Control Advice Research Articles

Natural course of gestational diabetes mellitus: long term follow up of women in the SPAWN study

Objectives Long term follow up women with gestational diabetes mellitus (GDM). Design Case–control study. Setting Academic obesity unit. Population Women earlier identified as having gestational diabetes mellitus. Method Twenty-eight women diagnosed with GDM in 1984–1985, and a control group ( n = 52) who gave birth at the same time performed a 2-h oral glucose tolerance test 15 years later. Basic anthropometry and questions about various aspects of eating and exercise habits were furthermore obtained. Results Ten women (35%) in the GDM group were diagnosed with type 2 diabetes mellitus and none in the control group ( P < 0.001). Mean BMI in the diabetic group was 27.4 kg/m 2 and in the non-diabetic GDM group 24.6 kg/m 2 ( P < 0.05). The mean weight gain since the first child was 8.4 kg in all GDM versus 8.1 kg in controls (ns). The women who developed type 2 diabetes mellitus, however, gained 15.1 kg since the birth of their first child ( P < 0.05). Conclusions Women who are diagnosed with GDM have a considerably higher risk of developing type 2 diabetes mellitus later in life. Despite a close medical monitoring during pregnancy, the further follow up within the health care system and information about long term consequences of GDM for later type 2 diabetes mellitus development seems to be generally lacking. More active strategies for future weight control and lifestyle advice after delivery might therefore be indicated for women with GDM.

Knowledge, Beliefs, Attitudes, and Behaviors Related to Weight Control, Eating Disorders, and Body Image in Australian Trainee Home Economics and Physical Education Teachers

Objective To examine the knowledge, beliefs, and attitudes about weight control and eating disorders among trainee home economics and physical education teachers and to assess their body image and weight control practices. The association between actual body weight and body image was also examined. Design Survey research was undertaken using a self-report questionnaire. Height and weight were measured. Subjects/Settings Trainee home economics and physical education teachers (N = 216, 96% participation rate) in their last month of training at three major state teacher training universities completed a questionnaire during their regular class times. Main Outcome Measures Advice teachers give to overweight adolescents knowledge and beliefs about eating disorders, body image, desired weight, food habits, dieting, body appearance ratings, weight control practices, and diagnosed and self-reported eating disorders. Statistical Analysis Performed Descriptive statistics, chi square, and analyses of variance compare gender and Body Mass Index differences. Results Males (85%) and females (87%) advised young overweight adolescents to diet to lose weight. Twenty percent of females and 13% of males regularly skipped breakfast. The advise given showed a lack of specific nutrition education about weight control, adolescent nutritional needs, and fad diets. Participants held misconceptions about eating disorders, and a range of 14% to 72% answered these questions incorrectly. Fourteen percent of females self-reported that they currently had an eating disorder, but only 6% had received treatment. Some females used potentially dangerous methods of weight loss, including 19% who abused laxatives and 10% who induced vomiting. Implications Trainee home economics and physical education teachers need specific nutrition information and training about eating disorders, weight control, and suitable advice for overweight students. The female trainee teachers in our study had a poor body image and disordered eating similar to other young women in Western countries, and this should be taken into account by teacher training institutions.

Can clinically significant weight loss be achieved and sustained? An evaluation of a general practice based weight control clinic

Background and aims: An evaluation was carried out of a general practice based weight control advice clinic to determine if clinically significant weight loss can be achieved and maintained in patients by this means. The weekly clinic was run by a health visitor for 8 years during which time 198 patients attended. Patients were seen individually by appointment on average between 1 and 4 weeks following referral by the GP, nurse or health visitor. The intervention was based on dietary and lifestyle advice. Methods: Short‐term outcomes were determined from retrospective inspection of clinic data for all 198 patients. One hundred and five patients were followed‐up at least 1 year after completion of the programme of clinic attendance and weighed to determine the long‐term outcome. Results: One hundred and ninety‐three (97%) patients achieved some weight loss during the programme, 33% achieved a 10% reduction in weight and 52% of patients achieved a reduction of BMI from above to below 30 kg/m2. Long‐term follow‐up showed that 6% patients maintained a 10% weight loss and 18% maintained a reduction of BMI from above to below 30 kg/m2. Conclusion: The results of this evaluation suggest that research on appropriate follow‐up to enable patients to maintain weight loss is needed.

エルゴメーターの負荷 一目盛が脂肪代謝に与える影響

It is important to give weight control advice to obese female with gonarthritis to prevent ischemic heat diseases as well as in the conservative treatment of gonarthritis.In our study, we compared the changes of blood sugar and lipid metabolism by comparing the result before, right after, and one hour after bicycle rowing exercise with the load shift lever set to load I and load II.We compared the results for six female patients. Three hours after their breakfast, we asked them to contine the bicycle rowing exercise for ten minutes three times, with an interval of five minutes in between. Comparison of the results for load I and load II showed no difference in the blood pressure, heart rate, blood sugar, T-cho, and HDL-cho. We however found an obvious increase in the blood density of FFA for load II.We realized that even the aged can increase their FFA by raising the load shift level one level higher. The bicycle rowing exercise did not produce any effects on the heart rate.

A UK scheme to help small firms control health risks from chemicals: toxicological considerations.

The UK has developed a simple scheme to provide practical control advice to small and medium-sized enterprises (SMEs), to assist them in their risk assessments and risk management decisions. This scheme makes use of toxicological hazard information indicated by R-phrases assigned under the European Union (EU) classification system, to assign substances to hazard bands. In the UK scheme, the allocation of substances to hazard bands according to R-phrases has taken into account three key factors: whether or not the toxicological endpoint has an identifiable dose threshold; the seriousness of the resultant health effect; and the relative exposure levels at which toxic effects occur. Based on all these considerations, R-phrases have been allocated to hazard bands within the scheme. An evaluation exercise has been undertaken, to compare the output of the scheme with established health-based occupational exposure limits, for more than 100 substances. The results of this exercise demonstrate that as far as possible, the scheme recommends control strategies which should provide adequate control. This scheme is potentially a very powerful means of helping SMEs adequately control chemical health risks in the workplace. Since it utilises the EU-agreed classification system, the scheme can be applied to any substance supplied and used in the workplace and it may also be used internationally.

Eugenics and birth control: contraceptive provision in North Wales, 1918-1939.

The close relationship between the provision of birth control advice and the ideology of eugenics deserves closer attention. This paper focuses on the enthusiasm for eugenic ideas amongst an influential section of the medical profession and their ability to initiate contraceptive provision. A study of North Wales suggests that clinic provision in the interwar period reflected the enthusiasm or hostility of the medical profession more closely than the needs or demands of the female population, and illustrates how, for some doctors, the issue of contraception was seen in the wider context of the nation's health.

Nurses' documentation of infection control precautions: 2.

A small action research study was undertaken, using a quasi-experimental approach, to establish to what extent infection control advice was documented and to assess the effectiveness of the provision of an example care plan for control of infection. The study population comprised two groups of patients colonized or infected with ALERT organisms and involved 28 wards in six hospitals. Baseline data confirmed that infection control precautions were documented for less than 25% of patients overall. Provision of an 'example' care plan, together with guidance in its use, was followed by an increase in documentation for all items audited, while identification of the infection in the care plan showed a statistically significant increase (P < 0.05). However, in spite of this apparent improvement the documentation of appropriate care for control of infection remained inadequate. It is concluded that, while various strategies to effect change are at the infection control nurse's disposal, the need to integrate infection control with practice must be addressed at every level to include managers, educators and practitioners.

FLYPAST: an information management system for the Rothamsted Aphid Database to aid pest control research and advice

The development of an information management system (FLYPAST) for the suction traps of the Rothamsted Insect Survey is described. FLYPAST is written in dBASE IV [Borland International (UK) Ltd] and runs on IBM-compatible personal computers. Information delivery, in the form of a weekly bulletin, and information analysis have been improved by increased accessibility to, and faster retrieval of, the data. Prototype decision support systems that use suction trap data have been incorporated into the system for forecasting outbreaks of the black bean aphid ( Aphis fabae) on field beans and of potato virus Y levels in crops intended for use as home-saved seed. The potential for expanding the system to produce, automatically, commentaries of aphid catches for use in advisory work is discussed.

COMPUTER DECISION SUPPORT TOOL FOR HEIGHT CONTROL OF POINSETTIAS

Height control is a major challenge in the production of high quality poinsettia crops. Graphical tracking is a technique where growers make height control decisions by comparing actual measured plant height with a desired height. A computer decision support tool, the Poinsettia Care System, is being developed to combine graphical display of plant height with an expert system to provide height control advice. A simulation model is used to predict future growth of the crop based on greenhouse temperature, growth retardant applications, plant spacing, plant maturity, and light quality. Growth retardant and temperature recommendations are made based on a crop's deviation from the target height, expected future growth rate, and crop maturity. The program was beta tested by 8 Michigan growers over the 1991 poinsettia season. The test growers reacted positively to the program in a follow-up survey. Perceived benefits included improved height control, consistent crop recording, and a `second opinion' when making height control decisions. Improvements were suggested to combine the advice of different crops within the same greenhouse zone, to improve the predictive growth model, and to streamline data entry and output.

Pilot Disorientation as the Most Frequent Cause of Fatal, Weather-Related Accidents in UK Civil and General Aviation

Over 20 years ago, collision with high ground was identified as being the single most significant cause of fatalities among air travellers worldwide (Smith, 1968), and some human factors responsible were highlighted. The three factors most commonly found to be present during major civil aviation accidents were: (i) pilot's visual flight in instrument meterological conditions (IMC); (ii) navigational error by the crew and'; (iii) pilot's failure to react correctly to new circumstances resulting from air traffic control (ATC) instructions or advice – sometimes made in a language foreign to that of the aircrew. The latter factor will be tested here to see if it still applies to recent cases in the UK.

Makcal: An Application Generator for Advice

With the increased sophistication of analog-circuit simulation tools comes a heavier reliance on the interfaces to these tools. Today, designers can control simulation tools through programs — a technique referred to as procedural simulation — and derive performance measures (e.g., common-mode rejection ratio, bandwidth, etc.) easily from more-basic circuit-simulation variables (i.e., voltages and currents). This technique has proved to be a valuable feature of AT&T's analog-circuit simulator, ADVICE. To enable designers to exploit procedural simulation more fully, a program called makca1 was created. Makca1 writes a procedural-simulation program that a designer can use to control ADVICE. Makca1 includes the capability to select and present performance measures in a variety of graphic and textual formats. Because makca1 streamlines the programming process, designers can concentrate more fully on designing, which reduces the product's time to market.

A model-based approach to on-line process disturbance management: The application

Abstract A model-based methodology for developing a real-time expert system for on-line process disturbance management has been presented in the companion paper ( Reliab. Engng Sys. Safety , Vol. 28, pp. 265–305). The methodology includes diverse functional aspects required for effective process disturbance management: intelligent process monitoring and alarming, sensor failure diagnosis, hardware (except sensors) failure diagnosis, and corrective measure synthesis. The application of the methodology to a target process—the main feedwater system of a pressurized water reactor (PWR) nuclear plant employing a complex control scheme—is presented in this paper. The performance tests of the real-time expert system, MOAS II, developed by the application of the methodology demonstrate that the expert system successfully carries out its intended functions: early detection of occurring disturbance, correct diagnosis of the disturbance cause, and presentation of optimal control advice to the operator. Therefore, the model-based technique lends itself to the development of a valuable operator aid for on-line process disturbance management.

Weight control advice for breast cancer patients

Weight control advice for breast cancer patients

An experimental study of Phototactic responses of Tanytarsus barbitarsis Freeman (Diptera: Chironomidae

A series of salt lakes near Port Augusta, South Australia, supports large larval populations of Tanytarsus barbitarsis Freeman, a chironomid midge. When adults emerge they often fly to nearby artificial lights, and when large numbers do so a considerable nuisance to local residents is caused. In an investigation designed to provide control advice, those parts of the spectrum of particular attractivity to adults were identified in an experimental study of phototactic responses. Results indicated that the peak of attractivity lies in the near-ultraviolet part of the spectrum (370-400 nm). A second, weaker peak lies between 490 and 510 nm. Light intensity does not appear to be important. Certain sorts of commercially available lamps emit light with peaks in those parts of the spectrum attractive to T. barbitarsis and may be suitable for control purposes.

Incorporating Environmental Considerations in Pest Control Advice for Farmers

AbstractThis article develops a model for incorporating environmental quality objectives into pest control advice provided to farmers by agricultural agencies. The model relies on existing institutions and current pest management decision practice and its use has potential for improvements in farm profit as well as environmental quality.

Development of a prototype expert system for identification and control of insect pests

A prototype, rule-based expert system (PEST - Pest Expert SysTem) was developed to evaluate how knowledge engineering techniques may be used to provide insect identification and control advice to farmers and extension workers in Western Australia. PEST uses expert system techniques to ask questions and gives recommendations and advice in a manner akin to an agricultural entomologist. This paper describes the types of decisions made and the knowledge engineering tasks undertaken during development of PEST. The methods used to acquire and represent entomological knowledge in the form of facts, rules and relationships are explained. The reasoning mechanisms employed by the system to interpret and apply rules are also discussed and an example of a session with the PEST program is presented. It is concluded that the problem of identifying insect pests and recommending control strategies is suitable for resolution by a rule-based expert system because the knowledge is of a shallow or empirical nature, the problem domain is of a manageable size, the solutions are well defined and solving the problem requires heuristic solution and the application of expertise that few people possess. PEST was implemented in LPA MacProlog ™ using the University of Edinburgh standard on the Macintosh Plus ™ microcomputer.

CONTRACEPTIVE RISK-TAKING BEHAVIOR BY SEXUALLY ACTIVE ADOLESCENT FEMALES

Despite the availability of effective contraceptives, adolescent pregnancy remains a formidable health issue. Previous studies of adolescent contraceptive risk-taking have been atheoretical in nature and have been analyzed in univariate and bivariate modes. The purpose of this study was to test a multivariate theoretical model which predicts (1) the decision to use contraceptives and (2) the choice of a specific method. The model consists of: premarital sexual standards and experiences→frequency of coitus→perceived probability of pregnancy→cognitive assessment of pregnancy→contraceptive activity. The model was tested using a recent national (U.S.A.) representative sample of nonmarried, sexually active females ages 15 to 20 years (n=1010) and was analyzed with three multiple regression analysis models. The number of years of sexual activity and the frequency of attendance at religious services were associated with coital frequency (R=.17, p<0001). Coital frequency, followed by post menarchial age and years dating also had a direct effect on contraceptive use (R=.23, p<0001). Attitude toward pregnancy, previous professional birth control advice, compliance with first contraceptive method, coital frequency and the source of their first family planning services were highly associated with contraceptive use (r=.84, p<0.0001). These data support the model and provide insight into the decision process used by adolescents to take contraceptive risks.

Learner control and educational advice in computer based learning: The study-station concept

Advances in computer technology are allowing the development of software tools which can give more knowledgeable advice and support to students in managing their own learning. This approach is particularly important when attempting to improve problem solving skills. The paper comments on experience in developing and evaluating software support systems for students' learning to apply mathematical methods in the Biological Sciences. Included are the analysis of talk-aloud problem solving protocols and the implementation of a learner command vocabulary for the on-line investigation and solving of pre-stored problems. These techniques improved performances but were less successful in the transfer of skills. The conclusion provides the design of a knowledge based learning Advisor to overcome these defects.

RISK‐EFFICIENT THRESHOLDS FOR PEST CONTROL DECISIONS

Risk and uncertainty are incorporated in an economic model to develop risk‐efficient pest control advice similar in character to advice currently being offered by researchers to farmers. An example to illustrate computation of risk‐efficient advice is presented and implications of risk aversion for efficient pest control advice and average pesticide use are examined.

A survey of attitudes among 979 women attending a birth control clinic

Interviews were carried out with 979 women attending a clinic for birth control advice. Most of the patients were single, middle-class women who worked in central London offices. More than 600 had never approached their GP for advice; of these, about 200 were reluctant to do so because of embarrassment or fear of the reception they might get. Those that did visit a GP intially tended to complain of a lack of interest. Fewer patients who had sought help from a local family planning clinic expressed a similar dissatisfaction but one-third did criticize the facilities and service provided. Two-thirds of the patients were surprisingly ignorant about the contraceptive facilities available in the areas in which they lived.