Sleep characteristics modify the association between genetic predisposition to obesity and anthropometric measurements in 119,679 UK Biobank participants

Background - Obesity is a multifactorial condition influenced by genetics, lifestyle and environment. Objective - To investigate whether the association between a validated genetic profile risk score for obesity (GPRS-obesity) with body mass index (BMI) and waist circumference (WC) was modified by sleep characteristics. Design - This study included cross-sectional data from 119,859 white European adults, aged 37-73 years, participating on the UK Biobank. Interactions between GPRS-obesity, and sleep characteristics (sleep duration, chronotype, day napping, and shift work) in their effects on BMI and WC were investigated. Results - The GPRS-obesity was associated with BMI (β:0.57 kg.m-2 per standard deviation (SD) increase in GPRS, [95%CI:0.55, 0.60]; P=6.3x10-207) and WC (β:1.21 cm, [1.15, 1.28]; P=4.2x10-289). There were significant interactions between GPRS-obesity and a variety of sleep characteristics in their relationship with BMI (P-interaction <0.05). In participants who slept <7 hrs or >9 hrs daily, the effect of GPRS-obesity on BMI was stronger (β:0.60 [0.54, 0.65] and 0.73 [0.49, 0.97] kg.m-2 per SD increase in GPRS, respectively) than in normal length sleepers (7-9 hours; β:0.52 [0.49, 0.55] kg.m-2 per SD). A similar pattern was observed for shiftworkers (β:0.68 [0.59, 0.77] versus 0.54 [0.51, 0.58] kg.m-2 for non-shiftworkers) and for night-shiftworkers (β:0.69 [0.56, 0.82] versus 0.55 [0.51, 0.58] kg.m-2 for non-night- shiftworkers), for those taking naps during the day (β:0.65 [0.52, 0.78] versus 0.51 [0.48, 0.55] kg.m-2 for those who never/rarely had naps) and for those with a self-reported evening chronotype (β:0.72 [0.61, 0.82] versus β:0.52 [0.47, 0.57] kg.m-2 for morning chronotype). Similar findings were obtained using WC as the outcome. Conclusions – This study shows that the association between genetic risk for obesity and phenotypic adiposity measures is exacerbated by adverse sleeping characteristics

Dietary fat and total energy intake modifies the association of genetic profile risk score on obesity: evidence from 48 170 UK Biobank participants

Background: Obesity is a multifactorial condition influenced by both genetics and lifestyle. The aim of this study was to investigate whether the association between a validated genetic profile risk score for obesity (GPRS-obesity) and body mass index (BMI) or waist circumference (WC) was modified by macronutrient intake in a large general population study. Methods: This study included cross-sectional data from 48 170 white European adults, aged 37–73 years, participating on the UK Biobank. Interactions between GPRS-obesity, and macronutrient intake (including total energy, protein, fat, carbohydrate and dietary fibre intake) and its effects on BMI and WC were investigated. Results: The 93-SNPs genetic profile risk score was associated with a higher BMI (β:0.57 kg.m−2 per standard deviation (s.d.) increase in GPRS, [95%CI:0.53–0.60]; P=1.9 × 10−183) independent of major confounding factors. There was a significant interaction between GPRS and total fat intake (P[interaction]=0.007). Among high fat intake individuals, BMI was higher by 0.60 [0.52, 0.67] kg.m−2 per s.d. increase in GPRS-obesity; the change in BMI with GPRS was lower among low fat intake individuals (β:0.50 [0.44, 0.57] kg.m-2). Significant interactions with similar patterns were observed for saturated fat intake (High β:0.66 [0.59, 0.73] versus Low β:0.49 [0.42, 0.55] kg.m-2, P-interaction=2 × 10-4), and total energy intake (High β:0.58 [0.51, 0.64] versus Low β:0.49 [0.42, 0.56] kg.m−2, P-interaction=0.019), but not for protein intake, carbohydrate intake and fiber intake (P-interaction >0.05). The findings were broadly similar using WC as the outcome. Conclusions: These data suggest that the benefits of reducing the intake of fats and total energy intake, may be more important in individuals with high genetic risk for obesity

General practice registrars’ intentions for future practice: Implications for rural medical workforce planning

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91) = 3.528, P = 0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88) = –4.280, P \u3c 0.001) and women ranked the ability to work part-time higher (t(94) = 3.697, P \u3c 0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ2(1) = 8.498, P = 0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice

Capital Management Techniques In Developing Countries: An Assessment of Experiences From the 1990s and Lessons for the Future

The Ghana Poverty Reduction Strategy (GPRS) is currently Ghana's blueprint for growth, poverty reduction, and human development. It represents the framework the government of Ghana adopted to foster economic growth and fight poverty. A joint ILO/UNDP team was set up to specifically study the employment initiatives, programs, and projects that the government of Ghana is currently pursuing within the context of the GPRS. This report examines the current content of the GPRS with regard to employment; identifies challenges for realizing employment objectives; and develops recommendations for strengthening the employment content of national policies. In doing so, it outlines the elements of an employment framework for poverty-reducing growth in Ghana.

EVALUASI POLA IMPLEMENTASI GPRS DALAM HUBUNGANNYA DENGAN UNJUK KERJA JARINGAN PADA JARINGAN SELULER DUALBAND (EVALUATION OF GPRS IMPLEMENTATION SYSTEM IN RELATION WITH NETWORK PERFORMANCE IN DUALBAND CELLULAR NETWORK)

ABSTRAKSI: -Kata Kunci : -ABSTRACT: GPRS has been being implemented by. PT. Telkomsel as a data packet service to fill the demand of increasing data communication service. The implementation of GPRS in PT. Telkomsel is done by allocate 3 timeslot in 1 sector for GPRS, where 2 timeslot is switchable and another one is reserved timeslot. The existence of GPRS implementation system as allocation timeslot configuration affect decreasing of network performance level. The high affect of GPRS implementation system is depend on number of channel allocation. The analysis is done by evaluating of parameters network performance change level. The monitoring is done at the time before GPRS implementation and after GPRS implementation in one site at PT. Telkomsel that is Srigading’s site. From the evaluation result of data statistic is found that the GPRS implementation in PT.Telkomsel does not affect very much to existing network performance. The monitoring result of some parameter from network performance indicate that for GSM 900 system does not accur increasing of TCH blocking level for each sector or zero increasing. Whereas in DCS system the significant increasing of TCH Blocking is occur in sector 3 about 0,51 %, that is 0,04 % before GPRS Implementation and 0,55 % after GPRS implementation. The affect for other parameters of performance is too insignificant, indeed almost nothing.Keyword: