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Aim Expert recommendations for child/adolescent obesity include extensive investigation for weight-related comorbidities, based on body mass index (BMI) percentile cut-offs. This study aimed to estimate the cost of initial investigations for weight-related comorbidities in children/adolescents with obesity, according to international expert guidelines. Methods The annual mean cost of investigations for weight-related comorbidities in children/adolescents was calculated from a health-funder perspective using 2019 cost data obtained from three New Zealand District Health Boards. Prevalence data for child/adolescent obesity (aged 2-14 years) were obtained from the New Zealand Health Survey (2017/2018), and prevalence of weight-related comorbidities requiring further investigation were obtained from a previous New Zealand study of a cohort of children with obesity. Results The cost of initial laboratory screening for weight-related comorbidities per child was NZD 28.36. Based on national prevalence data from 2018/2019 for children with BMI greater than the 98th percentile (obesity cut-off), the total annual cost for initial laboratory screening for weight-related comorbidities in children/adolescents aged 2-14 years with obesity was estimated at NZD 2,665,840. The cost of further investigation in the presence of risk factors was estimated at NZD 2,972,934. Conclusions Investigating weight-related comorbidities in New Zealand according to international expert guidelines is resource-intensive. Ways to further determine who warrants investigation with an individualised approach are required.

Objective To understand facilitators and barriers to engagement in a multidisciplinary assessment and intervention program for children and adolescents with obesity, particularly for Māori, the Indigenous people of New Zealand. Methods Whānau Pakari participants and caregivers (n = 71, 21% response rate) referred to the family-based healthy lifestyles program in Taranaki, New Zealand, were asked to participate in a confidential survey, which collected self-reported attendance levels and agreement with statements around service accessibility and appropriateness and open-text comments identifying barriers and facilitators to attendance. Results Self-reported attendance levels were higher when respondents reported sessions to be conveniently located (P = .03) and lower when respondents considered other priorities as more important for their family (P = .02). Māori more frequently reported that past experiences of health care influenced their decision to attend (P = .03). Facilitators included perceived convenience of the program, parental motivation to improve child health, and ongoing support from the program. Conclusions and Implications Program convenience and parental and/or self-motivation to improve health were facilitators of attendance. Further research is required to understand the relationship between past experiences with health care and subsequent engagement with services.

Background: Little is known about adults’ experience of living with cystic fibrosis (CF) specifically in relation to the gut. However, their unique perspectives may be meaningful to children with CF and inform the understanding and practice of dietitians. The present study aimed to explore adults’ lived experience of the CF gut and how they learnt to manage the gut as they were growing up. Methods: Semi‐structured interviews were conducted with adult inpatients (n = 10). Interviews were audio‐recorded, transcribed verbatim and accounts analysed using interpretative phenomenological analysis. Results: Three super‐ordinate themes were identified: taking Creon, the learning process and this much I (now) know. Participants accounts of how CF affects the gut predominantly focused on taking Creon (pancreatin, Mylan). Various strategies were employed for coping with peer responses to taking Creon at school. Several participants reached adulthood before they understood and/or accepted that taking Creon consistently needed to be normal for them. Knowledge and understanding developed over time, with ‘CF experience’ and was shaped by family, CF care teams and other children with CF. All had unmet information needs when growing up. Having key explanations earlier, to make connections between eating, taking Creon, gaining weight and growth, did or would have helped most participants. Participants urged children to be assertive, ask questions and not only be involved in managing their diet and gut, but also begin to take control of this aspect of their CF. Conclusions: Supporting development of knowledge, skills and confidence to manage diet and the gut needs to be integral to care throughout childhood.

ObjectiveChild and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change.DesignQualitative focus group study.SettingCommunity-based healthy lifestyle intervention programme in a mixed urban–rural region of Aotearoa/New Zealand.ParticipantsParents/caregivers (n=6) and children/adolescents (n=8) who participated in at least 6 months of an assessment and weekly session, family-based community intervention programme for children and adolescents affected by obesity.ResultsFindings covered participant experiences, healthy lifestyle changes due to participating in the programme, the delivery team, barriers to engagement and improvements. Across these domains, four key themes emerged from the focus groups for participants and their caregivers relating to their experience: knowledge-sharing, enabling a family to become self-determining in their process to achieve healthy lifestyle change; the importance of connectedness and a family-based programme; the sense of a collective journey and the importance of a nonjudgemental, respectful welcoming environment. Logistical challenges and recommendations for improvement were also identified.ConclusionsPolicymakers need to consider the experiences of participants alongside quantitative outcomes when informing multidisciplinary intervention programmes for children and adolescents affected by obesity.Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR):12611000862943; Post-results.

Māori and Pacific Islander people are a priority population originating from Australasia. Māori and Pacific Islander children exhibit greater risk of obesity and associated morbidities compared to children of other descent, secondary to unique cultural practices and socioeconomic disadvantage. Despite these known risk factors, there is limited synthesised evidence for preventing and treating childhood obesity in this unique population. The objective of this systematic review was to identify and evaluate global prevention or treatment interventions for overweight or obesity that targeted Māori and Pacific Islander children and adolescents (aged 2-17 years).The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The databases PubMed, EMBASE, Scopus, Web of Science and CINAHL were searched from inception to August 2018. Study quality and risk of bias was assessed using a modified Downs and Black Quality Checklist for Health Care Intervention Studies. Studies were included if RCT/intervention/case control/ or prevention study designs. The study group was defined under the search term 'Oceanic Ancestry Group'.Of the initial 94 articles identified, six were included describing two prevention and three treatment interventions. Interventions were heterogenous in setting, design, length and outcomes. Four interventions were implemented in New Zealand. Most studies were of 'fair' quality. One study recruited an exclusive population of Māori and Pacific Islander participants. In the five studies that recruited mixed populations, one performed sub-group analysis on Māori and Pacific Islander participants. No study reported an improvement in anthropometric outcomes post-intervention in complete or sub-group analysis. Improvements in cardiometabolic or psychological secondary outcomes were inconsistent across all studies.There is a lack of evidence to recommend specific intervention characteristics to optimise obesity prevention or treatment outcomes for Māori and Pacific Islander children. Future research requires greater consideration of cultural values and beliefs, community engagement, exclusive targeting of Māori and Pacific Islander children and families, and sub-group analyses for mixed-population studies. Incorporating co-design principles during study design and implementation can maximise the cultural specificity of interventions and may contribute to improved health and weight-related outcomes for this at-risk, priority population.PROSPERO CRD42019121790 (26 March 2019).

Objective To determine whether 12-month BMI SDS reductions persisted at 24 months in a multi-disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved. Methods This was a community-based 12-month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight-related comorbidities. The low-intensity control received comprehensive home-based baseline assessments and advice, and 6-monthly follow-up. The high-intensity intervention received the same assessments and advice, but also weekly multidisciplinary sessions. Primary outcome was BMI SDS at 12 months. Secondary outcomes included cardiovascular and metabolic markers. Results 121 participants (60% of participants at baseline) were assessed at 24 months. BMI SDS reduction at 12 months was lost at 24 months in the modified intention-to-treat analysis [Control -0.03 (95%CI -0.14, 0.09) and Intervention -0.02 (-0.12, 0.08); P = .93]. However, sweet drink intake was reduced, water intake increased, and there were improvements in cardiovascular fitness in the high-intensity intervention. ≥70% attendance in the high-intensity intervention resulted in a persistent BMI SDS reduction of -0.22 after 24 months (95%CI -0.38, -0.06). Conclusions This trial was negative in terms of primary outcome at 24 months. However, high engagement led to sustained treatment effect, and there were multiple improvements in health measures.

Objective To report 12-month outcomes from a multidisciplinary child obesity intervention program, targeting high-risk groups. Methods In this unblinded randomized controlled trial, participants (recruited January 2012-August 2014) were aged 5 to 16 years, resided in Taranaki, Aotearoa/New Zealand, and had BMI ≥ 98th percentile or BMI > 91st percentile with weight-related comorbidities. Randomization was by minimization (age and ethnicity), with participants assigned to an intense intervention group (home-based assessments at 6-month intervals and a 12-month multidisciplinary program with weekly group sessions) or to a minimal-intensity control group with home-based assessments and advice at each 6-month follow-up. The primary outcome was the change in BMI standard deviation score (SDS) at 12 months from baseline. A mixed model analysis was undertaken, incorporating all 6- and 12-month data. Results Two hundred and three children were randomly assigned (47% Māori, 43% New Zealand European, 53% female, 28% from the most deprived quintile, mean age 10.7 years, mean BMI SDS 3.12). Both groups displayed a change in BMI SDS at 12 months from baseline (−0.12 control, −0.10 intervention), improvements in cardiovascular fitness (P

Objective/designIt remains unclear as to the efficacy of readiness for change measurements in child and adolescent obesity intervention programmes. This observational study aimed to determine whether the caregiver’s stage of change could predict outcome and adherence to treatment in an intensive intervention programme for children and adolescents with obesity.SettingParticipants were from the Whānau Pakari randomised clinical trial, a community based multi-disciplinary intervention programme for obesity in Taranaki, New Zealand.ParticipantsEligible participants (recruited January 2012 to August 2014) were aged 5–16 years and had a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities.InterventionsThis study only assessed participants randomised to the high-intensity intervention programme (6-month assessments with weekly group sessions for 12 months) given attendance data were required (n=96).Primary and secondary outcome measuresPrimary trial outcome was BMI SD score (SDS). Secondary outcome measures included indices such as fruit and vegetable intake, 550-m run/walk time and quality of life scores. At baseline assessment, participants (if >11 years old) and their accompanying adult were assessed for readiness to make healthy lifestyle change.ResultsA quantitative measure of stage of change in caregivers was not a predictor of primary or secondary outcomes (change in BMI SDS pre-contemplation/contemplation −0.08, 95% CI −0.18 to 0.03, action −0.16, 95% CI −0.27 to –0.05, p=0.27), or overall attendance in the weekly activity sessions (40.0% vs 37.1%, respectively, p=0.54) in the child or adolescent.ConclusionsCaregiver’s stage of change was not a predictor of success in this multi-disciplinary assessment and intervention programme for children and adolescents with obesity. Future research needs to determine participants’ factors for success.Trial registration numberANZCTR12611000862943; Post-results.

Aim The aim of this study was to describe the characteristics at enrolment of children and adolescents referred to an obesity programme and to determine how the prevalence of comorbidities differed in Indigenous versus non-Indigenous children. Methods Participants were residents of a semi-rural region of New Zealand (NZ). Eligibility was defined by a body mass index (BMI) of ≥98th percentile or >91st centile with weight-related comorbidities. Fasting blood, medical and physical assessments were obtained. Results During the recruitment period from January 2012 to August 2014, 239 participants, aged 4.8–16.8 years, undertook assessment. Average BMI standard deviation score was 3.09 (standard deviation (SD) = 0.60, range 1.52–5.34 SD). The majority of participants were of either Maori (NZ’s indigenous people (45%)) or NZ European (45%) ethnicity; 29% of participants were from the most deprived quintile of household deprivation. Maori participants were more likely than NZ Europeans to have a mother who smoked during pregnancy (52% vs. 28%, P = 0.001), a family history of type 2 diabetes (66% vs. 53%, P = 0.04), acanthosis nigricans on examination (58% vs. 20%, P

Clinical pharmacy services in North American are well implemented both in community pharmacies and in hospital pharmacies. In 2009 the Chinese government mandated the implementation of clinical pharmacy services in all secondary and tertiary hospitals by 2020. The mandate would require adequately trained clinical pharmacists. However, most pharmacy education programs in China have not yet incorporated clinical pharmacy into their curricula. Many pharmacists have been sent to countries, including the United States and Canada, to receive clinical pharmacy training. Because of different health care systems, medical team dynamics, and language barriers, it became difficult for the returning pharmacists to apply the skills gained from this type of training. As a result, the Second Xiangya Hospital of Central South University initiated an international academic–run train-the-trainer program. The objectives are to provide adequate training for pharmacists to provide pharmaceutical care to patients, conduct clinical pharmacy–related research, and engage in scholarly activities. After evaluation of local readiness, the course commenced in 2014, and to date four trainers have received personalized one-on-one training by an advanced pharmacist with 15 years of experience of delivering similar curricula in North America. We present the initial process evaluation and learning that will contribute to the development of clinical pharmacy courses at Central South University.

ObjectiveTo describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data.MethodsThis study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0TM) (parent and child reports), and Achenbach’s Child Behavior Checklist (CBCL)/Youth Self Report (YSR).ResultsAssessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01–5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=−0.70 and p=0.031, β=−0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (pConclusionsIn this cohort, children and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention programmes.Trial registration numberAustralian NZ Clinical Trials Registry ANZCTR 12611000862943; Pre-results.

We aimed to describe physical activity and sedentary behaviour of obese children and adolescents in Taranaki, New Zealand, and to determine how these differ in Māori (indigenous) versus non-indigenous children. Participants (n = 239; 45% Māori, 45% New Zealand European [NZE], 10% other ethnicities) aged 4.8–16.8 years enrolled in a community-based obesity programme from January 2012 to August 2014 who had a body mass index (BMI) ≥ 98th percentile (n = 233) or >91st–98th percentile with weight-related comorbidities (n = 6) were assessed. Baseline activity levels were assessed using the children’s physical activity questionnaire (C-PAQ), a fitness test, and ≥3 days of accelerometer wear. Average BMI standard deviation score was 3.09 (SD = 0.60, range 1.52–5.34 SDS). Reported median daily activity was 80 minutes (IQR = 88). Although 44% of the cohort met the national recommended screen time of

ObjectivesIt is unclear whether an association exists between obesity in children/adolescents and cognitive function, and whether the latter can be altered by body mass index (BMI) standard deviation score (SDS) reductions. We aimed to determine whether an association exists between BMI SDS and cognitive function in children/adolescents with obesity engaged in an obesity intervention. Second, we sought to determine if BMI SDS reduction at 12 months was associated with improved cognitive function.DesignSecondary analysis of a clinical trial.ParticipantsParticipants (n=69) were recruited from an obesity intervention. Eligible participants (recruited June 2013 to June 2015) were aged 6–16 years, with a BMI ≥98th centile or BMI >91st centile with weight-related comorbidities.Outcome measuresPrimary outcome measure was change in BMI SDS from baseline at 12 months. Dependent variables of cognitive functioning and school achievement were assessed at baseline and 12 months, using dependent variables of cognitive functioning (elements of Ravens Standard Progressive Matrices, Wide Range Achievement Test-fourth edition and Wechsler Intelligence Scale for Children-fourth edition).ResultsAt baseline, BMI SDS was not associated with all aspects of cognitive function tested (n=69). Reductions in BMI SDS over time did not alter cognitive function overall. However, there was a greater reduction in comprehension standard scores in participants who increased their BMI SDS (adjusted estimated difference −6.1, 95% CI −11.6 to −0.6; p=0.03).ConclusionsThere were no observed associations between BMI SDS and cognitive function in participants, apart from comprehension in the exploratory analyses, which may have been a random finding. Further studies need to include larger longitudinal cohorts incorporating a wider BMI range at entry to determine whether our findings persist.Trial registration numberANZCTR12611000862943; Pre-results.

Objectives The aim of this study was to describe dietary intake and eating behaviours of obese children and adolescents, and also to determine how these differ in Indigenous versus non-Indigenous children at enrolment in an obesity programme. Methods Baseline dietary intake and eating behaviour records were assessed from those enrolled in a clinical unblinded randomised controlled trial of a multi-disciplinary intervention. The setting was a community-based obesity programme in Taranaki, New Zealand. Children or adolescents who were enrolled from January 2012 to August 2014, with a BMI ≥98th percentile or >91st centile with weight-related comorbidities were eligible. Results 239 participants (45% Māori, 45% NZ Europeans, 10% other ethnicities), aged 5–17 years were assessed. Two-thirds of participants experienced hyperphagia and half were not satiated after a meal. Comfort eating was reported by 62% of participants, and daily energy intake was above the recommended guidelines for 54%. Fruit and vegetable intake was suboptimal compared with the recommended 5 servings per day (mean 3.5 [SD = 1.9] servings per day), and the mean weekly breakfasts were less than the national average (5.9 vs 6.5; p

Nearly one-third of Canadian children can be categorized as overweight or obese. There is a growing interest in applying e-health approaches to prevent unhealthy weight gain in children, especially in settings that families access regularly. Our objective was to develop and refine an e-health screening, brief intervention, and referral to treatment (SBIRT) for parents to help prevent childhood obesity in primary care.Our SBIRT, titled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), was developed by our research team and an e-health intervention development company. RIPPLE was based on existing SBIRT models and contemporary literature on children's lifestyle behaviors. Refinements to RIPPLE were guided by feedback from five focus groups (6-10 participants per group) that documented perceptions of the SBIRT by participants (healthcare professionals [n = 20], parents [n = 10], and researchers and graduate trainees [n = 8]). Focus group commentaries were transcribed in real time using a court reporter. Data were analyzed thematically.Participants viewed RIPPLE as a practical, well-designed, and novel tool to facilitate the prevention of childhood obesity in primary care. However, they also perceived that RIPPLE may elicit negative reactions from some parents and suggested improvements to specific elements (e.g., weight-related terms).RIPPLE may enhance parents' awareness of children's weight status and motivation to change their children's lifestyle behaviors but should be improved prior to implementation. Findings from this research directly informed revisions to our SBIRT, which will undergo preliminary testing in a randomized controlled trial.

With increasing life expectancy patients with CF are encountering medical complications that historically have never been an issue. Over the last 10 years three patients with CF have been diagnosed with skin malignancy at the Leeds Adult CF unit. Specific risk factors in CF include photosensitive medication, such as ciprofloxacin and anti-fungals, as well as immune suppression post-transplant. In view of this we undertook a questionnaire based survey of our adult patients’ behaviours regarding sun health. The questionnaire was handed out to patients at routine outpatient appointments. Results to date indicate that two thirds of our patients have been sunburnt in the last 12 months. Over half of patients never use any form of sun protection when going out in the sun and only 17% use sun cream most or all of the time. Over 40% of patients had used tanning beds in the past with a third of these using them regularly over the past 12 months. These high risk behaviours were also seen in patients post-lung transplant. In terms of medications almost 60% were able to name medications that increased the risk of sunburn; however, 20% did not know that medications increased the risk. Once the study is completed we plan to implement an educational programme for patients. Particular attention will be paid to high risk groups such as post-transplant patients, patients who have had skin cancer, and patients who have a family history of cancer.

Fig 1. Prebypass midesophageal atrioventricular long-axis view showing a severe aortic insufficiency, an aortic root abscess, and vegetations casting shadowing in the far field. (Color version of figure is available online.)

The effect of a stern flap on the powering performance and annual fuel consumption of an FFG-7 Oliver Hazard Perry Class Guided Missile Frigate is presented. Analytical analysis using free surface potential flow theory was conducted to evaluate the flow on the afterbody of the ship. Model tests were conducted to determine the optimum geometrical characteristics of the stern flap. Based on the analytical and model test results, a stern flap was retrofitted to an FFG-7 Class frigate, and full-scale results on powering performance were collected. Results of model powering experiments showed that the flap, set at 10 deg trailing edge down, decreased the delivered power by 8.4 percent at 26 knots, and provided for a 3.8 percent decrease in annual fuel consumption. This decrease in annual fuel consumption places the payback period on the cost of the flap installation at only 10 months. The full-scale comparison of the flap's effectiveness was marred by adverse weather conditions and differences in the pre-and post-flap ship configurations. However, observations of the full-scale stern wave system, before and after the installation of the stern flap, lead the authors to conclude that the flap will produce a larger decrease in delivered power at full scale than shown by the model experiments.

BackgroundParents play a central role in preventing childhood obesity. There is a need for innovative, scalable, and evidence-based interventions designed to enhance parents’ motivation to support and sustain healthy lifestyle behaviors in their children, which can facilitate obesity prevention. Objective(1) Develop an online screening, brief intervention, and referral to treatment (SBIRT) eHealth tool to enhance parents’ concern for, and motivation to, support children’s healthy lifestyle behaviors, (2) refine the SBIRT eHealth tool by assessing end-user acceptability, satisfaction, and usability through focus groups, and (3) determine feasibility and preliminary effectiveness of the refined SBIRT eHealth tool through a randomized controlled trial. MethodsThis is a three-phase, multi-method study that includes SBIRT eHealth tool development (Phase I), refinement (Phase II), and testing (Phase III). Phase I: Theoretical underpinnings of the SBIRT tool, entitled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), will be informed by concepts applied within existing interventions, and content will be based on literature regarding healthy lifestyle behaviors in children. The SBIRT platform will be developed in partnership between our research team and a third-party intervention development company. Phase II: Focus groups with parents, as well as health care professionals, researchers, and trainees in pediatrics (n=30), will explore intervention-related perceptions and preferences. Qualitative data from the focus groups will inform refinements to the aesthetics, content, structure, and function of the SBIRT. Phase III: Parents (n=200) of children—boys and girls, 5 to 17 years old—will be recruited from a primary care pediatric clinic while they await their children’s clinical appointment. Parents will be randomly assigned to one of five groups—four intervention groups and one control group—as they complete the SBIRT. The randomization function is built into the tool. Parents will complete the eHealth SBIRT using a tablet that will be connected to the Internet. Subsequently, parents will be contacted via email at 1-month follow-up to assess (1) change in concern for, and motivation to, support children’s dietary and physical activity behaviors (primary outcome), and (2) use of online resources and referrals to health services for obesity prevention (secondary outcome). ResultsThis research was successfully funded and received ethics approval. Development of the SBIRT started in summer 2012, and we expect all study-related activities to be completed by fall 2016. ConclusionsThe proposed research is timely and applies a novel, technology-based application designed to enhance parents concern for, and motivation to, support children’s healthy lifestyle behaviors and encourage use of online resources and community services for childhood obesity prevention. Overall, this research builds on a foundation of evidence supporting the application of SBIRTs to encourage or “nudge” individuals to make healthy lifestyle choices. Findings from Phase III of this project will directly inform a cluster randomized controlled trial to study the effectiveness of our intervention across multiple primary care-based settings. Trial RegistrationClinicalTrials.gov NCT02330588; http://clinicaltrials.gov/ct2/show/NCT02330588 (Archived by WebCite at http://www.webcitation.org/6WyUOeRlr).

Tami L. Cave1,2,∗, Michelle S. Butler 1, Kris R. Moller 3, Katharine F. Treves1, Cervantee E.K. Wild1,2, Lisa E. Wynter1, Cameron C. Grant4, Paul L. Hofman2, Yvonne C. Anderson1,2 1 Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand 2 Liggins Institute, The University of Auckland, Auckland, New Zealand 3Whanau Pakari, Sport Taranaki, New Plymouth, New Zealand 4 Department of Paediatrics, The University of Auckland, Auckland, New Zealand

nutrition and diet. Grants with a primary focus on adults and health conditions directly associated with obesity (e.g. key modifiable risk factor) were included (i.e. CVD, diabetes). Grants related to infants/children/adolescents or animals or that did not clearly stipulate adults were excluded. Major findings: For NHMRC it was found that 24 projects/development grants and 12 fellowships ($41,179,720) were funded, equating to 1% of total available NHMRC funding. For ARC there was inadequate information for ARC fellowships available to permit classification for this project. For ARC discovery projects with the included FOR codes a total of three projects were identified, accounting for approximately 9% ($760,540) of total available funding that was allocated. Conclusion: Only a small proportion of federal funds were allocated to obesity research from 2009 to 2014 despite this major public health concern being specifically aligned to National Research Priorities.

A computational capability has been developed to predict and visualize the flow about podded propulsors appended to the 154-foot transom stern research vessel, R/V ATHENA. The computer generation of a complex geometric model for the hull and appendages is an important part of this new capability. The flow field is computed using a free surface potential flow method. The steady flow induced by the propulsor is simulated by an idealized propeller model (actuator disk). The upstream effects of an actuator disk are examined and results are compared to the case without an actuator disk. Computed results for the inflow to the propeller disk are presented as velocity vector plots and contour plots. Harmonic analyses are performed on the computed velocity components. The numerical results can be used in conjunction with experiments to aid in the design of podded propulsors. This powerful design approach can be used for future Navy ship designs.

There have been numerous studies which have had as their objective the determination of societal attitudes to risk. The case of the Canvey Island population appears to offer an almost unique opportunity to study the reaction of a large community (some 33,000 persons) exposied to risks from local industries which, as estimated by the regulatory body concerned, are much larger than the average for the rest of the public in the UK. In order to provide further perspective on public reaction to large risks, in conditions where many of the community do not perceive themselves to benefit from the activities which generate the risk, it is worthwhile to record the reaction of the islanders to the situation.

Information is presented concerning the restrictive effect of existing NRC requirements; definition of possible targets for containment; possible containment systems for LWR; optimization of containment design for class 3 through class 8 accidents (PWR); estimated costs of some possible containment arrangements for PWR relative to the standard dry containment system; estimated costs of BWR containment.

This paper describes the design and fabrication of an integrated circuit consisting of four general purpose JFET operational amplifiers each having the following features: internal compensation, unity gain stability, large bandwidth, high slew rate, and low input bias current. This was all made possible by the use of ion-implanted JFET devices and simple circuit techniques.

The reliability program which was established for the Clinch River Fast Breeder Reactor Project is reviewed. The review reveals several problems and uncertainties which need to be appropriately addressed by the reliability program. The main problems are stated to be the choice of the reliability criterion, the prospects of attaining high reliabilities of systems and critical structures, the role of external phenomena as well as the verification by tests and the reliability assurance program.