Bridging the gap: SHINE – a Tier 3 service for severely obese children and young people

In March 2014, the consultation document Joined up Clinical Pathways for Obesity was published, exploring options for the future commissioning responsibilities of Tier 3 and 4 weight management services. What became apparent was the lack of reference to childhood weight management services (more so at Tier 3), which mirrors the scarcity of evidence-based research in this area. This article asks a number of key questions: who should provide Tier 3 services for children and young people (CYP), what does such a service look like and who should fund these services for CYP? Greater commitment is needed from the Department of Health to provide clarity for Tier 3 service providers. SHINE (Self-Help, Independence, Nutrition and Exercise), an established Tier 3 service for CYP with severe obesity, is an example of what a Tier 3 programme can look like. Finally, it is proposed that funding is better distributed across the Obesity Care Pathway to ensure that CYP with severe obesity can access appropriate treatment

Effective online privacy policies

Online privacy policies are important mechanisms for informing web site users about the level of information privacy protection afforded when visiting web sites. To date, societal mechanisms and technologies have been the focus of attempts to improve the quality and effectiveness of online privacy policies. Little attention, however, has been given to the development and use of organisational measures for this purpose. In this paper we present findings from an empirical study of online privacy policies, resulting in a set of organisational guidelines for effective online privacy policies, which extend the research base in this area and, more immediately, will assist companies concerned about the impact of privacy concerns on consumer web usage

Trends and guidelines in online privacy policy

Online privacy policies (OPP) are important mechanisms for informing online consumers about the level of information privacy protection afforded when visiting web sites. To date, societal mechanisms and technologies have been the focus of attempts to improve the quality and effectiveness of OPPs. We present findings from a longitudinal, empirical study of online privacy policies. Our research found that although online privacy policies have improved in quality and effectiveness since 2000, they still fall well short of the level of privacy assurance desired by consumers. This study analyses trends in OPPs over the two years of the study, identifying areas of deficiency and improvements, and offering a solution in the form of a detailed set of guidelines for organisational online privacy policy. Our study adds to existing theory in this area and, more immediately, will assist businesses concerned about the effect of privacy issues on consumer web usage.<br /

Adding value to online privacy for consumers: remedying deficiences in online privacy policies with an holistic approach

We present findings from a longitudinal, empirical study of online privacy policies. Our research found that although online privacy policies have improved in quality and effectiveness since 2000, they still fall well short of the level of privacy assurance desired by consumers. This study has identified broad areas of deficiency in existing online privacy policies, and offers a solution in the form of an holistic framework for the development, factors and content of online privacy policies for organizations. Our study adds to existing theory in this area and, more immediately, will assist businesses concerned about the effect of privacy issues on consumer Web usage.<br /

Prevalence of clinical autistic traits within a homeless population: barriers to accessing homeless services

Recent research suggests a high prevalence rate of Autism Spectrum Conditions (ASC) amongst the homeless population. Although, it is well-documented that autistic people experienced many barriers to accessing health services, little is known about their challenges in accessing homeless services. Thus, the present study aimed to measure prevalence of high levels of autistic traits, and to identify barriers that prevent autistic people accessing homeless services. Participants recruited from homeless services (n = 65) completed the Autism Quotient-10 (AQ-10) alongside a questionnaire regarding perceived accessibility of homeless services. Results revealed that 18.5% of participants scored Above the Clinical Threshold of the AQ-10 (ACT-AQ). Moreover, the ACT-AQ group reported that encountering big groups in shared accommodation represent a significant barrier to engaging with homeless services. Further research is needed to identify the full degree of ASC representation and the factors that might prevent autistic homeless people accessing homeless services, and thus overcoming homelessness

Psychosocial Interventions in the Management of Severe Adolescent Obesity

Purpose: Psychosocial Interventions (PSI) are commonly utilised in mental health management, and to our knowledge, have not been explicitly used in weight management. PSI are characterised by three distinct phases: 1) an initial in-depth assessment; 2) an intensive group intervention to stabilise the condition (in this instance weight gain); and 3) an intensive group maintenance programme. PSI focus on the psychosocial elements of obesity, including: stress management, body dysmorphia and self-esteem. As such, the PSI approach is more holistic than traditional weight management approaches. This paper evaluated the outcomes of a PSI when delivered under service level conditions. Methods: SHINE (Self-Help, Independence, Nutrition, and Exercise) is a community-based weight management programme that implements a PSI approach. The programme is located in Sheffield, UK. Adolescents (n = 393) with severe obesity signed onto the programme between 2011 and 2013. The programme spans 12-15 months and participants attend three phases of the PSI. Phase One is undertaken before the programme, Phase Two is a 12-week intervention and Phase Three is split into three 12-week maintenance interventions. Anthropometric measurements (BMI and WC) were collected at baseline, 3-, 6-, 9- and 12-months. Psychosocial measures (self-esteem, anxiety and depression) were collected at baseline and 3-months. Participant retention was also assessed. Results: 304 participants started the programme and 289 were retained at 3 months. At 3 months BMI z-score reduced by 0.21 (95% CI: 0.19, 0.24) and WC by 7.8cm (95% CI: 7.2, 8.5). Almost 25% of participants reduced their BMI classification (e.g. severely obese to obese). Anxiety and self-esteem improved by 63% and 50% respectively. 89 participants continued to attend the programme after 12 months, obtaining a BMI z-score reduction of 0.46 (95% CI: 0.35, 0.58) and a WC reduction of 10.5cm (95% CI: 7.8, 13.1). Conclusions: Obesity is a highly complex condition to manage and requires intensive and prolonged support to produce meaningful and lasting behavioural and anthropometric changes. The SHINE PSI approach has shown promise and demonstrated encouraging results - suggesting that it may be beneficial for interventions to consider wider determinants of health and wellbeing beyond simply diet and physical activity

On high-speed turning of a third-generation gamma titanium aluminide

Gamma titanium aluminides are heat-resistant intermetallic alloys predestined to be employed in components suffering from high mechanical stresses and thermal loads. These materials are regarded as difficult to cut, so this makes process adaptation essential in order to obtain high-quality and defect-free surfaces suitable for aerospace and automotive parts. In this paper, an innovative approach for longitudinal external high-speed turning of a third-generation Ti-45Al-8Nb- 0.2C-0.2B gamma titanium aluminide is presented. The experimental campaign has been executed with different process parameters, tool geometries and lubrication conditions. The results are discussed in terms of surface roughness/integrity, chip morphology, cutting forces and tool wear. Experimental evidence showed that, due to the high cutting speed, the high temperatures reached in the shear zone improve chip formation, so a crack-free surface can be obtained. Furthermore, the use of a cryogenic lubrication system has been identified in order to reduce the huge tool wear, which represents the main drawback when machining gamma titanium aluminides under the chosen process condition

Melatonin Alters Age-Related Changes in Transcription Factors and Kinase Activation

Male mice were fed 40 ppm melatonin for 2 months prior to sacrifice at age 26 months, and compared with both 26 and 4 month-old untreated controls. The nuclear translocation of NF-κB increased with age in both brain and spleen and this was reversed by melatonin only in brain. Another transcription factor, AP-1 was increased with age in the spleen and not in brain and this could be blocked by melatonin treatment. The fraction of the active relative to the inactive form of several enabling kinases was compared. The proportion of activated ERK was elevated with age in brain and spleen but this change was unresponsive to melatonin. A similar age-related increase in glial fibrillary acidic protein (GFAP) was also refractory to melatonin treatment. The cerebral melatonin M1 receptor decreased with age in brain but increased in spleen. The potentially beneficial nature of melatonin for the preservation of brain function with aging was suggested by the finding that an age-related decline in cortical synaptophysin levels was prevented by dietary melatonin

Global Standards in Action: Insights from Anti-Money Laundering Regulation

As organizations have come under the increasing influence of global rules of all sorts, organization scholars have started studying the dynamics of global regulation. The purpose of this article is to identify and evaluate the contribution to this interdisciplinary field by the ‘Stockholm Centre for Organisational Research’. The latter’s key proposition is that while global regulation often consists of voluntary best practice rules it can nevertheless become highly influential under certain conditions. We assess how innovative this approach is using as a benchmark the state of the art in another field of relevance to the study of global regulation, i.e. ‘International Relations’. Our discussion is primarily theoretical but we draw on the case of global anti-money laundering regulation to illustrate our arguments and for inspirations of how to further elaborate the approach

Improved ambient stability of thermally annealed zinc nitride thin films

Zinc nitride films are known to readily oxidize in an ambient atmosphere, forming a ZnO/Zn(OH)2 medium. We report that post-growth thermal annealing significantly improves the stability of zinc nitride with a three-order magnitude increase in degradation time from a few days in un-annealed films to several years after annealing. A degradation study was performed on samples annealed under a flow of nitrogen at 200–400 °C, which showed that the stability of the films depends strongly on the annealing temperature. We propose a mechanism for this improvement, which involves a stabilization of the native oxide layer that forms on the surface of zinc nitride films after exposure to ambient conditions. The result holds significant promise for the use of zinc nitride in devices where operational stability is a critical factor in applications