Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Regional atmospheric circulation over Europe during the Last Glacial Maximum and its links to precipitation

The Last Glacial Maximum (LGM) exhibits different large-scale atmospheric conditions compared to present-day climate due to altered boundary conditions. The regional atmospheric circulation and associated precipitation patterns over Europe are characterized for the first time with a weather typing approach (circulation weather types, CWT) for LGM paleoclimate simulations. The CWT approach is applied to four representative regions across Europe. While the CWTs over Western Europe are prevailing westerly for both present-day and LGM conditions, considerable differences are identified elsewhere: Southern Europe experienced more frequent westerly and cyclonic CWTs under LGM conditions, while Central and Eastern Europe was predominantly affected by southerly and easterly flow patterns. Under LGM conditions, rainfall is enhanced over Western Europe but is reduced over most of Central and Eastern Europe. These differences are explained by changing CWT frequencies and evaporation patterns over the North Atlantic Ocean. The regional differences of the CWTs and precipitation patterns are linked to the North Atlantic storm track, which was stronger over Europe in all considered models during the LGM, explaining the overall increase of the cyclonic CWT. Enhanced evaporation over the North Atlantic leads to higher moisture availability over the ocean. Despite the overall cooling during the LGM, this explains the enhanced precipitation over southwestern Europe, particularly Iberia. This study links large-scale atmospheric dynamics to the regional circulation and associated precipitation patterns and provides an improved regional assessment of the European climate under LGM conditions.

Monotone positive solutions for a fourth order equation with nonlinear boundary conditions

This work is concerned with the existence of monotone positive solutions for a class of beam equations with nonlinear boundary conditions. The results are obtained by using the monotone iteration method and they extend early works on beams with null boundary conditions. Numerical simulations are also presented. (C) 2009 Elsevier Ltd. All rights reserved.

Separation and Execution of graphical engine on a cross platform IDE to enhance performance

“Biosim” is a simulation software which works to simulate the harvesting system.This system is able to design a model for any logistic problem with the combination of several objects so that the artificial system can show the performance of an individual model. The system will also describe the efficiency, possibility to be chosen for real life application of that particular model. So, when any one wish to setup a logistic model like- harvesting system, in real life he/she may be noticed about the suitable prostitution for his plants and factories as well as he/she may get information about the least number of objects, total time to complete the task, total investment required for his model, total amount of noise produced for his establishment in advance. It will produce an advance over view for his model. But “Biosim” is quite slow .As it is an object based system, it takes long time to make its decision. Here the main task is to modify the system so that it can work faster than the previous. So, the main objective of this thesis is to reduce the load of “Biosim” by making some modification of the original system as well as to increase its efficiency. So that the whole system will be faster than the previous one and performs more efficiently when it will be applied in real life. Theconcept is to separate the execution part of ”Biosim” form its graphical engine and run this separated portion in a third generation language platform. C++ is chosenhere as this external platform. After completing the proposed system, results with different models have been observed. The results show that, for any type of plants of fields, for any number of trucks, the proposed system is faster than the original system. The proposed system takes at least 15% less time “Biosim”. The efficiency increase with the complexity of than the original the model. More complex the model, more efficient the proposed system is than original “Biosim”.Depending on the complexity of a model, the proposed system can be 56.53 % faster than the original “Biosim”.

La thématique de l’eau dans l’œuvre de Marguerite Duras

The aim of this thematic study is to examine how the water motif is used in Marguerite Duras’s literary work. The study shows that water has multiple functions in these texts: it is linked to major themes and creates an enigmatic atmosphere by its association with the unknown, the inexplicable and the unconscious. The strong presence of water in Duras’s texts is striking. References to the water element can be found in several titles throughout her career, from early works such as Un barrage contre le Pacifique (1950) to La mer écrite (1996), published just after her death. Almost all of her fiction take place near water – and the rain or the sound of waves serve as leitmotifs in specific novels. The water motif can play a metonymic as well as a metaphoric role in the texts and it sometimes takes on human or animalistic characteristics (Chapter 4). Several emblematic Durassian characters (e.g. the beggar-woman, Anne-Marie Stretter and Lol V. Stein) have a close relationship to water (Chapter 5). The water motif is linked to many major Durassian themes, and illustrates themes with positive connotations, for example, creation, fecundity, maternity, liberty and desire, as well as themes with negative connotations such as destruction and death (Chapter 6). A close reading of three novels, La vie tranquille (1944), L’après-midi de Monsieur Andesmas (1962) and La maladie de la mort (1982), shows that the realism of the first novel is replaced by intriguing evocations of the sea and the pond in the second text, motifs which resist straightforward interpretation. The enigmatic feeling persists in the last novel, in which the sea illustrates the overall sombre mood of the story (Chapter 7). Finally, the role of the water element in psychoanalytic theory is discussed (Chapter 8), and a parallel is drawn between the Jungian concept of the mother archetype and the water motif in Duras’s texts. The suggestion is made in this last chapter that water is used to illustrate an oriental influence (Taoist or Buddhist) of some of the female characters in Duras’s work.

Teachers reactions to outcomes-based music education in South African primary schools

This article examines the reactions of specialist music teachers to the introduction of Outcomes-Based Education (OBE) in South Africa. OBE has been seen in post-apartheid South Africa as a way to transform education and address the imbalances of the past. The study reported here used questionnaires to explore attitudes of teachers at independent schools in Johannesburg in the first year of implementing OBE. Analysis of data revealed both positive and negative attitudes as well as the strong need for teachers professional development if OBE is to succeed.

Re-badged environmental education: is ESD more than just a slogan?

In the field of environment-related education, the period from the early 70s to the present is marked by continuity and contestation. There has been a remarkable continuity of environmentrelated practice; and there has also been contestation in the language of the field, with terms like ecology education, environmental education and education for sustainable development becoming highly visible at different times. Presently, the environment-related work formerly known as ‘environmental education’ (EE) is being aggressively and extensively ‘re-badged’ as ‘education for sustainable development’ (ESD). This paper explores the role of slogans in the fields of environmental education and education for sustainable development.

Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature

Preventing the development of obesity in children is an international health priority. To assess the effectiveness of interventions designed to prevent obesity, promote healthy eating and/or physical activity and/or to reduce sedentary behaviours in 0–5-year-old children, a systematic review of the literature was performed. Literature searches were limited to articles published between January 1995 and June 2006, printed in English and sampling children aged 0–5-years. Searches excluded literature concerned with breastfeeding, eating disorders, and interventions which were school-based or concerned with obesity treatment. Two reviewers independently extracted data and assessed study strengths and weaknesses. Nine included studies were grouped based on the settings in which they were delivered. Most studies involved multi-approach interventions, were conducted in the USA and varied in study designs and quality. All showed some level of effectiveness on at least one obesity-behaviour in young children. These studies support, at a range of levels, the premise that parents are receptive to and capable of some behavioural changes that may promote healthy weight in their young children. The small quantity of research heralds the need, particularly given the potential for early intervention to have long-lasting impacts on individual and population health, to build in a substantial way upon this evidence base.

Isogramma Meek and Worthen, 1870 (Dictyonellida, Brachiopoda) from the upper Palaeozoic of East Asia: implications for biogeography and evolutionary trends

Isogramma manchoukuoensis from the Upper Carboniferous of northeast China is redefined based on re-examination of the type specimens. Isogramma specimens from the Middle Permian of northeastern Japan are reassigned to I. aff. paotechowensis. A new family, Schizopleuroniidae, is proposed to include Schizopleuronia, but excludes Megapleuronia, which belongs to the Megapleuroniidae Liao, 1983. The family Isogrammidae is considered to be a transitional group in the eichwaldid-isogrammid-schizopleuronid evolutionary lineage within the Dictyonellida. A review of the global distribution of Isogramma species reveals that the genus has a total of 56 species ranging from the Mississippian (Early Carboniferous) to the Lopingian (Late Permian). Isogramma diversified rapidly after its origination in the middle Viséan and its species diversity remained high throughout the Mississippian. The genus possibly suffered a severe mid-Carboniferous boundary mass extinction, with no Early Carboniferous species surviving this event. Bashkirian Isogramma species show low diversity, followed by a global recovery in the Moscovian. During the latest Carboniferous Isogramma became highly diversified again. At the Carboniferous–Permian (C/P) transition Isogramma underwent another dramatic diversity drop, followed by several stepwise declines in diversity during the Early–Middle Permian. The Wuchiapingian I. sinosa is the last Isogramma species.

Ukraine was the possible centre of origin for Isogramma. From Ukraine Isogramma spread over the Moscow Basin of Russia, Central Europe (Germany, Austria), South Europe (Spain) and West Europe (England, Ireland and Scotland), and migrated to the North American midcontinent and South China during the late Viséan (Early Carboniferous). In Europe, Isogramma migrated to Spain and eastern Europe (Serbia) in the Moscovian, from there it then dispersed into Central Asia (Uzbekistan and Kazakhstan) in the Kasimovian-Gzhelian. In the Palaeo-Tethys Isogramma migrated from South China to northeast and northwest China in the Moscovian, spread over the North China Block during the C/P transition, moved to Russian Siberia, Japan and the Qiangtang terrane of the Palaeo-Tethys during the Early–Late Permian. In North America Isogramma spread over the midcontinent during the Late Carboniferous and Early–Middle Permian and migrated to South America (Bolivia) in latest Carboniferous. Biogeographically, Isogramma was confined principally to the palaeo-tropical and warm to temperate zones throughout the Late Palaeozoic, with the possible exception of the Artinskian, as a questionable species of the genus also occurs in the Transbaikal region of southeast Russia.

Online interaction impacts on learning: teaching the teachers to teach online

This paper explores the importance of interaction in the online teaching environment and the important role of staff development in developing teacher presence online. Professionally developing staff to use information and communication technologies is viewed from the standpoint of diffusion of innovation, moving from early adopters to mainstream majority, and targeting staff development at this latter group. Approaches to staff development using information and communication technologies are described, and recommendations for staff development for online teaching are made.

Poetry as a starting point for drama: learning to tolerate ambiguity

This article explores the use of process drama in an English classroom to explore issues raised by 'A poem for the Rainforest' by Judith Nicholls. The drama is used to explore both the themes and forms of the poem, the episodic nature of the drama reflecting the episodic form of the poem. The work engages the students, and the process drama works to layer complexity onto the issues rather than simplifying them.

Rogue en vogue : North Korea and the war on terror

North Korea occupies a unique place in the thinking of US policymakers insofar as it represents both a direct, physical threat and also a reminder of the limits to American power. In numerous ways, North Korea is anathema to the US: it has fulsomely rejected America’s systems of political–economic organisation, its gradual rapproachment with South Korea threatens to undermine the rationale for America’s military presence in Northeast Asia, and its possession of nuclear weapons threatens the safety of the US and its allies. For these reasons, and despite its lowly standing in the international political system, North Korea continues to severely frustrate the superpower’s interests and thus represents an existential threat to the US.

Implementation of evidence into practice : Development of a tool to improve emergency nursing care of acute stroke

Background
Stroke is an increasing global health issue that places considerable burden on society and health care services. An important part of acute stroke management and decreasing stroke-related mortality is preventing complications within the first 24–48 hours. The current climate of prolonged time spent in the Emergency Department (ED) means that many aspects of stroke management are now the responsibility of emergency nurses.

Aims
The aims of this paper are to: i) examine the evidence related to nursing care of acute stroke, ii) identify evidence-based elements of stroke care with most applicability to emergency nursing and iii) use evidence-based stroke care recommendations to develop a guideline for the emergency nursing management of acute stroke.

Results
Emergency nursing care of acute stroke should focus on optimal triage decisions, physiological surveillance, fluid management, risk management, and early referral to specialists.

Conclusions
The role of emergency nurses in stroke care will increase and it is important that emergency nurses deliver evidence-based stroke care in order to optimise patient outcomes. Guidelines and decision support tools for use in emergency nursing must be practical and have high levels of clinical utility for maximum uptake in a busy clinical environment.