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

The Emergence of the ‘Social Economy’: the Australian not-for-profit sector in transition

The Not-for-Profit (NFP) sector in Australia is currently in transition. There is a growing recognition, in Australia and worldwide, that government and philanthropic funds are insufficient to address the problems facing society; as well as demands for increased accountability and demonstration of improved outcomes from traditional funding to the non-profit sector. There is also a growing global interest in social enterprises, socially responsible investment, and, in particular, impact investing – where investors aim to achieve a blend between commercial value and social impact. These trends are contributing to the emergence of new organizational forms, partnerships and financial products, and as a consequence, NFP organizations are becoming just one form of organization within the broader spectrum of organizations and activity described as the ‘social economy’. This research project begins to explore this transition by analysing a sample of organizations in Australia that while having formal non-profit structures, identified themselves as social enterprises in a bid for funding from one of Australia’s leading corporate foundations, the Westpac Foundation. The research builds on previous studies, yet also enables more detailed data on the leadership, governance, human resources, financial challenges, and focus of activities of social enterprises and raises questions about the future of the sector and the social economy

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

Narrowing the Tax Gap Through Presumptive Taxation

This Article highlights the primary tax enforcement problem in the United States, that of noncompliant small and medium-sized businesses (" SMBs"), and it explores the possibility of a radical solution: shifting away from the current system, which attempts to tax the actual income of each business, and toward a system that taxes only a rough approximation (or probabilistic estimate) of business income. This sort of presumptive tax approach has been used for years in developing economies, where the problem of SMB noncompliance is even worse than in the U.S. This Article argues that the time has come to at least consider various ways of taxing SMBs in the U.S. on a presumptive basis as well. The particular regime that the Article spends the most time developing is a type of modified gross receipts (MGR) tax of the sort that is used in some developing economies. Under our version of the MGR approach, SMB taxpayers would be taxed on a rough estimate of their annual income using (a) their reported gross receipts and (b) presumed profit ratios based on historical line-of-business profit margins. Whether such a regime would make sense depends on a number of key unanswered questions, including how narrowly and accurately such historical line-of-business profit percentages can be drawn and at what cost. We also discuss whether such a regime should be mandatory or optional; and, if mandatory, whether it should be only a mandatory minimum (like the alternative minimum tax) or both a minimum and maximum. Moving to an MGR approach to taxing SMB income would require a major change in the Internal Revenue Code. As a more modest alternative, the Article also considers instead having the IRS begin to use presumptive-tax principles as part of their audit strategies. If the Service could credibly commit to applying some form of presumptive/probabilistic tax system in its auditing decisions (perhaps as part of the Discriminate Index Function), and if taxpayers reacted rationally to such an audit policy, the results could be similar to an optional presumptive business income tax

tert-Butyl 2-methyl-2-(4-methyl­benzo­yl)propanoate

The title compound, C16H22O3, is bent with a dihedral angle of 75.3 (1)° between the mean planes of the benzene ring and a group encompassing the ester functionality (O=C—O—C). In the crystal, the mol­ecules are linked into infinite chains held together by weak C—H⋯O hydrogen-bonded inter­actions between an H atom on the benzene ring of one mol­ecule and an O atom on the ketone functionality of an adjacent mol­ecule. The chains are arranged with neighbouring tert-butyl and dimethyl groups on adjacent chains exhibiting hydro­phobic stacking, with short C—H⋯H—C contacts (2.37 Å) between adjacent chain

Racial Discrimination in Life Insurance

We examine the historical and statistical relationship between race and life insurance. Life insurance can play a central role in households’ financial security. Race has played an important and changing role in the provision of life insurance in the U.S. from slave insurance before the Civil War, to “Scientific Racism” continuing into the 20th century, to policies that do not explicitly mention race in recent decades. In empirical work using new data, we confirm earlier work showing that Black individuals have higher life insurance coverage rates than white individuals, controlling for observable characteristics. We find no difference in the likelihood of purchasing coverage—for Black individuals versus white individuals—in states with strong versus weak anti-discrimination laws. We also find that the presence of strong anti-discrimination laws tends to reduce overall life insurance coverage – by about 3 percentage points. We present some evidence that this finding is due to a generally stronger regulatory stance in the state rather than the specific impact of the anti-discrimination life insurance law. This analysis bears on the presence of discrimination in the current life insurance industry as well as related issues like the financial status of minority households

Voigt transmission windows in optically thick atomic vapours: a method to create single-peaked line centre filters

Cascading light through two thermal vapour cells has been shown to improve the performance of atomic filters that aim to maximise peak transmission over a minimised bandpass window. In this paper, we explore the atomic physics responsible for the operation of the second cell, which is situated in a transverse (Voigt) magnetic field and opens a narrow transmission window in an optically thick atomic vapour. By assuming transitions with Gaussian line shapes and magnetic fields sufficiently large to access the hyperfine Paschen–Back regime, the window is modelled by resolving the two transitions closest to line centre. We discuss the validity of this model and perform an experiment which demonstrates the evolution of a naturally abundant Rb transmission window as a function of magnetic field. The model results in a significant reduction in two-cell parameter space, which we use to find theoretical optimised cascaded line centre filters for Na, K, Rb and Cs across both D lines. With the exception of Cs, these all have a better figure of merit than comparable single cell filters in literature. Most noteworthy is a Rb-D2 filter which outputs >92% of light through a single peak at line centre, with maximum transmission 0.71 and a width of 330 MHz at half maximum

A device for magnetic-field angle control in magneto-optical filters using a solenoid-permanent magnet pair.

Atomic bandpass filters are used in a variety of applications due to their narrow bandwidths and high transmission at specific frequencies. Predominantly, these filters are in the Faraday (Voigt) geometry, using an applied axial (transverse) magnetic field with respect to the laser propagation direction. Recently, there has been interest in filters realized with arbitrary-angle magnetic fields, which have been made by rotating permanent magnets with respect to the k-vector of the interrogating laser beam. However, the magnetic field angle achievable with this method is limited as field uniformity across the cell decreases as the rotation angle increases. In this work, we propose and demonstrate a new method of generating an arbitrary-angle magnetic field, using a solenoid to produce a small, and easily alterable, axial field, in conjunction with fixed permanent magnets to produce a large transverse field. We directly measure the fields produced by both methods, finding them to be very similar over the length of the vapor cell. We then compare the transmission profiles of filters produced using both methods, again finding excellent agreement. Finally, we demonstrate the sensitivity of the filter profile to changing magnetic field angle (solenoid current), which becomes easier to exploit with the much improved angle control and precision offered by our new design

A device for magnetic-field angle control in magneto-optical filters using a solenoid-permanent magnet pair

Atomic bandpass filters are used in a variety of applications due to their narrow bandwidths and high transmission at specific frequencies. Predominantly these filters in the Faraday (Voigt) geometry, using an applied axial(transverse) magnetic field with respect to the laser propagation direction. Recently, there has been interest in filters realized with arbitrary-angle magnetic fields, which have been made by rotating permanent magnets with respect to the $k$-vector of the interrogating laser beam. However, the magnetic-field angle achievable with this method is limited as field uniformity across the cell decreases as the rotation angle increases. In this work, we propose and demonstrate a new method of generating an arbitrary-angle magnetic field, using a solenoid to produce a small, and easily alterable, axial field, in conjunction with fixed permanent magnets to produce a large transverse field. We directly measure the fields produced by both methods, finding them to be very similar over the length of the vapor cell. We then compare the transmission profiles of filters produced using both methods, again finding excellent agreement. Finally, we demonstrate the sensitivity of filter profile to changing magnetic-field angle (solenoid current), which becomes easier to exploit with the much improved angle control and precision offered by our new design.Comment: 8 pages, 6 figure