Prioritising and tackling socio-economic inequalities in obesity

This article discusses some of the recent trends in obesity and demonstrates why deeper consideration of differences in trends and intervention effectiveness across socioeconomicgroups is critical

Estimating the proportion of metabolic health outcomes attributable to obesity: a cross-sectional exploration of body mass index and waist circumference combinations

BACKGROUND: Recent evidence suggests that a substantial subgroup of the population who have a high-risk waist circumference (WC) do not have an obese body mass index (BMI). This study aimed to explore whether including those with a non-obese BMI but high risk WC as \u27obese\u27 improves prediction of adiposity-related metabolic outcomes. METHODS: Eleven thousand, two hundred forty-seven participants were recruited. Height, weight and WC were measured. Ten thousand, six hundred fifty-nine participants with complete data were included. Adiposity categories were defined as: BMI(N)/WC(N), BMI(N)/WC(O), BMI(O)/WC(N), and BMI(O)/WC(O) (N = non-obese and O = obese). Population attributable fraction, area under the receiver operating characteristic curve (AUC), and odds ratios (OR) were calculated. RESULTS: Participants were on average 48 years old and 50 % were men. The proportions of BMI(N)/WC(N), BMI(N)/WC(O), BMI(O)/WC(N) and BMI(O)/WC(O) were 68, 12, 2 and 18 %, respectively. A lower proportion of diabetes was attributable to obesity defined using BMI alone compared to BMI and WC combined (32 % vs 47 %). AUC for diabetes was also lower when obesity was defined using BMI alone (0.62 vs 0.66). Similar results were observed for all outcomes. The odds for hypertension, dyslipidaemia, diabetes and CVD were increased for those with BMI(N)/WC(O) (OR range 1.8-2.7) and BMI(O)/WC(O) (OR 1.9-4.9) compared to those with BMI(N)/WC(N). CONCLUSIONS: Current population monitoring, assessing obesity by BMI only, misses a proportion of the population who are at increased health risk through excess adiposity. Improved identification of those at increased health risk needs to be considered for better prioritisation of policy and resources

A systematic review and meta-analysis of diabetes and risk of physical disability and functional impairment - protocol

BackgroundDiabetes and increased age are known risk factors for physical disability. With the increasing prevalence of diabetes within our aging population, the future burden of disability is expected to increase. To date, there has not been a pooled estimate of the risk for disability associated with diabetes or its precursor states, impaired glucose tolerance and impaired fasting glucose. We aim to conduct a systematic review and meta-analysis of the association between prediabetes and diabetes with disability, and quantify the risk of association.Methods/designWe will search for relevant studies in Medline via Pubmed, Embase, Cochrane library and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as scan reference lists from relevant reviews and publications included in our review. We will review all publications that include studies on human adults (18 years and older) where information is included on diabetes status and at least one measure of disability (Activities of Daily Living (ADL), Instrumental ADL (IADL) or functional/mobility limitation), and where a risk association is available for the relationship between diabetes and/or prediabetes with disability, with reference to those without diabetes.We will further conduct a meta-analysis to pool estimates of the risk of disability associated with prediabetes and diabetes. Sensitivity analysis will be conducted to assess for publication bias and study quality.Findings from this systematic review and meta-analysis will be widely disseminated through discussions with stake-holders, publication in a peer-reviewed journal and conference presentation.<br /

PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TIPE MAKE A MATCH DENGAN MEDIA FLASH CARD UNTUK MENINGKATKAN HASIL BELAJAR BAHASA INGGRIS PESERTA DIDIK KELAS V MI IRSYADUT THOLIBIN TUGU REJOTANGAN TULUNGAGUNG

ABSTRAK Skripsi dengan judul “Penerapan Model Pembelajaran Kooperatif Tipe Make A Match Dengan Media Flash Card Untuk Meningkatkan Hasil Belajar Bahasa Inggris Peserta Didik Kelas V MI Irsyadut Tholibin Tugu Rejotangan Tulungagung”ini ditulis oleh Sufiya, Ulfa Ayu Ainin NIM. 2817133194, Jurusan Pendidikan Guru Madrasah Ibtidaiyah, Fakultas Tarbiyah dan Ilmu Keguruan, Institut Agama Islam Negeri Tulungagung, yang dibimbing oleh Bapak Dr. Susanto, M.Pd. Kata Kunci: Make A Match, Flash Card, Hasil Belajar, Bahasa Inggris. Penelitian ini dilatar belakangi oleh permasalahan pembelajaran Bahasa Inggris di MI Irsyadut Tholibin, Rejotangan Tulungagung. Berdasarkan hasil observasi awal permasalahan tersebut disebabkan oleh penggunaan metode pembelajaran yang kurang bervariatif bagi peserta didik, sehingga peserta didik menjadi lebih cepat bosan dan kurang aktif selama proses pembelajaran. Tentu saja hal tersebut menyebabkan hasil belajar peserta didik yang rendah. Rumusan masalah dalam penulisan skripsi ini adalah: 1) Bagaimana penerapan Model Pembelajaran Kooperatif Tipe Make A Match yang dikembangkan dengan media Flash Card pada mata pelajaran Bahasa Inggris pokok bahasan Shapes Kelas V MI Irsyadut Tholibin, Rejotangan Tulungagung? 2) Bagaimana peningkatan keaktifan pada mata pelajaran Bahasa Inggris materi Shapes melalui penerapan Model Pembelajaran Kooperatif Tipe Make A Match yang dikembangkan dengan media Flash Card pada peserta didik Kelas V MI Irsyadut Tholibin, Rejotangan Tulungagung? 3) Bagaimana peningkatan hasil belajar pada mata pelajaran Bahasa Inggris materi Shapes melalui penerapan Model Pembelajaran Kooperatif Tipe Make A Match yang dikembangkan dengan media Flash Card pada peserta didik Kelas V MI Irsyadut Tholibin, Rejotangan Tulungagung? Penelitian ini menggunakan penelitian tindakan kelas (PTK) sebanyak dua siklus. Setiap siklus terdiri dari empat tahap, yaitu perencanaan, pelaksanaan, pengamatan, dan refleksi. Adapun teknik pengumpulan datanya menggunakan tes, wawancara, observasi, catatan lapangan, dan dokumentasi. Tes digunakan untuk menggali data tentang hasil belajar peserta didik. Sedangkan observasi, wawancara, dan catatan lapangan digunakan untuk menggali data tentang proses pembelajaran Bahasa Inggris, respon peserta didik, keadaan peserta didik dan guru serta keaktifan peserta didik. Analisis data yang digunakan mencakup reduksi data, penyajian data, dan penarikan kesimpulan. Akhirnya dalam refleksi I dan II data yang terkumpul dianalisis untuk mengetahui apakah indikator yang telah ditentukan sebelumnya sudah dipenuhi apa tidak. Hasil penelitian menunjukkan bahwa penerapan Model Pembelajaran Kooperatif Tipe Make A Match yang dikembangkan dengan media Flash Card dengan langkah-langkahnya dapat meningkatkan keaktifan dan hasil belajar peserta didik. Keaktifan peserta didik dalam pembelajaran Bahasa Inggris meningkat dari Siklus I ke Siklus II yaitu pada Siklus I keaktifan peserta didik mencapai taraf keberhasilan 80% dengan kriteria baik dan pada Siklus II keaktifan peserta didik mencapai taraf keberhasilan 95% dengan kriteria sangat baik. Sedangkan hasil belajar Bahasa Inggris peserta didik meningkatkan, yaitu pada Pre Test rata-rata peserta didik yaitu 44,37 dengan ketuntasan belajar 4,17%, meningkat pada Siklus I rata- rata peserta didik 74,37 dengan ketuntasan belajar pada Siklus I 70,83%. Hasil belajar peserta didik meningkat pada Siklus II yaitu dengan rata-rata 96 dengan ketuntasan belajar 100%. Dari data tersebut terlihat bahwa penerapan Model Pembelajaran Kooperatif Tipe Make A Match dengan media Flash Card dapat meningkatkan hasil belajar Bahasa Inggris peserta didik Kelas V MI Irsyadut Tholibin, Tugu Rejotangan Tulungagung

Co-Expression of c-Fos with Oestradiol Receptor alpha or Somatostatin in the Arcuate Nucleus, Ventromedial Nucleus and Medial Preoptic Area in the Follicular Phase of Intact Ewes: Alteration after Insulin-Induced Hypoglycaemia

The aim of this study was to investigate how acute insulin‐induced hypoglycaemia (IIH) alters the activity of cells containing oestradiol receptor α (ERα) or somatostatin (SST) in the arcuate nucleus (ARC) and ventromedial nucleus (VMN), and ERα cells in the medial preoptic area (mPOA) of intact ewes. Follicular phases were synchronized with progesterone vaginal pessaries. Control animals were killed at 0 h or 31 h (n = 5 and 6, respectively) after progesterone withdrawal (PW; time zero). At 28 h, five other animals received insulin (INS; 4 iu/kg) and were subsequently killed at 31 h. Hypothalamic sections were immunostained for ERα or SST each with c‐Fos, a marker of neuronal transcriptional activation. Insulin did not alter the percentage of activated ERα cells in the ARC; however, it appeared visually that two insulin‐treated animals (INS responders, with no LH surge) had an increase in the VMN (from 32 to 78%) and a decrease in the mPOA (from 40 to 12%) compared to no increase in the two INS non‐responders (with an LH surge). The percentage of activated SST cells in the ARC was greater in all four insulin‐treated animals (from 10 to 60%), whereas it was visually estimated that activated SST cells in the VMN increased only in the two insulin responders (from 10 to 70%). From these results, we suggest that IIH stimulates SST activation in the ARC as part of the glucose‐sensing mechanism but ERα activation is unaffected in this region. We present evidence to support a hypothesis that disruption of the GnRH/LH surge may occur in insulin responders via a mechanism that involves, at least in part, SST cell activation in the VMN along with decreased ERα cell activation in the mPOA

Obesity and Trends in Life Expectancy

Background. Increasing levels of obesity over recent decades have been expected to lead to an epidemic of diabetes and a subsequent reduction in life expectancy, but instead all-cause and cardiovascular-specific mortality rates have decreased steadily i

The effect of sugar-sweetened beverage price increases and educational messages on beverage purchasing behavior among adults

There is a paucity of evidence regarding the impact of sugar sweetened beverage (SSB) price increases on beverage consumption, using individual-level data, for the population overall and for different socioeconomic groups. This study aimed to predict the impact of altered beverage prices and educational messages on consumer purchasing behavior. 2020 adults representative of the Australian population by age, gender and income completed a discrete choice experiment online in 2016. Each subject completed 20 choice scenarios in a hypothetical convenience store setting where subjects chose between seven SSB and non-SSB beverage options or a no beverage option. Beverage prices and volumes varied between scenarios. Half of participants (n = 1012) were randomly exposed to an educational poster discouraging SSB consumption prior to completing choice scenarios. We used discrete choice models to predict purchases under several policy proposals, overall and for income and SSB consumption frequency sub-groups. Compared to baseline prices, a 10% SSB price increase was predicted to reduce SSB purchases by 15.0% [95%CI -15.2, -14.7], and increase purchases of non-SSBs by +11.0% [95%CI 10.8, 11.2] and no beverage by +15.5% [95%CI 15.1, 15.9]. Effects were greater with a 20% SSB price increase. Across all policy scenarios, the highest income quintile had a similar absolute and slightly greater relative decrease in SSB purchases compared to the lowest quintile. Educational poster exposure reduced SSB choice for all groups, with a greater reduction in the lower compared to higher income group, and additively increased response to price changes. Our results support the use of population-wide SSB pricing and educational interventions to reduce demand across all income groups.This research was funded by a Monash University Faculty of Businessand Economics Interdisciplinary Grant. MB is supported by an AustralianGovernment Research Training Program Scholarship and a MonashUniversity Departmental Scholarship. KB is supported by a post-doctoralfellowship from the National Heart Foundation of Australia (grant numberPH 12 M 6824). AP is supported by a National Health and Medical ResearchCouncil (NHMRC) fellowship. EL is supported by an Australian ResearchCouncil (ARC) fellowship (grant number DE140101260

Past and projected trends of body mass index and weight status in South Australia:2003 to 2019

OBJECTIVE: Functional data analysis (FDA) is a forecasting approach that, to date, has not been applied to obesity, and that may provide more accurate forecasting analysis to manage uncertainty in public health. This paper uses FDA to provide projections of Body Mass Index (BMI), overweight and obesity in an Australian population through to 2019.  METHODS: Data from the South Australian Monitoring and Surveillance System (January 2003 to December 2012, n=51,618 adults) were collected via telephone interview survey. FDA was conducted in four steps: 1) age-gender specific BMIs for each year were smoothed using a weighted regression; 2) the functional principal components decomposition was applied to estimate the basis functions; 3) an exponential smoothing state space model was used for forecasting the coefficient series; and 4) forecast coefficients were combined with the basis function.  RESULTS: The forecast models suggest that between 2012 and 2019 average BMI will increase from 27.2 kg/m(2) to 28.0 kg/m(2) in males and 26.4 kg/m(2) to 27.6 kg/m(2) in females. The prevalence of obesity is forecast to increase by 6-7 percentage points by 2019 (to 28.7% in males and 29.2% in females).  CONCLUSIONS: Projections identify age-gender groups at greatest risk of obesity over time. The novel approach will be useful to facilitate more accurate planning and policy development