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

Spatial and temporal variability of urban soil water dynamics observed by a soil monitoring network

Purpose Urban soils’ variability in the vertical direction presumably affects hydrological parameters at the timescale. Moreover, horizontal soil alterations at small spatial scales are common in urban areas. This spatio-temporal variability and heterogeneity of soil moisture and the possible influencing factors were to be described and quantified, using data of a soil monitoring network in the city of Hamburg, Germany. Materials and methods Soil moisture data from ten observation sites within the project HUSCO was evaluated for two different years. The sites were located within districts with different mean groundwater table depths and characteristic urban soil properties. Soil hydrological simulations with SWAP were calculated for a selected site. Results and discussion The temporal evolution of soil water content and tension for the sites was very distinct, related to soil substrate, organic matter content, and groundwater table depth. Impacts of different vegetation rooting depths, the soil substrates’ type, and to some extent the degree of disturbance on soil water dynamics could be identified. An impact of groundwater table depth on the water content of the topsoil during low-precipitation periods could be assumed. The comparison of the results of soil hydrological simulations with empirical data indicated an overestimation of infiltration and percolation for the given soil substrates. Conclusions While soil properties are mainly determinant for the long-term progression of soil hydrology, local site factors affect the short-term regime. A shallow groundwater table contributes to more constant water dynamics while the relative decrease of water during a dry phase is diminished

Nonlinear time-series modeling of unconfined groundwater head

Abstract This paper presents a nonlinear transfer function noise model for time‐series modeling of unconfined groundwater hydrographs. The motivation for its development was that existing groundwater time‐series models were unable to simulate large recharge events and multiyear droughts. This was because existing methods do not partition rainfall to runoff and do not account for nonlinear soil water drainage. To account for these nonlinear processes, a vertically integrated soil moisture module was added to an existing transfer function noise model. The soil moisture module has a highly flexible structure that allowed 84 different forms to be built. Application of the time‐series model requires numerical calibration of parameters for the transfer functions, noise model and, for the nonlinear models, the soil moisture module. This was undertaken using the Covariance Matrix Adaptation Evolutionary Strategy (CMA‐ES) global calibration scheme. However, reproducible calibration to the global optima was challenging and a number of modifications were required to the transfer function noise model. In trialing the 84 nonlinear models and 2 linear models, each was applied to eleven observation bores within a paired catchment study area in Great Western, Victoria, Australia. In comparison with existing groundwater hydrograph time‐series models, the proposed nonlinear time‐series model performed significantly better at all observation bores during calibration and evaluation periods. Both the linear and nonlinear models were also used to quantify the impact of revegetation within the paired catchment; however, results were inconclusive, which is likely due to time‐series data for the state of the revegetation being unavailable. By analyzing the application of 84 nonlinear models to each bore, an optimal structure for the soil moisture module was identified. It is unlikely, however, that this model structure would be appropriate for all climates and geologies. To encourage further investigations, open‐source code for the highly flexible groundwater time‐series modeling framework is available and we invite others to develop new models

Multiple hydrological attractors under stochastic daily forcing: 1. Can multiple attractors exist?

Including positive feedbacks in hydrological models has recently been shown to result in complex behavior with multiple steady states. When a large disturbance, say a major drought, is simulated within such models the hydrology changes. Once the disturbance ends the hydrology does not return to that prior to the disturbance, but rather, persists within an alternate state. These multiple steady states (henceforth attractors) exist for a single model parameterization and cause the system to have a finite resilience to such transient disturbances. A limitation of past hydrological resilience studies is that multiple attractors have been identified using mean annual or mean monthly forcing. Considering that most hydrological fluxes are subject to significant forcing stochasticity and do not operate at such large timescales, it remains an open question whether multiple hydrological attractors can exist when a catchment is subject to stochastic daily forcing. This question is the focus of this paper and it needs to be addressed prior to searching for multiple hydrological attractors in the field. To investigate this, a previously developed semidistributed hillslope ecohydrological model was adopted which exhibited multiple steady states under average monthly climate forcing. In this paper, the ecohydrological model was used to explore if feedbacks between the vegetation and a saline water table result in two attractors existing under daily stochastic forcing. The attractors and the threshold between them (henceforth repellor) were quantified using a new limit cycle continuation technique that upscaled climate forcing from daily to monthly (model and limit cycle code is freely available). The method was used to determine the values of saturated lateral hydraulic conductivity at which multiple attractors exist. These estimates were then assessed against time-integration estimates, which they agreed with. Overall, multiple attractors were found to exist under stochastic daily forcing. However, changing the climate forcing from monthly to daily did significantly reduce the parameter range over which two attractors existed. This suggests fewer catchments may have multiple attractors than previously considered