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

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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Tackling reporting issues and variation in behavioural weight management interventions: Design and piloting of the standardized reporting of adult behavioural weight management interventions to aid evaluation (STAR-LITE) template.

In the United Kingdom, the National Institute for Health and Care Excellence make recommendations to guide the local-level selection and implementation of adult behavioural weight management interventions (BWMIs) which lack specificity. The reporting of BWMIs is generally poorly detailed, resulting in difficulties when comparing effectiveness, quality and appropriateness for participants. This non-standardized reporting makes meta-analysis of intervention data impossible, resulting in vague guidance based on weak evidence, reinforcing the urgent need for consistency and detail within BWMI description. STAR-LITE - a 4-section, 119-item standardized adult BWMI reporting template - was developed and tested using a two-phase process. After initial design, the template was piloted using adult behavioural weight management RCTs and currently implemented UK BWMI mapping information to further refine the template and examine current reporting and variance. Overall, reporting quality of weight management RCTs was poor, and large variance across different components of real-world BWMIs was observed. Non-specific guidance and wide variation in adult BWMIs are likely linked to inadequate RCT reporting quality and the inability to perform reliable comparisons of data. Future use of STAR-LITE would facilitate the consistent, detailed reporting of adult BWMIs, supporting their evaluation and comparison, to ultimately inform effective policy and improve weight management practice

LM LINUSS™ - Lockheed Martin In-Space Upgrade Servicing System

The LM LINUSS system is a pair of LM 50™ 12U CubeSats – each about the size of a four-slice toaster – designed to demonstrate how small satellites can serve an essential role in sustaining critical space architectures in any orbit. Developed using internal funding, the LM LINUSS system performed multiple demonstrations in Geosynchronous Earth Orbit (GEO). The LM LINUSS mission is to validate essential maneuvering capabilities for Lockheed Martin’s (LM) future space upgrade and servicing missions, as well as to showcase miniaturized Space Domain Awareness capabilities. The LM LINUSS mission also demonstrated mature new onboard high-performance processing by Innoflight; low-toxicity propulsion by VACCO; inertial measurement units, machine vision, 3-D printed components and SmartSat™ (transformational on-orbit software upgrade architecture) technologies by LM. Part of Lockheed Martin’s LM50 family of smallsats, both LM LINUSS spacecraft – measuring roughly 8x8x12 inches – are the collaborative integration of the company’s mission electro-optical payload deck with a next-generation 12U bus from Tyvak Nano-Satellite Systems, a Terran Orbital Company. On orbit performance data from 1Q2023 is presented