Whole systems approach to diet and healthy weight: a longitudinal process evaluation in East Scotland.

AIMS: Obesity contributes to morbidity and early mortality, affecting people of all ages and sociodemographic backgrounds. Despite attempts to address obesity, efforts to date have only had limited success. Adopting a whole systems approach (WSA) may potentially address obesity and emphasise complex inter-relating factors beyond individual choice. This study aimed to assess implementation of WSA to diet and healthy weight in two council areas of Scotland, longitudinally exploring enablers and barriers. One area followed a Leeds Beckett WSA model (LBM) of implementation, while the other used a hybrid model incorporating existing working systems. METHODS: To assess the process of implementing a WSA, interviews and focus groups were conducted after initiation and 1 year later. RESULTS: Main enablers included: belief in WSA effectiveness; positive relationships between key personnel; buy-in at community and national levels; funding availability; the working group responsible for coordinating the system development comprising individuals with diverse expertise; good communication; and existing governance structures. Barriers included: insufficient funding; high staff turnover; inadequate training in WSA methodology; engaging all relevant stakeholders and reverting to 'old ways' of non-WSA working. The LBM provided a framework for system setup and generating an action plan. CONCLUSION: This study provides the first independent longitudinal process evaluation of WSAs that have incorporated Leeds Beckett methodology, and offers insights into how a WSA can be implemented to address diet and healthy weight.

The biochemical, physiological and psychological consequences of a "1,000 miles in 1,000 hours" walking challenge.

The combined effects of 42 days of chronic sleep disruption and repeated hourly bouts of physical exertion have not been described. This case study reports the physiological and psychological demands placed on one individual who walked 1 mile in each consecutive hour for a period of 1,000 h (42 days), covering a total distance of 1,000 miles. The participant walked at a mean speed of 1.75 m/s completing each mile in approximately 15 min. Over the course of the challenge, the individual lost 1.6 kg in body weight. Markers of skeletal muscle damage, increased gradually whilst free testosterone levels decreased over the course of the challenge. Stress hormones increased whilst inflammatory markers (CRP) initially rose but then returned towards baseline over the course of the study. Cognitive motor performance measured via reaction time was maintained throughout the 42 days. The participant also displayed mood states typical of an elite athlete at baseline and throughout the challenge. Participation in this novel '1,000 mile 1,000 h' walking challenge evoked considerable physiological stress in a fit, healthy middle-aged participant but did not markedly alter cognitive performance or mood over the 42-day period.

Attentional bias to food-related visual cues: is there a role in obesity?

The incentive sensitisation model of obesity suggests that modification of the dopaminergic associated reward systems in the brain may result in increased awareness of food-related visual cues present in the current food environment. Having a heightened awareness of these visual food cues may impact on food choices and eating behaviours with those being most aware of or demonstrating greater attention to food-related stimuli potentially being at greater risk of overeating and subsequent weight gain. To date, research related to attentional responses to visual food cues has been both limited and conflicting. Such inconsistent findings may in part be explained by the use of different methodological approaches to measure attentional bias and the impact of other factors such as hunger levels, energy density of visual food cues and individual eating style traits that may influence visual attention to food-related cues outside of weight status alone. This review examines the various methodologies employed to measure attentional bias with a particular focus on the role that attentional processing of food-related visual cues may have in obesity. Based on the findings of this review, it appears that it may be too early to clarify the role visual attention to food-related cues may have in obesity. Results however highlight the importance of considering the most appropriate methodology to use when measuring attentional bias and the characteristics of the study populations targeted while interpreting results to date and in designing future studies.

Visual uncertainty influences the extent of an especial skill.

An especial skill in basketball emerges through highly repetitive practice at the 15 ft free throw line. The extent of the role vision plays in the emergence of an especial skill is unknown. We examined the especial skills of ten skilled basketball players in normal and blurred vision conditions where participants wore corrective lenses. As such, we selectively manipulated visual information without affecting the participants' explicit knowledge that they were shooting free throws. We found that shot efficiency was significantly lower in blurred vision conditions as expected, and that the concave shape of shot proficiency function in normal vision conditions became approximately linear in blurred vision conditions. By applying a recently proposed generalization model of especial skills, we suggest that the linearity of shot proficiency function reflects the participants' lesser dependence on especial skill in blurred vision conditions. The findings further characterize the role of visual context in the emergence of an especial skill.

An especial skill in elite wheelchair basketball players.

We aimed to investigate whether an especial skill is present in elite wheelchair basketball players when taking twenty shots with a regular basketball from five different distances (11 ft, 13 ft, 17 ft, & 19 ft) from the basket including the free throw line (15 ft). Twelve elite male basketball players participated. The results showed that as distance increased shot accuracy decreased in line with force by variability predictions for the 11 ft, 13 ft, 17 ft, & 19 ft distances. However, shot performance at the free throw line where players are more familiar with practicing free throw shots did not follow this trend. A linear regression line was drawn to predict performance at the free throw line based on nearer (11 ft & 13 ft) and farer (17 ft & 19 ft) distances to the basket, this was then compared to actual performance. A significant difference between actual and predicted scores was found (p<.05) supporting the presence of an especial skill. Significant positive correlations were found for the 11 ft and 17 ft distance, age, years of playing, and accumulated practice hours with performance at the 15 ft line (p<.05). These correlations imply the operation of generalization in the especial skill. This observation received support from applying a model in which shot accuracy as a function of distance was approximated by two regression lines.

Especial skill effect across age and performance level: the nature and degree of generalization.

It has been claimed that an especial skill emerges after massive amounts of basketball practice. Despite this no direct evidence is available to support this claim. The authors aimed to shed light on this question. Thirty-seven male basketball players took part representing four groups: 2 groups of senior players, a cadet group, and a group of juniors. Players performed free throw shots from 7 distances including shots from the free throw line (15 ft). It was shown that an especial skill was present in senior players, but not in junior players who had only 3 years of playing experience. The authors present a descriptive model of especial skill and express it using the formalism of a hierarchical Bayesian model to fit the data and estimate the parameters. This model can account not only for the results, which indicate the presence and a substantial degree of generalizability of especial skill to nearby distances, but also for results of the original study on especial skill where it was proposed that specificity in practice leads to the emergence of the especial skill.