A randomised trial of an internet weight control resource: The UK Weight Control Trial [ISRCTN58621669]

BACKGROUND: Obesity treatment is notoriously unsuccessful and one of the barriers to successful weight loss reported by patients is a lack of social support. The Internet offers a novel and fast approach to the delivery of health information, enabling 24-hour access to help and advice. However, much of the health information available on the Internet is unregulated or not written by qualified health professionals to provide unbiased information. The proposed study aims to compare a web-based weight loss package with traditional dietary treatment of obesity in participants. The project aims to deliver high quality information to the patient and to evaluate the effectiveness of this information, both in terms of weight loss outcomes and cost-effectiveness. METHODS: This study is a randomised controlled trial of a weight loss package against usual care provided within General Practice (GP) surgeries in Leeds, UK. Participants will be recruited via posters placed in participating practices. A target recruitment figure of 220 will enable 180 people to be recruited (allowing for 22% dropout). Participants agreeing to take part in the study will be randomly allocated using minimisation to either the intervention group, receiving access to the Internet site, or the usual care group. The primary outcome of the study will be the ability of the package to promote change in BMI over 6 and 12 months compared with traditional treatment. Secondary outcomes will be the ability of the Internet package to promote change in reported lifestyle behaviours. Data will be collected on participant preferences, adherence to treatment, health care use and time off work. Difference in cost between groups in provision of the intervention and the cost of the primary outcome will also be estimated. CONCLUSION: A positive result from this study would enhance the repertoire of treatment approaches available for the management of obesity. A negative result would be used to inform the research agenda and contribute to redefining future strategies for tackling obesity

Final Technical Report

The following report contributes to our knowledge of how to economically produce wildlife-friendly grass mixtures for future fuel feedstocks in the northern plains. It investigates northern-adapted cultivars; management and harvest regimes that are good for yields, soils and wildlife; comparative analysis of monocultures and simple mixtures of native grasses; economic implications of growing grasses for fuel feedstocks in specific locations in the northern plains; and conversion options for turning the grasses into useful chemicals and fuels. The core results of this study suggest the following: Native grasses, even simple grass mixtures, can be produced profitably in the northern plains as far west as the 100th meridian with yields ranging from 2 to 6 tons per acre. Northern adapted cultivars may yield less in good years, but have much greater long-term sustainable yield potential than higher-yielding southern varieties. Grasses require very little inputs and stop economically responding to N applications above 56kg/hectare. Harvesting after a killing frost may reduce the yield available in that given year but will increase overall yields averaged throughout multiple years. Harvesting after a killing frost or even in early spring reduces the level of ash and undesirable molecules like K which cause adverse reactions in pyrolysis processing. Grasses can be managed for biomass harvest and maintain or improve overall soil-health and carbon sequestration benefits of idled grassland The carbon sequestration activity of the grasses seems to follow the above ground health of the biomass. In other words plots where the above ground biomass is regularly removed can continue to sequester carbon at the rate of 2 tons/acre/year if the stand health is strong and yielding significant amounts of biomass. Managing grasses for feedstock quality in a biomass system requires some of the same management strategies as managing for wildlife benefit. We believe that biomass development can be done in such a way that also maximizes or improves upon conservation and other environmental goals (in some cases even when compared to idled land). Switchgrass and big bluestem work well together in simple mixture plots where big bluestem fills in around the switchgrass which alone grows in bunches and leaves patches of bare soil open and susceptible to erosion. Longer-term studies in the northern plains may also find that every other year harvest schemes produce as much biomass averaged over the years as annual harvests Grasses can be grown for between $23 and$54/ton in the northern plains at production rates between 3 and 5 tons/acre. Land costs, yields, and harvest frequency are the largest determining factors in the farm scale economics. Without any land rent offset or incentive for production, and with annual harvesting, grass production is likely to be around $35/ton in the northern plains (farm gate). Average transportation costs range from$3 to $10/ton delivered to the plant gate. Average distance from the plant is the biggest factor -$3/ton at 10 miles, $10/ton at 50 miles. There is a substantial penalty paid on a per unit of energy produced basis when one converts grasses to bio-oil, but the bio-oil can then compete in higher priced fuel markets whereas grasses alone compete directly with relatively cheap coal. Bio oil or modified bio-oil (without the HA or other chemical fraction) is a suitable fuel for boiler and combustion turbines that would otherwise use residual fuel oil or number 2 diesel. Ensyn has already commercialized the use of HA in smokey flavorants for the food industry but that market is rather small. HA, however, is also found to be a suitable replacement for the much larger US market for ethanolamines and ethalyne oxides that are used as dispersants. Unless crude oil prices rise, the highest and best use of grass based bio-oil is primarily as a direct fuel. As prices rise, HA, phenol and other chemical fractions may become more attractive Although we were able to create available glucose from the AHG fraction in the bio-oil it proved recalcitrant to fermentation by yeast. Although fermentation results were much more positive with wood based bio-oil sugars, ethanol does not appear to be a likely product from grass based bio-oil. A package of policy recommendations has been developed with roughly 75 key stakeholders from throughout the region that would support the transition to greater development of advanced biofuels and products in the region, as well as a strong role for native grass agriculture to support those industries

The limits of instrumentalism: Informal work and gendered cycles of food insecurity in Mozambique

The instrumentalist literature suggests that women can help achieve household food security if they have access to productive resources but do not become overburdened as a result. This paper seeks to assess the relevance of this literature by exploring the gendered cycles of food insecurity in the context of women’s informal labour in northern Mozambique. It considers the relation between women and food security as embedded in the broader socio-economic setting, and finds that the interaction of different forms of deprivation, such as lack of secure employment and conflicting labour demands, generates food insecurity

From the Commodification to the Corporatization of Care: European Perspectives and Debates

Recent developments in western Europe show that for-profit companies of different sizes, including large multinational firms, are increasingly investing in care and buying significant shares within the on-going privatization of the care and health national systems. Reflecting upon these developments this article argues that the current reconfiguration of care is driven not only by processes of commodification and marketization, but also by complex mechanisms of “corporatization.” To substantiate this argument we undertake an overview of the transformations investing elder and childcare in some European countries and provide a “typology of care” in order to clarify our concept of care corporatization