This latter approach draws on the foundations of the former.  It is vital that the links between the two are therefore considered especially from the perspective of transfer of knowledge between the two.  The paper will explore the similarities, the differences, the tensions and the lessons that can be learned.  It will report on the progress of a national study being conducted by Mary Mahoney and Gillian Durham that is looking at what is happening (or has happened) in other countires including Canada, New Zealand, Sweden, Netherlands, Germany and the United Kingdom

Web enabled just-in-time salvaged material management for demolition projects

The demolition activities of buildings produce numerous environmental pressures as a large proportion of demolition waste materials are sent to landfill directly in many projects. Web-based waste exchange systems could provide right solutions for releasing these pressures. Because the approaches adopted in current waste exchange systems are inefficient, these systems cannot generate waste exchange, not achieving their final goal, environmental protection. The Just-in-time (JIT) philosophy has been applied in the manufacture industry for decades and it is proven to be effective to eliminate or minimise inventory during production. This research aims to adopt the JIT philosophy into a demolition project management informapon system so that the system is more efficient in handling waste exchange. The system structure, key components and Just-in-time adoption are proposed and identified. Finally, a proto typed system is demonstrated.

The rise and fall of management: undergraduate engineering management education in Australia

The modern disciplines of engineering and management are inextricably linked. Frederick Taylor, Henry Gantt and Henri Fayol are engineers whose names are also part of the history of the theory and practice of management. As far back as 1968 it was identified that, “In all phases of practice in the profession the technical work is coupled, to a greater or lesser extent, with engineering management.” For more than 20 years the call had been increasing for an improvement in the preparation of engineering graduates in the area of management skills. In 1989 the IEAust created the task force on management engineering with the goal of formulating a policy for management education in engineering undergraduate courses. In 1990, the Council of the IEAust approved the Policy on Management Studies in Engineering Undergraduate Courses that said, “From January 1991 the Institution will require at least 5% management content in all professional engineering undergraduate courses and that the total of all management and management related components rises to the vicinity of 10% by 1995.” A 1999 analysis of engineering programs showed that the Policy had been applied with enthusiasm by about one-third of the engineering schools, fairly well in another third, remaining responses were ineffectual. Around the same time, revisions to the IEAust accreditation requirements de-emphasised the importance of management studies, mentioning it only as a subset of ‘professional practice’. By 2004 the IEAust stage 1 competency standards for professional engineers mentioned ‘management’ in only three of 79 indicators of competency. In 2002, the IEAust established the Centre for Engineering Leadership and Management. In December 2005 CELM established a working group, “…for improving the business and management content of undergraduate courses. It appears that it’s back (about 20 years) to the future for Australian undergraduate engineering management education.

EDMS, ERMS,ECMS or EDRMS : fighting through the acronyms towards a strategy for effective corporate records management

Records management has been receiving increased attention around the world over the last two decades as governments issue ever more laws and regulations about the management of corporate records. An electronic system to manage records effectively is the ultimate goal of every organisation in both the public private sectors – whether to support the development of E-Government or to conduct business legally. Such systems are not yet clearly defined, however, as the obvious confusion and inconsistency of nomenclature makes very clear. This paper highlights the problem and calls for research into this essential but currently ignored area.

RFID-based real-time smart waste management system

In an environmental context, the use of RFID (radio frequency identification) and load cell sensor technology can be employed for not only bringing down waste management costs, but also to facilitate automating and streamlining waste (e.g., garbage, recycling, and green) identification and weight measurement processes for designing smart waste management systems. In this paper, we outline a RFID and sensor model for designing a system in real-time waste management. An application of the architecture is described in the area of RFID and sensor based automatic waste identity, weight, and stolen bins identification system (WIWSBIS).

Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommentations for practice.

The quality of sedation management in mechanically ventilated patients has been a source of concern in recent years. This paper summarises the literature on the principles of optimal sedation, discusses the consequences of over and undersedation, highlighting the importance of appropriate pain management, and presents a case study using the results of an audit of 48 mechanically ventilated adults. As a result of the review and audit, we are implementing changes to practice.

The most important recommendations from the literature are the use of a sedation scale, setting of a goal sedation score, appropriate pain management and implementation of a nurse initiated sedation algorithm. Other recommendations include use of bolus rather than continuous sedative infusions and recommencing regular medications for anxiety, depression and other phychiatric disorders as soon as possible. A recommendation arising from our audit was the need to identify patients at high risk of oversedation and undersedation and adopt a proactive rather than reactive approach to management. The practice goal is to provide adequate and appropriate analgesia and anxiolysis for patients. This will improve patient comfort while reducing length of mechanical ventilation and minimising risk of complications.

Conservation management and diets of Powerful Owls (Ninox strenua) in outer urban Melbourne, Australia

The Powerful Owl Ninox strenua is Australia’s largest owl, and is mainly found east of the Great Dividing Range on the mainland in tall-open forests. The species is considered rare, both nationally and in the State of Victoria; and threatened in the Greater Melbourne area. Recovery plans for the future conservation management of N. strenua are being prepared in 2 states.

Historically, Powerful Owls have been thought to require large homes ranges (about 1000 ha per pair) in suitable old-growth forest, which provides nest hollows for the owls and their arboreal marsupial prey. Recent research, however, has found N. strenua may be more numerous and breed more successfully in a wider range of habitats than previously believed. In particular, the birds have been found living in forests and woodlands within the greater metropolitan areas of cities. The most extreme case is where a nest tree has been found within 800m of urban settlement and 6km from the centre of Brisbane.

In this paper we report on the diet, habitat use, and conservation management by a number of breeding pairs of owls in outer urban Melbourne. Study sites range from a relatively undisturbed rainforest habitat 80km from central Melbourne, through dry sclerophyll, eucalyptus-dominated open forest with some disturbance to a site 8km from central Melbourne in highly disturbed urban parkland.

Diets of the families of owls were determined by analyzing remains in regurgitated pellets. The data confirm that arboreal marsupials constitute the major prey items, especially the Common Ringtail Possum Pseudocheirus peregrinus. There were differences in diets depending on the availability of prey species, which suggest a level of opportunism not previously suspected. Our study is also the first to confirm the owls capture adult Common Brushtail Possums Trichosurus vulpecula (15% of pellets containing the remains of this large opossum have bones of mature adults at 1 site) and thus take prey up to two and a half times their own weight. As well our data suggest Powerful Owls are not restricted to hollow-dwelling prey, as in some sites the marsupials rested during the day either in leafy nests called dreys (P. peregrinus) or in house roofs (T. vulpecula).

In the most heavily disturbed sites, breeding success has been reduced, and we have evidence that in one particular year the young were eaten by one of the parents. This followed construction of a bicycle track under the nest during the breeding season. Recommendations are made for the future conservation and habitat management of Powerful Owls in the Yarra Valley corridor.

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background:
Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.
Objective:
The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.
Methods and Procedures:
A total of 103 women lost weight on a meal replacement–supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.
Results:
Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.
Discussion:
Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group's diet, if shown to be sustainable in future studies, could have weight maintenance benefits.

Chronic disease self-management education programs: challenges ahead

♦ Chronic disease self-management education programs aim to empower patients through providing information and teaching skills and techniques to improve self-care and doctor–patient interaction, with the ultimate goal of improving quality of life.

♦ The recent 2006–07 federal budget allocated an unprecedented $515 million over 5 years for activation of patient self-management activities, commencing this financial year.

♦ Previous attempts in other countries to incorporate self-management education activities into the health care sector have faced setbacks because of inadequate integration into primary care.

♦ Engagement of health care professionals and their endorsement of self-management activities is critical to success.

Risk management or goods promotion : the relationship between approach and avoidance goals in treatment for sex offenders

In this paper, we propose that there is a direct relationship between risk management and goods (or goal) promotion in the treatment of sexual offenders. We argue that the causal conditions required to promote specific goods are likely, in turn, to eliminate or modify dynamic risk factors (i.e., criminogenic needs). First, the concepts of risk and goals are briefly discussed and their important dimensions clarified. Second, the relationship between criminogenic needs and goals are analyzed in depth. Third, we further clarify our arguments by focusing on four classes of criminogenic needs recently identified in the sexual offending literature: sexual self-regulation, offense supportive cognitions, level of interpersonal functioning, and general self-management problems. Finally, we conclude the paper with some suggestions for future research and treatment.

Weight, physical activity and dietary behavior change in young mothers : short term results of the HeLP-her cluster randomized controlled trial

Background
Preventing weight gain rather than treating established obesity is an important economic and public health response to the rapidly increasing rates of obesity worldwide. Treatment of established obesity is complex and costly requiring multiple resources. Preventing weight gain potentially requires fewer resources to reach broad population groups, yet there is little evidence for successful interventions to prevent weight gain in the community. Women with children are an important target group because of high rates of weight gain and the potential to influence the health behaviors in family members.

Methods
The aim of this cluster randomized controlled trial was to evaluate the short term effect of a community-based self-management intervention to prevent weight gain. Two hundred and fifty mothers of young children (mean age 40 years ± 4.5, BMI 27.9 kg/m2 ± 5.6) were recruited from the community in Melbourne, Australia. The intervention group (n = 127) attended four interactive group sessions over 4 months, held in 12 local primary schools in 2006, and was compared to a group (n = 123) receiving a single, non-interactive, health education session. Data collection included self-reported weight (both groups), measured weight (intervention only), self-efficacy, dietary intake and physical activity.

Results
Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001). Comparing groups using self-reported weight, both the intervention and comparison groups decreased weight, -0.75 kg (95% CI; -1.57 to 0.07, p = 0.07) and -0.72 kg (95% CI; -1.59 to 0.14 p = 0.10) respectively with no significant difference between groups (-0.03 kg, 95% CI; -1.32 to 1.26, p = 0.95). More women lost or maintained weight in the intervention group. The intervention group tended to have the greatest effect in those who were overweight at baseline and in those who weighed themselves regularly. Intervention women who rarely self-weighed gained weight (+0.07 kg) and regular self-weighers lost weight (-1.66 kg) a difference of -1.73 kg (95% CI; -3.35 to -0.11 p = 0.04). The intervention reported increased physical activity although the difference between groups did not reach significance. Both groups reported replacing high fat foods with low fat alternatives and self-efficacy deteriorated in the comparison group only.

Conclusion
Both a single health education session and interactive behavioral intervention will result in a similar weight loss in the short term, although more participants in the interactive intervention lost or maintained weight. There were small non-significant changes to physical activity and changes to fat intake specifically replacing high fat foods with low fat alternatives such as fruit and vegetables. Self-monitoring appears to enhance weight loss when part of an intervention.

Women's work. Maintaining a healthy body weight

This study describes women's perceptions of the supports and barriers to maintaining a healthy weight among currently healthy weight women from urban and rural socio-economically disadvantaged areas. Using focus groups and interviews, we asked women about their experiences of maintaining a healthy weight. Overwhelmingly, women described their healthy weight practices in terms of concepts related to work and management. The theme of ‘managing health’ comprised issues of managing multiple responsibilities, time, and emotions associated with healthy practices. Rural women faced particular difficulties in accessing supports at a practical level (for example, lack of childcare) and due to the gendered roles they enacted in caring for others. Family background (in particular, mothers’ attitudes to food and weight) also appeared to influence perceptions about healthy weight maintenance. In the context of global increases in the prevalence of obesity, the value of initiatives aimed at supporting healthy weight women to maintain their weight should not be under-estimated. Such initiatives need to work within the social and personal constraints that women face in maintaining good health.

The impact of using a pedometer on time spent walking in older adults with Type 2 diabetes

Purpose

The purpose of this study was to investigate the impact of using a pedometer on time spent walking, in sedentary and overweight adults with type 2 diabetes participating in a coaching intervention. It was hypothesized that participants using a pedometer would spend more time walking than would nonpedometer participants.

Method

A sample of 57 men and women with a mean age of 62 years participated in a randomized controlled trial in a community setting. Participants were allocated to either a pedometer and coaching (intervention) group or a coaching-only (control) group. Coaching for both groups involved education, goal setting, and supportive/ motivational strategies to increase time spent walking. The duration of the study was 6 months, with blood pressure, glycosylated hemoglobin, anthropometric, and fitness measurements assessed at baseline and at 3-month intervals.

Results

A repeated-measures analysis of variance indicated that the coaching-only group spent significantly more time walking than did the pedometer group. However, when an analysis of covariance with all the other variables as covariates was performed, group membership had no influence on time spent walking. Significant reductions in waist circumference and weight were achieved for both groups from baseline to 6 months. Cardiovascular fitness also increased significantly for both groups.

Conclusion

The study demonstrated that previously sedentary older adults with type 2 diabetes, supported with a coaching intervention, were able to achieve the physical activity targets known to be beneficial to health. However, using a pedometer added no further benefit. Further research on the impact of specific coaching strategies in diabetes management is warranted.