Fitness and fatness in childhood obesity : implications of physical activity

Overweight and obesity are a significant cause of poor health worldwide, particularly in conjunction with low levels of physical activity (PA). PA is health-protective and essential for the physical growth and development of children, promoting physical and psychological health while simultaneously increasing the probability of remaining active as an adult. However, many obese children and adolescents have a unique set of physiological, biomechanical, and neuromuscular barriers to PA that they must overcome. It is essential to understand the influence of these barriers on an obese child's motivation in order to exercise and tailor exercise programs to the special needs of this population. Chapter Outline • Introduction • Defining Physical Activity, Exercise, and Physical Fitness • Physical Activity, Physical Fitness, And Motor Competence In Obese Children • Physical Activity and Obesity in Children • Physical Fitness in Obese Children • Balance and Gait in Obese Children • Motor Competence in Obese Children • Physical Activity Guidelines for Obese Children • Clinical Assessment of the Obese Child • Physical Activity Characteristics: Mode • Physical Activity Characteristics: Intensity • Physical Activity Characteristics: Frequency • Physical Activity Characteristics: Duration • Conclusion

Lessons learnt : complementing good clinical renal questions with an appropriate research strategy

The purpose of this article is to present lessons learnt by nurses when conducting research to encourage colleagues to ask good clinical research questions. This is accomplished by presenting a study designed to challenge current practice which included research flaws. The longstanding practice of weighing renal patients at 0600 hours and then again prior to receiving haemodialysis was examined. Nurses believed that performing the assessment twice, often within a few hours, was unnecessary and that patients were angry when woken to be weighed. An observational study with convenience sampling collected data from 46 individuals requiring haemodialysis, who were repeatedly sampled to provide 139 episodes of data. Although the research hypotheses were rejected, invaluable experience was gained, with research and clinical practice lessons learnt, along with surprising findings.

The causes and consequences of corruption

This thesis comprehensively studies the causes and consequences of corruption in both crosscountry and within-country contexts, mainly focusing on China. The thesis commences by extensively investigating the causes of corruption. Using the standard economic approach, this study finds that in China regions with more anti-corruption efforts, higher education attainment, Anglo-American historic influence, higher openness, more access to media, higher relative wages of government employees, and a greater representation of women in legislature are markedly less corrupt; while the social heterogeneity, deregulation and abundance of resources, substantially breed regional corruption. Moreover, fiscal decentralization is discovered to depress corruption significantly. This study also observes a positive relationship between corruption and the economic development in current China that is mainly driven by the transition to a market economy. Focusing on the influence of political institutions on corruption, the thesis then provides evidence that a high level of political interest helps to reduce corruption within a society, while the effect of democracy upon corruption depends on property rights protection and income distribution. With the social economic approach, however, the thesis presents both cross-country and within-country evidence that the social interaction plays an important role in determining corruption. The thesis then continues by comprehensively evaluating the consequences of corruption in China. The study provides evidence that corruption can simultaneously have both positive and negative effects on economic development. And it also observes that corruption considerably increases the income inequality in China. Furthermore this study finds that corruption in China significantly distorts public expenditures. Local corruption is also observed to substantially reduce FDI in Chinese regions. Finally the study documents that corruption substantially aggravates pollution probably through a loosening of the environmental regulation, and that it also modifies the effects of trade openness and FDI on the stringency of environmental policy. Overall, this thesis adds to the current literature by a number of novel findings concerning both the causes and the consequences of corruption.

Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3%) of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost). A further 119 (49%) could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status). Another 88 (36%) required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases) and 28 (11.5%) required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression.