Living well with diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes

Background By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Methods/Design Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. Discussion This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.

Innovation strategies for developing the traditional souvenir craft industry

This paper describes the concept of innovation strategies for traditional souvenir craft industries. There are many traditional souvenir craft industries in Indonesia, and they have to compete in today‘s global markets. The craftsmanship and uniqueness of traditional crafts must be developed to attract a larger market. This competition is not easy for craftspeople, neither financially nor culturally. The authors propose some innovation strategies to facilitate craftspeople in generating ideas based on their traditional value, to ensure their sustainability in global context. However, even though there are a number of studies about the craft industry and souvenirs, there is little research focused on the souvenir product development process, especially in the traditional craft industry. Considering that souvenirs are products for pleasure which require hedonic value more than utilitarian value, the offered innovation strategy refers to the strategy applied in existing industries that produce hedonic products. Innovation strategy in the fashion industry is selected as a reference, which is discussed by considering the context of the traditional souvenir craft industry. This investigation will support further research about knowledge sharing systems to enable collaborative learning within traditional craftspeople.

The effects of weight loss strategies on gastric emptying and appetite control

The gastrointestinal tract plays an important role in the improved appetite control and weight loss in response to bariatric surgery. Other strategies which similarly alter gastrointestinal responses to food intake could contribute to successful weight management. The aim of this review is to discuss the effects of surgical, pharmacological and behavioural weight loss interventions on gastrointestinal targets of appetite control, including gastric emptying. Gastrointestinal peptides are also discussed because of their integrative relationship in appetite control. This review shows that different strategies exert diverse effects and there is no consensus on the optimal strategy for manipulating gastric emptying to improve appetite control. Emerging evidence from surgical procedures (e.g., sleeve gastrectomy and Roux en-Y gastric bypass) suggests a faster emptying rate and earlier delivery of nutrients to the distal small intestine may improve appetite control. Energy restriction slows gastric emptying, while the effect of exercise-induced weight loss on gastric emptying remains to be established. The limited evidence suggests that chronic exercise is associated with faster gastric emptying which we hypothesise will impact on appetite control and energy balance. Understanding how behavioural weight loss interventions (e.g., diet and exercise) alter gastrointestinal targets of appetite control may be important to improve their success in weight management.

Hybrid-Game Strategies for multi-objective design optimization in engineering

A number of Game Strategies (GS) have been developed in past decades. They have been used in the fields of economics, engineering, computer science and biology due to their efficiency in solving design optimization problems. In addition, research in multi-objective (MO) and multidisciplinary design optimization (MDO) has focused on developing robust and efficient optimization methods to produce a set of high quality solutions with low computational cost. In this paper, two optimization techniques are considered; the first optimization method uses multi-fidelity hierarchical Pareto optimality. The second optimization method uses the combination of two Game Strategies; Nash-equilibrium and Pareto optimality. The paper shows how Game Strategies can be hybridised and coupled to Multi-Objective Evolutionary Algorithms (MOEA) to accelerate convergence speed and to produce a set of high quality solutions. Numerical results obtained from both optimization methods are compared in terms of computational expense and model quality. The benefits of using Hybrid-Game Strategies are clearly demonstrated

Optimal strategies and minimax lower bounds for online convex games

A number of learning problems can be cast as an Online Convex Game: on each round, a learner makes a prediction x from a convex set, the environment plays a loss function f, and the learner’s long-term goal is to minimize regret. Algorithms have been proposed by Zinkevich, when f is assumed to be convex, and Hazan et al., when f is assumed to be strongly convex, that have provably low regret. We consider these two settings and analyze such games from a minimax perspective, proving minimax strategies and lower bounds in each case. These results prove that the existing algorithms are essentially optimal.

Group maintenance scheduling : a case study for a pipeline network

This paper presents a group maintenance scheduling case study for a water distributed network. This water pipeline network presents the challenge of maintaining aging pipelines with the associated increases in annual maintenance costs. The case study focuses on developing an effective maintenance plan for the water utility. Current replacement planning is difficult as it needs to balance the replacement needs under limited budgets. A Maintenance Grouping Optimization (MGO) model based on a modified genetic algorithm was utilized to develop an optimum group maintenance schedule over a 20-year cycle. The adjacent geographical distribution of pipelines was used as a grouping criterion to control the searching space of the MGO model through a Judgment Matrix. Based on the optimum group maintenance schedule, the total cost was effectively reduced compared with the schedules without grouping maintenance jobs. This optimum result can be used as a guidance to optimize the current maintenance plan for the water utility.