Effects of a pediatric weight management program with and without active video games

Importance Active video games may offer an effective strategy to increase physical activity in overweight and obese children. However, the specific effects of active gaming when delivered within the context of a pediatric weight management program are unknown. Objective To evaluate the effects of active video gaming on physical activity and weight loss in children participating in an evidence-based weight management program delivered in the community. Design, Setting, and Participants Group-randomized clinical trial conducted during a 16-week period in YMCAs and schools located in Massachusetts, Rhode Island, and Texas. Seventy-five overweight or obese children (41 girls [55%], 34 whites [45%], 20 Hispanics [27%], and 17 blacks [23%]) enrolled in a community-based pediatric weight management program. Mean (SD) age of the participants was 10.0 (1.7) years; body mass index (BMI) z score, 2.15 (0.40); and percentage overweight from the median BMI for age and sex, 64.3% (19.9%). Interventions All participants received a comprehensive family-based pediatric weight management program (JOIN for ME). Participants in the program and active gaming group received hardware consisting of a game console and motion capture device and 1 active game at their second treatment session and a second game in week 9 of the program. Participants in the program-only group were given the hardware and 2 games at the completion of the 16-week program. Main Outcomes and Measures Objectively measured daily moderate-to-vigorous and vigorous physical activity, percentage overweight, and BMI z score. Results Participants in the program and active gaming group exhibited significant increases in moderate-to-vigorous (mean [SD], 7.4 [2.7] min/d) and vigorous (2.8 [0.9] min/d) physical activity at week 16 (P < .05). In the program-only group, a decline or no change was observed in the moderate-to-vigorous (mean [SD] net difference, 8.0 [3.8] min/d; P = .04) and vigorous (3.1 [1.3] min/d; P = .02) physical activity. Participants in both groups exhibited significant reductions in percentage overweight and BMI z scores at week 16. However, the program and active gaming group exhibited significantly greater reductions in percentage overweight (mean [SD], −10.9% [1.6%] vs −5.5% [1.5%]; P = .02) and BMI z score (−0.25 [0.03] vs −0.11 [0.03]; P < .001). Conclusions and Relevance Incorporating active video gaming into an evidence-based pediatric weight management program has positive effects on physical activity and relative weight.

Using value-based partnerships to support community engaged learning : benefits, challenges, stakeholder perspectives

Increasingly, the not-for-profit sector, as an emerging contributor to the creative economy, is creating a context for engaging creative practitioners in developing solutions to complex problems, triggering a demand for skills and knowledge needed to address this complexity. Across the university and community contexts alternative models of engagement are emerging to support this dynamic. This paper presents a case study of a creative project in which a value-based approach is used to foster a collaborative partnership between community partners and a multidisciplinary team of final year Creative Industries students who in the course of the project developed a range of communication resources, including a social media campaign, an interactive game and a series of short films to support volunteer engagement and leadership initiatives. The paper considers the implications this values approach has for the design of service learning curriculum for multidisciplinary creative teams and the potential it has to support meaningful collaboration between creatives and the not-for-profit sector. It further explores how it impact on student and partner engagement, learning outcomes and the benefits for the partner organisation. The paper concludes that a value-based approach to university-community engagement has the potential to support and enable a greater degree of reciprocity, deeper engagement between stakeholders and greater relevance of the final outcome.

Management of project knowledge in a project-based organisation : a case study of research enterprise

Knowledge Management (KM) is vital factor to successfully undertake projects. The temporary nature of projects necessitates employing useful KM practices to reduce any issues such as knowledge leakiness and rework. The Project Management Office (PMO) is a unit within organisations to facilitate and oversee organisational projects. Project Management Maturity Models (PMMM) show the development of PMOs from immature to mature levels. The existing PMMMs have focused on discussing Project Management (PM) practices, however, the management of project knowledge is yet to be addressed, at various levels of maturity. A research project was undertaken to investigate the mentioned gap for addressing KM practices at the existing PMMMs. Due to the exploratory and inductive nature of this research, qualitative methods using case studies were chosen as the research methodology to investigate the problem in the real world. In total, three cases selected from different industries: research; mining and government organisations, to provide broad categories for research and research questions were examined using the developed framework. This paper presents the findings from the investigation of the research organisation with the lowest level of maturity. From KM process point of view, knowledge creation and capturing are the most important processes, while knowledge transferring and reusing received less attention. In addition, it was revealed that provision of “knowledge about client” and “project management knowledge” are the most important types of knowledge that are required at this level of maturity. The results also revealed that PMOs with higher maturity level have better knowledge management, however, some improvement is needed. In addition, the importance of KM processes varies at different levels of maturity. In conclusion, the outcomes of this paper could provide powerful guidance to PMOs at lowest level of maturity from KM point of view.

Art spaces in community and economic development : connections to neighborhoods, artists, and the cultural economy

There is growing interest in the arts in community and economic development, yet little research examines the dynamics of community-based arts institutions to inform urban planning and policy. Drawing on interviews with participants and organizers of small and midsized art spaces, the study explores the factors that influence their involvement in neighborhood revitalization and outreach, support for artistic communities, and efforts to build bridges to commercial cultural sectors. Art spaces function as a conduit for building social networks that contribute to both community revitalization and artistic development. But issues pertaining to the location, organization, and management of art spaces may limit their community and economic development potential. The article concludes with proposals to craft stronger arts-based community and economic development programs.

Development and evaluation of the Ontrack Diabetes Program : an automated, web-based type 2 diabetes self-management and dysphoria intervention

This research was conducted in the area of Clinical and Health Psychology. The study involved the development and evaluation of a novel, web-based program aimed to improve Type 2 diabetes self-management and mood. The program was developed as an original technological intervention aimed to improve access to support for rural and remote communities, and is currently being trialled across Australia with a larger sample size. The researcher aims to continue research into the field of clinical psychology, and in particular is interested in working on further interventions to support those with comorbid physical and mental health conditions.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice.

Management of atopic dermatitis in children : evaluation of parents' self-efficacy, outcome expectations, and self-reported task performance using the Child Eczema Management Questionnaire

Child behaviour management is crucial to successful treatment of atopic dermatitis. This study tested relationships between parents’ self-efficacy, outcome expectations, and self-reported task performance when caring for a child with atopic dermatitis. Using a cross-sectional study design, a community-based convenience sample of 120 parents participated in pilot-testing of the Child Eczema Management Questionnaire - a self-administered questionnaire which appraises parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis. Overall, parents’ self-reported confidence and success with performing routine management tasks was greater than that for managing their child’s symptoms and behaviour. Therewas a positive relationship between time since diagnosis and self-reported performance of routine management tasks; however, success with managing the child’s symptoms and behaviour did not improve with illness duration. Longer time since diagnosis was also associated with more positive outcome expectations of performing tasks that involved others in the child’s care (i.e. healthcare professionals, or the child themselves). This study provides the foundation for further research examining relationships between child, parent, and family psychosocial variables, parent management of atopic dermatitis, and child health outcomes. Improved understanding of these relationships will assist healthcare providers to better support parents and families caring for children with atopic dermatitis. KEYWORDS

The long and winding road : health services for clients with chronic leg ulcers in the community

The prevalence of leg ulcers of is 0.12%–1.1% and >3,000 lower limb amputations are performed yearly in Australia due to non-healing leg or foot ulcers. Although evidence on leg ulcer management is available, a significant evidence-practice gap exists. To identify current leg ulcer management, a cross-sectional retrospective study was undertaken in Brisbane, Australia. A sample of 104 clients was recruited from a community specialist wound clinic and a tertiary hospital outpatient’s specialist wound clinic. All clients had an ulcer below their knee or on their foot for ≥4 weeks. Data were collected on ulcer care, health service usage and clinical history for the year prior to admission. On admission, participants reported having their ulcer for a median of 25 weeks (range 2-728 weeks); with 51% (53/104) reporting an ulcer duration of ≥24 weeks. Including the wound clinic, participants sought ulcer care from a median of 3 health care providers (range 2-7). General Practitioners provided ulcer care to 82% of participants. Nearly half (42%) had self-cared for their ulcer; 29% (30/104) received treatment by a community nurse. A gap was found between the community-based ulcer care experienced by this population and evidence-based guidelines in regards to assessment, management, advice, and referrals.

Practice-based learning in community contexts: A collaborative exploration of pedagogical principles

The primary focus of this chapter is an exploration of four pedagogical principles emerging from a practice-based learning lab. Following an overview of community engaged learning and the Lab approach, the chapter is structured around a discussion of pedagogical principles related to (1) collaboration, (2) interdisciplinarity, (3) complexity and uncertainty and (4) reflection. Through a participatory action research (PAR) framework, students, academics and community partners have worked to identify and refine what it takes to support students negotiate complexity and uncertainty inherent in problems facing communities. It also examines the pedagogical strategies employed to facilitate collaboration across disciplines and professional contexts in ways that leverage difference and challenge values and practices.

Disaster management in Nepal: Media engagement in the Post-2015 Framework for Disaster Risk Reduction

Nepal, as a consequence of its geographical location and changing climate, faces frequent threats of natural disasters. According to the World Bank’s 2005 Natural Disasters Hotspots Report, Nepal is ranked the 11th most vulnerable country to earthquake and 30th to flood risk. Geo-Hazards International (2011) has classified Kathmandu as one of the world’s most vulnerable cities to earthquakes. In the last four decades more than 32,000 people in Nepal have lost their lives and annual monetary loss is estimated at more than 15 million (US) dollars. This review identifies gaps in knowledge, and progress towards implementation of the Post Hyogo Framework of Action. Nepal has identified priority areas: community resilience, sustainable development and climate change induced disaster risk reduction. However, one gap between policy and action lies in the ability of Nepal to act effectively in accordance with an appropriate framework for media activities. Supporting media agencies include the Press Council, Federation of Nepalese Journalists, Nepal Television, Radio Nepal and Telecommunications Authority and community based organizations. The challenge lies in further strengthening traditional and new media to undertake systematic work supported by government bodies and the National Risk Reduction Consortium (NRRC). Within this context, the ideal role for media is one that is proactive where journalists pay attention to a range of appropriate angles or frames when preparing and disseminating information. It is important to develop policy for effective information collection, sharing and dissemination in collaboration with Telecommunication, Media and Journalists. The aim of this paper is to describe the developments in disaster management in Nepal and their implications for media management. This study provides lessons for government, community and the media to help improve the framing of disaster messages. Significantly, the research highlights the prominence that should be given to flood, landslides, lightning and earthquakes.

Women, environmental changes and forestry-related development : Gender-affected roles of rural people in land degradation and environmental rehabilitation in a dry region of Sudan

The purpose of the present study was to increase understanding of the interaction of rural people and, specifically, women with the environment in a dry area in Sudan. The study that included both nomadic pastoralists and farmers aimed at answering two main research questions, namely: What kinds of roles have the local people, and the women in particular, had in land degradation in the study area and what kinds of issues would a gender-sensitive, forestry-related environmental rehabilitation intervention need to consider there? The study adopted the definition of land degradation as proposed by the United Nations Convention to Combat Desertification (UNCCD), which describes land degradation as reduction or loss the biological or economic productivity and complexity of land in arid, semi-arid and dry sub-humid areas. The Convention perceives desertification as land degradation. The dry study area in Sudan, South of the Sahara, has been the subject of land degradation or desertification discussions since the 1970s, and other studies have been also conducted to assess the degradation in the area. Nevertheless, the exact occurrence, scale and local significance of land degradation in the area is still unclear. This study explored how the rural population whose livelihood depended on the area, perceived environmental changes occurring there and compared their conceptions with other sources of information of the area such as research reports. The main fieldwork methods included interviews with open-ended questions and observation of people and the environment. The theoretical framework conceptualised the rural population as land users whose choices of environmental activities are affected by multiple factors in the social and biophysical contexts in which they live. It was emphasised that these factors have their own specific characteristics in different contexts, simultaneously recognising that there are also factors that generally affect environmental practices in various areas such as the land users' environmental literacy (conceptions of the environment), gender and livelihood needs. The people studied described that environmental changes, such as reduced vegetation cover and cropland production, had complicated the maintenance of their livelihoods in the study area. Some degraded sites were also identified through observations during the fieldwork. Whether a large-scale reduction of cropland productivity had occurred in the farmers' croplands remained, however, unclear. The study found that the environmental impact of the rural women's activities varied and was normally limited. The women's most significant environmental impact resulted from their cutting of trees, which was likely to contribute, at least in some places, to land degradation, affecting the environment together with climate and livestock. However, when a wider perspective is taken, it becomes questionable whether the women have really played roles in land degradation, since gender, poverty and the need to maintain livelihood had caused them to conduct environmentally harmful activities. The women have had, however, no power to change the causes of their activities. The findings further suggested that an inadequate availability of food was the most critical problem in the study area. Therefore, an environmental programme in the area was suggested to include technical measures to increase the productivity of croplands, opportunities for income generation and readiness to co-operate with other programmes to improve the local people's abilities to maintain their livelihoods. In order to protect the environment and alleviate the women's work burden, the introduction of fuel-saving stoves was also suggested. Furthermore, it was suggested that increased planting of trees on homesteads would be supported by an easy availability of tree seedlings. Planting trees on common property land was, however, perceived as extremely demanding in the study area, due to scarcity of such land. In addition, it became apparent that the local land users, and women in particular, needed to allocate their labour to maintain the immediate livelihood of their families and were not motivated to allocate their labour solely for environmental rehabilitation. Nonetheless, from the point of view of the existing social structures, women's active participation in a community-based environmental programme would be rather natural, particularly among the farmer women who had already formed a women's group and participated in communal decision making. Forming of a women group or groups was suggested to further support both the farmer women's and pastoral women's active participation within an environmental programme and their general empowerment. An Environmental programme would need to acknowledge that improving rural people's well-being and maintaining their livelihood in the study area requires development and co-operation with various sectors in Sudan.

Early recovery signs of an Australian grassland following the management of Parthenium hysterophorus L

Parthenium weed (Parthenium hysterophorus L.) is believed to reduce the above- and below-ground plant species diversity and the above-ground productivity in several ecosystems. We quantified the impact of this invasive weed upon species diversity in an Australian grassland and assessed the resulting shifts in plant community composition following management using two traditional approaches. A baseline plant community survey, prior to management, showed that the above-ground community was dominated by P. hysterophorus, stoloniferous grasses, with a further high frequency of species from Malvaceae, Chenopodiaceae and Amaranthaceae. In heavily invaded areas, P. hysterophorus abundance and biomass was found to negatively correlate with species diversity and native species abundance. Digitaria didactyla Willd. was present in high abundance when P. hysterophorus was not, with these two species, contributing most to the dissimilarity seen between areas. The application of selective broad leaf weed herbicides significantly reduced P. hysterophorus biomass under ungrazed conditions, but this management did not yet result in an increase in species diversity. In the above-ground community, P. hysterophorus was partly replaced by the introduced grass species Cynodon dactylon L. (Pers.) 1 year after management began, increasing the above-ground forage biomass production, while D. didactyla replaced P. hysterophorus in the below-ground community. This improvement in forage availability continued to strengthen over the time of the study resulting in a total increase of 80% after 2 years in the ungrazed treatment, demonstrating the stress that grazing was imposing upon this grassland-based agro-ecosystem and showing that it is necessary to remove grazing to obtain the best results from the chemical management approach.

Potential and economics of forestry options for carbon sequestration in India

There is a need to understand the carbon (C) sequestration potential of the forestry option and its financial implications for each country.In India the C emissions from deforestation are estimated to be nearly offset by C sequestration in forests under succession and tree plantations. India has nearly succeeded in stabilizing the area under forests and has adequate forest conservation strategies. Biomass demands for softwood, hardwood and firewood are estimated to double or treble by the year 2020. A set of forestry options were developed to meet the projected biomass needs, and keeping in mind the features of land categories available, three scenarios were developed: potential; demand-driven; and programme-driven scenarios. Adoption of the demand-driven scenario, targeted at meeting the projected biomass needs, is estimated to sequester 78 Mt of C annually after accounting for all emissions resulting from clearfelling and end use of biomass. The demand-driven scenario is estimated to offset 50% of national C emission at 1990 level. The cost per t of C sequestered for forestry options is lower than the energy options considered. The annual investment required for implementing the demand-driven scenario is estimated to be US$ 2.1 billion for six years and is shown to be feasible. Among forestry options, the ranking based on investment cost per t of C sequestered from least cost to highest cost is; natural regeneration-agro-forestry-enhanced natural regeneration (< US$ 2.5/t C)-timber-community-softwood forestry (US$ 3.3 to 7.3 per t of C).

Macro-economic analysis of forestry options on carbon sequestration in India

The forestry sector provides a number of climate change mitigation options. Apart from this ecological benefit, it has significant social and economic relevance. Implementation of forestry options requires large investments and sustained long-term planning. Thus there is a need for a detailed analysis of forestry options to understand their implications on stock and flow of carbon, required investments, value of forest wealth, contribution to GNP and livelihood, demand management, employment and foreign trade. There is a need to evaluate the additional spending on forestry by analysing the environmental (particularly carbon abatement), social and economic benefits. The biomass needs for India are expected to increase by two to three times by 2020. Depending upon the forest types, ownership patterns and land use patterns, feasible forestry options are identified. It is found among many supply options to be feasible to meet the 'demand based needs' with a mix of management options, species choices and organisational set up. A comparative static framework is used to analyze the macro-economic impacts. Forestry accounts for 1.84% of GNP in India. It is characterized by significant forward industrial linkages and least backward linkage. Forestry generates about 36 million person years of employment annually. India imports Rs. 15 billion worth of forest based materials annually. Implementation of the demand based forestry options can lead to a number of ecological, economic and institutional changes. The notable ones are: enhancement of C stock from 9578 to 17 094 Mt and a net annual C-sequestration from 73 to 149 Mt after accounting for all emissions; a trebling of the output of forestry sector from Rs. 49 billion to Rs. 146 billion annually; an increase in GDP contribution of forestry from Rs. 32 billion to Rs. 105 billion over a period of 35 years; an increase in annual employment level by 23 million person years, emergence of forestry as a net contributor of foreign exchange through trading of forestry products; and an increase in economic value of forest capital stock by Rs. 7260 billion with a cost benefit analysis showing forestry as a profitable option. Implementation of forestry options calls for an understanding of current forest policies and barriers which are analyzed and a number of policy options are suggested. (C) 1997 Elsevier Science B.V.