Outcomes of a specialist weight management programme in the UK national health service: prospective study of 1838 patients

Objectives There is limited evidence on the effectiveness of weight management programmes provided within routine healthcare and inconsistent use of outcome measures. Our aim was to evaluate a large National Health Service (NHS) weight management service and report absolute and proportional weight losses over 12 months.<p></p> Design Prospective observational study.<p></p> Setting Glasgow and Clyde Weight Management Service (GCWMS), which provides care for residents of NHS Greater Glasgow and Clyde area (population 1.2 million).<p></p> Participants All patients who began GCWMS between 1 October 2008 and 30 September 2009.<p></p> Interventions Structured educational lifestyle programme employing cognitive behavioural therapy, 600 kcal deficit diet, physical activity advice, lower calorie diet and pharmacotherapy.<p></p> Primary and secondary outcomes measures Baseline observation carried forward (BOCF), last observation carried forward (LOCF) and changes in programme completers reported using outcomes of absolute 5 kg and 5% weight losses and mean weight changes at a variety of time points.<p></p> Results 6505 referrals were made to GCWMS, 5637 were eligible, 3460 opted in and 1916 (34%) attended a first session. 78 patients were excluded from our analysis on 1838 patients. 72.9% of patients were women, mean age of all patients at baseline was 49.1 years, 43.3% lived in highly socioeconomically deprived areas and mean weights and body mass indices at baseline were 118.1 kg and 43.3 kg/m2, respectively. 26% lost ≥5 kg by the end of phase 1, 30% by the end of phase 2 and 28% by the end of phase 3 (all LOCF). Weight loss was more successful among men, particularly those ≤29 years old.<p></p> Conclusions Routine NHS weight management services may achieve moderate weight losses through a comprehensive evidence-based dietary, activity and behavioural approach including psychological care. Weight losses should be reported using a range of outcome measures so that the effectiveness of different services can be compared

Social Entrepreneurship and Impact Investing Report

This report investigates the viability of a range of portfolio interventions designed to leverage new sources of investment finance and to support the growth and investability of new businesses in the Indo-Pacific region, with a particular focus on the development of social enterprises. While some of these interventions are relatively new within the aid sector, others are designed to take a fresh perspective on an existing activity. The report sets out the findings for each of the interventions and while interventions were wide ranging, they all form key components of an entrepreneur’s journey and their ultimate participation in an impact investing marketplace. The study focused on the development of new businesses in the region and considers how early stage enterprises could be funded; how entrepreneurs (and particularly social entrepreneurs) could be incubated and supported to develop their business skills; how new financing structures could be deployed by government to attract more private investment into the sector; and the role of platforms in connecting enterprises and sources of capital in brokering deals

The Value of Understandable Consumer Insurance Contracts

Insurance consumers, the intermediaries who serve them, and the regulators who protect them all would benefit from understandable consumer insurance contracts. This article outlines the benefits of understandable insurance contracts, identifies the regulatory tools that are or can be used to ensure such comprehensibility, and reviews the existing literature about how well consumers comprehend their insurance policies within the context of personal lines insurance in the U.S. The article concludes by proposing an empirical research strategy to study consumers’ understanding of the terms of homeowners insurance policies and, even when they have not read their policies, their expectations about coverage

Developments in the Application of Florida\u27s Capital Felony Sentencing Law

The authors discuss the Florida capital felony sentencing law, as amended in response to the decision of the Supreme Court of the United States in Furman v. Georgia. They examine developments in the construction and application of the statutory provisions for sentencing and appellate review, with a particular emphasis on the aggravating circumstances that the statute provides as standards to guide and control the imposition of the death sentence

Developments in the Application of Florida\u27s Capital Felony Sentencing Law

The authors discuss the Florida capital felony sentencing law, as amended in response to the decision of the Supreme Court of the United States in Furman v. Georgia. They examine developments in the construction and application of the statutory provisions for sentencing and appellate review, with a particular emphasis on the aggravating circumstances that the statute provides as standards to guide and control the imposition of the death sentence

Core outcome set for behavioural weight management interventions for adults with overweight and obesity: Standardised reporting of lifestyle weight management interventions to aid evaluation (STAR-LITE).

Behavioural weight management interventions in research studies and clinical practice differ in length, advice, frequency of meetings, staff, and cost. Few real-world programmes have published patient outcomes and those that have used different ways of reporting information, making it impossible to compare interventions and develop the evidence base. To address this issue, we have developed a core outcome set for behavioural weight management intervention programmes for adults with overweight and obesity. Outcomes were identified via systematic review of the literature. A representative expert group was formed comprising people with experience of adult weight management services. An online Delphi process was employed to reach consensus as to which outcomes should be measured and reported and which definitions/instruments should be utilised. The expert group identified eight core outcomes and 12 core processes for reporting by weight management services. Eleven outcomes and five processes were identified as optional. The most appropriate definitions/instruments for measuring each outcome/process were also agreed. Our core outcome set will ensure consistency of reporting. This will allow behavioural weight management interventions to be compared, revealing which interventions work best for which members of the population and helping inform development of adult behavioural weight management interventions

Impacts of Scale on Geographic Analysis of Health Data: An Example of Obesity Prevalence

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