Comparison of weight loss outcomes between obese patients with and without Type 2 diabetes attending a weight management focused structured educational group

Aims: Specialist lifestyle management (SLiM) is a medically supported dietetically led structured group education and self-management programme focusing on weight management. Obese patients with Type 2 diabetes are perceived to find it more difficult to lose weight compared with those without diabetes. We aimed to compare the weight loss achieved by obese patients with or without Type 2 diabetes completing the SLiM programme. Methods: A prospective analysis of patients attending SLiM between 2009 and 2013 was conducted. Results: There were 454 obese patients (mean age 49.1 ± 11.6years, women 72.5%, body mass index 49.8 ± 9.3kg/m2, weight137.3 ± 28kg). 152/454 patients (33%) had Type 2 diabetes of which 31 (20.4%) were insulin treated. Patients with Type 2diabetes were older (52.4 ± 11.3 vs 47.5 ± 11.4 years, p < 0.001). SLiM resulted in significant weight loss in patients with (136.5 ± 27 vs 130.2 ± 25.3, p < 0.001) or without (137.6 ± 29 vs 132.6 ± 28.4, p < 0.001) Type 2 diabetes. Weight loss was comparable between patients with and without Type 2 diabetes (6.1 ± 7.9 vs5.1 ± 7kg, p = 0.2). The proportion of patients achieving ≥ 10%weight loss was similar between patients with and without Type 2diabetes (10.5% vs 9.9%, p = 0.4). Insulin-treated patients lost similar weight to those not treated with insulin (6.3 ± 9.4 vs 6.1 ± 7.6kg, p = 0.9). After adjustment for age, sex, referral weight and medications, Type 2 diabetes did not predict weight change during the SLiM programme (b = 0.3, p = 0.5). Conclusions: Attending the SLiM groups produces a significant weight loss in patients with Type 2 diabetes which is comparable to those without Type 2 diabetes. Insulin-treated patients lost similar weight to those not on insulin. Weight gain with Type 2 diabetes and insulin treatment is not ‘unavoidable’ if patients receive the appropriate support and education.

Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors

In his dialogue - Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors - by William O'Brien, Associate Professor, School of Hospitality Management at Florida International University, Associate Professor O’Brien initially states: “The computer revolution has only just begun. Rapid improvement in hardware will continue into the foreseeable future; over the last five years it has set the stage for more significant improvements in software technology still to come. John Naisbitt's information electronics economy¹ based on the creation and distribution of information has already arrived and as computer devices improve, hospitality managers will increasingly do at least a portion of their work with software tools.” At the time of this writing Assistant Professor O’Brien will have you know, contrary to what some people might think, the computer revolution is not over, it’s just beginning; it’s just an embryo. Computer technology will only continue to develop and expand, says O’Brien with citation. “A complacent few of us who feel “we have survived the computer revolution” will miss opportunities as a new wave of technology moves through the hospitality industry,” says ‘Professor O’Brien. “Both managers who buy technology and vendors who sell it can profit from strategy based on understanding the wave of technological innovation,” is his informed opinion. Property managers who embrace rather than eschew innovation, in this case computer technology, will benefit greatly from this new science in hospitality management, O’Brien says. “The manager who is not alert to or misunderstands the nature of this wave of innovation will be the constant victim of technology,” he advises. On the vendor side of the equation, O’Brien observes, “Computer-wise hospitality managers want systems which are easier and more profitable to operate. Some view their own industry as being somewhat behind the times… They plan to pay significantly less for better computer devices. Their high expectations are fed by vendor marketing efforts…” he says. O’Brien warns against taking a gamble on a risky computer system by falling victim to un-substantiated claims and pie-in-the-sky promises. He recommends affiliating with turn-key vendors who provide hardware, software, and training, or soliciting the help of large mainstream vendors such as IBM, NCR, or Apple. Many experts agree that the computer revolution has merely and genuinely morphed into the software revolution, informs O’Brien; “…recognizing that a computer is nothing but a box in which programs run.” Yes, some of the empirical data in this article is dated by now, but the core philosophy of advancing technology, and properties continually tapping current knowledge is sound.

Social-Cognitive Determinants of Success in Online Communities for Weight Management

Background: Online communities may be an effective, convenient, and relatively inexpensive intervention platform for individuals seeking assistance with weight management. Recent research suggests that these communities may be as effective as in-person treatments for weight management; however, very little is known about the characteristics that predict weight loss amongst those using an online community. Methods: Within a social-cognitive framework, we sought to identify the psychosocial characteristics that are associated with successful weight management for users of MyFitnessPal, a popular online community for weight management. We recruited participants who were new to the online community and asked them to complete 2 surveys (one at baseline and one 3 months later) that assessed various psychosocial constructs as well as self-reported height and weight. Results: Participants in our sample reported losing, on average, 4.55 kg during the 3-month time period. We found that engaging in weight control behaviors (e.g., monitoring food intake, weighing oneself, etc.) fully mediated the relationship between several of our variables of interest (i.e., baseline self-efficacy and perceived social support within the community) and weight loss. We also found that participants who expected to lose more weight at baseline were significantly more likely to have lost more weight at follow-up. Conclusions: On average, participants in our study lost a clinically meaningful amount of weight. Predictors of weight loss within this community included perceived support within the community (mediated by weight control behaviors), baseline self-efficacy (mediated by weight control behaviors), and baseline outcome expectations. Results of this study can ultimately serve to inform the design of future eHealth interventions for weight management.

The £ for lb challenge – a lose – win – win scenario. Results from a novel workplace-based, peer-led weight management programme

Title: The £ for lb. Challenge – A lose - win – win scenario. Results from a novel workplace-based, peer-led weight management programme in 2016.

Names: Damien Bennett, Declan Bradley, Angela McComb, Amy Kiernan, Tracey Owen

Background: Tackling obesity is a public health priority. The £ for lb. Challenge is the first country wide, workplace-based peer-led weight management programme in the UK or Ireland with participants from a range of private and public businesses in Northern Ireland (NI).
Intervention: The intervention was workplace-based, led by workplace Champions and based on the NHS Choices 12 week weight loss guide. It operated from January to April 2016. Overweight and obese adult workers were eligible. Training of Peer Champions (staff volunteers) involved two half day workshops delivered by dieticians and physical activity professionals.
Outcome measurement: Weight was measured at enrolment and 12 weekly intervals. Changes in weight, % weight, BMI and % BMI were determined for the whole cohort and sex and deprivation subgroups.
Results: There were 1513 eligible participants from 35 companies. Engagement rate was 98%. 75% of participants completed the programme. Mean weight loss was 2.4 kg or 2.7%. Almost a quarter (24%) lost at least 5% initial bodyweight. Male participants were over twice as likely to complete the programme and three times more likely to lose 5% body weight or more. Over £17,000 was raised for NI charities.
Discussion: The £ for lb. Challenge is a successful health improvement programme with important weight loss for many participants, particularly male workers. With high levels of user engagement and ownership and successful multidisciplinary collaboration between public health, voluntary bodies, private and public companies it is a novel workplace based model with potential to expand.

The impact of gillnet mesh sizes on Oreochromis niloticus: a proposed management strategy

Gillnets are popularly used in commercial fishing on both Lake kioga and lake Victoria. On Lake kioga the legal mesh size is from 4½ (114) upwards while on Lake Victoria, a multifishery lake, various mesh sizes are in operation. However, the fishermen on these lakes still use the smaller meshes to be able to harvest certain categories of fish especially Oreochromis species group whose catch rates are already on the decline due to either use of small mesh size nets, high fishing pressure and to L.Kioga in particular, predation by lates niloticus.

Lake Albert fisheries resources and their management strategy

Lake Albert/Mobutu lies along the Zaire-Uganda border in 43/57 per cent ratio in the faulted depression tending south-west to the north east. It is bounded by latitudes 1o0 n to 2o 20’ N and longitudes 30o 20’ to 31o 20’E. It has a width varying from 35 to 45 km (22 to 28 miles) as measured between the scarps at the lake level. It covers an area of 5600km2 and has a maximum depth of 48m. The major inflow is through the Semiliki, an outflow of Lake Edward, Muzizi and Victoria Nile draining lakes Victoria and Kyoga while the Albert Nile is the outflow. The physical, chemical and biological productivity parameters are summarized in Table 1. The scarp is steep but not sheer and there are at least 4 tracks leading down it to villages on the shore and scarp land scarp is a young one, formed as a result of earth movements of the Pleistocene times, and the numerous streams come down headlong down its thousand feet drop, more often than not in falls (Baker, 1954). Sometimes there appears to be a clean fault; and at other places there is the appearrence of step faulting, although this may be of only a superical nature .The escarpment’s composed of rocks belonging to the pre-Cambrian Basement complex of the content; but the floor of the depression is covered with young sedimentary rocks, known as kaiso beds. In their upper part these latter beds contains many pebbles; whilst low down the occurrence fossiliferous beds is sufficiently rare phenomenon in the interior plateau of Africa. The kaiso beds dated as possibly middle Pleistocene in age, are exposed in various flats on the shore, and they presumably extend under the relatively shallow waters of the lake. A feature of the shore is the development of sandpits and the enclosure of lagoons; and these can be observed in various stages of development at kaiso, Tonya, kibiro, Buhuka and above all, at Butiaba. On an island lake over 1100 km (700 miles) from the shores of the Indian Ocean one can thus study some of the shore-line phenomena usually associated with the sea- coast (Worthington, 1929). In the north, from Butiaba onwards, the flats become wider and from a continuous lowland as the lake shore curves away from the straight edge of the escarpment. At a height of just 610m (2000 feet) above sea-level, the rift valley floor at Butiaba has a mean annual temperature of 25.60c (780 f), from which there is virtually no seasonal variation; and and the mean daily range is only 6.50c (130f) (E.Afr. met. Dept.1953). With a mean annual rainfall of not much more than 762mm (309 inches) and only 92 rain days in ayear, again to judge from Butiaba, conditions in the rift valley are semi-arid; and the vegetation cover consists of grasses and scattered drought-resisting trees and bushes. Only near the stream courses does the vegetation thicken.

Impact of Routine Fractional Flow Reserve Evaluation During Coronary Angiography on Management Strategy and Clinical Outcome: One-Year Results of the POST-IT.

Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. METHODS AND RESULTS: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P=0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization (P=0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR. CONCLUSIONS: Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials.

Defining a management strategy for the azorean natural thermal resources : valuing criteria identification

Dissertação de Mestrado, Gestão de Empresas (MBA), 23 de Maio de 2016, Universidade dos Açores.

Implementation and Validation of a Self-Consumption Maximization Energy Management Strategy in a Vanadium Redox Flow BIPV Demonstrator

This paper presents the results of the implementation of a self-consumption maximization strategy tested in a real-scale Vanadium Redox Flow Battery (VRFB) (5 kW, 60 kWh) and Building Integrated Photovoltaics (BIPV) demonstrator (6.74 kWp). The tested energy management strategy aims to maximize the consumption of energy generated by a BIPV system through the usage of a battery. Whenever possible, the residual load is either stored in the battery to be used later or is supplied by the energy stored previously. The strategy was tested over seven days in a real-scale VRF battery to assess the validity of this battery to implement BIPV-focused energy management strategies. The results show that it was possible to obtain a self-consumption ratio of 100.0%, and that 75.6% of the energy consumed was provided by PV power. The VRFB was able to perform the strategy, although it was noticed that the available power (either to charge or discharge) varied with the state of charge.

Development of an innovative non rule-based energy management strategy for a Hybrid Electric Vehicle, structured for predictive driving controls based on external information knowledge

Recently, the interest of the automotive market for hybrid vehicles has increased due to the more restrictive pollutants emissions legislation and to the necessity of decreasing the fossil fuel consumption, since such solution allows a consistent improvement of the vehicle global efficiency. The term hybridization regards the energy flow in the powertrain of a vehicle: a standard vehicle has, usually, only one energy source and one energy tank; instead, a hybrid vehicle has at least two energy sources. In most cases, the prime mover is an internal combustion engine (ICE) while the auxiliary energy source can be mechanical, electrical, pneumatic or hydraulic. It is expected from the control unit of a hybrid vehicle the use of the ICE in high efficiency working zones and to shut it down when it is more convenient, while using the EMG at partial loads and as a fast torque response during transients. However, the battery state of charge may represent a limitation for such a strategy. That’s the reason why, in most cases, energy management strategies are based on the State Of Charge, or SOC, control. Several studies have been conducted on this topic and many different approaches have been illustrated. The purpose of this dissertation is to develop an online (usable on-board) control strategy in which the operating modes are defined using an instantaneous optimization method that minimizes the equivalent fuel consumption of a hybrid electric vehicle. The equivalent fuel consumption is calculated by taking into account the total energy used by the hybrid powertrain during the propulsion phases. The first section presents the hybrid vehicles characteristics. The second chapter describes the global model, with a particular focus on the energy management strategies usable for the supervisory control of such a powertrain. The third chapter shows the performance of the implemented controller on a NEDC cycle compared with the one obtained with the original control strategy.

A new sward management strategy to mitigate the methane (CH4) emissions by grazing ruminants.

2016

Le rôle d’une insatisfaction corporelle dans l’adoption de pratiques de maintien et de changement du poids chez des adolescents québécois

L’objectif de recherche principal poursuivi dans cette thèse de doctorat est de mieux comprendre le rôle d’une insatisfaction corporelle dans l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Pour atteindre cet objectif de recherche principal, trois articles scientifiques liés les uns aux autres ont été rédigés. Chaque article poursuit des objectifs spécifiques (1er article: estimer les proportions d’adolescent(e)s québécois(e)s poursuivant un objectif de poids apparié et non-apparié à leur poids actuel et identifier les déterminants des objectifs de poids non-apparié au poids actuel, 2e article: identifier des associations entre un objectif de poids apparié vs. non-apparié au poids actuel et la fréquence d’utilisation de différents comportements liés au poids et à l’alimentation, 3e article: observer des associations entre différents degrés d’insatisfaction corporelle et l’utilisation de divers comportements liés au poids et à l’alimentation et examiner le rôle modérateur d’un objectif de poids apparié vs. non-apparié au poids actuel dans ces associations) permettant de répondre à l’objectif de recherche principal. Ces articles ont tous été élaborés à partir de l’analyse secondaire d’une banque de données quantitatives constituée par l’Institut de la statistique du Québec (ISQ) et nommée: Enquête sociale et de santé auprès des enfants et des adolescents québécois (ESSEA). L’ESSEA a été constitué auprès d’un échantillon populationnel et représentatif d’enfants et d’adolescent(e)s québécois(es) âgé(e)s de neuf, 13 et 16 ans. Les résultats de cette thèse indiquent qu’une insatisfaction corporelle est associée à la poursuite d’un objectif de poids non-apparié au poids actuel, ainsi qu’à l’utilisation de comportements liés au poids et à l’alimentation sains, malsains et déviants. Des associations ont également été observées entre l’objectif de poids poursuivi par un adolescent(e) et divers comportements utilisés pour l’atteindre. En effet, la poursuite d’un objectif de poids non-apparié au poids actuel est associée à l’utilisation de comportements malsains. Cette association n’est cependant pas présente en ce qui à trait à l’utilisation de comportements sains et déviants, ceux-ci étant strictement prédits par une insatisfaction corporelle. Des effets de médiation et de modération ont aussi été identifiés. Une insatisfaction corporelle est une variable de médiation entre une détresse psychologique chez les adolescentes et la poursuite d’un objectif de poids non-apparié au poids actuel. Finalement, un objectif de poids non-apparié au poids actuel est une variable modifiant l’association entre une insatisfaction corporelle et l’utilisation de comportements malsains chez les adolescent(e)s québécois(es). En conclusion, il existe diverses associations entre une insatisfaction corporelle et l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Une insatisfaction corporelle est donc une cible d’intervention pertinente pour la santé publique puisqu’elle peut servir de base à l’élaboration d’interventions visant la promotion d’un poids santé ainsi que de saines stratégies de contrôle du poids.

Strategy for the development of investment decision-making framework for road asset management for queensland department of main roads

The aim of this project is to develop a systematic investment decision-making framework for infrastructure asset management by incorporation economic justification, social and environmental consideration in the decision-making process. This project assesses the factors that are expected to provide significant impacts on the variability of expenditures. A procedure for assessing risk and reliability for project investment appraisals will be developed. The project investigates public perception, social and environmental impacts on road infrastructure investment. This research will contribute to the debate about how important social and environmental issues should be incorporated into the investment decision-making process for infrastructure asset management.

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.