A Statewide Intervention Reduces BMI in Adults: Shape Up Rhode Island Results

Given the epidemic of obesity, approaches to weight loss that can be applied on a community, state, or national level are needed. We report results from Shape Up Rhode Island 2007 (SURI), a state-wide Internet based program involving team-based competition to increase physical activity and achieve weight loss. A total of 4,717 adults (84% female; mean BMI = 29.6 kg/m2 ) enrolled in the 16 week weight loss competition of SURI and 3311 completed at least 12 weeks. Completers reported losing 3.2 ± 3.4 kg, and 30% achieved a clinically significant weight loss of 5% or more. Although modest, these weight losses shifted the BMI distribution from a mean BMI of 29.4 to 28.2 kg/m2 and reduced the population that was obese from 39% to 31%. More conservative intent-to-treat analyses and analysis of 132 participants with objective weights still showed a significant reduction in BMI of −0.8 units. These findings suggest that state-wide weight loss campaigns can produce modest weight losses in large numbers of participants. These data provide a bench-mark that can be used for comparisons with other state-wide campaigns. Research on ways to improve such campaigns is needed

Successful weight loss maintenance in relation to method of weight loss

This study examined the relation between method of weight loss and long-term maintenance among successful weight losers enrolled in a weight-loss maintenance trial. Participants were 186 adults (mean age = 51.6 +/- 10.7 years, mean BMI = 28.6 +/- 4.7 kg/m(2)) enrolled in the STOP Regain trial who had lost at least 10% of their body weight in the past 2 years using a very low-calorie diet (VLCD; n = 24), commercial program (n = 95), or self-guided approach (n = 67). Participants were randomized to a weight-maintenance intervention delivered face to face or over the internet or to a newsletter control condition, and followed for 18 months. At study entry, individuals who had used a VLCD had achieved a weight loss of 24% of their maximum weight within the past 2 years compared to 17% achieved by those who had used a commercial program or self-guided approach (P \u3c 0.001). However, individuals who had used a VLCD regained significantly more weight than the other two groups and by 6 months, there were no significant differences in overall percent weight loss (i.e., initial weight loss and maintenance) between VLCD, commercial, and self-guided methods. In contrast, individuals who had used a self-guided approach maintained their weight losses from baseline through 18 months. The large initial weight losses achieved by individuals who had used a VLCD were not maintained over time, whereas individuals who had used a self-guided approach maintained their initial weight losses with the greatest success. The generalizability of these findings is limited by the sizeable weight losses achieved by study participants

Effect of teammates on changes in physical activity in a statewide campaign

Objective—Most Americans do not meet physical activity recommendations. Statewide campaigns can effectively increase activity levels. Reported herein are physical activity outcomes from Shape Up Rhode Island (SURI) 2007, a statewide campaign to increase steps through team-based competition. Given the importance of social networks in behavior change, this paper focused on the effects of team and team characteristics on activity outcomes. Method—For 16-weeks, 5333 adults comprising 652 teams wore pedometers and reported their steps online. Results—Participants’ daily steps increased from 7029(3915) at baseline to 9393(5976) at SURI end (p\u3c.001). There was a significant intraclass correlation for step change among team members (ICC=.09); thus, an individual’s change in steps was influenced by what team they were on. Moreover, baseline team characteristics predicted individual step change; being on a more active team was associated with greater increases in activity for individual members (p\u3c.001), whereas being on a team with a broad range of steps was associated with smaller changes in activity for individual members (p=.02). Conclusion—These findings are the first to suggest that team members influence individual activity outcomes in team-based statewide campaigns. Future research should explore ways to use social network factors to enhance team-based physical activity programs

Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy

Background: Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. Methods: The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. Results: Mortality was significantly increased for ‘All Causes’ and ‘All Malignant Neoplasm (MN)’, in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. Conclusions: Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studie

Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure

Objective. Italy has been a large user of asbestos and asbestos containing materials until the 1992 ban. We present a pooled cohort study on long-term mortality in exposed workers. Methods. Pool of 43 Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding, glasswork, harbors, insulation and other industries). SMRs were computed by industrial sector for the 1970-2010 period, for the major causes, using reference rates by age, sex, region and calendar period. Results. The study included 51 801 subjects (5741 women): 55.9% alive, 42.6% died (cause known for 95%) and 1.5% lost to follow-up. Asbestos exposure was estimated at the plant and period levels. Asbestos related mortality was significantly increased. All industrial sectors showed increased mortality from pleural malignancies, and most als

EVALUACIÓN DE RESPUESTAS Y ÁNGULOS DE INCIDENCIA CRÍTICOS OBTENIDOS POR MÉTODOS ESPECTRALES / Evaluation of Critical Responses and Critical Incidence Angles Obtained With Spectral Methods

Las respuestas y los ángulos de incidencia críticos para una estructura pueden ser obtenidos mediante la integración enel tiempo (RHA) o mediante análisis espectral (RSA). Los resultados del RHA pueden ser considerados como la mejoraproximación disponible, pero son obtenidos con un esfuerzo numérico bastante mayor. Los resultados del RSA son obtenidosmás fácilmente, pero tienen las limitaciones asociadas al método de análisis espectral. El objetivo de este trabajoes comparar los ángulos de incidencia críticos y las respuestas críticas obtenidos mediante RHA y RSA. Se obtuvieron lasrespuestas de diversas estructuras de concreto reforzado de un piso, comportamiento lineal, amortiguamiento viscoelásticoy períodos naturales que varían entre 0,1 y 5,0 segundos. Se consideraron los siguientes casos: (a) la acción de una únicacomponente sísmica horizontal (la principal mayor) y (b) dos componentes sísmicas horizontales ortogonales entre sí (lasprincipales mayor y menor), usando registros sísmicos de campo lejano tomados en roca. Los resultados de RHA fueronobtenidos cubriendo todos los posibles ángulos de incidencia para cada registro sísmico. Los resultados de RSA fueronobtenidos con la fórmula del ángulo crítico propuesto por la regla CQC3, usando los espectros medios de los sismos seleccionados.Los resultados obtenidos indican que el RSA es adecuado para estimar las respuestas críticas y los ángulosde incidencia críticos para fines de diseño estructural o evaluación de estructuras existentes. Valores más refinados de lasrespuestas críticas pueden ser obtenidos utilizando el RHA, usando un rango reducido de ángulos de incidencia definidosa partir del RSA. ABSTRACTCritical responses and critical angles for a structure can be obtained by response history analysis (RHA) or by responsespectrum analysis (RSA). Results obtained with RHA can be considered as the best approximation available to actual responses,but they require a great amount of numerical effort. Results obtained with RSA are more easily obtained, but theyhave the limitations associated with spectrum analysis. The goal of this investigation is to compare the critical incidenceangles and the critical responses obtained with response history analysis (RHA) and response spectrum analysis (RSA).The responses are obtained for several one story reinforced concrete structures with linear behavior, viscous damping, andnatural periods ranging between 0.1 and 5.0 sec. The analyses are performed for the following two cases: (a) the action ofonly one horizontal component (the major component), and (b) two horizontal orthogonal components (the major and theminor components). An ensemble of far field ground motions recorded on rock was selected to perform the analyses. TheRHA results are obtained covering all possible incidence angles for each ground motion. The RSA results are obtainedwith the critical incidence angle formula given by the CQC3 combination rule, using the mean spectra for the ensemble ofthe recorded ground motions. The results show that RSA is adequate to estimate the critical responses and correspondingcritical incidence angles for design purposes or evaluation of existing structures. More refined values of the critical responsescould be obtained using RHA in a reduced incidence angle range, given by RSA results, thus reducing the numericalcomputations required.Keywords: Critical incidence angle, Critical response, Response history analysis (RHA), Response spectrum analysis(RSA), CQC3