Obesity and health in Europeans aged 50 years and older

Background: Obesity is increasing globally across all population groups. Limited data are available on how obesity patterns differ across countries. Objective: To document the prevalence of obesity and related health conditions for Europeans aged 50 years and older, and to estimate the association between obesity and health outcomes across 10 European countries. Methods: Data were obtained from the 2004 Survey of Health, Ageing and Retirement in Europe, a cross-national survey of 22 777 Continental Europeans over the age of 50 years. The health outcomes included self-reported health, disability, doctor-diagnosed chronic health conditions and depression. Multivariate regression analysis was used to predict health outcomes across weight classes (defined by body mass index [BMI] from self-reported weight and height) in the pooled sample and individually in each country. Results: The prevalence of obesity (BMI >= 30) ranged from 12.8% in Sweden to 20.2% in Spain for men and from 12.3% in Switzerland to 25.6% in Spain for women. Adjusting for compositional differences across countries changed little in the observed large heterogeneity in obesity rates throughout Europe. Compared with normal weight individuals, men and women with greater BMI had significantly higher risks for all chronic health conditions examined except heart disease in overweight men. Depression was linked to obesity in women only. Particularly pronounced risks of impaired health and chronic health conditions were found among severely obese people. The effects of obesity on health did not vary significantly across countries. Conclusions: Cross-country differences in the prevalence of obesity in older Europeans are substantial and exceed socio-demographic differentials in excessive body weight. Obesity is associated with significantly poorer health outcomes among Europeans aged 50 years and over, with effects similar across countries. Large heterogeneity in obesity throughout Europe should be investigated further to identify areas for effective public policy. (C) 2007 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health.

Autonomous intelligent cruise control using a novel multiple-controller framework incorporating fuzzy-logic-based switching and tuning

This paper presents a novel intelligent multiple-controller framework incorporating a fuzzy-logic-based switching and tuning supervisor along with a generalised learning model (GLM) for an autonomous cruise control application. The proposed methodology combines the benefits of a conventional proportional-integral-derivative (PID) controller, and a PID structure-based (simultaneous) zero and pole placement controller. The switching decision between the two nonlinear fixed structure controllers is made on the basis of the required performance measure using a fuzzy-logic-based supervisor, operating at the highest level of the system. The supervisor is also employed to adaptively tune the parameters of the multiple controllers in order to achieve the desired closed-loop system performance. The intelligent multiple-controller framework is applied to the autonomous cruise control problem in order to maintain a desired vehicle speed by controlling the throttle plate angle in an electronic throttle control (ETC) system. Sample simulation results using a validated nonlinear vehicle model are used to demonstrate the effectiveness of the multiple-controller with respect to adaptively tracking the desired vehicle speed changes and achieving the desired speed of response, whilst penalising excessive control action. Crown Copyright (C) 2008 Published by Elsevier B.V. All rights reserved.

A Gentle/S approach to robot assisted neuro-rehabilitation

Movement disorders (MD) include a group of neurological disorders that involve neuromotor systems. MD can result in several abnormalities ranging from an inability to move, to severe constant and excessive movements. Strokes are a leading cause of disability affecting largely the older people worldwide. Traditional treatments rely on the use of physiotherapy that is partially based on theories and also heavily reliant on the therapists training and past experience. The lack of evidence to prove that one treatment is more effective than any other makes the rehabilitation of stroke patients a difficult task. UL motor re-learning and recovery levels tend to improve with intensive physiotherapy delivery. The need for conclusive evidence supporting one method over the other and the need to stimulate the stroke patient clearly suggest that traditional methods lack high motivational content, as well as objective standardised analytical methods for evaluating a patient's performance and assessment of therapy effectiveness. Despite all the advances in machine mediated therapies, there is still a need to improve therapy tools. This chapter describes a new approach to robot assisted neuro-rehabilitation for upper limb rehabilitation. Gentle/S introduces a new approach on the integration of appropriate haptic technologies to high quality virtual environments, so as to deliver challenging and meaningful therapies to people with upper limb impairment in consequence of a stroke. The described approach can enhance traditional therapy tools, provide therapy "on demand" and can present accurate objective measurements of a patient's progression. Our recent studies suggest the use of tele-presence and VR-based systems can potentially motivate patients to exercise for longer periods of time. Two identical prototypes have undergone extended clinical trials in the UK and Ireland with a cohort of 30 stroke subjects. From the lessons learnt with the Gentle/S approach, it is clear also that high quality therapy devices of this nature have a role in future delivery of stroke rehabilitation, and machine mediated therapies should be available to patient and his/her clinical team from initial hospital admission, through to long term placement in the patient's home following hospital discharge.

Effects of dietary fat modification on insulin sensitivity and on other risk factors of the metabolic syndrome—LIPGENE: a European randomized dietary intervention study

Background:Excessive energy intake and obesity lead to the metabolic syndrome (MetS). Dietary saturated fatty acids (SFAs) may be particularly detrimental on insulin sensitivity (SI) and on other components of the MetS. Objective:This study determined the relative efficacy of reducing dietary SFA, by isoenergetic alteration of the quality and quantity of dietary fat, on risk factors associated with MetS. Design:A free-living, single-blinded dietary intervention study. Subjects and Methods:MetS subjects (n=417) from eight European countries completed the randomized dietary intervention study with four isoenergetic diets distinct in fat quantity and quality: high-SFA; high-monounsaturated fatty acids and two low-fat, high-complex carbohydrate (LFHCC) diets, supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) (1.2 g per day) or placebo for 12 weeks. SI estimated from an intravenous glucose tolerance test (IVGTT) was the primary outcome measure. Lipid and inflammatory markers associated with MetS were also determined. Results:In weight-stable subjects, reducing dietary SFA intake had no effect on SI, total and low-density lipoprotein cholesterol concentration, inflammation or blood pressure in the entire cohort. The LFHCC n-3 PUFA diet reduced plasma triacylglycerol (TAG) and non-esterified fatty acid concentrations (P<0.01), particularly in men. Conclusion:There was no effect of reducing SFA on SI in weight-stable obese MetS subjects. LC n-3 PUFA supplementation, in association with a low-fat diet, improved TAG-related MetS risk profiles.

Lesbian and gay parents and reproductive technologies: The 2008 Australian and UK reforms

This article analyses the laws that govern the allocation of parental responsibility for children conceived through non-coital reproduction by lesbians and gay men in England/Wales and Australia. In 2008 both jurisdictions introduced important reforms affecting this area of law, providing new options for the legal recognition of parent–child relationships in lesbian and gay households. However, the practical usefulness or effectiveness of the reforms may be limited by the excessive complexity or obscurity of the system of parental responsibility thus introduced. Furthermore, the reform Acts encourage the formation of some family structures—especially homonuclear families—while discouraging the emergence of more imaginative and cooperative parenting configurations at odds with heteronormative parenting scripts. Only through a clearer commitment to intentionality as a ground for the allocation of parental responsibility will future reform be likely to adequately protect the interests of lesbian and gay parents and their children.

Increased protein SUMOylation following focal cerebral ischemia

Stroke is a major cause of death and disability, which involves excessive glutamate receptor activation leading to excitotoxic cell death. We recently reported that SUMOylation can regulate kainate receptor (KAR) function. Here we investigated changes in protein SUMOylation and levels of KAR and AMPA receptor subunits in two different animal stroke models: a rat model of focal ischemia with reperfusion and a mouse model without reperfusion. In rats, transient middle cerebral artery occlusion (MCAO) resulted in a striatal and cortical infarct. A dramatic increase in SUMOylation by both SUMO-1 and SUMO-2/3 was observed at 6h and 24h in the striatal infarct area and by SUMO-2/3 at 24h in the hippocampus, which was not directly subjected to ischemia. In mice, permanent MCAO resulted in a selective cortical infarct. No changes in SUMOylation occurred at 6h but there was increased SUMO-1 conjugation in the cortical infarct and non-ischemic hippocampus at 24h after MCAO. Interestingly, SUMOylation by SUMO-2/3 occurred only outside the infarct area. In both rat and mouse levels of KARs were only decreased in the infarct regions whereas AMPARs were decreased in the infarct and in other brain areas. These results suggest that posttranslational modification by SUMO and down-regulation of AMPARs and KARs may play important roles in the pathophysiological response to ischemia.

3D scanning by multiple fan beam X-ray sources and sensors

*** Purpose – Computer tomography (CT) for 3D reconstruction entails a huge number of coplanar fan-beam projections for each of a large number of 2D slice images, and excessive radiation intensities and dosages. For some applications its rate of throughput is also inadequate. A technique for overcoming these limitations is outlined. *** Design methodology/approach – A novel method to reconstruct 3D surface models of objects is presented, using, typically, ten, 2D projective images. These images are generated by relative motion between this set of objects and a set of ten fanbeam X-ray sources and sensors, with their viewing axes suitably distributed in 2D angular space. *** Findings – The method entails a radiation dosage several orders of magnitude lower than CT, and requires far less computational power. Experimental results are given to illustrate the capability of the technique *** Practical implications – The substantially lower cost of the method and, more particularly, its dramatically lower irradiation make it relevant to many applications precluded by current techniques *** Originality/value – The method can be used in many applications such as aircraft hold-luggage screening, 3D industrial modelling and measurement, and it should also have important applications to medical diagnosis and surgery.

Automatic X-ray screening of aircraft hold luggage

R. Benjamin (1995) addressed the application of the “object 3D” X ray reconstruction technique for electronically “unpacking” suspect items, when screening aircraft luggage. However, there is no satisfactory solution to the mass screening of hold luggage. Computed Tomography, CT, entails excessive radiation dosages, and its rate of throughput is quite inadequate. A novel variant of “object 3D” is therefore put forward, adapting some of the technology of existing cabin luggage screening systems-but on a substantially larger scale-which does achieve the required throughput at an acceptable radiation dosage and cost.

Mirror lightpipes: daylighting performance in real buildings

Mirror lightpipes are useful for providing healthy and energy-efficient daylight into buildings where windows and skylights are unsuitable, insufficient or generate too much heat gain. The lightpipes have been installed in dozens of buildings in the UK. Field monitoring has been carried out to assess their performance in four different buildings: the headquaters of a major insurance company, a health clinic, a residential building and a college dining hall In those cases where lighipipes with moderate aspect ratios were installed, good illuminance of up to 450 lux has been obtained with internal/external illuminance ratios around 1%. When long and narrow lightpipes with many bends are used, however, the ratio reduced to around 0.1%. These results showed that lightpipes can be effective daylighting devices provided that excessive aspect ratios and numbers of bends are avoided. Lightpipes with larger diameters should be used whenever possible. The lightpipes often improved signiScantly the visual quality af the interior environment, and high user satisfaction was found even in buildings where a relatively low level of daylight was admitted through the lightpipes

Dynamic Niche Clustering: a fuzzy variable radius niching technique for multimodal optimisation in GAs

This paper describes the recent developments and improvements made to the variable radius niching technique called Dynamic Niche Clustering (DNC). DNC is fitness sharing based technique that employs a separate population of overlapping fuzzy niches with independent radii which operate in the decoded parameter space, and are maintained alongside the normal GA population. We describe a speedup process that can be applied to the initial generation which greatly reduces the complexity of the initial stages. A split operator is also introduced that is designed to counteract the excessive growth of niches, and it is shown that this improves the overall robustness of the technique. Finally, the effect of local elitism is documented and compared to the performance of the basic DNC technique on a selection of 2D test functions. The paper is concluded with a view to future work to be undertaken on the technique.

Combining satellite data and models to estimate cloud radiative effect at the surface and in the atmosphere

Satellite measurements and numerical forecast model reanalysis data are used to compute an updated estimate of the cloud radiative effect on the global multi-annual mean radiative energy budget of the atmosphere and surface. The cloud radiative cooling effect through reflection of shortwave radiation dominates over the longwave heating effect, resulting in a net cooling of the climate system of –21 Wm-2. The shortwave radiative effect of cloud is primarily manifest as a reduction in the solar radiation absorbed at the surface of -53 Wm-2. Clouds impact longwave radiation by heating the moist tropical atmosphere (up to around 40 Wm-2 for global annual means) while enhancing the radiative cooling of the atmosphere over other regions, in particular higher latitudes and sub-tropical marine stratocumulus regimes. While clouds act to cool the climate system during the daytime, the cloud greenhouse effect heats the climate system at night. The influence of cloud radiative effect on determining cloud feedbacks and changes in the water cycle are discussed.