Obesity in People with Learning Disabilities: the impact of nurse led health screenings and health promotion activities

Background. Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. Aim. Firstly, to follow up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. Methods. A clinic led by two learning disbaility nurses was held for all people aged 10 years and over (n=464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organised health promotion classes for 20 people over a 6 - 8 week period. Findings. The health screen identified 64% of adults and 26% of 10 - 19 year olds as being overweight or obese. Moreover, those aged 40 - 49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow up questionnaire sent after 3 months suggested that of the 122 people identified for wiehgt reduciton, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. Conclusion. Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabiltieis to create more active lifestyles.

Agricultura urbana, condición para el desarrollo sostenible y la mejora del paisaje

Este artículo resulta de investigaciones en torno al “enverdecimiento” de las ciudades y las oportunidades de la agricultura urbana para la alimentación de una población en constante aumento que no trabaja la tierra. También es fruto de actividades de mejora de ambientes urbanos realizadas con la Escuela de Ingenieros Agrónomos de la Universidad Politécnica de Madrid. A través de casos de agricultura urbana, entendiendo por ella el conjunto de prácticas para la producción de alimentos y plantas ornamentales dentro de las ciudades y en sus entornos, se analizan alternativas para la recuperación de espacios construidos e incremento de la calidad de vida de la población. Todo ello se traduce, además, en creación de riqueza y mejora del paisaje urbano, siempre desde criterios de sostenibilidad que favorecen el desarrollo local desde la Cumbre de la Tierra de Río de 1992 y la Conferencia sobre Desarrollo Sostenible Río+20 de 2013.

Evidence against dietary advanced glycation endproducts being a risk to human health

In vivo, advanced glycation endproducts (AGEs) are linked to various diseases, particularly those associated with diabetes. AGEs are also formed when many foods are thermally processed. The extent to which dietary AGEs are absorbed by the gastrointestinal (GI) tract and their possible role in the onset and promotion of disease are currently of considerable interest. This paper reviews information that supports the argument that dietary AGEs are not a risk to human health.

Predatory nature of the littoral amphipod Echinogammarus marinus: gut content analysis and effects of alternative food and substrate heterogeneity

Interspecific interactions are major structuring forces in marine littoral communities; however, it is unclear which of these interactions are exhibited by many key-component species. Gut content analysis showed that the ubiquitous rocky/cobble shore amphipod Echinogammarus marinas, often ascribed as a mesograzer, consumes both algae and macroinvertebrates. Further, laboratory experiments showed that E. marinus is an active predator of such macroinvertebrates, killing and consuming the isopod Jaera nordmanni and the oligochaete Tubificoides benedii. Predatory impacts of E. marinus were not alleviated by the presence of alternative food in the form of alga discs. However, in the presence of prey, consumption of alga by E. marinus was significantly reduced. Further, survival of prey was significantly higher when substrate was provided, but predation remained significant and did not decline with further increases in substrate heterogeneity. We conclude that such amphipods can have pervasive predatory impacts on a range of species, with implications for community structure, diversity and functioning.

Direct and indirect effects of obestatin peptides on food intake and the regulation of glucose homeostasis and insulin secretion in mice

Obestatin is a recently discovered peptide hormone that appears to be involved in reducing food intake, gut motility and body weight. Obestatin is a product of the preproghrelin gene and appears to oppose several physiological actions of ghrelin. This study investigated the acute effects of obestatin (1-23) and the truncated form, obestatin (11-23), on feeding activity, glucose homeostasis or insulin secretion. Mice received either intraperitoneal obestatin (1-23) or (11-23) (1 mu mol/kg) 4 h prior to an allowed 15 min period of feeding. Glucose excursions and insulin responses were lowered by 64-77% and 39-41%, respectively, compared with saline controls. However this was accompanied by 43% and 53% reductions in food intake, respectively. The effects of obestatin peptides were examined under either basal or glucose (18 mmol/kg) challenge conditions to establish whether effects were independent of changes in feeding. No alterations in plasma glucose or insulin responses were observed. In addition, obestatin peptides had no effect on insulin sensitivity as revealed by hypoglycaemic response when co-administered with insulin. Our observations support a role for obestatin in regulating metabolism through changes of appetite, but indicate no direct actions on glucose homeostasis or insulin secretion. (c) 2007 Elsevier Inc. All rights reserved.

Comparative seasonal acclimatization of food and energy consumption in adjacent populations of common spiny mice (Acomys cahirinus)

Animals inhabiting environments with low productivity and food availability commonly have reduced energy demands and increased digestive efficiencies. The dry matter intake (DMI), apparent digestible dry matter (ADDM), digestible efficiency (DE) and digestible energy intake (DEI) of two populations of common spiny mouse Acomys cahirinus were compared during both winter and summer under conditions of simulated water stress. Mice were captured from the north- and south-facing slopes (NFS and SFS) of the same canyon that represent mesic and xeric habitats, respectively. Measured variables were also compared between F-1 mice that had been born to either NFS or SFS mice, and raised in the laboratory. SFS mice were able to assimilate energy more efficiently than NFS mice during the summer. By comparison, NFS mice were able to assimilate more energy during the winter. During winter, NFS mice assimilated more energy at low levels of water stress, whereas SFS mice assimilated more energy at higher levels. Differences were also apparent in F-1 mice. It is therefore suggested that local climatic conditions can impose physiological adaptations that are retained in succeeding generations, creating unique meta-populations.

Hydroisomerisation of n-alkanes over partially reduced MoO3: Promotion by CoAlPO-11 and relations to reaction mechanism and rate-determining step

The reaction mechanism and the rate-determining step (RDS) of the isomerisation of n-alkanes (C-4-C-6) over partially reduced MoO3 catalysts were studied through the effects of the addition of an alkene isomerisation catalyst (i.e. CoAlPO- 11). When an acidic CoAlPO- 11 sample was mechanically mixed with the MoO3, a decrease of the induction period and an increase of the steady-state conversion of n-butane to isobutane were observed. These data support previous assumptions that a bifunctional mechanism occurred over the partially reduced MoO3 (a complex nanoscale mixture of oxide-based phases) during n-butane isomerisation and that the RDS was the skeletal isomerisation of the linear butene intermediates. The only promotional effect of CoAlPO-11 on the activity of partially reduced MoO3 for C-5-C-6 alkane hydroisomerisation was a reduction of the induction period, as the RDS at steady-state conditions appeared to be dehydrogenation of the alkane in this case. However, lower yields of branched isomers were observed in this case, the reason of which is yet unclear. (c) 2005 Elsevier B.V. All rights reserved.

A framework for assessing the vulnerability of food systems to future shocks

Modem society depends on complex agro-ecological and trading systems to provide food for urban residents, yet there are few tools available to assess whether these systems are vulnerable to future disturbances. We propose a preliminary framework to assess the vulnerability of food systems to future shocks based on landscape ecology's 'Panarchy Framework'. According to Panarchy, ecosystem vulnerability is determined by three generic characteristics: (1) the wealth available in the system, (2) how connected the system is, and (3) how much diversity exists in the system. In this framework, wealthy, non-diverse, tightly connected systems are highly vulnerable. The wealth of food systems can be measured using the approach pioneered by development economists to assess how poverty affects food security. Diversity can be measured using the tools investors use to measure the diversity of investment portfolios to assess financial risk. The connectivity of a system can be evaluated with the tools chemists use to assess the pathways chemicals use to flow through the environment. This approach can lead to better tools for creating policy designed to reduce vulnerability, and can help urban or regional planners identify where food systems are vulnerable to shocks and disturbances that may occur in the future. (c) 2005 Elsevier Ltd. All rights reserved.

Habitat for Humanity: Calibrating Best Practice Against the MDGs

Poverty alleviation lies at the heart of contemporary international initiatives on development. The key to development is the creation of an environment in which people can develop their potential, leading productive, creative lives in accordance with their needs, interests and faith. This entails, on the one hand, protecting the vulnerable from things that threaten their survival, such as inadequate nutrition, disease, conflict, natural disasters and the impact of climate change, thereby enhancing the poor’s capabilities to develop resilience in difficult conditions. On the other hand, it also requires a means of empowering the poor to act on their own behalf, as individuals and communities, to secure access to resources and the basic necessities of life such as water, food, shelter, sanitation, health and education. ‘Development’, from this perspective, seeks to address the sources of human insecurity, working towards ‘freedom from want, freedom from fear’ in ways that empower the vulnerable as agents of development (not passive recipients of benefaction).

Recognition of the magnitude of the problems confronted by the poor and failure of past interventions to tackle basic issues of human security led the United Nations (UN) in September 2000 to set out a range of ambitious, but clearly defined, development goals to be achieved by 2015. These are known as the Millennium Development Goals (MDGs). The intention of the UN was to mobilise multilateral international organisations, non-governmental organisations and the wider international community to focus attention on fulfilling earlier promises to combat global poverty. This international framework for development prioritises: the eradication of extreme poverty and hunger; achieving universal primary education; promoting gender equality and empowering women; reducing child mortality; improving maternal health; combating HIV/AIDS, malaria and other diseases; ensuring environmental sustainability; and developing a global partnership for development. These goals have been mapped onto specific targets (18 in total) against which outcomes of associated development initiatives can be measured and the international community held to account. If the world achieves the MDGs, more than 500 million people will be lifted out of poverty. However, the challenges the goals represent are formidable. Interim reports on the initiative indicate a need to scale-up efforts and accelerate progress.
Only MDG 7, Target 11 explicitly identifies shelter as a priority, identifying the need to secure ‘by 2020 a significant improvement in the lives of at least 100 million slum dwellers’. This raises a question over how Habitat for Humanity’s commitment to tackling poverty housing fits within this broader international framework designed to allievate global poverty. From an analysis of HFH case studies, this report argues that the processes by which Habitat for Humanity tackles poverty housing directly engages with the agenda set by the MDGs. This should not be regarded as a beneficial by-product of the delivery of decent, affordable shelter, but rather understood in terms of the ways in which Habitat for Humanity has translated its mission and values into a participatory model that empowers individuals and communities to address the interdependencies between inadequate shelter and other sources of human insecurity. What housing can deliver is as important as what housing itself is.

Examples of the ways in which Habitat for Humanity projects engage with the MDG framework include the incorporation of sustainable livelihoods strategies, up-grading of basic infrastructure and promotion of models of good governance. This includes housing projects that have also offered training to young people in skills used in the construction industry, microfinanced loans for women to start up their own home-based businesses, and the provision of food gardens. These play an important role in lifting families out of poverty and ensuring the sustainability of HFH projects. Studies of the impact of improved shelter and security of livelihood upon family life and the welfare of children evidence higher rates of participation in education, more time dedicated to study and greater individual achievement. Habitat for Humanity projects also typically incorporate measures to up-grade the provision of basic sanitation facilities and supplies of safe, potable drinking water. These measures not only directly help reduce mortality rates (e.g. diarrheal diseases account for around 2 million deaths annually in children under 5), but also, when delivered through HFH project-related ‘community funds’, empower the poor to mobilise community resources, develop local leadership capacities and even secure de facto security of tenure from government authorities.

In the process of translating its mission and values into practical measures, HFH has developed a range of innovative practices that deliver much more than housing alone. The organisation’s participatory model enables both direct beneficiaries and the wider community to tackle the insecurities they face, unlocking latent skills and enterprise, building sustainable livelihood capabilities. HFH plays an important role as a catalyst for change, delivering through the vehicle of housing the means to address the primary causes of poverty itself. Its contribution to wider development priorities deserves better recognition. In calibrating the success of HFH projects in terms of units completed or renovated alone, the significance of the process by which HFH realises these outcomes is often not sufficiently acknowledged, both within the organisation and externally. As the case studies developed in the report illustrate, the methodologies Habitat for Humanity employs to address the issue of poverty housing within the developing world, place the organisation at the centre of a global strategic agenda to address the root causes of poverty through community empowerment and the transformation of structures of governance.

Given this, the global network of HFH affiliates constitutes a unique organisational framework to faciliate sharing resources, ideas and practical experience across a diverse range of cultural, political and institutional environments. This said, it is apparent that work needs to be done to better to faciliate the pooling of experience and lessons learnt from across its affiliates. Much is to be gained from learning from less successful projects, sharing innovative practices, identifying strategic partnerships with donors, other NGOs and CBOs, and engaging with the international development community on how housing fits within a broader agenda to alleviate poverty and promote good governance.