Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour : a systematic review

Background: Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults. Methods: Systematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers. Results: Twenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes. Conclusions: This review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than standalone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy

Law Firms as Defendants: Family Responsibilities Discrimination in Legal Workplaces

This article analyzes how the growing trend of litigation alleging employment discrimination based on workers\u27 family caregiving responsibilities applies to law firms and other legal employers. Our research has found at least thirty-three cases since 1990 in which employees of law firms or other legal employers--both attorneys and support staff--have sued their employers for family responsibilities discrimination (“FRD”). FRD is discrimination against employees based on their family caregiving responsibilities for newborns, young children, elderly parents, or ill spouses or partners. Here we analyze these cases, including the employee experiences that have prompted litigation and the legal theories on which the lawsuits are based. We conclude with strategies designed to help law firms respond proactively to the potential risks posed by FRD. Our research indicates that family responsibilities discrimination has become a risk management issue for all employers. For a variety of reasons discussed in this article--most notably, the structure and culture of law firms that has been based on traditionally masculine norms and life patterns--legal employers may be particularly susceptible to FRD liability

Law Firms as Defendants: Family Responsibilities Discrimination in Legal Workplaces

This article analyzes how the growing trend of litigation alleging employment discrimination based on workers\u27 family caregiving responsibilities applies to law firms and other legal employers. Our research has found at least thirty-three cases since 1990 in which employees of law firms or other legal employers--both attorneys and support staff--have sued their employers for family responsibilities discrimination (“FRD”). FRD is discrimination against employees based on their family caregiving responsibilities for newborns, young children, elderly parents, or ill spouses or partners. Here we analyze these cases, including the employee experiences that have prompted litigation and the legal theories on which the lawsuits are based. We conclude with strategies designed to help law firms respond proactively to the potential risks posed by FRD. Our research indicates that family responsibilities discrimination has become a risk management issue for all employers. For a variety of reasons discussed in this article--most notably, the structure and culture of law firms that has been based on traditionally masculine norms and life patterns--legal employers may be particularly susceptible to FRD liability

Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: a systematic review and meta-analysis

Background: Psychiatric disorders are reported to be present in 80-90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC. Methods and findings: PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC which reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on ICD-10 criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%; China: 15%; and Other LMIC: 60%) were identified, including 18 non-English articles. They included 30030 individuals with non-fatal suicidal behaviour and 4996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths, and between 3% and 86% in those who engaged in non-fatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46-71%) of those who died by suicide and 45% (95% CI 30-61%) of those who engaged in non-fatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and non-fatal suicidal behaviour was mood disorder (25% and 21% respectively). Schizophrenia and related disorders were identified in 8% (4-12%) of those who died by suicide and 7% (3-11%) of those who engaged in non-fatal suicidal behaviour. In non-fatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1-36%) and 11% (7-16%) of individuals respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases which mainly indexed English language journals. Conclusions: Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focused interventions

Masters of the Universe: Bid Rigging by Private Equity Firms in Multibillion Dollar LBOs

In the first successful case of its kind, a class action alleging widespread collusion in the market for leveraged buyouts, some of the world’s largest private equity firms settled Dahl v. Bain Capital Partners, LLC for $590.5 million. The case was unique not only for its size and the fact that it involved complex financial transactions instead of a typical commodity, but also because the claimants used auction theory to demonstrate both the “plus” factors required to prove antitrust injury and the resulting damages. Economic analyses show that the cost to shareholders of collusion in the eight litigated multi-billion dollar leveraged buyout transactions approached$12 billion. The use of empirical economic analysis in antitrust litigation is now de rigueur. Courts expect it, and litigants have an array of econometricians available who understand both how to work with data and antitrust doctrine. In “ordinary” commodities price fixing cases, plaintiffs and defendants are expected to engage experts who gather transaction data and apply regression theory and other economic analyses to contest whether it is possible to demonstrate injury, impact, and damages. Dahl was not an ordinary case in that it involved neither a commodity nor a sellers’ cartel. Instead, it involved a buyers’ cartel which, Plaintiffs alleged, conspired to drive down the price of a number of unique, large LBOs during the mid-2000s. Additionally, the case was notable because of the Plaintiffs’ decision to use the auction theory to demonstrate the existence of antitrust violations and the extent of damage

Toward integrated conservation of North America's crop wild relatives

North America harbors a rich native flora of crop wild relatives—the progenitors and closely related species of domesticated plants—as well as a range of culturally significant wild utilized plants. Despite their current and potential future value, they are rarely prioritized for conservation efforts; thus many species are threatened in their natural habitats, and most are underrepresented in plant genebanks and botanical gardens. Further coordination of efforts among land management, botanical, and agricultural science organizations will improve conservation and general public awareness with regard to these species. We present examples of productive collaborations focused on wild cranberries (Vaccinium macrocarpon and Vaccinium oxycoccos) and chile peppers (Capsicum annuum var. glabriusculum). We then discuss five shared priorities for further action: (1) understand and document North America's crop wild relatives and wild utilized plants, (2) protect threatened species in their natural habitats, (3) collect and conserve ex situ the diversity of prioritized species, (4) make this diversity accessible and attractive for plant breeding, research, and education, and (5) raise public awareness of their value and the threats to their persistence

Need for Cognition and Message Complexity in Motivating Fruit and Vegetable Intake Among Callers to the Cancer Information Service

This field experiment examined the impact of an individual\u27s need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed immediately following the call, and additional brochures were mailed 2 and 3 months later. Although NFC did not predict intake, complex messages were more effective than simple messages in motivating fruit and vegetable consumption 1 and 4 months later