Children, Obesity and Exercise: Prevention, Treatment and Management of Childhood and Adolescent Obesity

Throughout the developed world there is an increasing prevalence of childhood obesity. Because of this increase, and awareness of the risks to long term health that childhood obesity presents, the phenomena is now described by many as a global epidemic. Children, Obesity and Exercise provides sport, exercise and medicine students and professionals with an accessible and practical guide to understanding and managing childhood and adolescent obesity. It covers: overweight, obesity and body composition; physical activity, growth and development; psycho-social aspects of childhood obesity; physical activity behaviours; eating behaviours; measuring childrens behaviour; interventions for prevention and management of childhood obesity. Children, Obesity and Exercise addresses the need for authoritative advice and innovative approaches to the prevention and management of this chronic problem.

Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

Improved understanding of the damage, ecology, and management of mirids and stinkbugs in Bollgard II

In recent years mirids and stinkbugs have emerged as important sucking pests in cotton. While stinkbugs are causing damage to bolls, mirids are causing damage to seedlings, squares and bolls. With the increasing adoption of Bollgard II and IPM approaches the use of broad-spectrum chemicals to kill Helicoverpa has been reduced and as a result mirids and stinkbugs are building to levels causing damage to bolls later in crop growth stages. Studies on stinkbugs by Dr Moazzem Khan revealed that green vegetable bug (GVB) caused significant boll damage and yield loss. A preliminary study by Dr Khan on mirids revealed that high mirid numbers at later growth stages also caused significant boll damage and that damage caused by mirids and GVB were similar. Mirids and stinkbugs therefore demand greater attention in order to minimise losses caused by these pests and to develop IPM strategies against these pests to enhance gains in IPM that have been made with Bt-transgenic cotton. Progress in this area of research will maintain sustainability and profitability of the Australian cotton industry. Mirid damage at early growth stages of cotton (up to squaring stage) has been studied in detail by Dr Khan. He found that all ages of mirids cause damage to young plants and damage by mirid nymphs is cumulative. Maximum damage occurs when the insect reaches the 4th and 5th nymphal stages. He also found that mirid feeding causes shedding of small and medium squares, and damaged large squares develop as ‘parrot beak’ bolls. Detailed studies at the boll stage, such as which stage of mirids is most damaging or which age boll is most vulnerable to feeding, is lacking. This information is a prerequisite to developing an IPM strategy for the pest in later crop growth stages. Understanding population change of the pest over time in relation to crop development is an important aspect for developing management strategies for the pest which is lacking for mirids in BollgardII. Predators and parasitoids are integral components of any IPM system and play an important part in regulating pest populations. Some generalist predators such as ants, spiders, damsel bugs and assassin bugs are known to predate on mirids. Nothing is known about parasitoids of mirids. Since green mirid (GM), Creontiades dilutus, is indigenous to Australia it is likely that we have one or more parasitoids of this mirid in Australia, but that possibility has not been investigated yet. The impact of the GVB adult parasitoid, Trichopoda giacomelli, has been studied by Dr Khan who found that the fly is established in the released areas and continues to spread. However, to get wider and greater impact, the fly should be released in new locations across the valleys. The insecticides registered for mirids and stinkbugs are mostly non-selective and are extremely disruptive to a wide range of beneficial insects. Use of these insecticides at stage I and II will minimise the impact of existing IPM programs. Therefore less disruptive control tactics including soft chemicals for mirids and stinkbugs are necessary. As with soft chemicals, salt mixtures, biopesticides based on fungal pathogens and attractants based on plant volatiles may be useful tools in managing mirids and stinkbugs with less or no disruption. Dr Khan has investigated salt mixture against mirids and GVB. While salt mixtures are quite effective and less disruptive, they are quite chemical specific. Not all chemicals mixed with salt will give the desired benefit. Therefore further investigation is needed to identify those chemicals that are effective with salt mixture against mirids and 3 of 37 GVB. Dr Caroline Hauxwell of DPI&F is working on fungal pathogen-based biopesticides against mirids and GVB and Drs Peter Gregg and Alice Del Socorro of Australian Cotton CRC are working on plant volatile-based attractants against mirids. Depending on their findings, inclusion of fungal-based biopestcides and plant volatile-based attractants in developing a management system against mirids and stinkbugs in cotton could be an important component of an IPM approach.

Management of mirids and stinkbugs in Bollgard II

The 'insurance' sprays by the growers run the risk of flaring secondary pests such as whitefly, mites and aphids. Although recent research on mirids has addressed some aspects of this issue, further effort is needed to refine mirid management.

Advantages and Versatility of Fluorescence-Based Methodology to Characterize the Functionality of LDLR and Class Mutation Assignment

Familial hypercholesterolemia (FH) is a common autosomal codominant disease with a frequency of 1:500 individuals in its heterozygous form. The genetic basis of FH is most commonly mutations within the LDLR gene. Assessing the pathogenicity of LDLR variants is particularly important to give a patient a definitive diagnosis of FH. Current studies of LDLR activity ex vivo are based on the analysis of I-125-labeled lipoproteins (reference method) or fluorescent-labelled LDL. The main purpose of this study was to compare the effectiveness of these two methods to assess LDLR functionality in order to validate a functional assay to analyse LDLR mutations. LDLR activity of different variants has been studied by flow cytometry using FITC-labelled LDL and compared with studies performed previously with I-125-labeled lipoproteins. Flow cytometry results are in full agreement with the data obtained by the I-125 methodology. Additionally confocal microscopy allowed the assignment of different class mutation to the variants assayed. Use of fluorescence yielded similar results than I-125-labeled lipoproteins concerning LDLR activity determination, and also allows class mutation classification. The use of FITC-labelled LDL is easier in handling and disposal, cheaper than radioactivity and can be routinely performed by any group doing LDLR functional validations.

Management of broodstock and quality control of fish seed in Hungary

Common carp (Cyprinus carpio) breeding has a long tradition in Hungary. However, recent economic changes in Eastern Europe and new developments in aquaculture necessitated the need for ensuring quality of the brood stock used in hatcheries and the legal and institutional frameworks needed to implement the program. In addition to good research and development programs and gene banking, it became essential to establish an appropriate legal framework, organize, coordinate and control breeding activities, and provide financial support. It was a major breakthrough for carp breeding when C.carpio was recognized as one of the cultivated animals in the Animal Breeding Act in 1993. The Carp Breeding Section of the Hungarian Fish Producers Association plays an important role in carp breeding programs. Thirteen breeding farms of the Carp Breeding Section have 24 certified C.carpio varieties. In Hungary, about 80 % of the seed used as stocking for commercial production are from high quality certified breeders.

Assessment and Management of Atlantic and Gulf Menhaden Stocks

The organization of coastwide management programs for Atlantic menhaden, Brevoortia tyrannus, and Gulf menhaden, B. patronus, are described. Recent assessments of the status of the Atlantic and Gulf menhaden stocks are summarized. Estimates of population size and fishing mortalities are obtained from virtual population analysis, and are used in determining spawner-recruit relationships, spawning stock ratios, yield-per-recruit, and surplus production. Management issues are addressed in the framework of assessment results.

Work experience in transition year: a mixed methods study of subject and career choices

Transition Year (TY) has been a feature of the Irish Education landscape for 39 years. Work experience (WE) has become a key component of TY. WE is defined as a module of between five and fifteen days duration where students engage in a work placement in the broader community. It places a major emphasis on building relationships between schools and their external communities and concomitantly between students and their potential future employers. Yet, the idea that participation in a TY work experience programme could facilitate an increased awareness of potential careers has drawn little attention from the research community. This research examines the influence WE has on the subsequent subjects choices made by students along with the effects of that experience on the students’ identities and emerging vocational identities. Socio-cultural Learning Theory and Occupational Choice Theory frame the overall study. A mixed methods approach to data collection was adopted through the administration of 323 quantitative questionnaires and 32 individual semi-structured interviews in three secondary schools. The analysis of the data was conducted using a grounded theory approach. The findings from the research show that WE makes a significant contribution to the students’ sense of agency in their own lives. It facilitates the otherwise complex process of subject choice, motivates students to work harder in their senior cycle, introduces them to the concepts of active, experience-based and self-directed learning, while boosting their self-confidence and nurturing the emergence of their personal and vocational identities. This research is a gateway to further study in this field. It also has wide reaching implications for students, teachers, school authorities, parents and policy makers regarding teaching and learning in our schools and the value of learning beyond the walls of the classroom.

Nurse-led behavioral management of diabetes and hypertension in community practices: a randomized trial.

BACKGROUND: Several trials have demonstrated the efficacy of nurse telephone case management for diabetes (DM) and hypertension (HTN) in academic or vertically integrated systems. Little is known about the real-world potency of these interventions. OBJECTIVE: To assess the effectiveness of nurse behavioral management of DM and HTN in community practices among patients with both diseases. DESIGN: The study was designed as a patient-level randomized controlled trial. PARTICIPANTS: Participants included adult patients with both type 2 DM and HTN who were receiving care at one of nine community fee-for-service practices. Subjects were required to have inadequately controlled DM (hemoglobin A1c [A1c] ≥ 7.5%) but could have well-controlled HTN. INTERVENTIONS: All patients received a call from a nurse experienced in DM and HTN management once every two months over a period of two years, for a total of 12 calls. Intervention patients received tailored DM- and HTN- focused behavioral content; control patients received non-tailored, non-interactive information regarding health issues unrelated to DM and HTN (e.g., skin cancer prevention). MAIN OUTCOMES AND MEASURES: Systolic blood pressure (SBP) and A1c were co-primary outcomes, measured at 6, 12, and 24 months; 24 months was the primary time point. RESULTS: Three hundred seventy-seven subjects were enrolled; 193 were randomized to intervention, 184 to control. Subjects were 55% female and 50% white; the mean baseline A1c was 9.1% (SD = 1%) and mean SBP was 142 mmHg (SD = 20). Eighty-two percent of scheduled interviews were conducted; 69% of intervention patients and 70% of control patients reached the 24-month time point. Expressing model estimated differences as (intervention--control), at 24 months, intervention patients had similar A1c [diff = 0.1 %, 95 % CI (-0.3, 0.5), p = 0.51] and SBP [diff = -0.9 mmHg, 95% CI (-5.4, 3.5), p = 0.68] values compared to control patients. Likewise, DBP (diff = 0.4 mmHg, p = 0.76), weight (diff = 0.3 kg, p = 0.80), and physical activity levels (diff = 153 MET-min/week, p = 0.41) were similar between control and intervention patients. Results were also similar at the 6- and 12-month time points. CONCLUSIONS: In nine community fee-for-service practices, telephonic nurse case management did not lead to improvement in A1c or SBP. Gains seen in telephonic behavioral self-management interventions in optimal settings may not translate to the wider range of primary care settings.