Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting

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INTRODUCTION............................................................................................................. 3 BIBLIOGRAPHY............................................................................................................. 4 SELECTED INTERNET SITES................................................................................... 14 GLOSSARY OF ELECTRONIC GOVERNMENT TERMS................................... 1

The estuarine phase in the spawning run of the River lamprey Lampetra fluviatilis

The biology of the very early stages in the upstream migration of the River lamprey has been studied using samples taken from the cooling water intake screens of the Oldbury Power Station in the Severn Estuary. Examination of the numbers of lampreys caught at different times indicate that an increase in freshwater discharge is the predominant environmental factor responsible for initiating the movement from the sea into the estuary, although temperature may also be a contributory factor. The migrants could be separated on the basis of size into typical and praecox forms whose mean lengths during peak abundance were approximately 300 and 240 mm respectively, the corresponding weights being about 53 and 22 g respectively. The typical forms were occasionally found in the estuary as early as July and as late as April, with peak abundance generally being reached in November, whereas the praecox forms were present mainly between January and March. The ratio of typical to praecox forms over the four years of sampling was estimated as 3.3 : 1. In both size categories, the gonadosomic and hepatosomic ratio was greater in females than males. Evidence was also found in the typical forms for a correlation between high numbers and an increased proportion of males. Measurement of a number of different characters, including lengths, weights and condition factors, as well as gonadosomic, hepatosomic and gut ratios, suggest that, although the typical forms enter the estuary over a long period of time, the onset of the changes leading to sexual maturity are more synchronous. A small number of the later typical migrants, however, exhibited different characteristics to those of the majority of the animals comprising this size category. Measurements made on typical animals from Oldbury in November indicate that they can regulate their plasma ions in salinities as high as 70% of full strength sea water