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

A Study of the Role of the Master Printmaker at Edinburgh Printmakers

The Master Printmaker is at the heart of the print workshop maintaining traditional techniques as well as developing and experimenting with new approaches to print practice.1 My research, focusing on Edinburgh Printmakers’ Studio Director Alastair Clark, reveals the complexities of the traditional role of Master Printmaker, as well as the impact of the rapid development of digital technology. This paper explores the collaborative process of the Master Printmaker and reflects on his working partnership with a selection of artists. These artists include Callum Innes, Eric Great-­‐Rex and Rachel Maclean. The selection represents established artists with an ongoing collaborative partnership with the Master Printmaker, experienced printmakers pushing the boundaries of their practice and artists new to print studio practice

Does woman + a network = career progression?

Question: I am an ambitious and talented junior manager who has recently been hired by FAB plc, a large multinational company. I am also a woman and, as part of my induction pack, have received an invitation to join FABFemmes - the in-company women's network. I don't think my gender has been an obstacle to my success thus far and so I don't really feel the need to join. But on the other hand I don't want to turn my back on something that might offer me a useful source of contacts to help me advance up the career ladder. What would be the best thing to do? - Ms Ambitious, UK

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

The title compound, C15H19NO5, is bent with a dihedral angle of 61.8 (2)° between the mean planes of the benzene ring and a group encompassing the ester functionality (O=C—O—C). The dihedral angle of 0.8 (2)° between the mean planes of the nitro group and the benzene ring indicates near coplanarity. In the crystal, each mol­ecule is linked to four adjacent mol­ecules by weak C—H⋯O hydrogen-bonding inter­actions. Both benzene H atoms ortho to the ketone O atom form C—H⋯O hydrogen bonds with the keto O atoms of two neighboring mol­ecules (of the keto and ester groups, respectively), and the two other inter­actions involve the H atoms from a methyl group of the dimethyl residue, displaying C—H⋯O inter­actions with the O atoms of the nitro groups. These four inter­actions for each mol­ecule lead to the formation of two-dimensional sheets with a hydro­philic inter­ior, held together by weak hydrogen-bonded inter­actions, and a hydro­phobic exterior composed of protruding methyl groups which interst­ack with the methyl groups in adjacent sheets

The Influence of Signaling Conspecific and Heterospecific Neighbors on Eavesdropper Pressure

The study of tradeoffs between the attraction of mates and the attraction of eavesdropping predators and parasites has generally focused on a single species of prey, signaling in isolation. In nature, however, animals often signal from mixed-species aggregations, where interactions with heterospecific group members may be an important mechanism modulating tradeoffs between sexual and natural selection, and thus driving signal evolution. Although studies have shown that conspecific signalers can influence eavesdropper pressure on mating signals, the effects of signaling heterospecifics on eavesdropper pressure, and on the balance between natural and sexual selection, are likely to be different. Here, we review the role of neighboring signalers in mediating changes in eavesdropper pressure, and present a simple model that explores how selection imposed by eavesdropping enemies varies as a function of a signaling aggregation\u27s species composition, the attractiveness of aggregation members to eavesdroppers, and the eavesdroppers\u27 preferences for different member types. This approach can be used to model mixed-species signaling aggregations, as well as same-species aggregations, including those with non-signaling individuals, such as satellites or females. We discuss the implications of our model for the evolution of signal structure, signaling behavior, mixed-species aggregations, and community dynamics

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

The Analysis of Protein-Bound Thiocyanate in Plasma of Smokers and Non-Smokers as a Marker of Cyanide Exposure

When cyanide is introduced into the body, it quickly transforms through a variety of chemical reactions, normally involving sulfur donors, to form more stable chemical species. Depending on the nature of the sulfur donor, cyanide may be transformed into free thiocyanate, the major metabolite of cyanide transformation, 2-amino-2-thiazoline-4-carboxylic acid or protein-bound thiocyanate (PB-SCN) adducts. Because protein adducts are generally stable in biological systems, it has been suggested that PB-SCN may have distinct advantages as a marker of cyanide exposure. In this study, plasma was analyzed from 25 smokers (chronic low-level cyanide exposure group) and 25 non-smokers for PB-SCN. The amount of PB-SCN found in the plasma of smokers, 1.35 µM, was significantly elevated (p \u3c 0.0001) when compared to non-smokers, 0.66 µM. Differences in sub-groups of smokers and non-smokers were also evaluated. The results of this study indicate the effectiveness of analyzing PB-SCN in determining instances of chronic cyanide exposure with possible extension to confirmation of acute cyanide exposure

Quantification of α-ketoglutarate cyanohydrin in Swine Plasma by Ultra-high Performance Liquid Chromatography Tandem Mass Spectrometry

Determination of exposure to cyanide can be accomplished by direct cyanide analysis or indirectly by analysis of cyanide detoxification products, such as thiocyanate and 2-amino-2-thiazoline-4-carboxylic acid. A potentially important marker and detoxification product of cyanide exposure, α-ketoglutarate cyanohydrin (α-KgCN), is produced by the reaction of cyanide and α-ketoglutarate. Therefore, an ultra high-performance liquid chromatography tandem mass spectrometry method to determine α-KgCN in plasma was developed. Swine plasma was spiked with α-KgCN and α-KgCN-d4 (internal standard) and proteins were precipitated with 1% formic acid in acetonitrile. After centrifugation, the supernatant was dried, reconstituted, separated by reversed phase high performance liquid chromatography and analyzed by tandem mass spectrometry. The method produced a dynamic range of 0.3–50 μM and a detection limit of 200 nM for α-KgCN. Furthermore, the method produced a %RSD of less than 13% for all intra- and inter-assay analyses. The stability of α-KgCN was poor for most storage conditions tested, except for −80 °C, which produced stable concentrations of α-KgCN for the 30 days tested. The validated method was tested by analysis of α-KgCN in the plasma of cyanide-exposed swine. α-KgCN was not detected pre-exposure, but was detected in all post-exposure plasma samples tested. To our knowledge, this method is the first reported analytical method for detecting α-KgCN in any matrix

tert-Butyl 2-benzoyl-2-methyl­propanoate

The title compound, C15H20O3, is bent with a dihedral angle of 67.28 (9)° between the mean planes of the phenyl ring and a group encompassing the ester functionality (O=C—O—C). In the crystal, mol­ecules related by inversion symmetry are connected by weak C—H⋯O inter­actions into infinite chains. On one side of the mol­ecule there are two adjacent inter­actions between neighbouring mol­ecules involving the H atoms of methyl groups from the dimethyl groups and the O atoms of the ketone; on the other side, there are also two inter­actions to another adjacent mol­ecule involving the H atoms on the phenyl rings and the carbonyl O atoms of the ester functionality

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