Economic Evaluation of a Primary Care Trial to Reduce Weight Gain in Overweight/Obese Children: The LEAP Trial

Background:- A common policy response to the childhood obesity epidemic is to recommend that primary care physicians screen for and offer counseling to the overweight/obese. As the literature suggests, this approach may be ineffective; it is important to document the opportunity costs incurred by brief primary care obesity interventions that ultimately may not alter body mass index (BMI) trajectory.

Methods:- Live, Eat and Play (LEAP) was a randomized controlled trial of a brief secondary prevention intervention delivered by family physicians in 2002-2003 that targeted overweight/ mildly obese children aged 5 to 9 years. Primary care utilization was prospectively audited via medical records, and parents reported family resource use by written questionnaire. Outcome measures were BMI (primary) and parent-reported physical activity and dietary habits (secondary) in intervention compared with control children.

Results:- The cost of LEAP per intervention family was AU $4094 greater than for control families, mainly due to increased family resources devoted to child physical activity. Total health sector costs were AU $873 per intervention family and AU $64 per control, a difference of AU $809 {P < .001). At 15 months, intervention children did not differ significantly in adjusted BMI or daily physical activity scores compared with the control group, but dietary habits had improved.

Conclusions:- This brief intervention resulted in higher costs to families and the health care sector, which could have been devoted to other uses that do create benefits to health and/or family well-being. This has implications for countries such as the United States, the United Kingdom, and Australia, whose current guidelines recommend routine surveillance and counseling for high child BMI in the primary care sector.

Reducing unhealthy weight gain in children through community capacity−building: results of a quasi−experimental intervention program, Be Active Eat Well

Background:
Be Active Eat Well (BAEW) was a multifaceted community capacity-building program promoting healthy eating and physical activity for children (aged 4–12 years) in the Australian town of Colac.
Objective:
To evaluate the effects of BAEW on reducing children's unhealthy weight gain.
Methods:
BAEW had a quasi-experimental, longitudinal design with anthropometric and demographic data collected on Colac children in four preschools and six primary schools at baseline (2003, n=1001, response rate: 58%) and follow-up (2006, n=839, follow-up rate: 84%). The comparison sample was a stratified random selection of preschools (n=4) and primary schools (n=12) from the rest of the Barwon South Western region of Victoria, with baseline assessment in 2003–2004 (n=1183, response rate: 44%) and follow-up in 2006 (n=979, follow-up rate: 83%).
Results:
Colac children had significantly lower increases in body weight (mean: -0.92 kg, 95% CI: -1.74 to -0.11), waist (-3.14 cm, -5.07 to -1.22), waist/height (-0.02, -0.03 to -0.004), and body mass index z-score (-0.11, -0.21 to -0.01) than comparison children, adjusted for baseline variable, age, height, gender, duration between measurements and clustering by school. In Colac, the anthropometric changes were not related to four indicators of socioeconomic status (SES), whereas in the comparison group 19/20 such analyses showed significantly greater gains in anthropometry in children from lower SES families. Changes in underweight and attempted weight loss were no different between the groups.
Conclusions:
Building community capacity to promote healthy eating and physical activity appears to be a safe and effective way to reduce unhealthy weight gain in children without increasing health inequalities.

Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children : switch-play

Objectives : To evaluate the effectiveness of an intervention to prevent excess weight gain, reduce time spent in screen behaviours, promote participation in and enjoyment of physical activity (PA), and improve fundamental movement skills among children.

Participants : In 2002, 311 children (78% response; 49% boys), average age 10 years 8 months, were recruited from three government schools in low socioeconomic areas of Melbourne, Australia.

Design : Group-randomized controlled trial. Children were randomized by class to one of the four conditions: a behavioural modification group (BM; n=66); a fundamental movement skills group (FMS; n=74); a combined BM/FMS group (BM/FMS; n=93); and a control (usual curriculum) group (n=62). Data were collected at baseline, post intervention, 6- and 12-month follow-up periods.

Results : BMI data were available for 295 children at baseline and 268 at 12-month follow-up. After adjusting for food intake and PA, there was a significant intervention effect from baseline to post intervention on age- and sex-adjusted BMI in the BM/FMS group compared with controls (-1.88 kg m-2, P<0.01), which was maintained at 6- and 12-month follow-up periods (-1.53 kg m-2, P<0.05). Children in the BM/FMS group were less likely than controls to be overweight/obese between baseline and post intervention (adjusted odds ratio (AOR)=0.36, P<0.05); also maintained at 12-month follow-up (AOR=0.38, P<0.05). Compared with controls, FMS group children recorded higher levels and greater enjoyment of PA; and BM children recorded higher levels of PA and TV viewing across all four time points. Gender moderated the intervention effects for participation in and enjoyment of PA, and fundamental movement skills.

Conclusion : This programme represents a promising approach to preventing excess weight gain and promoting participation in and enjoyment of PA. Examination of the mediators of this intervention and further tailoring of the programme to suit both genders is required.

Factors influencing Australian SMEs knowledge sharing online

The Web offers a powerful tool for knowledge-sharing among small and medium sized enterprises (SMEs). Such online initiatives have, however, frequently been unsuccessful. This paper examines factors motivating SMEs to share knowledge online. It reports data from a telephone survey of 192 SME members of two successful regional business networks comprising members from diverse industries. Although the majority of SMEs actively used the Web in their daily business operations and most were willing to share knowledge face-to-face, this did not translate into willingness to share online. The most significant factors affecting the willingness to share knowledge online were the how many of networks SMEs were involved in, the number of years an SME had been in business, the geographical scope of their operations, and intensity of their use of the web. These findings challenge the commonly-held view that SMEs will automatically share online if the infrastructure is provided.

Sharing music and culture through singing in Australia

This article discusses the notion of sharing music and culture as an effective platform to celebrate diversity in Melbourne, Australia. My research project ‘Celebrating Music Making and Finding Meaning’ investigates and illustrates a context of diversity, one that promotes respect in a multicultural society sharing music and culture of a minority group. In 2007, I interviewed members of the South African choir in Melbourne; here I report on some data regarding why members sing in the choir, what are their understandings of a so-called South African identity and what they would like to share with the wider Australian community. I present some theoretical perspectives focusing on the notion of cultural and musical identity within a multicultural society. Such findings may have similar implications for other multicultural educational settings exploring the possibilities of valuing cultural diversity and making music across ages through a choir where difference can be shared and celebrated.

Television viewing time and weight gain in colorectal cancer survivors : a prospective population-based study

Objective To investigate the prospective relationships between television viewing time and weight gain in the 3 years following colorectal cancer diagnosis for 1,867 colorectal cancer survivors (body mass index (BMI) ≥ 18.5 kg/m2).

Methods BMI, television viewing time, physical activity, and socio-demographic and clinical covariates were assessed at baseline (5 months), 24 months and 36 months post-diagnosis. Multiple linear regression was used to study independent associations between baseline television viewing time and BMI at 24 and 36 months post-diagnosis.

Results At both follow-up time points, there was a significant increase in mean BMI for participants reporting ≥5 h/day of television viewing compared to those watching <3 h/day at baseline (24 months: 0.72 kg/m2 (0.31, 1.12), p < 0.001; 36 months: 0.61 kg/m2 (0.14, 1.07), p = 0.01), independent of baseline BMI, gender, age, education, marital status, smoking, cancer site, cancer disease stage, treatment mode and co-morbidities. Additional adjustment for baseline physical activity did not change results.

Conclusions These findings suggest that a greater emphasis on decreasing television viewing time could help reduce weight gain among colorectal cancer survivors. This, in turn, could contribute to a risk reduction for co-morbid conditions such as type 2 diabetes and cardiovascular disease.

Is sex-specific mass gain in Cory's shearwaters Calonectris diomedea related to begging and steroid hormone expression?

Mass differences between the sexes of dimorphic bird species often appear early in the nestling development. But how do adults know how much to feed a chick in a sexually dimorphic species? Do chicks of the heavier sex beg more? We studied begging in Cory’s shearwaters Calonectris diomedea, a species with heavier adult and juvenile males than females. We found that begging rates and call numbers were not different between male and female chicks, but parameters of begging intensity differed between the sexes in their relationship to chick body condition. For the same body condition, males had significantly higher begging call numbers and rates. Acoustical parameters, which were analysed semi-automatically, included the lengths of call and silence intervals, the minimum, mean and maximum frequency in a call and the number of frequency peaks within a call. We found no consistent differences of acoustic begging call elements between the sexes. Male and female chicks did not differ in the levels of the steroid hormones testosterone or corticosterone in the second quarter of the nestling period, and the mechanism leading to sex-related differences in begging rates for a given body condition remains unknown.

Knowledge sharing by organisations in sustainable development projects

There are an increasing number of organisations seeing the benefits of implementing sustainable development practices within their processes and product design. However, there are a number of barriers that are preventing organisations from taking up this challenge. Some of these barriers could be reduced through the application of better external knowledge sharing. This paper explores the potential for sharing knowledge about sustainable development practices in academic and industry journals. Using content analysis, the types of projects that are discussed and the level of detail provided in the reporting of sustainable development initiatives by organisations are examined to identify what is being communicated and more importantly to identify what is not being shared. The results show that there is a lack of detail in reporting with a focus on reporting only certain types of sustainable development projects that may prevent knowledge sharing from occurring.

Deakin University Library website 2.0 : iterative change for maximum gain

The purpose of library websites is evolving. Deakin University Library originally undertook to redevelop its website to provide improved access to information, resources and services and to better meet clients in their space. The first phase redeveloped the library homepage and top level link pages. During this time, social networking applications were becoming part of higher education. There were new choices: the Library website and search tools could undergo significant metamorphosis; adopt Web2.0 functionality and move from being the public face of the online library to the public space of its online community, with students and staff as active partners in its development.

Sharing community through singing : the Bosnian Behar Choir in Victoria, Australia

In 2008, the Australian Federal Minister for Ageing identified the importance of promoting social engagement amongst older Australians who frequently rely on community arts organizations to enhance quality of life, specifically in health, happiness and community. The arts are identified as a powerful catalyst in building strong communities that have the potential for connection, caring and social development. Greater active engagement in performing arts by older people is positively related to enhanced individual and community well-being. Our research study, Wellbeing and ageing: community, diversity and the arts (begun in 2008), explores cultural diversity and complexity within older Australian society through an examination of engagement with a community choir. In 2009 data were collected via semi-structured interviews that were analysed using Interpretative Phenomenological Analysis which utilises a phenomenological approach that explores personal experience in the participant’s life-world. Our research study focuses on one community choir, the Bosnian Behar Choir, in Victoria, Australia, as a lens through which to explore active ageing. Three significant issues were identified from this research which will be reported under the themes of well-being, community and cultural diversity. The Bosnian Behar Choir demonstrates how community music making can enhance well-being and positive ageing in contemporary Australia.

Metabolic adaptations to short-term high-intensity interval training : a little pain for a lot of gain?

High-intensity interval training (HIT) is a potent time-efficient strategy to induce numerous metabolic adaptations usually associated with traditional endurance training. As little as six sessions of HIT over 2 wk or a total of only approximately 15 min of very intense exercise (~600 kJ), can increase skeletal muscle oxidative capacity and endurance performance and alter metabolic control during aerobic-based exercise.