Long-term weight loss maintenance and management following a VLCD: a 3-year outcome.

Background: Effective weight loss treatment is important as obesity has severe health and socioeconomic repercussions. Emerging evidence suggests that rapid initial weight loss results in better long-term weight loss maintenance. This remains controversial and contradicts current recommendations for slower weight loss. Aim: To determine the effect of a very low calorie diet (VLCD) with group-based behaviour therapy on weight loss and long-term weight management by means of a retrospective database analysis. Methods: Data for this retrospective analysis included participants who embarked on the LighterLife Total VLCD programme between 2007 and 2010, and whose weights at baseline and at least 12 months were available (n = 5965). Results: Data were available for 5965 individuals at 1 year, 2044 at 2 years and 580 at 3 years. At baseline, the majority of individuals were Caucasian (n = 5155), female (n = 5419), ≥ 40 years old (n = 4272), 49% were within the body mass index (BMI) range of 30-35 kg/m2 while 51% had a BMI > 35 kg/m2. The average initial weight of the whole cohort was 99.1 kg (SD 16.6). Initial weight and BMI at entry onto programme, as well as numbers of weeks of weight loss were all significantly associated with weight loss achieved on the first weight loss attempt. Weight lost during the initial weight loss phase was the only factor, which was significantly associated with percentage weight loss maintenance for years 1, 2, and 3. Conclusion: The findings of this retrospective analysis suggest that provided a longer term weight loss management programme is adhered to, large amounts of initial weight loss can result in important longer term weight loss maintenance in motivated individuals

Gastrostomies Preserve but do not Increase Quality of Life for Patients and Caregivers

BACKGROUND & AIMS: Gastrostomies are widely used to provide long-term enteral nutrition to patients with neurological conditions that affect swallowing (such as following a cerebrovascular accident or for patients with motor neuron disease) or with oropharyngeal malignancies. The benefits derived from this intervention are uncertain for patients and caregivers. We conducted a prospective, multicenter cohort study to determine how gastrostomies affect health-related quality of life (HRQoL) in recipients and caregivers. METHODS: We performed a study of 100 patients who received gastrostomies (55% percutaneous endoscopic gastrostomy, 45% radiologically inserted) at 5 centers in the United Kingdom, 100 caregivers, and 200 population controls. We used the EuroQol-5D (EQ-5D, comprising a questionnaire, index, visual analogue scale) to assess HRQoL for patients and caregivers before the gastrostomy insertion and then 3 months afterward; findings were compared with those from controls. Ten patients and 10 caregivers were also interviewed after the procedure to explore quantitative findings. Findings from the EQ-5D and semi-structured interviews were integrated using a mixed methods matrix. RESULTS: Six patients died before the 3-month HRQoL reassessments. We observed no significant longitudinal changes in mean EQ-5D index scores for patients (0.70 before vs 0.710 after; P=.83) or caregivers (0.95 before vs 0.95 after; P=.32) following gastrostomy insertion. The semi-structured interviews revealed problems in managing gastrostomy tubes, social isolation, and psychological and emotional consequences that reduced HRQoL. CONCLUSIONS: We performed a mixed methods prospective study of the effects of gastrostomy feeding on HRQoL. HRQoL did not significantly improve after gastrostomy insertion for patients or caregivers. The lack of significant decrease in HRQoL after the procedure indicates that gastrostomies may help maintain HRQoL. Findings have relevance to those involved in gastrostomy insertion decisions and indicate the importance of carefully selecting patients for this intervention, despite the relative ease of insertion

Effects of built environment on walking among Hong Kong older adults

 Key Messages1. Reliable and valid intervieweradministered questionnaires were developed to investigate associations of perceived neighbourhood attributes of Hong Kong older adults with their walking for transportation and recreation.2. Access to and availability of different types of services and destinations, provision offacilities for resting/sitting in the neighbourhood, and easy access to/from residentialbuildings may help maintain an active lifestyle by facilitating walking for transport in the neighbourhood.3. Access to services, indoor places for walking, environmental aesthetics, low traffic, and absence of physical barriers may promote recreational walking

Development and validation of measures to study the effects of the built environment on walking in Hong Kong older adults

Conference Theme: Age-friendly Cities with Cooperation & Participatio

‘Brands in Higher Education ; Challenges and Potential Strategies’

This study explores the challenges of university branding and the qualities that make university branding different from commercial branding in terms of cultural issues, branding concepts and frameworks and brands architecture. The literature about branding in the university sector is described and viewed in the context of exploratory interviews with fifty five university managers. The results present the differences between university and commercial brandings as well as culture, brand concepts and brand architecture,. The study was conducted in UK universities, but similar issues in many other countries means that the results are comparable internationally. Overall, the findings presented in this research offer a valuable contribution to our understanding of the complexities of higher education branding

A new approach to modelling the relationship between annual population abundance indices and weather data

Weather has often been associated with fluctuations in population sizes of species; however, it can be difficult to estimate the effects satisfactorily because population size is naturally measured by annual abundance indices whilst weather varies on much shorter timescales. We describe a novel method for estimating the effects of a temporal sequence of a weather variable (such as mean temperatures from successive months) on annual species abundance indices. The model we use has a separate regression coefficient for each covariate in the temporal sequence, and over-fitting is avoided by constraining the regression coefficients to lie on a curve defined by a small number of parameters. The constrained curve is the product of a periodic function, reflecting assumptions that associations with weather will vary smoothly throughout the year and tend to be repetitive across years, and an exponentially decaying term, reflecting an assumption that the weather from the most recent year will tend to have the greatest effect on the current population and that the effect of weather in previous years tends to diminish as the time lag increases. We have used this approach to model 501 species abundance indices from Great Britain and present detailed results for two contrasting species alongside an overall impression of the results across all species. We believe this approach provides an important advance to the challenge of robustly modelling relationships between weather and species population size

Applications of electrified dust and dust devil electrodynamics to Martian atmospheric electricity

Atmospheric transport and suspension of dust frequently brings electrification, which may be substantial. Electric fields of 10 kVm-1 to 100 kVm-1 have been observed at the surface beneath suspended dust in the terrestrial atmosphere, and some electrification has been observed to persist in dust at levels to 5 km, as well as in volcanic plumes. The interaction between individual particles which causes the electrification is incompletely understood, and multiple processes are thought to be acting. A variation in particle charge with particle size, and the effect of gravitational separation explains to, some extent, the charge structures observed in terrestrial dust storms. More extensive flow-based modelling demonstrates that bulk electric fields in excess of 10 kV m-1 can be obtained rapidly (in less than 10 s) from rotating dust systems (dust devils) and that terrestrial breakdown fields can be obtained. Modelled profiles of electrical conductivity in the Martian atmosphere suggest the possibility of dust electrification, and dust devils have been suggested as a mechanism of charge separation able to maintain current flow between one region of the atmosphere and another, through a global circuit. Fundamental new understanding of Martian atmospheric electricity will result from the ExoMars mission, which carries the DREAMS (Dust characterization, Risk Assessment, and Environment Analyser on the Martian Surface)-MicroARES (Atmospheric Radiation and Electricity Sensor) instrumentation to Mars in 2016 for the first in situ measurements

Multiple drivers of decline in the global status of freshwater crayfish (Decapoda: Astacidea)

International audienceRates of biodiversity loss are higher in freshwater ecosystems than in most terrestrial or marine ecosystems, making freshwater conservation a priority. However, prioritization methods are impeded by insufficient knowledge on the distribution and conservation status of freshwater taxa, particularly invertebrates. We evaluated the extinction risk of the world's 590 freshwater crayfish species using the IUCN Categories and Criteria and found 32% of all species are threatened with extinction. The level of extinction risk differed between families, with proportionally more threatened species in the Parastacidae and Astacidae than in the Cambaridae. Four described species were Extinct and 21% were assessed as Data Deficient. There was geographical variation in the dominant threats affecting the main centres of crayfish diversity. The majority of threatened US and Mexican species face threats associated with urban development, pollution, damming and water management. Conversely, the majority of Australian threatened species are affected by climate change, harvesting, agriculture and invasive species. Only a small proportion of crayfish are found within the boundaries of protected areas, suggesting that alternative means of long-term protection will be required. Our study highlights many of the significant challenges yet to come for freshwater biodiversity unless conservation planning shifts from a reactive to proactive approach

Quantitative importance of staminodes for female reproductive success in Parnassia palustris under contrasting environmental conditions.

The five sterile stamens, or staminodes, in Parnassia palustris act both as false and as true nectaries. They attract pollinators with their conspicuous, but non-rewarding tips, and also produce nectar at the base. We removed staminodes experimentally and compared pollinator visitation rate and duration and seed set in flowers with and without staminodes in two different populations. We also examined the relative importance of the staminode size to other plant traits. Finally, we bagged, emasculated, and supplementary cross-pollinated flowers to determine the pollination strategy and whether reproduction was limited by pollen availability. Flowers in both populations were highly dependent on pollinator visitation for maximum seed set. In one population pollinators primarily cross-pollinated flowers, whereas in the other the pollinators facilitated self-pollination. The staminodes caused increased pollinator visitation rate and duration to flowers in both populations. The staminodes increased female reproductive success, but only when pollen availability constrained female reproduction. Simple linear regression indicated a strong selection on staminode size, multiple regression suggested that selection on staminode size was mainly caused by correlation with other traits that affected female fitness. [ABSTRACT FROM AUTHOR