The current evidence suggests that many diet and exercise interventions to prevent obesity in children are not effective in preventing weight gain, but can be effective in promoting a healthy diet and increased physical activity levels.Being very overweight (obese) can cause health, psychological and social problems for children. Children who are obese are more likely to have weight and health problems as adults. Programmes designed to prevent obesity focus on modifying one or more of the factors considered to promote obesity.This review included 22 studies that tested a variety of intervention programmes, which involved increased physical activity and dietary changes, singly or in combination. Participants were under 18 and living in Asia, South America, Europe or North America. There is not enough evidence from trials to prove that any one particular programme can prevent obesity in children, although comprehensive strategies to address dietary and physical activity change, together with psycho-social support and environmental change may help. There was a trend for newer interventions to involve their respective communities and to include evaluations.Future research might usefully assess changes made on behalf of entire populations, such as improvements in the types of foods available at schools and in the availability of safe places to run and play, and should assess health effects and costs over several years.The programmes in this review used different strategies to prevent obesity so direct comparisons were difficult. Also, the duration of the studies ranged from 12 weeks to three years, but most lasted less than a year.

/pdf/interventions-for-preventing-obesity-in-children-4arhbcud58.pdf

Interventions for preventing obesity in children

The UK Medical Research Council’s widely used guidance for developing and evaluating complex interventions has been replaced by a new framework, commissioned jointly by the Medical Research Council and the National Institute for Health Research, which takes account of recent developments in theory and methods and the need to maximise the efficiency, use, and impact of research.

https://www.bmj.com/content/bmj/374/bmj.n2061.full.pdf

A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance

There are two kinds of tutorial articles: those that provide a primer on an established topic and those that let us in on the ground floor of something of emerging importance. The first type of tutorial can have a noted expert who has been gracious (and brave) enough to write a field guide about a particular topic. The other sort of tutorial typically involves researchers who have each been laboring on a topic for some years. Both sorts of tutorial articles are very much desired. But we, as an editorial board for both Systems and Transactions, know that there has been no logical place for them in the AESS until this series was started several years ago. With these tutorials, we hope to continue to give them a home, a welcome, and provide a service to our membership. We do not intend to publish tutorials on a regular basis, but we hope to deliver them once or twice per year. We need and welcome good, useful tutorial articles (both kinds) in relevant AESS areas. If you, the reader, can offer a topic of interest and an author to write about it, please contact us. Self-nominations are welcome, and even more ideal is a suggestion of an article that the editor(s) can solicit. All articles will be reviewed in detail. Criteria on which they will be judged include their clarity of presentation, relevance, and likely audience, and, of course, their correctness and scientific merit. As to the mathematical level, the articles in this issue are a good guide: in each case the author has striven to explain complicated topics in simple-well, tutorial-terms. There should be no (or very little) novel material: the home for archival science is the Transactions Magazine, and submissions that need to be properly peer reviewed would be rerouted there. Likewise, articles that are interesting and descriptive, but lack significant tutorial content, ought more properly be submitted to the Systems Magazine.

What is a tutorial

Complexity is much talked about but sub-optimally studied in health services research. Although the significance of the complex system as an analytic lens is increasingly recognised, many researchers are still using methods that assume a closed system in which predictive studies in general, and controlled experiments in particular, are possible and preferred. We argue that in open systems characterised by dynamically changing inter-relationships and tensions, conventional research designs predicated on linearity and predictability must be augmented by the study of how we can best deal with uncertainty, unpredictability and emergent causality. Accordingly, the study of complexity in health services and systems requires new standards of research quality, namely (for example) rich theorising, generative learning, and pragmatic adaptation to changing contexts. This framing of complexity-informed health services research provides a backdrop for a new collection of empirical studies. Each of the initial five papers in this collection illustrates, in different ways, the value of theoretically grounded, methodologically pluralistic, flexible and adaptive study designs. We propose an agenda for future research and invite researchers to contribute to this on-going series.

/pdf/studying-complexity-in-health-services-research-desperately-48r9u7f35q.pdf

Studying complexity in health services research: desperately seeking an overdue paradigm shift

Modelling has been used extensively by all national governments and the World Health Organisation in deciding on the best strategies to pursue in mitigating the effects of COVID-19. Principally the...

https://www.tandfonline.com/doi/pdf/10.1080/17477778.2020.1751570

How simulation modelling can help reduce the impact of COVID-19

https://purehost.bath.ac.uk/ws/files/190174563/The_need_for_a_complex_systems_model_of_evidence_for_public_health_Rutter_et_al_Lancet_2017_1.pdf

Jo Bibby

Papers

The need for a complex systems model of evidence for public health