Using a technology-based intervention to promote weight loss in sedentary overweight or obese adults: a randomized controlled trial study design

Purpose: The SenseWearTM Armband is an activity monitor developed to improve lifestyle self-monitoring. Currently, few studies assess electronic self-monitoring and weight loss with a lifestyle intervention program. To our knowledge, only one study has used the SenseWear Armband in combination with a lifestyle intervention to improve weight loss, and no studies have evaluated whether a self-monitoring intervention based solely on the armband can promote weight loss. Consequently, the aims of the study were to assess weight loss from electronic self-monitoring, to compare these values to the lifestyle intervention and standard care groups, and to compare weight loss with lifestyle intervention with and without the armband. Patients and methods: We recruited 197 sedentary overweight or obese adults (age, 46.8 ± 10.8 years; BMI, 33.3 ± 5.2 kg/m2) to participate in the 9-month study. Participants were randomized into one of four weight loss groups: 1) the standard care group received a self-directed weight loss program, complete with an evidence-based weight loss manual (standard care, n = 50); 2) a 14-week group-based behavioral weight loss program followed by weekly, biweekly, and monthly telephone counseling calls (GWL, n = 49); 3) the use of the armband to help improve lifestyle self-monitoring (SWA alone, n = 49); or (4) the group-based behavioral weight loss program and follow-up telephone counseling calls plus the armband (GWL + SWA, n = 49). All participants received the evidence-based weight loss manual at baseline. All measures were performed at baseline and months 4 and 9. The primary outcomes were weight loss and waist circumference reduction. Results: This study is a well-designed randomized controlled study powered to detect a 0.5-kg weight loss and 0.6-cm waist circumference reduction in overweight and obese sedentary adults. Conclusion: Innovative technologies are providing lifestyle self-monitoring and weight loss tools. Utilizing these technologies may be an important step in improving the current obesity epidemic

Electronic feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The SenseWear™ Armband (SWA) (BodyMedia, Inc. Pittsburgh, PA) is a physical activity and lifestyle monitor that objectively and accurately measures free-living energy balance and sleep and includes software for self-monitoring of daily energy expenditure and energy intake. The real-time feedback of the SWA can improve individual self-monitoring and, therefore, enhance weight loss outcomes.</p> <p>Methods</p> <p>We recruited 197 sedentary overweight or obese adults (age, 46.8 ± 10.8 y; body mass index (BMI), 33.3 ± 5.2 kg/m²; 81% women, 32% African-American) from the greater Columbia, South Carolina area. Participants were randomized into 1 of 4 groups, a self-directed weight loss program via an evidence-based weight loss manual (Standard Care, n = 50), a group-based behavioral weight loss program (GWL, n = 49), the armband alone (SWA-alone, n = 49), or the GWL plus the armband (GWL+SWA, n = 49), during the 9-month intervention. The primary outcome was change in body weight and waist circumference. A mixed-model repeated-measures analysis compared change in the intervention groups to the standard care group on weight and waist circumference status after adjusting for age, sex, race, education, energy expenditure, and recruitment wave.</p> <p>Results</p> <p>Body weight was available for 62% of participants at 9 months (52% standard care, 70% intervention). There was significant weight loss in all 3 intervention groups (GWL, 1.86 kg, P = 0.05; SWA-alone, 3.55 kg, P = 0.0002; GWL+SWA, 6.59 kg, P < 0.0001) but not in the Standard Care group (0.89 kg, P = 0.39) at month 9. Only the GWL+SWA group achieved significant weight loss at month 9 compared to the Standard Care group (P = 0.04). Significant waist circumference reductions were achieved in all 4 groups at month 9 (Standard Care, 3.49 cm, P = 0.0004; GWL, 2.42 cm, P = 0.008; SWA-alone, 3.59 cm, P < 0.0001; GWL+SWA, 6.77 cm, P < 0.0001), but no intervention group had significantly reduced waist circumference compared to the Standard Care group.</p> <p>Conclusions</p> <p>Continuous self-monitoring from wearable technology with real-time feedback may be particularly useful to enhance lifestyle changes that promote weight loss in sedentary overweight or obese adults. This strategy, combined with a group-based behavioral intervention, may yield optimal weight loss.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00957008">NCT00957008</a></p

Electronic feedback in a diet- and physical activity-based intervention for weight loss: a randomized controlled trial

Background: The SenseWearTM Armband (SWA) (BodyMedia, Inc. Pittsburgh, PA) is a physical activity and lifestyle monitor that objectively and accurately measures free-living energy balance and sleep and includes software for self-monitoring of daily energy expenditure and energy intake. The real-time feedback of the SWA can improve individual self-monitoring and, therefore, enhance weight loss outcomes. Methods: We recruited 197 sedentary overweight or obese adults (age, 46.8 ± 10.8 y; body mass index (BMI), 33.3 ± 5.2 kg/m2; 81% women, 32% African-American) from the greater Columbia, South Carolina area. Participants were randomized into 1 of 4 groups, a self-directed weight loss program via an evidence-based weight loss manual (Standard Care, n = 50), a group-based behavioral weight loss program (GWL, n = 49), the armband alone (SWA-alone, n = 49), or the GWL plus the armband (GWL+SWA, n = 49), during the 9-month intervention. The primary outcome was change in body weight and waist circumference. A mixed-model repeated-measures analysis compared change in the intervention groups to the standard care group on weight and waist circumference status after adjusting for age, sex, race, education, energy expenditure, and recruitment wave. Results: Body weight was available for 62% of participants at 9 months (52% standard care, 70% intervention). There was significant weight loss in all 3 intervention groups (GWL, 1.86 kg, P = 0.05; SWA-alone, 3.55 kg, P = 0.0002; GWL+SWA, 6.59 kg, P \u3c 0.0001) but not in the Standard Care group (0.89 kg, P = 0.39) at month 9. Only the GWL+SWA group achieved significant weight loss at month 9 compared to the Standard Care group (P = 0.04). Significant waist circumference reductions were achieved in all 4 groups at month 9 (Standard Care, 3.49 cm, P = 0.0004; GWL, 2.42 cm, P = 0.008; SWA-alone, 3.59 cm, P \u3c 0.0001; GWL+SWA, 6.77 cm, P \u3c 0.0001), but no intervention group had significantly reduced waist circumference compared to the Standard Care group. Conclusions: Continuous self-monitoring from wearable technology with real-time feedback may be particularly useful to enhance lifestyle changes that promote weight loss in sedentary overweight or obese adults. This strategy, combined with a group-based behavioral intervention, may yield optimal weight loss

Indulgent representation: theatricality and sectarian metaphor in The Tempest

At the end of The Tempest, Prospero (or, perhaps, the actor playing him) urges the audience, ‘As you from crimes would pardoned be, / Let your indulgence set me free’ (5.1.337-8). The lines are a plea for applause, for the audience to conclude the drama happily. As the play-world dissolves into the real world, at the threshold between fiction and reality, Prospero appeals to be set free from representation. He strikes an ethical bargain in the mode of the Lord's Prayer (‘forgive us our trespasses as we forgive those who trespass against us’). But, in speaking of ‘pardon’ and ‘indulgence’, he also alludes to a much maligned Catholic practice of purchased remission of sins. Thus, the audience's decision over whether or not to applaud the drama is playfully implicated in trying out a confessional attitude. Even so, the status of these ‘Catholic’ terms as wordplay means that they only flirt with sectarian resonance, rather than declaring a theological message. Taking the play's self-conscious theatricality as a starting point, this essay explores the ambiguity of this epilogue. It questions what it means for a post-Reformation audience to ‘indulge’ in metaphorically ‘Catholic’ behaviour, and how a play that stages forgiveness as a form of revenge negotiates difference ethically. These themes are part of a broader theatrical dynamic in which representation is constantly destabilised. The essay offers a case-study of the significance of equivocally Catholic material in post-Reformation drama, suggesting that as much attention needs to be paid to dramaturgy as to theology

An HDG Method for Dirichlet Boundary Control of Convection Dominated Diffusion PDE

We first propose a hybridizable discontinuous Galerkin (HDG) method to approximate the solution of a \emph{convection dominated} Dirichlet boundary control problem. Dirichlet boundary control problems and convection dominated problems are each very challenging numerically due to solutions with low regularity and sharp layers, respectively. Although there are some numerical analysis works in the literature on \emph{diffusion dominated} convection diffusion Dirichlet boundary control problems, we are not aware of any existing numerical analysis works for convection dominated boundary control problems. Moreover, the existing numerical analysis techniques for convection dominated PDEs are not directly applicable for the Dirichlet boundary control problem because of the low regularity solutions. In this work, we obtain an optimal a priori error estimate for the control under some conditions on the domain and the desired state. We also present some numerical experiments to illustrate the performance of the HDG method for convection dominated Dirichlet boundary control problems

Measurements of daily energy intake and total energy expenditure in people with dementia in care homes: the use of wearable technology.

Objectives: To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. Design and setting: A cross-sectional study in care homes in the UK. Participants: Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. Measurements: A physical activity monitor (Sensewear TM Armband , Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. Results: The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2 ; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. Conclusions: The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementi

Visualising Surfaces, Surfacing Vision: Introduction

In this Introduction to a special section on Visualising Surfaces, Surfacing Vision, we argue that to conceive vision in the contemporary world it is necessary to examine its embedding within, expression via and organisation on the surface. First, we review recent social and cultural theories to demonstrate how and why an attention to surfaces is salient today. Second, we consider how vision may be understood in terms of surfaces, discussing the emergence of the term ‘surface’, and its transhistorical relationship with vision. Third, we introduce the contributions to the special section, which cover written articles and artworks. We make connections between them, including their exploration of reflexivity and recursion, observation, objectivity and agency, ontology and epistemology, relationality, process, and two- and three-dimensionality. Fourth, we consider some implications of an understanding of visualising surfaces/surfacing vision

eHealth interventions for the prevention and treatment of overweight and obesity in adults: A systematic review with meta-analysis

A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n=139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n=55) of interventions used more than one type of technology, and 43.2% (n=60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P<0.001) or minimal interventions (MD -1.40 [-1.98,-0.82], P<0.001), and in eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P<0.001) compared with standard eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention