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Obesity and psychosocial stress are inter-related chronic conditions which lead to increased cardiovascular morbidity and mortality. The aim of this parallel randomized controlled trial was to determine whether the addition of a structured cognitive behavioral stress management (CBSM) on to a commercial online weight loss program, resulted in greater weight loss than the standard weight loss program in isolation. Eligible participants were adults between the ages 18–65, BMI 30–45 kg/m2, with no major systemic or psychiatric conditions. Seventy-four participants were assigned according to simple randomization using computer generated random numbers to either a 3-month online Weight Watchers® program (n = 36), or Weight Watchers® plus 10 weekly sessions of CBSM (n = 38). The primary outcome was weight at 3 months compared to baseline. Secondary outcomes were weight at 12 months and subjective/objective stress system measures and metabolic markers at 3 and 12 months. The study was powered at 90% to detect a 5 kg difference in weight between the two groups at 3 months. Independent sample t-tests were used to analyze the difference in weight (in kg) between the groups and paired sample t-tests were used to analyze the difference within group at different time intervals. At follow-up, there was no significant difference in weight loss between the groups (1.8 kg, 2.1 kg). However, CBSM was effective in reducing psychological measures of stress (p

Summary: Background & aims: Malnutrition is associated with functional decline and poorer clinical outcomes for hospitalised patients. This study aimed to survey the knowledge of clinical staff concerning identification/diagnosis and management of inpatient malnutrition and to assess attitudes and knowledge of malnutrition as a shared inter-disciplinary responsibility. Methods: A survey designed to investigate the aims was distributed to clinical staff (medical, nursing, dietitians and allied health) across three hospital campuses including acute, sub-acute and rehabilitation sites. Results: Survey responses were received from 14% (n = 302) of eligible clinical staff (116 nursing, 68 medical, 20 dietitians and 98 other allied health staff). With the exception of dietitians, responses to questions regarding skills and knowledge in the areas of malnutrition identification, diagnosis, treatment and management indicated sub-optimal knowledge. Only 60% of medical/surgical staff and 42% of nursing staff self-reported the ability to diagnose malnutrition. Responses to questions regarding responsibility for malnutrition were highly variable and suggested no significant ‘shared ownership’ of malnutrition as clinical responsibility. Conclusion: Apart from dietitians, malnutrition management skills were modest and knowledge gaps of clinical staff were marked. Confusion also existed as to the responsibility for malnutrition care for inpatients. To improve inpatient nutrition further multidisciplinary engagement and improved education may be required.