80 research outputs found
The Golden Rule* of Water Management
California follows a âGolden Ruleâ of water management, which requires management of the stateâs water for maximum beneficial use. This principle is codified at Article X, Section 2 of Californiaâs Constitution. However, the Golden Rule has a qualifierâan asteriskâwhich requires that water management âpreserve water right priorities to the extent those priorities do not lead to unreasonable use.â We call this qualifier the Mojave Rule, named after the California Supreme Courtâs decision in City of Barstow v. Mojave Water Agency. The Golden Rule* is the foundation of water management in California and the Mojave Rule is the key qualifier.
This article explores the Golden Rule* as a lens to analyze perplexing water management issues and controversies, including the tension between âpublicâ and âprivateâ interests affected by water management; balancing the countervailing interests of adaptable water management on the one hand, and water supply reliability and legal certainty on the other; the demarcation between reasonable water regulations and a taking of a water right; and the dual roles of the courts to both adjudicate the rights of the litigants and advance implicated social welfare interests affected by water management.
These issues are analyzed here in two parts. Part II explains the overarching constitutional obligation on public agencies and the courts to manage water resources for maximum beneficial use in a manner that reasonably preserves common law water rights. This part discusses the underlying nature of a water right and water right priorities in California and how the Golden Rule* balances the tensions that underlie water management. Part III discusses application of the Golden Rule*. This part explains how the rule may be used to assess whether a water management regulation will sustain legal challenge, the courtsâ duty to apply the Golden Rule* in water management conflicts, operation of the Golden Rule* in the recently enacted Sustainable Groundwater Management Act (SGMA), projections concerning the Golden Rule* in future groundwater basin adjudications, and how the rule may apply to conflicts concerning the use of subterranean storage space for groundwater storage and conjunctive use programs. A postscript provides an update on recent California legislation enacted to streamline the judicial procedures applicable to groundwater adjudications and to ensure that future groundwater adjudications are managed consistent with SGMA
Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial.
INTRODUCTION: Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glycemia and metabolic parameters following evening exercise in type 1 diabetes. METHODS: Ten male participants (glycated hemoglobin: 52.4±2.2â
mmol/mol), treated with multiple daily injections, completed two randomized study-days, whereby administration of total daily basal insulin dose was unchanged (100%), or reduced by 20% (80%). Participants attended the laboratory at âŒ08:00â
h for a fasted blood sample, before returning in the evening. On arrival (âŒ17:00â
h), participants consumed a carbohydrate meal and administered a 75% reduced rapid-acting insulin dose and 60â
min later performed 45â
min of treadmill running. At 60â
min postexercise, participants consumed a low glycemic index (LGI) meal and administered a 50% reduced rapid-acting insulin dose, before returning home. At âŒ23:00â
h, participants consumed a LGI bedtime snack and returned to the laboratory the following morning (âŒ08:00â
h) for a fasted blood sample. Venous blood samples were analyzed for glucose, glucoregulatory hormones, non-esterified fatty acids, ÎČ-hydroxybutyrate, interleukin 6, and tumor necrosis factor α. Interstitial glucose was monitored for 24â
h pre-exercise and postexercise. RESULTS: Glycemia was similar until 6â
h postexercise, with no hypoglycemic episodes. Beyond 6â
h glucose levels fell during 100%, and nine participants experienced nocturnal hypoglycemia. Conversely, all participants during 80% were protected from nocturnal hypoglycemia, and remained protected for 24â
h postexercise. All metabolic parameters were similar. CONCLUSIONS: Reducing basal insulin dose with reduced prandial bolus insulin and LGI carbohydrate feeding provides protection from hypoglycemia during and for 24â
h following evening exercise. This strategy is not associated with hyperglycemia, or adverse metabolic disturbances. CLINICAL TRIALS NUMBER: NCT02204839, ClinicalTrials.gov
Effect of weekly physical activity frequency on weight loss in healthy overweight and obese women attending a weight loss program: a randomized controlled trial
ABSTRACT
Background: The effect of intensity and duration of physical activity (PA) on weight loss has been well described. However, the effect of the frequency of weekly PA on weight loss is still unknown.
Objective: The purpose of this study was to evaluate the effect of the frequency of weekly PA sessions while maintaining the same total activity time on weight loss during a 24-wk weight loss program.
Design: Overweight and obese women [n = 75; body mass index(BMI; in kg/m2): 27â37; age: 18â40 y] who had a normally sedentary lifestyle were randomly allocated to 1 of 2 intervention groups: a high-frequency physical activity (HF) or a low-frequency physical activity (LF) group. The HF group included 50 min/d PA, 6 d/wk (300 min/wk). The LF group included 100 min/d PA, 3 d/wk (300 min/wk). Both groups were advised to follow the same dietary weight loss program.
Results: Both groups showed a significant decrease in anthropometric measurements and significant improvements in cardiometabolic disease risk characteristics over the 24 wk of the study. Compared with the HF group, the LF group had a greater decrease in weight (mean 6 SD; LF: 9.58 6 3.77 kg; HF: 7.78 6 2.68 kg; P = 0.028), BMI (LF: 3.62 6 1.56; HF: 2.97 6 1.02; P = 0.029) and waist circumference (LF: 9.36 6 4.02 cm; HF: 7.86 6 2.41 cm; P = 0.031).
However, there were no significant differences in carbohydrate metabolism characteristics or lipid profile after the 24 wk of intervention.
Conclusion: Weekly PA undertaken over fewer sessions of longer duration during the week could be more effective for weight loss than when undertaken as more frequent shorter sessions in overweight and obese women on a weight loss program. This may be helpful for those who are neither willing nor able to schedule time for PA almost every day to achieve weight loss. This trial was registered at www.irct.ir as IRCT201402157754N4
Physical activity guidelines and cardiovascular risk in children: a cross-sectional analysis to determine whether 60 minutes is enough
Background
Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects.
Methods
PA was measured using accelerometry in 182 children (9â11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score â„1SD indicated âhigher riskâ). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile.
Results
Active children (92 (53 boys)) undertook more MVPA (38â±â11 min, Pââ0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9â±â0.6, Pâ<â0.05), and the OR was 4.7 times higher.
Conclusion
Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines
Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors
Background: To improve adherence to physical activity (PA), behavioural support in the form of behavioural change counselling may be necessary. However, limited evidence of the effectiveness of home-based PA combined with counselling in breast cancer patients exists. The aim of this current randomised controlled trial with a parallel group design was to evaluate the effectiveness of a home-based PA intervention on PA levels, anthropometric measures, health-related quality of life (HRQoL), and blood biomarkers in breast cancer survivors. Methods: Eighty post-adjuvant therapy invasive breast cancer patients (age = 53.6 ± 9.4 years; height = 161.2 ± 6.8 cm; mass = 68.7 ± 10.5 kg) were randomly allocated to a 6-month home-based PA intervention or usual care. The intervention group received face-to-face and telephone PA counselling aimed at encouraging the achievement of current recommended PA guidelines. All patients were evaluated for our primary outcome, PA (International PA Questionnaire) and secondary outcomes, mass, BMI, body fat %, HRQoL (Functional assessment of Cancer Therapy-Breast), insulin resistance, triglycerides (TG) and total (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol were assessed at baseline and at 6-months. Results: On the basis of linear mixed-model analyses adjusted for baseline values performed on 40 patients in each group, total, leisure and vigorous PA significantly increased from baseline to post-intervention in the intervention compared to usual care (between-group differences, 578.5 MET-minâwkâ1, p = .024, 382.2 MET-minâwkâ1, p = .010, and 264.1 MET-minâwkâ1, p = .007, respectively). Both body mass and BMI decreased significantly in the intervention compared to usual care (between-group differences, â1.6 kg, p = .040, and â.6 kg/m2, p = .020, respectively). Of the HRQoL variables, FACT-Breast, Trial Outcome Index, functional wellbeing, and breast cancer subscale improved significantly in the PA group compared to the usual care group (between-group differences, 5.1, p= .024; 5.6, p = .001; 1.9 p = .025; and 2.8, p=.007, respectively). Finally, TC and LDL-C was significantly reduced in the PA group compared to the usual care group (between-group differences, â.38 mmolâLâ1, p=.001; and â.3 mmolâLâ1, p=.023, respectively). Conclusions: We found that home-based PA resulted in significant albeit small to moderate improvements in selfreported PA, mass, BMI, breast cancer specific HRQoL, and TC and LDL-C compared with usual care
El duro camino hacia la reforma polĂtica
La crisis polĂtica desatada el pasado febrero puso en evidencia la debilidad de las instituciones democrĂĄticas ecuatorianas, y su limitada capacidad para regular la actividad polĂtica y atender las demandas de grupos polĂticos y sociales emergentes
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