Validity of self-reported weight, height, and body mass index among university students in Thailand: Implications for population studies of obesity in developing countries

<p>Abstract</p> <p>Background</p> <p>Large-scale epidemiological studies commonly use self-reported weights and heights to determine weight status. Validity of such self-reported data has been assessed primarily in Western populations in developed countries, although its use is widespread in developing countries. We examine the validity of obesity based on self-reported data in an Asian developing country, and derive improved obesity prevalence estimates using the "reduced BMI threshold" method.</p> <p>Methods</p> <p>Self-reported and measured heights and weights were obtained from 741 students attending an open university in Thailand (mean age 34 years). Receiver operator characteristic techniques were applied to derive "reduced BMI thresholds."</p> <p>Results</p> <p>Height was over-reported by a mean of 1.54 cm (SD 2.23) in men and 1.33 cm (1.84) in women. Weight was under-reported by 0.93 kg (3.47) in men and 0.62 kg (2.14) in women. Sensitivity and specificity for determining obesity (Thai BMI threshold 25 kg/m²) using self-reported data were 74.2% and 97.3%, respectively, for men and 71.9% and 100% for women. For men, reducing the BMI threshold to 24.5 kg/m²increased the estimated obesity prevalence based on self-reports from 29.1% to 33.8% (true prevalence was 36.9%). For women, using a BMI threshold of 24.4 kg/m², the improvement was from 12.0% to 15.9% (true prevalence 16.7%).</p> <p>Conclusion</p> <p>Young educated Thais under-report weight and over-report height in ways similar to their counterparts in developed countries. Simple adjustments to BMI thresholds will overcome these reporting biases for estimation of obesity prevalence. Our study suggests that self-reported weights and heights can provide economical and valid measures of weight status in high school-educated populations in developing countries.</p

Decision Agriculture

In this chapter, the latest developments in the field of decision agriculture are discussed. The practice of management zones in digital agriculture is described for efficient and smart faming. Accordingly, the methodology for delineating management zones is presented. Modeling of decision support systems is explained along with discussion of the issues and challenges in this area. Moreover, the precision agriculture technology is also considered. Moreover, the chapter surveys the state of the decision agriculture technologies in the countries such as Bulgaria, Denmark, France, Israel, Malaysia, Pakistan, United Kingdom, Ukraine, and Sweden. Finally, different field factors such as GPS accuracy and crop growth are also analyzed

Fixed and random effects models: making an informed choice

This paper assesses the options available to researchers analysing multilevel (including longitudinal) data, with the aim of supporting good methodological decision-making. Given the confusion in the literature about the key properties of fixed and random effects (FE and RE) models, we present these models’ capabilities and limitations. We also discuss the within-between RE model, sometimes misleadingly labelled a ‘hybrid’ model, showing that it is the most general of the three, with all the strengths of the other two. As such, and because it allows for important extensions—notably random slopes—we argue it should be used (as a starting point at least) in all multilevel analyses. We develop the argument through simulations, evaluating how these models cope with some likely mis-specifications. These simulations reveal that (1) failing to include random slopes can generate anti-conservative standard errors, and (2) assuming random intercepts are Normally distributed, when they are not, introduces only modest biases. These results strengthen the case for the use of, and need for, these models

Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa – a qualitative study

BACKGROUND: Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders’ perspectives on the barriers to – and opportunities for – delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant’s first year of life. METHODS: Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa’s two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. RESULTS: The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. CONCLUSION: Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided

Recharge mechanisms in an Arid Zone River: Effects of channelisation

Arid zone, ephemeral rivers typically experience very high transmission losses. Most international studies have identified infiltration into stream sediments and subsequent percolation to the unconfined alluvial aquifer as the major cause of transmission losses. There is relatively little data regarding mechanisms and stores controlling transmission loss processes in Australian arid zone streams, particularly in regards recharge to the unconfined aquifer. This study reports on a field study of recharge mechanisms occurring in the Neales River of the Lake Eyre Basin (northern South Australia). Piezometric monitoring, numerical and analytical modelling were used to identify and quantify recharge to the unconfined aquifer during streamflow events in 2004-2005. Significant recharge only occurred in channelised reaches and rates of recharge did not show a clear relationship with stage but tended to be higher for flow events occurring after longer periods of no flow. Reaches lacking a single, well-defined channel are common in the anastomosing rivers of the Lake Eyre Basin. Piezometers monitoring the alluvial sediments at two locations lacking well-defined channels did not measure any development of a saturated zone in the alluvial aquifer following flow events. The data suggests that most percolation and recharge occurs through the bank, rather than the floodplain and this needs to be taken into account when estimating transmission losses for these river systems

Detection of a soil moisture and groundwater signal in ground-based gravity observations

Gravity observations have the potential to provide an exciting new source of remotely sensed data to constrain the water balance in land surface models. This would result in more accurate soil moisture and flux predictions and correspondingly improved numerical weather prediction and global climate forecasts. However before existing or future (GRACE or GOCE) dedicated gravity satellites can be utilised in an operational setting it must be shown that a soil moisture signal is detectable in gravity observations. This is extremely difficult to show directly for the satellite observations due to the massive spatial scale involved (1000 km2or larger depending on accuracy requirements), so a ground-based field study of soil moisture, groundwater and gravity changes is essential in verifying the magnitude of the hydrological signal in gravity observations. This paper presents results from two field sites in the Kyeamba Creek catchment in NSW where soil moisture, groundwater and gravity have been monitored for one year. One is a hillslope site with no groundwater whereas the other is a valley site with a shallow water table. After correcting for earth tides and gravity meter drift, a gravity network adjustment is performed for two time periods chosen to capture the full range of subsurface water storage (autumn and spring). The adjustment improves the precision of the gravity estimates at each site relative to a hydrologically stable bedrock reference site. A t-test is performed on the gravity changes at the two sites and the valley site is found to have a significant change in gravity that corresponds extremely well to the predicted hydrologically induced gravity change. There are many complicating factors in a ground-based study, but nevertheless a hydrological signal (predominantly soil moisture) has been detected in the gravity observations of a valley site with a shallow groundwater table