Changes in Weight Loss, Health Behaviors, and Intentions among 400 Participants Who Dropped out from an Insurance-Sponsored, Community-Based Weight Management Program

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Sam J. Zizzi

2016-01-01

Full Text Available The majority of weight management research is based on data from randomized controlled studies conducted in clinical settings. As these findings are translated into community-based settings, additional research is needed to understand patterns of lifestyle change and dropout. The purpose of this study was to examine reasons for and consequences associated with dropout (or removal from an insurance-funded weight management program. Using a mixed methods approach with objectively measured changes in body weight and attendance along with quantitative and qualitative survey data, patterns of intention and behavior change were explored. The results from a sample of 400 respondents support the idea that there are both positive and negative consequences of program participation. Overall, 1 in 5 respondents lost a clinically significant amount of weight during the program (>5% of baseline body weight and 1 in 3 experienced a positive consequence, while only 6% expressed a negative outcome of participation. Additionally, nearly 90% of all of the consequences that emerged from the data were positive. Attitude change was a major theme, including positive health intentions, perceived success, learning skills, and new appreciation of exercise.

Implementing the MOVE! weight-management program in the Veterans Health Administration, 2007-2010: a qualitative study.

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Weiner, Bryan J; Haynes-Maslow, Lindsey; Kahwati, Leila C; Kinsinger, Linda S; Campbell, Marci K

2012-01-01

One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.

The need of a weight management control program in judo: a proposal based on the successful case of wrestling.

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Artioli, Guilherme G; Franchini, Emerson; Nicastro, Humberto; Sterkowicz, Stanislaw; Solis, Marina Y; Lancha, Antonio H

2010-05-04

Judo competitions are divided into weight classes. However, most athletes reduce their body weight in a few days before competition in order to obtain a competitive advantage over lighter opponents. To achieve fast weight reduction, athletes use a number of aggressive nutritional strategies so many of them place themselves at a high health-injury risk. In collegiate wrestling, a similar problem has been observed and three wrestlers died in 1997 due to rapid weight loss regimes. After these deaths, the National Collegiate Athletic Association had implemented a successful weight management program which was proven to improve weight management behavior. No similar program has ever been discussed by judo federations even though judo competitors present a comparable inappropriate pattern of weight control. In view of this, the basis for a weight control program is provided in this manuscript, as follows: competition should begin within 1 hour after weigh-in, at the latest; each athlete is allowed to be weighed-in only once; rapid weight loss as well as artificial rehydration (i.e., saline infusion) methods are prohibited during the entire competition day; athletes should pass the hydration test to get their weigh-in validated; an individual minimum competitive weight (male athletes competing at no less than 7% and females at no less than 12% of body fat) should be determined at the beginning of each season; athletes are not allowed to compete in any weight class that requires weight reductions greater than 1.5% of body weight per week. In parallel, educational programs should aim at increasing the athletes', coaches' and parents' awareness about the risks of aggressive nutritional strategies as well as healthier ways to properly manage body weight.

Social/Electronic Media Use of Children and Adolescents Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

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Siegel, Robert; Fals, Angela; Mirza, Nazrat; Datto, George; Stratbucker, William; Ievers-Landis, Carolyn E; Christison, Amy; Wang, Yu; Woolford, Susan J

2015-10-01

Obesity is a major healthcare problem in youth and their social/electronic media (SEM) use has been described as a risk factor. Though much is known about the newer technologies youth use to communicate, little is known about what is used by those in weight management programs. The aim of this study was to determine what types of SEM, including sedentary and active video games, youth in weight management programs use and which they prefer for communicating with healthcare providers. This was a multisite study using a 24-question online SurveyMonkey® questionnaire. Youth, 12-17 years old, attending pediatric weight management programs at seven participating centers in the Childhood Obesity Multi Program Analysis and Study System network were eligible. There were 292 responders with a mean age of 14.2 years. Fifty-four percent were female, 36% Caucasian, 35% African American, and 33% were Hispanic. Ninety-four percent had access to a computer, 71% had Internet access, and 63% had smartphones. Whereas 87% had at least one gaming system at home, 50% reported they never played sedentary video games (71% of females vs. 25% males; p social media (6%). Face-to-face communication with healthcare providers is the preferred method for youth in pediatric weight management programs. They self-reported video game use less than previously described.

A Mixed Methods Evaluation of a 12-Week Insurance-Sponsored Weight Management Program Incorporating Cognitive-Behavioral Counseling

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Abildso, Christiaan; Zizzi, Sam; Gilleland, Diana; Thomas, James; Bonner, Daniel

2010-01-01

Physical activity is critical in healthy weight loss, yet there is still much to be learned about psychosocial mechanisms of physical activity behavior change in weight loss. A sequential mixed methods approach was used to assess the physical and psychosocial impact of a 12-week cognitive-behavioral weight management program and explore factors…

The Efficacy of a Multifaceted Weight Management Program for Children and Young Adolescents

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Kihm, Holly Spencer

2014-01-01

The incidence of overweight and obesity among children and young adolescents remains unacceptably high and places our youth at risk for several negative outcomes. Recognizing the need for a youth-focused weight management program in our community, the researcher developed, implemented, and evaluated a small pilot study, FitKids. The aims of…

Weight loss and frequency of body-weight self-monitoring in an online commercial weight management program with and without a cellular-connected 'smart' scale: a randomized pilot study.

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Thomas, J G; Raynor, H A; Bond, D S; Luke, A K; Cardoso, C C; Wojtanowski, A C; Vander Veur, S; Tate, D; Wing, R R; Foster, G D

2017-12-01

Evaluate the effects of an online commercial weight management program, with and without provision of a 'smart' scale with instructions to weigh daily and weekly tailored feedback, on weight loss and the frequency of body-weight self-monitoring. Participants (N = 92; body mass index 27-40 kg/m 2 ) were randomized to 6 months of no-cost access to the Weight Watchers Online (WWO) platform alone, or enhanced with a cellular-connected 'smart' scale, instructions to weigh daily and weekly pre-scripted email feedback (Weight Watchers Online Enhanced [WWO-E]). The number of days that weight was self-monitored (via 'smart' scale in WWO-E and manually in WWO) was recorded automatically across the 6-month trial. Objective weight was measured at baseline, 3 and 6 months. While both groups achieved statistically significant weight loss, mean ± standard error weight loss did not differ between WWO-E and WWO at 3 months (5.1 ± 0.6 kg vs. 4.0 ± 0.7 kg, respectively; p = 0.257) or 6 months (5.3 ± 0.6 kg vs. 3.9 ± 0.7 kg, respectively; p = 0.116). However, a greater proportion of WWO-E lost ≥5% of initial body weight at 3 months (52.2% vs. 28.3%; p = 0.033), but not 6 months (43.5% vs. 30.4%; p = 0.280), compared with WWO. Mean ± standard deviation days with self-monitored weight was higher in WWO-E (80.5 ± 5.6; 44.7% of days) than WWO (12.0 ± 1.0; 6.7% of days; p weight loss (52% vs. 28%) in an online commercial weight management program. Both WWO and WWO-E produced significant weight loss over 6 months. While mean weight losses were slightly greater in the enhanced group, the difference was not statistically significant in this small sample. This study provides support for the clinical utility of online commercial weight management programs and the potential for supporting technology such as 'smart' scales to improve adherence to body-weight self-monitoring and clinical outcomes.

Weight Management

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... Health Information Weight Management English English Español Weight Management Obesity is a chronic condition that affects more ... Liver (NASH) Heart Disease & Stroke Sleep Apnea Weight Management Topics About Food Portions Bariatric Surgery for Severe ...

The school nutrition program's role in weight management of 4th grade elementary students

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We are attempting to uncover the school nutrition program's role in weight management of 4th grade elementary students. Data was collected within a time frame for the food frequency questionnaire (FFQ) set at two months at the WT Cheney Elementary School and South Wood Elementary for 4th grade stud...

Randomized Controlled Trial Examining the Ripple Effect of a Nationally Available Weight Management Program on Untreated Spouses.

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Gorin, Amy A; Lenz, Erin M; Cornelius, Talea; Huedo-Medina, Tania; Wojtanowski, Alexis C; Foster, Gary D

2018-03-01

For married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program. One hundred thirty dyads were randomized to Weight Watchers (WW; n = 65) or to a self-guided control group (SG; n = 65) and assessed at 0, 3, and 6 months. Inclusion criteria were age ≥ 25 years, BMI 27 to 40 kg/m 2 (≥ 25 kg/m 2 for untreated spouses), and no weight loss contraindications. WW participants received 6 months of free access to in-person meetings and online tools. SG participants received a weight loss handout. Spouses did not receive treatment. Untreated spouses lost weight at 3 months (WW = -1.5 ± 2.9 kg; SG = -1.1 ± 3.3 kg) and 6 months (WW = -2.2 ± 4.2 kg; SG = -1.9 ± 3.6 kg), but weight losses did not differ by condition. Overall, 32.0% of untreated spouses lost ≥ 3% of initial body weight by 6 months. Baseline weight was significantly correlated within couples (r = 0.26; P ripple effect was found in untreated spouses in both formal and self-guided weight management approaches. These data suggest that weight loss can spread within couples, and that widely available lifestyle programs have weight loss effects beyond the treated individual. © 2018 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

A pilot study of a weight management program with food provision in schizophrenia.

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Jean-Baptiste, Michel; Tek, Cenk; Liskov, Ellen; Chakunta, Umesh Rao; Nicholls, Sarah; Hassan, Akm Q; Brownell, Kelly D; Wexler, Bruce E

2007-11-01

Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

Unique barriers and needs in weight management for obese women with fibromyalgia.

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Craft, Jennifer M; Ridgeway, Jennifer L; Vickers, Kristin S; Hathaway, Julie C; Vincent, Ann; Oh, Terry H

2015-01-01

The aim of this study was to identify barriers, needs, and preferences of weight management intervention for women with fibromyalgia (FM). Obesity appears in higher rates in women with fibromyalgia compared to the population at large, and no study to date has taken a qualitative approach to better understand how these women view weight management in relation to their disease and vice versa. We designed a qualitative interview study with women patients with FM and obesity. Women (N = 15) were recruited by their participation in a fibromyalgia treatment program (FTP) within the year prior. The women approached for the study met the following inclusion criteria: confirmed diagnosis of FM, age between 30 and 60 years (M = 51 ± 6.27), and body mass index (BMI) ≥ 30 (M = 37.88 ± 4.87). Patients completed questionnaire data prior to their participation in focus groups (N = 3), including weight loss history, physical activity data, the Revised Fibromyalgia Impact Questionnaire (FIQR), and the Patient Health Questionnaire 9-item (PHQ-9). Three focus group interviews were conducted to collect qualitative data. Consistent themes were revealed within and between groups. Patients expressed the complex relationships between FM symptoms, daily responsibilities, and weight management. Weight was viewed as an emotionally laden topic requiring compassionate delivery of programming from an empathetic leader who is knowledgeable about fibromyalgia. Patients view themselves as complex and different, requiring a specifically tailored weight management program for women with FM. Women with FM identify unique barriers to weight management, including the complex interrelationships between symptoms of FM and health behaviors, such as diet and exercise. They prefer a weight management program for women with FM that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program. Feasibility may be one of the biggest barriers

A naturalistic multicenter trial of a 12-week weight management program for overweight and obese patients with schizophrenia or schizoaffective disorder.

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Lee, Seung Jae; Choi, Eun Ju; Kwon, Jun Soo

2008-04-01

The primary aim of this study was to examine the efficacy and feasibility of a weight control program for overweight and obese patients with schizophrenia or schizoaffective disorder using a large sample across various clinical settings. Psychiatric patients taking antipsychotics participated in a 12-week weight management program at 33 clinical centers across South Korea, and the data for 232 subjects who had a body mass index (BMI) 25 kg/m(2) or above and were diagnosed with DSM-IV schizophrenia or schizoaffective disorder were used in the final analysis. The primary measures of efficacy were changes in body weight and BMI. The study was conducted from December 2005 to July 2006. These patients showed significant mean +/- SD reductions in BMI (0.98 +/- 1.01 kg/m(2), p weight loss. Although significant differences in BMI reduction occurred between groups classified by clinical setting and compliance, all sex, age, clinical setting, compliance, and initial BMI groups showed significant BMI reductions, which fell between 0.4 and 1.5 kg/m(2). Overall results suggest that a weight management program may be disseminated and adopted by practitioners across settings, resulting in short-term weight loss in schizophrenic and schizoaffective patients.

Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS

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Minneboo, Madelon; Peters, Ron J. G.; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J. J.

2015-01-01

To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were

Using personality as a predictor of diet induced weight loss and weight management

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Munro Irene A

2011-11-01

Full Text Available Abstract Background A major challenge for successful weight management is tailoring weight loss programs to individual needs. The aim of this study was to investigate whether personality traits could be used to match individuals to a compatible weight loss program that would maximize weight loss. Method Two different weight loss trials were conducted, both with a weight loss greater than 5% the measure of success. Fifty-four individuals, BMI 30-40 kg/m2, either followed a slow, healthy eating weight loss diet (HEWLD of 5000-6000 kJ/day for 12 weeks (n = 22, or a fast, very low energy diet (VLED of 3000 kJ/day for 4 weeks (n = 32. Anthropometric measurements were recorded at baseline, at the end of the weight loss period and, for VLED, at the end of 10 weeks of weight maintenance. Personality traits were measured at baseline using the Tangney Self Control Scale plus 3 of the scales from the Five Factor Model - Neuroticism, Conscientiousness and Extraversion. Results The percentage weight loss was significantly greater in VLED (-7.38% compared to HEWLD (-4.11%, (p Conclusion The personality factor, Neuroticism, was linked to successful weight loss (that is ≥ 5% with a particular weight loss treatment, suggesting that there is a potential to use measures of personality to identify appropriate weight loss/management strategies for individuals. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12611000716965

Web based Health Education, E-learning, for weight management.

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Heetebry, Irene; Hatcher, Myron; Tabriziani, Hossein

2005-12-01

Obesity is a major health problem across the United States and becoming a progressive world wide problem. An overweight person could access the weight management program and develop a personalized weight reduction plan. The customer enters specific data to personalize the program and in the future an artificial intelligence program can evaluate customer behavior and adjust accordingly. This is an on-line program with class room support, offered as back up when desired by the patient.

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

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Curry Chelsea

2007-11-01

Full Text Available Abstract Background Recent evidence suggests that a low carbohydrate (LC diet may be equally or more effective for short-term weight loss than a traditional low fat (LF diet; however, less is known about how they compare for weight maintenance. The purpose of this study was to compare body weight (BW for participants in a clinical weight management program, consuming a LC or LF weight maintenance diet for 6 months following weight loss. Methods Fifty-five (29 low carbohydrate diet; 26 low fat diet overweight/obese middle-aged adults completed a 9 month weight management program that included instruction for behavior, physical activity (PA, and nutrition. For 3 months all participants consumed an identical liquid diet (2177 kJ/day followed by 1 month of re-feeding with solid foods either low in carbohydrate or low in fat. For the remaining 5 months, participants were prescribed a meal plan low in dietary carbohydrate (~20% or fat (~30%. BW and carbohydrate or fat grams were collected at each group meeting. Energy and macronutrient intake were assessed at baseline, 3, 6, and 9 months. Results The LC group increased BW from 89.2 ± 14.4 kg at 3 months to 89.3 ± 16.1 kg at 9 months (P = 0.84. The LF group decreased BW from 86.3 ± 12.0 kg at 3 months to 86.0 ± 14.0 kg at 9 months (P = 0.96. BW was not different between groups during weight maintenance (P = 0.87. Fifty-five percent (16/29 and 50% (13/26 of participants for the LC and LF groups, respectively, continued to decrease their body weight during weight maintenance. Conclusion Following a 3 month liquid diet, the LC and LF diet groups were equally effective for BW maintenance over 6 months; however, there was significant variation in weight change within each group.

Weight Management Preferences in a Non-Treatment Seeking Sample

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Victoria B. Barry

2013-12-01

Full Text Available Background: Obesity is a serious public health issue in the United States, with the CDC reporting that most adult Americans are now either overweight or obese. Little is known about the comparative acceptability of available weight management approaches in non-treatment seeking samples. Method: This report presents preliminary survey data collected from an online sample on weight management preferences for 8 different weight management strategies including a proposed incentive-based program. Participants were 72 individuals (15 men, 55 women and 2 transgendered individuals who self-re-ported being overweight or obese, or who currently self-reported a normal weight but had attempted to lose weight in the past. Results: ANOVA and Pair-wise comparison indicated clear preferences for certain treatments over others in the full sample; most notably, the most popular option in our sample for managing weight was to diet and exercise without professional assistance. Several differences in preference between the three weight groups were also observed. Conclusions: Dieting and exercising without any professional assistance is the most highly endorsed weight management option among all groups. Overweight and obese individuals may find self-management strategies for weight loss less attractive than normal weight individuals, but still prefer it to other alternatives. This has implications for the development and dissemination of empirically based self-management strategies for weight.

I like to jump on my trampoline: an analysis of drawings from 8- to 12-year-old children beginning a weight-management program.

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Walker, Kathleen; Caine-Bish, Natalie; Wait, Samantha

2009-07-01

The main objective of this exploratory study was to assess children's perceptions of their activity choices as they began a weight-management program for overweight children and their families. During pretesting of a 10-week weight-management program, participating children were asked to draw pictures of themselves doing something. The drawings of 35 children, ages 8 to 12, were qualitatively analyzed. The analysis focused on (a) the type of activities (i.e., physical or sedentary) children chose to convey, (b) the specific focus of the activities described, (c) the children's future activity choices, and (d) the children's responses to the activities they drew. Seventy-one percent of the participating children drew themselves engaged in a physical activity. These results are notable and suggest positive perceptions of physical activities. Children's views related to their activity choices might play a role in designing weight-management programs that successfully increase children's adherence to long-term physical activity.

Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

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Fruh, Sharon M

2017-10-01

The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

The Weight Management Dietetics Practice Group collecting outcomes mentoring program

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The is a newsletter article for the Academy of Nutrition and Dietetics (AND), Weight Management Dietetics Practice Group (WM DPG). The article presents the ‘Collecting Outcomes Mentoring Program’ for 2017 that is managed by the Research Section of the WM DPG. Dietitians in the WM DGP are provided wi...

Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

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Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C.; Weiner, Bryan J.; Kinsinger, Linda

2013-01-01

Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer counselor training program for volunteer veterans, the “Buddies” program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Results Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. Conclusions MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion. PMID:24199738

Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices.

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Barlow, Sarah E; Butte, Nancy F; Hoelscher, Deanna M; Salahuddin, Meliha; Pont, Stephen J

2017-12-21

Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to a trial of weight management programs. This article describes recruitment strategies developed to benefit both families and health care practices and the modification of electronic health records (EHRs) to reflect recruitment outcomes. To facilitate family participation, materials and programs were provided in English and Spanish, and programs were conducted in convenient locations. To support health care practices, EHRs and print materials were provided to facilitate obesity recognition, screening, and study referral. We provided brief training for providers and their office staffs that covered screening patients for obesity, empathetic communication, obesity billing coding, and use of counseling materials. We collected EHR data from 2012 through 2014, including demographics, weight, and height, for all patients aged 2 to 12 years who were seen in the 12 provider practices during the study's recruitment phase. The data of patients with a body mass index (BMI) at or above the 85th percentile were compared with the same data for patients who were referred to the study and patients who enrolled in the study. We also examined reasons that patients referred to the study declined to participate. Overall, 26% of 7,845 patients with a BMI at or above the 85th percentile were referred to the study, and 27% of referred patients enrolled. Enrollment among patients with a BMI at or above the 85th percentile was associated with being Hispanic and with more severe obesity than with patients of other races/ethnicities or less severe obesity, respectively. Among families of children aged 2 to 5 years who were referred, 20% enrolled, compared with 30% of families of older children (>5 y

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

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Renate Kruschitz

2017-04-01

Full Text Available Objective: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria according to the currently applicable guidelines. Methods: Data of overweight and obese individuals (n = 70 who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0 as well as after 1, 3, 6, 12, 24, and 36 (T1-T36 months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Results: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. Conclusion: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

Introduction of the transtheoretical model and organisational development theory in weight management: A narrative review.

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Wu, Ya-Ke; Chu, Nain-Feng

2015-01-01

Overweight and obesity are serious public health and medical problems among children and adults worldwide. Behavioural change has been demonstrably contributory to weight management programs. Behavioural change-based weight loss programs require a theoretical framework. We will review the transtheoretical model and the organisational development theory in weight management. The transtheoretical model is a behaviour theory of individual level frequently used for weight management programs. The organisational development theory is a more complicated behaviour theory that applies to behavioural change on the system level. Both of these two theories have their respective strengths and weaknesses. In this manuscript, we try to introduce the transtheoretical model and the organisational development theory in the context of weight loss programs among population that are overweight or obese. Ultimately, we wish to present a new framework/strategy of weight management by integrating these two theories together. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Cohort Study of the Success of Controlled Weight Loss Programs for Obese Dogs.

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German, A J; Titcomb, J M; Holden, S L; Queau, Y; Morris, P J; Biourge, V

2015-01-01

Most weight loss studies in obese dogs assess rate and percentage of weight loss in the first 2-3 months, rather than the likelihood of successfully reaching target weight. To determine outcome of controlled weight loss programs for obese dogs, and to determine the factors associated with successful completion. 143 obese dogs undergoing a controlled weight loss program. This was a cohort study of obese dogs attending a referral weight management clinic. Dogs were studied during their period of weight loss, and cases classified according to outcome as "completed" (reached target weight), "euthanized" (was euthanized before reaching target weight), or "stopped prematurely" (program stopped early for other reasons). Factors associated with successful completion were assessed using simple and multiple logistic regression. 87/143 dogs (61%) completed their weight loss program, 11 [8%] died or were euthanized, and the remaining 45 [32%] stopped prematurely. Reasons for dogs stopping prematurely included inability to contact owner, refusal to comply with weight management advice, or development of another illness. Successful weight loss was positively associated with a faster rate (P obese dogs on a controlled weight loss program reach their target weight. Future studies should better clarify reasons for success in individual cases, and also the role of factors such as activity and behavioral modification. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care.

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Kruschitz, Renate; Wallner-Liebmann, Sandra; Lothaller, Harald; Luger, Maria; Ludvik, Bernhard

2017-01-01

Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria) according to the currently applicable guidelines. Data of overweight and obese individuals (n = 70) who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0) as well as after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care.. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Effect of Workplace Weight Management on Health Care Expenditures and Quality of Life.

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Michaud, Tzeyu L; Nyman, John A; Jutkowitz, Eric; Su, Dejun; Dowd, Bryan; Abraham, Jean M

2016-11-01

We examined the effectiveness of the weight management program used by the University of Minnesota in reducing health care expenditures and improving quality of life of its employees, and also in reducing their absenteeism during a 3-year intervention. A differences-in-differences regression approach was used to estimate the effect of weight management participation. We further applied ordinary least squares regression models with fixed effects to estimate the effect in an alternative analysis. Participation in the weight management program significantly reduced health care expenditures by $69 per month for employees, spouses, and dependents, and by $73 for employees only. Quality-of-life weights were 0.0045 points higher for participating employees than for nonparticipating ones. No significant effect was found for absenteeism. The workplace weight management used by the University of Minnesota reduced health care expenditures and improved quality of life.

Effectiveness of Hypnosis as an Adjunct to Behavioral Weight Management.

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Bolocofsky, David N.; And Others

1985-01-01

Subjects (N=109) completed a behavioral weight-management program either with or without the addition of hypnosis. Both interventions resulted in significant weight reduction. At the eight-month and two-year follow-ups, the hypnosis clients showed significant additional weight loss and were more likely to have achieved and maintained their…

Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs

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Elizabeth Jacob-Files

2018-06-01

Full Text Available Incentives can promote adult wellness. We sought to examine whether incentives might help overcome barriers to engagement in child weight management programs and the ideal value, type and recipient of incentives. In 2017, we conducted semi-structured phone interviews with parents of children ≤17 years old, formerly or currently affected by obesity, who had (n = 11 or had never (n = 12 participated in family-based behavioral treatment (FBT for obesity. Interviews explored the range and type of incentives families would be willing to accept. Interview transcripts were coded and data were analyzed using a thematic analysis. We found that some parents were skeptical about receiving cash incentives. However, once treatment-related costs were identified, some became more interested in reimbursement for out of pocket expenditures. Most parents felt up to $100/month would be adequate and that incentives should be tied to changing behaviors, not BMI. Some interviewees expressed preferences for non-cash incentives (e.g. a gift card over cash incentives. Parents were willing to share incentives with adolescents, up to $50/month, but there was concern about incentives affecting a child's intrinsic motivation for behavior change. All parents acknowledged that moderate incentives alone couldn't overcome the realities of structural and familial barriers to engaging in weight management programs. In summary, we identified aspects of an incentive program to promote engagement in FBT that would be desirable and feasible to implement. Future quantitative work can reveal the value and structure of incentives that are effective for improving obesogenic health behaviors and outcomes. Keywords: Behavioral economics, Family-based treatment, Financial incentives, Health incentives, Childhood obesity

Weight Management for Athletes: Important Things to be Considered

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Chara Odysseos Maria Avraamidou

2017-06-01

Full Text Available Weight management is difficult for most individuals, as indicated by the high numbers of obesity around the world. Obesity has increased dramatically over the past decades. Unfortunately, this epidemic is not limited to adults but also to children in both globally and Cyprus. Developing a weight management plan is essential for everyone. Regarding to an athlete, weight management is an increasingly integral part, as consuming the right kind of food can lead them in success or failure. The special nutritional needs of athletes are depending on the sport. The most important priority for them is to establish a well-chosen nutrition program based on the type of the sport; the training load and the competitions needs. Health professionals and sport nutritionists need to understand dynamic energy balance and be prepared with effective and evidence-based dietary approaches to help athletes and active individuals achieve their body-weight goals. Therefore, the following review aiming to examine the most recent published data for weight-management both elite and recreational athletes of all ages, and to set out the most appropriate weight-management guidelines and dietary strategies to help them apply this knowledge to the practicalities of their own sport and individual situation.

Short- and Long-Term Theory-Based Predictors of Physical Activity in Women Who Participated in a Weight-Management Program

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Wasserkampf, A.; Silva, M. N.; Santos, I. C.; Carraça, E. V.; Meis, J. J. M.; Kremers, S. P. J.; Teixeira, P. J.

2014-01-01

This study analyzed psychosocial predictors of the Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) and evaluated their associations with short- and long-term moderate plus vigorous physical activity (MVPA) and lifestyle physical activity (PA) outcomes in women who underwent a weight-management program. 221 participants (age…

Using new technologies to promote weight management: a randomised controlled trial study protocol.

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Jane, Monica; Foster, Jonathan; Hagger, Martin; Pal, Sebely

2015-05-27

Over the last three decades, overweight and obesity and the associated health consequences have become global public health priorities. Methods that have been tried to address this problem have not had the desired impact, suggesting that other approaches need to be considered. One of the lessons learned throughout these attempts is that permanent weight loss requires sustained dietary and lifestyle changes, yet adherence to weight management programs has often been noted as one of the biggest challenges. This trial aims to address this issue by examining whether social media, as a potential health promotion tool, will improve adherence to a weight management program. To test the effectiveness of this measure, the designated program will be delivered via the popular social networking site Facebook, and compared to a standard delivery method that provides exactly the same content but which is communicated through a pamphlet. The trial will be conducted over a period of twelve weeks, with a twelve week follow-up. Although weight loss is expected, this study will specifically investigate the effectiveness of social media as a program delivery method. The program utilised will be one that has already been proven to achieve weight loss, namely The CSIRO Total Wellbeing Diet. This project will be conducted as a 3-arm randomised controlled trial. One hundred and twenty participants will be recruited from the Perth community, and will be randomly assigned to one of the following three groups: the Facebook group, the pamphlet group, or a control group. The Facebook Group will receive the weight management program delivered via a closed group in Facebook, the Pamphlet Group will be given the same weight management program presented in a booklet, and the Control Group will follow the Australian Dietary Guidelines and the National Physical Activity Guidelines for Adults as usual care. Change in weight, body composition and waist circumference will be initial indicators of

Weight-of-Evidence Concepts: Introduction and Application to Sediment Management

Science.gov (United States)

2018-03-01

Application to Sediment Management En vi ro nm en ta l L ab or at or y Matthew E. Bates, Olivia C. Massey, and Matthew D. Wood March 2018...Program ERDC/EL SR-18-1 March 2018 Weight-of-Evidence Concepts: Introduction and Application to Sediment Management Matthew E. Bates and Matthew D...Program Manager was Dr. Todd S. Bridges (CEERD-EMD). The work was performed by the Environmental Risk Branch (CEERD- EPR) of the Environmental

Canadian Physicians' Use of Antiobesity Drugs and Their Referral Patterns to Weight Management Programs or Providers: The SOCCER Study

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R. S. Padwal

2011-01-01

Full Text Available Antiobesity pharmacotherapy and programs/providers that possess weight management expertise are not commonly used by physicians. The underlying reasons for this are not known. We performed a cross-sectional study in 33 Canadian medical practices (36 physicians examining 1788 overweight/obese adult patients. The frequency of pharmacotherapy use and referral for further diet, exercise, behavioral management and/or bariatric surgery was documented. If drug treatment or referral was not made, reasons were documented by choosing amongst preselected categories. Logistic regression models were used to identify predictors of antiobesity drug use. No single antiobesity management strategy was recommended by physicians in more than 50% of patients. Referral was most common for exercise (49% of cases followed by dietary advice (46%, and only 5% of eligible patients were referred for bariatric surgery. Significant predictors of initiating/continuing pharmacotherapy were male sex (OR 0.70; 95% CI 0.52–0.94, increasing BMI (1.02; 95% CI 1.01–1.03, and private drug coverage (1.78; 95% CI 1.39–2.29. “Not considered” and “patient refusal” were the main reasons for not initiating further weight management. We conclude that both physician and patient factors act as barriers to the use of weight management strategies and both need to be addressed to increase uptake of these interventions.

Polycystic ovary syndrome and weight management.

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Moran, Lisa J; Lombard, Catherine B; Lim, Siew; Noakes, Manny; Teede, Helena J

2010-03-01

Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age, and has reproductive, metabolic and psychological implications. Weight gain and obesity worsen the features of PCOS, while weight loss improves the features of PCOS. While there are potential barriers to successful weight management in young women who do not suffer from PCOS, women with PCOS may experience additional barriers. Weight management strategies in younger women with or without PCOS should encompass both the prevention of excess weight gain and achieving and maintaining a reduced weight through multidisciplinary lifestyle management, comprising dietary, exercise and behavioral therapy, as well as attention to psychosocial stress and practical and physiological barriers to weight management. Further research is warranted in the examination of specific barriers to weight management in women with PCOS, as well as in the determination of optimal components of lifestyle weight management interventions in young women in order to facilitate long-term compliance.

Evaluation of a meal replacement-based weight management program in primary care settings according to the actual European Clinical Practice Guidelines for the Management of Obesity in Adults.

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Kruschitz, Renate; Wallner-Liebmann, Sandra Johanna; Lothaller, Harald; Luger, Maria; Schindler, Karin; Hoppichler, Friedrich; Ludvik, Bernhard

2014-10-01

The purpose of this study was the evaluation of a weight loss program in primary care settings with respect to the European Clinical Practice Guidelines for the Management of Obesity in Adults with regard to the long-term success of changes in body weight and composition. Overweight and obese patients (n = 1167) who underwent a standardized meal replacement-based weight loss program (myLINE(®), AENGUS, Austria) in primary care settings were included in this evaluation. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis (AKERN BIA101(®), BIACORPUS RX4000(®), SoftwareBodycomp Version 8.4 Professional). Data of patients who participated at least 12 months in the program were analyzed retrospectively and compared with their baseline data. After 12 months, a weight loss of 8.6 ± 7.5 kg (mean ± standard deviation) or 8.2 ± 7.8 % from baseline was seen (p < 0.001). In all, 71.9 % of all patients achieved a minimal weight loss of 5 %, and 18.8 % lost 15 % of their initial weight. In comparison with the baseline (35.7 ± 11.5 kg), body fat decreased to 29.6 ± 10.7 kg, which is 83.7 ± 18.9 % from baseline (100 %; p < 0.001). Body cell mass showed an absolute reduction of - 1.4 ± 2.2 kg (p < 0.001), although a relative increase of 1.5 ± 2.5 % (p < 0.001). There were no significant differences between male and female subjects regarding changes in weight, body fat, and body cell mass. The evaluated program complies with the European Clinical Practice Guidelines for Management of Obesity in Adults (2008), which recommend a weight reduction of 5-15 % from initial weight within 6 months. Furthermore, the data showed a significant reduction of body fat and a relative increase of body cell mass.

A systematic exploration of differences in contextual factors related to implementing the MOVE! weight management program in VA: A mixed methods study

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Fletcher Carol E

2011-09-01

Full Text Available Abstract Background In January 2006, Veterans Affairs (VA disseminated the MOVE!® Weight Management Program to VA medical centers to address the high prevalence of overweight/obesity. In its second year, MOVE! implementation varied widely across facilities. The objective of this study was to understand contextual factors that facilitated or impeded implementation of MOVE! in VA medical centers in the second year after its dissemination. Methods We used an embedded mixed methods cross-sectional study design. Qualitative and quantitative data were collected simultaneously with the primary purpose to explore contextual factors most likely to influence MOVE! implementation effectiveness at five purposively selected facilities. Facilities were selected to maximize variation with respect to participation in MOVE! by candidate Veterans. Semi-structured phone interviews were conducted with 24 staff across the five facilities. Quantitative responses were elicited followed by open-ended questions. The quantitative measures were adapted from a published implementation model. Qualitative analysis was conducted using rigorous content analysis methods. Results Qualitative and quantitative data converged to strengthen findings that point to several recommendations. Management support can help increase visibility of the program, commit needed resources, and communicate the importance of implementation efforts. Establishing a receptive implementation climate can be accomplished by emphasizing the important role that weight management may have in reducing incidence and severity of obesity-related chronic conditions. Coalescing highly functioning multi-disciplinary teams was an essential step for more effective implementation of MOVE!. In some situations, local champions can overcome challenging barriers in facilities that lack sufficient management support. Conclusions Key organizational factors at local VA medical centers were strongly associated with MOVE

Weight Management in Phenylketonuria

DEFF Research Database (Denmark)

Rocha, Julio César; van Rijn, Margreet; van Dam, Esther

2016-01-01

. It is becoming evident that in addition to acceptable blood phenylalanine control, metabolic dieticians should regard weight management as part of routine clinical practice. SUMMARY: It is important for practitioners to differentiate the 3 levels for overweight interpretation: anthropometry, body composition...... and frequency and severity of associated metabolic comorbidities. The main objectives of this review are to suggest proposals for the minimal standard and gold standard for the assessment of weight management in PKU. While the former aims to underline the importance of nutritional status evaluation in every...... specialized clinic, the second objective is important in establishing an understanding of the breadth of overweight and obesity in PKU in Europe. KEY MESSAGES: In PKU, the importance of adopting a European nutritional management strategy on weight management is highlighted in order to optimize long...

Individualized weight management: what can be learned from nutrigenomics and nutrigenetics?

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Rudkowska, Iwona; Pérusse, Louis

2012-01-01

The rise in the prevalence of obesity observed over the past decades is taken by many as an indication of the predominance of environmental factors (the so-called obesogenic environment) over genetic factors in explaining why obesity has reached epidemic proportions. While a changing environment favoring increased food intake and decreased physical activity levels has clearly contributed to shifting the distribution of body mass index (BMI) at the population level, not everyone is becoming overweight or obese. This suggests that there are genetic factors interacting with environmental factors to predispose some individuals to obesity. This gene-environment interaction is not only important in determining an individual's susceptibility to obesity but can also influence the outcome of weight-loss programs and weight-management strategies in overweight and obese subjects. This chapter reviews the role of gene-nutrient interactions in the context of weight management. The first section reviews the application of transcriptomics in human nutrition intervention studies on the molecular impact of caloric restriction and macronutrient composition. The second section reviews the effects of various obesity candidate gene polymorphisms on the response of body weight or weight-related phenotypes to weight-loss programs which include nutritional interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

The role of primary care in adult weight management: qualitative interviews with key stakeholders in weight management services

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Blane, David N.; Macdonald, Sara; Morrison, David; O’Donnell, Catherine A.

2017-01-01

Background Primary care has a key role to play in the prevention and management of obesity, but there remain barriers to engagement in weight management by primary care practitioners. The aim of this study was to explore the views of key stakeholders in adult weight management services on the role of primary care in adult weight management. Methods Qualitative study involving semi-structured interviews with nine senior dietitians involved in NHS weight management from seven Scottish health bo...

Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry.

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Street, Tamara D; Thomas, Drew L

2017-03-01

Rates of overweight and obese Australians are high and continue to rise, putting a large proportion of the population at risk of chronic illness. Examining characteristics associated with preference for a work-based weight-loss program will enable employers to better target programs to increase enrolment and benefit employees' health and fitness for work. A cross-sectional survey was undertaken at two Australian mining sites. The survey collected information on employee demographics, health characteristics, work characteristics, stages of behavior change, and preference for workplace assistance with reaching a healthy weight. A total of 897 employees participated; 73.7% were male, and 68% had a body mass index in the overweight or obese range. Employees at risk of developing obesity-related chronic illnesses (based on high body mass index) were more likely to report preference for weight management assistance than lower risk employees. This indicates that, even in the absence of workplace promotion for weight management, some at risk employees want workplace assistance. Employees who were not aware of a need to change their current nutrition or physical activity behaviors were less likely to seek assistance. This indicates that practitioners need to communicate the negative effects of excess weight and promote the benefits of a healthy lifestyle to increase the likelihood of weight management. Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

Knowledge, attitudes and management skills of medical practitioners regarding weight management.

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Mkhatshwa, Vangile B; Ogunbanjo, Gboyega A; Mabuza, Langalibalele H

2016-11-29

Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient's family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient's family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels.

Marital status and body weight, weight perception, and weight management among U.S. adults.

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Klos, Lori A; Sobal, Jeffery

2013-12-01

Married individuals often have higher body weights than unmarried individuals, but it is unclear how marital roles affect body weight-related perceptions, desires, and behaviors. This study analyzed cross-sectional data for 4,089 adult men and 3,989 adult women using multinomial logistic regression to examine associations between marital status, perceived body weight, desired body weight, and weight management approach. Controlling for demographics and current weight, married or cohabiting women and divorced or separated women more often perceived themselves as overweight and desired to weigh less than women who had never married. Marital status was unrelated to men's weight perception and desired weight change. Marital status was also generally unrelated to weight management approach, except that divorced or separated women were more likely to have intentionally lost weight within the past year compared to never married women. Additionally, never married men were more likely to be attempting to prevent weight gain than married or cohabiting men and widowed men. Overall, married and formerly married women more often perceived themselves as overweight and desired a lower weight. Men's marital status was generally unassociated with weight-related perceptions, desires, and behaviors. Women's but not men's marital roles appear to influence their perceived and desired weight, suggesting that weight management interventions should be sensitive to both marital status and gender differences. © 2013 Elsevier Ltd. All rights reserved.

Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program.

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Schneider, Andrew; Hutcheon, Deborah A; Hale, Allyson; Ewing, Joseph A; Miller, Megan; Scott, John D

2018-02-02

Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Regional referral center and teaching hospital. A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months (P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial.

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John, Leslie K; Troxel, Andrea B; Yancy, William S; Friedman, Joelle; Zhu, Jingsan; Yang, Lin; Galvin, Robert; Miller-Kovach, Karen; Halpern, Scott D; Loewenstein, George; Volpp, Kevin

2018-01-01

To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program. A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets. NCT01756066. Twenty three thousand twenty-three employees of 2 US companies. The primary outcome was the percentage of employees who enrolled in the weight management program. We also tested whether the subsidies were associated with differential attendance and weight loss over 12 months, as might be predicted by the expectation that they attract employees with differing degrees of motivation. Analysis and Results: Enrollment differed significantly by subsidy level ( P < .0001). The 100% subsidy produced the highest enrollment (7.7%), significantly higher than each of the lower subsidies (vs 80% subsidy: 6.2%, P = .002; vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Enrollment in the 80% subsidy group was significantly higher than both lower subsidy groups (vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Among enrollees, there were no differences among the 4 groups in attendance or weight loss. This pragmatic trial, conducted in a real-world workplace setting, suggests that higher rates of employer subsidization help individuals to enroll in weight loss programs, without a decrement in program effectiveness. Future research could explore the cost-effectiveness of such subsidies or alternative designs.

Can mindfulness influence weight management related eating behaviors? If so, how?

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Tapper, Katy

2017-04-01

Mindfulness is increasingly being used for weight management. However, the strength of the evidence for such an approach is unclear; although mindfulness-based weight management programs have had some success, it is difficult to conclude that the mindfulness components were responsible. Research in this area is further complicated by the fact that the term 'mindfulness' is used to refer to a range of different practices. Additionally, we have little understanding of the mechanisms by which mindfulness might exert its effects. This review addresses these issues by examining research that has looked at the independent effects of mindfulness and mindfulness-related strategies on weight loss and weight management related eating behaviors. As well as looking at evidence for effects, the review also considers whether effects may vary with different types of strategy, and the kinds of mechanisms that may be responsible for any change. It is concluded that there is some evidence to support the effects of (a) present moment awareness, when applied to the sensory properties of food, and (b) decentering. However, research in these areas has yet to be examined in a controlled manner in relation to weight management. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain.

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Dunn, Carolyn; Haubenreiser, Megan; Johnson, Madison; Nordby, Kelly; Aggarwal, Surabhi; Myer, Sarah; Thomas, Cathy

2018-03-01

There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management. The practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable. This review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.

Weight Optimization of Active Thermal Management Using a Novel Heat Pump

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Lear, William E.; Sherif, S. A.

2004-01-01

Efficient lightweight power generation and thermal management are two important aspects for space applications. Weight is added to the space platforms due to the inherent weight of the onboard power generation equipment and the additional weight of the required thermal management systems. Thermal management of spacecraft relies on rejection of heat via radiation, a process that can result in large radiator mass, depending upon the heat rejection temperature. For some missions, it is advantageous to incorporate an active thermal management system, allowing the heat rejection temperature to be greater than the load temperature. This allows a reduction of radiator mass at the expense of additional system complexity. A particular type of active thermal management system is based on a thermodynamic cycle, developed by the authors, called the Solar Integrated Thermal Management and Power (SITMAP) cycle. This system has been a focus of the authors research program in the recent past (see Fig. 1). One implementation of the system requires no moving parts, which decreases the vibration level and enhances reliability. Compression of the refrigerant working fluid is accomplished in this scheme via an ejector.

The impact of body weight management in chronic kidney disease patients with obesity.

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Wang, Ya-Ling; Shu, Kuo-Hsiung; Yang, Mei-Fang; Yang, Wen-Ching; Wu, Ming-Ju; Lin, Tzu-Mei; Chen, Cheng-Hsu

2013-09-01

Chronic kidney disease (CKD) and obesity are important public health concerns. Because obesity may initiate and/or accelerate kidney damage, weight control may benefit CKD patients. We examined the influence of dietary management and physical exercise in 38 obese CKD patients with or without target reduction of body weight 3% or more from baseline. After a 2-month lifestyle intervention program, those with target body weight control had significant improvement of blood pressure control, as well as reduced lipid profiles, serum creatinine level (1.1 ± 0.3 vs. 0.8 ± 0.3; P management and exercise were associated with improvements in health-related physical fitness, cardiovascular risk factors (blood pressure and lipid control), and renal profiles in obese CKD patients. Supportive individualized programs for lifestyle change could exert beneficial effects, but long-term research with a larger patient population is needed to elucidate the optimal effective combination of dietary management and exercise. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

[Therapeutic options for weight management in schizophrenic patients treated with atypical antipsychotics].

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Cordes, J; Sinha-Röder, A; Kahl, K G; Malevani, J; Thuenker, J; Lange-Asschenfeldt, C; Hauner, H; Agelink, M W; Klimke, A

2008-12-01

Extensive, selective literature review of 2500 articles from the last years (up to December 2007) predominantly from Medline and Cochrane, using as search terms "antipsychotic or schizophrenia or individual drug names (amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, ziprasidone)" and the terms "BMI, weight gain, metabolic syndrome, diabetes, lipid(s), cholesterol, triglycerides" was conducted. Regardless of the advantages ascribed to atypical antipsychotics and the special effectiveness of clozapine in patients resistant to therapy and at risk for suicide, the probability of weight gain is considerably increased for some of these substances. Patients with schizophrenia have a considerably reduced life expectancy associated with an increased prevalence of cardiovascular risk factors. There is a lack of practical guidelines integrated into clinical psychiatric care for the management of cardiovascular risk factors. The monitoring of patients treated with atypics, which has been recommended in the APA/ADA Consensus Paper in light of these facts, is insufficiently established in clinical practice. A regular monitoring can convey self control and motivation to the patient. In the case of corresponding risk constellations further decisions regarding indication and therapy have to be considered. Especially patients with a high cardiovascular risk profile are highly recommended to participate in a weight-management program for prevention purposes. Such a special program should include elements of dietetic treatment and behaviour and exercise therapy. First controlled studies suggest an effective prevention of weight gain and metabolic changes when applying such a structured program. The practice oriented step by step concept presented here is meant to provide points of reference for the implementation of required medical and psychoeducative measures facilitating the management of weight and further cardiovascular risk factors in the context of

Employers should disband employee weight control programs.

Science.gov (United States)

Lewis, Alfred; Khanna, Vikram; Montrose, Shana

2015-02-01

American corporations continue to expand wellness programs, which now reach an estimated 90% of workers in large organizations, yet no study has demonstrated that the main focus of these programs-weight control-has any positive effect. There is no published evidence that large-scale corporate attempts to control employee body weight through financial incentives and penalties have generated savings from long-term weight loss, or a reduction in inpatient admissions associated with obesity or even long-term weight loss itself. Other evidence contradicts the hypothesis that population obesity rates meaningfully retard economic growth or manufacturing productivity. Quite the contrary, overscreening and crash dieting can impact employee morale and even harm employee health. Therefore, the authors believe that corporations should disband or significantly reconfigure weight-oriented wellness programs, and that the Affordable Care Act should be amended to require such programs to conform to accepted guidelines for harm avoidance.

Design and Methods of a Synchronous Online Motivational Interviewing Intervention for Weight Management

Science.gov (United States)

DiLillo, Vicki; Ingle, Krista; Harvey, Jean Ruth; West, Delia Smith

2016-01-01

Background While Internet-based weight management programs can facilitate access to and engagement in evidence-based lifestyle weight loss programs, the results have generally not been as effective as in-person programs. Furthermore, motivational interviewing (MI) has shown promise as a technique for enhancing weight loss outcomes within face-to-face programs. Objective This paper describes the design, intervention development, and analysis of a therapist-delivered online MI intervention for weight loss in the context of an online weight loss program. Methods The MI intervention is delivered within the context of a randomized controlled trial examining the efficacy of an 18-month, group-based, online behavioral weight control program plus individually administered, synchronous online MI sessions relative to the group-based program alone. Six individual 30-minute MI sessions are conducted in private chat rooms over 18 months by doctoral-level psychologists. Sessions use a semistructured interview format for content and session flow and incorporate core MI components (eg, collaborative agenda setting, open-ended questions, reflective listening and summary statements, objective data, and a focus on evoking and amplifying change talk). Results The project was funded in 2010 and enrollment was completed in 2012. Data analysis is currently under way and the first results are expected in 2016. Conclusions This is the first trial to test the efficacy of a synchronous online, one-on-one MI intervention designed to augment an online group behavioral weight loss program. If the addition of MI sessions proves to be successful, this intervention could be disseminated to enhance other distance-based weight loss interventions. Trial Registration Clinicaltrials.gov NCT01232699; https://clinicaltrials.gov/ct2/show/NCT01232699 PMID:27095604

Effectiveness of a structured diet program in antipsychotic-induced weight gain in patients with schizophrenia.

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Direk, Nese; Ucok, Alp

2008-01-01

Objective.The aim of this study was to evaluate the effectiveness of a structured diet program in weight loss in patients with schizophrenia. Methods. A total of 38 outpatients diagnosed with schizophrenia according to DSM-IV and who had complaints of weight gain during treatment with various antipsychotic drugs were invited to participate in a 3-month structured diet program. Thirty-two patients and another 40 patients were included as the control group. At the beginning of the diet program, the patients were given a form in order to evaluate their eating habits, and blood samples were taken to measure plasma lipid profile, and fasting blood glucose (FBG) level. Patients' baseline weight, body mass index (BMI), and basal metabolism rate (BMR) were recorded. Results. Thirty-two patients with schizophrenia, who attended a 3-month structured diet program had mean weight loss of 6.19 kg, whereas patients in the control group gained 1.6 kg. Conclusion. Our findings show that a diet program is effective in managing antipsychotic-induced weight gain. The degree of weight loss seems to be correlated with the duration in which the patient is on the diet program. However; younger patients had less benefit from the diet program.

Weight management practices associated with PCOS and their relationships with diet and physical activity.

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Moran, L J; Brown, W J; McNaughton, S A; Joham, A E; Teede, H J

2017-03-01

Do weight management practices differ in women with and without PCOS? Women in the general population with self-reported PCOS are more likely to be using healthy weight management practices and alternative non-lifestyle measures for weight management than women without PCOS. Lifestyle management is the first-line treatment in PCOS. However, the specific weight management practices used by women with PCOS and their effect on diet and physical activity are unclear. The study was a population-based observational cross-sectional study involving women in the 1973-1978 cohort (n = 7767 total; n = 556 with PCOS, n = 7211 without PCOS). Women with and without self-reported PCOS were included. Self-reported outcome measures included healthy lifestyle-related or alternative non-lifestyle-related (e.g. laxatives or smoking) weight management practices, dietary intake and physical activity. Women with PCOS were more likely to be following both healthy [reducing meal or snack size (odds ratio (OR) 1.50, 95% CI 1.14, 1.96, P = 0.004) and reducing fat or sugar intake (OR 1.32, 95% CI 1.03, 1.69, P = 0.027) or following a low glycaemic index diet (OR 2.88, 95% CI 2.30, 3.59, P PCOS. In PCOS, the use of a range of healthy weight management practices was associated with increases in physical activity (P PCOS, height, weight, diet, physical activity and weight management behaviours. In PCOS, we should focus on improving healthy weight practices across both diet quality and quantity, and on assessing alternative weight practices and their potential adverse effect on dietary intake. L.M. is supported by a South Australian Cardiovascular Research Development Program Fellowship (ID AC11S374); a program collaboratively funded by the National Heart Foundation, the South Australian Department of Health and the South Australian Health and Medical Research Institute. H.T. is supported by the NHMRC. S.A.M. is supported by an NHMRC Career Development Fellowship Level 2, ID1104636 and was

Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry

Directory of Open Access Journals (Sweden)

Tamara D. Street

2017-03-01

Conclusion: Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

Is There an Optimal Diet for Weight Management and Metabolic Health?

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Thom, George; Lean, Mike

2017-05-01

Individuals can lose body weight and improve health status on a wide range of energy (calorie)-restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate, and Mediterranean approaches, in addition to commercial slimming programs, meal replacements, and newly popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve low-density lipoprotein cholesterol the most, while lower-carbohydrate diets may preferentially improve triglycerides and high-density lipoprotein cholesterol. However, differences between diets are marginal. Weight loss improves almost all obesity-related co-morbidities and metabolic markers, regardless of the macronutrient composition of the diet, but individuals do vary in preferences and ability to adhere to different diets. Optimizing adherence is the most important factor for weight loss success, and this is enhanced by regular professional contact and supportive behavioral change programs. Maintaining weight losses in the long term remains the biggest challenge, and is undermined by an "obesogenic" environment and biological adaptations that accompany weight loss. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

Science.gov (United States)

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2013-07-01

The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs. Copyright © 2013 Elsevier Inc. All rights reserved.

Dissemination of an effective weight management program for Mexican American children in schools

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The rates of child obesity are epidemic in the United States, and Mexican American children are at particular risk. We have found an intensive, multi-component, school-based, weight management intervention to be efficacious at reducing standardized body mass index (zBMI) in overweight children. Our ...

Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion.

Science.gov (United States)

Martin, Corby K; Gilmore, L Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M; Redman, Leanne M

2016-03-16

Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. To describe SmartLoss, a semiautomated mHealth platform for weight loss. We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight

A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial

Directory of Open Access Journals (Sweden)

Pellegrini Christine A

2012-11-01

Full Text Available Abstract Background Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Methods/design Ninety-six obese adults (BMI 30–39.9 kg/m2 will be randomized to one of three treatment conditions: (1 standard behavioral weight loss (STND, (2 technology-supported behavioral weight loss (TECH; or (3 self-guided behavioral weight loss (SELF. All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD’s and will not receive coaching calls. During months 1–6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer. STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. Trial registration NCT01051713

Developing fire management mixes for fire program planning

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Armando González-Cabán; Patricia B. Shinkle; Thomas J. Mills

1986-01-01

Evaluating economic efficiency of fire management program options requires information on the firefighting inputs, such as vehicles and crews, that would be needed to execute the program option selected. An algorithm was developed to translate automatically dollars allocated to type of firefighting inputs to numbers of units, using a set of weights for a specific fire...

Toward a Middle-Range Theory of Weight Management.

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Pickett, Stephanie; Peters, Rosalind M; Jarosz, Patricia A

2014-07-01

The authors of this paper present the middle-range theory of weight management that focuses on cultural, environmental, and psychosocial factors that influence behaviors needed for weight control. The theory of weight management was developed deductively from Orem's theory of self-care, a constituent theory within the broader self-care deficit nursing theory and from research literature. Linkages between the conceptual and middle-range theory concepts are illustrated using a substruction model. The development of the theory of weight management serves to build nursing science by integrating extant nursing theory and empirical knowledge. This theory may help predict weight management in populations at risk for obesity-related disorders. © The Author(s) 2014.

Self-reported receipt of healthcare professional?s weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

OpenAIRE

Mogre, Victor; Wanaba, Peter; Apala, Peter; Nsoh, Jonas A.

2016-01-01

Background Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional?s weight management counselling and the weight management behaviours of type 2 diabetes patients. Methods This cross-sectional study was conducted among 378 type 2 ...

Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching

Science.gov (United States)

Michaelides, Andreas; Raby, Christine; Wood, Meghan; Farr, Kit

2016-01-01

Objective To evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program. Research Design and Methods 43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression. Results Weight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management. PMID:27651911

A novel prescription pedometer-assisted walking intervention and weight management for Chinese occupational population.

Directory of Open Access Journals (Sweden)

Yingxiang Yu

Full Text Available Information technology has been previously used for the research and practice of health promotion. Appropriate and effective health promotion methods used by professional groups remain to be investigated. This study aimed to assess the feasibility and effectiveness of a weight management program among the Chinese occupational population using and a novel information technology exercise prescription.A 3-month open, self-monitored intervention trial, involving individualized pedometer-assisted exercise prescription and a one-time targeted dietary guidance prior to exercise was conducted on the Chinese occupational population aged 18-65 years in China from 2015 to 2016. Data were collected from March 2015 to May 2016 and analyzed from June 2016 to August 2016. Participants were also asked to synchronize exercise data of the pedometer to the Internet-based Health System Center daily (at least weekly, by connecting to the personal computer (PC using a USB cable or via Bluetooth.Eligible participants included 802 Chinese occupational persons, and 718 of them followed exercise interventions with 89.5% (718/802 adherence to the exercise programs. Of them, 688 participants completed the program with 85.8% (688/802 adherence to the exercise program and their data were analyzed. Weight decreased by 2.2% among all overweight/obese participants, with 1.8% reduction in waist circumference and 3.3% reduction in body fat percentage (p< 0.001. Weight and body fat percentage in normal-weight individuals decreased by 0.7% and 2.5%, respectively (p < 0.01. A weight gain of 1.0% was observed in all underweight participants (p< 0.05, and 68.2% (208/305 of overweight/obese participants experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208 of them achieving weight loss ≥5%. Blood pressure and fasting serum glucose decreased significantly in both the overweight/obese and the normal-weight individuals (p < 0.05. The incidence of hypertension

Knowledge, attitudes and management skills of medical practitioners regarding weight management

OpenAIRE

Vangile B. Mkhatshwa; Gboyega A. Ogunbanjo; Langalibalele H. Mabuza

2016-01-01

Background: Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa.Methods: We conducted a cross-sectional study on 48 medical practitioners at Od...

The design of maternal centered life-style modification program for weight gain management during pregnancy - a study protocol.

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Farajzadegan, Ziba; Pozveh, Zahra Amini

2013-08-01

Abnormal weight gain during pregnancy increases the adverse health outcomes during the pregnancy, delivery, and the postpartum period. Most of the pregnant women develop weight gain more than the recommended limits; therefore, interventions to manage such disproportionate weight gain are needed. In this paper, the design of the maternal centered life-style intervention study is described, which focuses on controlling weight gaining during pregnancy for all body mass index (BMI) groups. In our randomized field trial, 160 pregnant women with 6-10 weeks of gestational age who visit one of the participating Isfahan four urban public-health centers and 4 private obstetric offices are included. The maternal centered life-style intervention carried out by trained midwives is standardized in a protocol. All the participants are visited at 6-10, 11-15, 16-20, 21-25, 26-30, 31-34, 35-37, 38, 39, and 40 weeks of pregnancy. The women who are randomized in the intervention group receive maternal centered educational package of prenatal care for the pregnant woman and a log book in the first visit. Counselors accompany the pregnant women to maintain or develop a healthy life-style. Data collection will perform monthly measuring body weight, BMI. Because, we don't have structured protocol for weight management during pregnancy especially, in private sectors if the maternal centered life-style intervention proves to be effective, it will be suggested to merge this package to routine care. Therewith by empowering women to manage their weight the public-health burden can be reduced. Beside that private obstetricians also have structured protocol for their client management.

Is consuming yoghurt associated with weight management outcomes? Results from a systematic review

NARCIS (Netherlands)

Eales, J.; Lenoir-Wijnkoop, I.; King, S.; Wood, H.; Kok, F.J.; Shamir, R.; Prentice, A.; Edwards, M.; Glanville, J.; Atkinson, R.L.

2016-01-01

Background:Yoghurt is part of the diet of many people worldwide and is commonly recognised as a 'health food'. Epidemiological studies suggest that yoghurt may be useful as part of weight management programs. In the absence of comprehensive systematic reviews, this systematic review investigated

Changes in weight control behaviors and hedonic hunger during a 12-week commercial weight loss program.

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O'Neil, Patrick M; Theim, Kelly R; Boeka, Abbe; Johnson, Gail; Miller-Kovach, Karen

2012-12-01

Greater use of key self-regulatory behaviors (e.g., self-monitoring of food intake and weight) is associated with greater weight loss within behavioral weight loss treatments, although this association is less established within widely-available commercial weight loss programs. Further, high hedonic hunger (i.e., susceptibility to environmental food cues) may present a barrier to successful behavior change and weight loss, although this has not yet been examined. Adult men and women (N=111, body mass index M±SD=31.5±2.7kg/m(2)) were assessed before and after participating in a 12-week commercial weight loss program. From pre- to post-treatment, reported usage of weight control behaviors improved and hedonic hunger decreased, and these changes were inversely associated. A decrease in hedonic hunger was associated with better weight loss. An improvement in reported weight control behaviors (e.g., self-regulatory behaviors) was associated with better weight loss, and this association was even stronger among individuals with high baseline hedonic hunger. Findings highlight the importance of specific self-regulatory behaviors within weight loss treatment, including a commercial weight loss program developed for widespread community implementation. Assessment of weight control behavioral skills usage and hedonic hunger may be useful to further identify mediators of weight loss within commercial weight loss programs. Future interventions might specifically target high hedonic hunger and prospectively examine changes in hedonic hunger during other types of weight loss treatment to inform its potential impact on sustained behavior change and weight control. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: Systematic review and meta-analysis.

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McEvedy, Samantha M; Sullivan-Mort, Gillian; McLean, Siân A; Pascoe, Michaela C; Paxton, Susan J

2017-10-01

This study collates existing evidence regarding weight loss among overweight but otherwise healthy adults who use commercial weight-loss programs. Systematic search of 3 databases identified 11 randomized controlled trials and 14 observational studies of commercial meal-replacement, calorie-counting, or pre-packaged meal programs which met inclusion criteria. In meta-analysis using intention-to-treat data, 57 percent of individuals who commenced a commercial weight program lost less than 5 percent of their initial body weight. One in two (49%) studies reported attrition ≥30 percent. A second meta-analysis found that 37 percent of program completers lost less than 5 percent of initial body weight. We conclude that commercial weight-loss programs frequently fail to produce modest but clinically meaningful weight loss with high rates of attrition suggesting that many consumers find dietary changes required by these programs unsustainable.

Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.

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Jay, Melanie; Chintapalli, Sumana; Squires, Allison; Mateo, Katrina F; Sherman, Scott E; Kalet, Adina L

2015-11-14

Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. We recruited 25 PACT teamlet members from a single VA study site-11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist)-for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA

Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

Directory of Open Access Journals (Sweden)

Max Lafontan

2015-01-01

Full Text Available Summary: Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity, water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.

Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

Science.gov (United States)

Lafontan, Max; Visscher, Tommy L.S.; Farpour-Lambert, Nathalie; Yumuk, Volkan

2015-01-01

Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols. PMID:25765164

Weight change in a commercial web-based weight loss program and its association with website use: cohort study.

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Neve, Melinda; Morgan, Philip J; Collins, Clare E

2011-10-12

There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven. The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to describe participants' program use in relation to weight change. Participants enrolled in an Australian commercial Web-based weight loss program from August 15, 2007, through May 31, 2008. Self-reported weekly weight records were used to determine weight change after 12- and 52-week subscriptions. The primary analysis estimated weight change using generalized linear mixed models (GLMMs) for all participants who subscribed for 12 weeks and also for those who subscribed for 52 weeks. A sensitivity analysis was conducted using the last observation carried forward (LOCF) method. Website use (ie, the number of days participants logged on, made food or exercise entries to the Web-based diary, or posted to the discussion forum) was described from program enrollment to 12 and 52 weeks, and differences in website use by percentage weight change category were tested using Kruskal-Wallis test for equality of populations. Participants (n = 9599) had a mean (standard deviation [SD]) age of 35.7 (9.5) years and were predominantly female (86% or 8279/9599) and obese (61% or 5866/9599). Results from the primary GLMM analysis including all enrollees found the mean percentage weight change was -6.2% among 12-week subscribers (n = 6943) and -6.9% among 52-week subscribers (n = 2656). Sensitivity analysis using LOCF revealed an average weight change of -3.0% and -3.5% after 12 and 52 weeks respectively. The use of all website features increased significantly (P Web-based weight loss program is likely to be in the range of

Should providers encourage realistic weight expectations and satisfaction with lost weight in commercial weight loss programs? a preliminary study.

Science.gov (United States)

Ames, Gretchen E; Thomas, Colleen S; Patel, Roshni H; McMullen, Jillian S; Lutes, Lesley D

2014-01-01

Attrition is a problem among patients who participate in commercial weight loss programs. One possible explanation is that if patients are unable to reach a weight that they expect to achieve, they may be more likely to drop out of treatment. This study investigated variables associated with attrition among 30 obese patients who completed a liquid meal replacement program (LMR) and enrolled in a 52-week Small Changes Maintenance intervention (SCM). Patients lost a median 18% of body weight during LMR and completed assessments about weight expectations and weight satisfaction pre- and post-SCM. Of the 30 patients who started SCM, 8 (27%) were lost to attrition. Odds of SCM attrition were higher in patients who lost ≤ 18.2% of pre-LMR weight (OR: 12.25, P = 0.035), had lower satisfaction (≤7) pre-SCM (OR: 10.11, P = 0.040), and who expected further weight loss of 9.1 kg or more pre-SCM (OR: 10.11, P = 0.040). SCM completers significantly increased weight loss expectations by a median of 2.3 kg from pre-SCM to post-SCM (WSR P = 0.049) that paralleled weight regained post-SCM (2.7 kg). After completion of a medically-supervised commercial weight loss program, patients with the greatest expectations for further weight loss and the lowest weight satisfaction were more likely to drop out of SCM. Failure to participate in maintenance treatment may lead to regain of greater than half of lost weight over the next year. Among SCM completers, lower expectations for further weight loss and greater weight satisfaction appeared to be associated with continued engagement in maintenance treatment.

Weight loss and weight loss maintenance efficacy of a novel weight loss program: The retrospective RNPC® cohort

DEFF Research Database (Denmark)

Thorning, Tanja Kongerslev; Fabre, Odile; Legrand, Rémy

2018-01-01

or obese patients treated in 54 RNPC® weight loss clinics in France. Results: A total of 10,809 (89%) patients completed the initial weight loss phase and 2996 (25%) completed the full program. Median weight loss percentage was 10.7% (Interquartile range [IQR]: 5.8; 16.5) after a median of 105 days (IQR...

Yogurt and weight management.

Science.gov (United States)

Jacques, Paul F; Wang, Huifen

2014-05-01

A large body of observational studies and randomized controlled trials (RCTs) has examined the role of dairy products in weight loss and maintenance of healthy weight. Yogurt is a dairy product that is generally very similar to milk, but it also has some unique properties that may enhance its possible role in weight maintenance. This review summarizes the human RCT and prospective observational evidence on the relation of yogurt consumption to the management and maintenance of body weight and composition. The RCT evidence is limited to 2 small, short-term, energy-restricted trials. They both showed greater weight losses with yogurt interventions, but the difference between the yogurt intervention and the control diet was only significant in one of these trials. There are 5 prospective observational studies that have examined the association between yogurt and weight gain. The results of these studies are equivocal. Two of these studies reported that individuals with higher yogurt consumption gained less weight over time. One of these same studies also considered changes in waist circumference (WC) and showed that higher yogurt consumption was associated with smaller increases in WC. A third study was inconclusive because of low statistical power. A fourth study observed no association between changes in yogurt intake and weight gain, but the results suggested that those with the largest increases in yogurt intake during the study also had the highest increase in WC. The final study examined weight and WC change separately by sex and baseline weight status and showed benefits for both weight and WC changes for higher yogurt consumption in overweight men, but it also found that higher yogurt consumption in normal-weight women was associated with a greater increase in weight over follow-up. Potential underlying mechanisms for the action of yogurt on weight are briefly discussed.

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

Science.gov (United States)

Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

2016-10-01

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

Improved Birth Weight for Black Infants: Outcomes of a Healthy Start Program

Science.gov (United States)

Zielinski, Ruth; James, Arthur; Charoth, Remitha M.; del Carmen Sweezy, Luz

2014-01-01

Objectives. We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County–level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women. PMID:24354844

The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review.

Science.gov (United States)

Zhu, D Q; Norman, I J; While, A E

2011-06-01

It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Position of the American Dietetic Association: weight management.

Science.gov (United States)

Seagle, Helen M; Strain, Gladys Witt; Makris, Angela; Reeves, Rebecca S

2009-02-01

It is the position of the American Dietetic Association that successful weight management to improve overall health for adults requires a lifelong commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity. Given the increasing incidence of overweight and obesity along with the escalating health care costs associated with weight-related illnesses, health care providers must discover how to effectively treat this complex condition. Food and nutrition professionals should stay current and skilled in weight management to assist clients in preventing weight gain, optimizing individual weight loss interventions, and achieving long-term weight loss maintenance. Using the American Dietetic Association's Evidence Analysis Process and Evidence Analysis Library, this position paper presents the current data and recommendations for weight management. The evidence supporting the value of portion control, eating frequency, meal replacements, and very-low-energy diets are discussed as well as physical activity, behavior therapy, pharmacotherapy, and surgery. Public policy changes to create environments that can assist all populations to achieve and sustain healthful lifestyle behaviors are also reviewed.

A study on body-weight perception, future intention and weight-management behaviour among normal-weight, overweight and obese women in India.

Science.gov (United States)

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2014-04-01

We examined the socio-economic differential in the self-perception of body weight, future intention for weight management and actual weight-management behaviour among normal-weight, overweight and obese women in India. A population-based follow-up survey of ever-married women, systematically selected from the second round of the National Family Health Survey (NFHS-2, 1998-99) samples, who were re-interviewed after four years in 2003. Information on women's perception about their own weight, intention of weight management and actual weight-management behaviour were collected through personal interview. Anthropometric measurements were obtained from women to compute their current BMI. Three hundred and twenty-five ever-married women aged 20-54 years residing in the national capital territory of Delhi in India. Discrepancy between self-perceived body weight and women's actual body weight was reported. One-quarter of overweight women and one in ten obese women perceived themselves as normal weight. Although a majority of overweight and obese women wanted to reduce their weight, a significant proportion of overweight (one in four) and 4 % of obese women also wanted to maintain their weight as it is. Only one in three overweight and one in four obese women were performing any physical activity to reduce their weight. These findings are important for public health interventions in obesity care. Implementation of health promotion and health education in the community should use effective school education and mass-media programmes to raise awareness of appropriate body weight to combat the growing level of obesity among Indian women.

Effects on Diabetes Medications, Weight and Glycated Hemoglobin Among Adult Patients With Obesity and Type 2 Diabetes: 6-Month Observations From a Full Meal Replacement, Low-Calorie Diet Weight Management Program.

Science.gov (United States)

Shiau, Judy Y; So, Derek Y F; Dent, Robert R

2018-02-01

A 6-month weight-management program with full meal replacement, low-calorie diet (full MR-LCD) (900 kcal/day for 6 to 12 weeks) follows a protocol for patients with diabetes for decreasing or discontinuing weight-gaining diabetes medications first (Group WG) and then titrating weight-neutral medications (Group WN). This is a retrospective cohort study (1992 to 2009) of weight, glycemic control and diabetes medications changes in 317 patients with obesity and type 2 diabetes who were taking medications. Group WG and Group WN were similar at baseline, except that glycated hemoglobin (A1C) levels were significantly lower in Group WN (7.5% vs. 6.6%; p<0.001). At 6 months, both groups had lost 16% of their weight, and the decreases or discontinuations of medications were 92.1% sulfonureas, 86.5% insulins, 78.8% thiazolidinediones, 77.8% alpha-glucosidase inhibitors, 50% meglitinides, 33.3% dipeptidyl peptidase-4 (DPP-4) inhibitors and 32.8% metformin. At 6 months, compared with baseline, A1C levels improved in Group WG and Group WN (6-month A1C levels 6.7% and 5.8%, respectively; p<0.0001), and Group WN had significantly better A1C levels than Group WG. At 6 months, 30% of patients were no longer taking diabetes medications and had significantly better percentages of weight loss compared with those taking medications (18.6% vs. 16%; p=0.002); both groups had improved glycemic control at 6 months (A1C 6.0% vs. A1C 6.6%; NS). In patients with obesity and type 2 diabetes taking medications, a full MR-LCD program appears to be safe and includes improvement in A1C levels. At 6 months, the percentage of weight loss can be significantly better in patients who no longer require diabetes medications, and A1C levels are best controlled in patients who are on WN medications. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Determinants of Successful Weight Loss After Using a Commercial Web-Based Weight Reduction Program for Six Months: Cohort Study

OpenAIRE

Postrach, Elisa; Aspalter, Rosa; Elbelt, Ulf; Koller, Michael; Longin, Rita; Schulzke, J?rg-Dieter; Valentini, Luzia

2013-01-01

Background The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program curre...

Weight Management for Athletes: Important Things to be Considered

OpenAIRE

Chara Odysseos Maria Avraamidou; Maria Avraamidou

2017-01-01

Weight management is difficult for most individuals, as indicated by the high numbers of obesity around the world. Obesity has increased dramatically over the past decades. Unfortunately, this epidemic is not limited to adults but also to children in both globally and Cyprus. Developing a weight management plan is essential for everyone. Regarding to an athlete, weight management is an increasingly integral part, as consuming the right kind of food can lead them in success or failure. The spe...

Lifestyle Intervention for Weight Loss: a group-based program for Emiratis in Ajman, United Arab Emirates

Directory of Open Access Journals (Sweden)

Sadiya A

2016-03-01

Full Text Available Amena Sadiya,1,* Sarah Abdi,1,* Salah Abusnana2 1Lifestyle Clinic, 2Research and Education Department, Rashid Center for Diabetes and Research, Ajman, United Arab Emirates *These authors contributed equally to this work Background: Lifestyle Intervention for Weight Loss (LIFE-8 is developed as a structured, group-based weight management program for Emiratis with obesity and type 2 diabetes. It is a 3-month program followed by a 1-year follow-up. The results from the first 2 years are presented here to indicate the possibility of its further adaptation and implementation in this region. Methodology: We recruited 45 participants with obesity and/or type 2 diabetes based on inclusion/exclusion criteria. The LIFE-8 program was executed by incorporating dietary modification, physical activity, and behavioral therapy, aiming to achieve up to 5% weight loss. The outcomes included body weight, fat mass, waist circumference, blood pressure, fasting blood glucose (FBG, hemoglobin A1c (HbA1c, and nutritional knowledge at 3 months and 12 months. Results: We observed a reduction of 5.0% in body weight (4.8±2.8 kg; 95% CI 3.7–5.8, fat mass (–7.8%, P<0.01, and waist circumference (Δ=4±4 cm, P<0.01 in the completed participants (n=28. An improvement (P<0.05 in HbA1c (7.1%±1.0% vs 6.6%±0.7% and FBG (8.2±2.0 mmol/L vs 6.8±0.8 mmol/L was observed in participants with obesity and type 2 diabetes after the program. Increase in nutritional knowledge (<0.01 and overall evaluation of the program (9/10 was favorable. On 1-year follow-up, we found that the participants could sustain weight loss (–4.0%, while obese, type 2 diabetic participants sustained HbA1c (6.6%±0.7% vs 6.4%±0.7% and further improved (P<0.05 the level of FBG (6.8±0.8 mmol/L vs 6.7±0.4 mmol/L. Conclusion: LIFE-8 could be an effective, affordable, acceptable, and adaptable lifestyle intervention program for the prevention and management of diabetes in Emiratis. It was successful not

Is air-displacement plethysmography a reliable method of detecting ongoing changes in percent body fat within obese children involved in a weight management program?

DEFF Research Database (Denmark)

Ewane, Cecile; McConkey, Stacy A; Kreiter, Clarence D

2010-01-01

(percent body fat) over time. The gold standard method, hydrodensitometry, has severe limitations for the pediatric population. OBJECTIVE: This study examines the reliability of air-displacement plethysmography (ADP) in detecting percent body fat changes within obese children over time. METHODS: Percent...... body fat by ADP, weight, and body mass index (BMI) were measured for eight obese children aged 5-12 years enrolled in a weight management program over a 12-month period. These measurements were taken at initial evaluation, 1.5 months, 3 months, 6 months, and 12 months to monitor the progress...... of the subjects and detect any changes in these measures over time. Statistical analysis was used to determine the reliability of the data collected. RESULTS: The reliability estimate for percent body fat by ADP was 0.78. This was much lower than the reliability of BMI, 0.98, and weight measurements, 0...

Therapy and Weight Management (For Teens)

Science.gov (United States)

... learn to outsmart them. Help you learn self-management skills. Some people need to strengthen the skills that ... don't get worked out can suck up time and energy that you need for your weight-management plan. Everyone's different, so each person's plan for ...

Mobile Apps for Weight Management: A Scoping Review.

Science.gov (United States)

Rivera, Jordan; McPherson, Amy; Hamilton, Jill; Birken, Catherine; Coons, Michael; Iyer, Sindoora; Agarwal, Arnav; Lalloo, Chitra; Stinson, Jennifer

2016-07-26

Obesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for 'weight loss apps' has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control. To characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management. An electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support. A total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the assessment criteria, with the majority

Weight management in community pharmacy: what do the experts think?

Science.gov (United States)

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2013-06-01

The increasing prevalence of obesity and overweight adults creates a significant public health burden and there is great potential for pharmacists to be involved in the provision of weight management services, other than the mundane supply of commercial products. In order to provide optimal services that can be integrated into the healthcare system, a best practice model for weight management services in community pharmacy should be in place. We sought experts' and key stakeholders' opinions on this matter. (1) To identify components of a best practice model of a weight management service feasible in Australian community pharmacy. (2) To identify the role of pharmacists and the training requirements to up-skill pharmacists to competently provide weight management services. (3) To elicit any practical suggestions that would contribute to successful implementation of weight management services in pharmacy. Australian primary care sector. Semi-structured interviews were conducted with a purposive sample of 12 participants including Australian experts in obesity and representatives of main Australian professional organisations in pharmacy. Interviews were digitally recorded, transcribed verbatim and thematically analysed using the framework approach. Recommended components of pharmacy-based weight management services and training requirements. Participants perceived two potential roles for pharmacists involved in weight management: health promotion and individualised service. Multi-component interventions targeting all three areas: diet, physical activity and behaviour change were emphasised. Physical assessment (e.g. weight, waist circumference measurements), goal setting, referral to allied healthcare professionals and on-going support for weight maintenance were also proposed. Participants suggested pharmacists should undergo formal training and identified various training topics to improve pharmacists' knowledge, attributes and skills to acquire competencies

Construction program management

CERN Document Server

Delaney, Joseph

2013-01-01

Although construction is one of the largest industries in the United States, it lags behind other industries in its implementation of modern management techniques such as those contained in the Standard for Program Management (the Standard) by the Project Management Institute (PMI(R)). Construction Program Management details the successful use of the PMI(R) approach for the construction of capital programs. It demonstrates, through case studies, how implementation of PMI's set of tools and techniques can improve the chances of program success. Exploring tactical and strategic management method

Waste Management Program management plan. Revision 1

International Nuclear Information System (INIS)

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management's objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL

Popular weight-management apps: Their use and quality

Directory of Open Access Journals (Sweden)

Juliana Chen

2015-09-01

Conclusions: While greater popularity of apps was associated with higher quality, the overall quality of commercial dietary weight-management apps remains suboptimal. Popular weight-management apps are useful for self-monitoring, however are lacking in the recognised behavioural change techniques that may facilitate changes in health behaviours. With the majority of these apps designed for self-directed management, strategies to improve the rigour of these apps are warranted and commercial app developers could benefit from collaboration with behavioural researchers.

Waste Management Program management plan. Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management`s objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL.

Steps to Health employee weight management randomized control trial: short-term follow-up results.

Science.gov (United States)

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2015-02-01

To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System. A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline. There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms. The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.

Self-Management Patient Education and Weight Loss

Science.gov (United States)

Stombaugh, Angela M.

2010-01-01

Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

Innovation in weight loss programs: a 3-dimensional virtual-world approach.

Science.gov (United States)

Johnston, Jeanne D; Massey, Anne P; Devaneaux, Celeste A

2012-09-20

The rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning. To explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change. We collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time. A total of 54 participants with a BMI of 32 (SD 6.05) kg/m(2)enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P virtual-world group. Overall, these results offer positive early evidence that a

Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth.

Science.gov (United States)

Guss, Carly E; Williams, David N; Reisner, Sari L; Austin, S Bryn; Katz-Wise, Sabra L

2017-01-01

Disordered weight management behaviors are prevalent among youth; recent case reports suggested that these behaviors might also be common in transgender youth. We studied associations of gender identity with disordered weight management behaviors, nonprescription steroid use, and weight perception among transgender and cisgender (nontransgender) high-school students in Massachusetts. Data were analyzed from the 2013 Massachusetts Youth Health Survey, an anonymous survey in a random sample of Massachusetts public high schools. Respondents were divided into three groups: transgender (n = 67), cisgender male (n = 1,117), and cisgender female (n = 1,289). Fisher's exact tests and multivariable logistic regression models were used to examine unhealthy weight management behaviors in the past 30 days: fasting >24 hours, vomiting, diet pill use, and laxative use; nonprescription steroid use; and self-perceived weight status. Analyses controlled for age, race/ethnicity, and body mass index. Compared with cisgender males, transgender adolescents had higher odds of fasting >24 hours (adjusted odds ratio [AOR] = 2.9, confidence interval [CI] = 1.1-7.8), using diet pills (AOR = 8.9, 95% CI = 2.3-35.2) and taking laxatives (AOR = 7.2, 95% CI = 1.4-38.4). Transgender youth had higher odds of lifetime use of steroids without a prescription than male cisgender respondents (AOR = 26.6, 95% CI = 3.5-200.1). Compared with cisgender females, transgender respondents had higher odds of perceiving themselves as healthy weight/underweight when they were overweight/obese (AOR = 2.4, 95% CI = 1.5-4.1). Transgender youth disproportionately self-reported unsafe weight management behaviors and nonprescription steroid use compared with cisgender youth. Clinicians should be aware of this increased risk among transgender youth. Research is needed to further understand these disparities and to inform future interventions. Copyright © 2016 Society for Adolescent Health and

A pilot test of the GoWoman weight management intervention for women with mobility impairments in the online virtual world of Second Life®.

Science.gov (United States)

Nosek, Margaret A; Robinson-Whelen, Susan; Ledoux, Tracey A; Hughes, Rosemary B; O'Connor, Daniel P; Lee, Rebecca E; Goe, Rebecca; Silveira, Stephanie L; Markley, Rachel; Nosek, Thomas M

2018-06-11

Pilot test GoWoman, a small-group weight management intervention for mobility impaired women that was a disability- and gender-responsive adaptation of the Diabetes Prevention Program delivered in the online virtual world of Second Life ® . Objectives were to (1) examine pre-/post-intervention differences in weight, waist circumference, diet, physical activity, self-efficacy for diet and physical activity, nutrition knowledge and social support for weight management, (2) determine intervention feasibility (fidelity, attrition, engagement, acceptability). Single-group modified interrupted time series quasi-experimental design whereby participants served as their own controls. Thirteen women attended ≥8 of 16 GoWoman weekly sessions and lost an average of 5.97 pounds (2.71 kg) (3.31%) body weight (Cohen's d = 0.74) and 1.44 inches (3.66 cm) (3.58%) waist circumference (Cohen's d = 0.83). There were significant improvements in physical activity, diet and self-efficacy for diet and physical activity. All benchmarks for feasibility were met. Ratings of intervention content, group interactions and support and virtual world experiences were highly positive. Findings suggest that a disability- and gender-responsive weight management intervention with peer group support delivered in an online virtual world is feasible, meaningful and may assist with weight management for mobility impaired women. Implications for Rehabilitation This study addresses a gap in the general and rehabilitation research literature by addressing the disproportionately high rates of obesity among women with mobility impairments, who are generally excluded from tests of weight management interventions if they have limited ability to engage in vigorous physical activity. The GoWoman program is an adaptation of the Diabetes Prevention Program Lifestyle Change curriculum that is tailored to meet the unique weight management needs of women with mobility impairments, and was created to

Beliefs about causes of weight gain, effective weight gain prevention strategies, and barriers to weight management in the Australian population

OpenAIRE

Dryer, Rachel; Ware, Nicole

2014-01-01

Purpose: To identify beliefs held by the general public regarding causes of weight gain, weight prevention strategies, and barriers to weight management; and to examine whether such beliefs predict the actual body mass of participants. Methods: A questionnaire-based survey was administered to participants recruited from regional and metropolitan areas of Australia. This questionnaire obtained demographic information, height, weight; as well as beliefs about causes of weight gain, weight preve...

Integration of a physical training program in a weight loss plan for overweight pet dogs.

Science.gov (United States)

Vitger, Anne D; Stallknecht, Bente M; Nielsen, Dorte H; Bjornvad, Charlotte R

2016-01-15

To investigate whether a controlled physical training plan for overweight dogs during a weight loss program would improve cardiorespiratory fitness and better preserve lean body mass, compared with results for dogs undergoing a weight loss program based on caloric restriction alone. Prospective, nonrandomized clinical study. 19 client-owned overweight or obese dogs. All dogs were fed the same calorie-restricted diet rationed to achieve a weight loss rate of 1% to 2%/wk for 12 weeks. The fitness-and-diet (FD) group participated in a training program that included underwater and land-based treadmill exercise 3 times/wk. The diet-only (DO) group had no change in exercise routines. Daily activity before and during the intervention was recorded by accelerometry. Before and after intervention, heart rate during exercise was recorded to assess cardiovascular fitness, and body composition was analyzed by dual-energy x-ray absorptiometry. Differences between groups were evaluated with t tests and multiple regression analysis. Mean weight loss was 13.9% and 12.9% for the FD and DO groups, respectively (n = 8 dogs/group that completed the study). Mean accelerometer counts during intervention were 13% higher than baseline counts for the FD group. Heart rate during exercise declined after intervention in both groups. Lean body mass was preserved in the FD group and lost in the DO group during intervention. The controlled exercise plan used with a dietary weight loss program prevented loss of lean body mass in dogs. This finding supports inclusion of controlled physical training for obesity management in dogs.

EDIN0613P weight estimating program. [for launch vehicles

Science.gov (United States)

Hirsch, G. N.

1976-01-01

The weight estimating relationships and program developed for space power system simulation are described. The program was developed to size a two-stage launch vehicle for the space power system. The program is actually part of an overall simulation technique called EDIN (Engineering Design and Integration) system. The program sizes the overall vehicle, generates major component weights and derives a large amount of overall vehicle geometry. The program is written in FORTRAN V and is designed for use on the Univac Exec 8 (1110). By utilizing the flexibility of this program while remaining cognizant of the limits imposed upon output depth and accuracy by utilization of generalized input, this program concept can be a useful tool for estimating purposes at the conceptual design stage of a launch vehicle.

Development of and feedback on a fully automated virtual reality system for online training in weight management skills.

Science.gov (United States)

Thomas, J Graham; Spitalnick, Josh S; Hadley, Wendy; Bond, Dale S; Wing, Rena R

2015-01-01

Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations. © 2014 Diabetes Technology Society.

Smartphone Usage, Social Media Engagement, and Willingness to Participate in mHealth Weight Management Research among African American Women

Science.gov (United States)

James, Delores C. S.; Harville, Cedric, II

2018-01-01

Background: African American women (AAW) are in a unique position to be recruited into mobile (mHealth) weight management research and programs due to their high rates of obesity and their high ownership of smartphones. Aim: This study examined smartphone usage, social media engagement, and willingness to participate in mHealth weight management…

Conceptual Model of Weight Management in Overweight and Obese African-American Females.

Science.gov (United States)

Sutton, Suzanne M; Magwood, Gayenell S; Nemeth, Lynne S; Jenkins, Carolyn M

2017-04-01

Weight management of overweight and obese (OWO) African-American females (AAFs) is a poorly defined concept, leading to ineffective treatment of overweight and obesity, prevention of health sequelae, and risk reduction. A conceptual model of the phenomenon of weight management in OWO AAFs was developed through dimensional analysis of the literature. Constructs were identified and sorted into the dimensions of perspective, context, conditions, process, and consequences and integrated into an explanatory matrix. Through dimensional analysis, weight management in OWO AAFs was characterized as a multidimensional concept, defined from the perspective of weight loss in community-dwelling AAFs. Behaviors associated with weight management are strongly influenced by intrinsic factors and extrinsic conditions, which influence engagement in the processes and consequences of weight management. The resulting conceptual model of weight management in OWO AAFs provides a framework for research interventions applicable in a variety of settings. © 2016 Wiley Periodicals, Inc.

The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review

Directory of Open Access Journals (Sweden)

Welsh Ericka M

2008-11-01

Full Text Available Abstract Background Regular self-weighing has been a focus of attention recently in the obesity literature. It has received conflicting endorsement in that some researchers and practitioners recommend it as a key behavioral strategy for weight management, while others caution against its use due to its potential to cause negative psychological consequences associated with weight management failure. The evidence on frequent self-weighing, however, has not yet been synthesized. The purpose of this paper is to evaluate the evidence regarding the use of regular self-weighing for both weight loss and weight maintenance. Methods A systematic literature review was conducted using the MEDLINE, CINAHL, and PsycINFO online databases. Reviewed studies were broken down by sample characteristics, predictors/conditions, dependent measures, findings, and evidence grade. Results Twelve studies met the inclusion/exclusion criteria, but nearly half received low evidence grades in terms of methodological quality. Findings from 11 of the 12 reviewed studies indicated that more frequent self-weighing was associated with greater weight loss or weight gain prevention. Specifically, individuals who reported self-weighing weekly or daily, typically over a period of several months, held a 1 to 3 kg/m2 (current advantage over individuals who did not self-weigh frequently. The effects of self-weighing in experimental studies, especially those where self-weighing behaviors could be isolated, were less clear. Conclusion Based on the consistency of the evidence reviewed, frequent self-weighing, at the very least, seems to be a good predictor of moderate weight loss, less weight regain, or the avoidance of initial weight gain in adults. More targeted research is needed in this area to determine the causal role of frequent self-weighing in weight loss/weight gain prevention programs. Other open questions to be pursued include the optimal dose of self-weighing, as well as the

Prevention of Weight Gain Following a Worksite Nutrition and Exercise Program

Science.gov (United States)

Thorndike, Anne N.; Sonnenberg, Lillian; Healey, Erica; Myint-U, Khinlei; Kvedar, Joseph C.; Regan, Susan

2012-01-01

Background Many employers are now providing wellness programs to help employees make changes in diet and exercise behaviors. Improving health outcomes and reducing costs will depend on whether employees sustain lifestyle changes and maintain a healthy weight over time. Purpose To determine if a 9-month maintenance intervention immediately following a 10-week worksite exercise and nutrition program would prevent regain of the weight lost during the program. Design RCT. Setting/participants In 2008, a total of 330 employees from 24 teams completed a 10-week exercise and nutrition program at a large hospital worksite and were randomized by team to maintenance or control (usual care) for 9 months. Intervention Internet support with a website for goal-setting and self-monitoring of weight and exercise plus minimal personal support. Main outcome measures Weight loss, percentage weight loss, time spent in physical activity, and frequency of consumption of fruits/vegetables, fatty foods, and sugary foods at 1 year compared to baseline. One-year follow-up was completed in 2010, and data were analyzed in 2011. Results At 1 year, 238 subjects (72%) completed follow-up assessments. Mean baseline BMI was 27.6 and did not differ between intervention and control. Compared to baseline, both groups lost weight during the 10-week program and maintained 65% of weight loss at 1 year (p<0.001). There was no difference in weight loss between groups at end of the 10-week program (4.8 lbs vs 4.3 lbs, p=0.53 for group×time interaction) or end of maintenance at 1 year (3.4 lbs vs 2.5 lbs, p=0.40 for group×time interaction). All subjects had improvements in physical activity and nutrition (increased fruits/vegetables and decreased fat and sugar intake) at 1 year but did not differ by group. Conclusions An intensive 10-week team-based worksite exercise and nutrition program resulted in moderate weight loss and improvements in diet and exercise behaviors at 1 year, but an Internet

One-Year Weight Loss with a Telephone-Based Lifestyle Program

Directory of Open Access Journals (Sweden)

Christina Holzapfel

2016-07-01

Full Text Available Objective: Telephone-based weight loss programs are offered as an alternative to face-to-face obesity treatments, but data on the effectiveness regarding weight loss are limited. Therefore, we evaluated a telephone-based lifestyle program in a real-world setting. Methods: The telephone-based intervention consists of regular phone calls providing individualized lifestyle recommendations, and delivery of printed materials. Anthropometric and metabolic data are collected by general practitioners or are self-reported. Results: Baseline data were available from 398 participants (61% men; weight 103.12 ± 14.21 kg; BMI 33.38 ± 2.83 kg/m2 and 1-year data from 258 (65% participants. In the completers, mean weight change was -4.25 ± 5.18 kg (p Conclusions: The telephone-based lifestyle program results in a moderate weight loss after 12 months, which may be comparable to face-to-face interventions. Telephone-based weight loss support is independent of time and location and represents a tool which is also accepted by men.

Cost Effectiveness of a Weight Management Program Implemented in the Worksite: Translation of Fuel Your Life.

Science.gov (United States)

Corso, Phaedra S; Ingels, Justin B; Padilla, Heather M; Zuercher, Heather; DeJoy, David M; Vandenberg, Robert J; Wilson, Mark G

2018-04-18

Conduct a cost-effectiveness analysis of the Fuel Your Life (FYL) program dissemination. Employees were recruited from three workplaces randomly assigned to one of the conditions: telephone coaching, small group coaching, and self-study. Costs were collected prospectively during the efficacy trial. The main outcome measures of interest were weight loss and quality-adjusted life years (QALYs). The phone condition was most costly ($601-$589/employee) and the self-study condition was least costly ($145-$143/employee). For weight loss, delivering FYL through the small group condition was no more effective, yet more expensive, than the self-study delivery. For QALYs, the group delivery of FYL was in an acceptable cost-effectiveness range ($22,400/QALY) relative to self-study (95% CI: $10,600/QALY - dominated). Prevention programs require adaptation at the local level and significantly affect the cost, effectiveness, and cost effectiveness of the program.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

Designing for psychological change: individuals' reward and cost valuations in weight management.

Science.gov (United States)

Hsu, Anne; Blandford, Ann

2014-06-26

Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. We applied a decision theory-based analysis in the domain of weight management to understand the rewards and costs that surround individuals' weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range

A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women

DEFF Research Database (Denmark)

Geiker, Nina R W; Ritz, Christian; Pedersen, Sue D

2016-01-01

compared with the effect of simple energy restriction. DESIGN: A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program...... that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). RESULTS: Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study....... CONCLUSION: A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial...

Primary-Care Weight-Management Strategies: Parental Priorities and Preferences.

Science.gov (United States)

Turer, Christy Boling; Upperman, Carla; Merchant, Zahra; Montaño, Sergio; Flores, Glenn

2016-04-01

To examine parental perspectives/rankings of the most important weight-management clinical practices and to determine whether preferences/rankings differ when parents disagree that their child is overweight. We performed mixed-methods analysis of a 32-question survey of parents of 2- to 18-year-old overweight children assessing parental agreement that their child is overweight, the single most important thing providers can do to improve weight status, ranking American Academy of Pediatrics-recommended clinical practices, and preferred follow-up interval. Four independent reviewers analyzed open-response data to identify qualitative themes/subthemes. Multivariable analyses examined parental rankings, preferred follow-up interval, and differences by agreement with their child's overweight assessment. Thirty-six percent of 219 children were overweight, 42% obese, and 22% severely obese; 16% of parents disagreed with their child's overweight assessment. Qualitative analysis of the most important practice to help overweight children yielded 10 themes; unique to parents disagreeing with their children's overweight assessments was "change weight-status assessments." After adjustment, the 3 highest-ranked clinical practices included, "check for weight-related problems," "review growth chart," and "recommend general dietary changes" (all P parents disagreeing with their children's overweight assessments ranked "review growth chart" as less important and ranked "reducing screen time" and "general activity changes" as more important. The mean preferred weight-management follow-up interval (10-12 weeks) did not differ by agreement with children's overweight assessments. Parents prefer weight-management strategies that prioritize evaluating weight-related problems, growth-chart review, and regular follow-up. Parents who disagree that their child is overweight want changes in how overweight is assessed. Using parent-preferred weight-management strategies may prove useful in

Economic effectiveness of disease management programs: a meta-analysis.

Science.gov (United States)

Krause, David S

2005-04-01

The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Although some studies contained multiple measurements of direct economic outcomes, only one average effect size per study was included in the meta-analysis. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350). Statistically significant differences of effect sizes by study design, disease type and intensity of disease management program interventions were not found after a moderating variable, disease severity, was taken into consideration. The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity. The findings can be generalized, which may assist health care policy makers and practitioners in addressing the issue of providing economically effective care for the growing number of individuals with chronic illness.

[Experiences of a nation-wide integrated program for healthy body weight among students].

Science.gov (United States)

Liou, Yiing Mei; Chen, Mei-Yen; Chiang, Li-Chi; Chien, Li-Yin; Chang, Po-Lun; Hung, Yung-Tai

2007-10-01

Taiwan has good support systems for obesity prevention and management. The percentage of elementary school students with normal body weight, however, has undergone a sustained decrease to 55%. Many factors are associated with this trend, such as lack of physical activity, dissatisfaction with body image, unbalanced dietary pattern, and unsupportive environment. Even though the rate of overweight and obesity is under control, the rate of underweight among girls has undergone a sustained increase, to 28%. Nurses therefore organized the "Aid students to fit" project, which emphasizes the bipolar issue of overweight and underweight. This national project is sponsored by the Ministry of Education and is expected to establish a beneficial environment, in which students can easily adopt healthy lifestyles and increase self-esteem. The program incorporates the AID triangle concept (Active, Image, Diet) and five strategies for achieving the goals. These strategies are: 1. Develop a persuasive statement to fit in with the philosophies of parents, students and teachers. 2. Set up measurable behavior indices and slogans. (Active life: 210 minutes per week. Image: confident and elegant. Diet: balanced and wise choice of low fat and high fiber foods.) 3. Establish a nation-wide interactive surveillance system for body weight control. 4. Develop an internet system that emphasizes tailored case management for overweight students. 5. Develop a supportive teaching plan, material, and aids to promote a healthy school environment. Five modeling schools, moreover, can be used to demonstrate the program. Educators can also download a free teaching plan, material, and aids at the website for healthy weight management (www.ym.edu.tw/active/aid). The authors brought together scholars from eight universities to accomplish the program. In support of the program, the Taiwan Ministry of Education addressed the new recommendation for physical activity which is to engage in moderate intensity

14 CFR 91.1017 - Amending program manager's management specifications.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Amending program manager's management... Ownership Operations Program Management § 91.1017 Amending program manager's management specifications. (a... specifications; or (2) The program manager applies for the amendment of any management specifications, and the...

A lifestyle program of exercise and weight loss is effective in preventing and treating type 2 diabetes mellitus: Why are programs not more available?

Science.gov (United States)

Ades, Philip A

2015-11-01

There is substantial evidence that type 2 diabetes mellitus (T2DM) can be prevented in high-risk individuals by a lifestyle program of regular exercise and weight reduction. Additionally, there is emerging evidence that new onset T2DM (lifestyle programs to support such behavior change are not widely available. Moreover, health care insurance companies generally do not provide coverage for behavioral weight loss programs to prevent or treat T2DM. Consequently, physicians caring for individuals with T2DM may find it much easier to start a chronic glucose lowering medication rather than attempting to motivate and support patients through long-term behavior change. The cardiac rehabilitation model of disease management, with a network of over 2000 programs in the U.S., is well suited to deliver medically-supervised lifestyle programs. National organizations such as the American Diabetes Association and the American Association of Cardiovascular and Pulmonary Rehabilitation should support greater availability and use of lifestyle programs for T2DM treatment and prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

Contingency management adapted for African-American adolescents with obesity enhances youth weight loss with caregiver participation: a multiple baseline pilot study.

Science.gov (United States)

Hartlieb, Kathryn Brogan; Naar, Sylvie; Ledgerwood, David M; Templin, Thomas N; Ellis, Deborah A; Donohue, Bradley; Cunningham, Phillippe B

2015-12-07

Contingency management (CM) interventions, which use operant conditioning principles to encourage completion of target behavioral goals, may be useful for improving adherence to behavioral skills training (BST). Research-to-date has yet to explore CM for weight loss in minority adolescents. To examine the effects of CM in improving adolescent weight loss when added to BST. The study utilized an innovative experimental design that builds upon multiple baseline approaches as recommended by the National Institutes of Health. Six obese African-American youth and their primary caregivers living in Detroit, Michigan, USA. Adolescents received between 4 and 12 weeks of BST during a baseline period and subsequently received CM targeting weight loss. Youth weight. Linear mixed effects modeling was used in the analysis. CM did not directly affect adolescent weight loss above that of BST (p=0.053). However, when caregivers were involved in CM session treatment, contingency management had a positive effect on adolescent weight loss. The estimated weight loss due to CM when caregivers also attended was 0.66 kg/week (pcontingency management for minority youth weight loss. Lessons learned from contingency management program implementation are also discussed in order to inform practice.

Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia.

Science.gov (United States)

Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

2016-05-25

Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled "Weight Management in Pharmacy" was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students' ORK scores and students' perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were "service-ready" and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services.

Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia

Science.gov (United States)

Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B.

2016-01-01

Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled “Weight Management in Pharmacy” was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students’ ORK scores and students’ perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were “service-ready” and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services. PMID:27293236

Program management system manual

International Nuclear Information System (INIS)

1989-08-01

OCRWM has developed a program management system (PMS) to assist in organizing, planning, directing and controlling the Civilian Radioactive Waste Management Program. A well defined management system is necessary because: (1) the Program is a complex technical undertaking with a large number of participants, (2) the disposal and storage facilities to be developed by the Program must be licensed by the Nuclear Regulatory Commission (NRC) and hence are subject to rigorous quality assurance (QA) requirements, (3) the legislation mandating the Program creates a dichotomy between demanding schedules of performance and a requirement for close and continuous consultation and cooperation with external entities, (4) the various elements of the Program must be managed as parts of an integrated waste management system, (5) the Program has an estimated total system life cycle cost of over $30 billion, and (6) the Program has a unique fiduciary responsibility to the owners and generators of the nuclear waste for controlling costs and minimizing the user fees paid into the Nuclear Waste Fund. This PMS Manual is designed and structured to facilitate strong, effective Program management by providing policies and requirements for organizing, planning, directing and controlling the major Program functions

Antipsychotic-associated weight gain: management strategies and impact on treatment adherence

Directory of Open Access Journals (Sweden)

Dayabandara M

2017-08-01

Full Text Available Madhubhashinee Dayabandara, Raveen Hanwella, Suhashini Ratnatunga, Sudarshi Seneviratne, Chathurie Suraweera, Varuni A de Silva Department of Psychiatry, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka Abstract: Antipsychotic-induced weight gain is a major management problem for clinicians. It has been shown that weight gain and obesity lead to increased cardiovascular and cerebrovascular morbidity and mortality, reduced quality of life and poor drug compliance. This narrative review discusses the propensity of various antipsychotics to cause weight gain, the pharmacologic and nonpharmacologic interventions available to counteract this effect and its impact on adherence. Most antipsychotics cause weight gain. The risk appears to be highest with olanzapine and clozapine. Weight increases rapidly in the initial period after starting antipsychotics. Patients continue to gain weight in the long term. Children appear to be particularly vulnerable to antipsychotic-induced weight gain. Tailoring antipsychotics according to the needs of the individual and close monitoring of weight and other metabolic parameters are the best preventive strategies at the outset. Switching to an agent with lesser tendency to cause weight gain is an option, but carries the risk of relapse of the illness. Nonpharmacologic interventions of dietary counseling, exercise programs and cognitive and behavioral strategies appear to be equally effective in individual and group therapy formats. Both nonpharmacologic prevention and intervention strategies have shown modest effects on weight. Multiple compounds have been investigated as add-on medications to cause weight loss. Metformin has the best evidence in this respect. Burden of side effects needs to be considered when prescribing weight loss medications. There is no strong evidence to recommend routine prescription of add-on medication for weight reduction. Heterogeneity of study methodologies and other

Program Management System manual

International Nuclear Information System (INIS)

1986-01-01

The Program Management System (PMS), as detailed in this manual, consists of all the plans, policies, procedure, systems, and processes that, taken together, serve as a mechanism for managing the various subprograms and program elements in a cohesive, cost-effective manner. The PMS is consistent with the requirements of the Nuclear Waste Policy Act of 1982 and the ''Mission Plan for the Civilian Radioactive Waste Management Program'' (DOE/RW-0005). It is based on, but goes beyond, the Department of Energy (DOE) management policies and procedures applicable to all DOE programs by adapting these directives to the specific needs of the Civilian Radioactive Waste Management program. This PMS Manual describes the hierarchy of plans required to develop and maintain the cost, schedule, and technical baselines at the various organizational levels of the Civilian Radioactive Waste Management Program. It also establishes the management policies and procedures used in the implementation of the Program. These include requirements for internal reports, data, and other information; systems engineering management; regulatory compliance; safety; quality assurance; and institutional affairs. Although expanded versions of many of these plans, policies, and procedures are found in separate documents, they are an integral part of this manual. The PMS provides the basis for the effective management that is needed to ensure that the Civilian Radioactive Waste Management Program fulfills the mandate of the Nuclear Waste Policy Act of 1982. 5 figs., 2 tabs

Parental perspectives regarding primary-care weight-management strategies for school-age children.

Science.gov (United States)

Turer, Christy Boling; Mehta, Megha; Durante, Richard; Wazni, Fatima; Flores, Glenn

2016-04-01

To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance. © 2014 John Wiley & Sons Ltd.

Program Management Tool

Science.gov (United States)

Gawadiak, Yuri; Wong, Alan; Maluf, David; Bell, David; Gurram, Mohana; Tran, Khai Peter; Hsu, Jennifer; Yagi, Kenji; Patel, Hemil

2007-01-01

The Program Management Tool (PMT) is a comprehensive, Web-enabled business intelligence software tool for assisting program and project managers within NASA enterprises in gathering, comprehending, and disseminating information on the progress of their programs and projects. The PMT provides planning and management support for implementing NASA programmatic and project management processes and requirements. It provides an online environment for program and line management to develop, communicate, and manage their programs, projects, and tasks in a comprehensive tool suite. The information managed by use of the PMT can include monthly reports as well as data on goals, deliverables, milestones, business processes, personnel, task plans, monthly reports, and budgetary allocations. The PMT provides an intuitive and enhanced Web interface to automate the tedious process of gathering and sharing monthly progress reports, task plans, financial data, and other information on project resources based on technical, schedule, budget, and management criteria and merits. The PMT is consistent with the latest Web standards and software practices, including the use of Extensible Markup Language (XML) for exchanging data and the WebDAV (Web Distributed Authoring and Versioning) protocol for collaborative management of documents. The PMT provides graphical displays of resource allocations in the form of bar and pie charts using Microsoft Excel Visual Basic for Application (VBA) libraries. The PMT has an extensible architecture that enables integration of PMT with other strategic-information software systems, including, for example, the Erasmus reporting system, now part of the NASA Integrated Enterprise Management Program (IEMP) tool suite, at NASA Marshall Space Flight Center (MSFC). The PMT data architecture provides automated and extensive software interfaces and reports to various strategic information systems to eliminate duplicative human entries and minimize data integrity

Long-term effects of a non-intensive weight program on body mass index and metabolic abnormalities of obese children and adolescents

Directory of Open Access Journals (Sweden)

Kubicky Rita

2012-06-01

Full Text Available Abstract Background Previous studies have demonstrated positive effects of short-term, intensive weight-loss programs in obese children. Objectives We evaluated the long-term effects of a non-intensive weight management program on the BMI, glycemic measures and lipid profiles of obese youth. Methods Retrospective chart review of 61 obese children followed at our Weight Management Center. During visits, dietary changes and regular physical activity were recommended. Anthropometric and laboratory parameters were evaluated. Results At the initial visit, the mean age was 11.1 ± 2.6 years. The follow-up period was 47.3 ± 11.1 months; the number of outpatient visits per year (OV/yr was 2.9 ± 0.9. At the end of the follow-up, the whole group exhibited decreased BMI z-score and LDL-cholesterol when compared to the initial visit. In the subset of subjects in whom OGTT was performed, 2-hour glucose and peak insulin were decreased. Compared to children with ≤ 2 OV/year, those with > 2 OV/year (3.19 ± 0.7 exhibited a significant decrease in their BMI z-score, LDL-cholesterol, 2-hour glucose, and peak insulin. Conclusions Our study suggests that a periodical (~ 3 OV/yr evaluation in a non-intensive, long-term weight management program may significantly improve the degree of obesity and cardiovascular risk factors in childhood.

The standard for program management

CERN Document Server

2017-01-01

The Standard for Program Management – Fourth Edition differs from prior editions by focusing on the principles of good program management. Program activities have been realigned to program lifecycle phases rather than topics, and the first section was expanded to address the key roles of program manager, program sponsor and program management office. It has also been updated to better align with PMI’s Governance of Portfolios, Programs, and Projects: A Practice Guide.

Challenges and solutions in the evaluation of a low back pain disease management program.

Science.gov (United States)

Kotsos, Thomas; Muldowney, Kevin; Chapa, Griselda; Martin, J Eric; Linares, Antonio

2009-02-01

This paper examines a novel approach to evaluating a nurse-run telephonic low back pain (LBP) disease management (DM) program offered by a fully-insured commercial health plan population with approximately 150,000 members located in the northeastern United States. Members with at least 6 member months of eligibility were identified to have LBP using administrative claims and eligibility data. The LBP program relies on telephonic nurse management augmented by printed materials, adapting and advocating HEDIS imaging guidelines, and drug utilization review. Outcomes of this LBP DM program were assessed using a pre-post population-based approach as recommended in the DMAA Outcomes Guidelines Report. Baseline year and program year populations were segmented into 5 LBP clinical categories and each was weight adjusted using population size. LBP-related medical service utilization and pharmacy utilization also were evaluated. Individuals under active LBP management exhibited a decrease in LBP-related imaging and surgeries. Overall analgesic use also decreased. These data suggest the LBP DM program is associated with a decrease in imaging, surgeries, and analgesic use. The magnitude of the clinically segmented weight-adjusted return on investment (ROI) was lower than the unadjusted ROI, but was directionally positive indicating program impact. This adjustment is necessary in order to gain insight into and consistency of the results of a comprehensive LBP DM program evaluation.

Chronic kidney disease management program in Shahreza, Iran.

Science.gov (United States)

Barahimi, Hamid; Aghighi, Mohammad; Aghayani, Katayon; Rahimi Foroushani, Abbas

2014-11-01

Chronic kidney disease (CKD) is a public health problem that needs an integrated program to be detected, monitored, and controlled. This study reports the results of a CKD program designed and implemented in Shahreza, Iran. After initial evaluation of CKD in Shahreza, a CKD management program was developed in the Ministry of Health and the pilot project was started in February 2011 in Shahreza rural areas. The patients at risk, including those with diabetes mellitus and hypertension, were tested with serum creatinine and urine albumin-creatinine ratio. The CKD management program included training, screening, monitoring, and controlling of weight, hypertension, diabetes mellitus, lipids, and vitamin D. This pilot program was organized in the rural population aged over 30 years who were suffering from hypertension, diabetes mellitus, or both, and resulted in the discovery of cases in various stages of CKD. The prevalence of CKD in this high-risk group was 21.5%. Persistent albuminuria and a glomerular filtration rate less than 60 mL/min/1.73 m(2) were 13% and 11%, respectively. The rate of CKD stages 1, 2, 3a, 3b, 4, and 5 were 2.75%, 6.82%, 10.08%, 0.92%, 0.31%, and 0.17% respectively. After 1 year of the program implemented, incidence rate of CKD was 24% and improvement rate was 21%. In diabetic patients, the mean of hemoglobin A1c decreased from 8.5 ± 1.9% to 7.5% ± 1.8%. Integration of CKD programs in primary health care is possible and results in improvement in management of CKD patients.

Barriers and Health Beliefs Related to Weight Management Among Veterans With Human Immunodeficiency Virus.

Science.gov (United States)

Munro, Shannon; Dinatale, Emily; Hartley, Sarah; St Jacques, Monica; Oursler, Kris Ann

2017-01-01

The success of antiretroviral therapy has led to dramatic changes in causes of morbidity and mortality among U.S. Veterans with human immunodeficiency virus (HIV). Among the 25,000 Veterans treated for HIV, 70% are over age 50 and the rate of obesity has doubled in this population. Veterans with HIV have a 50% increased risk of myocardial infarction yet have limited presence in prevention-related programs designed to lower cardiovascular disease risk. This mixed methods study (focus groups, Schwarzer and Renner physical activity, and nutrition self-efficacy questionnaires) was used to explore factors related to health behavior and identify barriers that overweight Veterans with HIV face in enrolling in the MOVE weight management program. Institutional review board approval was granted before the start of the study. All participants were recruited from the Infectious Disease clinic if they met national inclusion criteria for the MOVE weight management program and had not previously participated in the program. Transcribed audio recordings were independently analyzed and coded by four of the researchers using an exploratory process to obtain consensus regarding themes. An interrater reliability analysis for the Kappa statistic was performed to determine consistency among raters. The relationship between physical activity self-efficacy scores and nutrition self-efficacy scores was tested using Spearman's correlation coefficient. The median age of the sample was 56 with high rates of diabetes (36%), hypertension (73%), hyperlipidemia (36%), and tobacco use history (82%). External barriers to participation were discussed in addition to 8 other themes, which influence treatment engagement for Veterans with obesity and HIV including adaptation, stigma, self-management, and support. Veterans held strong beliefs about responsibility and commitment to their health and wanted to assume an active and informed role in their health care. Veterans with high levels of perceived

The Effect of Adherence to Dietary Tracking on Weight Loss: Using HLM to Model Weight Loss over Time.

Science.gov (United States)

Ingels, John Spencer; Misra, Ranjita; Stewart, Jonathan; Lucke-Wold, Brandon; Shawley-Brzoska, Samantha

2017-01-01

The role of dietary tracking on weight loss remains unexplored despite being part of multiple diabetes and weight management programs. Hence, participants of the Diabetes Prevention and Management (DPM) program (12 months, 22 sessions) tracked their food intake for the duration of the study. A scatterplot of days tracked versus total weight loss revealed a nonlinear relationship. Hence, the number of possible tracking days was divided to create the 3 groups of participants: rare trackers (66% total days tracked). After controlling for initial body mass index, hemoglobin A 1c , and gender, only consistent trackers had significant weight loss (-9.99 pounds), following a linear relationship with consistent loss throughout the year. In addition, the weight loss trend for the rare and inconsistent trackers followed a nonlinear path, with the holidays slowing weight loss and the onset of summer increasing weight loss. These results show the importance of frequent dietary tracking for consistent long-term weight loss success.

Long-Term Body Weight Maintenance among StrongWomen–Healthy Hearts Program Participants

Directory of Open Access Journals (Sweden)

Rebecca A. Seguin

2017-01-01

Full Text Available Background. The repeated loss and regain of body weight, referred to as weight cycling, may be associated with negative health complications. Given today’s obesity epidemic and related interventions to address obesity, it is increasingly important to understand contexts and factors associated with weight loss maintenance. This study examined BMI among individuals who had previously participated in a 12-week, evidence-based, nationally disseminated nutrition and physical activity program designed for overweight and obese middle-aged and older women. Methods. Data were collected using follow-up surveys. Complete height and weight data were available for baseline, 12-week program completion (post-program and follow-up (approximately 3 years later for 154 women (response rate = 27.5%; BMI characteristics did not differ between responders and nonresponders. Results. Mean BMI decreased significantly from baseline to post-program (−0.5, P<0.001 and post-program to follow-up (−0.7, P<0.001. Seventy-five percent of survey respondents maintained or decreased BMI post-program to follow-up. Self-efficacy and social support for healthy eating behaviors (but not physical activity were associated with BMI maintenance or additional weight loss. Conclusions. These findings support the durability of weight loss following participation in a relatively short-term intervention.

Long-Term Weight Maintenance after a 17-Week Weight Loss Intervention with or without a One-Year Maintenance Program: A Randomized Controlled Trial

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Tuula Pekkarinen

2015-01-01

Full Text Available Background. Weight lost by obese patients is almost always regained over time. Extended treatment may improve maintenance, but solid evidence is lacking. Purpose. We determined effectiveness of maintenance therapy after a weight loss program. Methods. Together 201 patients (mean age 47 years and BMI 42 kg/m2, 71% women were randomly assigned to either a 17-week weight loss program followed by a one-year maintenance program or to a weight loss program without subsequent maintenance intervention. The weight loss program included behavior modification and a very-low-calorie diet, and maintenance program behavior modification. The primary outcome measure was percentage of patients with 5% or more weight loss at the end of maintenance (week 69 and one year later (week 121. Secondary outcomes were weight related changes in lifestyle and quality of life. Results. At week 69, 52% of the patients with and 44% of those without maintenance program had lost weight ≥5%, P=0.40, and, at week 121, 33% and 34%, P=0.77, respectively. At week 121 secondary outcomes did not differ between the groups among those successfully followed up. Conclusions. This one-year maintenance program was not effective in preventing weight regain in severely obese patients. Trial Registration. This trial is registered under clinicaltrials.gov Identifier: NCT00590655.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Science.gov (United States)

Donnelly, J E; Ptomey, L T; Goetz, J R; Sullivan, D K; Gibson, C A; Greene, J L; Lee, R H; Mayo, M S; Honas, J J; Washburn, R A

2016-11-01

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery. Copyright © 2016. Published by Elsevier Inc.

Patients' Reported Usage of Weight Management Skills Following Bariatric Surgery.

Science.gov (United States)

Essayli, Jamal H; LaGrotte, Caitlin A; Fink-Miller, Erin L; Rigby, Andrea

2018-02-01

Little is known about which specific weight management skills bariatric patients find most and least valuable. Participants completed a measure assessing their usage of weight management skills at a follow-up appointment one or more years after undergoing bariatric surgery. Decreased usage of skills was associated with unsuccessful weight outcome, defined as losing less than 50% of excess weight, as well as weight regain. Weighing regularly was the skill selected most often by successful participants as helpful, and was chosen by a significantly smaller percentage of unsuccessful participants and those who regained a clinically significant amount of weight. A majority of both successful and unsuccessful participants indicated that they had discontinued food journaling. Weighing regularly may be perceived as a more useful method of self-monitoring.

Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

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Ryan C. Case

2009-01-01

Full Text Available Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology. Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI and rate of decannulation from weight loss alone. Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2 per patient. Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

Assessment of Processes of Change for Weight Management in a UK Sample

Science.gov (United States)

Andrés, Ana; Saldaña, Carmina; Beeken, Rebecca J.

2015-01-01

Objective The present study aimed to validate the English version of the Processes of Change questionnaire in weight management (P-Weight). Methods Participants were 1,087 UK adults, including people enrolled in a behavioural weight management programme, university students and an opportunistic sample. The mean age of the sample was 34.80 (SD = 13.56) years, and 83% were women. BMI ranged from 18.51 to 55.36 (mean = 25.92, SD = 6.26) kg/m2. Participants completed both the stages and processes questionnaires in weight management (S-Weight and P-Weight), and subscales from the EDI-2 and EAT-40. A refined version of the P-Weight consisting of 32 items was obtained based on the item analysis. Results The internal structure of the scale fitted a four-factor model, and statistically significant correlations with external measures supported the convergent validity of the scale. Conclusion The adequate psychometric properties of the P-Weight English version suggest that it could be a useful tool to tailor weight management interventions. PMID:25765163

Repository-Based Software Engineering Program: Working Program Management Plan

Science.gov (United States)

1993-01-01

Repository-Based Software Engineering Program (RBSE) is a National Aeronautics and Space Administration (NASA) sponsored program dedicated to introducing and supporting common, effective approaches to software engineering practices. The process of conceiving, designing, building, and maintaining software systems by using existing software assets that are stored in a specialized operational reuse library or repository, accessible to system designers, is the foundation of the program. In addition to operating a software repository, RBSE promotes (1) software engineering technology transfer, (2) academic and instructional support of reuse programs, (3) the use of common software engineering standards and practices, (4) software reuse technology research, and (5) interoperability between reuse libraries. This Program Management Plan (PMP) is intended to communicate program goals and objectives, describe major work areas, and define a management report and control process. This process will assist the Program Manager, University of Houston at Clear Lake (UHCL) in tracking work progress and describing major program activities to NASA management. The goal of this PMP is to make managing the RBSE program a relatively easy process that improves the work of all team members. The PMP describes work areas addressed and work efforts being accomplished by the program; however, it is not intended as a complete description of the program. Its focus is on providing management tools and management processes for monitoring, evaluating, and administering the program; and it includes schedules for charting milestones and deliveries of program products. The PMP was developed by soliciting and obtaining guidance from appropriate program participants, analyzing program management guidance, and reviewing related program management documents.

Attitudes to weight and weight management in the early teenage years: a qualitative study of parental perceptions and views.

Science.gov (United States)

Wills, Wendy J; Lawton, Julia

2015-10-01

As most young teenagers grow up in families, parents might be well situated to facilitate and support their weight management and thereby prevent or manage obesity prior to adulthood. This paper explores parents' perceptions of, and views about, their teenage children's weight and the factors that influence parents' weight management strategies. We conducted two qualitative studies in Scotland, UK, involving in-depth interviews with the parents of overweight/obese and 'normal' weight 13-15 year olds (n = 69). Parents' concerns about their own weight provided useful context for understanding their attitudes or actions with regards to their teenage child. Some parents described their teenager's weight as being of concern to them, although puberty often introduced confusion about a child's weight status. Genetic explanations were very often put forward as a way of making sense of teenage weight or body size. Frustration about advising teenagers about weight management was expressed, and some parents worried about giving their growing child a 'problem' if they directly raised concerns about weight with them. Parents' views about their own weight as well as social and moral norms about labelling a teenager as overweight or as needing help with their weight could usefully inform patient-centred service development. Parent/teenage partnerships and supporting parents to create a healthy home in which teenagers can make healthier choices are suggestions for intervention development. The study highlights the importance of taking parents' perceptions into account when developing family-based interventions to address teenage overweight and obesity. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

A work-site weight control program using financial incentives collected through payroll deduction.

Science.gov (United States)

Forster, J L; Jeffery, R W; Sullivan, S; Snell, M K

1985-11-01

In a work-site weight control program using a self-motivational program of financial incentives implemented through payroll deduction, 131 university employees chose weight loss goals (0 to 60 lb) and incentives (+5 to +30) to be deducted from each paycheck for six months. Return of incentive money was contingent on progress toward weight goals. Participants were assigned randomly to one of four protocols, involving group educational sessions v self-instruction only and required v optional attendance at weigh-ins and sessions. Overall, dropout rates (21.4%) and mean weight loss (12.2 lb) were encouraging, especially compared with those of other work-site programs. Weight loss was positively associated with attendance at weigh-ins and educational sessions. However, requiring attendance did not increase program effectiveness and seemed also to discourage enrollment among men. The weight control program was equally effective when offered with professionally led educational sessions or when accompanied by self-instructional materials only.

The role of social media in online weight management: systematic review.

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Chang, Tammy; Chopra, Vineet; Zhang, Catherine; Woolford, Susan J

2013-11-28

Social media applications are promising adjuncts to online weight management interventions through facilitating education, engagement, and peer support. However, the precise impact of social media on weight management is unclear. The objective of this study was to systematically describe the use and impact of social media in online weight management interventions. PubMed, PsycINFO, EMBASE, Web of Science, and Scopus were searched for English-language studies published through March 25, 2013. Additional studies were identified by searching bibliographies of electronically retrieved articles. Randomized controlled trials of online weight management interventions that included a social media component for individuals of all ages were selected. Studies were evaluated using 2 systematic scales to assess risk of bias and study quality. Of 517 citations identified, 20 studies met eligibility criteria. All study participants were adults. Because the included studies varied greatly in study design and reported outcomes, meta-analysis of interventions was not attempted. Although message boards and chat rooms were the most common social media component included, their effect on weight outcomes was not reported in most studies. Only one study measured the isolated effect of social media. It found greater engagement of participants, but no difference in weight-related outcomes. In all, 65% of studies were of high quality; 15% of studies were at low risk of bias. Despite the widespread use of social media, few studies have quantified the effect of social media in online weight management interventions; thus, its impact is still unknown. Although social media may play a role in retaining and engaging participants, studies that are designed to measure its effect are needed to understand whether and how social media may meaningfully improve weight management.

A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program.

Science.gov (United States)

Carpenter, Kelly M; Vickerman, Katrina A; Salmon, Erica E; Javitz, Harold S; Epel, Elissa S; Lovejoy, Jennifer C

2017-10-06

This study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.

How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study

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Senkowski, Valerie; Branscum, Paul

2015-01-01

Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight…

The Impact of Acculturation Level on Weight Status and Weight Outcomes in Hispanic Children.

Science.gov (United States)

Moreno, Jennette P; Vaughan, Elizabeth; Hernandez, Daphne; Cameron, Ryan T; Foreyt, John P; Johnston, Craig A

2016-12-01

Previous studies revealed that higher levels of acculturation are related to obesity in Hispanic adults. Conflicting findings exist regarding this relationship in children, and little is known about the impact of acculturation on children's success in pediatric weight management programs. The purposes of the study were to (1) examine the relationship between acculturation and overweight/obese weight status and (2) determine the impact of acculturation on the changes in weight status among overweight/obese children 12 and 24 months after having participated in a weight management intervention. This is a secondary analysis of aggregated data from three randomized control trials that occurred between 2005 and 2009. Height, weight, and level of acculturation using the Child Short Scale for Hispanics (C-SASH) were measured in a sample of Hispanic children (n = 559). Logistic regression models were used to study phase 1 (n = 559) and phase 2 (n = 142), controlling for child and family characteristics. Children reporting high levels of acculturation had a 52 % lower odds of being overweight or obese. Among overweight/obese children who participated in the intervention, high levels of acculturation demonstrated greater reductions in standardized body mass index (zBMI) at 24 months. The results of this study indicate a need to tailor weight management programs for Hispanic children who have lower levels of acculturation.

DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

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Constantin PREDA

2012-01-01

Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

Managing Weight: What Do People with an Intellectual Disability Want from Mobile Technology?

Science.gov (United States)

Smyth, Phil; McDowell, Claire; Leslie, Julian C; Leader, Geraldine; Donnelly, Mark; Simpson, Elizabeth; Skelly, Laura

2017-01-01

Obesity is a significant health challenge. People with Intellectual Disability (ID) are particularly vulnerable to developing obesity. Mobile technology has been developed to support the management of weight and obesity in the form of apps, although not with people with an ID in mind. As a result existing off-the-shelf weight management apps currently available may not be functional in supporting weight reduction within this population. This paper presents the results of consultations with people with ID regarding weight management, comfort with mobile technology and desired characteristics in apps designed for people with ID that target weight management.

[The effects of a weight control program with competence].

Science.gov (United States)

Seo, Yeong-Mi; Suh, Sun-Lim

2007-12-01

The purpose of this study was to identify the effects of a weight control program and compliancy in overweight women. This program was composed of strategies to modify diet and exercise and to change compliance and self determination over an 8 week period. The subjects were 19 overweight women who participated in our project voluntarily. Data was collected from May 4 to June 30 of 2007. The program consisted of regular rapid walking exercise, diet, mobile phone messages and e-mail. The data was analyzed by Repeated Measures ANOVA using the SPSS WIN program. According to 3 assessment periods, there were significant differences in body weight, body mass index, and compliance. There were no significant differences in self determination. These findings suggest that more intensive interventions may be needed to demonstrate a change in self determination.

Does the incorporation of portion-control strategies in a behavioral program improve weight loss in a 1-year randomized controlled trial?

Science.gov (United States)

Rolls, B J; Roe, L S; James, B L; Sanchez, C E

2017-03-01

Controlling food portion sizes can help reduce energy intake, but the effect of different portion-control methods on weight management is not known. In a 1-year randomized trial, we tested whether the efficacy of a behavioral weight-loss program was improved by incorporating either of the two portion-control strategies instead of standard advice about eating less. The Portion-Control Strategies Trial included 186 women with obesity (81%) or overweight (19%). Participants were randomly assigned to one of three equally intensive behavioral programs, consisting of 19 individual sessions over 12 months. The Standard Advice Group was instructed to eat less food while making healthy choices, the Portion Selection Group was instructed to choose portions based on the energy density using tools such as food scales and the Pre-portioned Foods Group was instructed to structure meals around pre-portioned foods such as single-serving main dishes, for which some vouchers were provided. In an intention-to-treat analysis, a mixed-effects model compared weight loss trajectories across 23 measurements; at month 12, weight was measured for 151 participants (81%). The trajectories showed that the Pre-portioned Foods Group initially lost weight at a greater rate than the other two groups (P=0.021), but subsequently regained weight at a greater rate (P=0.0005). As a result, weight loss did not differ significantly across groups at month 6 (mean±s.e. 5.2±0.4 kg) or month 12 (4.5±0.5 kg). After 1 year, measured weight loss averaged 6% of baseline weight. The frequency of using portion-control strategies initially differed across groups, then declined over time and converged at months 6 and 12. Incorporating instruction on portion-control strategies within a 1-year behavioral program did not lead to a greater weight loss than standard advice. Using pre-portioned foods enhanced early weight loss, but this was not sustained over time. Long-term maintenance of behavioral strategies to

Dutch general practitioners’ weight management policy for overweight and obese patients.

NARCIS (Netherlands)

Kloek, C.J.J.; Tol, J.; Veenhof, C.; Wulp, I. van der; Swinkels, I.C.S.

2014-01-01

Background: General practitioners (GPs) can play an important role in both the prevention and management of overweight and obesity. Current general practice guidelines in the Netherlands allow room for GPs to execute their own weight management policy. Objective: To examine GPs’ current weight

Effectiveness of workplace weight management interventions: a systematic review

Science.gov (United States)

Background: A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral and incentive based components. Main outcomes were defined as change in weight-related measures. Methods: Key w...

Obesity Prevention and Weight Maintenance After Loss.

Science.gov (United States)

German, Alexander James

2016-09-01

Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

Smoking status and sex as indicators of differences in 2582 obese patients presenting for weight management

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Abunassar MJ

2012-05-01

Full Text Available Michael J Abunassar1, George A Wells2, Robert R Dent31Faculty of Medicine, 2Heart Institute, University of Ottawa, Ottawa, Ontario, Canada; 3The Ottawa Hospital Weight Management Clinic, Ottawa, Ontario, CanadaBackground: Smoking remains the most common preventable cause of death. Very little tobacco exposure can increase cardiovascular disease risk. The relationship between smoking, sex, and weight remains unclear.Methods: Between September 1992 and June 2007, 2582 consenting patients starting the Ottawa Hospital Weight Management program were grouped by sex and smoking status. “Former smokers” (771 females, 312 males had quit for at least 1 year. “Smokers” (135 females, 54 males smoked >9 cigarettes daily. There were 979 females and 331 males who never smoked. Using SAS 9.2 statistical software, the prevalence of coronary artery disease (CAD, type 2 diabetes (T2DM, major depressive disorder (MDD, and medication use among the groups was compared (Chi-square [χ2]. Anthropometric measurements, lipid, glucose and thyroid levels were compared using analysis of variance (ANOVA. Interactions were assessed using 2-way ANOVA analysis for continuous data, and logistic regression for discrete data.Results: Smokers were more likely to have MDD (χ2, lower high-density lipoprotein levels and higher triglyceride levels than other groups. Former smokers had a greater prevalence of CAD, T2DM on pharmacotherapy, and impaired fasting glucose than other groups. They were also more likely to be taking lipid-lowering agents and antihypertensives (χ2. Never smokers had less MDD, CAD, and were less likely to be on antidepressants than the other groups. Males were more likely to have CAD and T2DM than females. Females were more likely to have MDD than males. Interactions between smoking status and sex were found for age, weight, fasting glucose and thyroid-stimulating hormone levels.Conclusion: Obese never smokers suffer from the fewest chronic diseases

Referrals for pediatric weight management: the importance of proximity

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Hagedorn Douglas WJ

2010-11-01

Full Text Available Abstract Background Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity. Methods All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada between April, 2005 and April, 2009. Results Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4 were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455 or beyond (distant; n = 100 the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children. Conclusion Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Knowledge management program

International Nuclear Information System (INIS)

Henderson, T.

2013-01-01

To capture and retain the CANDU experience from a wider CANDU base and transfer knowledge and experience to our members, supplier participants and universities in a cost effective manner. Major focus area of the program is knowledge management joint projects, generic training delivery, inter-utilities mentoring and technical support, public education programs. The path forward is execution of transition of OPG NPDS Program as an ongoing program in COG with member funding, pursue opportunities to provide member utilities with additional leadership and train-the-trainer training and grow the knowledge management activities by 20% per year based on 2013/2014 results.

Knowledge management program

Energy Technology Data Exchange (ETDEWEB)

Henderson, T. [CANDU Owners' Group, Toronto, Ontario (Canada)

2013-07-01

To capture and retain the CANDU experience from a wider CANDU base and transfer knowledge and experience to our members, supplier participants and universities in a cost effective manner. Major focus area of the program is knowledge management joint projects, generic training delivery, inter-utilities mentoring and technical support, public education programs. The path forward is execution of transition of OPG NPDS Program as an ongoing program in COG with member funding, pursue opportunities to provide member utilities with additional leadership and train-the-trainer training and grow the knowledge management activities by 20% per year based on 2013/2014 results.

Weighted curve-fitting program for the HP 67/97 calculator

International Nuclear Information System (INIS)

Stockli, M.P.

1983-01-01

The HP 67/97 calculator provides in its standard equipment a curve-fit program for linear, logarithmic, exponential and power functions that is quite useful and popular. However, in more sophisticated applications, proper weights for data are often essential. For this purpose a program package was created which is very similar to the standard curve-fit program but which includes the weights of the data for proper statistical analysis. This allows accurate calculation of the uncertainties of the fitted curve parameters as well as the uncertainties of interpolations or extrapolations, or optionally the uncertainties can be normalized with chi-square. The program is very versatile and allows one to perform quite difficult data analysis in a convenient way with the pocket calculator HP 67/97

The Impact of a School-Based Weight Management Program Involving Parents via mHealth for Overweight and Obese Children and Adolescents with Intellectual Disability: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Regina Lai-Tong Lee

2017-10-01

Full Text Available There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs extended from school to a home setting. To test the feasibility and acceptability of a school-based weight program (SBWMP involving parents via mHealth tools designed to reduce weight, enhance knowledge and adopt healthy lifestyles, and thereby achieve better psychosocial well-being among children and adolescents with MIDs. Four special schools were randomly assigned as intervention or control schools. Students from the intervention group (n = 63 were compared to those in the control group (n = 52, which comprised those with usual school planned activities and no parental involvement. Demographics were considered as covariates in a general linear model, an ordinal regression model and a binary logistic regression model analyzing the relationships between the SBWMP and the outcome variables at baseline (T0 and six months later (T1. Body weight, body mass index, and triceps and subscapular skinfold thickness were lower in the intervention group compared to the control group, although the differences were not statistically significant. There was a positive and direct impact of the SBWMP on students’ health knowledge and psychological impacts in the intervention group. The SBWMP extended to the home involving parents via mHealth tools is a feasible and acceptable program for this group with MIDs and their parents.

Risk Preferences, Probability Weighting, and Strategy Tradeoffs in Wildfire Management.

Science.gov (United States)

Hand, Michael S; Wibbenmeyer, Matthew J; Calkin, David E; Thompson, Matthew P

2015-10-01

Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to federal wildfire managers. Respondents were presented with a multiattribute lottery-choice experiment where each lottery is defined by three outcome attributes: expenditures for fire suppression, damage to private property, and exposure of firefighters to the risk of aviation-related fatalities. Respondents choose one of two strategies, each of which includes "good" (low cost/low damage) and "bad" (high cost/high damage) outcomes that occur with varying probabilities. The choice task also incorporates an information framing experiment to test whether information about fatality risk to firefighters alters managers' responses to risk. Results suggest that managers exhibit risk aversion and nonlinear probability weighting, which can result in choices that do not minimize expected expenditures, property damage, or firefighter exposure. Information framing tends to result in choices that reduce the risk of aviation fatalities, but exacerbates nonlinear probability weighting. © 2015 Society for Risk Analysis.

Management of Pregnant Women with Type 2 Diabetes Mellitus and the Consequences of Fetal Programming in Their Offspring.

Science.gov (United States)

Berry, Diane C; Boggess, Kim; Johnson, Quinetta B

2016-05-01

The obesity epidemic has fueled an epidemic of prediabetes and type 2 diabetes mellitus in women of childbearing age. This paper examines the state of the science on preconception and pregnancy management of women with type 2 diabetes to optimize outcomes for the women and their infants. In addition, the consequence of fetal programming as a result of suboptimal maternal glycemic control is discussed. The paper focuses on type 2 diabetes, not type 1 diabetes or gestational diabetes. Management of women with type 2 diabetes includes preconception counseling, preconception weight management and weight loss, proper weight gain during pregnancy, self-monitoring of blood glucose levels, medication, medical nutrition therapy, and exercise.

Smartphone applications to aid weight loss and management: current perspectives

Directory of Open Access Journals (Sweden)

Sutton EF

2016-07-01

Full Text Available Elizabeth F Sutton, Leanne M Redman Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA Abstract: The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. Keywords: smartphone, mobile phone, application, app, weight, weight loss, weight maintenance

Employee weight management through health coaching.

Science.gov (United States)

Merrill, R M; Aldana, S G; Bowden, D E

2010-01-01

This study will evaluate the effectiveness of an interactive health coaching intervention at lowering weight. The study involved 5405 overweight or obese employees aged 18-85, who entered the program sometime during 2001-2008. Average body mass index (BMI) significantly decreased from 32.1 at baseline to 31.4 at 3 months, 31.0 at 6 months, and 30.6 at 12 months. Decreasing BMI was more pronounced in older age groups and among women, those using weight loss medication, those with higher BMI, and those with higher motivation and confidence to make behavior changes. When the effects of these variables on the decreasing trend in BMI were simultaneously estimated, only baseline classifications of BMI, health status, and confidence remained significant. Change in BMI through 12 months was -0.7% for those with normal weight, -2.0% for overweight, -3.6% for obese, and -7.1% for morbidly obese individuals at baseline. Among morbidly obese individuals, decrease in BMI through 12 months was -7.6% for those with "high" confidence to lose weight at baseline vs -4.4% for those with low confidence. Better health status at baseline was also related to more pronounced weight loss. Interactive health coaching significantly lowered BMI among participants through 3, 6, and 12 months of follow-up.

Smartphone Usage, Social Media Engagement, and Willingness to Participate in mHealth Weight Management Research Among African American Women.

Science.gov (United States)

James, Delores C S; Harville, Cedric

2018-06-01

African American women (AAW) are in a unique position to be recruited into mobile (mHealth) weight management research and programs due to their high rates of obesity and their high ownership of smartphones. This study examined smartphone usage, social media engagement, and willingness to participate in mHealth weight management among AAW in north-central Florida, United States. A self-administered survey was completed by a convenience sample of 425 smartphone owners in north-central Florida. Mean age was 34.84 ± 13.74, with age distribution of 18 to 29 (45%), 30 to 50 (39%), and 51+ years (17%). Mean body mass index was 29.52 ± 8.18. Most used smartphones to access the Internet daily and were engaged with eight social media sites, such as Facebook (85%), YouTube (75%), and Google+ (57%). Compared to those 51+, those 18 to 29 were more likely to use YouTube (odds ratio [OR] = 2.52, p = .017) and Instagram (OR = 10.90, p smartphone apps (68%). Compared to those 51+, women 18 to 29 were more likely to report willingness to use a smartphone app (OR = 5.45, p smartphones, use of mHealth apps and tools, and willingness to participate in mHealth research has the potential to curb the obesity epidemic by participating in mHealth weight management programs and research.

Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study.

Science.gov (United States)

Prout Parks, Elizabeth; Moore, Reneé H; Li, Ziyi; Bishop-Gilyard, Chanelle T; Garrett, Andrew R; Hill, Douglas L; Bruton, Yasmeen P; Sarwer, David B

2018-03-19

Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or "posts" 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at

Effectiveness of a CD-ROM Nutrient Analysis Program on Self-Monitoring Behavior of Active Duty Military Personnel Receiving Nutrition Counseling for Weight Loss

National Research Council Canada - National Science Library

Heetderks-Cox, Jane

1999-01-01

..., restriction from duty-related travel, and even discharge from military service. Less than 3% of total Air Force active duty population are placed on the punitive Active Duty Mandatory Weight Management Program...

Space program management methods and tools

CERN Document Server

Spagnulo, Marcello; Balduccini, Mauro; Nasini, Federico

2013-01-01

Beginning with the basic elements that differentiate space programs from other management challenges, Space Program Management explains through theory and example of real programs from around the world, the philosophical and technical tools needed to successfully manage large, technically complex space programs both in the government and commercial environment. Chapters address both systems and configuration management, the management of risk, estimation, measurement and control of both funding and the program schedule, and the structure of the aerospace industry worldwide.

A three-component cognitive behavioural lifestyle program for preconceptional weight-loss in women with polycystic ovary syndrome (PCOS): A protocol for a randomized controlled trial

OpenAIRE

Jiskoot, Geranne; Benneheij, Sofie; Beerthuizen, Annemerle; Niet, J.E.; Klerk, Cora; Timman, Reinier; Busschbach, Jan; Laven, Joop

2017-01-01

textabstractBackground: Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing dysfunctional thought patterns in women with PCOS are key points in losing weight. The biggest challenge in weight management programs is to achieve a reasonable and sustainable weight loss. The ai...

Facilitating Factors and Barriers to Weight Management in Women: Physician Perspectives

Directory of Open Access Journals (Sweden)

Renee E. Walker

2018-01-01

Full Text Available Purpose: The complexity of addressing overweight and obesity in women has been an ongoing public health and health care challenge. While the mechanism for addressing overweight and obesity in women remains unclear, it has been speculated that disparities in overweight and obesity by race and gender contribute to the complexity. The purpose of the present study was to examine perceptions of primary care physicians when discussing weight management with their patients. Methods: We conducted focus group discussions exploring facilitators and barriers to discussing weight management and weight loss among women patients. Participants included 18 family medicine and internal medicine physicians who were recruited using a snowball sampling technique from two large urban institutions. Focus group discussions were transcribed verbatim. Responses were then codified and analyzed in frequency of occurrence using specialized computer software. Results: Nine themes emerged from group discussions. These recurring themes reflected three overarching critical points: 1 potential utility of the primary care setting to address weight management; 2 the importance of positive patient-provider communication in supporting weight loss efforts; and 3 acknowledgement of motivation as intrinsic or extrinsic, and its role in obesity treatment. Conclusions: Physician perceptions of their own lack of education or training and their inability to influence patient behaviors play crucial roles in discussing weight management with patients.

Decisions about weight management: a synthesis of qualitative studies of obesity.

Science.gov (United States)

Brown, I; Gould, J

2011-04-01

There is a high non-attendance and dropout attrition from weight management interventions for adults with obesity. Patient dissatisfaction with consultations involving decisions about interventions may be a factor. A systematic review was undertaken of qualitative studies reporting perceptions, experiences, contexts and influences for adults facing, or reflecting on, weight management. The aim was to synthesize a generic model of influences on decision-making about weight management for adult patients. Electronic database and hand searches identified 29 qualitative studies involving 1387 participants (mean age 45.3 years; mean BMI 37.1 kg m(-2) ; 79.9% women). Seven overarching themes were inductively derived from extracted data spanning: cultural identity; social structures such as gender; responses to obesity stigma; previous weight loss experiences; personal motivators and barriers; social support; and practical resources. A model is presented in the paper. Improving decisions about weight management requires attention to how diffuse cultural and psycho-social factors, such as obesity stigma, influence patient choices. Reflection on experiences of previous attempts at weight loss is also essential, as are practical resource factors - particularly for less affluent groups. Considering these factors along with more established theories of individual psychological motivations and barriers may help to improve initial participation and retention within interventions. © 2011 The Authors. Clinical Obesity © 2011 International Association for the Study of Obesity.

Choosing a Safe and Successful Weight-Loss Program

Science.gov (United States)

... getting enough sleep, changes in work schedules, lack of motivation, and injury or illness? Is the program in ... physical activity, behavior change, and weight loss? What type of certifications, education, experience, and training do staff members ...

Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

Science.gov (United States)

Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

2014-01-01

With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

Health promotion and disease prevention: a look at demand management programs.

Science.gov (United States)

Fronstin, P

1996-09-01

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health

76 FR 39857 - Alaska Coastal Management Program Withdrawal From the National Coastal Management Program Under...

Science.gov (United States)

2011-07-07

... DEPARTMENT OF COMMERCE National Oceanic Atmospheric Administration Alaska Coastal Management Program Withdrawal From the National Coastal Management Program Under the Coastal Zone Management Act (CZMA) AGENCY: Office of Ocean and Coastal Resource Management (OCRM), National Ocean Service (NOS...

FLUOR HANFORD SAFETY MANAGEMENT PROGRAMS

Energy Technology Data Exchange (ETDEWEB)

GARVIN, L. J.; JENSEN, M. A.

2004-04-13

This document summarizes safety management programs used within the scope of the ''Project Hanford Management Contract''. The document has been developed to meet the format and content requirements of DOE-STD-3009-94, ''Preparation Guide for US. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses''. This document provides summary descriptions of Fluor Hanford safety management programs, which Fluor Hanford nuclear facilities may reference and incorporate into their safety basis when producing facility- or activity-specific documented safety analyses (DSA). Facility- or activity-specific DSAs will identify any variances to the safety management programs described in this document and any specific attributes of these safety management programs that are important for controlling potentially hazardous conditions. In addition, facility- or activity-specific DSAs may identify unique additions to the safety management programs that are needed to control potentially hazardous conditions.

Body Mass Index Self-Perception and Weight Management Behaviors during Late Adolescence

Science.gov (United States)

Yang, Kyeongra; Turk, Melanie T.; Allison, Virginia L.; James, Khara A.; Chasens, Eileen

2014-01-01

Background: This study examined the relationship between actual body weight and self-perceived weight, and how perception of one's weight affects weight management behaviors among US adolescents. Methods: Adolescents ages 16-19 years with objectively-measured weight and height and self-reported perception of weight, weight-loss efforts, and…

Effectiveness of a Low-Calorie Weight Loss Program in Moderately and Severely Obese Patients

Directory of Open Access Journals (Sweden)

Julia K. Winkler

2013-10-01

Full Text Available Aims: To compare effectiveness of a 1-year weight loss program in moderately and severely obese patients. Methods: The study sample included 311 obese patients participating in a weight loss program, which comprised a 12-week weight reduction phase (low-calorie formula diet and a 40-week weight maintenance phase. Body weight and glucose and lipid values were determined at the beginning of the program as well as after the weight reduction and the weight maintenance phase. Participants were analyzed according to their BMI class at baseline (30-34.9 kg/m2; 35-39.9 kg/m2; 40-44.9 kg/m2; 45-49.9 kg/m2; ≥50 kg/m2. Furthermore, moderately obese patients (BMI 2 were compared to severely obese participants (BMI ≥ 40 kg/m2. Results: Out of 311 participants, 217 individuals completed the program. Their mean baseline BMI was 41.8 ± 0.5 kg/m2. Average weight loss was 17.9 ± 0.6%, resulting in a BMI of 34.3 ± 0.4 kg/m2 after 1 year (p Conclusion: 1-year weight loss intervention improves body weight as well as lipid and glucose metabolism not only in moderately, but also in severely obese individuals.

Consumer preferences in format and type of community-based weight control programs.

Science.gov (United States)

Sherwood, N E; Morton, N; Jeffery, R W; French, S A; Neumark-Sztainer, D; Falkner, N H

1998-01-01

The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. The study was conducted at a university and three local health department sites. Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain. The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offering ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offering attracted health-conscious participants with higher education and income levels. These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.

14 CFR 91.1003 - Management contract between owner and program manager.

Science.gov (United States)

2010-01-01

... program manager. 91.1003 Section 91.1003 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... RULES Fractional Ownership Operations § 91.1003 Management contract between owner and program manager. Each owner must have a contract with the program manager that— (a) Requires the program manager to...

Permissive flexibility in successful lifelong weight management: A qualitative study among Finnish men and women.

Science.gov (United States)

Joki, Anu; Mäkelä, Johanna; Fogelholm, Mikael

2017-09-01

Maintaining normal weight in the current obesogenic environment is a challenge. However, some people can do it. More insight is needed to understand how and why some people succeed in long-term weight maintenance. This study uses a rare, qualitative approach by describing the thoughts of successful weight management and self-perceived requirements for success in weight maintenance. We interviewed 39 individuals who have maintained normal weight for their entire lives (men and women). The content analysis revealed a main theme: flexible, permissive and conscious self-regulation, which was divided into two subthemes (eating-related behavior and weight-related behavior). The informants reported certain routines that supported their weight management: regular eating, sufficient meal sizes, eating in response to hunger, healthy and vegetable-rich diet along with moderate feasting and flexible eating restriction. Flexibility in routines allowed freedom in their eating behavior. In addition, informants regarded themselves as physically active, and they enjoyed regular exercise. Regular weighing was generally considered unnecessary. Normal weight was regarded as a valuable and worthwhile issue, and most of the informants worked to keep their weight stable. Although the perceived workload varied among informants, the weight management strategies were similar. It was crucial to be conscious of the balance between eating and energy consumption. Further, flexibility characterized their behavior and was the basis of successful weight management. Women were more aware of weight control practices and knowledge than men, but otherwise, women and men reported similar weight management methods and attitudes. In conclusion, the interviewees who have maintained the normal weight had created a personal weight-management support environment where weight management was a lifestyle. Copyright © 2017 Elsevier Ltd. All rights reserved.

Discrepancies in Communication Versus Documentation of Weight-Management Benchmarks

Directory of Open Access Journals (Sweden)

Christy B. Turer MD, MHS

2017-02-01

Full Text Available To examine gaps in communication versus documentation of weight-management clinical practices, communication was recorded during primary care visits with 6- to 12-year-old overweight/obese Latino children. Communication/documentation content was coded by 3 reviewers using communication transcripts and health-record documentation. Discrepancies in communication/documentation content codes were resolved through consensus. Bivariate/multivariable analyses examined factors associated with discrepancies in benchmark communication/documentation. Benchmarks were neither communicated nor documented in up to 42% of visits, and communicated but not documented or documented but not communicated in up to 20% of visits. Lowest benchmark performance rates were for laboratory studies (35% and nutrition/weight-management referrals (42%. In multivariable analysis, overweight (vs obesity was associated with 1.6 more discrepancies in communication versus documentation (P = .03. Many weight-management benchmarks are not met, not documented, or performed without being communicated. Enhanced communication with families and documentation in health records may promote lifestyle changes in overweight children and higher quality care for overweight children in primary care.

Behavior Modification for Obesity: The Evaluation of Exercise, Contingency Management, and Program Adherence.

Science.gov (United States)

And Others; Stalonas, Peter M., Jr.

1978-01-01

Investigated behavioral programs for obesity. Exercise and self-managed contingency components were compared using obese subjects who were evaluated after treatment and follow-up. Significant weight loss was observed at termination. The influence of exercise at follow-up was noticeable. Subjects engaged in behaviors, yet behaviors were not related…

Surplus Facilities Management Program

International Nuclear Information System (INIS)

Coobs, J.H.

1983-01-01

This is the second of two programs that are concerned with the management of surplus facilities. The facilities in this program are those related to commercial activities, which include the three surplus experimental and test reactors [(MSRE, HRE-2, and the Low Intensity Test Reactor (LITR)] and seven experimental loops at the ORR. The program is an integral part of the Surplus Facilities Management Program, which is a national program administered for DOE by the Richland Operations Office. Very briefly reported here are routine surveillance and maintenance of surplus radioactively contaminated DOE facilities awaiting decommissioning

Enhancing the role of nutrition professionals in weight management: A cross-sectional survey.

Science.gov (United States)

Bleich, Sara N; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A; Gudzune, Kimberly A

2015-02-01

(1) To determine the nonphysician health profession perceived as best qualified to provide weight management. (2) To examine nutrition professionals' current practice characteristics and perceived challenges and solutions for obesity care. (3) To examine the association between nutrition professionals' quality of training and self-efficacy in weight management. A 2014 national cross-sectional online survey of 500 U.S. nonphysician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy) was analyzed. Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high-quality training in weight loss counseling. Nutrition professionals who reported high-quality training were significantly more likely to report confidence (95% vs. 48%) and success (74 vs. 50%) in helping obese patients lose weight (Pweight management counseling to obese patients. Yet nutrition professionals' receipt of high-quality weight management training appears critical to their success in helping patients lose weight. © 2014 The Obesity Society.

Weight management in obese pets: the tailoring concept and how it can improve results.

Science.gov (United States)

German, Alexander J

2016-10-20

Obesity is now recognised as the most important medical disease in pets worldwide. All current strategies for weight management involve dietary energy restriction with a purpose-formulated diet. Whilst current weight management regimes can be successful, outcomes are often disappointing with the rate of weight loss progressively slowing down as time goes on. Success is most challenging for the most obese dogs and cats that are more likely to discontinue the programme before reaching target weight. To improve outcomes, clinicians must focus carefully on better tailoring programmes, paying particular to setting an appropriate target weight so as to maximise the benefits for the individual. In this opinionated review, the author will discuss findings from recent clinical research studies examining weight management in obese dogs and cats. A strategy for tailoring weight management targets will then be discussed, illustrated with case examples.

Training chiropractic students in weight management counseling using standardized patients.

Science.gov (United States)

Hawk, Cheryl; Ramcharan, Michael; Kruger, Carla LeRiche

2017-03-01

The aim of this study was to describe and assess an activity that trained chiropractic students to counsel patients on weight management through the use of standardized patients. This was a descriptive study using mixed methods. Students were trained to apply health behavior theory and the transtheoretical model. Standardized patients were given a case to portray with the students. Students had 15 minutes for the encounter. The encounters were assessed in 2 ways: (1) standardized patients answered a brief questionnaire about the students' performance, and (2) students answered a questionnaire about the utility of the intervention. Numerical data were extracted from the audiovisual management platform, and statistics were computed for each question. Comments made by students and patients were transferred verbatim for content analysis. A total of 102 students took part in the activity. Students' performance in the encounter was uniformly high, with over 90% "yes" responses to all questions except "gave me printed information material" and "discussed the printed material with me." The key issue identified in the comments by standardized patients was that students tended not to connect weight management with their chief complaint (low back pain). Nearly all students (97%) thought the activity would be useful to their future practice, and 97% felt it had increased their confidence in providing weight management counseling. This experiential activity was assessed to be useful to students' future practice and appeared to provide them with skills to successfully communicate with patients on weight management.

Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

Science.gov (United States)

Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

2016-09-01

Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt

Missing an opportunity: the embedded nature of weight management in primary care.

Science.gov (United States)

Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D

2015-12-01

The 5As Team study was designed to create, implement and evaluate a flexible intervention to improve the quality and quantity of weight management visits in primary care. The objective of this portion of the study was to explore how primary care providers incorporate weight management in their practice. 5AsT is a randomized controlled trial (RCT) on the implementation of a 6-month 5 As Team (5AsT) intervention designed to operationalize the 5As of obesity management in primary care. Data for the qualitative portion of the study presented here included semi-structured interviews with 29 multidisciplinary team providers and field notes of intervention sessions. Thematic analysis was undertaken. A key pattern that emerged from the data was that healthcare providers usually do not address obesity as a primary focus for a visit. Rather, obesity is embedded in a wide range of primary care encounters for other conditions. Implications were it can take extra time to discuss weight, it can be inappropriate to bring up weight as a topic, and treating risk factors and root causes of obesity have indirect benefits to patient weight management. Our findings have implications for obesity treatment approaches and tools that assume a discreet weight management visit. The embedded nature of obesity management in primary care can be harnessed to leverage multiple opportunities for asking and assessing root causes of obesity, and working longitudinally towards individual health goals. © 2015 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity.

Functional foods for weight management: Dietary Fiber – a systematic review

Directory of Open Access Journals (Sweden)

Mona Boaz

2013-04-01

Full Text Available ABSTRACTIt has been estimated that more than 1.5 billion adults are overweight or obese worldwide [1], rendering obesity a global epidemic [2]. Obesity is associated with significant morbidity, including type 2 diabetes, cardiovascular disease, osteoarthritis and some cancers [3]. Thus, obesity is clearly a medical issue, its costs impacting heavily on health care systems in both developed and developing nations [4]. The combined impact of transmissible and chronic disease in the third world is particularly devastating to the very health care systems with fewest resources [5].Because obesity has been identified as a major health issue, treating obesity is an important goal. However, weight loss management has proven notoriously difficult. It is well documented that reduced energy intake and increased energy expenditure may reduce body weight in the short term, but obesity relapse is the long term is anticipated [6]. In a study of overweight or obese US adults who weighed ≥ 10% less than their maximum body weight the year prior to the survey (n=1310, 33.5% regained > 5% during that year [7].Despite its somewhat unimpressive success rate, "lifestyle" weight management remains the first line intervention for obesity treatment [8]. Lifestyle weight management can be defined as interventions based on energy restriction (weight loss diet; increased energy output (exercise; and/or behavioral change (cognitive or behavior therapy. Functional foods have been explored as a tool for enhancing lifestyle weight management.Functional foods evaluated for their efficacy as obesity interventions can be divided into two broad categories: 1 foods which suppress appetite and increase satiety; and 2 foods which enhance thermogenesis. The present review will focus on those foods thought to act by increasing satiety and suppressing appetite.Key words: Obesity, weight loss, systematic review, dietary fiber

Weight satisfaction, management strategies and health beliefs in knee osteoarthritis patients attending an outpatient clinic.

Science.gov (United States)

Ekram, A R M S; Cicuttini, F M; Teichtahl, A J; Crammond, B R; Lombard, C B; Liew, S M; Urquhart, D M; Wluka, A E

2016-04-01

Although weight control is important in managing knee osteoarthritis (OA), it is difficult to achieve. Understanding beliefs regarding weight management in people with knee OA may improve weight control. To examine differences in bodyweight satisfaction, weight management strategies and weight-related health-beliefs in obese, overweight and normal weight people with knee OA. The beliefs and attitudes to weight in 102 people with symptomatic knee OA were ascertained. Participants were classified as being obese, overweight or of normal weight. Although obese and overweight participants were less satisfied with their bodyweight, they were more likely to want to lose weight and to report dieting compared with normal weight participants(P weight gain in the past 6 months (P weight participants (P = 0.04). When asked about their own weight gain, obese participants more frequently believed genetic and metabolic factors to be important than normal and overweight participants (P = 0.01). While 51 (53%) believed that increasing activity was more important than dietary change to avoid weight gain, this was more commonly believed by obese and overweight participants (P weight, obese people with symptomatic knee OA more commonly reported weight gain. Overweight and obese participants attributed weight gain to non-modifiable factors but believed physical activity is more important than dietary change in weight management. Thus, education regarding the importance of diet as compared with non-modifiable factors and physical activity may improve weight management in obese people with knee OA. © 2016 Royal Australasian College of Physicians.

Obesity Prevention Interventions in US Public Schools: Are Schools Using Programs That Promote Weight Stigma?

Science.gov (United States)

Kenney, Erica L; Wintner, Suzanne; Lee, Rebekka M; Austin, S Bryn

2017-12-28

Despite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors. In spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses. Slightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students' or staff members' weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making. Evidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

Directory of Open Access Journals (Sweden)

Jennifer K. Cheng

2014-01-01

Full Text Available Objective. To examine body mass index (BMI changes among pediatric multidisciplinary weight management participants and nonparticipants. Design. In this retrospective database analysis, we used multivariable mixed effect models to compare 2-year BMI z-score trajectories among 583 eligible overweight or obese children referred to the One Step Ahead program at the Boston Children’s Primary Care Center between 2003 and 2009. Results. Of the referred children, 338 (58% attended the program; 245 (42% did not participate and were instead followed by their primary care providers within the group practice. The mean BMI z-score of program participants decreased modestly over a 2-year period and was lower than that of nonparticipants. The group-level difference in the rate of change in BMI z-score between participants and nonparticipants was statistically significant for 0–6 months (P=0.001 and 19–24 months (P=0.008; it was marginally significant for 13–18 months (P=0.051 after referral. Younger participants (<5 years had better outcomes across all time periods examined. Conclusion. Children attending a multidisciplinary program experienced greater BMI z-score reductions compared with usual primary care in a real world practice; younger participants had significantly better outcomes. Future research should consider early intervention and cost-effectiveness analyses.

Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters

Directory of Open Access Journals (Sweden)

Marjanne Senekal

2016-09-01

Full Text Available Abstract Background Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Methods Two hundred and fifty female students from South Africa universities, aged 18–25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters and 88 were non-dieters. Weight and height were measured and BMI (kg/m2 computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data. Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m2 were identified using regression models. Results Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students, dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased

What is the role of portion control in weight management?

Science.gov (United States)

Rolls, B J

2014-01-01

Systematic studies have shown that providing individuals with larger portions of foods and beverages leads to substantial increases in energy intake. The effect is sustained over weeks, supporting the possibility that large portions have a role in the development of obesity. The challenge is to find strategies to effectively manage the effects of portion size. One approach involves teaching people to select appropriate portions and to use tools that facilitate portion control. Although tools such as portion-control plates have been shown in several randomized trials to improve weight loss, limited data are available on whether education and tools lead to long-term changes in eating behavior and body weight. Another approach is to use preportioned foods (PPFs) to add structure to meals and minimize decisions about the amount of food to eat. A number of randomized controlled trials have demonstrated the efficacy of both liquid meal replacements and solid PPFs for weight loss and weight loss maintenance, but it is not known if they lead to better understanding of appropriate portions. Although portion control is important for weight management, urging people simply to ‘eat less' of all foods may not be the best approach as high-energy-dense foods disproportionately increase energy intake compared with those lower in energy density. A more effective strategy may be to encourage people to increase the proportion of foods low in energy density in their diets while limiting portions of high-energy-dense foods. If people lower the energy density of their diet, they can eat satisfying portions while managing their body weight. PMID:25033958

Validity of claims made in weight management research: a narrative review of dietetic articles

Directory of Open Access Journals (Sweden)

Aphramor Lucy

2010-07-01

Full Text Available Abstract Background The best available evidence demonstrates that conventional weight management has a high long-term failure rate. The ethical implications of continued reliance on an energy deficit approach to weight management are under-explored. Methods A narrative literature review of journal articles in The Journal of Human Nutrition and Dietetics from 2004 to 2008. Results Although the energy deficit approach to weight management has a high long-term failure rate it continues to dominate research in the field. In the current research agenda, controversies and complexities in the evidence base are inadequately discussed, and claims about the likely success of weight management misrepresent available evidence. Conclusions Dietetic literature on weight management fails to meet the standards of evidence based medicine. Research in the field is characterised by speculative claims that fail to accurately represent the available data. There is a corresponding lack of debate on the ethical implications of continuing to promote ineffective treatment regimes and little research into alternative non-weight centred approaches. An alternative health at every size approach is recommended.

14 CFR 1214.1706 - Program management.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Program management. 1214.1706 Section 1214... Participants § 1214.1706 Program management. The Associate Administrator for Space Flight is responsible for program management under the direction of the Committee chairperson. ...

Effects of a 12-week, school-based obesity management program on obese primary school children

Directory of Open Access Journals (Sweden)

Han Gyu Kim

2010-03-01

Full Text Available Purpose:This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods:A total of 995 children (6&#8211;12 years old in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI ?#249;5 percentile were enrolled for a study group. The school- based, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP, and bioelectrical impedance analysis (BIA was performed before and after the program. Results:Height and weight increased significantly (P&lt;0.05. The BMI and obesity index decreased significantly (P&lt;0.01. Systolic and diastolic BP decreased significantly (P&lt;0.01. BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR increased significantly on the BIA (P&lt;0.01. Fat decreased significantly (P&lt;0.05. The total body water (TBW and percent body fat (PBF decreased significantly (P&lt;0.01. The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P&lt;0.05. In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P&lt;0.01. Conclusion:The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

The relationship between prevalence and duration of weight loss strategies and weight loss among overweight managed care organization members enrolled in a weight loss trial

Directory of Open Access Journals (Sweden)

Jeffery Robert W

2006-02-01

Full Text Available Abstract Background Many adults in the United States report engaging in weight loss behaviors. The current study examined weight loss strategies among managed care organization members, to determine the prevalence and impact of weight loss behaviors in this population. We hypothesized that greater engagement in weight loss strategies would be associated with greater weight loss success. Methods Data were taken from Weigh-to-Be (WTB, a two-year weight loss trial (N = 1801, 72% female, mean age = 50.7 years, mean weight = 95.9 kg, mean BMI = 34.2 kg/m2. Every six months, participants completed a questionnaire assessing frequency and duration of weight loss strategies (calorie reduction, fat reduction, increased fruit/vegetable intake, increased exercise, elimination of sweets, consumption of less food. General linear models and structural equation methods were used to examine associations between weight loss strategy use and weight change over time. Results Weight loss strategy prevalence rates ranged from 68% to 76% over two years. For all dietary strategies, any use of the strategy between baseline and 24 months was associated with weight loss at 24 months; those who did not engage in the strategy showed weight gains during that period. Results of general linear models and structural equation models indicated that increased use of weight loss strategies was significantly associated with greater 24-month weight loss. Conclusion The prevalence of weight loss strategies in this obese adult managed care population was quite high, and use of these strategies was associated in dose-response fashion with better weight loss. Future interventions may benefit from emphasis on persistence of similar strategies to achieve more successful outcomes.

Communicating Risk to Program Managers

Science.gov (United States)

Shivers, C. Herbert

2005-01-01

Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

Risk preferences, probability weighting, and strategy tradeoffs in wildfire management

Science.gov (United States)

Michael S. Hand; Matthew J. Wibbenmeyer; Dave Calkin; Matthew P. Thompson

2015-01-01

Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to...

Weight maintenance through behaviour modification with a cooking course or neurolinguistic programming.

Science.gov (United States)

Sørensen, Lone Brinkmann; Greve, Tine; Kreutzer, Martin; Pedersen, Ulla; Nielsen, Claus Meyer; Toubro, Søren; Astrup, Arne

2011-01-01

We compared the effect on weight regain of behaviour modification consisting of either a gourmet cooking course or neurolinguistic programming (NLP) therapy. Fifty-six overweight and obese subjects participated. The first step was a 12-week weight loss program. Participants achieving at least 8% weight loss were randomized to five months of either NLP therapy or a course in gourmet cooking. Follow-up occurred after two and three years. Forty-nine participants lost at least 8% of their initial body weight and were randomized to the next step. The NLP group lost an additional 1.8 kg and the cooking group lost 0.2 kg during the five months of weight maintenance (NS). The dropout rate in the cooking group was 4%, compared with 26% in the NLP group (p=0.04). There was no difference in weight maintenance after two and three years of follow-up. In conclusion, weight loss in overweight and obese participants was maintained equally efficiently with a healthy cooking course or NLP therapy, but the dropout rate was lower during the active cooking treatment.

Quality Management Program

International Nuclear Information System (INIS)

1991-10-01

According to section 35.32, ''Quality Management Program,'' of 10 CFR Part 35, ''Medical Use of Byproduct Material,'' applicants or licensees, as applicable, are required to establish a quality management (QM) program. This regulatory guide provides guidance to licensees and applicants for developing policies and procedures for the QM program. This guide does not restrict or limit the licensee from using other guidance that may be equally useful in developing a QM program, e.g., information available from the Joint Commission on Accreditation of Healthcare Organizations or the American College of Radiology. Any information collection activities mentioned in this regulatory guide are contained as requirements in 10 CFR Part 35, which provides the regulatory basis for this guide. This information collection requirements in 10 CFR Part 35 have been cleared under OMB Clearance No. 3150-0010

10 CFR 800.002 - Program management.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Program management. 800.002 Section 800.002 Energy DEPARTMENT OF ENERGY LOANS FOR BID OR PROPOSAL PREPARATION BY MINORITY BUSINESS ENTERPRISES SEEKING DOE CONTRACTS AND ASSISTANCE General § 800.002 Program management. Program management responsibility for...

30 CFR 401.12 - Program management.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Program management. 401.12 Section 401.12 Mineral Resources GEOLOGICAL SURVEY, DEPARTMENT OF THE INTERIOR STATE WATER RESEARCH INSTITUTE PROGRAM Application and Management Procedures § 401.12 Program management. (a) Upon approval of each fiscal year's...

30 CFR 402.13 - Program management.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Program management. 402.13 Section 402.13... WATER-RESOURCES TECHNOLOGY DEVELOPMENT PROGRAM Application, Evaluation, and Management Procedures § 402.13 Program management. (a) After the conclusion of negotiations, the USGS will transmit a grant or...

Mindfulness-Based Interventions for Weight Loss and CVD Risk Management

Science.gov (United States)

Fulwiler, Carl; Brewer, Judson A.; Sinnott, Sinead; Loucks, Eric B.

2017-01-01

Obesity affects more than one-third of U.S. adults and is a major cause of preventable morbidity and mortality, primarily from cardiovascular disease. Traditional behavioral interventions for weight loss typically focus on diet and exercise habits and often give little attention to the role of stress and emotions in the initiation and maintenance of unhealthy behaviors, which may account for their modest results and considerable variability in outcomes. Stress eating and emotional eating are increasingly recognized as important targets of weight loss interventions. Mindfulness-based interventions were specifically developed to promote greater self-efficacy in coping with stress and negative emotions, and appear to be effective for a variety of conditions. In recent years researchers have begun to study mindfulness interventions for weight loss and CVD risk management. This review describes the rationale for the use of mindfulness in interventions for weight loss and CVD risk management, summarizes the research to date, and suggests priorities for future research. PMID:28405260

Influence of body weight, age and management system on ...

African Journals Online (AJOL)

The effect of doe age, body weight and different management systems, as practiced in various Angora goat studs, on reproductive performance of does was investigated. The data used were collected from 2000 to 2004 on 12 Angora goat studs kept under different management systems. The data set analysed for this study ...

High Molecular Weight Polymers in the New Chemicals Program

Science.gov (United States)

There are three categories or types of High Molecular Weight (HMW, 10,000 daltons) polymers typically reviewed by the New Chemicals Program: Soluble, insoluble, and water absorbing. Each of the three types are treated differently.

20 CFR 638.800 - Program management.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program management. 638.800 Section 638.800... TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.800 Program management. (a) The Job Corps Director shall establish and use internal program management procedures sufficient...

Environmental Restoration Program Management Control Plan

International Nuclear Information System (INIS)

1991-09-01

This Management Control Plan has been prepared to define the Energy Systems approach to managing its participation in the US DOE's Environmental Restoration (ER) Program in a manner consistent with DOE/ORO 931: Management Plan for the DOE Field Office, Oak Ridge, Decontamination and Decommissioning Program; and the Energy Systems Environmental Restoration Contract Management Plan (CMP). This plan discusses the systems, procedures, methodology, and controls to be used by the program management team to attain these objectives

Virtual worlds as a tool to facilitate weight management for young people.

Science.gov (United States)

Taylor, Michael; Taylor, Dave; Kulendran, Myutan; Gately, Paul; Darzi, Ara

Childhood obesity is a serious problem in the UK, with around 20% of children aged 10-11 being overweight or obese. Lifestyle interventions can be effective, but there is limited evidence of their effectiveness in delivering sustained weight loss. The present research explored potential of web-based, 3-dimensional virtual worlds (VWs) for facilitation of weight-management, well-being and patient and public involvement (PPI) for young people. Attendees of a weight management camp took part in induction sessions for use of the VW of Second Life. All participants successfully learned how to interact with one another and navigate the virtual environment. Participant appraisals of Second Life were varied. Some found it complicated and difficult to use, and some found it fun and the majority stated that they would choose to use VWs again. There is considerable potential for use of VWs to promote weight management, and Second Life or a similar VW could be used to deliver this. Potential barriers include members of the target sample having limited access to computers with necessary system requirements for running VWs, and that some may find VW-based educational experiences unappealing or challenging to navigate. For some however, VWs may provide a useful mode for provision of education, PPI and support relating to weight management.

The NASA risk management program

International Nuclear Information System (INIS)

Buchbinder, B.; Philipson, L.L.

1989-01-01

This paper reports that the NASA Risk Management Program has been established to ensure the appropriate application of risk-based procedures in support of the elimination, reduction, or acceptance of significant safety risks of concern in NASA. The term appropriate is emphasized, in that the particular procedures applied to each given risk are to reflect its character and prioritized importance, the technological and economic feasibility of its treatment. A number of key documents have been produced in support of this implementation. Databases, risk analysis tools, and risk communication procedures requisite to the execution of the risk management functions also are being developed or documented. Several risk management applications have been made and a comprehensive application to a major new NASA program is underway. This paper summarizes the development and current status of the NASA Risk Management Program. Some principal actions that have been carried out in NASA in consonance with the program are noted particularly, and views are presented on the program's likely future directions

An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

Science.gov (United States)

Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

2015-01-01

To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

Influence of weight status on physical and mental health in ...

African Journals Online (AJOL)

Conclusion: Cardiovascular and lipid profile and fitness, important indicators of cardiovascular disease risk, worsened as weight status increased, whereas quality of life appears to be independent of weight status. Exercise and nutritional programs focus on weight management may be advisable in this under studied ...

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

Science.gov (United States)

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2014-08-01

Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

Science.gov (United States)

Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

2012-01-01

Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

Mediation of Weight Loss and Weight Loss Maintenance through Dietary Disinhibition and Restraint.

Science.gov (United States)

JaKa, Meghan M; Sherwood, Nancy E; Flatt, Shirley W; Pacanowski, Carly R; Pakiz, Bilgé; Thomson, Cynthia A; Rock, Cheryl L

2015-04-01

Understanding the degree to which eating behaviors, such as disinhibition and restraint, are associated with weight loss and weight loss maintenance could contribute to further refinement of effective weight management intervention strategies. The purpose of this analysis was to examine if these factors mediate weight loss or weight loss maintenance using data from a randomized controlled trial testing a commercial weight loss program that delivered behavioral counseling and structured meal plans including prepackaged foods. Mediation analyses were used to examine whether changes in disinhibition and restraint mediated the relationship between intervention and weight change during initial weight loss (0-6 months), continued weight loss (6-12 months), or weight loss maintenance (12-24 months) phases. Only decreases in disinhibition between baseline and 6 months mediated the intervention effect on initial weight loss. Our results suggest the mediation effects of these eating behaviors are modest and other factors contribute to a larger, more complex long-term weight loss prognosis.

Sport Management Graduate Programs: Characteristics of Effectiveness.

Science.gov (United States)

Li, Ming; And Others

1994-01-01

Reports a study that examined the characteristics that enable graduate sport management programs to achieve their objectives. Surveys of sport management educators found they agreed on 11 characteristics that indicated a sport management program's effectiveness. Respondents believed an effective program should produce sport managers, not…

Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial.

Science.gov (United States)

Phelan, Suzanne; Hagobian, Todd; Brannen, Anna; Hatley, Karen E; Schaffner, Andrew; Muñoz-Christian, Karen; Tate, Deborah F

2017-06-20

Postpartum weight retention increases lifetime risk of obesity and related morbidity. Few effective interventions exist for multicultural, low-income women. To test whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months. A 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between July 2011 and May 2015 with data collection completed in May 2016. Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics. The primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months. Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet. Participants included 371 women (mean age, 28.1 years; Hispanic, 81.6%; mean weight above prepregnancy weight, 7.8 kg; mean months post partum, 5.2 months) randomized to the intervention group (n = 174) or standard care group (n = 197); 89.2% of participants completed the study. The intervention group produced greater mean 12-month weight loss compared with the standard care group (3.2 kg in the intervention group vs 0.9 kg in standard care group, P income postpartum women, an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) compared with the WIC program alone resulted in a statistically significant greater weight loss over 12 months. Further research is needed to

Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

International Nuclear Information System (INIS)

1993-11-01

This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial

Science.gov (United States)

Crane, Melissa M.; Tate, Deborah F.; Finkelstein, Eric A.; Linnan, Laura A.

2012-01-01

This analysis investigated if changes in autonomous or controlled motivation for participation in a weight loss program differed between individuals offered a financial incentive for weight loss compared to individuals not offered an incentive. Additionally, the same relationships were tested among those who lost weight and either received or did not receive an incentive. This analysis used data from a year-long randomized worksite weight loss program that randomly assigned employees in each worksite to either a low-intensity weight loss program or the same program plus small financial incentives for weight loss ($5.00 per percentage of initial weight lost). There were no differences in changes between groups on motivation during the study, however, increases in autonomous motivation were consistently associated with greater weight losses. This suggests that the small incentives used in this program did not lead to increases in controlled motivation nor did they undermine autonomous motivation. Future studies are needed to evaluate the magnitude and timing of incentives to more fully understand the relationship between incentives and motivation. PMID:22577524

Tribal Waste Management Program

Science.gov (United States)

The EPA’s Tribal Waste Management Program encourages environmentally sound waste management practices that promote resource conservation through recycling, recovery, reduction, clean up, and elimination of waste.

20 CFR 632.76 - Program management systems.

Science.gov (United States)

2010-04-01

... management and participant tracking systems in accordance with § 632.32 and § 632.77. The principal... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program management systems. 632.76 Section... NATIVE AMERICAN EMPLOYMENT AND TRAINING PROGRAMS Program Design and Management § 632.76 Program...

40 CFR 130.11 - Program management.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Program management. 130.11 Section 130... PLANNING AND MANAGEMENT § 130.11 Program management. (a) State agencies may apply for grants under sections 106, 205(j) and 205(g) to carry out water quality planning and management activities. Interstate...

GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION.

Energy Technology Data Exchange (ETDEWEB)

PAQUETTE,D.E.; BENNETT,D.B.; DORSCH,W.R.; GOODE,G.A.; LEE,R.J.; KLAUS,K.; HOWE,R.F.; GEIGER,K.

2002-05-31

THE DEPARTMENT OF ENERGY ORDER 5400.1, GENERAL ENVIRONMENTAL PROTECTION PROGRAM, REQUIRES THE DEVELOPMENT AND IMPLEMENTATION OF A GROUNDWATER PROTECTION PROGRAM. THE BNL GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION PROVIDES AN OVERVIEW OF HOW THE LABORATORY ENSURES THAT PLANS FOR GROUNDWATER PROTECTION, MONITORING, AND RESTORATION ARE FULLY DEFINED, INTEGRATED, AND MANAGED IN A COST EFFECTIVE MANNER THAT IS CONSISTENT WITH FEDERAL, STATE, AND LOCAL REGULATIONS.

Examining Factors of Engagement With Digital Interventions for Weight Management: Rapid Review.

Science.gov (United States)

Sharpe, Emma Elizabeth; Karasouli, Eleni; Meyer, Caroline

2017-10-23

Digital interventions for weight management provide a unique opportunity to target daily lifestyle choices and eating behaviors over a sustained period of time. However, recent evidence has demonstrated a lack of user engagement with digital health interventions, impacting on the levels of intervention effectiveness. Thus, it is critical to identify the factors that may facilitate user engagement with digital health interventions to encourage behavior change and weight management. The aim of this study was to identify and synthesize the available evidence to gain insights about users' perspectives on factors that affect engagement with digital interventions for weight management. A rapid review methodology was adopted. The search strategy was executed in the following databases: Web of Science, PsycINFO, and PubMed. Studies were eligible for inclusion if they investigated users' engagement with a digital weight management intervention and were published from 2000 onwards. A narrative synthesis of data was performed on all included studies. A total of 11 studies were included in the review. The studies were qualitative, mixed-methods, or randomized controlled trials. Some of the studies explored features influencing engagement when using a Web-based digital intervention, others specifically explored engagement when accessing a mobile phone app, and some looked at engagement after text message (short message service, SMS) reminders. Factors influencing engagement with digital weight management interventions were found to be both user-related (eg, perceived health benefits) and digital intervention-related (eg, ease of use and the provision of personalized information). The findings highlight the importance of incorporating user perspectives during the digital intervention development process to encourage engagement. The review contributes to our understanding of what facilitates user engagement and points toward a coproduction approach for developing digital

Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review.

Science.gov (United States)

Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Washburn, Richard A; Donnelly, Joseph E

2017-02-01

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

Weight Management Interventions in Women with and without PCOS: A Systematic Review

Directory of Open Access Journals (Sweden)

Josefin Kataoka

2017-09-01

Full Text Available Polycystic ovary syndrome (PCOS is a common endocrinopathy among women associated with reproductive, metabolic and psychological features. While weight management is recommended as first-line treatment, it is unclear if women with PCOS achieve similar benefits as women without PCOS. This systematic review thus aimed to compare the efficacy of weight management interventions in women with and without PCOS. Databases were searched until May 2017. The primary outcome was weight and anthropometric, reproductive, metabolic and psychological measures were secondary outcomes. Of 3264 articles identified, 14 studies involving n = 933 (n = 9 high and n = 5 moderate risk of bias met the inclusion criteria. No statistically significant differences in weight or weight loss following the intervention were found between women with and without PCOS in five studies, with the remaining studies not comparing the difference in weight or weight loss between these groups. Secondary outcomes did not differ significantly between the two groups. This review identified that there is a paucity of high quality research in this area and that more rigorous research is needed.

Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

Science.gov (United States)

Pan, Qing; Jablonski, Kathleen A.; Aroda, Vanita R.; Watson, Karol E.; Bray, George A.; Kahn, Steven E.; Florez, Jose C.; Perreault, Leigh; Franks, Paul W.

2014-01-01

OBJECTIVE This study examined specific measures of weight loss in relation to incident diabetes and improvement in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS This prospective, observational study analyzed nine weight measures, characterizing baseline weight, short- versus long-term weight loss, short- versus long-term weight regain, and weight cycling, within the Diabetes Prevention Program (DPP) lifestyle intervention arm (n = 1,000) for predictors of incident diabetes and improvement in cardiometabolic risk factors over 2 years. RESULTS Although weight loss in the first 6 months was protective of diabetes (hazard ratio [HR] 0.94 per kg, 95% CI 0.90, 0.98; P weight loss from 0 to 2 years was the strongest predictor of reduced diabetes incidence (HR 0.90 per kg, 95% CI 0.87, 0.93; P Weight cycling (defined as number of 5-lb [2.25-kg] weight cycles) ranged 0–6 times per participant and was positively associated with incident diabetes (HR 1.33, 95% CI 1.12, 1.58; P weight, the effect of weight cycling remained statistically significant for diabetes risk (HR 1.22, 95% CI 1.02, 1.47; P = 0.03) but not for cardiometabolic traits. CONCLUSIONS Two-year weight loss was the strongest predictor of reduced diabetes risk and improvements in cardiometabolic traits. PMID:25024396

Potential transportation demand management programs and measures

Energy Technology Data Exchange (ETDEWEB)

Litman, T. [Victoria Transport Policy Institute, Victoria, BC (Canada)

1997-02-07

The advantages of transportation demand management (TDM) programs were discussed. TDM includes several policies, programs and measures designed to change travel patterns. TDM programs include commute trip reductions, pricing policies, land use management strategies, and programs to support alternative modes of transportation such as public transit, carpooling, bicycling, walking and telecommuting. TDM programs are designed to reduce traffic congestion and air pollution. Some other TDM programs and measures include: enabling programs, alternative mode encouragement, driving disincentives, parking programs, marginalizing user costs, reducing automobile ownership, and land use management.

In-House Energy Management Program Plan

International Nuclear Information System (INIS)

1991-01-01

DOE facilities are required to develop a documented energy management program encompassing owned and leased facilities and vehicles and equipment. The program includes an Energy Management Plan consistent with the requirements of the DOE ten-year In-House Energy Management Plan, an ECP specifying actions associated with the sudden disruption in the supply of critical fuels, an Energy Management Committee comprised of WIPP employees, and reporting criteria for quarterly energy consumption reporting to DOE Headquarters. The In-House Energy Management Program will include an implementation plan, a budget, and an interaction and coordination plan. The goal of this program is to sensitize the WIPP employees to the energy consequences of their actions and to motivate them to use energy more efficiently. To achieve this goal, the program is designed to both improve energy conservation at the WIPP through the direct efforts of every employee, and to encourage employees to take the lead in conserving energy at home, on the road, and in the community

NPP Krsko Aging Management Program

International Nuclear Information System (INIS)

Glaser, B.; Spiler, J.

2002-01-01

As a part of Periodic Safety Review Program (PSR) NEK will review and perform some activities related to Equipment Qualification (EQ) and Aging Management Program (AMP). (EQ) and AMP are safety factors, which need to be assessed during PSR. The goal of PSR and AMP is to determine aging effects and give the conclusion whether the plant has been managed to control aging related degradations and that safety margins are maintained. The parallel goal is also to establish AMP for future plant operation and provide basis for possible Life Extension Program. NEK will develop NEK Aging and Life Cycle Management Program, similar by format and content to one determined by License Renewal program. The bases are in 10CFR54, and NEI 95-10 Industry Guidelines for 10 CFR 54 implementation. The process of establishment the AMP is to be done in two steps. The first step is dealing with SSC's (Systems Structures and Components) scoping and screening and identification of TLAA's (Time Limited Aging Analyses). That means, that a database of all SSC's and TLAA's will be created and then evaluated within AMP program. Based on the scope in first phase an evaluation will be performed in step two. NEK will maintain AMP program as a living program that may be also used for Life Extension and Life Cycle Management. This paper will present and describe AMP, scoping and screening process and the results achieved through the first phase of the project.(author)

Establishments of scientific radiation protection management program

International Nuclear Information System (INIS)

Pan Ziqiang

1988-01-01

Some aspects for establishing the radiation protection management program have been discussed. Radiation protection management program includes: definite aims of management, complete data register, strict supervision system, and scientific management methodology

A content analysis of weight stigmatization in popular television programming for adolescents.

Science.gov (United States)

Eisenberg, Marla E; Carlson-McGuire, Ashley; Gollust, Sarah E; Neumark-Sztainer, Dianne

2015-09-01

This study provides updated information regarding the prevalence and characteristics of weight stigma in popular adolescent television programming, using a sample of favorite shows named by diverse adolescents. Participants in a large, population-based study of Minnesota adolescents (N = 2,793, mean age = 14.4) listed their top three favorite television shows. A coding instrument was developed to analyze randomly selected episodes from the most popular 10 programs. Weight-stigmatizing incidents were compared across television show characteristics and characters' gender and weight status. Half (50%) of the 30 episodes analyzed contained at least one weight-stigmatizing incident. Both youth- and adult-targeted shows contained weight-stigmatizing comments, but the percent of these comments was much higher for youth-targeted (55.6%) than general audience-targeted shows (8.3%). Male characters were more likely than females to engage in (72.7% vs. 27.3%), and be the targets of, weight stigma (63.6% vs. 36.4%), and there was no difference in the amount of weight stigmatizing directed at average weight females compared to overweight females. Targets of these instances showed a negative response in only about one-third of cases, but audience laughter followed 40.9% of cases. The portrayal of weight stigmatization on popular television shows-including targeting women of average weight-sends signals to adolescents about the wide acceptability of this behavior and the expected response, which may be harmful. Prevention of weight stigmatization should take a multi-faceted approach and include the media. Future research should explore the impact that weight-related stigma in television content has on viewers. © 2014 Wiley Periodicals, Inc.

Successful management of a set of preterm, low birth weight ...

African Journals Online (AJOL)

Case report: We report a case of successful management of preterm, low birth weight quadruplets (QI, QII, QIII, and QIV) delivered at 32 weeks by Caesarean section to a 30 year old primiparous mother. QIII and QIV developed septicaemia with conjugated bilirubinaemia and were managed with intravenous antibiotics, and ...

Obese Employee Participation Patterns in a Wellness Program.

Science.gov (United States)

Fink, Jennifer T; Smith, David R; Singh, Maharaj; Ihrke, Doug M; Cisler, Ron A

2016-04-01

The purpose of this research was to retrospectively examine whether demographic differences exist between those who participated in an employee wellness program and those who did not, and to identify the selection of employees' choice in weight management activities. A nonequivalent, 2-group retrospective design was used. This study involved employees at a large, not-for-profit integrated health system. Of the total organization employee pool (29,194), 19,771 (68%) employees volunteered to be weighed (mean body mass index [BMI]=28.9) as part of an employee wellness program. Weight management activities available included: (1) Self-directed 5% total body weight loss; (2) Healthy Solutions at home; (3) Weight Watchers group meetings; (4) Weight Watchers online; and (5) Employee Assistance Program (EAP)-directed healthy weight coaching. Measures were participation rate and available weight management activity participation rate among obese employees across demographic variables, including sex, age, race, job type, and job location. The analysis included chi-square tests for all categorical variables; odds ratios were calculated to examine factors predictive of participation. Of the total 19,771 employees weighed, 6375 (32%) employees were obese (defined as BMI ≥30); of those, 3094 (49%) participated in available weight management activities. Participation was higher among females, whites, those ages >50 years, and non-nursing staff. In conclusion, participation rate varied significantly based on demographic variables. Self-directed 5% weight loss was the most popular weight management activity selected. (Population Health Management 2016;19:132-135).

French plutonium management program

International Nuclear Information System (INIS)

Greneche, D.

2002-01-01

The French plutonium management program is summarized in this paper. The program considers nuclear generation as a major component of national electric power supply and includes the reprocessing of the spent fuel. (author)

Strategic management of population programs

OpenAIRE

Bernhart, Michael H.

1992-01-01

Formal strategic planning and management appear to contribute to organizational effectiveness. The author surveys the literature on strategic management in private/for-profit organizations and applies lessons from that literature to population programs. Few would argue that population programs would not benefit from strategic planning and management, but it would be inadvisable to initiate the process when the organization is faced with a short-term crisis; during or immediately before a chan...

Russia air management program

Energy Technology Data Exchange (ETDEWEB)

Pace, T.G. [U.S. Environmental Protection Agency, NC (United States); Markin, S. [Ministry of Environmental Protection and Natural Resources, Moscow (Sweden); Kosenkova, S.V. [Volgograd Environmental Services Administration, Volgograd (Russian Federation)

1995-12-31

The Russia Air Management Program is in the second year of a four-year cooperative program between the Russian Ministry of Environmental Protection and Natural Resources (MEPNR) and the U.S. Environmental Protection Agency (EPA) to improve national institutions, policies, and practices for air quality management in Russia. This program is part of the Environmental Policy and Technology project being conducted by the U.S. Agency for International Development. The Russia Air Management Program will pilot the application of potential air program improvements in the important industrial City of Volgograd which will enable the development, practical demonstration and evaluation of alternative approaches for improving AQM policies and practices in Russia. Volgograd has a progressive and environmentally enlightened local government, a diverse industrial base and a relatively healthy economy. It is located south of Moscow on the Volga River and was proposed by the Ministry of Environmental Protection and Natural Resources. It was selected after a site visit and a series of discussions with the Ministry, Volgograd officials, the World Bank and the EPA. Following the pilot, RAMP will work to facilitate implementation of selected parts of the pilot in other areas of Russia using training, technology transfer, and public awareness. (author)

Russia air management program

International Nuclear Information System (INIS)

Pace, T.G.; Markin, S.; Kosenkova, S.V.

1995-01-01

The Russia Air Management Program is in the second year of a four-year cooperative program between the Russian Ministry of Environmental Protection and Natural Resources (MEPNR) and the U.S. Environmental Protection Agency (EPA) to improve national institutions, policies, and practices for air quality management in Russia. This program is part of the Environmental Policy and Technology project being conducted by the U.S. Agency for International Development. The Russia Air Management Program will pilot the application of potential air program improvements in the important industrial City of Volgograd which will enable the development, practical demonstration and evaluation of alternative approaches for improving AQM policies and practices in Russia. Volgograd has a progressive and environmentally enlightened local government, a diverse industrial base and a relatively healthy economy. It is located south of Moscow on the Volga River and was proposed by the Ministry of Environmental Protection and Natural Resources. It was selected after a site visit and a series of discussions with the Ministry, Volgograd officials, the World Bank and the EPA. Following the pilot, RAMP will work to facilitate implementation of selected parts of the pilot in other areas of Russia using training, technology transfer, and public awareness. (author)

Russia air management program

Energy Technology Data Exchange (ETDEWEB)

Pace, T G [U.S. Environmental Protection Agency, NC (United States); Markin, S [Ministry of Environmental Protection and Natural Resources, Moscow (Sweden); Kosenkova, S V [Volgograd Environmental Services Administration, Volgograd (Russian Federation)

1996-12-31

The Russia Air Management Program is in the second year of a four-year cooperative program between the Russian Ministry of Environmental Protection and Natural Resources (MEPNR) and the U.S. Environmental Protection Agency (EPA) to improve national institutions, policies, and practices for air quality management in Russia. This program is part of the Environmental Policy and Technology project being conducted by the U.S. Agency for International Development. The Russia Air Management Program will pilot the application of potential air program improvements in the important industrial City of Volgograd which will enable the development, practical demonstration and evaluation of alternative approaches for improving AQM policies and practices in Russia. Volgograd has a progressive and environmentally enlightened local government, a diverse industrial base and a relatively healthy economy. It is located south of Moscow on the Volga River and was proposed by the Ministry of Environmental Protection and Natural Resources. It was selected after a site visit and a series of discussions with the Ministry, Volgograd officials, the World Bank and the EPA. Following the pilot, RAMP will work to facilitate implementation of selected parts of the pilot in other areas of Russia using training, technology transfer, and public awareness. (author)

Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program.

Science.gov (United States)

Ismail, Tengku Alina Tengku; Jalil, Rohana Abdul; Wan Ishak, Wan Rosli; Hamid, Noor Fadzlina; Wan Nik, Wan Suriati; Jan Mohamed, Hamid Jan; Mohd, Nor Haslina; Arifin, Wan Nor; Mohamed, Wan Mohd Izani Wan; Ibrahim, Mohd Ismail; Ismail, Rohaida; Hassim, Tengku Fatimatul Tengku; Aris, Tahir; Wan Muda, Wan Manan

2018-01-01

A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

One-year postpartum outcomes following a weight management intervention in pregnant women with obesity

Science.gov (United States)

Vesco, Kimberly K.; Leo, Michael C.; Karanja, Njeri; Gillman, Matthew W.; McEvoy, Cindy T.; King, Janet C.; Eckhardt, Cara L.; Smith, K. Sabina; Perrin, Nancy; Stevens, Victor J.

2016-01-01

Objective This analysis focuses on 1-year maternal and infant follow-up of a randomized trial that tested a weight management intervention conducted during pregnancy. Methods We randomly assigned 114 women with obesity (mean BMI 36.7 kg/m2) at a mean of 15 weeks’ gestation to a weight management intervention or usual care control condition. The intervention ended at delivery and resulted in less gestational weight gain and a lower proportion of large-for-gestational age newborns among intervention compared to control participants. The primary outcome at 12 months postpartum was maternal weight. Secondary outcomes included infant weight-for-age and weight-for-length z-scores. Results At 1 year, mothers in the intervention group weighed 96.3±18.6 kg, and in the control group, 99.7±19.2 kg. There was no significant difference between groups in change in weight from randomization to 1-year postpartum (b=-0.47, 95% CI [-4.03, 3.08]. There was a significant main effect of group for infant weight-for-age z-score (b=-0.40, 95% CI [-0.75,-0.05]) but not infant weight-for-length z-scores (b=-0.20, 95% CI [-0.59,0.20]. Conclusions A gestational weight management intervention did not influence maternal weight or infant weight-for-length at 1-year postpartum. Future studies may be warranted to determine if extending prenatal interventions into the postpartum period would be beneficial for maternal and infant outcomes. PMID:27670399

Hanford Environmental Management Program implementation plan

International Nuclear Information System (INIS)

1988-08-01

The Hanford Environmental Management Program (HEMP) was established to facilitate compliance with the applicable environmental statues, regulations, and standards on the Hanford Site. The HEMP provides a structured approach to achieve environmental management objectives. The Hanford Environmental Management Program Plan (HEMP Plan) was prepared as a strategic level planning document to describe the program management, technical implementation, verification, and communications activities that guide the HEMP. Four basic program objectives are identified in the HEMP Plan as follows: establish ongoing monitoring to ensure that Hanford Site operations comply with environmental requirements; attain regulatory compliance through the modification of activities; mitigate any environmental consequences; and minimize the environmental impacts of future operations at the Hanford Site. 2 refs., 24 figs., 27 tabs

14 CFR 91.1411 - Continuous airworthiness maintenance program use by fractional ownership program manager.

Science.gov (United States)

2010-01-01

... program use by fractional ownership program manager. 91.1411 Section 91.1411 Aeronautics and Space FEDERAL... airworthiness maintenance program use by fractional ownership program manager. Fractional ownership program... through 91.1443. Any program manager who elects to maintain the program aircraft using a continuous...

Exploring parental factors related to weight management in survivors of childhood central nervous system tumors.

Science.gov (United States)

Santa Maria, Diane; Swartz, Maria C; Markham, Christine; Chandra, Joya; McCurdy, Sheryl; Basen-Engquist, Karen

2014-01-01

Childhood central nervous system tumor survivors (CCNSTS) are at risk for adverse health issues. Little research has been conducted to explore the role of parental factors in weight management to mitigate adverse health outcomes. We conducted 9 group interviews (n=20) with CCNSTS, their parents, and health care providers to ascertain parental factors that may influence weight management practices in CCNSTS. Three main themes were identified: parenting style, parent-child connectedness, and food and physical activity (PA) environment. Although most parents adopted an authoritative parenting style related to diet and PA practices, some adopted a permissive parenting style. Participants expressed high levels of connection that may hinder the development of peer relationships and described the food and PA environments that promote or hinder weight management through parental modeling of healthy eating and PA and access to healthy food and activities. Weight management interventions for CCNSTS may experience greater benefit from using a family-focused approach, promoting positive food and PA environments, parental modeling of healthy eating and exercise, and partnering with youth to adopt weight management behaviors.

Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives.

Science.gov (United States)

Jeffery, R W; Forster, J L; Snell, M K

1985-03-01

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

Science.gov (United States)

James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

2014-05-01

While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment. © 2013 John Wiley & Sons Ltd.

Nuclear Waste Management Program summary document, FY 1981

Energy Technology Data Exchange (ETDEWEB)

Meyers, Sheldon

1980-03-01

The Nuclear Waste Management Program Summary Document outlines the operational and research and development (R and D) activities of the Office of Nuclear Waste Management (NEW) under the Assistant Secretary for Nuclear Energy, US Department of Energy (DOE). This document focuses on the current and planned activities in waste management for FY 1981. This Program Summary Document (PSD) was prepared in order to explain the Federal nuclear waste management and spent fuel storage programs to Congress and its committees and to interested members of the public, the private sector, and the research community. The national energy policy as it applies to waste management and spent fuel storage is presented first. The program strategy, structure, budget, management approach, and public participation programs are then identified. The next section describes program activities and outlines their status. Finally, the applicability of departmental policies to NEW programs is summarized, including field and regional activities, commercialization plans, and environmental and socioeconomic implications of waste management activities, and international programs. This Nuclear Waste Management Program Summary Document is meant to serve as a guide to the progress of R and D and other energy technology programs in radioactive waste management. The R and D objective is to provide the Nation with acceptable solutions to short- and long-term management problems for all forms of radioactive waste and spent fuel.

Nuclear Waste Management Program summary document, FY 1981

International Nuclear Information System (INIS)

1980-03-01

The Nuclear Waste Management Program Summary Document outlines the operational and research and development (R and D) activities of the Office of Nuclear Waste Management (NEW) under the Assistant Secretary for Nuclear Energy, US Department of Energy (DOE). This document focuses on the current and planned activities in waste management for FY 1981. This Program Summary Document (PSD) was prepared in order to explain the Federal nuclear waste management and spent fuel storage programs to Congress and its committees and to interested members of the public, the private sector, and the research community. The national energy policy as it applies to waste management and spent fuel storage is presented first. The program strategy, structure, budget, management approach, and public participation programs are then identified. The next section describes program activities and outlines their status. Finally, the applicability of departmental policies to NEW programs is summarized, including field and regional activities, commercialization plans, and environmental and socioeconomic implications of waste management activities, and international programs. This Nuclear Waste Management Program Summary Document is meant to serve as a guide to the progress of R and D and other energy technology programs in radioactive waste management. The R and D objective is to provide the Nation with acceptable solutions to short- and long-term management problems for all forms of radioactive waste and spent fuel

The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management.

Science.gov (United States)

Koritzky, Gilly; Rice, Chantelle; Dieterle, Camille; Bechara, Antoine

2015-01-01

Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development.

Science.gov (United States)

Lanoye, Autumn; Gorin, Amy A; LaRose, Jessica Gokee

2016-03-01

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.

Young Adults’ Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development

Science.gov (United States)

Lanoye, Autumn; Gorin, Amy A.; LaRose, Jessica Gokee

2017-01-01

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight related constructs. The aim of this review is to explore young adults’ attitudes toward obesity and weight management, with particular attention to those factors that may play a role in development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults’ perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group. PMID:26923688

Environmental Restoration Information Resource Management Program Plan

Energy Technology Data Exchange (ETDEWEB)

1994-09-01

The Environmental Restoration Information Resources Management (ER IRM) Program Plan defines program requirements, organizational structures and responsibilities, and work breakdown structure and to establish an approved baseline against which overall progress of the program as well as the effectiveness of its management will be measured. This plan will guide ER IRM Program execution and define the program`s essential elements. This plan will be routinely updated to incorporate key decisions and programmatic changes and will serve as the project baseline document. Environmental Restoration Waste Management Program intersite procedures and work instructions will be developed to facilitate the implementation of this plan.

Environmental Management Science Program Workshop

Energy Technology Data Exchange (ETDEWEB)

None

1998-07-01

This program summary book is a compendium of project summaries submitted by principal investigators in the Environmental Management Science Program and Environmental Management/Energy Research Pilot Collaborative Research Program (Wolf-Broido Program). These summaries provide information about the most recent project activities and accomplishments. All projects will be represented at the workshop poster sessions, so you will have an opportunity to meet with the researchers. The projects will be presented in the same order at the poster session as they are presented in this summary book. Detailed questions about an individual project may be directed to the investigators involved.

Establishing a total information management program

International Nuclear Information System (INIS)

Hegstrom, K.L.; Fisher, J.

1982-01-01

A total information management program manages documents for easy access and identifies data elements commonly found in all documents. The program thus links disparate documents by identifying information they share in common

Unstable slope management program.

Science.gov (United States)

2009-08-01

This Rapid Response Project gathered information on existing unstable slope management programs, with a : focus on asset management practices in the United States and overseas. On the basis of this study, the research : team summarized and recommende...

Environmental Management Science Program Workshop. Proceedings

Energy Technology Data Exchange (ETDEWEB)

None

1998-07-01

The Department of Energy Office of Environmental Management (EM), in partnership with the Office of Energy Research (ER), designed, developed, and implemented the Environmental Management Science Program as a basic research effort to fund the scientific and engineering understanding required to solve the most challenging technical problems facing the government's largest, most complex environmental cleanup program. The intent of the Environmental Management Science Program is to: (1) Provide scientific knowledge that will revolutionize technologies and cleanup approaches to significantly reduce future costs, schedules, and risks. (2) Bridge the gap between broad fundamental research that has wide-ranging applications such as that performed in the Department's Office of Energy Research and needs-driven applied technology development that is conducted in Environmental Management's Office of Science and Technology. (3) Focus the nation's science infrastructure on critical Department of Energy environmental problems. In an effort to share information regarding basic research efforts being funded by the Environmental Management Science Program and the Environmental Management/Energy Research Pilot Collaborative Research Program (Wolf-Broido Program), this CD includes summaries for each project. These project summaries, available in portable document format (PDF), were prepared in the spring of 1998 by the principal investigators and provide information about their most recent project activities and accomplishments.

"Taking Charge of One's Life": A Model for Weight Management Success

Science.gov (United States)

Adams, Marlene

2008-01-01

Obesity is a serious, prevalent, and refractory disorder that increases with age particularly in women who enroll in formal weight loss treatments. This study examined the processes used by obese postmenopausal women as they participated in a formal weight loss program. Using grounded theory, interviews were conducted with 14 women engaged in a…

Liraglutide 3.0 mg for weight management: weight-loss dependent and independent effects.

Science.gov (United States)

Bays, Harold; Pi-Sunyer, Xavier; Hemmingsson, Joanna Uddén; Claudius, Birgitte; Jensen, Christine B; Van Gaal, Luc

2017-02-01

As an adjunct to a reduced-calorie diet and increased physical activity, treatment with liraglutide 3.0 mg for weight management provides a statistically significant and clinically meaningful weight loss of 5.7%-8.0% compared to 1.6%-2.6% with placebo. The objective of this post hoc analysis was to quantify the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key efficacy endpoints. The analysis utilized data from 4725 participants across three randomized, placebo-controlled, double-blind trials that evaluated the efficacy and safety of liraglutide 3.0 mg versus placebo, as an adjunct to a reduced-calorie diet and increased physical activity (ClinicalTrials.gov identifiers: NCT01272219, NCT01272232 and NCT01557166). The duration of two of the trials was 56 weeks; one trial was of 32 weeks' duration. A mediation analysis was performed, which ranked the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key cardiometabolic efficacy endpoints, Apnea-Hypopnea Index (AHI) and health-related quality of life (QoL). A limitation of this type of analysis is that it cannot conclusively prove a causal relationship. In individuals without type 2 diabetes mellitus (T2DM), endpoints predominantly driven by liraglutide-induced weight loss included waist circumference, diastolic blood pressure, triglycerides, high density lipoprotein cholesterol, AHI, and Impact of Weight on Quality of Life-Lite total and physical function scores. Endpoints predominantly independent of weight loss included the glycemic endpoints hemoglobin A1c and fasting plasma glucose in individuals with and without T2DM. Regardless of the degree of dependence on weight loss according to the mediation analysis, greater weight loss was associated with greater improvement in all endpoints. Treatment with liraglutide 3.0 mg contributes to improved cardiometabolic parameters, AHI and health-related QoL through both weight

Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

Science.gov (United States)

Igel, L I; Saunders, K H; Fins, J J

2018-05-21

In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

Science.gov (United States)

Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

2017-07-01

The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p rewards concluded (3.3 kg vs 1.8 kg, p rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

DOE Low-Level Waste Management Program

International Nuclear Information System (INIS)

Mezga, L.J.

1983-01-01

The Oak Ridge National Laboratory (ORNL) in its role as associate lead contractor of the DOE LLWMP has responsibility for the management of program-funded technology development activities. In this role with general guidance provided by DOE and the lead contractor (EG and G Idaho), the ORNL program office is charged with the responsibility to (1) develop program plans for the major technology areas, (2) recommend allocations for the program resources, (3) review the technology development tasks to ensure that program objectives are being met, and (4) to assist the lead contractor in coordinating the DOE LLWMP with other on-going US and foreign waste technology programs. Although the ORNL office generally assists the lead laboratory in management of the total program, our emphasis is on management of R and D for development of basic technology and to assess concepts for alternative systems of processing and disposal of LLW. Technical progress for each of the tasks of this program for FY 1982 is summarized

[The efficacy of e-health management on weight control in adolescents: a systematic review].

Science.gov (United States)

Su, Mei-Chen; Lin, Chia-Ling; Tsao, Lee-Ing

2014-02-01

Advances during the past decade have made it feasible to apply e-health methods to chronic disease management. Researchers have recently begun applying these methods to weight control. The application of e-health management methods to weight control in adolescents has yet to be investigated empirically. This study conducted a systematic review of reports discussing the weight-control effects of e-health management in adolescents. Researchers searched 6 electronic databases for relevant articles published between 1995 and April 2013. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used to evaluate the quality of the identified articles. Seven studies met the inclusion criterion of targeting adolescent subject populations. A total of 3728 adolescents and 1394 parents participated in these studies. The majority of participants were overweight girls and median participant ages ranged from 12.52 (SD = 3.15) to 15.31 (SD = 0.69). All studies reported that e-health management reduced body mass index and body fat percentage. Four studies indicate that e-health management may improve physical activity knowledge and skills. However, diet control outcomes among the seven studies varied. Empirical results demonstrate that e-health management significantly affects weight control. However, the effectiveness of log-in versus primary outcome indicators was inconclusive. Future studies should consider the use of incentives, reminder systems, and other strategies to enhance website usage. The development of an Internet-based, computer-tailored weight-management intervention for overweight adolescents and the development of an appropriate care model are recommended.

Project TEAMS (Talking about Eating, Activity, and Mutual Support: a randomized controlled trial of a theory-based weight loss program for couples

Directory of Open Access Journals (Sweden)

Amy A. Gorin

2017-09-01

Full Text Available Abstract Background Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT, greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one’s spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses. Methods Project TEAMS (Talking about Eating, Activity, and Mutual Support is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other’s eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL or to 6 months of standard behavioral weight loss treatment (BWL. Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence. Discussion This

Project TEAMS (Talking about Eating, Activity, and Mutual Support): a randomized controlled trial of a theory-based weight loss program for couples.

Science.gov (United States)

Gorin, Amy A; Powers, Theodore A; Gettens, Katelyn; Cornelius, Talea; Koestner, Richard; Mobley, Amy R; Pescatello, Linda; Medina, Tania Huedo

2017-09-29

Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT), greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one's spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses. Project TEAMS (Talking about Eating, Activity, and Mutual Support) is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other's eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL) or to 6 months of standard behavioral weight loss treatment (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence. This study addresses the fundamental importance of interpersonal

Process evaluation of the Living Green, Healthy and Thrifty (LiGHT) web-based child obesity management program: combining health promotion with ecology and economy.

Science.gov (United States)

Jogova, Maria; Song, Joshua Eun-Soo; Campbell, Audrey Clare; Warbuton, Darren; Warshawski, Tom; Chanoine, Jean-Pierre

2013-04-01

To conduct a process evaluation of the Living Green, Healthy and Thrifty (LiGHT) program, a novel virtual child obesity management program that combines health promotion with ecology and economy (Phase 1). We carried out a mixed methods process evaluation involving qualitative and quantitative data collection in 3 phases: among 3 child-parent units, (group 1) that informed program development; 9 child-parent units (group 2) that tested the draft program and further aided program refinement; and 17 child-parent units (group 3) for a 4-week pilot of the program. In the program pilot, we assessed participants' knowledge and readiness to change pre- and postintervention and explored perceptions of the program. Participants generally felt that the online format for program delivery was convenient and accessible, the content was practical, and the integration of health-environment-economy was well received. Many parents also appreciated the involvement of the family. However, the lack of visual appeal and overabundance of text was identified as a challenge, and children/youth in particular requested assurance that their personal information (e.g. weight) was not seen by their parents. The online method of program delivery holds the unique challenge of requiring special efforts to create a sense of personal connection and community. The presence of a "Way-finder" to assist participants and discussion boards/forums are potential solutions. The LiGHT online weight management program offers an accessible, convenient weight management resource that children and families appreciate for its availability, broader educational scope, and practicality. Outcome evaluation of LiGHT will be carried out in Phase 2 of the project. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Effect of partial weight bearing program on functional ability and ...

African Journals Online (AJOL)

Lilian A. Zaky

2013-03-17

Mar 17, 2013 ... essence of the importance of partial weight bearing program in rehabilitation of lower limb condi ... and long term physical and psychosocial impairments [11,12]. .... gram for their functional walking using the 6-min walking test,.

Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community.

Science.gov (United States)

Pappa, Gisele Lobo; Cunha, Tiago Oliveira; Bicalho, Paulo Viana; Ribeiro, Antonio; Couto Silva, Ana Paula; Meira, Wagner; Beleigoli, Alline Maria Rezende

2017-01-16

Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes received per post, and topics discussed

Low-level waste management program: technical program overview

International Nuclear Information System (INIS)

Lowrie, R.S.

1981-01-01

The mission of the technical program is to develop the technology component of the Department of Energy's Low-Level Waste Management Program and to manage research and development, demonstration, and documentation of the technical aspects of the program. Some of the major technology objectives are: develop and demonstrate techniques for waste generation reduction; develop and demonstrate waste treatment, handling and packaging techniques; develop and demonstrate the technology for greater confinement; and develop the technology for remedial action at existing sites. In addition there is the technology transfer objective which is to compile and issue a handbook documenting the technology for each of the above technology objectives

Tier 3 multidisciplinary medical weight management improves outcome of Roux-en-Y gastric bypass surgery.

Science.gov (United States)

Patel, P; Hartland, A; Hollis, A; Ali, R; Elshaw, A; Jain, S; Khan, A; Mirza, S

2015-04-01

In 2013 the Department of Health specified eligibility for bariatric surgery funded by the National Health Service. This included a mandatory specification that patients first complete a Tier 3 medical weight management programme. The clinical effectiveness of this recommendation has not been evaluated previously. Our bariatric centre has provided a Tier 3 programme six months prior to bariatric surgery since 2009. The aim of our retrospective study was to compare weight loss in two cohorts: Roux-en-Y gastric bypass only (RYGB only cohort) versus Tier 3 weight management followed by RYGB (Tier 3 cohort). A total of 110 patients were selected for the study: 66 in the RYGB only cohort and 44 in the Tier 3 cohort. Patients in both cohorts were matched for age, sex, preoperative body mass index and pre-existing co-morbidities. The principal variable was therefore whether they undertook the weight management programme prior to RYGB. Patients from both cohorts were followed up at 6 and 12 months to assess weight loss. The mean weight loss at 6 months for the Tier 3 cohort was 31% (range: 18-69%, standard deviation [SD]: 0.10 percentage points) compared with 23% (range: 4-93%, SD: 0.12 percentage points) for the RYGB only cohort (p=0.0002). The mean weight loss at 12 months for the Tier 3 cohort was 34% (range: 17-51%, SD: 0.09 percentage points) compared with 27% (range: 14-48%, SD: 0.87 percentage points) in the RYGB only cohort (p=0.0037). Our study revealed that in our matched cohorts, patients receiving Tier 3 specialist medical weight management input prior to RYGB lost significantly more weight at 6 and 12 months than RYGB only patients. This confirms the clinical efficacy of such a weight management programme prior to gastric bypass surgery and supports its inclusion in eligibility criteria for bariatric surgery.

Holiday Weight Management by Successful Weight Losers and Normal Weight Individuals

Science.gov (United States)

Phelan, Suzanne; Wing, Rena R.; Raynor, Hollie A.; Dibello, Julia; Nedeau, Kim; Peng, Wanfeng

2008-01-01

This study compared weight control strategies during the winter holidays among successful weight losers (SWL) in the National Weight Control Registry and normal weight individuals (NW) with no history of obesity. SWL (n = 178) had lost a mean of 34.9 kg and had kept greater than or equal to 13.6 kg off for a mean of 5.9 years. NW (n = 101) had a…

Environmental Restoration Information Resource Management Program Plan

International Nuclear Information System (INIS)

1994-09-01

The Environmental Restoration Information Resources Management (ER IRM) Program Plan defines program requirements, organizational structures and responsibilities, and work breakdown structure and to establish an approved baseline against which overall progress of the program as well as the effectiveness of its management will be measured. This plan will guide ER IRM Program execution and define the program's essential elements. This plan will be routinely updated to incorporate key decisions and programmatic changes and will serve as the project baseline document. Environmental Restoration Waste Management Program intersite procedures and work instructions will be developed to facilitate the implementation of this plan

Improving maintenance of lost weight following a commercial liquid meal replacement program: a preliminary study.

Science.gov (United States)

Ames, Gretchen E; Patel, Roshni H; McMullen, Jillian S; Thomas, Colleen S; Crook, Julia E; Lynch, Scott A; Lutes, Lesley D

2014-01-01

Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52 weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9 kg/m(2) and weight of 111 kg at the start of LMR. At LMR completion, they lost 18% (21 kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended ≥ 17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351 days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8 kg) of lost weight (range, -42 to 74%), significantly less than a median of 56% (11 kg) percent regain of lost weight (range, -78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P<0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes. © 2013.

Antenatal Weight Management: Women’s Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy

Directory of Open Access Journals (Sweden)

J. A. Swift

2016-01-01

Full Text Available The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy sought to examine women’s self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+ were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n=80 between 12 and 14 and 43.0% (n=83 between 20 and 22 weeks. At recruitment 50.3% of participants (n=97 could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2 did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

Program summary. Nuclear waste management and fuel cycle programs

International Nuclear Information System (INIS)

1982-07-01

This Program Summary Document describes the US Department of Energy (DOE) Nuclear Waste Management and Fuel Cycle Programs. Particular emphasis is given to near-term, specifically Fiscal Year (FY) 1982, activities. The overall objective of these programs will be achieved by the demonstration of: (1) safe radioactive waste management practices for storage and disposal of high-level waste and (2) advanced technologies necessary to close the nuclear fuel cycle on a schedule which would assure a healthy future for the development of nuclear power in this country

The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management

Directory of Open Access Journals (Sweden)

Gilly eKoritzky

2015-12-01

Full Text Available Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n=12 had lower recency scores than unsuccessful ones (n=32; p=0.006. Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

Time perspective and weight management behaviors in newly diagnosed Type 2 diabetes: a mediational analysis.

Science.gov (United States)

Hall, Peter A; Fong, Geoffrey T; Cheng, Alice Y

2012-12-01

The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up. Hierarchical multiple regression analyses revealed a prospective association between domain-specific time perspective and uptake of weight management behaviors. Individuals with newly diagnosed T2DM possessing a future-oriented time perspective reported making less frequent fatty food choices and greater increases in physical activity over the 6-month follow-up interval. These effects were selectively mediated by intention strength, and not competing social cognitive variables. For both behaviors, the total effects and meditational models were robust to adjustments for demographics, body composition and disease variables. A future-oriented time perspective is prospectively associated with superior uptake of weight management behaviors among those with newly diagnosed Type 2 diabetes. The facilitating effect of future-oriented thinking appears to occur via enhanced strength of intentions to perform weight management behaviors.

The Air Program Information Management System (APIMS)

Science.gov (United States)

2011-11-02

Technology November 2, 2011 The Air Program Information Management System (APIMS) Frank Castaneda, III, P.E. APIMS Program Manager AFCEE/TDNQ APIMS...NOV 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Air Program Information Management System (APIMS... Information   Management   System : Sustainability of  Enterprise air quality management system • Aspects and Impacts to Process • Auditing and Measurement

The development of SisterTalk: a cable TV-delivered weight control program for black women.

Science.gov (United States)

Gans, Kim M; Kumanyika, Shiriki K; Lovell, H Joan; Risica, Patricia M; Goldman, Roberta; Odoms-Young, Angela; Strolla, Leslie O; Decaille, Donna O; Caron, Colleen; Lasater, Thomas M

2003-12-01

Overweight and obesity have reached epidemic proportions in the United States, with black women disproportionately affected. SisterTalk is a weight control program designed specifically for delivery to black women via cable TV. The theoretical and conceptual frameworks and formative research that guided the development and cultural tailoring of SisterTalk are described. Social Action Theory was applied in the development of SisterTalk along with a detailed behavioral analysis of the way that black women view weight and weight loss within the context of their cultural and social realities. The entire intervention development process was framed using this information, rather than by changing only superficial aspects of program delivery. Community networking and both qualitative and quantitative interview techniques from the fields of social marketing and cultural anthropology were used to involve black women from Boston in the design and implementation of a program that would be practical, appealing, and culturally sensitive. Also discussed are strategies for evaluating the program, and lessons learned that might have broader applicability are highlighted. The development of the SisterTalk program could provide a useful starting point for development of successful weight control programs for black women in other parts of the United States as well as for other ethnic and racial groups.

Data warehousing in disease management programs.

Science.gov (United States)

Ramick, D C

2001-01-01

Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.

Older members perform better in an internet-based behavioral weight loss program compared to younger members.

Science.gov (United States)

van der Mark, Marianne; Jonasson, Josefine; Svensson, Madeleine; Linné, Yvonne; Rossner, Stephan; Lagerros, Ylva Trolle

2009-01-01

New technology offers increased opportunities for weight control. However, it is not clear whether older people with less computer training can make use of this tool. Our objective was to examine how members above the age of 65 years performed in an internet-based behavioral weight loss program, compared to younger members. Data from members (n = 23,233) of an internet-based behavioral weight loss program were analyzed. We restricted our study to active participants accessing the weight club, during a 6-month period (n = 4,440). The number of logins, food intake, and weight records were examined. Participants were divided into age tertiles separately for men and women. The oldest tertile was further subdivided into two groups: above and below the age of 65 years. Participants aged 65 or older were more likely to remain active in the weight club for at least 6 months compared to younger age groups. They had the highest frequency of recordings of food intake and current weight. Among women, those older than 65 years had on average the highest percentage of weight loss (5.6 kg, 6.8%). Men above 65 years of age had the highest number of logins, on average 161 times during the 6-month period. Older participants are performing equally well or even better in an internet-based behavioral weight loss program than younger participants. Internet-based programs could be a promising and attractive option for older adults requiring assistance in losing weight. 2009 S. Karger AG, Basel.

Body image and weight management: young people, internet advertisements and pharmacists

OpenAIRE

Luevorasirikul, Kanokrat

2007-01-01

Media promotion of the ideal body as slimness for women and muscularity for men, has led to increasing numbers of both genders reporting dissatisfaction with their bodies and trying to change using weight control products. It has been suggested that pharmacists can play a key role in promoting healthy lifestyles and weight management. The main aim of the research study was to examine the impact of media on body image perception and to investigate the role of pharmacists in weight man...

Adiposity, hypertension and weight management behaviours in Ghanaian type 2 diabetes mellitus patients aged 20-70 years.

Science.gov (United States)

Mogre, Victor; Apala, Peter; Nsoh, Jonas A; Wanaba, Peter

2016-01-01

This study assessed the prevalence of general and abdominal obesity and hypertension as well the weight management behaviours of type 2 diabetes mellitus patients. It included 378 diabetes patients seeking care from two hospitals in Ghana. Standard methods and tools were used to assess participants' weight, height, waist circumference (WC), blood pressure (BP) and fasting plasma glucose (FPG). Weight management behaviours were measured using a questionnaire. The prevalence of general obesity, abdominal obesity and hypertension was 20.1%, 46.6% and 67.7% respectively. Abdominal obesity was more likely in participants who: skipped breakfast, engaged in exercise to lose weight and were generally overweight/obese. General overweight and obesity was more likely in participants who: reported receipt of weight management counselling, engaged in exercise to lose weight, had a weight management plan/goal, and were abdominally obese. Hypertension was less likely in participants who had: no formal education, diabetes for ≥5 years and modified their dietary habits to lose weight but more likely in those who skipped breakfast. Abdominal obesity, general overweight/obesity, and hypertension were frequent in this sample and were influenced by weight management behaviours. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Managing a mixed waste program

International Nuclear Information System (INIS)

Koch, J.D.

1994-01-01

IT Corporation operates an analytical laboratory in St. Louis capable of analyzing environmental samples that are contaminated with both chemical and radioactive materials. Wastes generated during these analyses are hazardous in nature; some are listed wastes others exhibit characteristic hazards. When the original samples contain significant quantities of radioactive material, the waste must be treated as a mixed waste. A plan was written to document the waste management program describing the management of hazardous, radioactive and mixed wastes. This presentation summarizes the methods employed by the St. Louis facility to reduce personnel exposures to the hazardous materials, minimize the volume of mixed waste and treat the materials prior to disposal. The procedures that are used and the effectiveness of each procedure will also be discussed. Some of the lessons that have been learned while dealing with mixed wastes will be presented as well as the solutions that were applied. This program has been effective in reducing the volume of mixed waste that is generated. The management program also serves as a method to manage the costs of the waste disposal program by effectively segregating the different wastes that are generated

Motivation, self-determination, and long-term weight control

OpenAIRE

Teixeira, Pedro J; Silva, Marlene N; Mata, Jutta; Palmeira, António L; Markland, David

2012-01-01

Abstract This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation - not only considering the level but also type of motivation - in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theor...

Who will lose weight? A reexamination of predictors of weight loss in women

Directory of Open Access Journals (Sweden)

Barata José T

2004-08-01

Full Text Available Abstract Background The purpose of this study was to analyze pretreatment predictors of short-term weight loss in Portuguese overweight and obese women involved in a weight management program. Behavioral and psychosocial predictors were selected a priori from previous results reported in American women who participated in a similar program. Methods Subjects were 140 healthy overweight/obese women (age, 38.3 ± 5.9 y; BMI, 30.3 ± 3.7 kg/m2 who participated in a 4-month lifestyle weight loss program consisting of group-based behavior therapy to improve diet and increase physical activity. At baseline, all women completed a comprehensive behavioral and psychosocial battery, in standardized conditions. Results Of all starting participants, 3.5% (5 subjects did not finish the program. By treatment's end, more than half of all women had met the recomended weight loss goals, despite a large variability in individual results (range for weight loss = 19 kg. In bivariate and multivariate correlation/regression analysis fewer previous diets and weight outcome evaluations, and to a lesser extent self-motivation and body image were significant and independent predictors of weight reduction, before and after adjustment for baseline weight. A negative and slightly curvilinear relationship best described the association between outcome evaluations and weight change, revealing that persons with very accepting evaluations (that would accept or be happy with minimal weight change lost the least amount of weight while positive but moderate evaluations of outcomes (i.e., neither low nor extremely demanding were more predictive of success. Among those subjects who reported having initiated more than 3–4 diets in the year before the study, very few were found to be in the most successful group after treatment. Quality of life, self-esteem, and exercise variables did not predict outcomes. Conclusions Several variables were confirmed as predictors of success in short

University Students' Views of Obesity and Weight Management Strategies

Science.gov (United States)

Okonkwo, Ononuju; While, Alison

2010-01-01

Objective: To investigate the knowledge and views of university students regarding obesity and weight management strategies. Design: Online questionnaire-based survey of undergraduate and postgraduate university students in a large London university with a diverse student population. Method: The survey was administered online and circulated…

Autonomy support and control in weight management: what important others do and say matters.

Science.gov (United States)

Ng, Johan Y Y; Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie

2014-09-01

Drawing from self-determination theory (Ryan & Deci, 2002, Overview of self-determination theory: An organismic-dialectical perspective. In E. L. Deci & R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3-33). Rochester, NY: The University of Rochester Press.), we examined how individuals' psychological needs, motivation, and behaviours (i.e., physical activity and eating) associated with weight management could be predicted by perceptions of their important others' supportive and controlling behaviours. Using a cross-sectional survey design, 235 participants (mean age = 27.39 years, SD = 8.96 years) completed an online questionnaire. Statistical analyses showed that when important others were perceived to be more supportive, participants reported higher levels of more optimal forms of motivation for weight management, which in turn predicted more physical activity and healthy eating behaviours. In contrast, when important others were perceived to be controlling, participants reported higher levels of less optimal forms of motivation, which in turn predicted less physical activity and healthy eating behaviours, as well as more unhealthy eating behaviours. Significant indirect effects were also found from perceived support and control from important others to physical activity and eating behaviours, all in the expected directions. The findings support the importance of important others providing support and refraining from controlling behaviours in order to facilitate motivation and behaviours conducive to successful weight management. What is already known on this subject? Autonomy support is related to basic need satisfaction and autonomous motivation in the context of weight management. In turn, these variables are related to adaptive outcomes for weight management. What does this study add? Measurement of perceived controlling behaviours by important others. Measurement of perceived need thwarting. Structural model on how important others affect

Performance Demonstration Program Management Plan

International Nuclear Information System (INIS)

2005-01-01

To demonstrate compliance with the Waste Isolation Pilot Plant (WIPP) waste characterization program, each testing and analytical facility performing waste characterization activities participates in the Performance Demonstration Program (PDP). The PDP serves as a quality control check against expected results and provides information about the quality of data generated in the characterization of waste destined for WIPP. Single blind audit samples are prepared and distributed by an independent organization to each of the facilities participating in the PDP. There are three elements within the PDP: analysis of simulated headspace gases, analysis of solids for Resource Conservation and Recovery Act (RCRA) constituents, and analysis for transuranic (TRU) radionuclides using nondestructive assay (NDA) techniques. Because the analysis for TRU radionuclides using NDA techniques involves both the counting of drums and standard waste boxes, four PDP plans are required to describe the activities of the three PDP elements. In accordance with these PDP plans, the reviewing and approving authority for PDP results and for the overall program is the CBFO PDP Appointee. The CBFO PDP Appointee is responsible for ensuring the implementation of each of these plans by concurring with the designation of the Program Coordinator and by providing technical oversight and coordination for the program. The Program Coordinator will designate the PDP Manager, who will coordinate the three elements of the PDP. The purpose of this management plan is to identify how the requirements applicable to the PDP are implemented during the management and coordination of PDP activities. The other participants in the program (organizations that perform site implementation and activities under CBFO contracts or interoffice work orders) are not covered under this management plan. Those activities are governed by the organization's quality assurance (QA) program and procedures or as otherwise directed by CBFO.

Mother-teen communication about weight management.

Science.gov (United States)

Dailey, René M; Thompson, Charee M; Romo, Lynsey Kluever

2014-01-01

Although research shows family members can influence each other's diet and exercise behaviors, the specific strategies that most effectively motivate individuals to enact healthy behaviors have not been revealed. Toward this goal, this study employed confirmation theory to assess how the quality of weight management (WM) communication between 107 mother-teen dyads was related to their diet and exercise behaviors as well as their subjective perceptions of the productivity of WM conversations. Confirmation theory proposes two components of confirmation: acceptance and challenge. Analyses revealed that accepting and challenging communication were both positively related to the perceived productivity of WM conversations. However, more complex associations emerged for diet and exercise. Acceptance was more helpful in motivating better eating habits for mothers with low health motivation and teens with high health motivation. For exercise, challenge was helpful in motivating teens with higher sensitivity about communicating about weight issues; however, counter to predictions, challenge was negatively related to exercise for teens with low health motivation and low sensitivity. These interactions, however, explained less variance than analyses for perceived effectiveness and satisfaction.

Fetal Programming of Obesity: Maternal Obesity and Excessive Weight Gain

Directory of Open Access Journals (Sweden)

Seray Kabaran

2014-10-01

Full Text Available The prevalence of obesity is an increasing health problem throughout the world. Maternal pre-pregnancy weight, maternal nutrition and maternal weight gain are among the factors that can cause childhood obesity. Both maternal obesity and excessive weight gain increase the risks of excessive fetal weight gain and high birth weight. Rapid weight gain during fetal period leads to changes in the newborn body composition. Specifically, the increase in body fat ratio in the early periods is associated with an increased risk of obesity in the later periods. It was reported that over-nutrition during fetal period could cause excessive food intake during postpartum period as a result of metabolic programming. By influencing the fetal metabolism and tissue development, maternal obesity and excessive weight gain change the amounts of nutrients and metabolites that pass to the fetus, thus causing excessive fetal weight gain which in turn increases the risk of obesity. Fetal over-nutrition and excessive weight gain cause permanent metabolic and physiologic changes in developing organs. While mechanisms that affect these organs are not fully understood, it is thought that the changes may occur as a result of the changes in fetal energy metabolism, appetite control, neuroendocrine functions, adipose tissue mass, epigenetic mechanisms and gene expression. In this review article, the effects of maternal body weight and weight gain on fetal development, newborn birth weight and risk of obesity were evaluated, and additionally potential mechanisms that can explain the effects of fetal over-nutrition on the risk of obesity were investigated [TAF Prev Med Bull 2014; 13(5.000: 427-434

Disease management: findings from leading state programs.

Science.gov (United States)

Wheatley, Ben

2002-12-01

Disease management programs are designed to contain costs by improving health among the chronically ill. More than 20 states are now engaged in developing and implementing Medicaid disease management programs for their primary care case management and fee-for-service populations.

Weight management in pregnancy

OpenAIRE

Olander, E. K.

2015-01-01

Key learning points:\\ud - Women who start pregnancy in an overweight or obese weight category have increased health risks\\ud - Irrespective of pre-pregnancy weight category, there are health risks associated with gaining too much weight in pregnancy for both mother and baby\\ud - There are currently no official weight gain guidelines for pregnancy in the UK, thus focus needs to be on supporting pregnant women to eat healthily and keep active

Strategies in disability management. Corporate disability management programs implemented at the work site.

Science.gov (United States)

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

‘Small Changes' to Diet and Physical Activity Behaviors for Weight Management

Directory of Open Access Journals (Sweden)

Andrew P. Hills

2013-05-01

Full Text Available Obesity is associated with numerous short- and long-term health consequences. Low levels of physical activity and poor dietary habits are consistent with an increased risk of obesity in an obesogenic environment. Relatively little research has investigated associations between eating and activity behaviors by using a systems biology approach and by considering the dynamics of the energy balance concept. A significant body of research indicates that a small positive energy balance over time is sufficient to cause weight gain in many individuals. In contrast, small changes in nutrition and physical activity behaviors can prevent weight gain. In the context of weight management, it may be more feasible for most people to make small compared to large short-term changes in diet and activity. This paper presents a case for the use of small and incremental changes in diet and physical activity for improved weight management in the context of a toxic obesogenic environment.

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Science.gov (United States)

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps.

Science.gov (United States)

Driscoll, Kimberly A; Corbin, Karen D; Maahs, David M; Pratley, Richard; Bishop, Franziska K; Kahkoska, Anna; Hood, Korey K; Mayer-Davis, Elizabeth

2017-08-01

This review aims to summarize the type 1 diabetes (T1D) and weight literature with an emphasis on barriers associated with weight management, the unique T1D-specific factors that impact weight loss success, maladaptive and adaptive strategies for weight loss, and interventions to promote weight loss. Weight gain is associated with intensive insulin therapy. Overweight and obese weight status in individuals with T1D is higher than the general population and prevalence is rising. A variety of demographic (e.g., female sex), clinical (e.g., greater insulin needs), environmental (e.g., skipping meals), and psychosocial (e.g., depression, stress) factors are associated with overweight/obese weight status in T1D. Fear of hypoglycemia is a significant barrier to engagement in physical activity. Studies evaluating adaptive weight loss strategies in people with T1D are limited. There is a growing literature highlighting the prevalence and seriousness of overweight and obesity among both youth and adults with T1D. There is an urgent need to develop evidence-based weight management guidelines and interventions that address the unique concerns of individuals with T1D and that concurrently address glycemic control.

Sandia National Laboratories, California Waste Management Program annual report.

Energy Technology Data Exchange (ETDEWEB)

Brynildson, Mark E.

2010-02-01

The annual program report provides detailed information about all aspects of the Sandia National Laboratories, California (SNL/CA) Waste Management Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. This annual program report describes the activities undertaken during the past year, and activities planned in future years to implement the Waste Management (WM) Program, one of six programs that supports environmental management at SNL/CA.

Waste management in Canadian nuclear programs

International Nuclear Information System (INIS)

Dyne, P.J.

1975-08-01

The report describes the wide-ranging program of engineering developments and applications to provide the Canadian nuclear industry with the knowledge and expertise it needs to conduct its waste management program. The need for interim dry storage of spent fuel, and the storage and ultimate disposal of waste from fuel reprocessing are examined. The role of geologic storage in AECL's current waste management program is also considered. (R.A.)

76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

Science.gov (United States)

2011-06-13

... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

Weight management in type 2 diabetes: current and emerging approaches to treatment.

Science.gov (United States)

Van Gaal, Luc; Scheen, André

2015-06-01

Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Defense Contract Management Command Support to System Acquisition Program Managers

National Research Council Canada - National Science Library

1999-01-01

.... This report discusses the planning of contract administration office support to system acquisition program managers through the program integration process and the customer support outreach program...

18 CFR 260.400 - Cash management programs.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Cash management... Cash management programs. Natural gas companies subject to the provisions of the Commission's Uniform... management programs must file these agreements with the Commission. The documentation establishing the cash...

Developing Program Management Leadership for Acquisition Reform

Science.gov (United States)

2011-04-30

mêçÅÉÉÇáåÖë= çÑ=íÜÉ= bfdeqe=^kkr^i=^`nrfpfqflk== obpb^o`e=pvjmlpfrj== qeropa^v=pbppflkp== slirjb ff Developing Program Management Leadership for...4. TITLE AND SUBTITLE Developing Program Management Leadership for Acquisition Reform 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...Developing Program  Management   Leadership   for Acquisition Reform    The 8th Annual Acquisition Research Symposium Panel #20: Investing in People

Perceived Barriers to Weight loss Programs for Overweight or Obese Women

Directory of Open Access Journals (Sweden)

Nasrin Sharifi

2013-06-01

Full Text Available Background: In order to develop appropriate obesity control and treat¬ment strategies, the key point is to understand the barriers perceived by overweight or obese people in trying to follow weight-loss programs. This study examined perceived barriers to weight-loss programs among over¬weight or obese women.Methods: In this descriptive-analytical study, 204 overweight or obese women aged 31.97± 10.62 yr, were selected randomly from the nutritional counseling centers in 2008 in Tabriz, Iran. The mean BMI was 33.83 ±5.75 kg/ m2. A structured questionnaire including questions on barriers to weight-loss diet and physical activity was filled out for each participant by face-to-face interview. Height and weight measured objectively and demo¬graphic details were obtained. Data analysis carried out using mul¬tiple re¬gression and factor analysis.Results: The most important perceived barriers to weight-loss diets were 'situational barriers', stress, depression, and food craving. High educational level was independent determinant of situational barriers (β=0.329, P=0.048. Employee women had a higher mean score on stress and de¬pres¬sion than students and housewives. Lack of time and exercising lonely were the most important items of "External barriers" and Lack of motiva¬tion was the most important item of "internal barriers" to physical activity. Employ¬ment and being student were highly associated with external bar¬riers (β=1.018, P<0.001 and β=0.541, P= 0.002. Moreover, older women who had low educational level, perceived more internal barriers. Conclusion: Weight reducing strategies should take into account the spe¬cific perceived barriers to weight-loss diets faced by overweight or obese women, particularly situational barriers, stress and depression and food craving; and lack of time and lack of motivation as barriers to physical ac¬tivity.

Predicting short-term weight loss using four leading health behavior change theories

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Barata José T

2007-04-01

Full Text Available Abstract Background This study was conceived to analyze how exercise and weight management psychosocial variables, derived from several health behavior change theories, predict weight change in a short-term intervention. The theories under analysis were the Social Cognitive Theory, the Transtheoretical Model, the Theory of Planned Behavior, and Self-Determination Theory. Methods Subjects were 142 overweight and obese women (BMI = 30.2 ± 3.7 kg/m2; age = 38.3 ± 5.8y, participating in a 16-week University-based weight control program. Body weight and a comprehensive psychometric battery were assessed at baseline and at program's end. Results Weight decreased significantly (-3.6 ± 3.4%, p Conclusion The present models were able to predict 20–30% of variance in short-term weight loss and changes in weight management self-efficacy accounted for a large share of the predictive power. As expected from previous studies, exercise variables were only moderately associated with short-term outcomes; they are expected to play a larger explanatory role in longer-term results.

Apollo Soyuz Test Project Weights and Mass Properties Operational Management System

Science.gov (United States)

Collins, M. A., Jr.; Hischke, E. R.

1975-01-01

The Apollo Soyuz Test Project (ASTP) Weights and Mass Properties Operational Management System was established to assure a timely and authoritative method of acquiring, controlling, generating, and disseminating an official set of vehicle weights and mass properties data. This paper provides an overview of the system and its interaction with the various aspects of vehicle and component design, mission planning, hardware and software simulations and verification, and real-time mission support activities. The effect of vehicle configuration, design maturity, and consumables updates is discussed in the context of weight control.

Expert Coaching in Weight Loss: Retrospective Analysis

Science.gov (United States)

Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

2018-01-01

Background Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. Objective The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. Methods A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Conclusions Participant’s one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. PMID:29535082

The Primary Results of the Treating Adult Smokers at Risk for Weight Gain with Interactive Technology (TARGIT) Study.

Science.gov (United States)

Johnson, Karen C; Thomas, Fridtjof; Richey, Phyllis; Tran, Quynh T; Tylavsky, Fran; Miro, Danielle; Coday, Mace

2017-10-01

To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent postcessation weight gain. Three hundred and thirty young adult smokers, age 18 to 35 years, were randomized to a smoking cessation program alone (comparison group), which included behavioral counseling and nicotine replacement, or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (intervention group). The Treating Adult Smokers at Risk for Weight Gain with Interactive Technology study randomized 164 participants to the comparison group and 166 participants to the intervention group. On average, the participants gained 0.91 kg after 24 months in the trial (comparison group + 1.45 kg and intervention group + 0.32; P = 0.157). The only variable systematically affecting weight change over time was smoking abstinence, in which those who were abstinent, on average, gained 0.14 kg more per month compared with those who continued to smoke (P technology was not associated with greater long-term weight gain prevention. © 2017 The Obesity Society.

Following Suit: Using Conversation Cards for Priority Setting in Pediatric Weight Management.

Science.gov (United States)

Kebbe, Maryam; Byrne, Jillian L S; Damanhoury, Samah; Ball, Geoff D C

To describe families' selections of Conversation Cards (CCs), a priority-setting tool in pediatric weight management, and examine CC-related differences based on families' anthropometric and sociodemographic characteristics. A retrospective medical record review was conducted of 2- to 17-year-olds with obesity and their families who enrolled in a pediatric weight management clinic between January, 2012 and September, 2016. Medical records of 146 children were included. On average, families selected 10 ± 6 CCs (range, 3-32 CCs); only 50% of families (n = 73) indicated perceived readiness to make healthy changes. Adolescents (vs children) revealed less healthy eating behaviors (P = .001) and physical activity habits (P = .002). Goal setting was perceived to be a motivator across several sociodemographic characteristics (all P < .05). The CCs were useful in describing families' priorities. The diversity of issues identified by families highlighted the importance of multidisciplinary expertise in pediatric weight management. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Perceived helpfulness of the individual components of a behavioural weight loss program: results from the Hopkins POWER Trial

OpenAIRE

Dalcin, A. T.; Jerome, G. J.; Fitzpatrick, S. L.; Louis, T. A.; Wang, N?Y.; Bennett, W. L.; Durkin, N.; Clark, J. M.; Daumit, G. L.; Appel, L. J.; Coughlin, J. W.

2015-01-01

Summary Background Behavioural weight loss programs are effective first?line treatments for obesity and are recommended by the US Preventive Services Task Force. Gaining an understanding of intervention components that are found helpful by different demographic groups can improve tailoring of weight loss programs. This paper examined the perceived helpfulness of different weight loss program components. Methods Participants (n?=?236) from the active intervention conditions of the Practice?bas...

Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.

Science.gov (United States)

Yon, Bethany A; Johnson, Rachel K; Harvey-Berino, Jean; Gold, Beth Casey; Howard, Alan B

2007-04-01

Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (pself-monitoring that is fitting to their lifestyle and skills.

Prenatal centrifugation: A model for fetal programming of adult weight?

Science.gov (United States)

Baer, Lisa A.; Rushing, Linda; Wade, Charles E.; Ronca, April E.

2005-08-01

'Fetal programming' is a newly emerging field that is revealing astounding insights into the prenatal origins of adult disease, including metabolic, endocrine, and cardiovascular pathophysiology. In the present study, we tested the hypothesis that rat pups conceived, gestated and born at 2-g have significantly reduced birth weights and increased adult body weights as compared to 1-g controls. Offspring were produced by mating young adult male and female rats that were adapted to 2-g centrifugation. Female rats underwent conception, pregnancy and birth at 2-g. Newborn pups in the 2-g condition were removed from the centrifuge and fostered to non-manipulated, newly parturient dams maintained at 1-g. Comparisons were made with 1-g stationary controls, also cross- fostered at birth. As compared to 1-g controls, birth weights of pups gestated and born at 2-g were significantly reduced. Pup body weights were significantly reduced until Postnatal day (P)12. Beginning on P63, body weights of 2-g-gestated offspring exceeded those of 1-g controls by 7-10%. Thus, prenatal rearing at 2-g restricts neonatal growth and increases adult body weight. Collectively, these data support the hypothesis that 2-g centrifugation alters the intrauterine milieu, thereby inducing persistent changes in adult phenotype.

Evaluating and Selecting Sport Management Undergraduate Programs.

Science.gov (United States)

Cuneen, Jacquelyn; Sidwell, M. Joy

1998-01-01

States that the accelerated growth of sport management undergraduate programs that began in the 1980s has continued into the current decade. There are currently 180 sport management major programs in American colleges and universities. Describes the sports management approval process and suggests useful strategies to evaluate sport management…

Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

Science.gov (United States)

Crowley, Matthew J; Edelman, David; Voils, Corrine I; Maciejewski, Matthew L; Coffman, Cynthia J; Jeffreys, Amy S; Turner, Marsha J; Gaillard, Leslie A; Hinton, Teresa A; Strawbridge, Elizabeth; Zervakis, Jennifer; Barton, Anna Beth; Yancy, William S

2017-07-01

Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m 2 ) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes. Copyright © 2017. Published by Elsevier Inc.

A multidisciplinary weight-loss program: the importance of psychological group therapy

Directory of Open Access Journals (Sweden)

Gustavo Duarte Ferrari

Full Text Available Abstract In addition to dietary factors and sedentary habits, there is a relationship between obesity and psychological variables, even without a clear distinction between cause, effect, and correlation. Despite this relationship, weight-loss programs are limited to a combination of nutrition and physical education, leaving psychological intervention out of the treatment plan. Self-esteem issues, depression, and anxiety are just some of the emotional conditions related to obesity. However, there is no information in the literature about the importance of psychological counseling in a multidisciplinary program for weight-loss in adults. In this context, the main objective of this study was to analyze the effect of cognitive-behavioral therapy in groups (CBTG combined with nutrition and physical education within a multidisciplinary approach to treat obesity. 46 individuals (7 men and 39 women were divided into two groups: control (GC and psychology (GP. Baseline and intervention measures were obtained prior to intervention and before the final meeting, including physical capacity tests and the administering the International Physical Activities Questionnaire (IPAQ. Both groups attended weekly lectures given by a nutritionist and two physical education professionals for 12 weeks. In addition, the GP participated in weekly sessions of CBTG for the same period. After the program, there were significant changes in body mass index, waist circumference, body fat percentage, and strength of the lower limbs in both groups. In addition to these changes, the GP also showed improvements in diastolic blood pressure and IPAQ scores, being the only one that increased its time of weekly physical activity. Thus, it was concluded that the psychological treatment might play an important role in a multidisciplinary weight-loss program.

Outcomes of weight management in obese pet dogs: what can we do better?

Science.gov (United States)

German, Alexander J

2016-08-01

Obesity is arguably the biggest health and welfare issue affecting pet dogs. Although successful weight loss has health benefits, current strategies are far from ideal. Many obese dogs that start a weight programme fail to lose weight, or subsequently regain the weight they have lost. Given that current weight loss strategies are not perfect, clinicians need to focus carefully on tailoring the programme, perhaps setting a pragmatic target for weight loss, so as to ensure the benefits are maximised. This review will summarise key findings from recent clinical research into pet obesity, and present a framework for improving success, by better tailoring weight management regimens and end points to the individual.

Using management action plans to integrate program improvement efforts

Energy Technology Data Exchange (ETDEWEB)

Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N. [Project Performance Corporation, Sterling, VA (United States)

1994-12-31

The Department of Energy`s (DOE`s) Environmental Management Program is the country`s largest and most sophisticated environmental program to date. The rapid expansion of the DOE`s environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program`s management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities.

Beverage consumption and adult weight management: A review.

Science.gov (United States)