Assessing the short-term outcomes of a community-based intervention for overweight and obese children: The MEND 5-7 programme

Objective The aim of this study was to report outcomes of the UK service level delivery of MEND (Mind,Exercise,Nutrition...Do it!) 5-7, a multicomponent, community-based, healthy lifestyle intervention designed for overweight and obese children aged 5–7 years and their families. Design Repeated measures. Setting Community venues at 37 locations across the UK. Participants 440 overweight or obese children (42% boys; mean age 6.1 years; body mass index (BMI) z-score 2.86) and their parents/carers participated in the intervention. Intervention MEND 5-7 is a 10-week, family-based, child weight-management intervention consisting of weekly group sessions. It includes positive parenting, active play, nutrition education and behaviour change strategies. The intervention is designed to be scalable and delivered by a range of health and social care professionals. Primary and secondary outcome measures The primary outcome was BMI z-score. Secondary outcome measures included BMI, waist circumference, waist circumference z-score, children's psychological symptoms, parenting self-efficacy, physical activity and sedentary behaviours and the proportion of parents and children eating five or more portions of fruit and vegetables. Results 274 (62%) children were measured preintervention and post-intervention (baseline; 10-weeks). Post-intervention, mean BMI and waist circumference decreased by 0.5 kg/m2 and 0.9 cm, while z-scores decreased by 0.20 and 0.20, respectively (p<0.0001). Improvements were found in children's psychological symptoms (−1.6 units, p<0.0001), parent self-efficacy (p<0.0001), physical activity (+2.9 h/week, p<0.01), sedentary activities (−4.1 h/week, p<0.0001) and the proportion of parents and children eating five or more portions of fruit and vegetables per day (both p<0.0001). Attendance at the 10 sessions was 73% with a 70% retention rate. Conclusions Participation in the MEND 5-7 programme was associated with beneficial changes in physical, behavioural and psychological outcomes for children with complete sets of measurement data, when implemented in UK community settings under service level conditions. Further investigation is warranted to establish if these findings are replicable under controlled conditions

Arctic Sea Ice and Its Role in Global Change

Sea ice is an important component of the global climate system. Sea ice forms, grows, and melts in the ocean. Sea ice grows during the fall and winter and melts during the spring and summer. Sea ice can melt completely in summer or survive multiple years. Sea ice can be classified by stages of development (thickness and age), that is, first-year sea ice (ice thickness typically 1.8 m). Sea ice occurs in both hemispheres. In the Northern Hemisphere, sea ice develops in the Arctic Ocean and surrounding bodies including Hudson and Baffin Bay, Gulf of St. Lawrence, the Greenland Sea, the Bering Sea, and the Sea of Okhotsk (sea ice can be observed as far south as Bohai Bay, China, ~38N). In the Southern Hemisphere, sea ice only develops around Antarctica, reaching a maximum equatorward extension at around ~55S)

Understanding and Treating Posttraumatic Stress Disorder Using the Six Principles of Naturopathic Medicine

Posttraumatic Stress Disorder (PTSD) is a health condition that has been increasing in occurrence due to a high number of traumatic events individuals have been experiencing around the world as well as the awareness of the effects of such traumatic events on individuals. There are several effective treatment options available for those who have PTSD. This includes conventional therapies, as well as complementary and alternative medicine approaches. Naturopathic Medicine is one field of medicine that can be utilized by patients with PTSD seeking safe and effective treatments. A complete understanding of PTSD including risk factors, symptoms and neurophysiology is important in determining an appropriate treatment plan for patients. Knowing that each case presentation may be different will play a role in providing the most effective individualized treatment plan. With the increased understanding of PTSD, there are many ways to approach a PTSD case, one of which can involve the use of the six principles of Naturopathic Medicine. This approach uses a variety of modalities as part of an effective treatment plan. It will take into account the individuality of each case as well as constitute a holistic approach to each presenting PTSD patient. This thesis/poster aims to link the six principles of Naturopathic Medicine to aspects of PTSD that allows for us to understand and potentially treat PTSD

Is BMI alone a sufficient outcome to evaluate interventions for child obesity?

BACKGROUND: BMI is often used to evaluate the effectiveness of childhood obesity interventions, but such interventions may have additional benefits independent of effects on adiposity. We investigated whether benefits to health outcomes following the Mind, Exercise, Nutrition…Do It! (MEND) childhood obesity intervention were independent of or associated with changes in zBMI. METHODS: A total of 79 obese children were measured at baseline; 71 and 42 participants were followed-up at 6 and 12 months respectively, and split into four groups depending on magnitude of change in zBMI. Differences between groups for waist circumference, cardiovascular fitness, physical and sedentary activities, and self-esteem were investigated. RESULTS: Apart from waist circumference and its z-score, there were no differences or trends across zBMI subgroups for any outcome. Independent of the degree of zBMI change, benefits in several parameters were observed in children participating in this obesity intervention. CONCLUSION: We concluded that isolating a single parameter like zBMI change and neglecting other important outcomes is restrictive and may undermine the evaluation of childhood obesity intervention effectiveness

Reducing Spread in Climate Model Projections of a September Ice-Free Arctic

This paper addresses the specter of a September ice-free Arctic in the 21st century using newly available simulations from the Coupled Model Intercomparison Project Phase 5 (CMIP5). We find that large spread in the projected timing of the September ice-free Arctic in 30 CMIP5 models is associated at least as much with different atmospheric model components as with initial conditions. Here we reduce the spread in the timing of an ice-free state using two different approaches for the 30 CMIP5 models: (i) model selection based on the ability to reproduce the observed sea ice climatology and variability since 1979 and (ii) constrained estimation based on the strong and persistent relationship between present and future sea ice conditions. Results from the two approaches show good agreement. Under a high-emission scenario both approaches project that September ice extent will drop to approx. 1.7 million sq km in the mid 2040s and reach the ice-free state (defined as 1 million sq km) in 2054-2058. Under a medium-mitigation scenario, both approaches project a decrease to approx.1.7 million sq km in the early 2060s, followed by a leveling off in the ice extent

How has big data contributed to obesity research? A review of the literature

There has been growing interest in the potential of ‘big data’ to enhance our understanding in medicine and public health. Although there is no agreed definition of big data, accepted critical components include greater volume, complexity, coverage and speed of availability. Much of these data are ‘found’ (as opposed to ‘made’), in that they have been collected for non-research purposes but could include valuable information for research. The aim of this paper is to review the contribution of ‘found’ data to obesity research to date, and describe the benefits and challenges encountered. A narrative review was conducted to identify and collate peer-reviewed research studies. Database searches conducted up to September 2017 found original studies using a variety of data types and sources. These included: retail sales, transport, geospatial, commercial weight management data, social media, and smartphones and wearable technologies. The narrative review highlights the variety of data uses in the literature: describing the built environment, exploring social networks, estimating nutrient purchases or assessing the impact of interventions. The examples demonstrate four significant ways in which ‘found’ data can complement conventional ‘made’ data: firstly, in moving beyond constraints in scope (coverage, size, and temporality); secondly, in providing objective, quantitative measures; thirdly, in reaching hard-to-access population groups; and lastly in the potential for evaluating real-world interventions. Alongside these opportunities, ‘found’ data come with distinct challenges, such as: ethical and legal questions around access and ownership; commercial sensitivities; costs; lack of control over data acquisition; validity; representativeness; finding appropriate comparators; and complexities of data processing, management and linkage. Despite widespread recognition of the opportunities, the impact of ‘found’ data on academic obesity research has been limited. The merit of such data lies not in their novelty, but in the benefits they could add over and above, or in combination with, conventionally collected data

Long-Term Outcomes following the MEND 7-13 Child Weight Management Program.

Background: In the current study, we report outcomes 2.4 years from baseline in a random subsample of overweight and obese children who attended MEND 7-13 programs delivered in UK community settings under service level conditions. Methods: The study employed an uncontrolled pre-follow-up design. A total of 165 children were measured. Outcomes included anthropometry, parental perception of emotional distress, body esteem, and self-esteem. Results: Overall, there were significant improvements in all outcomes apart from BMI z-score. In boys, BMI z-score, waist circumference z-score, and psychometrics all improved. In girls, there were no statistically significant differences at 2.4 years, except for body esteem. Conclusions: In real-world settings, the MEND intervention, when delivered by nonspecialists, may result in modest, yet positive, long-term outcomes. Subsequent research should focus on improving the outcome effect size, providing effective behavior change maintenance strategies, and further investigating the reasons behind the observed gender differences

Climate Change in New York State Updating the 2011 ClimAID Climate Risk Information Supplement to NYSERDA Report 11-18 (Responding to Climate Change in New York State)

In its 2013-2014 Fifth Assessment Report (AR5), the Intergovernmental Panel on Climate Change (IPCC) states that there is a greater than 95 percent chance that rising global average temperatures, observed since the mid-20th century, are primarily due to human activities. As had been predicted in the 1800s, the principal driver of climate change over the past century has been increasing levels of atmospheric greenhouse gases associated with fossil-fuel combustion, changing land-use practices, and other human activities. Atmospheric concentrations of the greenhouse gas carbon dioxide are now approximately 40 percent higher than in preindustrial times. Concentrations of other important greenhouse gases, including methane and nitrous oxide, have increased rapidly as well